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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Share your thoughts on this case: Email me at ben[at]bencaldwell[dot]com, post a comment below, or find me on Twitter (@benjamincaldwel).

Iowa State MFT program closing; Saint Louis U. may do the same

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While some family therapy graduate programs fight to survive, others open or expand.
                                                                                                                                                                                                                                                                                                           

Abandoned 4The Iowa State Daily is reporting on the pending closure of the university’s marriage and family therapy program and associated clinic. While there are only four students remaining in the program, the Daily reports that the clinic continues to serve a beneficial role in the community, as one of very few low-cost service providers in mental health.

Meanwhile, the Saint Louis Beacon is reporting that Saint Louis University’s COAMFTE-accredited MFT PhD program could stop accepting new students as early as next year, with plans to close completely in 2015. A document the newspaper described as a “draft memo” circulated to a faculty retreat outlined the proposed changes, which would also include the shuttering of several other programs. The university responded to the newspaper by saying the recommendations were preliminary, and faculty would have the opportunity to respond to them before final decisions are made by the university’s board of trustees. Last week, the Beacon reported that the trustees took no immediate action, which could leave the door open for the targeted programs to survive.

If both MFT programs do ultimately close (and the Iowa State closing appears certain, while Saint Louis is more in the air), they would join a small but significant list of MFT program closures in recent years. Although accreditation in MFT is growing, with more than 100 programs around the country now COAMFTE accredited (hey Californians, COAMFTE accreditation matters), even these programs are sometimes threatened with closure. Last year, the University of Nevada Las Vegas threatened to close its MFT program, though the program survived after a reorganization.

Saint Louis and Iowa State would make at least the third and fourth closures of COAMFTE-accredited MFT graduate programs in recent years. Syracuse and Purdue both shuttered their MFT doctoral programs, though both continue to have strong masters degree programs. In addition, the MS in Clinical Psychology program at San Jose State University, which was not COAMFTE-accredited but had been producing graduates headed for MFT licensure, is on at least a two-year hiatus. According to its web site, the program will reopen as an LPCC program if it reopens at all.

It would be a mistake, though, to presume that means that opportunities for high-quality education in MFT are decreasing. As I mentioned above, COAMFTE accreditation is growing, and as some programs close, others open or expand. Alliant International University (where I teach) will be expanding its COAMFTE-accredited PsyD program in Couple and Family Therapy to my beautiful new hometown of Los Angeles this fall.

Proposed Ethics Code revision would remove MFTs’ social responsibility

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The proposal would eliminate three sections of the AAMFT Code of Ethics that currently call for service and responsibility to larger systems. Members have until January 31 to weigh in.
                                                                                                                                                                                                                                                                                                           

Angry Talk (Comic Style)The AAMFT Board of Directors is proposing an incremental change to the marriage and family therapy profession’s Code of Ethics, the guiding document that defines professional standards in the field. At least one of the proposed changes would drastically redefine what it means to be an MFT.

Some quick background: The AAMFT Code of Ethics was last updated way back in 2001, and much has changed in the profession since then. In particular, the emergence of new technologies for both marketing and service delivery has raised concerns about how to best manage confidentiality and informed consent. The AAMFT Board has known the Code was in need of updating, but did not want to engage in a full-scale overhaul of the Code at this time; that would be about a two-year undertaking. So, they instead are looking at smaller-scale changes. (Full disclosure: I chaired a Task Force, at the Board’s request, looking at possible changes to the Code over the summer. The Task Force was just one of several sources of input for the Board as they developed the current proposal.)

One element of the proposed revised Code is shocking to me. It would change what it means to be a marriage and family therapist. The Board is proposing removing each of the following sections from the AAMFT Code of Ethics:

6.6 Marriage and family therapists participate in activities that contribute to a better community and society, including devoting a portion of their professional activity to services for which there is little or no financial return.

6.7 Marriage and family therapists are concerned with developing laws and regulations pertaining to marriage and family therapy that serve the public interest, and with altering such laws and regulations that are not in the public interest.

6.8 Marriage and family therapists encourage public participation in the design and delivery of professional services and in the regulation of practitioners.

Together, these are the sections that place MFTs in a position of larger social responsibility and make us accountable to the communities we serve. The removal of these sections would have far-reaching implications: If MFTs no longer need to have a place at the table when laws are being developed or altered that are not in the public interest, do we simply allow others to set for us the legal standards that govern our profession? Do we now need to stay out of the same-sex marriage debate? Is it OK for us to be ignorant of major legal issues in our field, from the fight for Medicare reimbursement to the Texas lawsuit over MFTs’ ability to diagnose?

Perhaps on an even more fundamental level, we can look at the proposed removal of 6.6. Is contributing to a better community and society no longer a value of this profession? If so, I would be a lot less enthusiastic about being a part of it.

And that’s the rub. A Code of Ethics is more than just a list of behaviors that can get you in trouble in a profession; it also serves as a vital statement of what it means to be an MFT. It reflects our values and desires as a professional group. One of those values, historically, has been responsibility to the communities we serve. If nothing else, devoting some of our professional activity to services with minimal return is a clear way of demonstrating through our behavior that we truly understand systems and our role, as professionals, in those larger communities.

The Board did not provide its rationale for this proposed change (or any others). But the reasons are likely not important. These subprinciples are key to my identity as a marriage and family therapist. They set AAMFT, as an association, and MFTs as professionals apart from other professional groups. Serving the community through pro bono work and involvement in policy discussions is part and parcel to being an MFT. Isn’t it?

Members can review the full proposal of changes to the AAMFT Code of Ethics through the AAMFT web site (you will need to log in). Members can submit comments through January 31 via email; the address to send feedback can be found here. Whether you agree with me on this issue or not, if you are a member, please do weigh in on the full proposal. The more feedback AAMFT gets from members on the proposed changes (most of which are really quite good!), the better.

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If you’re wondering, the CAMFT Code of Ethics encourages (but does not require) pro bono work. It also has language nearly identical to AAMFT’s 6.7 above, about influencing laws.

Like AAMFT, I, too, appreciate your feedback. And you don’t even have to log in to give me a piece of your mind. Post a comment below, drop me an email to ben[at]bencaldwell[dot]com, or post something to me on Twitter.

How to get the divorce rate wrong

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Do what a CNBC reporter did: Ask divorce lawyers.
                                                                                                                                                                                                                                                                                                           

Wedding ringsI’ve mentioned here in the past that estimates of the divorce rate are notoriously difficult to make well. There’s some inherent guesswork involved, unless you just wait for an entire annual cohort of marriages to reach either death or divorce. And that would take a long time. To simply compare a given year’s number of marriages with that year’s number of divorces is to compare different cohorts, making estimates of the divorce rate done that way wildly inaccurate.

Instead, demographers and social scientists do the best-educated guesswork they can based on past data and current trends. (Government data does not do forward-looking prediction, but rather focuses on divorces that have already occurred.) As new divorce-rate studies are released, you can keep up with them on the Divorce Statistics and Studies Blog. Reasonable people can disagree about the best scientific ways to determine the divorce rate, and there is probably some value to several different approaches. So news reporters, talking to scientists, will sometimes come up with different numbers, and that’s okay. They tend to wind up in that least the same neighborhood. (That neighborhood, by the way, projects the divorce rate for people getting married this year in the low 40s, percentage-wise.)

What is not okay — what shows rather extreme laziness in news reporting — is to ask a scientific question of someone who is in no place to answer it, and then not bother to check the accuracy of their statement. What’s even worse is when that person can directly benefit from providing misinformation.

So it went with CNBC.com in September, when reporter Cindy Perman opened her story about affairs (reprinted by USA Today) by providing an estimate of the divorce rate — a measurable, objective, scientific thing — helpfully volunteered by the director of the American Academy of Matrimonial Lawyers.

The problems with this are so obvious that I’m stunned the article was printed. I don’t even blame the lawyer, at least not any more than I blame spokespeople from the National Association of Realtors for suggesting that any economic news, good or bad, means it’s a great time to buy a home. They’re lying, but that’s their job. I just wish reporters would subject those claims to actual scrutiny.

Like, fact-checking.

I’ll say it here again: The divorce rate in the US probably never got as high as 50%, and is currently declining. The best current estimates of the divorce rate place it in the low 40s, and the divorce rate is much lower for well-educated couples than for less-educated couples.

It’s a topic taken on quite well by Tara Parker-Pope in her book For Better, which dissects the science surrounding a number of elements of marriage and divorce.

Any time you see the lazy and wrong estimate that half of all marriages end in divorce, go ahead and — nicely — say something to correct it. I suppose as a couples therapist I might also benefit from inflating the divorce rate, but I’d rather let facts speak for themselves — and I think effective, widely-available therapy would bring down the divorce rate even further. It would save us all some money, too.

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If you know of egregious repeat offenders with the half-of-all-marriages-end-in-divorce nonsense, email examples to me at ben[at]bencaldwell.com, post a comment below, or send me a link to it on Twitter. Of course, other comments are always welcome.

The myth of the portable license

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California’s new LPCC isn’t any more of a “national license” than the MFT license is: not at all. Why do rumors persist that it is?                                                                                                                                                                                                                                                                                                            

Cloth SuitcaseHere in California, we’re currently in the middle of the grandparenting period for licensed MFTs and LCSWs who want the state’s new Licensed Professional Clinical Counselor (LPCC) license. One of the most common reasons I hear from MFTs for wanting the LPCC is the notion that it, unlike the MFT, is a “national license.”

Except it isn’t.

For clarity: An LPCC license is no more of a national license than an MFT license, which is to say, neither is a national license at all. Both are state licenses only. Both professions now have licensure laws in all of the 50 United States (and DC), but for both, the licensing laws from state to state differ. How portable your license is — that is, how easily you could get licensed in a new state once you move — depends on a number of factors, including which state you move to. (For more on this, see my earlier post on MFTs and license portability.) But neither license has true reciprocity, which is automatic recognition of another state’s license.

The only reason I know of that could explain the myth of a portable LPCC license is that California’s Board of Behavioral Sciences is recognizing the National Clinical Mental Health Counselor Exam for LPCCs, while for MFTs, we use state-based exams. Admittedly, that can make moving into or out of California with an MFT license slightly more challenging: If you move into California, even if you have been licensed elsewhere for decades, you will need to take California’s MFT licensing exams. And if you move out of California, even if you have been licensed here for decades, you will need to take the National MFT Exam (many states also require a state-based law and ethics exam) to get licensed in your new home state. But the BBS has already gotten legislative approval to restructure the MFT license exam process, and is working with the folks who develop the National MFT Exam to have that exam offered and recognized in California. So that difference between the professions will hopefully be vanishing in the not-too-distant future.

There are good reasons for some MFTs to pursue the California LPCC license. Unfortunately, the ones I hear most often from MFTs as their motivators are falsehoods, and this portability issue is a great example.

If you are interested in hearing more about the LPCC license (including debunking of more myths!), differences between the philosophies of MFT and LPCC, scopes of practice, legal and workplace recognition, and much, much more, please consider attending “The California LPCC,” a presentation I’m giving with Angela Kahn, MA. Angela has helped develop the LPCC curriculum for Antioch University in Los Angeles, and is going through the grandparenting process; I helped AAMFT-CA negotiate what became the LPCC licensing bill, and I’m probably not going to go through grandparenting. So we present an informed perspective from both sides of that question. We’re giving the talk at Antioch in LA this Saturday, November 19 (that one’s just for Antioch students, faculty and alumni, so contact the school for more info or to RSVP). We’re also giving the talk in San Diego on December 3. Use this link for more information or to register: The California LPCC, Dec. 3, San Diego.

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Your comments are always free to cross state lines. Offer them here, by email to ben[at]bencaldwell[dot]com, or through my easily-portable Twitter feed.