The AAMFT Blog

AAMFT20: MFTs Changing the World + Special Announcement!

In a year filled with unprecedented challenges, MFTs have been an integral part of our society’s coping and healing efforts. From facing a global pandemic to the call for correcting systemic oppression, racism, and injustice, our members have been on the front lines of the pain being felt by others. And we know this hasn’t been easy for you.

In the face of these huge challenges, there have also been incredible moments for our profession. Many of our members have shifted their entire way of working, seemingly overnight, while continuing to deliver vital care – both to their clients and their families. In the midst of COVID-19 lockdowns, over 6,000 MFTs from around the world came together to share in our At Home series focused on how we can continue to impact change. Members also worked swiftly to re-imagine and author two issues of the Family Therapy magazine to focus on the pandemic and the struggle with racial injustice. In the U.S., through vigilant efforts, our MFTs in Medicare bill recently passed through committee and should later be heard by the full U.S. House of Representatives for the first time since 2009. We also continue to make incredible gains with the VA, including the passage by both the U.S. Senate and a House committee of Veterans mental health legislation.

There is so much being done to discuss, so much that we need to learn from one another in these times. And yet, one of our greatest opportunities to do this, together in-person at our Annual Conference, is another loss in a year that feels filled with unfulfilled and cancelled plans. However, I am confident that our re-imagined virtual Annual Conference, AAMFT20: MFTs Changing the World, (November 12 – 13) will deliver in so many ways.

And as a thank you to all who have worked so hard this year, AAMFT20 will be FREE to ALL current AAMFT members*.

That’s right – all you have to do is register and show up and you can share in this re-imagined experience! Highlights include:

• Keynote presentations by former Rep. Patrick Kennedy, one of the leading voices in mental health advocacy today, and a panel of MFT experts discussing the State of Systemic Family Therapy and the World.
• Breakout sessions that focus on a variety of clinical topics from couples to trauma and highlight key issues facing MFTs and their clients including anxiety, alcohol and drug misuse and abuse, systemic oppression, and more.
• An interview series highlighting MFTs doing good in our world with their work creating impactful change.
• Topic oriented tracks hosted by AAMFT’s Topical Interest Networks.
• Favorite events from our in-person conference, such as our Spotlight reception, re-imagined in a virtual space.

Each day offers space in the schedule to connect with your fellow participants, exhibitors, and presenters. Join together with your peers and colleagues from around the world as we discuss the clinical and societal impacts in our first ever virtual AAMFT Annual Conference.

Non-members registration rate is $150. Non-members who are students can contact us to receive a discounted rate. Interested in attending for free and enjoying all of the other great benefits of AAMFT membership? Sign up today to join AAMFT.

Review the schedule and register today at aamft.org/conference. And I will see you in November!

Tracy Todd, PhD

CEO, AAMFT

*Membership must be current as of November 10, 2020.

 

Thank you to our sponsors!

                   

Updated: U.S. House of Representatives Unanimously Passes S.785

UPDATE:

On October 17, President Donald Trump signed into law S. 785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019. This legislation includes many important suicide prevention measures, as well as provisions that will assist MFTs hoping to practice in clinics and other facilities operated by the VA. Read more about it here. 

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On September 23, The U.S. House of Representatives unanimously passed S. 785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act of 2019. This legislation ensures that more veterans will be connected to critical mental health care and combat veteran suicide. The bill passed the Senate on August 8, after which it was sent to the House. This legislation will be presented to President Trump for signature in the near future. AAMFT is excited at the progress of this important legislation.

Along with improving suicide prevention and crisis resources for veterans, this legislation will have several direct benefits to MFTs hoping to practice in clinics and other facilities operated by the Department of Veterans Affairs (VA). The provisions pertaining to MFTs include the following:

• Requiring the VA to work with the Office of Personnel Management to develop a separate occupational series for MFTs, which would greatly facilitate the hiring of MFTs as federal employees.
• A study to review the staffing levels of MFTs and mental health counselors (MHCs) within the VA, including a description of any impediments to the hiring of MFTs and MHCs within the VA, a strategy for addressing those impediments, and a description of actions taken by the VA to ensure that the national, regional, and local professional standards boards for MFT and MHCs are comprised of only MFTs and MHCs.

• The creation of a Readjustment Counseling Service Scholarship Program that would allow MFT students, as well as other students in other mental health disciplines, to receive scholarships from the VA if they agree to be employed in a Vet Center for several years. 
• The development of a staffing plan by the VA to address staffing shortages of mental health providers, including MFTs, as well as the steps the VA will take to address these shortages.

AAMFT has been working for many years to improve the hiring of MFTs within the VA.  Although MFTs have been recognized and hired as eligible providers since 2010, barriers have hindered many MFTs from becoming hired as VA employees.  Counselors, who were also first recognized as eligible VA providers in 2010, are experiencing similar problems. AAMFT has been working with the American Mental Health Counselors Association (AMHCA) to address these problems. AAMFT and AMHCA also advocated for similar legislation that was introduced in the House of Representatives.

This legislation, S. 785, is considered one of the most significant mental healthcare and suicide prevention bills pertaining to Veterans that Congress has ever approved. The Senate Committee on Veterans’ Affairs Chairman Jerry Moran, along with other ranking members of the Senate shared their excitement about the passing of S. 785 in the House. Chairman Moran stated, “Every day we lose 20 veterans to suicide and this pandemic has further worsened mental health conditions and resulted in more veterans being isolated from friends and family… Passing this legislation to serve veterans was our top priority this Congress, and I look forward to the president quickly signing the Commander John Scott Hannon Veterans Mental Health Care Improvement Act into law.”

AAMFT is grateful for the passing of these bills in the Senate and the House, and look forward to the signing into law of this historical legislation.  

AAMFT Signs Letter to Senate Supporting S. 4349

AAMFT has signed on to a letter sent to the U.S. Senate, written by the Mental Health Liaison Group, showing support for the Dr. Lorna Breen Health Care Provider Protection Act (S. 4349). This bill is aimed at reducing and preventing suicide and mental and behavioral health conditions among health care professionals. We know that “burn out” is all too real, and hope that moving this bill forward will help fulfill the needs and safety of Marriage and Family Therapists, along with the many other mental health professionals in the country. The letter can be found here, as well as the bill, should you wish to learn more.   

The Value of Between-Session Contact

This content is provided by SimplePractice, an affinity partner of AAMFT. This information is not necessarily the views of AAMFT and should not be interpreted as official policy. To view the original post, visit SimplePractice's website. 

Caring is a central component to your work, which is why it can be easy to assume clients already know you care about them. However, evidence suggests it’s the unexpected communication between clinician and client—outside of routine weekly contact—that can actually strengthen the therapeutic relationship. 

This may be especially true during unusual circumstances, such as the current upheaval of everyday life caused by the coronavirus pandemic. Out-of-session contact with clients shows that they’re in your thoughts even if they may be out of your sight.

Why There’s a Need for Balanced Connection

The existing research exploring this topic suggests that occasional, irregular contact outside of normal sessions can improve therapy in a meaningful way. 

For example, a 2012 study showed that therapeutic alliance was strengthened by a single phone call between sessions, where the therapist encourages their client to take a proactive role in treatment. 

Studies that analyze more frequent text-message support have shown mixed results. This 2014 study showed that clients who received routine text-messages as an accompaniment to therapy actually attended therapy sessions less often, though the key word there might be “routine.” A 2017 study that examined text messaging as a support to cognitive-behavioral therapy showed that clients receiving the texts stayed in therapy longer. 

The Right Way to Make Client Contact

While many therapists contact clients outside of sessions for billing and scheduling issues, it’s less common to reach out and ask about a client’s wellbeing unless they’re worried about a possible crisis.

In some cases, this is a question of time—a full caseload may leave little time for additional contacts. In other cases, it’s a billing issue—therapists typically can’t bill for a quick message, so they don’t do it. 

Unscheduled contact has the power to strengthen the therapeutic alliance even if they’re brief. These types of communication may even improve treatment outcomes. 

There are many different ways to reach out. It may be as simple as sending a message saying, “I know times are tough right now, and I hope you’re doing well.” If you want to keep communication directly linked to sessions, you might say “I hope [specific task planned in the last session] was a success” or “I hope [something learned or accomplished in therapy] remains helpful.” 

Of course, emailing and texting should be done with client permission to address security responsibilities. Secure Messaging may be a better option for some practices. Regardless of the method of contact, communication between sessions, in both directions, is something to discuss during the initial informed consent process. That way clients have a sense of what to expect and you know what they prefer.

Why Unexpected Communication Works Despite Concerns

Some therapists understandably express concern about boundaries, fearing that by initiating communication with clients outside of session, they may open a door to clinical exchanges outside of the therapy room they don’t necessarily want opened. 

These concerns are valid. While most clients don’t use communication outside of sessions to test boundaries, some do, and you need to be prepared to hold boundaries well.

Equally true is that these types of contact may not help much if a clinician’s standard operating procedure is largely automated. Automating your work can be a powerful way to facilitate administrative tasks, but it should never occur at the expense of human connection. 

How to Find the Appropriate Cadence

Between-session contact with clients seems to make the biggest impact when they’re unusual, perhaps because they’re unusual. Even though this approach can be perceived as an annoyance—or worse—an invasion of client privacy, occasionally reaching out with intention and purpose has shown to be preferential.

As all of us continue to adapt to the changes brought on by COVID-19, some therapists and clients have moved to Telehealth while others are reducing or suspending contact. If you have clients whose therapy routine has changed this year, it may be worth sending a quick message of support.

You can remind them that you’re thinking of them, show that you understand the stressors they’re facing, and share your availability if they need your support in these next few weeks.

The lesson here? An occasional message of support outside of the therapy routine can strengthen the therapeutic bond. If nothing else, it shows the client in a very clear way that they don’t leave your thoughts when they—or you—leave your office.

Back to School in 2020

As summer comes to an end, parents everywhere are beginning a school year like no other. Our modern-day world is up against a pandemic that has parents, teachers, and administrators on edge about how to educate children best while also protecting everyone from COVID-19. Preparing for this school year has been anxiety-provoking for everyone as the nation struggles to find a cohesive narrative around fact and fiction.

Back to school is a time-honored tradition for many—another milestone on the developmental trajectory of life and a much-needed structure for families. It is experienced in many different ways. For many children, school is an escape from a less than desirable home life. Some single parents may depend on school for a variety of functions. At the same time, the school allows working parents the space to focus on providing for their families. Whatever the situation, the 2020-2021 school year brings a host of challenges to parents, guardians, and caregivers of school-age children.

The ripple effect of this pandemic presents us with tough choices. The decision-making process for those negotiating the best thing for their family comes with pandemic anxiety. If infected, children are likely to be asymptomatic or suffer mild symptoms, even as some studies indicate that children may carry greater amounts of virus in their noses and throats. The older adults in their life are at a much higher risk of becoming seriously ill. Depending on the ages and health concerns of a school-age child's family members, the consequences could be fatal.

With so many considerations, there is no one size fits all solution. Each family has a different situation to think about when it comes to sending kids back to school. Preschool and early elementary age children have different needs than middle school and high schoolers. And for those whose children require extra care due to unique physical or neurological challenges, school is a necessary resource that many are unable to outsource privately.

Back to school, 2020 looks different depending on where you live. Some of the proposed solutions to going back to school include in-person, hybrid, remote, and pod-style learning. Depending on the situation – private or public education – parent's choices are limited. In the month leading up to school starting, many families have been deciding between a hybrid of in-school and remote learning – as a seemingly perfect compromise to everyone's concerns. For some, this model has held and is currently in place; for others, remote learning is the only option for now.

With so much to digest, what approaches can one take?  There are things parents can do to manage their anxiety and help ease the transition for everyone. Depending on your situation – remote, hybrid, or in-school learning – parents and caregivers will benefit from the following ideas:

1. Develop Routines for Your Family: In any other situation, it is helpful to have a routine. Most of us thrive when we know what to expect. Pandemic times, with all of their uncertainty, has shifted their balance. Back to school is an opportunity to reclaim a new routine. Treat back-to-school (whatever your situation) as if it were a regular school day. During the school week, kids should wake up at a set time and go to bed at a reasonable time. Parents can adjust this accordingly based on the ages and specific needs of their child.

For example, in remote learning situations, it is helpful and empowering to make sure your child is: 

• Waking up at a set time, getting dressed, and eating breakfast
• Working in an appropriate space (as much as your home allows for), free of distractions
• Prepared by having learning materials ready (Chromebook, books, notebooks, pencils sharpened. etc.)

A similar routine applies to hybrid or in-person learning situations. Your child's new school routine can help facilitate a structure to support your needs as a parent.

2. Set Realistic Expectations: Finding the balance between work and school is challenging at the best of times. It requires flexibility and a willingness to make adjustments. COVID-19 challenges our balance in a new way. Be patient with yourself. Things will look different than they have in the past. It is okay to make room for uncertainty. We are all adapting to a "new normal." When you feel stress levels rising, it helps check in with your expectations and adjust accordingly.

3. Lead from Acceptance: 2020 has been a year of shifts and uncertainty. We are grieving the loss of our life as it was when we could move more freely, be with our friends and family, travel for work or pleasure, and buy groceries without standing in line and wearing a mask. And our kids could go to school without much worry. Some days we are in denial, while others may be angry, depressed, or bargaining. Whatever the stage of grief, it helps to lead from acceptance. Be in the moment that is available to you. Being mindful of the present moment helps ease anxiety and allows us to be present for ourselves and our children. It is a practice to be present, so when things feel overwhelming, try starting with acceptance.

4.Engage in Self-Care: For parents of school-age children, it is wise to engage in self-care routines that include – sleep, regular exercise, good nutrition, hydrations, a healthy media diet. With so much anxiety around helping our kids transition to a new learning environment, it can be easy to forget our own needs. Carving out time to take care of your mental and physical health is so important. Prioritizing self-care is preventative medicine, and it will serve you well as you navigate the school year with your family.

5.Seek Professional Help: With Telehealth readily available, don't hesitate to reach out to a professional for additional support. Talking to a third party with expertise provides another layer of support that can ease your concerns and validate the challenges of navigating life in a pandemic.

MFT Virtual Hangouts: Connect with Peers

Virtual hangouts are available for AAMFT members to connect and check in to discuss coping and adaptation to COVID-19. This month’s hangouts will center around back to school, reopening for in-person client sessions, and practicing telehealth. Hangouts are intended to be an informal discussion time for members to share, check in, and support each other.

Space is limited to 10 participants to encourage familiarity and interaction. Hosted by Vanessa Bradden, LMFT. Click on a session to RSVP:

• Friday, September 18 from 3:00 – 4:00 PM Eastern
• Tuesday, September 22 from 1:00 – 2:00 PM Eastern
• Friday, September 25 from 12:00 – 1:00 PM Eastern
• Tuesday, September 29 from 1:00 – 2:00 PM Eastern

We encourage members to visit the Events Calendar to see a full list of all upcoming events, including hangouts and Interest Network events. 

MFTs in Medicare Bill Passes House Committee!

On Wednesday, September 9^th, the House Energy and Commerce Committee voted to move the Mental Health Access Improvement Act (HR 945), as amended, to the floor of the House of Representatives! This bill, which passed without any opposition, is expected to be considered by the full House soon. See a summary of the Energy and Commerce Committee’s work in passing HR 945 and the other 25 healthcare bills.

This vote is a very significant development. It is the first committee vote on the MFTs in Medicare legislation since 2009, when the MFTs in Medicare language was included in an earlier version of the Affordable Care Act.

AAMFT would like to thank Representatives Mike Thompson (D-CA) and John Katko (R-NY) for sponsoring H.R. 945 and fighting for inclusion of H.R 945 as one of the bills considered by the committee this week. Additionally, we want to thank Energy and Commerce Health Subcommittee Chairwoman Anna Eshoo (D-CA) who spoke so eloquently in support of this bill at the markup session. Finally, we would like to thank the 120 Members of Congress who have cosponsored H.R. 945, as well as the members of the House Energy and Commerce Committee who voted, without any opposition, to move this legislation to the full House for consideration.

The House Energy and Commerce Committee formally passed an amended version of H.R. 945.  Almost all bills are amended at some point by committees. This amendment, which was agreed upon by the committee, makes a few changes to H.R. 945 as it was introduced. The amendment limits the ability of MFTs and MHCs to receive direct reimbursement for providing services to Medicare beneficiaries in hospice programs, as well as the authorization to develop discharge plans for post-hospital services. However, the other provisions remain in the bill, including the recognition of MFTs and MHCs as Medicare Part B providers, which is the provision that would benefit most members. If H.R. 945 becomes law, the Centers for Medicare and Medicaid Services (CMS) will have approximately two years to implement this legislation. The amendment does require a study, due by 2026, pertaining to the impact of this legislation.    

AAMFT would like to thank all Family TEAM members, other AAMFT members, and their allies and friends who have submitted grassroots messages to Members of Congress in support of the MFTs in Medicare legislations. These messages have led to Members of Congress supporting this important legislation.   

The next step is a vote by the full House of Representatives. If you have not already contacted your Members of Congress to support HR 945 and the companion bill in the Senate, S. 286, please do so through this link.

Health Subcommittee Chairwoman Anna Eshoo’s comments in support of H.R. 945

Representative John Katko’s press release on H.R. 945

Representative Morgan Griffith’s press release in support of H.R. 945

Update: Breaking News on MFTs in Medicare

Update:

On Wednesday afternoon, the House Energy and Commerce Committee voted to move the Mental Health Access Improvement Act (HR 945), as amended, to the floor of the House of Representatives! This bill, which passed without any opposition, is expected to be considered by the full House soon. See AAMFT on Twitter for additional details from today’s committee hearing.

 

This vote is a very significant development. It is the first committee vote on the MFTs in Medicare since 2009-10. The next step is a vote by the full House of Representatives. If you have not already contacted your Members of Congress to support HR 945 and the companion bill in the Senate, S. 286, please do so through this link.

 

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On Wednesday, September 9, the House Energy and Commerce Committee will hold a hearing to amend and pass 38 bills to the full House of Representatives. One of these bills is the Mental Health Access Improvement Act (HR 945), which is legislation that would allow MFTs and MHCs to serve as Medicare providers. Follow AAMFT on Twitter for additional details and as AAMFT tweets live from the hearing.

UPDATE: House of Representatives Introduces Legislation to Improve Hiring of MFTs within the VA

Update on House VA Hearing

On Thursday, September 10, the House Committee on Veterans’ Affairs held its hearing to discuss over 30 VA healthcare bills that, collectively, will serve as the House’s companion bill to S 785, the Senate-passed VA healthcare bill. Among these bills are two bills, the VA Mental Health Staffing Act (H.R. 8144) and the VA Mental Health Counseling Act (H.R. 8145), both introduced by Representative Jahana Hayes (D-CT), that will ensure that Veterans have access to the mental health care that they need. A recording of this hearing can be found on the committee’s website.

 

During this hearing, the Committee on Veterans’ Affairs heard testimony from representatives from several veterans’ service organizations. One witness, Joy Ilem, National Legislative Director for the Disabled American Veterans, submitted testimony in favor of both H.R. 8144 and H.R. 8145. In her written testimony, Ms. Ilem noted that “(m)arriage and family therapists are often specifically requested by veterans and their availability equates to rounding out a full complement of VA’s traditional interdisciplinary mental health care teams.”

 

In addition to H.R. 8144 and H.R. 8145, bills that AAMFT has endorsed, the remaining bills address Veteran suicide and would make many other changes to improve care for Veterans. The next step will be a markup of these bills in order to move them to the full House of Representatives for a vote, hopefully within the next few weeks.

 

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AAMFT has been advocating for Congress to pass legislation that would assist Veterans seeking mental health treatment by improving the hiring of MFTs with facilities operated by the Department of Veterans Affairs (VA) and other changes. Last month, the Senate passed, without opposition, S. 785, the Commander John Scott Hannon Veterans Mental Health Care Improvement Act. This bill contains several provisions to prevent Veteran suicide and strengthen the VA mental health workforce, such as improving the hiring of MFTs within the VA.  

On Thursday, September 10, a committee of the House of Representatives, the House Committee on Veterans’ Affairs, will hold a hearing on over 30 VA healthcare bills that, collectively, will serve as the House’s companion bill to S 785. Among these bills are two bills, the VA Mental Health Staffing Act (H.R 8144) and the VA Mental Health Counseling Act (H.R. 8145), both introduced by Representative Jahana Hayes (D-CT), that will ensure that Veterans have access to the mental health care that they need.

The VA Mental Health Staffing Act and the VA Mental Health Counseling Act would make several changes that will facilitate the hiring of MFTs as VA provider, including:

• Requiring the VA to develop a plan to address staffing of mental health providers within the VA;
• Requiring the VA to development a plan to address staffing shortages of MFTs and mental health counselors (MHCs) within the VA, including the steps the VA will take in each region to address these shortages; and
• Within one year from enactment, requiring the VA to work with the Office of Personnel Management to develop an occupational series for MFTs, as well as MHCs.

AAMFT has endorsed both bills, along with several other mental health and veteran support organizations, such as the American Foundation for Suicide Prevention, the American Mental Health Counselors Association, the California Association of Marriage and Family Therapists, Minority Veterans of America, Military Officers Association of America, and Veterans of Foreign Wars.

AAMFT thanks Representative Hayes for her sponsorship of the VA Mental Health Staffing Act and the VA Mental Health Counseling Act. We also thank the 15 Members of Congress who are cosponsoring H.R. 8144 and the 12 Members who are cosponsoring H.R. 8145. Thursday’s committee hearing will be the first step in moving the VA suicide prevention and mental health legislation through the House of Representatives.