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Read Part 1 of this series: Clinical Competencies for Family Therapists Working in Healthcare Settings
In 2013, a team of field leaders in Medical Family Therapy came together to develop competencies for family therapists working in healthcare settings. They initiated these efforts in response to the increasing number of therapists being sought-out for and placed within such settings, alongside a recognition that clear guidelines regarding knowledge, skills, and abilities for effective engagement in such placements were not yet available. Over the next four years, this team worked across small- and large- group formats to identify key domain areas, associated skillsets, and target indicators relevant to this work. For a thorough description of the steps encompassed in this effort, see American Association for Marriage and Family Therapy (AAMFT; 2018). The following is a summary of core competencies related to scholarship for family therapists in healthcare settings
A marked strength of Marriage/Couple and Family Therapy (M/CFT) programs, particularly among those that are accredited by the Commission on Accreditation for Marriage and Family Therapy (COAMFTE), is the rigor placed on clinical training. Without question, M/CFTs are well prepared to engage in relational screenings and interventions. What is greatly needed, building upon this, is a stronger skillset in scholarship for those at the master’s level and beyond. This becomes even more essential when considering collaboration with healthcare teams and in diverse healthcare contexts. This skill will also make family therapists more competitive for jobs, as the current hiring climate in health care continues to evolve. Behavioral health providers, in addition to providing clinical services, administrative duties, and perhaps supervision/teaching, may be asked to design evaluations, analyze findings, and present on or publish the outcomes from program development and process improvement studies. These types of studies are vital to successfully initiating, growing, and sustaining behavioral health services in a healthcare setting.
M/CFTs conventionally take a class during their master’s program that affords an opportunity to learn about commonly used statistics and/or research methods. However, having competencies in scholarship pertaining to family therapy in healthcare settings is what really makes the clinician a desirable team member. Those who have competencies in scholarship as a family therapist in healthcare have learned to navigate research that honors: (a) systems, (b) biological, psychological, social, and spiritual foci, (c) interdisciplinary collaboration, (d) leadership, (e) ethics, and (f) diversity. This erudition spans across scholars who contribute to the fields of family therapy, medical family therapy, and other healthcare disciplines – and the patient/family/community populations that they study.
Those who were influential in constructing these competencies believe that family therapists who work in healthcare contexts can transcend the roles that have historically bound them. As scholars who are savvy in these competencies, well-trained family therapists are able to effectively contribute to diverse research teams, with an ability to publish in a variety of healthcare journals (mental health, biomedical care, healthcare administration and policy, etc.). This opportunity strengthens the reputation of family therapists in our own field, and beyond our typical readership.
Scholarship Competencies related to General Systems
What is true in the broader family therapy research is also true in the relational facets of healthcare research; family therapists must be at the forefront on studies pertaining to the study of relational health.The door stands open for dyadic, triadic, and familial research (target indicator 1.4a; AAMFT, 2018) in relation to experiences with illness, loss, trauma, and wellness. Thus, family therapists should advocate for research that includes the voice of caregivers, siblings, partners, and providers on the health outcomes of participants.
Scholarship Competencies related to Biopsychosocial-spiritual (BPSS) Systems
Any therapist who works in a healthcare context ought to be a competent consumer of both mental and physical care literature in order to best support the families and teams within their practice setting. For some, the role as a researcher may have a prominent presence in the therapist’s life, including competencies in designing and conducting evaluations or research studies that include BPSS dimensions into interventions and protocols (target indicator 2.4b; AAMFT, 2018). Therapists can strengthen their competency by identifying ways to maximize BPSS data through big data analytics, clinical trials, and dissemination and implementation studies.
Scholarship Competencies related to Collaboration
Likely an easier competency for family therapists to engage in is collaboration within their own research/scholarship endeavors. However, what may sometimes cause a therapist to pause is the hierarchy within medical systems and the perception that their skills are “less-than” compared to other providers. An important element of any interdisciplinary collaboration on clinical, financial, and/or financial outcomes (target indicator 3.4b; AAMFT, 2018) is to have team members who are willing to serve as both experts and learners. Everyone on a team has something to contribute, and this mosaic of different strengths translates into a whole that is more than the sum of its respective parts.
Scholarship Competencies related to Leadership
A skill that requires even more attention among family therapists in healthcare settings is learning how to “serve as a leader in writing, submitting, and implementing grants or contracts on BPSS and relational health and health care” (Knowledge/Abilities/Personal Characteristics 4.4c; AAMFT, 2018). While grant writing may seem like a daunting or intimidating task, many foundations across any state, nation, or providence levels exist that support clinical research aimed at reducing health disparities, increasing best practices, improving healthcare employee productivity, and maximizing value of care services. Both modest- and large- grant sponsors support the systemic and BPSS lenses put forth in proposals led by family therapists.
Scholarship Competencies related to Ethics
Competencies for family therapists in healthcare settings align with the ethics of scholarship that are grounded in AAMFT’s Code of Ethics (2015); these include an awareness of ethics from other disciplines. This understanding is particularly important in healthcare research and grant writing, as the scholar may be accountable to multiple institutional review boards and layers of privacy and protocol requirements. The ethics of family therapy scholars in healthcare contexts must attend to participants, engaging with collaborators, and the role(s) of researchers within the system and/or community. Above all, the researcher must maintain an awareness for the role of sustainability for a program or grant initiated in the healthcare context.
Scholarship Competencies related to Diversity
An area of publishing, presenting, and grant writing that family therapists in healthcare settings must stay especially attuned to is cultural sensitivity, cultural humility, and the ethical implementation of research studies with vulnerable populations and minority groups (target indicators 6.4b and 6.4c; AAMFT, 2018). Upholding these competencies is essential, not just as scholars, but also as professionals whose ethical practice is grounded in interventions that are indicated for a specified family, community, or larger system.
The competencies for scholarship among family therapists working in healthcare settings cut across systems-, biopsychosocial/spiritual-, collaboration-, leadership-, ethics-, and diversity-domains. Crossing primary (e.g., family medicine, pediatrics), secondary (e.g., OBGYN, emergency medicine), tertiary (e.g., hospice care, alcohol and drug treatment), and other scholarly environments (e.g., research institutes, federal organizations), these skillsets are essential for strengthening our contributions in both family therapy and other healthcare literature, research, and scholarly productivity.
American Association for Marriage and Family Therapy (2018). Competencies for family therapists working in healthcare care settings. Retrieved from www.aamft.org/healthcare
American Association for Marriage and Family Therapy (2015). Code of ethics. Retrieved from https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx
Angela Lamson, Ph.D., LMFT
Tai J. Mendenhall, Ph.D., LMFT
Jennifer L. Hodgson, Ph.D., LMFT
Lisa Tyndall, Ph.D., LMFT
Stephanie Trudeau, Ph.D.