The AAMFT Blog

Disaster Resources

Millions of people are reeling from the heartbreak left behind by Hurricanes Helene and Milton. In the Carolinas, Helene left entire communities submerged by floodwaters and cut off from aid with people waiting to be rescued with no access to food, power, or fuel. In Georgia and Tennessee, damage from downed trees and flooding have left neighborhoods unrecognizable. In Florida, cars are buried in sand and homes have been gutted by the massive storm surge. Rescues are underway in Florida as the extent of damage and deaths from Milton are still unfolding. Hurricane Milton knocked out power to more than 3 million customers, flooded barrier islands, tore the roof off a baseball stadium and toppled a construction crane. Many are missing, possibly unable to leave their location or unable to contact family where communications infrastructure is inoperable. AAMFT will shortly release information on its partnership with the Red Cross letting AAMFT members know how they can help by volunteering in the impacted areas.

Following are ways for you to donate, volunteer, or get resources on helping families navigate this challenging and life-changing time.

• Make a donation to the Red Cross here for hurricane relief.

Resources and Information

Disastershock: How to Cope with the Emotional Stress of a Major Disaster has a systemic, trauma-informed, and evidence-based foundation, making the manual an excellent resource for MFTs. This resource was produced by AAMFT members who serve on the board for the Institute for School-based Family Counseling and are part of the Disastershock Global Volunteer Team, which has members from 16 countries.

From AAMFT’s Family Therapy Magazine

Helping Families Cope with Disasters

An Overview of the Red Cross and Disaster Mental Health

Systemic Therapists on the Frontlines of Climate Change

Attending to the Whole System: Eco-Informed Family Therapy

Tips for Parenting During Times of Crisis

• Model calm and control. Reassure children that they are safe and so are the other important adults in their lives.
• Talk with your children about crisis events. Take some time and determine what you wish to say. This is especially true since new information will unfold each day. Provide brief, accurate, and age-appropriate information. Don’t dwell on the scale or scope of the tragedy, particularly with young children.
• Keep your explanations developmentally appropriate. Early elementary school children need brief, simple information that should be balanced with reassurances that their lives will not change. Upper elementary school children will be more vocal in asking questions about their safety and what is being done. They may need assistance separating reality from fantasy.
• Understand what your child is asking. Difficult questions that children ask may be spurred by curiosity or feelings. Rather than plunging into an immediate answer, learn what motivates the question. Ask, “What made you think of that?” or “What ideas do you have?” Once the meaning of a question is known, it is easier to answer effectively.
• There may be questions we cannot answer. Rather than invent a response, it is more helpful to say, “I don’t know,” or “I’ll try to find out.”
• Acknowledge, validate, and accept your child’s feelings. He or she may be feeling confused, frightened, or even excited. Listen calmly and reassuringly as they express their thoughts and feelings.
• Limit the amount of your child’s television viewing of these events. If they must watch, watch with them for a brief time; then turn the set off. Young children should not be allowed to watch TV coverage of the event, as they are too young to process what they are seeing and hearing.
• Maintain a “normal” routine. To the extent possible, stick to your family’s normal routine for dinner, homework, chores, bedtime, etc. Children feel secure when routines are calmly followed.
• Spend extra time reading or playing quiet games with your children before bed without the television or news radio on. These activities are calming, foster a sense of closeness and security, and reinforce a sense of normalcy.

First Responder Toolkit: A free app for those deployed to emergency response events

Red Cross Disaster Mental Health Volunteers

From AAMFT: MFT Volunteer Opportunities with the American Red Cross

Red Cross Volunteers

Trauma Informed Care: A downloadable, comprehensive, and free guide to TIC

Psychological First Aid: A downloadable, comprehensive, and free guide to PFA

SAMHSA Resources by Disaster Type

SAMHSA Disaster Response Helpline (call or text): 1-800-985-5990

SAMHSA Disaster Response Overview

Doing What Matters in Times of Stress: An Illustrated Guide (from the World Health Organization). A stress management guide for coping with adversity. The guide aims to equip people with practical skills to help cope with stress. A few minutes each day is enough to practice the self-help techniques. Informed by evidence and extensive field testing, the guide is for anyone who experiences stress, wherever they live and whatever their circumstances.

Pan American Health Organization: Mental Health and Psychosocial Support in Emergencies (MHPSS). Health emergencies, natural and socio-environmental disasters, armed conflicts, and various migratory phenomena may cause severe suffering in affected populations. The psychological and social effects of emergencies can be severe in the short term, but they can also affect people in the long term. Protecting and improving people's mental health and psychosocial well-being is therefore a priority in emergencies.

Disaster Preparation

AARP offers tips on how to protect your important papers and property:

Protect Your Important Papers and Property

Information on preparing your office for an emergency:

8 Tips on Preparing your Office for an Emergency

Be prepared before the next storm. The Red Cross offers tips on “How to Prepare for a Hurricane”

Tips for a flooded office

Ways to donate and help

How to help those impacted by Hurricane Helene: Charities, organizations to support relief efforts

Pet Rescue

For those interested in helping pets impacted by the hurricane, a Virginia-based pet rescue organization is receiving cats and dogs from flood-impacted states and is in need of donations to care for the influx of arriving pets. Learn more in “Cats and dogs from flood-ravaged North Carolina find hope in Fairfax”

Homeward Trails: Donate

Celebrating Pioneers - LGBTQ+ Advocates in Family Therapy

Written by Ivonne Harting (She/Her) LAC, LPCC, MFTC, NCC

Diversity has always existed; it’s an intrinsic part of the human condition. Why is understanding diversity crucial in today's society? There isn’t a single person on Earth who is exactly like another. Yet, we often choose to rival our differences instead of rejoicing in them. Although we recognize the importance of support and acceptance as a society, hesitation still exists. Fortunately, we have made significant strides in celebrating diversity, particularly within the LGBTQIA+ community, which has relied on brave pioneers to advocate for our rights and illuminate the battles we face.

In honor of LGBTQIA+ History Month, I want to highlight one such pioneer: Dr. Deborah Coolhart. She is a prominent voice in family therapy, especially known for her work with trans and gender-expansive youth. Dr. Coolhart has made significant contributions to gender-affirmative therapy, centering the needs and voices of LGBTQIA+ youth in family therapy practices.

Dr. Coolhart emphasizes the critical importance of support—especially family support—in fostering positive mental health outcomes for LGBTQIA+ individuals. In her work, she discusses how dysphoria affects not just the mental health of trans masculine individuals, but also their physical and relational well-being. She states, “Because your dysphoria gets in the way of you…it affects everything.” This highlights the profound impact body dysphoria can have on a person’s identity and daily functioning. Addressing dysphoria through gender-affirming practices in therapy is essential, as it not only validates the experiences of trans individuals but also creates an environment where families can learn to support their loved ones effectively.

Dr. Coolhart’s work resonates deeply with me, especially as I reflect on my own experiences as a queer therapist. I remember the fear I felt when contemplating coming out to my family. Growing up in Venezuela—a society that lacks inclusivity regarding anything outside of heteronormativity—having a safe space that normalized discussions about gender and sexuality would have been life-changing. Such an environment would have allowed my family to understand my experiences from a different perspective and receive psychoeducation on how to support and accept me. This is what I believe our current society needs more of: education—not just about tolerance and acceptance, but about love and empathy. Community workshops and educational programs can play a vital role in fostering this understanding.

The progress we have seen in our field is monumental! We have transitioned from homosexuality being classified as a disorder in the DSM-I in 1952, to professionals like Dr. Coolhart advocating for and researching gender-affirming care, driving positive change in family therapy. It is clear that there is nothing we need to change about gender-diverse individuals. Conversion therapy is not the answer. Inclusion is. Let history be a reminder of how far we’ve come and where we are yet to go. Let’s continue to find ways to contribute as professionals, fostering environments that celebrate diversity and support all individuals in their journeys.

With love and pride,

Ivonne

National Hispanic Heritage Month: Embracing Diversity in Marriage and Family Therapy

Written By Julian Crespo, Ph.D., LMFT. 

As we celebrate National Hispanic Heritage Month from September 15 to October 15, it's impossible not to reflect on the rich multiplicity of Hispanic cultures. This annual observance provides marriage and family therapists an opportunity to consider the profound influence of Hispanic heritage on our field and society as a whole.

The Hispanic community defies simple categorization. It's a composite of cultures, traditions, and identities shaped by centuries of mestizaje – the blending of Indigenous, European, African, and other ancestries. This intricate history has fostered a wide array of perspectives on individual and family identity formation. Some Hispanic families celebrate their indigenous roots as a cornerstone of their identity, while others may emphasize their European heritage. Many embrace a fluid, multifaceted identity that honors all aspects of their lineage.

For marriage and family therapists, this diversity within Hispanic cultures is a wellspring of insight. It underscores the need for tailored approaches to therapy, even among seemingly similar cultural groups. Each family brings to the therapeutic space its unique historical narrative, cultural values, and identity constructs. Additionally, the multifaceted nature of Hispanic populations can significantly enrich and foster inclusivity in the United States. As therapists, we can draw valuable lessons from how Hispanic cultures have navigated complex identities and histories. This knowledge can shape our approach to working with all clients, helping us develop more inclusive and culturally responsive therapeutic practices.

Many Hispanic cultures, for instance, place great importance on strong family bonds, respect for elders, and collective decision-making. These values offer fresh perspectives that contrast with more individualistic approaches. By integrating these diverse worldviews, we can broaden our therapeutic toolkit and better serve a wider spectrum of clients.

Furthermore, the richness and complexities of Hispanic cultures can inform and nurture marriage and family therapy practices to adopt a critical stance. They push us to examine our assumptions and biases, encouraging us to create epistemological spaces where the profession can grow in multiple directions.

Take, for example, the concept of familismo – the strong identification and attachment to nuclear and extended family – prevalent in many Hispanic cultures. This concept prompts us to reconsider our understanding of family systems, encouraging us to look beyond the nuclear family and consider the roles of extended family members and close friends who may be considered family.

Similarly, the diverse spiritual and religious practices within Hispanic cultures can expand our approach to addressing spirituality in therapy. From indigenous spiritual practices to syncretic religions like Santería, these varied belief systems remind us of the many paths people take to find meaning and healing.

The linguistic diversity within Hispanic communities offers another valuable lesson. It highlights the importance of not just literal translation, but cultural interpretation in therapy. This insight can inspire us to be more attentive to the nuances of language and communication in all our therapeutic interactions. 

As we mark National Hispanic Heritage Month, let's embrace these lessons from Hispanic cultures. Let's use this richness and complexity to foster more inclusive, culturally responsive, and critically reflective marriage and family therapy practices. In doing so, we not only better serve our Hispanic clients but also enrich our field as a whole, creating space for multiple perspectives and approaches.

National Hispanic Heritage Month serves as a powerful reminder of the invaluable contributions Hispanic cultures make to our society and our field. It challenges us to continuously expand our understanding, question our assumptions, and strive for truly inclusive and effective therapeutic practices. In honoring Hispanic heritage, we also honor the diversity of human experience and the myriad ways families and individuals construct their identities and relationships.

September is National Suicide Prevention Month

Join AAMFT for a conversation on suicide prevention

Each September, the United States observes suicide awareness and prevention. The nationwide observance aims to raise awareness about suicide, identify ways to prevent suicide, and remember the lives lost to suicide.

In the U.S., someone dies by suicide every 11 minutes. Suicide can impact anyone—people of all ages and backgrounds. The White House World Suicide Prevention Day proclamation underscores this, noting that in 2023, nearly 50,000 Americans died by suicide, and in 2022, over 10 million seriously considered suicide. In 2022, suicide was the second leading cause of death for young people aged 10 to 14 and 25 to 34, and the suicide rate for veterans was 50 percent higher than for anyone else.

On September 24 at 12:00 p.m. Eastern, we invite you to a special LinkedIn live panel discussion titled “Understanding Suicide Prevention: Community, Signs, and Support.”

Hosted by AAMFT Board President Silvia Kaminsky, this critical session will feature insights from AAMFT members Dr. Marie-Nathalie Beaudoin and Dr. Katherine M. Hertlein, along with Dr. Lisa M. Horowitz of the National Institute of Mental Health. Together, they will explore the significant impact of family dynamics on mental health and discuss practical strategies for suicide prevention.

This session will provide expert insights into the warning signs of suicide; help you understand the support systems that can prevent crises; and insights from top professionals about the role of marriage and family therapists in mental health advocacy.

This event is essential for anyone interested in the latest approaches to mental health and wellness, especially in recognizing the crucial role families play in prevention. Whether you're a professional in the field, a student, or simply an advocate for better mental health practices, your participation is valuable.

Save the date and join the conversation that matters. Let's empower our communities with the knowledge to support and save lives.

REGISTER FOR THIS LIVE EVENT HERE

Resources for MFTs: War, Conflict, & Trauma

AAMFT is aware is that many of our members have clients going through a range of difficulties at this time. Some are distressed and fearful of yet another war erupting on our planet, while others are more directly impacted; perhaps Jewish or Palestinian families living in the US who are concerned about their loved ones in the Middle East; or perhaps families who have generational trauma lingering from the Holocaust who now face old wounds being reopened unexpectedly and horrifically. AAMFT is currently reaching out to systemic therapists in the Middle East, or those with experience working in the region, to obtain more information and resources for working with clients suffering the impacts of war and trauma in the region.

Below are some resources for clinicians related to the impact of war, conflict, trauma, and treatment approaches.

Doing What Matters in Times of Stress: An Illustrated Guide (from the World Health Organization) 

A stress management guide for coping with adversity. The guide aims to equip people with practical skills to help cope with stress. A few minutes each day is enough to practice the self-help techniques. The guide can be used alone or with the accompanying audio exercises. Available in multiple languages. Informed by evidence and extensive field testing, the guide is for anyone who experiences stress, wherever they live and whatever their circumstances.

Mental Health Innovation Network (MHIN)

Many great resources are included on this site. Search for “war” or “conflict” in the search bar for a variety of resources and information. One recommended resource is PFA-Psychological First Aid. Psychological first aid has been recommended by many international and national expert groups, including the Inter-Agency Standing Committee (IASC) and the Sphere Project. Psychological first aid is an alternative to psychological debriefing. In 2009, the World Health Organization’s mhGAP Guidelines Development Group evaluated the evidence for psychological first aid and psychological debriefing. They concluded that psychological first aid, rather than psychological debriefing, should be offered to people in severe distress after being recently exposed to a traumatic event."

Pan American Health Organization: Mental Health and Psychosocial Support in Emergencies (MHPSS)

Health emergencies, natural and socio-environmental disasters, armed conflicts, and various migratory phenomena may cause severe suffering in affected populations. The psychological and social effects of emergencies can be severe in the short term, but they can also affect people in the long term. These effects can also threaten peace, human rights, and development. Protecting and improving people's mental health and psychosocial well-being is therefore a priority in emergencies. To achieve this goal, coordinated action is needed among humanitarian assistance providers, including governmental agencies, non-governmental organizations and civil society groups involved in Mental Health and Psychosocial Support (MHPSS).

The Mental Health & Psychosocial Support Network

This online platform enables members to share resources, join groups, and interact with others, based on their work and interests. The platform also plays an important role in mobilizing capacities, resources, and supporting coordination around MHPSS response during emergencies. Scroll down to the "Latest Resources" section for resources on hostilities in the Gaza Strip and Israel.

Thank you to AAMFT Professional Member Dr. Laurie L. Charlés for her resource suggestions. Dr. Charlés has extensive experience working in regions experiencing conflict and war around the world.

Additional resources:

War Anxiety: How EMDR Therapists Can Help

Statement on Mental Health in Light of Global Conflict, with resources on Jewish and Muslim communities

Healing Circles

‘I Love You. I Am Sorry’: One Jew, One Muslim and a Friendship Tested by War
A Los Angeles program that connects Muslims and Jews has been strained by the war in Israel. But the group’s leaders found that it has strengthened their bond.

Family Therapy Magazine articles related to trauma:

Trauma-informed Family Therapy: Systemic Treatment of Trauma of Child Refugees
Charity Somo, PhD, and Laurie L. Charlés, PhD

Transgenerational Trauma: A Memory of a Therapist to Be

Ronald W. Lawrence, MS

Children’s Reactions to Death

Sarah Bauer, MMFT

Supporting Children Through Their Grief Journey

Nancy L. Kriseman, MSW and Lane Pease Hendricks, MS

Family Evacuation After the Collapse of Afghanistan

Laurie L Charlés, PhD and Florence J. Lewis, PhD

Helping Families Cope with Disasters

Michael Ungar, PhD

Journal of Marital and Family Therapy:
JMFT Special Section on Mass Trauma

Family Interventions for Populations Exposed to Traumatic Stress Related to War and Violence

Elizabeth Wieling

Experiencing Couple Relationships in the Line of Fire

Michal Shamai, Saray Fogel, and Dvorit Gilad

 

AAMFT Receives 2023 Power of Associations Silver Award for MFTs in Medicare: A New Approach for a Better Tomorrow

[Alexandria, VA]— The American Association for Marriage and Family Therapy (AAMFT) earned a Power of Associations Silver Award from the American Society of Association Executives (ASAE) for its successful MFTs in Medicare: A New Approach for a Better Tomorrow initiative.

Access to mental healthcare in the United States has been a perennial issue, however, it has been exacerbated and reached a tipping point with the COVID-19 crisis, the opioid epidemic, and the increase in mass violence incidents. As the environment around us has shifted, and the demand for mental healthcare for those dealing with chronic and acute issues expanded, it highlighted the weaknesses in our current system. Medicare, the largest insurance provider in the United States, failed to provide access to over 40% of the licensed and trained therapists in this country. With an already exponentially growing senior population now living longer than ever and facing isolation from families and growing health concerns and trauma, the problems with access to care that AAMFT had been highlighting for decades truly came to head.

Through a re-imagined approach to energize advocates and utilizing a unique and interactive method of conversational engagement, AAMFT generated over 23,000 actions in just a handful of weeks in this initiative. And most importantly, just a few months later, Congress and the President took action to add Marriage and Family Therapists (MFTs) as eligible Medicare providers in December 2022.

“Congratulations to AAMFT for exemplifying the impact associations have on the industries and professions they represent and on society at large,” said ASAE President and CEO Michelle Mason, FASAE, CAE. “It’s always so incredibly satisfying to see associations going above and beyond their everyday mission to change the world. We’re very proud to spotlight this award-winning initiative.”

"For over 30 years, AAMFT and its member Marriage and Family Therapists (MFTs) have valiantly led the effort for access to care by advocating for their inclusion as Medicare-eligible providers. I am incredibly proud of our staff and grassroots advocates for envisioning new methods and approaches to re-engage and tackle this critical issue. Thanks to our members’ tenacity and dedication, MFTs will be recognized as providers able to deliver vital services to over 65 million Americans in 2024,” remarked AAMFT CEO Chris Michaels.

 

>>To learn more about AAMFT’s Medicare efforts, visit our Medicare webpage.

About The Power of Associations Awards
ASAE’s Power of Associations Awards recognize the associations’ economic and societal contributions locally, nationally and globally. ASAE will celebrate The Power of Associations Award winners during its annual Summit Awards Dinner on September 28, 2023, at the National Building Museum in Washington, DC.

AAMFT Statement: Michigan State University Shooting

During the evening hours of February 13, students, faculty, and staff at Michigan State University (MSU) became the latest in the all too frequently growing list of victims of senseless violence. Our thoughts are with the marriage and family therapy program students, faculty, and staff, as well the entire MSU community, as they navigate the days ahead and begin to process this terrible tragedy.

For those on campus, MSU Counseling and Psychiatric Services, or CAPS, is partnering with local providers to offer counseling to students in need starting at 9 a.m. Tuesday, Feb. 14. Counselors will be available at the Hannah Community Center located at 819 Abbot Rd, East Lansing, MI 48823. 

Last summer, AAMFT joined over 60 organizations recognizing the deep impact on mental health caused by gun violence. Gun violence is a public health crisis, and the trauma and fear caused by mass shootings significantly worsen Americans’ mental health. A large majority of adults in the United States experience stress associated with mass shootings, and a third of U.S. adults say that fear of mass shootings stops them from going to certain places and events. [i] Moreover, research has shown that victims and members of affected communities experience increases in posttraumatic stress symptoms, depression, and other signs of psychological concerns. Other studies have found that, after previous mass shootings, youth felt less safe and more fearful. [ii] These findings, many of which are unsurprising, make it all the more important to take urgent action to prevent these shootings, particularly in light of our nation’s ongoing youth mental health crisis.

Our organizations welcome continued bipartisan efforts to improve our country’s mental health and substance use systems. These should be pursued because they will enhance our collective well-being, improve and save countless lives, and lead to a more vibrant and resilient country. However, what these reforms alone will not do is address the epidemic of mass shootings. To prevent more carnage, policymakers must act now to address the national crisis of gun violence and work on a bipartisan basis to pass meaningful solutions that promote gun safety in all of our communities.

Further reading: AAMFT Clinical Fellow Tina Timm shares her first-hand account of the MSU shooting and its impact on students and faculty at the University with the Lansing State Journal.

Resources

• On-campus: MSU Counseling and Psychiatric Services, or CAPS, is partnering with local providers to offer counseling to students in need starting at 9 a.m. Tuesday, Feb. 14. Counselors will be available at the Hannah Community Center located at 819 Abbot Rd, East Lansing, MI 48823. 
• The resources below have been created by member MFTs or compiled by AAMFT to help support this process:
  • Disastershock – How to Cope with the Emotional Stress of a Major Disaster
  • Supporting Children Through Their Grief Journey
  • How the Death of a Child Can Impact a Marriage
  • Tips for Parenting During Times of Crisis

To share a resource with our community of MFTs, please contact us.

Citations:

• American Psychological Association (APA) (2019). One-Third of US Adults Say Fear of Mass Shootings Prevents Them from Going to Certain Places or Events. Retrieved from:

            https://www.apa.org/news/press/releases/2019/08/fear-mass-shooting

• For a description of relevant research see: Lowe SR, Galea S. The Mental Health Consequences of Mass Shootings. Trauma Violence Abuse. 2017 Jan;18(1):62-82. doi: 10.1177/1524838015591572. Epub 2015 Jun 17. PMID: 26084284.

Breaking News on MFTs in Medicare!

AAMFT is thrilled to announce that the Mental Health Access Improvement Act (S. 828/H.R. 432), legislation that would allow MFTs, as well as MHCs, to serve as Medicare-eligible providers, has been included in the proposed omnibus package currently making its way through Congress. It is heavily anticipated that both houses of Congress will take action on this proposed legislation within the coming days.

As stated in the AAMFT Blog post from December 15, AAMFT and its allies have been advocating that Congress include the language from the Mental Health Access Improvement Act into the end of year omnibus spending package that Congress has been developing. We are pleased to report that the language from the Mental Health Access Improvement Act was included in the omnibus bill!

At over 4,100 pages, this massive omnibus bill will fund the federal government through the end of the current fiscal year, which ends on September 30, 2023. In addition to funding the federal government, this legislation also includes many policy provisions that change federal law. One of several changes to Medicare would finally allow MFTs and MHCs to serve as recognized providers under Medicare. This legislation would allow MFTs in private practice or other settings to become Medicare-eligible providers. The effective date for allowing MFTs to start serving as Medicare providers is a year from now – January 1, 2024.

 Below are a few FAQs concerning this legislation:

• Has this omnibus package been signed into law? - No, it has not. The Senate will first vote on this legislation. If it passes the Senate, the House of Representatives must vote on it, then it would be presented to President Biden for his signature.

• When should Congress pass this omnibus package? - Congress is expected to vote and send this legislation to the President by Friday, December 23. As of Tuesday afternoon, the Senate is expected to vote on this legislation on Wednesday, with the House voting on the legislation about a day after the Senate approves the package. Funding for the federal government will end on Friday evening if Congress does not act. Therefore, there is some pressure on Congress to act this week to prevent a government shutdown.

• Is passage of this omnibus package guaranteed?  -  No. Although a majority of Members of Congress are believed to support the omnibus package as it is now, passage of any legislation is not guaranteed.

• If this legislation is signed into law, when can I enroll as a Medicare provider and start providing services to Medicare beneficiaries? - Under this legislation, MFTs and MHCs would not be able to serve as Medicare-eligible providers and bill Medicare until January 1, 2024.  This delay is needed so that the federal government can make arrangements for MFTs and MHCs to serve as Medicare providers.

Please follow AAMFT through our social media pages and the AAMFT Blog to stay informed of the progress of this legislation. Please also consider sending a grassroots message to your Members of Congress urging them to pass the omnibus package as introduced.

Thank you in advance for advocating for MFTs as Medicare providers. Your messages and outreach to Congress in support of the Mental Health Improvement Act made the difference! Please contact us at [email protected] if you have any questions. 

Additional information:

Statement of Support from Finance Committee Chair Senator Ron Wyden (D-OR) for Mental Health Provisions in Omnibus Package

Statement from Energy and Commerce Committee Chair Frank Pallone, Jr. (D-NJ) and Health Subcommittee Chair Anna G. Eshoo (D-CA)  in Support of Healthcare Provisions in Omnibus Package

Description of Medicare Policy Changes in the Omnibus Package

Urgent: Please Contact Congress Now to Advocate for MFTs as Medicare Providers

This week, Congress is drafting a large end of year package that will fund the federal government through September 2023, as well as make some helpful changes to federal law. MFT advocates are pushing Congress to include in this package the Mental Health Access Improvement Act (S. 828/H.R. 432), legislation that would allow MFTs and MHCs to serve as Medicare-eligible providers. We need this package to include the MFTs in Medicare legislation. Please contact your Members of Congress today to advocate for MFTs as Medicare providers. 

Contact Congress Now 

As of December 15, high-level negotiations are taking place on Capitol Hill as to how to fund the government for the rest of fiscal year 2023. These negotiations will wrap up soon. If Congress decides to pass an end of year package, also known as an Omnibus funding bill, as opposed to a Continuing Resolution which simply continues funding levels from already passed bills, Congress COULD include other policy initiatives, such as the Mental Health Access Improvement Act. For this reason, we urge you to contact your Senators and Representative in Congress NOW and urge them to include MFTs in Medicare as part of the end of the year funding legislation.  

    

Background and Progress 

Introduced in 2021 as H.R. 432 by Rep. Mike Thompson (D-CA) and Rep. John Katko (R-NY) and as S. 828 by Sen. John Barrasso (R-WY) and Sen. Debbie Stabenow (D-MI), the Mental Health Access Improvement Act is a bill that would finally allow both  Marriage and Family Therapists and Mental Health Counselors to serve as independent Medicare Part B practitioners. This legislation would allow MFTs and MHCs to bill Medicare for providing covered mental health and substance use services to older adults and other Medicare beneficiaries.   

Since this legislation was introduced in early 2021, AAMFT and its allies in the Medicare Mental Health Workforce Coalition, who also advocate for passage of the Mental Health Access Improvement Act, have made substantial progress in advancing this legislation so that it could be eligible for inclusion in the end of year package: 

Support in the House of Representatives: Currently, 97 Members in the House of Representatives are cosponsoring H.R. 432, with strong bipartisan support. Earlier this year, the Mental Health Access Improvement Act was passed by a key House committee with jurisdiction over Medicare. On September 21, the House Ways and Means Committee met to discuss and vote to move several bills to the full House of Representatives, a process known as a committee markup. At this markup, the Ways and Means committee unanimously voted to move to the full House for consideration the Mental Health Access Improvement Act (H.R. 432). This vote was an important step in the process of moving this legislation forward. Legislation that has been approved by a committee is more likely to be considered in a larger package than bills that have not been considered by a committee. 

Support in the Senate: In the Senate, 34 Senators are cosponsoring S. 828, which is a record amount of support for any MFTs and MHCs in Medicare legislation in the Senate. In September, the Senate Finance Committee, which has jurisdiction over Medicare in the Senate, released a discussion draft of legislation to address mental health workforce needs and challenges. This draft includes legislation to add MFTs and MHCs as Medicare providers (S. 828), along with many other provisions to expand the behavioral health workforce. The release of this draft represents the most important action by the Senate in twelve years pertaining to adding MFTs and MHCs as Medicare providers. Please see this AAMFT Blog for additional information on the committee actions from September.   

Support from AAMFT Members and Allies: MFTs, as well as MHCs, other mental health providers, and allies, have been active and engaged in reaching out to their Members of Congress to advocate for the Mental Health Access Improvement Act. Thousands of email messages in support of this legislation have been sent by MFTs and MHCs to Congress. AAMFT members and other mental health providers have met with the offices of Members of Congress to advocate for this issue as well as AAMFT and its allies in the Medicare Mental Health Workforce Coalition. 

In addition, inclusion of the Mental Health Access Improvement Act in the end of year package is supported by a wide number of organizations besides associations representing MFTs and MHCs. Congress has received letters of support for including this legislation in the end of year package from groups as diverse as the Mental Health Liaison Group and the American Hospital Association. 

 

What You Can Do   

 Negotiations are occurring now to determine which bills make it into the omnibus, and it is unknown which bills would be included. These negotiations will end very soon, and a vote on the end of year package will occur next week. This is the best opportunity for passage of the MFTs in Medicare legislation in over twelve years. Therefore, it is imperative to contact your Members of Congress NOW to let them know that you want Congress to include the Mental Health Access Improvement Act in the end of year package.   

Finally, you can advocate for MFTs in Medicare by sending a message to your Members of Congress through AAMFT’s grassroots advocacy platform. If you have friends, family or colleagues who are also constituents of your Member of Congress, they can use this grassroots advocacy platform to send a message advocating for MFTs in Medicare. If you wish to send a more personalized message to your Members of Congress, use this link to find your Members of Congress and click on their profiles to find their D.C. office contact information.  

 

Thank you in advance for advocating for MFTs as Medicare providers. Please contact us at [email protected] if you have any questions.   

The Respect for Marriage Act – The MFT Perspective

Just last week, the Respect for Marriage Act passed in the House 258-169, marking an incredibly historic moment for not only the country, but also for marriage and family therapists. The first version of this bill was originally introduced back in 2009 and was reintroduced into Congress this past summer. The revised version still included protections for same-sex marriages, but now extends protections to interracial couples. The Senate previously passed the bill in November. 

The bill is on its way to Biden’s desk, which he says upon House passage of the bill, President Biden said he “looks forward to signing into law” this landmark legislation. Biden writes, “The House’s bipartisan passage of the Respect for Marriage Act—by a significant margin—will give peace of mind to millions of LGBTQI+ and interracial couples who are now guaranteed the rights and protections to which they and their children are entitled.” Biden signed the bill yesterday afternoon during a large celebration at the White House, marking a huge step forward for the field of marriage and family therapy.  

This past year, the Journal of Marital and Family Therapy (JMFT) released its Decade In Review– a special issue released every ten years that reviews what the past 10 years of systemic therapy research has to say about various topics within the field. This review included a special article on how couple and family therapy research can reduce mental health disparities for racially and ethnically diverse populations. The article reviewed research surrounding minority, interracial and LGBTQI+ couples, advocating for their inclusion in systemic therapy research and studies in order to advance the field.  

LGBTQI+ individuals are already more likely to struggle with issues like depression and anxiety, due to the stigmas and discrimination they face. Similarly, interracial couples face issues with stereotyping, isolation, negative comments, and rejection, which can often lead and contribute to mental health issues. These mental health concerns impact more than just the individual– they affect the entire family, marriage, and relationship structure. Thus, marriage and family therapy can help address and resolve these issues from a systemic perspective, mitigating any stressors or implications they may cause in marriages.  

JMFT’s Decade in Review article on mental health disparities noted that only 68 of the 271 (25%) articles they examined included predominantly racial/ethnic minority samples or globally underserved populations. Among the 60 relevant articles examined, there was a pattern of inattention to methodological considerations relevant to diverse populations. LGBTQI+ and interracial couples deserve to have the mental health and marriage therapy resources they need to maintain healthy relationships. The passing of this bill is just the first step towards including, accepting, and appreciating LGBTQI and interracial couples, both inside and outside the therapy room. 

Hurricane Ian Resources and Information

AAMFT is a member of the American Red Cross Disaster Mental Health Partners coalition. AAMFT has been participating in this coalition for many years.

Hurricane Ian strengthened into a Category 4 storm Wednesday and is expected to hit Florida’s west coast. The National Hurricane Center has warned of “life-threatening storm surge, catastrophic winds and flooding in the Florida Peninsula," with millions under evacuation orders. Read more on the Red Cross website .

Resources

The resources below have been created by member MFTs or compiled by AAMFT.

• How to Prepare for a Hurricane

• Systemic Therapists on the Frontlines of Climate Change

• Disastershock- How to cope with the emotional stress of a major disaster

• Helping Families Cope with Disaster

• Attending to the Whole System: Eco-Informed Family Therapy

• Tips for Parenting During Times of Crisis

Volunteering

MFTs and other mental health professionals are eligible to serve as Red Cross Disaster Mental Health providers. Learn more about disaster mental health and volunteering with the Red Cross.

Our thoughts are with our members and the many people in the path of Ian, as well as the first responders who will help. Please take all necessary precautions and stay safe.