The AAMFT Blog

Statement on Immigration Policy

In light of the recent executive order in the United States regarding immigration policy, AAMFT reiterates its global commitment to inclusivity, diversity, and a fundamental belief in the power of relationships upon which our passionate profession is built. Our profession has a longstanding and rich history of influence by immigrant marriage and family therapists and the ideas generated by MFTs throughout all areas of the world. With a membership that spans the globe, many of whom work with clients or have loved ones affected by these policies, we recognize that they may be impacted by the uncertainty around this rapidly evolving situation.  Just as our members honor their commitments to help their clients navigate life’s challenges and triumphs, AAMFT is equally dedicated to holding true to the position that we assert the value and positive impact of stable, long-term, emotionally enriching relationships. We believe that society is better off when social groupings are created that allow for and support these qualities – not creates fragmentation and segmentation.

Tracy Todd

CEO - AAMFT

Marriage and Family Therapy ranks as #51 on Best Jobs List

US News & World Report released their annual 100 Best Jobs report, ranking marriage and family at #51 overall and #2 in social services jobs. As the profession continues to expand, AAMFT will continue to provide MFTs with state and federal advocacy, research, advanced clinical training, resources, and a community of passionate therapists! 

In all seriousness, marriage and family therapists are sane, compassionate professionals who help people resolve conflicts as well as manage and overcome mental and emotional disorders. They see couples and families, of course, but increasingly, these therapists also treat individuals. As the stigma that was once associated with therapy vanishes, more people are seeking professional assistance in managing their mental and emotional problems. This field is also expected to see growth as insurance companies refer more clients to marriage and family therapists rather than psychiatrists or psychologists. Marriage and family therapy tends to be the more cost-effective option. By 2024, the Bureau of Labor Statistics predicts this occupation will grow by 15 percent, which is faster than the average for all occupations.

Read the full report on marriage and family therapy here, with contributions from Clinical Fellow Robert Salinger. 

Find a COAMFTE accredited school to pursue a degree in Marriage and Family Therapy

Find MFT Employment

 

Tennessee Division Defends AAMFT Code of Ethics

AAMFT's Tennessee Division defended the Code of Ethics in a recent Knoxville News Sentinel op-ed. This op-ed was in response to recent legislation introduced in the TN Legislature that would prohibit the MFT licensure board from referencing any national code of ethics, including AAMFT's Code of Ethics. 

Thank you to Richard Gillespie for writing this piece (excerpted below) and the TNAMFT Legislative Committee for being engaged in the advocacy essential to defense and advocacy of the profession. Though all members may not have their op-eds published, joining the Family TEAM is the best way to participate in advocacy. Please join today to stay informed on the public policy decisions of 2017 that will impact marriage and family therapy!

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State Sen. Jack Johnson has recently introduced SBO1, which would have the state Board of Licensed Professional Counselors and Marriage and Family Therapists replace our respective profession’s code of ethics with one written by the state board. Johnson incorrectly states that this gives the national counseling profession power to decide who is licensed as a counselor in Tennessee. What a code of ethics from a national counseling organization really does is to set the best possible practice rules for that profession. It protects consumers, makes for quality assurance in counseling services and assures a high standard of practice across Tennessee and the country.

Johnson’s comments make the American Counseling Association sound like a foreign, outside power trying to dictate to counselors and their clients in Tennessee, which is not true. Dr. Randall Phillips, a good friend and therapist, reminded me of something very important. It was and is Tennessee counselors and therapists who want the clinically best ethical services for those we serve. It was Tennessee counselors and marriage and family therapists who pressed to have high standards adopted. Continue reading »

Is Your Notice of Privacy Practices up to Date?

The HIPAA Privacy Rule (45 CFR Parts 160-164) requires that HIPAA covered entities provide clients information detailing how their protected health information* will be used or disclosed.  This is done through the familiar HIPAA Notice of Privacy Practices (NPP), which outlines client rights and the legal duties of the HIPAA covered entity.  The practitioner may not use or disclose protected health information in a manner that is inconsistent with the NPP.  HIPAA privacy rules have evolved, due to the Health Information Technology for Economic and Clinical Health Act, with changes solidified with the Omnibus Final Rules issued in January 2013.  These material changes brought about by the final rule require changes to the NPP.  While this occurred some time ago, in the midst of busy practices, therapists can have difficulty staying abreast of all regulatory changes, so changes that must be reflected in the NPP are reviewed herein.

Changes include the following additions to the NPP: 

• A statement that clients have a right to receive notification if their PHI is breached (viewed, used or disclosed inappropriately),
• A statement must be included that states that any uses or disclosures of PHI not described in the NPP require written authorization by the individual,
• A statement that individuals must be notified that they have the right to restrict certain disclosures of their PHI to their health plan if they pay out of pocket for a service or services, if that disclosure is only for carrying out payment or healthcare operations.
• A statement indicating that the following uses and disclosures require a separate written authorization:
  • Uses and disclosures for marketing purposes,
  • Disclosures that constitute sale of PHI, and
  • For most uses and disclosures of psychotherapy notes.
  • Any uses or disclosures not listed in the NPP
• If your practice engages in fundraising activities, a statement that the client has the right to opt-out of such communications.

The good news is that you do not need to re-distribute the notice to each client, but you can instead post it conspicuously in your waiting room, and it should be posted to your website.  If clients ask, you must have the updated notice available upon request.  New clients should receive the updated notice, and be asked to sign the concomitant acknowledgement of their receipt of the NPP.  While you must make a “good faith effort” to obtain acknowledgement of receipt of the NPP, clients are not required to sign the acknowledgement of receipt in order to receive services. Therapists should document their attempts to gain the acknowledgement signature. Because therapists can treat clients without a signed acknowledgement, the NPP is best kept as a separate document from your informed consent for treatment. NPPs may be emailed to the client should they request it.  

As therapists concerned with client confidentiality, there are a couple of things to remember regarding the NPP.  First, any stricter state law must be integrated into the NPP (45 CFR §164.520(b)(1)(ii)(C)).  This can be confusing for both the client and the therapist.  The Department of Health and Human Services notes that within the NPP, readers could be referred to a separate section of the NPP which details more stringent state privacy laws (U.S. Department of Health and Human Services, 2003).  This would allow for an easier update to your NPP in the event state law changes.  Thus, when there are material changes in state law affecting client privacy, the NPP must be updated to reflect those changes. It is an ethical imperative to accurately inform your clients of their privacy rights, in light of our professional ethical code, as well as state and federal laws. Be sure to note the effective date on your NPP, and keep old NPPs for a period of six years.   HIPAA requires that you retain documentation for “6 years from the date of its creation or the date when it last was in effect, whichever is later.” (45 CFR § 164.316(b)(2)(i)). 

You must also have a named privacy officer with whom clients can file a complaint should they believe their privacy rights have been violated.  This person’s name and contact information must be provided in the NPP.   For solo practices, this can be the solo practitioner.  For larger practices, one person must be named as the privacy officer and is tasked with making sure the practice is complying with the HIPAA privacy regulations.  A security officer must also be named, and may also be the same person as the privacy officer, though need not be.  You may opt to give clients the contact information for them to be able to complain to the Office for Civil Rights, but you are not required to do so. 

In summary, check your NPP to be certain you have the updated version, and be sure it can be made available to new clients, and to established clients should they ask for it.

The Department of Health and Human Services provides model notice of privacy practices in several formats that are user-friendly and using plain language (which is a requirement).  You can access updated model NPPs at http://www.hhs.gov/hipaa/for-professionals/privacy/guidance/model-notices-privacy-practices/index.html . Don’t forget that you must integrate stricter state law into your NPP. 

*Protected health information is “Individually identifiable health information, including demographic data, that relates to: 1) the individual’s past, present or future physical or mental health or condition, 2) the provision of health care to the individual, or 3) the past, present, or future payment for the provision of health care to the individual, and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual” (45 C.F.R. §160.103). 

References

HIPAA, Public Law 104-191, 45 CFR §160.103

HIPAA, Public Law 104-191, 45 CFR § 164.316

HIPAA, Public Law 104-191, 45 CFR §164.520

U.S. Department of Health and Human Services.  Frequently asked questions.  Retrieved from http://www.hhs.gov/hipaa/for-professionals/faq/464/must-a-covered-entity-with-a-notice-revise-the-notice-every-time-it-changes/index.html

Lorna Hecker, PhD, LMFT, CHPS has authored the book HIPAA Demystified:  HIPAA Compliance for Mental Health Professionals (2016).  She is a professor in the MFT program at Purdue University Northwest, and director of educational services at Carosh Compliance Solutions in Crown Point, Indiana.  She is an AAMFT Clinical Fellow and Approved Supervisor, and is certified in healthcare privacy and security through the American Health Information Management Association.