AAMFT

AAMFT, AFTA, CAMFT, IFTA, and more: A primer on MFT associations

by

There are at least six major professional associations that cater to marriage and family therapists. Each of the organizations has great value, and each focuses its energy a bit differently, so it is useful to know about them to determine where you want to make professional connections and what activities you want your member dues to support. Of course, for each organization, there is not room here to cover all of their member benefits; I would strongly suggest following the links to each organization’s web site to learn more about what they have to offer.

Note: The logos here are, of course, the trademarks of their respective owners. Like the rest of this post, they’re there to be informational, and to connect you to the organizations’ sites; they are not meant to indicate that the organization endorses this blog, or vice versa.

The American Association for Marriage and Family Therapy is the national professional association for MFTs. It has led the successful push to get MFT licensure in all 50 states, and now is working in support of legislation that would add MFTs to Medicare and improve employability in schools. Strengths: AAMFT is particularly known for its successes in advancing the field through research, education, and training. These efforts include publishing the Journal of Marital and Family Therapy; publishing Family Therapy Magazine, which focuses each issue on a particular clinical or advocacy topic; putting on a large annual conference; supporting the AAMFT Approved Supervisor designation and related training; and accrediting graduate programs in MFT through its accrediting arm, COAMFTE. AAMFT also has divisions dedicated to more localized efforts in US states and Canadian provinces. (Full disclosure: I’m on a consulting contract with AAMFT, focused on California educational and policy issues.)

The American Family Therapy Academy is a smaller, invitation-only organization dedicated to advancing systemic thinking and systemically-oriented services for families. AFTA produces an Annual Conference and publishes a special-topics journal, the AFTA Monograph Series. Strengths: The depth and quality of discourse within the organization is strengthened by the invitation-only membership model. The organization’s strong commitment to systemic work is evident.

The International Family Therapy Association is dedicated to supporting the work of MFTs overseas and training practitioners around the world to deliver culturally-appropriate family-based services. IFTA publishes the Journal of Family Psychotherapy and sponsors the World Family Therapy Congress, an international conference of family therapy researchers and practitioners. Strengths: The Congress is well-renowned for its ability to bring together international leaders in the field who otherwise may never make personal contact. The organization’s focus on culturally-appropriate care is also important when applying treatments to different populations than those for whom the treatment was initially developed.

The California Association of Marriage and Family Therapists is an independent organization (that is, separate from AAMFT and its California Division) dedicated to supporting MFTs in the state. That by itself makes the organization one that is important to the profession overall, since about half the MFTs in the country, by licensure, live in California. CAMFT produces its own magazine, The Therapist, which focuses largely on legislation, employment, and compliance issues. CAMFT also puts on an annual conference. Strengths: CAMFT has historically focused its energy effectively on state-level legislation and advocacy, and on local connections through its 29 local CAMFT chapters throughout the state.

The International Association of Marriage and Family Counselors is a division of the American Counseling Association. ACA considers marriage and family therapy to be simply one of many forms of counseling, and accredits MFT programs as specialty counseling programs. IAMFC publishes its own journal, which CAMFT has recently begun distributing to its members as the two organizations seek additional ways to collaborate. Strengths: IAMFC is seeking to grow in scope and influence through collaborative efforts, including its collaboration with CAMFT and with the National Credentialing Academy.

The National Council on Family Relations is an interdisciplinary organization focused on research and policy as they relate to family life. NCFR administers the Certified Family Life Educator credential, publishes a number of journals including family-studies leader Family Relations, and puts on its own annual conference. Strengths: The CFLE credential crosses state lines, and the organization’s focus on applied research and public policy have made it a go-to source for practitioners and policymakers alike.

Each of these organizations has a lot to offer. Students in particular can benefit from them, as they each have remarkably low membership costs for those currently in school. Professional associations advance the field on many levels, improving the quality of our training, the effectiveness of our clinical practices, the employability of MFTs, reimbursement practices, and public policy. I encourage you to find the ones that will be most valuable to you, join them, and then invest your time and energy in them. Being just a number in an organization is fine and has benefits; being an active voice and an advocate for your profession is even better.

Recapping the 2010 AAMFT Annual Conference

by

There was a lot to talk about at the just-concluded 2010 AAMFT Annual Conference in Atlanta, where more than 1,700 clinicians and researchers from around the country gathered to share the latest ideas in treatment. This year’s theme was “Marriage: Social and Relational Perspectives,” and this year’s jump in conference attendance was well-deserved. Hitting some of the high points:

* For my money, Stephanie Coontz should be a keynote speaker every year. Last year, she talked about time-use studies and the changing face of American families. This year she gave a lively summation of her great book, Marriage: A history, putting modern marriage into a larger context. Next year’s theme will be “The science of relationships,” and I hope there’s a way to bring her into that, too. The woman could make the history of the paper bag engaging.

* The last plenary speaker, John Witte Jr., was not quite as advertised, but started great dinner-table conversation. He had promised a speech on “Marriage, Religion, and the Law,” which could have been wonderful — a more conservative counterpoint to the arguments others made in favor of same-sex marriage. Ultimately, he barely mentioned religion at all. Which was too bad — as I’ve argued before, there is a reasonable debate to be had about the role of religion in marriage (and specifically whether religious therapists should refer out same-sex couples they do not feel they can work with supportively). I really, really wish someone could put together a respectful dialogue on the topic. But for what it turned out to be, Witte’s speech was valuable. His proposals for legal-system remedies to the changes in family formation and dissolution in the US were far-fetched, but started some great conversations. We all want parents to be responsible for their choices, but how do you have a legal system that best balances supporting families in need with punishing those who are irresponsible? I loved the variety of ideas about that just at my own dinner table; I’m sure similar discussions were happening at plenty of others.

* We’re making great strides in the effective treatment of military veterans and their families. MFTs are ideally trained to help keep military marriages and relationships strong (or to end them more peacefully when necessary), and there was a whole track at the conference dedicated to just this kind of work. The timing could not have been better: finally, after years of struggle with the implementation process, the Department of Veterans affairs has a job description specifically for marriage and family therapists.

It’s always refreshing to renew old connections and make new ones at the conference, and I especially enjoyed the opportunity to present with some of my faculty colleagues from the Alliant MFT program. My heartfelt thanks to everyone who made the conference such a success. I can’t wait for next year!

From the AAMFT Research Conference: Does marriage education work?

by

Marriage education (also known as relationship enhancement or RE) has gotten a big, warm spotlight lately. A recent big-deal writeup in the Washington Post hit on the high points: Marriage education programs are big business, they have a lot of federal money supporting them, and there’s not a lot of research on them. Do they work?

That was the basic question tackled yesterday by Howard Markman at the AAMFT Research Conference in Alexandria, VA. In general, it looks like the research base for such programs is growing but still fairly small relative to the number of RE programs in existence. Markman and his colleagues located 30 studies examining 21 different programs since 2002 — meaning that a large number of programs offered at the annual SmartMarriages conference have not been researched at all. The research that does exist is usually promising, but not definitive: programs are generally shown to produce short-term improvements in couple satisfaction and communication skills. However, there have not been studies addressing whether these programs actually do what they set out to do, reducing the risk that couples will eventually divorce over the long term.

The federal government has been running a huge study that should be able to offer clearer answers. Involving eight sites and more than 5,000 couples around the country, the Building Strong Families (BSF) project sponsored by the Administration for Children and Families is testing voluntary RE programs offered to unmarried couples who are expecting or recently had a baby. The project just released its 15-month follow-up data, and the news is not good:

When results are averaged across all programs, RE did not make couples more likely to stay together or get married. In addition, it did not improve couples’ relationship quality.

As Markman was quick to note, the news was not all bleak. It would be more accurate to say that couples didn’t finish the programs than it would be to say that the programs didn’t work; with the exception of the project’s Oklahoma site (which performed much better than other sites in a variety of ways), only 9% of couples completed at least 80% of the relationship enhancement curriculum offered to them. That’s a big problem. Where couples did tend to finish their program — at the Oklahoma site — they were more likely to still be together at the 15-month follow-up, and experienced a number of other measurable improvements as well. Furthermore, only the Oklahoma site used a program that included most of PREP, one of the best-known and more well-researched relationship enhancement programs around. Other sites used less established curricula.

The study will be releasing its 3-year follow-up data in 2012. As Markman noted, the 15-month followup may simply be too early to see the hoped-for impact on marriage that these programs would offer; by definition, preventing marriage breakup is a long-term goal. It is possible that changes will emerge over time. Until they do, however, RE programs will continue to face skepticism. Which is good, if it drives more research that will develop programs that really do ultimately meet their preventive goals.

From DC: Update on MFT inclusion in Medicare and school programs

by

I’m at the AAMFT Leadership Conference in Washington, DC, where Division leaders from across the country have spent the last three days visiting our federal representatives. Priorities this year include Medicare inclusion and adding MFTs as named providers within the Elementary and Secondary Education Act (otherwise known as No Child Left Behind). Before I go to the details on the visits, some words of praise: this was the first time that AAMFT’s California Division and CAMFT, an independent organization of California MFTs, have combined efforts on their federal advocacy visits, and it went swimmingly. CAMFT’s lobbyist and leaders were kind, cooperative and helpful throughout, and I hope their experience of AAMFT was similar. Legislators and their staff people seemed impressed with the level of cooperation. As to the key issues, here is where we currently stand:

Medicare. As we were starting our second day of hill visits to California representatives on Thursday, we were greeted with bad news: the inclusion of MFTs as providers under Medicare, which had been part of the House health care reform package but not the Senate package, was pulled out of the reconciliation bill that will be voted on as early as next week. There is a slim chance that MFT inclusion in Medicare could still be accomplished this year through a different piece of legislation, but at this point that appears unlikely. On a more positive note, though, there remains significant bipartisan support in both chambers for adding MFTs in Medicare, as it would improve access to mental health care for seniors and those with disabilities. For a video of Senator John Barrasso (R – Wyoming) discussing the importance of this issue, click here.

School programs. MFTs can provide services to school populations under the Elementary and Secondary Education Act (ESEA), but because we are under the somewhat vague category of “other providers,” most programs do not seek to include MFTs when they apply for federal grant funding under ESEA. Adding MFTs as specifically named providers would improve the availability of behavioral health services for children. It also comes at no cost, which is helpful in seeking bipartisan support. Currently, these changes are in a House bill (HR1710) that has sponsors from both parties. I always enjoy the Leadership Conference for the trips to the Hill as well as the opportunities to connect with divisions from around the country. I’ll have another update from the conference in the next few days.

California LPCC law passes; should MFTs dually license?

by

Late in the evening of October 11, Governor Schwarzenegger signed California Senate Bill 788, adding Licensed Professional Clinical Counselors (LPCCs) to the state’s masters-level mental health professions, alongside MFTs and LCSWs. Licensure by grandparenting will take place over a six-month period in 2011, with routine licensure starting January 1, 2012. Should MFTs dually license?

For most, there would be no benefit, and significant added expense. Since licensure is inherently a state-based activity, there is no reason to believe that licensing as an LPCC will make one’s license more portable; in fact, a license obtained through grandparenting may have greater trouble getting recognized in another state. Add to that the still-unclear question of whether California will recognize national exams in counseling (national exams in MFT and Clinical Social Work are not recognized in the state), and the likelihood of a portability benefit grows even slimmer. The added expense of two renewal fees could be little more than wasted money.

There is, however, a legitimate reason why some MFTs may want to dually license: They want to reflect what their professional orientation has been all along. California was the first state in the US to license MFTs, and the last in the country to license LPCCs. As a result, some who work under the MFT license do so because that was the masters-level entry point into a career in mental health, and not because they particularly identify with systemic concepts. For those therapists, the Clinical Counselor license is probably a better fit.

They will not, however, want to switch over entirely. Counselors will enter the mental health marketplace in California more than four decades after MFTs did, and will need to fight for themselves every battle MFTs waged and won for recognition in hiring and reimbursement. They’ll be able to make up ground, but it will be many years before counselors can claim the kind of recognition and stature in the state that MFTs claim today, thanks to decades of good work by CAMFT and AAMFT.