The best MFT programs

Education - Grad HatHow to choose the best MFT programs (master’s and doctoral) for your needs. Originally published August 2009; updated January 2013 and September 2014.

Aspiring MFTs have lots of options — there are more than 100 COAMFTE-accredited programs around the US, and about 80 license-eligible MFT programs (accredited and not) in California — for graduate school. How should you go about choosing the school that is right for you?

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MFT licensure: California

Ah, the Golden State. Home to me and half the licensed Marriage and Family Therapists in the country. And, in the eyes of the rest of the country, some pretty weird practices within the profession.

MFT licensure in California looks a lot different here than it does everywhere else. And it shouldn’t have to, seeing as the profession itself — that is, our scope of practice and competence — is pretty much the same here as it is everywhere else.

What the heck is so different here, and why?

Read moreMFT licensure: California

Would anyone buy stock in a future therapist?

CurrencyThere’s an interesting alternative to the student loan model of financing education floating around: In essence, sell stock in yourself.

On Wednesday, Senator Marco Rubio and Representative Tom Petri introduced legislation defining “income share agreements” (ISAs), which are basically contracts where investors could fund your education in exchange for a percentage of your future earnings. Under such agreements, which are expressly not loans, an investor could lay claim to a limit of 15 percent of your future income under a contract that could last no more than 30 years. (Those are just upper limits. Presumably most contracts would be shorter and have lower percentages of income involved.)

The idea is interesting, and worthy of consideration insofar as it transfers the risk associated with education funding away from the student and their family. One of the worst possible outcomes of taking out tens of thousands of dollars in student loans is then not being able to pay it back, either because you failed to finish your degree or, once you did, there simply weren’t enough well-paying jobs in your field. Changes in bankruptcy law have made it much more difficult to get out of student loan debt even in difficult circumstances. Under the proposed ISA rules, on the other hand, it would be the investor who would be out of luck, not the student.

Unfortunately, that doesn’t mean that selling stock in yourself is a good idea for a prospective student in the mental health professions of psychology, counseling, clinical social work, and family therapy. For one thing, private investors may simply not be willing to fund education that is long and expensive when they look at salary data in mental health. It seems much more likely that such investors would flock to students in more lucrative fields like business, engineering, technology, and medicine.

And even if some enterprising therapy students could attract investors willing to fund their education, the kind of system envisioned with ISAs holds the potential to be rather exploitive. Let’s say, for example, that you are unable to secure enough in student loans, so you turn to a private investor to fund your education. And — lucky you! — you find one willing to take on the risk. In exchange for $50,000 to fund your education, they ask for 10% of your income per year for the next 25 years.

To a hopeful student with no other options to fund schooling, that may be an attractive offer. From the outside, though, it just looks like a classier form of indentured servitude. It’s true that if you don’t complete your degree, you would not need to pay the money back. However, because these agreements define the investment as being in the individual, and not the specific career for which you received education funding, you would still owe a portion of what you make for the term of the agreement no matter what kind of work you wind up doing. Worse, if you do complete your degree, and you do find a well-paying job after graduation, you could easily wind up paying back four or five times the amount of the initial investment. Investors, after all, would understandably want their good investments to pay off bigger if they are taking all the risk for the bad investments.

If nothing else, I admire the creative thinking on Rubio’s and Petri’s part. (In fairness, it isn’t their original idea; startups like Upstart and Pave have been working on this model for some time.) There is certainly some merit in having the most successful students end up paying the most for their education, rather than further financially punishing those who struggle the most to find work or finish their degrees. However, as it applies in mental health, this kind of a funding vehicle seems like a band-aid at best. It would keep a supply of students coming in to overly long and expensive training programs, with primarily investors and universities profiting. We still need a viable long-term solution that makes graduate training in mental health accessible and affordable for those who prove they are capable of doing the work.

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Your comments here are welcome. You can post them in the comments below, or email me at ben[at]bencaldwell[dot]com.

Nazareth College was probably smart, not sexist, in rescinding tenure-track job offer

Education - Grad HatThe interwebs are in their typical fits of consternation this week over an accusation that Nazareth College, a small liberal-arts school in New York, rescinded an offer of a tenure-track professorship in philosophy to a woman who had attempted to negotiate the terms of the hire.

Those supporting the applicant, identified only as “W,” suggest the college was being sexist by refusing to negotiate with the woman when men negotiate terms of their employment commonly, including in academia. Those supporting the college are responding by describing W as immature and entitled, with criticisms boiling down to “Who the hell does she think she is?”

The histrionics are wrong on both sides. W was, like any applicant, wise to negotiate. But in what she asked for, she overplayed her hand and revealed a worrisome lack of knowledge about the university she was seeking to enter. There is no clear evidence the college was being sexist, even if many commentaries supporting Nazareth and criticizing the applicant have been.

For those readers not in academia, a tenure-track professorship is a big deal. It offers at least the potential of tenure, which at most schools means very strong job security. Tenure-track positions are increasingly rare, so they are very prized — putting universities at an advantage when negotiating the terms for such a hire.

Allegedly — and that term applies to this whole story, since it’s all based on W’s report to the blog The Philosophy Smoker — W received her initial job offer, and treated it like the beginning of a negotiation process. She responded with this:

As you know, I am very enthusiastic about the possibility of coming to Nazareth. Granting some of the following provisions would make my decision easier.

1) An increase of my starting salary to $65,000, which is more in line with what assistant professors in philosophy have been getting in the last few years.
2) An official semester of maternity leave.
3) A pre-tenure sabbatical at some point during the bottom half of my tenure clock.
4) No more than three new class preps per year for the first three years.
5) A start date of academic year 2015 so I can complete my postdoc.

I know that some of these might be easier to grant than others. Let me know what you think.

It is fully appropriate to negotiate salary in such a situation, and W has since said that her request was less than 20% above what was originally offered. The request for capping new class preps may or may not be reasonable; depending on her prior teaching experience, this might limit her to teaching no more than three classes total in her first year (which would be highly unusual), or it might not have much practical impact at all (if most of the classes the university wanted her to teach were ones she had taught elsewhere before, and thus would not need to create from scratch).

The maternity leave request seems silly — the university already would have to accommodate maternity leave in accordance with the law, and it is hard to tell what she meant by an “official semester” of such leave. But W said it was simply an effort to put in writing what she had already been informally offered, so let’s take her at her word there.

W’s mistakes are in the rest of the requests. (By the way, I am using that term “requests” purposefully — those who have been casting her requests as “demands” are themselves failing to understand how negotiation works. They also are apparently failing to actually read W’s letter.) The pre-tenure sabbatical and moved-start-date requests are would give any university pause, not because the requester is a woman, but because accommodating such requests just doesn’t happen at this type of school. A research university might honor such requests, though even there it would be extremely rare.

In a response rescinding the job offer entirely, Nazareth suggests that W should have been aware of that:

Thank you for your email. The search committee discussed your provisions. They were also reviewed by the Dean and the VPAA. It was determined that on the whole these provisions indicate an interest in teaching at a research university and not at a college, like ours, that is both teaching and student centered. Thus, the institution has decided to withdraw its offer of employment to you.

Thank you very much for your interest in Nazareth College. We wish you the best in finding a suitable position.

Liberal arts schools hire faculty to teach. (“Student-centered” is obtuse language, but it generally indicates that the school is focused more heavily on teaching and mentorship than on research.) If they hired for a position to start in fall 2014, they knew they would need someone who could start teaching then. If they would have been fine waiting a year to add a faculty member, they would have waited a year to do the hiring process.

You might argue that pushing her start date would not be a tremendous burden on the university — they could always hire more adjuncts — but this ignores the very real needs a university has for program administration, student advising and mentorship, and faculty governance, tasks that simply are not accomplished by part-timers. Depending on the school’s accreditors and their own internal targets, they might also have been hiring full-time faculty to meet specific requirements for the ratio of full-time faculty to full-time students.

And pre-tenure sabbatical — a (typically paid) break from teaching of a semester or more so that one can focus on research projects — is virtually unheard of. Would you go into an entry-level position in any company asking for a four-month break in your first few years?

The problem isn’t that W is a woman making these requests. It’s that the requests go far beyond what is reasonable in this context. Any good negotiator will be willing to walk away from a potential deal if the other side seems to be asking for too much. Perhaps the university unfairly blamed W for her naivete in making the requests, but regardless of whether those requests were viewed as troubling behavior in and of themselves or as a larger statement about the candidate’s preparedness, they would be enough to turn many universities away from her. It is an employer’s market in academia.

I would be the first to say that too many universities use that obtuse language of being “student-centered” to chill faculty into shutting up and making do with what the university is willing to offer them. It gets used to imply that faculty members should repress their own needs and desires in salary, benefits, and work-life balance in order for students to have lower tuition, greater access to faculty, shiny new sports facilities, or even guns on campus. And I agree with David Perry that questions of “fit” in an academic culture should be viewed skeptically, since they can be smokescreens for various forms of bias. Faculty absolutely should be critical of the use such terms, and absolutely should call out sexism where it exists in the negotiation process surrounding faculty hiring.

But there is no truly convincing evidence that sexism is present in Nazareth’s response to W. If anything, this simply seems to be an example of the importance of what one commenter on the original post noted:

This indicates how important it is to do your best to understand the culture and needs of the hiring institution, both before and during negotiations. […] “Will so-and-so be a good colleague and carry their fair share of the burden?” is often one of (if not *the*) most important considerations during the hiring process at small institutions.

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The Philosophy Smoker has a nice run-down of various commentaries since their original post was published, and takes a refreshingly positive and level-headed view of the whole debate.

Your comments here are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.

Training in mental health is unreasonably long

2010-07-20 Black windup alarm clock faceJust as a quick thought experiment, go over to this piece at Slate discussing medical training, and every time it references “medicine” change that to “mental health.” (Accordingly, change “physicians” and “doctors” to “therapists.”) You’ll find most of it applies perfectly. To wit:

Over the past century, there have been additions to, but few subtractions from, the training process. Residency and fellowship programs became longer and longer … and longer.

and

The long process doesn’t just weed out the incompetent and the lazy from the potential pool of physicians—it deters students who can’t pay for so many years of education or who need to make money quickly to support their families. That introduces a significant class bias into the physician population, depriving a large proportion of the population of doctors who understand their background, values, and challenges.

and

The fundamental problem here is that the argument between traditionalists and reformers [debating the appropriate length of training] is essentially theoretical — we are in an evidence vacuum.

In the time I’ve been in academia, I’ve watched as the requirements for training in mental health have increased dramatically. Family therapist training in California increased from 48 to 60 units based not on science but on workplace competitiveness. (MFTs were fighting clinical social workers for some of the same jobs, and since LCSWs need 60 units of training, MFTs couldn’t really argue that their training at 48 units was equivalent.) I’ve also watched as education in general has gotten much more expensive, and loans harder to come by. And I’ve been enlightened by learning that our 3,000-hour supervised training requirement is based entirely on tradition, and is in virtually no way linked to the science that we now have available (though admittedly, it isn’t much) on how therapist skill develops over time.

Our old apprenticeship model is broken. It’s as true in therapy as it is in medicine. It will be interesting to see how experimentation with medical training goes, as it can blaze the trail for similar efforts in other health care professions like ours. I’m just not sure we should be waiting for doctors to do it first.

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Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.

No, counseling psychology is not a terrible major in college

Of course salary numbers in mental health look bad when you leave out people with the graduate degrees necessary to practice.

US CurrencyNPR ran a story last month punctuated by a graph of the highest- and lowest-earning college majors. The worst on the list, by far, was Counseling Psychology. Those who majored in Counseling Psych brought in a median income of under $30,000 per year.

No one gets into mental health care for the money, but the numbers were a black eye for the Counseling field — the American Counseling Association has even responded by commissioning its own study of salaries among its members.

But there was a big problem with that original chart, one that the researchers themselves had noted but which was often ignored in discussions of their findings: It didn’t include people with graduate degrees.

In just about any mental health field, you need at least a master’s degree to practice. Those who don’t take that extra step are often limited to very basic, entry-level jobs with little hope for advancement.

So NPR is back this week with another chart, one that includes graduate-degree earners. And Counseling Psychology no longer shows up on the list of the 10 lowest-earning undergraduate majors. Counseling Psych majors get a big bump in median incomes when you include those who go on to advanced degrees, as should be expected.

Notably, social work stayed in the bottom 10, even when those who get their graduate degrees are included. Their median incomes went from just under $40,000 a year (with graduate degree earners excluded) to about $45,000 a year (with graduate degree earners included).

It’s hard to place family therapy here, since MFTs come from a wide variety of undergraduate majors, most commonly (but by no means exclusively) psychology or family studies. For MFT salary data, the best place to start is this Bureau of Labor Statistics page.

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Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.

California MFT program rankings: The best license exam preparation

The best MFT program on this measure isn’t one I expected.

Caldwell Rankings draft coverAs regular readers here are aware, a few weeks ago I released California Family Therapy Program Rankings, a guide to 34 of the state’s biggest and best MFT programs. The book includes top-10 rankings based on cost, graduates’ success on license exams, and research productivity.

A couple of weeks ago, I revealed the top-ranked MFT program based on cost. Today, I reveal who’s number one in MFT program rankings when it comes to success on California’s MFT license exams.

For this particular set of rankings, I looked at the most recent three years of available California MFT licensing exam data (2009-2011), and for each program, took their graduates’ pass rate among first-time test takers on the Standard Written Exam and averaged it with their graduates’ pass rate among first-time test takers on the Written Clinical Vignette.

As usual, a number of cautions here. The fact that the exam data is from 2009-2011, and would thus largely include people who graduated from their degree programs from about 2003-2010, means that there’s been some time in between for programs to get better or worse in quality. Almost every program has meaningfully changed their curriculum in the past couple of years, thanks to a state law that required all programs to provide at least 60 semester units of instruction (the prior minimum had been 48). Finally, while the school you attend does seem to impact your chances of success on MFT licensing exams, even as those exams take place years after graduation, the graduate program is certainly not the only thing that would have an impact on your passing or failing the exams.

Holding those cautions in mind, what do the numbers tell us?

  • The big winner here is Fuller Theological Seminary, which can claim an impressive 93% pass rate among graduates taking the state’s MFT licensing exams for the first time. That’s the best of all 34 reviewed programs, and actually a few solid percentage points above even the second-ranked program, which came in at 89%.

  • There is indeed a meaningful correlation between the program you graduate from and your chances of passing the licensing exams on the first try, or at least that’s the impression I get from eyeballing the data. Among the 34 programs reviewed, pass rates ranged from Fuller’s 93% pass rate all the way down to 56% at the lowest-performing school reviewed. Again, you can’t presume that pass rate equals instructional quality, so take all of these numbers with a grain of salt, and recognize that they are group numbers. They might help predict whether Joe or Jane Average would pass the licensing exams on their first try (and even that is debatable, since programs enroll different sets of students, creating what researchers call selection effects), but the numbers are certainly limited in terms of predicting whether you specifically would pass. After all, there’s a lot you can do to control that beyond just which school you choose to attend.

Proposed new MFT accreditation standards eliminate vague religious exemption

If adopted, the draft COAMFTE standards would require all programs to teach LGBTQ-affirmative practices.

W-classroomThe public comment period closes Wednesday on the draft version of new accreditation standards for graduate programs in marriage and family therapy. The Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) is proposing some major changes from current standards:

  • The draft standards would restore the 500-client-contact-hour requirement for practicum. Under the current, version 11.0 standards, programs can require fewer hours as long as they have evidence to show that their practicum results in students being competent to practice at the master’s level. This vague standard has left different accredited programs using different experience requirements, which can be confusing to state licensing boards who want to know how much practical experience they can reasonably expect to be included in graduate degrees.

  • The draft standards separate accreditation requirements into “eligibility standards” and “accreditation standards.” As it is now, the Commission makes its decisions based on the full scope of information presented to them. Programs that meet most but not all standards may still be granted accreditation, with stipulations — requirements that the program comes into full compliance with the standards within a year. This proposed split into eligibility and accreditation standards arguably makes the accreditation bar a bit higher: Programs that fail to meet even one of the eligibility standards would not be eligible for accreditation, regardless of their performance on the other standards.

  • The draft standards would go back to a singular, mandatory core curriculum for all accredited programs. Of course, programs would remain free to add on to this core curriculum as they see fit, but all accredited programs would be required to have the same core set of coursework.

  • Perhaps what is most notable in the draft standards is what is missing: The draft standards remove COAMFTE’s current vague, blanket exemption for religious programs. The exemption, present in the current COAMFTE standards (p. 3), says

    Religiously affiliated institutions that have core beliefs directed toward conduct within their communities are entitled to protect those beliefs.

    It has never been clear to me what that is supposed to mean in practice, but the way I read it, any religious-based program that wants COAMFTE accreditation but isn’t in tune with any part of the standards was free to ignore that part of the standards, as long as they could tie their objection to their religious beliefs. Under the proposed new standards, not only would that clause go away, but the required curriculum would include at least three semester units on

    diversity, power, privilege and oppression as they relate to race, age, gender, ethnicity, sexual orientation, gender identity, socioeconomic status, disability, health status, religious and spiritual practices, nation of origin or other relevant social categories throughout the curriculum. It includes practice with diverse, international, multicultural, marginalized, and/or underserved communities, including LGTBQ affirmative practices. [emphasis in original]

    It is much clearer what the new standards would mean: Every COAMFTE-accredited program would need to teach its students how to work with LGBTQ clients in a positive, affirming way, and an appreciation for the harm such clients suffer from living in a heterosexist society.

To me, these are all good and necessary changes. First, as to the hours and curriculum changes: I hear chatter among MFTs around the country that licensing boards haven’t known what to do with the current COAMFTE standards. Those current standards are so flexible that licensing boards don’t necessarily know what they’re getting when someone comes to them with a COAMFTE-accredited degree. The draft standards, if adopted, would bring back greater consistency in content across programs and could restore state boards’ confidence in maintaining COAMFTE accreditation as the standard educational requirement for licensure.

Second, as to the removal of the religious exception: I’ve written previously about the struggles some religious therapists face when trying to work with LGBT clients, and the debate there is far from settled. But accredited programs can and should teach affirmative practices. The debate here should be restricted to how a therapist balances their values with client needs in the therapy room, not about whether the therapist can be exempted from exposure to affirmative techniques or to the suffering LGBTQ clients genuinely experience.

There’s only one thing COAMFTE didn’t included that I wish they would: Require MFT programs to be more transparent about cost.

COAMFTE will be reviewing comments on the proposed changes this fall. If adopted, the new standards would likely take effect in 2014 for new accreditations and be phased in for those programs already accredited.