Money for MFTs

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Stipend and loan reimbursement programs for family therapists, updated for 2012 with current links, updated amounts, and additional programs.
                                                                                                                                                                                                                                                                                                           

A number of state and federal programs offer tens of thousands of dollars in stipends and loan reimbursements for marriage and family therapists to advance their careers. Generally, these programs aim to help bring mental health services to underserved areas and to reward therapists who dedicate themselves to such communities. Here are just a few of the programs MFTs may find enriching.

The federal National Health Service Corps program offers a whopping $60,000 in loan reimbursement, on top of the salary one would already make in an eligible position, for two years of service. Continue working in an NHSC-eligible position over time, and you can get as much as $360,000 in loan reimbursement for 16 years of full-time service. NHSC-eligible jobs can be found at the NHSC Jobs web site.

Also on the federal level, the Indian Health Service (IHS; www.ihs.gov) offers a similar program, awarding $20,000 per year for two years of service at an IHS site. (A cautionary note: MFTs are legally recognized for employment within IHS, but appear to fall within “other professions as determined by need” in the loan repayment program.)

The American Association for Marriage and Family Therapy (AAMFT) / US Substance Abuse and Mental Health Services Administration (SAMHSA) Minority Fellowship Program awards stipends to cover education, plus funding to conduct research and travel to conferences and trainings, to doctoral students in MFT programs. These awards can be worth tens of thousands of dollars and are renewable for multiple years.

In California, there are additional state-based stipend and loan reimbursement programs. The awards offered by each of these programs are in addition to the salary one would already earn in an eligible position.

The California State MFT Stipend Program provides awards of $18,500 per year to MFT Interns who agree to work in public mental health positions in underserved areas for at least one year. In 2010 and again in 2011, 60 of these stipends were awarded through the statewide MFT Consortium, which covers most of the state; Loma Linda University and CSU-Chico each administered a handful of additional stipends through the same state fund. For 2012, Alliant International University (where I teach) also is administering its own stipend program, awarding 15 stipends per year of $18,500 each, distributed across our four CFT campuses.

There are separate stipend programs at the county level. The Los Angeles County MFT Stipend Program has awarded more than 300 stipends of up to $18,500 since 2005, with recipients committing to similar service requirements. San Diego County and Orange County have more recently launched similar programs.

Finally, the state offers MFTs and MFT Interns its Mental Health Services Provider Education Program, which awards up to $15,000 in loan reimbursement for two years of service in an underserved area, and its Mental Health Loan Assumption Program, which offers $10,000 in loan reimbursement for a one-year commitment. Though these programs are both run by the same state agency, their separate amounts and selection processes are because their funding comes through two distinct streams (license renewal fees, and the Mental Health Services Act). They have different application forms and run on different deadline cycles. The next MHLAP deadline is in August; the next MHSPEP deadline is in September.

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To put in a plug for my program: Alliant students are eligible for our own stipend program, the county programs in San Diego and Los Angeles, and the state and federal programs. Some campuses are still accepting applications for fall 2012; more information is available here: Alliant Couple and Family Therapy programs.

Are you aware of other federal or state-based programs that should be added to this list? Email me at ben[at]bencaldwell[dot]com and let me know, and I’ll be happy to expand this post.

Universities win two discrimination lawsuits brought by student therapists

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Jennifer Keeton had refused to treat gay clients, and Maria Salcido alleged that racial bias kept her from finishing her family therapy degree.
                                                                                                                                                                                                                                                                                                           

JudgesTools IconThere have been at least three recent lawsuits involving students in the mental health professions and allegations of discrimination. In recent rulings, universities prevailed in two of those suits: Jennifer Keeton’s case against Augusta State University, and Maria Salcido’s case against Southern Miss University. The third case, in which Julea Ward sued Eastern Michigan University, remains in court.

In 2010, Jennifer Keeton sued Augusta State. The school had expelled her from its counseling program after she had said many times over in classes and in meetings with school officials that she would not counsel gay or lesbian clients. The university offered Keeton a remediation plan, with the hope of aiding her in not imposing her values on clients. Keeton claimed the university was trying to force her to change her religious beliefs. The university insisted that the intent of the remediation was in keeping with the ACA Code of Ethics. The ACA Code requires that counselors not impose their values on clients, regardless of what the counselor’s personal values may be.

A federal district court last month ruled in favor of the university. Importantly, the judge in the case also reinforced the importance of professional ethical codes, noting

[W]hen someone voluntarily chooses to enter a profession, he or she must comply with its rules and ethical requirements. […] The ACA and ASCA Codes, with their emphasis on the counselor’s role in facilitating personal client growth and self-determination, both expressly proscribe the imposition of a counselor’s personal views in counseling situations.

The AAMFT Code of Ethics, like most professional codes, includes a non-discrimination statement. Interestingly, the AAMFT Code does not include the kind of clear prohibition against professionals imposing their own personal values that is found in the codes of other organizations. At best, it is implied in the AAMFT Code. That could become important if an MFT program is ever challenged in court over similar issues.

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In a separate case last year, Maria Salcido filed a claim against Southern Miss, alleging that racial bias kept her from completing her MFT degree there. She had withdrawn after being unable to find a placement site for her required externship experience. Her suit accused the university of preventing her from getting a placement because of her race.

She not only lost her case, the language of the court ruling against her suggests frustration that she wasted everyone’s time:

[Salcido’s] bare factual allegations are seasoned with healthy doses of legal conclusions and fall far short of plausibly suggesting a discriminatory state of mind on the part of any defendant.

That was how the court reacted to her discrimination claim; she didn’t fare any better on the other claims she made against the university. The entirety of her suit was dismissed with prejudice.

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Together, these rulings appear to suggest that students cannot use accusations of discrimination to get what they want from graduate programs in mental health, particularly when (as in Keeton’s case) they are asking to overrule academic decisions tied to the ethical standards of the profession the student is trying to get into. Unfortunately, it is too early to say the question is settled: the Julea Ward case is still out there, and it bears more than a few things in common with Keeton’s. (The judge in Keeton’s case uses a lengthy footnote to discuss what is different between the Ward and Keeton cases [pages 49-50], one of many reasons that ruling is worth reading.) I’ve previously written about the Ward lawsuit, a recent ruling that keeps the Ward case alive, and “conscience clause” legislation proposed as a direct result of Ward’s experience.

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How long does it take to get an MFT license?

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State laws vary, but typically, you need a two-year masters degree and two more years of full-time, supervised experience. Here are the steps to becoming a licensed family therapist.

                                                                                                                                                                                                                                                                                                           

2010-07-20 Black windup alarm clock faceIf you are planning or considering a career as a marriage and family therapist, it is important to give thought to the time and money it will take to work your way to licensure. The timing of steps along the way could impact your choices for when to get married, have children, or maintain employment in another field.

Presented here are the typical steps to an MFT license and some common timeframes. The steps and timeframes listed here do not account for individual circumstances or the many state-to-state differences in licensure laws. You should check the web site of your state MFT licensing board (AAMFT offers a handy directory of state MFT licensing boards) to learn the specific requirements of the state where you want to license. I have some emphasis on California in this post because it is the state I call home, and because about half the MFTs in the country are here.

Note that a “typical timeframe” here means a common amount of time needed for those who are accomplishing that step through full-time work or study. If you build your career in MFT through part-time work or study, to allow you to balance family responsibilities, maintain outside employment, or for any other reason, naturally your timeframe will be longer.

Progression to licensure as a marriage and family therapist usually follows these steps:

  1. Complete a bachelor’s degree in psychology, family studies, or a related field. Many schools will be OK with a major in a different field if you can demonstrate adequate base knowledge in psychology and family development, through specific prerequisite classes, GRE subject test scores, or other means. Typical timeframe: 4 years.
     
  2. Complete a master’s degree in marriage and family therapy, counseling psychology with an emphasis in MFT, or a closely related field. Note that some states, like California, have specific requirements for what degree titles will make you eligible for MFT licensure. In most states, you will need to demonstrate that your master’s degree program was accredited by COAMFTE (the accrediting body for MFT programs), or is equivalent to COAMFTE standards. I’ve written in the past about the benefits of attending a COAMFTE-accredited program, and I’ve also offered tips for admissions interviews at MFT programs. You might want to consider a doctorate in MFT, though it will take longer. Typical timeframe (masters degree): 2-3 years.
     
  3. Complete additional supervised experience under a licensed MFT. In some states, including California, other licensed mental health professionals can supervise you as well; check with your state to see what their supervision standards are. Note that some states require your pre-licensed experience to be under an AAMFT Approved Supervisor. (A directory can be found here: Find an AAMFT Approved Supervisor.) During the time between graduation and licensure, while you are working under supervision, your state may call you an “intern” or an “associate” depending on the state. A few states use other titles. Most states require a total of 3,000 hours of supervised experience for you to be eligible to sit for licensing exams; there is some variability here, too, however. (Pennsylvania’s governor just signed a bill reducing that state’s requirement to 3,000 hours from 3,600.) Some states simply phrase this as two years full-time experience or the equivalent. Also note that in California, some hours gained within the master’s degree program can count toward the 3,000 total needed for licensure. (Other states tend not to allow this.) Typical timeframe: 2 years.
     
  4. Pass your state’s licensing exam(s). California is the only state that uses its own exams rather than the National MFT Exam. Many states require a state law and ethics exam in addition to the national exam, since state laws vary in key areas like child abuse reporting requirements. While an exam itself is over in a day, the licensing board needs time to process your MFT exam eligibility application, you need time to prepare, and you will need to schedule an appointment with a nearby testing facility. I’ve previously offered tips for preparing for MFT licensing exams, four myths about MFT licensing exams, and some discussion about whether MFT exam prep courses are worth the money. Typical timeframe: 6 months – 1 year. Longer if you need multiple attempts to pass.

Once you make it through that last step, congratulations! The state can now make you fully licensed as a marriage and family therapist, able to work independently in a private practice if you choose.

Overall, it’s good to plan for a total of at least 4-5 years from the start of your masters degree all the way through to licensure. Your time may be longer based on your circumstances; it would be possible (at least in CA) but unusual for your time to be any shorter.

In most states, the timelines for masters-level licensure are similar among clinical social workers, counselors, and MFTs. California is a noteworthy exception there: Only MFTs can count pre-degree hours of experience toward the 3,000 hours required for licensure, so it tends to be faster to get an MFT license in California than the other masters-level licenses. Licensing as a Psychologist requires a doctoral degree (typically 5 years, sometimes as short as 4) plus a postdoctoral internship (in California, 1,500 more hours, or about another year of full-time work) for a total of 5-6 years. Again, though, your individual circumstances may make your time longer.

Ed. note: This post originally published March 26, 2012. Some links updated June 11, 2018.

Julea Ward wins court ruling, while legislation bearing her name advances

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Her religious discrimination suit is returned to a federal jury. Meanwhile, a proposed law in Michigan would allow students to refuse to treat any client they chose, out of any genuine religious or moral belief.
                                                                                                                                                                                                                                                                                                           

EMUstudentCenterYpsilantiMIJulea Ward has enjoyed two big victories so far this year.

For the first time, she won a court ruling in her case against Eastern Michigan University, which had disciplined her for refusing to provide counseling services to a gay client as part of her graduate practicum training. Just weeks later, legislation bearing her name moved forward in the Michigan legislature despite protests from universities and professional associations that the Julea Ward Freedom of Conscience Act would make it harder to effectively train mental health professionals.

In the court case, Ward’s victory was limited but it does keep her case alive. While not making a determination of the merits of the case, the 6th Circuit Court of Appeals ruled that Ward should have the opportunity to argue that her religious beliefs were used against her, according to the Associated Press. The case will be returned to a Detroit-based federal jury.

In the Michigan legislature, the House Education Committee advanced HB5040, the bill bearing Ward’s name. According to the Holland Sentinel, the bill would “prohibit religious discrimination against students who are studying counseling, social work, and psychology.” That description seems a bit narrower to me than the bill itself, which goes beyond just prohibiting discrimination: it actually prohibits universities from any disciplinary actions against students who refuse to treat clients based on “a sincerely held religious belief or moral conviction of the student, if the student refers the client to a counselor who will provide the counseling or services.”
You can keep up with the bill’s progress here: HB5040.

I wrote about Ward’s case for Family Therapy Magazine a couple of months ago (full article: Can a religious therapist refuse to treat gay and lesbian clients?). She described the events that led to her lawsuit in this video for the Christian-based legal organization that is defending her:

I’ll be writing more about HB5040 and other “conscience clause” legislation in the near future. In the meantime, the Pew Research Center offers a fascinating legal history of conscience issues in health care.

Update: About a week after this post was initially published, I posted another piece about conscience clause legislation.

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