Cohabitation not so harmful to marriage, new studies show

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A trio of studies in the May Journal of Marriage and Family may be leading indicators of a fundamental shift in how cohabitation impacts eventual marriage. It may not be as harmful as previously thought.

It has been well-established for years that cohabitation before marriage increases eventual chances of divorce. (A good-albeit-old summary of this research, including possible explanations, is here.) This has been such a clear and consistent finding, in fact, that its opposite is featured in my 2008 article as a “myth about marriage” that research has convincingly debunked.

Now, all that may be changing. A study of marriages in Australia finds that the gap between cohabiting couples and non-cohabitors in later risk of divorce has been shrinking as cohabitation has become more common. The correlation may even have flipped. In one of the study’s predictive models, for couples married since about 1987, non-cohabitors have been more likely to eventually separate than those who cohabited prior to marriage. (In the study’s other predictive model, the lines have not yet crossed, but since the late 1990s there has been essentially no difference between cohabitors and non-cohabitors in risk of separation.)

There’s more. A separate national (US) study examining marital quality rather than simply separation looked at nearly 4,000 women born between 1957 and 1965. The authors found that

The negative correlation between premarital cohabitation and marital quality is largely driven by the nonmarital parents in the cohabiting population. […] Furthermore, marital quality is “locked in” at the start of marriage, with lower quality marriages neither catching up nor deteriorating more rapidly than others. (p. 313, emphasis mine)

In order to put meaning to these numbers, it is important to understand how couples today are looking at marriage and cohabitation. That’s exactly the purpose of a third study in the journal, titled “The Social Construction of Marital Commitment.” The researcher interviewed 75 women and men between ages 28 and 35, most in New York state. Based on their own descriptions, participants’ commitment to marriage was made of two parts: How they saw marriage as a “life style option” that had value compared with other options like cohabitation, and how (or whether) they saw themselves actually achieving married status. Speaking to the first element (value), most of those who were not in a relationship “were reluctant to assign a value to marital commitment that distinguished it from other forms of attachment” (p. 324, emphasis mine). Even among those who did place value on marriage, there appeared to be varying degrees of belief that the kind of marriage they envisioned was actually achievable.

Together, these three articles show in stark relief just how out-of-date our knowledge about marriage could be. Mind you, it’s not that we haven’t been doing the work. Rather, it appears that generational shifts in both attitudes and behavior toward marriage have been occurring much more rapidly than we’ve been able to effectively monitor. I wonder how many more of those supposed myths about marriage may be shifting to truth, and how long it would take for those shifts to be detected.

50 states of MFT licensure: Reflections

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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?

On same-sex marriage, CAMFT stands quietly alone

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Around the country, state governments have wrestled with questions of how to best recognize relationship commitments among same-sex couples. To provide guidance and respond to questions from legislators and the public, most mental health organizations have developed clear and specific policy statements that show where the organizations stand:

Of course organizations of marriage and family therapists (MFTs) are uniquely qualified and well-positioned to address this issue. The positions we stake can be particularly important to policymakers.

The American Association for Marriage and Family Therapy (AAMFT) went through a thoughtful, open process of debating the issue a few years ago. The result of that process is the following policy statement (emphasis mine):

AAMFT believes that all couples who willingly commit themselves to each other, and their children, have a right to expect equal support and benefits in civil society. Thus, we affirm the right of all committed couples and their families to legally equal benefits, protection, and responsibility.

That policy statement was developed through careful deliberation, member comments (about 800 pages’ worth), and importantly, a very extensive report (on their web site, but restricted to members) on the state of the research around same-sex couples and their children.

The California Association of Marriage and Family Therapists (CAMFT) has taken a very different approach to the question: Avoidance. Even after a great deal of member protest, at its most recent board meeting CAMFT only went so far as to put out a generic anti-discrimination statement that sidestepped any and all meaningful questions: Is refusal to allow same-sex marriage discrimination? Should same-sex parents be allowed to adopt and raise children? How does the term “marriage” relate to the work of MFTs, particularly our work with same-sex couples? They don’t say.

Officially, CAMFT’s refusal to step in has been on the grounds that it is not the best use of their resources. Get caught up in this social cause, the argument goes, and you wind up caught in many more, and they distract from the mission of the organization.

This is hogwash, of course. Professional associations in mental health usually have specific policies for addressing social issues, and processes for determining which social issues to get involved with. They understand that these issues need to be addressed, because social issues inherently impact the health and well-being of individuals, families, and communities. The dilemma for CAMFT — and I’m guessing here, trying to give the benefit of the doubt — must revolve around whether to risk alienating a significant portion of their membership. MFTs come in many stripes, from those who adamantly support same-sex marriage and see it as a human rights issue, to those who just as adamantly believe marriage is a religious institution and therefore needs to be restricted. Take a stand on either side of the debate, and in an instant, you’ve shown a major portion of your membership that you do not share their value.

As a worker in an evidence-based field, I would hope that my colleagues would be willing to be guided by the best available research at the time. The policy statements of other organizations make it clear that they are trying to do just that, even over the objections of a portion of their membership. To be sure, each organization likely lost a few members when they took the stands they did. Silence, however, does not seem like the ideal answer.

CAMFT members are now pushing back, organizing petitions and trying to encourage change from within the organization — or, failing that, suggesting that therapists quit CAMFT entirely (here are just a few resignation letters to CAMFT). Since CAMFT board members were this year selected by a committee (the most recent member “election” was a perfunctory exercise, with only one candidate put on the ballot for each open position), such actions may be the only way members feel they can have a voice in the organization, short of actually serving on the board.

It is interesting that California, which was the first state to license MFTs, now houses the group of psychotherapists last to recognize the harm done by staying silent about what “marriage” means.

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A quick aside: I haven’t mentioned the American Counseling Association (ACA) here because I can’t quite tell where they stand. I found an obtuse reference to a 1997 resolution the organization debated, but I can’t find the resolution or indications of whether they adopted it or not. They do have an active division on lesbian, gay, bisexual and transgender issues in counseling, which by itself is a step above CAMFT on the issue.

Montana becomes 50th state to license MFTs

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Montana governor Brian Schweitzer made his state the 50th to enact marriage and family therapist licensure last week, when he signed SB271 creating the MFT license there.

Congratulations, Montana MFTs! With a nation of MFT licensure laws complete, this should add great momentum to the push for MFTs to be included in federal programs, including Medicare and No Child Left Behind.

It is also worth pausing to reflect on just what an accomplishment this is — I’ll post more on this later in the week.

Montana could complete nation of MFT licensure

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The state legislatures in Montana and West Virginia have each now passed bills (Montana bill | West Virginia bill) that would create Marriage and Family Therapist licensure in those states. If Montana’s bill is signed by the governor, the country could be complete: MFT licensure would exist in each of the 50 states, and the District of Columbia.

The governor of West Virginia has formally approved the MFT bill there. It is unclear when the state will actually begin issuing MFT licenses, because the board has some rulemaking to do, but it may happen as early as next year.

The Montana bill was sent to the governor April 22; he has 10 days to sign or veto it, or it becomes law automatically. It’s not fully clear, at least from what I can find, whether the governor will sign it; the Montana chapter of NASW has opposed MFT licensure there, and the governor has been busy with his veto pen. Still, improving public safety in mental health services, as well as access to care, through MFT licensure would be a good way to demonstrate to Montana residents that mental health issues are important, even when budget limitations prevent expanding services.

Stay tuned…