education

How hard is it to become an MFT? I’d like to hear your story.

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It’s expensive and takes a long time, but job prospects are good. Is that enough?

Hurdles (Scenes from a Track Meet)While the job outlook remains good for MFTs — one of the reasons family therapy continues to be rated among the top careers to go into — the barriers to entry are high and getting higher. Graduate school tuition costs are rising (and it’s often hard to get accurate information about graduate tuition); pre-licensed, post-degree therapists (called “associates” in some states and “interns” in others) typically work under supervision for several years, often for little to no money, even though some unpaid MFT internships may be illegal; and these days in California, even after you finish your supervised experience you have to wait seven months or more for the licensing board to get around to your application to take the exams.

Is it all worth it?

I would say yes, but then, of course I would say yes. I’ve made, dare I say, a relatively good and stable career of being an MFT, and it is work that I love. At the same time, the environment when I came into the profession was different than it is today, and I was lucky in many ways. I got my bachelor’s degree without student loan debt, for example, which is today the exception and not the rule. California’s MFT curriculum requirements were not as tough then as they are now, requiring many to spend more time in school and pay more in tuition. (I’ve never needed to take a second job outside of the therapy world to pay the rent.) And when I applied to take the licensing exams, I didn’t have to twiddle my thumbs for another half-year waiting. So I only know my own experience, and I’m not in a good place to speak to how it is for new therapists. That’s where you come in.

In today’s environment, is it worth it to go through the struggle to become a family therapist? I was inspired to ask by a pair of articles making the rounds online: One arguing that Generation Y is made up of whiners with entitlement issues, and a counterpoint arguing that GenY is drowning in debt and poor prospects for improving their lives. Both are good articles. And Generation Y is made up of those born between roughly the late 1970s and the mid 1990s — so if you are in graduate school now, there’s a good chance you are part of that generation.

I would love to hear your stories of the struggles and rewards of becoming an MFT. If you’re new to the field and a part of Generation Y, what joys and struggles have you experienced so far, and what are your future expectations for success, salary, and happiness? If you’re an MFT veteran who is not part of that generation, how would you advise the GenYers coming into the field today? Post in the comments below or by email to me at ben[at]bencaldwell[dot]com.

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Bear in mind that by sharing your story, you’re granting permission for me to use it, with your name and with some editing if needed, here on the blog. I might also use it in other projects (as one example, I might forward it to AAMFT-CA for consideration in their work), with proper attribution of course. Thanks!

Proposed new MFT accreditation standards eliminate vague religious exemption

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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.

Want to know how much that MFT degree will cost? Good luck

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Many family therapy programs make it surprisingly difficult to plan for your graduate education budget.                                                                                                                                                                                                                                                                                                            

US Currency; public domain imageIn my research for California Family Therapy Program Rankings, where I offer a roundup of information and rankings on 34 of California’s biggest marriage and family therapy (MFT) graduate programs, I was determined to get readers the most objective information on cost possible. The amount of money students invest in their graduate degrees is significant, and sometimes has to be a factor in choosing programs.

I figured gathering this information wouldn’t be easy, necessarily, but that most programs would publish some way of estimating total tuition cost on their web sites. For example, I might have to multiply a per-unit tuition cost, usually given on one page of a university’s site, with the total number of units in the MFT program, which typically would be on a separate page.

If only it were that simple.

Whether by accident or by design, MFT programs in California are often less than fully transparent in letting prospective students know how much they can expect to pay for their graduate degrees.

Consider San Diego State University as an example. Theirs is a very well-regarded, COAMFTE-accredited program. They’re probably pretty inexpensive, as master’s programs go, since they’re a state school. They even advertise themselves as the most affordable MFT program in San Diego, and I suspect that’s probably true. But if you want to know how much the program actually costs, you’re out of luck. The university web site provides tuition costs for a nine-month academic year ($8,032 for California residents, if you’re wondering), which puts SDSU right in line with the other state schools. But as the program web site notes, two summers are also needed to complete their two-year program, and if you want to know how much those cost, you have to start by fishing your way here, to a 2013 summer tuition document that tells you the cost of summer tuition depends on how many units you take. And how many summer units are required for the MFT program?

I never could find that.

The information just isn’t there, or at the very least, it isn’t easy to locate. Do those two summers add up to six units, or more like 20? At up to $644 per unit in the summer, that’s a pretty big blank space in a prospective student’s budget. I know universities need to put all kinds of cautionary notes on their program plans — classes may be full, scheduling and tuition are subject to change, and on and on — but how hard would it be to tell prospective students how the program is designed, such that they can reasonably estimate how much the whole thing will cost?

My point here isn’t to single out SDSU. Again, theirs is a good program; no matter how much their summers cost, SDSU’s program will still be cheaper than private institutions; and they are hardly the only school to make cost information on their MFT program opaque. (Several programs even provide a sort of illusion of transparency in tuition cost, openly stating how much they charge per semester or per year, but not saying how many of those it takes an average student to finish the program. A $15,000-per-year program designed to be completed in two years looks a lot less attractive — and a lot less affordable — if it turns out that it takes most students four years to actually complete it.) Of the 34 programs I reviewed for the book, there were several where it was not possible to even estimate the total tuition cost of the program based on information available on the program’s web site.

My point instead is this: Prospective MFT students need more and simpler disclosure of graduate program costs. And that means more than just stating tuition and fees, especially for programs that charge by semester or by quarter: it means providing clear estimates of how long the program will take to complete. Ideally those estimates would come with graduation data to back them up; join me if you will in gasping at Phoenix’s abysmal 10% completion rate 30 months after enrollment, but at least they publish it.

Perhaps programs are concerned that making cost information too front-and-center will lead to the same kind of race to the bottom we have seen in airline fares, where consumers’ cost-driven decision-making has led to declining service, crowded planes, airline bankruptcies, and even more opaque pricing. If so, I don’t think we’re giving prospective MFT students enough credit. They’re choosing where to get years of education that will set the stage for their whole careers, not a two-hour bus-ride-in-the-sky to Toledo. Let’s give them the information they need to budget wisely, and trust that they know cost is only one of many factors to consider when choosing a graduate MFT program.

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Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.

Why cultural competence matters in MFT – and how to build yours

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Mental health professionals need to understand a variety of cultures (and, ideally, languages) to assess and diagnose properly.                                                                                                                                                                                                                                                                                                            

Globe image [public domain] via Wikimedia CommonsIf you are a mental health professional (or are in the process of becoming one), developing cultural competence will help ensure that you don’t mistakenly diagnose a culturally-appropriate behavior as some kind of mental illness. It will enable you to recognize the difference between a client who is ashamed and one who was simply taught to avoid eye contact. And most importantly, it will enable you to provide treatment within a client’s cultural context without imposing your own values, either intentionally or by mistake.

Cultural competence — that is, the ability to provide effective services to people from a wide variety of cultural backgrounds — gets built in a variety of ways. It is important to understand traditions and practices across a wide range of cultural groups, and you can’t possibly go to every single one of the places your clients will be from. In short, whether you ever travel or not, you need to internationalize your thinking.

But to really develop your cultural competence, you need to experience different cultures, both within and outside of your local area. To this end, many universities are ramping up their offerings (and their requirements) when it comes to truly experiencing the diversity of our world.

I teach in the Couple and Family Therapy Programs at Alliant International University in Los Angeles. To be sure, we are in one of the most diverse cities in the nation. Our student body reflects that, with students from a wide range of cultural, national, religious, and other traits that allow them to learn a great deal from one another when they share a classroom. Many of the benefits of study abroad can be achieved in classrooms just like ours. But a classroom is a controlled environment, and Alliant’s mission centers largely on both multiculturalism and internationalism, so we offer much more than just the classroom experience. We also offer cultural immersion experiences for our students in Mexico City, China, and India; we also have had students and faculty take part in a past Cambodia immersion.

The students who take advantage of these opportunities describe them as much more than professional development. They often describe them as life-changing.

Naturally, it is tough for faculty to teach from a fully-informed perspective if they have not travelled themselves. The need for cultural immersion is not limited to students, nor is it limited to a certain phase of one’s career. Times change and cultures change, and as professionals we need to stay in contact with these changes to best serve the clients with whom we work. In the past several years, I’ve been to Mexico City, Hong Kong, Costa Rica, and Europe, and many in our Alliant faculty have their own long list of recent travels. (As a group, we rack up a lot of frequent-flyer miles.) I can happily say that on each trip, I’ve learned far more about the local cultures than I ever could have understood from a book.

If you’re considering a career working in mental health, and are interested in developing your international and multicultural competence, I would strongly encourage you to check out Alliant’s programs. We have programs in six cities around California and in Mexico City, Tokyo, and Hong Kong. And many programs — including mine — are still accepting applications for this fall.

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Your comments are welcomed. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.

Eastern Michigan settles Julea Ward case

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The university settled in December and will pay Ward $75,000, according to AnnArbor.com.

JudgesTools IconJulea Ward’s lawsuit against her graduate program in counseling at Eastern Michigan University took several interesting turns last year. The case started when Ward refused to counsel a gay client as part of her training; the university determined this was discrimination, and expelled Ward from the program. She sued, claiming she was being singled out for her religious beliefs. I’ve previously discussed the case here and here.

Ward’s case is often discussed in the same breath as Jennifer Keeton’s. Keeton sued Augusta State University, where she had been a graduate student in counseling, after the university expelled her for clearly stating her refusal to counsel gay and lesbian clients and her unwillingness to complete a university-mandated remediation plan.

While Keeton lost her case, Ward appeared to at least have some chance of winning hers. In a footnote within his ruling in favor of Augusta State University in the Keeton case, United States District Judge J. Randal Hall made it clear that the two cases had similar themes but very different specifics (citations removed, and paragraph breaks and emphasis added, for clarity):

This case is distinguishable. In Ward, the plaintiff, a student enrolled in Eastern Michigan University’s graduate counseling program, asked to refer a gay client during her practicum course because she claimed that her faith prevented her from affirming a client’s same-sex relationships. No remediation plan was issued; instead, the plaintiff was promptly dismissed from the program following a formal review. […] The plaintiff in Ward was disciplined after she asked to refer a client, but evidence showed that the university may not have had a policy prohibiting such referrals; indeed, there was evidence that referrals had been permitted for others in the past. […] The Sixth Circuit held that a juror could find that the plaintiff was dismissed because of her religious views.

This case presents a stark contrast: Keeton was cited by faculty for statements which evinced an intent to clearly violate program policies, i.e., according to the remediation plan, faculty believed that Keeton had expressed an interest in conversion therapy. Moreover, Keeton later stated definitively, and without mention of referral, that she would not withhold open judgment of a client’s sexual choices in a counseling session, action also in violation of program policies. One final set of facts serves to
distinguish the two cases – Keeton was not, like the plaintiff in Ward, summarily dismissed. Instead, she was subjected to a remediation plan, the details and import of which was painstakingly explained by faculty members through meetings, written plans, emails, and face-to-face discussions. […]

In sum, the patience and measure exhibited by faculty members during the course of Keeton’s protracted remediation proceedings, coupled with the nature and content of their efforts to ensure that Keeton understood how her actions violated professional ethics and could harm future clients, mark this case as different from Ward.

Eastern Michigan, apparently seeing the writing on the wall, chose to settle with Ward and has agreed to pay her $75,000. Notably, the university is neither admitting any wrongdoing nor changing any of its policies as a result of the ruling, according to AnnArbor.com. In the meantime, Michigan’s legislature debated the “Julea Ward Freedom of Conscience Act” — which would have allowed graduate students in mental health to refuse to treat gay and lesbian clients if providing treatment would conflict with the student’s religious beliefs.

I’ve written about that and a similar “conscience clause” bill that did become law in Arizona. A similar bill has now been proposed in Tennessee, which I’ll tackle in a separate post.

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Your comments are welcomed in the comments section below, by email at ben[at]bencaldwell[dot]com, or in the conversation on my Twitter feed.