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.
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.
Casey Meinster is the Director of Evidence Based Practices at Hathaway-Sycamores Child and Family Services, a major mental health services provider in Los Angeles. In that role, she wrangles a lot of information. But one piece of information I learned from her changed how I think about the importance of measurement in psychotherapy.
Hathway-Sycamores serves thousands of clients a year through more than a dozen programs. They fund those programs through a variety of sources, including government contracts, grants, and other sources. And it is now the case that every single program they run now has to produce outcome data on its clients. Their payors demand it.
California suffers from a severe and worsening mental health workforce shortage. In fact, much of the US is in the same boat. There simply aren’t enough qualified mental health professionals to meet our country’s needs.
At the same time, therapists in private practice often complain about their local markets being saturated. There are so many therapists in some places, it seems, that it’s hard to get a career off the ground.
As it turns out, there’s truth to both of these perspectives.
Marriage and family therapists (MFTs) work with individuals, families, and couples of all types. We assess, diagnose and treat the full range of mental and emotional disorders. So, the title “marriage and family therapist” doesn’t provide the whole picture of what we do.
Should the name of the license be changed?
In testimony to Congress the week before last, Facebook CEO Mark Zuckerberg made a point of emphasizing that if you’re a Facebook user, you own your information. This is meant to reassure users, but it is more than a little misleading. “Your information” is what you personally have uploaded to Facebook. You do not own what other people have uploaded about you. That’s what has privacy advocates so concerned. It’s also why even therapists who don’t use Facebook should be worried about the client confidentiality risks that the company poses.
Under a bill signed into law last week by Governor Jerry Brown, counselors (PCCs) and marriage and family therapists (MFTs) in California who have completed their graduate degrees but are not yet licensed will see their title change from “Intern” to “Associate” on January 1, 2018. [Originally published September 26, 2016. Updated August 2, 2017: Added FAQ section. Republished December 19, 2017.]
Streamlining licensure. Banning reparative therapy for minors. Fixing problems in child abuse reporting. Changing “interns” to “associates.” Saving Psychotherapy.
I’ve spent years now fighting for major changes in the world of mental health care, and winning. Many of the changes I’ve played a role in were ones that I was told would be impossible.
Today we launch Ben Caldwell Labs, the most important project of my career. The change I’m fighting for this time involves you.
Student loan debt has been a regular topic here, as it should be. Mental health professionals need to have graduate degrees, which often means taking on significant debt. The American Psychological Association reports that PsyD students in psychology now graduate with a median of $200,000 in student debt just from their graduate studies. The federal government offers loan forgiveness for those who work in government and nonprofit organizations, through its Public Service Loan Forgiveness program.
Recently, there’s been some concern over the fate of that program. Therapists and counselors currently working in nonprofit settings wonder whether they will in fact be eligible — or whether the program will still exist — by the time they complete 10 years of service. But their concern is (at least so far) not supported by what’s actually been happening.
[Originally published May 2014.] Last week in Isla Vista, California, Elliot Rodger killed six people before taking his own life. His family says he was seeing multiple therapists. Meanwhile, in the California legislature, discussion of a bill that would mandate additional suicide prevention training for therapists has focused on research showing that more than 30% of those who commit suicide had seen a mental health professional within the past year. Why can’t therapists do more to stop violence among our own clients?