Recapping the 2010 AAMFT Annual Conference

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!

Great new books on modern marriage and divorce

Quick, true or false: Half or more of the couples getting married this year will eventually divorce. We hear that statistic over and over and over again. It’s wrong. The divorce rate has been in significant decline since the 1970s. By the tenth year of marriage, by which time we know that more than half of those who will ever divorce have already done so, only 16% of college-educated women who married in the 1990s had divorced. That represents a drop of almost a third since the 1970s; 23% of college-educated women married in that decade had divorced by the tenth year of marriage. (The trend runs parallel for those without a college education, whose divorce rates are consistently just a few points higher.)

Marriage is changing in the US — and in many ways for the better. The divorce rate is definitely declining. Young people are putting off marriage, for a variety of reasons (some of which are likely economic). And therapists’ knowledge of how to strengthen weak marriages grows stronger by the day. This research, on marriage itself as well as how to improve it, is the focus of Tara Parker-Pope’s excellent For Better. Parker-Pope, who writes the Well blog for the New York Times, condenses current family-studies and family-therapy data into a well-paced, eminently readable and optimistic portrait of modern American marriage. Simply put, the book is fascinating. Parker-Pope is certainly a gifted writer; she is able to accurately communicate the finer points of research with a light touch, never coming across as wonky or technical. She also includes a number of self-tests researchers have designed to assess marriages, which makes the book even more valuable on a therapist’s shelf.

For those couples who do divorce, they should know that modern divorce is changing, too. When Americans divorce, they are more likely than people anywhere else to remarry, and they tend to do so more quickly. Even those who do not marry are more likely to bounce from one relationship to another in the US, forming the framework for Andrew Cherlin’s book, The Marriage-Go-Round. Cherlin makes a compelling case that the US is different from the rest of the world in how we think about marriage and divorce. Even better, he offers a compelling explanation, rooted in our nation’s social and religious history. It too is a great read. (It also can be occasionally frustrating; Cherlin briefly dissects the half-of-all-marriages-end-in-divorce myth early in the book, only to repeatedly reinforce it later. Parker-Pope does a much more detailed job of demolishing that myth.)

Ultimately the two books are both worthwhile on their own, but they are even better in combination. For therapists wanting a comprehensive and digestible understanding of the choices Americans make in marriage, divorce and the spaces in between — and how we can improve those choices — read them both.

From the AAMFT Research Conference: Does marriage education work?

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.

CAMFT steps forward on same-sex marriage

At its board meeting in Sedona, AZ over the weekend, the California Association of Marriage and Family Therapists (CAMFT, not affiliated with AAMFT or its California Division) voted to support marriage equality for same-sex couples. This is a significant step forward for an association that had spent months struggling with the issue.

As a quick recap, CAMFT has been mired in controversy following their unwillingness to make any kind of statement about same-sex marriage or parenting. They made matters worse with a broad anti-discrimination statement that, while fine on its own, failed to address any of the relevant issues members had been asking CAMFT to address. Then they made matters worse again with the publication of several hateful and homophobic articles on the topic. Executive Director Mary Riemersma and the CAMFT Board both eventually apologized for the articles, and the California Therapists for Marriage Equality organized to try to push CAMFT toward a more socially and scientifically responsible stance.

Angela Kahn, who serves on the board of the Los Angeles chapter of CAMFT, reportedly gave an impassioned presentation to the statewide board in Sedona, systematically dismantling every possible reason for CAMFT’s continued silence on the issue. The board then voted 9-1 to endorse marriage equality.

Pending their permission, I’ll post the full text of the statement here.

I’m elated that CAMFT is be moving in the right direction, finally, on same-sex marriage. I am hopeful that the positive movement and responsiveness CAMFT is showing on same-sex marriage will extend to other areas as well.

CAMFT director apologies for articles opposing same-sex marriage

In a message on the organization’s web site, CAMFT Executive Director Mary Riemersma has apologized for the association’s publication of several articles opposing same-sex marriage. The apology is sincere, but the bigger issue remains: CAMFT is alone in the mental health world in its refusal to seriously address same-sex marriage.

As background, CAMFT (the California Association of Marriage and Family Therapists, which is has no affiliation with AAMFT or its California Division) has been harshly and rightly criticized by members, educational institutions, and in the media for their failure to make any kind of comment on same-sex marriage. Every other major mental health organization (APA | American Psychiatric Association | NASW | AAMFT) has taken a stand on the issue, and it is especially relevant to marriage and family therapists. The CAMFT board response has been underwhelming in the face of such criticism, issuing only a broad non-discrimination statement (members only) that sidestepped the important questions entirely.

In order to look like they were doing something on the issue without actually doing anything about it, CAMFT chose to publish a variety of articles supporting and opposing same-sex marriage in the May/June 2009 issue of its magazine, The Therapist. The sections were accompanied by a clear statement that while the articles presented a variety of viewpoints, the organization was not endorsing any of them.

The “pro” articles in the magazine were largely culled from scientific journals, as the science around the issue is quite clear. The origin of the “con” articles is unclear. Whatever their origin, their logic was horrible, and their arguments ranged from the potentially-worth-discussing to the blatantly homophobic and inflammatory.

Executive Director Mary Riemersma has now apologized for the publication of the “con” articles, and the entire issue of the magazine has been removed from their web site. (The next logical question, “Why were the ‘pro’ articles removed too, when there wasn’t a problem with them?” actually is answered in CAMFT’s non-stance on the issue. Leaving up the “pro” articles while taking down the “con” would appear to be endorsing the pro-same-sex-marriage point of view. As long as CAMFT is refusing to take a position, they were obligated to take down both sides.) The apology, which appears on the organization’s web site but is restricted to members, reads:

I am sorry that the objectionable articles appeared in the prior issue of The Therapist and that many found them offensive. I too found them distasteful and did not think they were credible. We were trying to create a balance of views and there was a paucity of articles submitted opposing marriage equality. If I had it to do over, we would have rejected the articles. Our ethics for the profession do not condone homophobia, I do not tolerate homophobia, and neither does the CAMFT Board. Let me know what we can do to overcome the unintended harm that some believe we have caused.

It’s not an outstanding apology, as apologies go (the phrase “these articles were homophobic,” or anything to that effect, is conspicuously absent, and “some believe” is a little grating), but it’s about as far as Riemersma can go. She’s responsible for the operations of the magazine, but the board determines CAMFT policies. And by staying silent on such an important issue, the CAMFT board wades father out of the mental health mainstream by the day, and harms the reputation of the profession of marriage and family therapy around the country.

Who will apologize for that?

Update: Apparently — and to their great credit — CAMFT will.