ACA, AAMFT, and CAMFT continue to work with and others in Washington to get LPCs and LMFTs included as eligible providers in Medicare. Bills pending before both the House and Senate would do it. And that change would be beneficial for consumers and taxpayers alike.
Barry Duncan has an article in the current Psychotherapy Networker asking, “Why would anybody become a therapist?” The job offers low pay compared to other jobs with similar training requirements. Workers in community mental health are often stretched beyond the breaking point. And as we’ve covered here regularly, employer abuses of therapists are unfortunately common. When even a single therapist pushes back against exploitation, it makes a real difference. But that doesn’t happen very often.
Duncan’s article offers some interesting overlaps with our past coverage here. It can explain fairly well why even the best therapists can be easy targets for exploitation at work.
Look, I’m not here to defend the BBS (California’s Board of Behavioral Sciences) or any other licensing board. They’re not your friend. They require deeply flawed exams that even they know don’t work. Their disciplinary guidelines, especially around substance use issues, are unreasonably punitive. They are notoriously unresponsive. There are a lot of problems there. But it’s also true that most complaints about the BBS are based on flat-out falsehoods.
Becoming a therapist is ridiculously expensive. There’s grad school, which costs about five times as much even in inflation-adjusted dollars today than it did 30 years ago. There’s the time between graduation and licensure, which is often filled with low-paying employment. And then at the end of all of that, you take your final license exam. (Some states have bumped up some exams to be earlier in the process.) Given all the expense that leads up to it, it’s common to wonder why that last major hurdle is itself so expensive. If your education and experience should have prepared you for licensure, why should you have to do license exam prep courses in addition? And if you do go the test-prep route, why is it so expensive?
Let’s take those questions in order.
As marriage and family therapists, we have a vast body of knowledge supporting our work with families and communities. Many of the pinciples and interventions from this body of knowledge could be utilized in public policy, to great positive effect. As two examples, family breakdown could be reduced, and juvenile crime recidivism decreased, both in ways that actually save taxpayers money. Politicians of all parties should be chomping at the bit for such policies.
Except that they don’t. And the April 2009 Family Relations journal helps us to understand why not.
Okay, let’s not pretend this is an important question in the grand scheme of things. It is not. But for anxious types (like me) who want to make sure we’re using the right terminology, how do we describe that service of providing relationship therapy for two people? Is it couple therapy, couple’s therapy, or couples therapy?
I’m proud to offer a definitive, authoritative answer.* Read on.
Whenever I get into conversations about the MFT licensure process, and how it differs from one state to another, similar questions come up. Earlier I addressed the fundamental question of whether license examinations make for better therapists. Another common question I hear: Why do we require 3,000 hours of supervised, prelicensed experience for MFT licensure?
(Making things more complicated, why do some states require more? California uses the 3,000-hour standard. Arizona, like a handful of other states, requires 3,200 hours. Some other states simply say “two years of full-time supervised experience or the equivalent.”)
We all remember the last semester of high school. A new life chapter was approaching. Our childhood was ending. We would soon experience the freedom of the college world.
It was scary to know that we would be on our own, but we were itching to leave. We knew the quality of our work did not reflect what we were capable of, we just wanted it out of the way. I even remember calculating how much I had to do to just barely pass my classes and coast through the rest of my school year. It did not matter that more difficult times and more responsibility were imminently ahead of us, we just wanted to be done with high school. We called it “senioritis.”
Nearing the end of your 3,000 hours towards licensure can be eerily similar.
In Part 1, which was an excerpt from my Basics of California Law text, I discussed the subtle ways that even well-meaning therapists can subvert a license exam. Here in Part 2, available only online, I’ll get more specific about what kinds of things I think can be safely shared and what probably can’t.
With so many therapists and clients owning iPhones, some therapists have started experimenting with doing sessions via Apple’s FaceTime videoconferencing. While Apple does not provide a Business Associate Agreement (typically required under HIPAA) for use of FaceTime, there is an interesting legal argument that suggests FaceTime may still be safe for therapists to use.