On being the therapist in your family

Nicole De Khors / Burst / Used under licenseIf you didn’t know this about me, I’m a white woman. Most psychotherapists are white women. (See the demographics of psychologists as an example.) When I sat down to write about how families respond when a family member starts down the road to becoming a therapist, I knew that culture and family background would have a lot to do with it. So instead of just focusing on my own experience, I decided to also interview some of my colleagues, to see what it was like being the therapist in their families. The differences surprised me.

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Mental health groups respond to Trump military transgender ban

VoA / Public domainYesterday, President Donald Trump announced a ban on people who identify as transgender serving in the US military. US mental health professional associations swiftly challenged the ban. The associations cite research supporting the inclusion of transgender men and women. For example, a 2016 RAND Corporation study showed that inclusion of transgender servicemembers would have little to no impact on costs or combat readiness.

The major US mental health associations issued the following statements in regard to the ban.

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Proposed new MFT accreditation standards eliminate vague religious exemption

If adopted, the draft COAMFTE standards would require all programs to teach LGBTQ-affirmative practices.

W-classroomThe public comment period closes Wednesday on the draft version of new accreditation standards for graduate programs in marriage and family therapy. The Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) is proposing some major changes from current standards:

  • The draft standards would restore the 500-client-contact-hour requirement for practicum. Under the current, version 11.0 standards, programs can require fewer hours as long as they have evidence to show that their practicum results in students being competent to practice at the master’s level. This vague standard has left different accredited programs using different experience requirements, which can be confusing to state licensing boards who want to know how much practical experience they can reasonably expect to be included in graduate degrees.

  • The draft standards separate accreditation requirements into “eligibility standards” and “accreditation standards.” As it is now, the Commission makes its decisions based on the full scope of information presented to them. Programs that meet most but not all standards may still be granted accreditation, with stipulations — requirements that the program comes into full compliance with the standards within a year. This proposed split into eligibility and accreditation standards arguably makes the accreditation bar a bit higher: Programs that fail to meet even one of the eligibility standards would not be eligible for accreditation, regardless of their performance on the other standards.

  • The draft standards would go back to a singular, mandatory core curriculum for all accredited programs. Of course, programs would remain free to add on to this core curriculum as they see fit, but all accredited programs would be required to have the same core set of coursework.

  • Perhaps what is most notable in the draft standards is what is missing: The draft standards remove COAMFTE’s current vague, blanket exemption for religious programs. The exemption, present in the current COAMFTE standards (p. 3), says

    Religiously affiliated institutions that have core beliefs directed toward conduct within their communities are entitled to protect those beliefs.

    It has never been clear to me what that is supposed to mean in practice, but the way I read it, any religious-based program that wants COAMFTE accreditation but isn’t in tune with any part of the standards was free to ignore that part of the standards, as long as they could tie their objection to their religious beliefs. Under the proposed new standards, not only would that clause go away, but the required curriculum would include at least three semester units on

    diversity, power, privilege and oppression as they relate to race, age, gender, ethnicity, sexual orientation, gender identity, socioeconomic status, disability, health status, religious and spiritual practices, nation of origin or other relevant social categories throughout the curriculum. It includes practice with diverse, international, multicultural, marginalized, and/or underserved communities, including LGTBQ affirmative practices. [emphasis in original]

    It is much clearer what the new standards would mean: Every COAMFTE-accredited program would need to teach its students how to work with LGBTQ clients in a positive, affirming way, and an appreciation for the harm such clients suffer from living in a heterosexist society.

To me, these are all good and necessary changes. First, as to the hours and curriculum changes: I hear chatter among MFTs around the country that licensing boards haven’t known what to do with the current COAMFTE standards. Those current standards are so flexible that licensing boards don’t necessarily know what they’re getting when someone comes to them with a COAMFTE-accredited degree. The draft standards, if adopted, would bring back greater consistency in content across programs and could restore state boards’ confidence in maintaining COAMFTE accreditation as the standard educational requirement for licensure.

Second, as to the removal of the religious exception: I’ve written previously about the struggles some religious therapists face when trying to work with LGBT clients, and the debate there is far from settled. But accredited programs can and should teach affirmative practices. The debate here should be restricted to how a therapist balances their values with client needs in the therapy room, not about whether the therapist can be exempted from exposure to affirmative techniques or to the suffering LGBTQ clients genuinely experience.

There’s only one thing COAMFTE didn’t included that I wish they would: Require MFT programs to be more transparent about cost.

COAMFTE will be reviewing comments on the proposed changes this fall. If adopted, the new standards would likely take effect in 2014 for new accreditations and be phased in for those programs already accredited.

MFT student alleges racial discrimination kept her from degree

A former MFT student at Southern Mississippi has sued the university, claiming their discrimination made it impossible for her to complete her practicum hours.

JudgesTools IconAccording to a report in Monday’s Hattiesburg American, former MFT student Maria Salcido has sued the University of Southern Mississippi over alleged racial discrimination. Salcido, who is Hispanic, alleges that she was told by faculty that she needed to secure a practicum working with Hispanic clients, and that the program then failed to find her such a placement. Salcido left the program in 2009 and moved to Wisconsin, though it is unclear from the newspaper report whether she left the program voluntarily or was kicked out.

Salcido appears to have completed all the rest of her academic coursework; the report indicates that both sides agree she only needs to complete the practicum to complete her masters degree. Salcido is seeking compensation, punitive damages, and the opportunity to finish her degree.

The newspaper attempted to reach the university’s lawyer for a response, but had not been successful as of Monday. According to a response the university filed in court, the university and its employees consistently acted legally and properly within their professional roles, and Salcido’s claims of racial discrimination are not accurate.

The case is currently at the District Court level as Salcido v Southern Mississippi et al. I’ll be keeping an eye out for more information as the case progresses.

Update: Salcido’s case was dismissed.

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