50 states of MFT licensure: Reflections

The news that Montana enacted MFT licensure law put me in a reflecting mood last week. The profession of marriage and family therapy now is distinctly licensed in all 50 states and the District of Columbia. This is a major milestone in the development of MFT as a profession. At the same time, it is just that — a milestone. Not a beginning, and not an end.

As I try to make meaning of having nationwide licensure, I’ve compiled a few reactions below. I’m sure this list is by no means complete, and I would welcome your reactions in the comments.

The progress in MFT science and regulation is only accelerating. It is these very areas of progress which this blog aims to review, and yet, they are advancing so quickly that my highlighting of some specific areas is necessarily incomplete. Consider this: Today, MFT licensure laws have been enacted in 50 states. In 1986, only 11 states had MFT licensure laws. And in 1963, just one did (California was the first). So, in one 23-year span, we went from having licensure in one state up to 11. In the 23 years since, we’ve made it to 50.

The research base in the field seems to be growing at a similarly exponential rate: There are now five family therapy-specific journals listed in the ISI index (formally, the Thomson ISI Web of Science, which evaluates the scientific impact of various publications), and another 23 in family science. There are also a number of MFT-specific journals not listed in ISI but still publishing relevant and useful articles, including the Journal of Systemic Therapies, the Journal of Couple and Relationship Therapy, and many more. When the next edition of Effectiveness Research in Marriage and Family Therapy comes out, it is likely to show that in a short time frame (probably about a decade, by the time it is published), MFT research has advanced in leaps and bounds.

A national name does not mean a national license. Of course, there is still much work to be done. (I’ll return focus to the regulatory side.) While the profession is now licensed everywhere in the nation, those licensing requirements continue to hold significant differences from state to state. As a result, it is often difficult for MFTs licensed in one state to move and obtain licensure in their new home. (That is, unless they are adequately prepared.) This is a particular issue in California, where about half the country’s MFTs live — and where licensure requirements are most out of sync with other states. There is now a license title recognized in all 50 states: “Marriage and Family Therapist.” There is much work to be done in having that mean the same thing from one state to the next.

This issue is not unique to marriage and family therapy — there is simply no such thing as a “national license” in any mental health profession, as licensing is accomplished through state regulatory bodies. However, improvements in license portability are often a goal of the national associations for mental health professions.

We can now work on a national scale like never before. While licensure is a state-by-state activity, there are some benefits to having licensure in every state. It certainly helps in making the case for MFT inclusion in federal programs, like Medicare and No Child Left Behind. It also makes partnerships with other national organizations much more feasible. One example of AAMFT’s work with a federal government organization is the Minority Fellowship Program, cooperatively developed with the Substance Abuse and Mental Health Services Administration. Such opportunities will only grow with licensure now available nationwide.

Associations matter. Neither MFT licensure nor the rapidly-growing research base for the field would be progressing at the rate they have in the absence of a strong national association working closely with state divisions. I initially got involved with AAMFT because I was proud of the work of the association and wanted to be a part of it. I’m glad I did. There is great power in professionals organizing themselves in the dual interest of advancing the profession and improving care for the clients we serve. With MFT licensure one that is now recognized across the US, that power appears more visible than ever.

Those are my initial reactions. It is inspiring and humbling to be part of, and hopefully in some small way a contributor to, an advancing profession that improves people’s lives and communities.

I’d be curious to hear your thoughts on 50 states of licensure. What does it mean to you?