technology

Four reasons to move your practice online

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USMC videoconferencing familyAs I’ve outlined in the past two weeks, there is a lot we know and a lot we don’t know about online therapy. If you’re considering moving part or all of your practice online, there are a lot of things to consider. Do you have the appropriate technology, and are you comfortable using it? Do you have policies and practices ready for online work? Have you ensured that your online work will be fully legally and ethically compliant, and consistent with best practices like those outlined in the new AAMFT Online Therapy Best Practices guide? Are your clients appropriate for online therapy?

Many therapists wrestle with the choice of whether to practice online. While these are not determining factors — in other words, I’m not saying your final decision should be to practice online, as there’s more to consider than what’s below — here are four good reasons to consider making the move.

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Online MFT programs

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Are you interested in getting your marriage and family therapy degree through an online program? Here are five MFT programs that are mostly or fully online.                                                                                                                                                                                                                                                                                                            

Computer and screenOnline education holds the promise of extending the reach of marriage and family therapy training. Champions of these programs argue that they make advanced education available to those who otherwise might not have access to it, due to scheduling, geographic, or other barriers. It is possible that the growth of online MFT programs will particularly help bring cultural diversity and rural practitioners into our community of licensees.

Of course, there are also general concerns about online education, including dropout rates, profit motives (as many online schools are for-profit), and overall effectiveness.

In the MFT field, online education seems to be an especially challenging proposition: We need to train practitioners in the art and science of relating, face-to-face, in a way that will heal clients and their family relationships. That is a skill set, and one that would seem to require a fair amount of face-to-face interaction to be best developed, shaped, and observed.

Online graduate programs in MFT are experimenting with a number of creative ways to resolve this dilemma — and also keep themselves eligible for COAMFTE accreditation. COAMFTE has tried to walk a difficult middle ground in its educational standards, saying that MFT programs can employ some distance education but not be fully online; since “fully” means “fully,” it would seem a program could get around the letter of this requirement simply by requiring a one-hour meeting on campus at some point during the educational process. But many of the online MFT programs appear to be genuinely interested in maximizing the potential benefits of online education alongside a recognition of the need for in-person work to develop relational skills. As such, many have integrated in-person events and coursework into their online curricula.

Below you will find a list of five MFT programs that are mostly or fully online. Some things to know about all of these programs: 1, As of early December 2012, none of them have yet earned COAMFTE accreditation. (Here’s why COAMFTE accreditation matters to you.) That is only one consideration in choosing the right MFT program, but it is worth considering. [Update 2013: Northcentral is now COAMFTE-accredited.] 2, The information here is drawn from the universities’ web sites. Information can change quickly. 3, Any cost statements do not include books, supplies, living expenses, or the cost of travel or lodging for any required in-person events. 4, It is always the responsibility of the student to ensure their academic program will meet the requirements for licensure in the state where they wish to be licensed; check with your state’s licensing board before choosing a program and remain up-to-date as state requirements change. 5, States typically require hours of supervised experience in a clinic setting as part of the graduate degree; the schools also have this requirement, and offer varying levels of assistance in locating placements. 6, And of course, requirements and costs can change quickly; the information here is as of December 2012, and you should check with the schools for current information.

  • Touro University Worldwide is based in Woodland Hills, CA and has been rapidly growing their Master of Arts in Marriage and Family Therapy program. Part of this is due to cost; at $500 per unit, Touro’s program is less expensive than some of their competitors. Their 60-semester-unit program is delivered in eight-week terms (six of them per year). This program is fully online.

  • Northcentral University is widely considered a pioneer in online MFT education. Members of their faculty have spoken at past AAMFT Annual Conferences about their efforts to comply with COAMFTE standards [Update 2013: Northcentral is now COAMFTE-accredited]; it looks to me like they do so by utilizing site supervisors as co-instructors with university mentors for the practicum courses, which would then be considered in-person instruction. The Northcentral MA in MFT program is a 45-semester-unit program that can be bumped to 48 or 60 units for those living in states requiring more units for licensure. They also offer a PhD in MFT that requires an additional 72 semester units.

  • Capella University offers a Master of Science degree in Marriage and Family Counseling/Therapy. They have quickly grown this program to national prominence and notably earned CACREP accreditation. To their credit, they list cost information plainly and prominently on their site: Their 92-quarter-unit degree, at $458 per credit, will run about $40,000 in total tuition. The program requires two six-day colloquia in to accompany the online instruction. Like many online schools, Capella is for-profit, which may or may not matter to you. (I’ll do a separate post in the next few months on non-profit versus for-profit schools.)

  • Liberty University promises an affordable online MFT masters degree with a Christian perspective. They advertise themselves as the nation’s largest private, nonprofit online university. Their MFT program requires four one-week intensives to accompany the online instruction. Unfortunately, the information on their web site is surprisingly thin — I could not locate a program plan (curriculum) or specific cost information anywhere on their site.

  • Cal Southern University offers a Marriage and Family Therapy concentration within its Master of Arts in Psychology program. This 63-semester-unit program is entirely online.

There are other online programs out there as well, I’m sure. Feel free to share info on them in the comments, and I’ll update this post every once in a while with more recent additions.

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Your comments are welcomed; you can email me at ben[at]bencaldwell[dot]com, post a comment below, or find me on Twitter @bcmft. I regret that I cannot answer every comment personally, but I do chime in on the comments when I can!

Teen texting study an example of a researcher misleading the media

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A new study connects the texting habits of teenagers with drug use and other risky behavior. Contrary to media reports, the study did not show texting to cause the teens’ risk-taking.

Teenagers who send more than 120 text messages a day are more likely than their peers to engage in a variety of risky behaviors, including sexual activity, smoking, drinking, and drug use. That much we can agree on. It was the key finding of a Case Western Reserve University School of Medicine study presented this week.

Media coverage was predictably breathless:

But there is a big problem with each of the stories linked above. As compelling as these stories are, texting did not cause poor health or risky behaviors in this study. More precisely, the study did not show a cause-effect relationship. It found correlations — associations between certain behaviors that tend to rise and fall together. It did not say what causes what.

If we know that one behavior (texting, in this case) is more common among people who also do another behavior (let’s use drinking), then we can say the two behaviors are correlated. But that leaves at least three very different possibilities when it comes to cause and effect:

  1. Texting causes drinking.
  2. Drinking causes texting.
  3. Some other thing (lack of parental supervision, maybe?) causes both drinking and texting.

A correlational study (like this one) does not tell us which of those three possibilities is most likely (the third strikes me as by far the most plausible). And reporters understand that conclusions about correlation are not especially enticing news stories. “This one thing is related to this other thing, but we do not really know what causes either one of them” makes for a lousy article.

So reporters sometimes go beyond what a study actually shows, and pull a cause-effect relationship out of thin air. In essence, they pick their favorite out of the three possibilities listed above, and run with it. They do this in spite of a complete lack of data supporting their conclusion over the other cause-effect possibilities.

That seems to be what happened here. What is unusual in this case is the degree to which the study’s lead author actively promoted the made-up conclusion.

Even though the press release about the teen-texting study largely uses the right terms in describing the results (labeling behaviors as being “associated with” each other), Scott Frank, the lead author of the study, was remarkably cavalier in determining a cause-effect relationship his study did not demonstrate. He is quoted in that same press release as saying

“When left unchecked, texting and other widely popular methods of staying connected can have dangerous health effects on teenagers.”

The medical school where the study was conducted is also encouraging this unsupported conclusion. The link to this study from the Case Western School of Medicine home page currently reads “Hyper-texting and Hyper-Networking Pose New Health Risks for Teens.”

Frank’s promotion of a conclusion his own data does not support prompted an unusually direct rebuke from John Grohol, the CEO of PsychCentral, whose own site had reported on the study earlier. Grohol wrote that Frank’s conclusions about texting having negative health effects are (emphasis Grohol’s)

all pure crap. You could just as easily write the following headlines:

Teens Who Smoke, Drink Also Text a Lot
Outgoing Teens Like to Do Things Outgoing Teens Like to Do
Teens Who Enjoy Sex Like to Text Too!

Scott Frank, MD, MS should be ashamed of himself.

I’m with Grohol on this. For Frank to say that texting can have negative health effects is, as Grohol put it, “sloppy at best, and unethical at worst.” Frank is promoting a conclusion his study simply does not support. And some media outlets appear to be all too happy to run a story confirming parents’ worst fears about teenagers and technology, even when the story and the data do not match.

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In deference to my journalist friends, it must be noted that the examples of poor media coverage above are far outweighed, in both quantity and quality, by the many stories covering this study that ignored Frank’s quotes and reported his results accurately. Search “teenagers texting drinking” on Google’s news site and you will find far more headlines using phrases like “linked to” or “associated with” than you will find “causes.” Kudos to those writers (of both the stories and the headlines, since they are often not the same person) who understand the difference.