The President's Column below, written by AAMFT President Timothy Dwyer, is excerpted from the May/June 2019 issue of AAMFT's Family Therapy Magazine. Eligible members of AAMFT can cast their votes in the current election at this link through 5:00 p.m eastern on August 15, 2019.
Someone asked me earlier this year, “What is the theme of your presidency going to be—or is it too early to know?” I appreciated the question, as I’d been thinking about that quite a lot. In a word, the theme for my term as president is
inclusivity. This theme does not begin on my watch, though I am happy and excited to advance it. This time last year, I had the privilege to serve as chair of the Diversity and Inclusivity Steering Committee. The charge of our committee was to operationally define diversity and inclusivity relative to AAMFT corporate expectations; identify existing barriers to meeting diversity and inclusion expectations in AAMFT governance units, and; to make specific board recommendations and steps to effectively eliminate barriers to diversity and inclusivity within AAMFT governance structures. The good work of that committee reflects a vital commitment to intentionally advance a more inclusive culture of belonging at all levels within AAMFT. The board and staff aim to create systems of inclusivity as both an ethical imperative and as association best practices.
I used to take a special pride in the very selective nature of AAMFT membership and her history. It felt inherently special to have graduated from a COAMFTE-accredited program and earned the keys to membership. I saw our association as the only one holding the banner and carrying the torch for systemic clinical practice. I was socialized to see marriage and family therapy as distinct and special, with a professional identity differentiated from other paths in the mental health field. Of course, I still see it that way, but through a more evolved and inclusive lens. Yes, I am proud to be a licensed marriage and family therapist. I value the special theoretical knowledge, clinical skill, supervised experience and training it took to achieve that title. I have always prized the rigorous path of my training, but I appreciate there are many ways in which to get there.
I became a Clinical Member (now Fellow) of AAMFT at the point of graduation from Purdue University’s doctoral program. It was a “one-two punch” as I was eligible for licensure at the same time. I worked my way up the ladder from student—skipping the Associate Member level—to Clinical Member. The first time I heard about clinical membership was long before we had licensure in very many of the states. It was a path of professional destiny for me. I was committed to the movement to advance recognition of the profession, lobbying for certification while in graduate school, and later to win licensure in my home state. I remember the caution members voiced about the grandfathering period for other licensed mental health providers (social work, counseling, psychology), and the concern about qualifications, standards, and the so-called dilution of the field if we let everyone in who wanted to become a licensed marriage and family therapist. We soon discovered however that the tent got bigger and more vibrant in the professional community, and those with systemic inclinations include more than MFTs.
I must admit my necessary humbling along the way. Equifinality informs us that in open systems there are many ways to arrive at a desired state. While we have heroically championed, codified, and advanced the clinical standards for marriage and family therapy, we did not create the big idea of systemic family therapy. It took many thinkers, scholars, clinicians and the committed systemic practice of many leaders over decades to do that. I’m not sure how we can continue that growth and advance the field by holding parochially to a narrow gate for the top tier of membership.
Reading the Nichols (1992) history of our association, it is easy to see that from our inception, we were unapologetically exclusive and elitist. From the beginning, there were intense rigorous debates about who should be eligible to become members. There were a variety of litmus tests to make sure that qualified applicants were systemically and professionally worthy of membership. Members needed to have the right subject base and theoretical pedigree. Applicants needed to provide clinical demonstration of their work, be recommended, submit to the standards of specified content areas, specific clinical experiences and supervision requirements, etc. And if this sounds familiar, well it’s because we still operate with many of these standards, which of course remain strongly held and highly prized.
The rich developmental history of our association illustrates that the innovators and leaders of our field emanated from disparate paths of training and inquiry, yet they banded together to form an organization that embodied that most fundamental of systemic truths. We are a more than a sum of our parts. Those historic tensions in our association relating to how distinct, exclusive, and special we are no doubt helped to launch us as a field and a profession. But as a professional organization with a mission to protect and advance the profession and practice of marriage and family therapy, those old tensions and barriers are impediments to meaning and relevance and more importantly carry historic inequities which need acknowledgement. Barriers to membership will not help us evolve and remain vital in the field. The current membership categories are confusing and exclusionary. Those hurdles to a sense of full belonging and access don’t serve an increasingly nimble, diverse, global, and inclusive association.
From a position of equity, how might we lift the barriers to membership for highly qualified systemic professionals, and not exclude them simply because they arrived on a different track in their training? I’m certain we all know highly qualified clinicians who practice with stellar systemic ability but who hold a license other than MFT. Some members may hold tightly to the paradigm of our uniqueness and ask how can AAMFT become inclusive without abandoning her standards? I might reframe the question as, how do our current member categories hinder us from advancing those standards and competencies more broadly and inclusively to the wider field?
In the upcoming election cycle, there is a ballot proposal to modify the bylaws and simplify the membership categories. The current membership system with its six (6) distinct categories is not only confusing, but clearly privileges the license and the geographic boundaries of the U.S. This poses an exclusive and geocentric system for which the unintended consequence is it limits those highly qualified applicants who can be “full members.” While Groucho Marx might assert he would not join a club that would have him as a member, most of us would not join an association if we couldn’t enjoy the benefits of full and equal membership or could acknowledge that our organization endures such obvious exclusion in admission. Our current membership system poses distinct barriers to those from other clinical training programs, other geographic areas, and prohibits them from striving for our most prized designation: Approved Supervisor. The new bylaws propose two (2) categories: Professional and Student. It also offers equitable and reachable aspirational goals for those who wish to develop and advance their unique systemic family therapy skills: Approved Supervisor (AS) and a new Clinical Fellow (CF) designation.
The key difference in the newly conceived designations is that any AAMFT member can pursue attainment—regardless of degree—as neither the AS nor CF designation will be tethered to license title. The effect of this bylaw change is greater equity and inclusion in AAMFT. It will level the member playing field. Some may argue that it jeopardizes the license and accredited programs. However, it still affords those electing to train in premiere COAMFTE-accredited programs and pursue the license as a marriage and family therapist a clear, bright path to those highly respected and meaningful designations.
I wanted to title this column “The big tent is still big, again.” For me, that first part acknowledges our historic roots, while signaling an emerging and renewed openness. We can certainly argue how big that tent was back in the days before licensing and regulation. But the origins of our association drew together a wide variety of systemically-minded individuals who helped champion a relational paradigm for understanding couple and family development and health, and new ways to understand and address the problems of living. That big tent attracted individuals from a broad spectrum of clinical training origins—medicine, social work, nursing, psychology, ministry or pastoral care, and others from diverse areas of study who steered their epistemological leanings to emerging systemic clinical lenses. In the early days, our membership was small but ever growing—expanding from 700 to 7,000 members between 1969-1979, and then doubling from 9,000 in 1982 to 18,000 by 1992 (Nichols, 1992). Today, our membership hovers around 25,000, but has not changed substantially in the past two decades. The structural impediments of our current member categories impose severe limits on further penetration. The imminent retirement bubble guarantees significant member loss in the very near future. While I could strenuously stake my position for change on the case of equity and inclusion, there are other compelling trends that argue in favor of your support of the bylaws vote, as well.
Please join me and the Board of Directors in our unanimous support of the bylaws revision for a more vital, vibrant and inclusive AAMFT. Thank you.
Timothy F. Dwyer, PhD
Nichols, W. C. (1992). The AAMFT: Fifty years of marriage and family therapy. Alexandria, VA: AAMFT.