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!

                   

Message from Tracy Todd, PhD., AAMFT CEO

March 17, 2020

AAMFT certainly hopes you and your loved ones are doing well in these unprecedented times.

I wanted to take a quick moment to update you on AAMFT’s situation from yesterday.

1. Today, we released a free resource “An Introduction to Setting up a Telebehavioral Health Practice: Competencies and Considerations” by Katherine Hertlein, PhD, LMFT on YouTube. Last week’s Family Therap-eNews included a link to the Online Therapy Guidelines. They are also available with the webinar on our COVID resource page. We hope you find these useful.
2. AAMFT works closely with the Mental Health Liaison Group (MHLG), a coalition of 60 mental health associations, and other allies to advocate for policies that advance and support treatment and strengthen access to behavioral health care for clients, such as increased funding and recognition for behavioral health care and mental health parity.  AAMFT and the mental health community support coverage and recognition for teletherapy services on par with therapy provided in a traditional office setting, and will continue advocating for such recognition. Since teletherapy laws are state specific, AAMFT will monitor and strategically advocate for teletherapy and reimbursement. Please consult your state licensing board and forward any information to the Family TEAM at [email protected].
3. Many of our AAMFT members utilize our partner CPH Insurance for your liability coverage. CPH has provided helpful information on their blog page about teletherapy and your existing policy coverage.
4. We continue to update our Coronavirus resource page with updates and resources as they are received. In addition to telehealth and online supervision professional resources, we also have included information on the following areas:
   1. Parenting and Children,
   2. Elderly,
   3. Health Care Providers,
   4. Stress and Coping.

As we informed previously, to ensure the safety of our team, the AAMFT office is now operating virtually until further notice.  AAMFT has tested our systems to insure we could continue our daily operations while working remotely. You should not notice any disruption in membership services during this crisis. As always, while this crisis continues, AAMFT will keep the Coronavirus: AAMFT Status page up to date for information relate to AAMFT, our profession, and the Coronavirus Pandemic.

Stay healthy,

Tracy Todd, PhD.

AAMFT CEO

AAMFT Endorses Evidence Based Practice Consensus Statement

As a participating organization at the 2018 and 2019 Coalition for the Advancement and Application of Psychological Science (CAAPS) Summits, AAMFT collaborated with numerous other organizations committed to clinical science in creating an evidence based practice statement.  

The Coalition for the Advancement and Application of Psychological Science (CAAPS) strives to promote science to understand, reduce, and prevent the burden of mental illness, and foster adaptive development and well-being. Member organizations work on many different aspects of the creation, dissemination, and application of clinical science and the training of clinical scientists but share a commitment to prioritizing a scientific epistemology to advance knowledge and improve human well-being.

Along with numerous other associations, AAMFT endorsed the following practice statement.

Evidence Based Practice Consensus Statement

Consensus Statement: Evidence-based practice decision-making for mental and behavioral health care

Evidence-based practice of mental and behavioral health care is an ongoing, collaborative approach to making decisions about services, which includes the following components:

1) Evidence-based practice begins with consideration of the best available basic and applied empirical research evidence when making decisions about mental and behavioral health services.

The limitations of the available empirical evidence are also considered, especially given contextual factors such as developmental level, community/cultural needs, the settings in which the services occur, barriers to services, and the strengths and assets of individuals and communities. The limitations of the evidence base, however, do not impede the retention or adaptation of principles and techniques from the empirical evidence that remain relevant and applicable after consideration of the limitations.

2) Evidence-based practice includes ongoing measurement and evaluation of the impact of services and, if necessary, outcome-informed adjustments to services that are intended to maximize their effectiveness.

3) Providers serve as a guide for collaborative decision-making in evidence-based practice, integrating different sources of information, including recipients’ values and preferences, as well as the provider’s competence and the organization’s capacity to provide effective services.

AAMFT is grateful for the invitation to attend and participate in CAAPS. This work is critical for decision making in mental and behavioral health issues.

Why So Many Changes?

Numerous times I have been asked, “Why is AAMFT making so many changes?”

When I became CEO, one of my first tasks was to assess the health of AAMFT with staff and consultants (financial, association management, and legal). While overall AAMFT’s health was very good, there were areas that suggested action was needed to assist in our continued long- term health. For example, our dues dependency was extremely high at 72%; the benchmark for associations similar in size to AAMFT was at the time 35%. Knowing that AAMFT was sitting on a very large retirement bubble, having such a high dues dependency was understandably alarming. Changes needed to be made to decrease dues dependency. Since these efforts were initiated, AAMFT has lowered our dues dependency to 57%; while we are still facing a retirement bubble burst, and I would like to see this dependency even lower, the progress is vital to our future stability.

Another necessary change to continue the positive health of AAMFT was creating mechanisms to access member expertise while also addressing the challenges identified in the preceding years related to our less than optimal geographic structure. Associations had already began making a gradual organizing structural shift from geography to content. To remain relevant, and give us the ability to access member expertise, AAMFT needed to embrace this trend towards a structure based on content – Interest Networks. For example, Integrated Health or Military Personnel and Families are areas that AAMFT needed content for advocacy work. Combining this need with the alarming rate at which the divisions were experiencing managerial challenges and volunteer burnout, precipitated the need for changes in our structure – a bylaws change. Already we have over 10,000 members participating in engagement programs including our nine new content driven networks to feature along with our geographic networks and Family TEAM.

Moving on to membership categories. AAMFT’s Clinical Fellow membership category is coupled to licensure which makes it very USA-centric, places a ceiling on the potential membership numbers, and acts as a barrier to those seeking membership outside of the USA. As our COAMFTE programs continue to graduate students that move out of the USA and often return to a country of origin, AAMFT had little ability to provide a membership path. Additionally, having five membership categories was complicated and appeared that AAMFT was trying to “keep others out” through this complexity. Simplifying our membership categories provides AAMFT opportunity to create a much more inclusive organization. Again however, these changes necessitate a Bylaws vote.

To try to identify how to stay relevant and current in today’s association landscape, and why so many of our changes necessitated taking action on changing Bylaws, we met with a number of association parliamentarians and consultants.  We learned that other associations were experiencing the same challenges. To address the challenges associations were working towards simplifying bylaws to make them more evergreen - providing their association with the ability to meet the rapidly changing business landscape. AAMFT had the choice of making a wholesale change to the bylaws (without context) with a single change or to proceed in a methodical manner that provided members the ability to walk in step with these important changes as they are being introduced and executed. We opted for the latter using these changes as an opportunity to have important conversations with members about the challenges our association was facing and utilizing task forces and steering committees of members to help generate solutions that kept our systemic perspective and profession first and foremost.

In short, for AAMFT’s long-term sustainability, and to be positioned for growth, AAMFT needs to make changes that capitalize on the changing association demographics, stakeholders, and needs. The roll-out of these changes has been thoughtful, purposeful, and done with a very close eye on unintended consequences as well as capitalizing on new opportunities. For these reasons, and more, the AAMFT Board is seeking member support for the proposed bylaws change. If you have not yet voted, please check your email (or spam email) for the link or visit our voting website here and express your leadership voice by voting in support of the bylaws.

Tracy Todd

CEO, AAMFT

CEO Statement on Children in U.S. Care

Marriage and family therapists are professionals who dedicate their lives to the well-being and health of families. As an association, AAMFT is committed to positive family policies that affirm the ability and responsibility for dependent care, responsible nurturing of children, and the ability to provide for dependents' basic needs. Recent reports of children in U.S. care being held in unsafe and potentially traumatizing conditions directly contradicts this commitment of our profession. Fundamental rights to basic needs, safety, and security for children is not a political issue but rather one that we as an association believe is a commitment that our society should strive for every day to support families as its most basic institutions.

AAMFT urges immediate action be taken to ensure that children and families in U.S. care be provided with these basic necessities essential to protecting their long-term well-being. As an association we will continue to seek out opportunities via our coalitions and partnerships with other mental health associations to honor our commitment to ameliorating challenges to relationships and emotional and mental health within the context of family and larger social systems.

 

Tracy Todd, PhD

CEO, AAMFT

CEO Statement: Leveraging AAMFT's Voice

In my role as CEO of AAMFT, I’m often asked to have the association issue comment or offer a position on a wide variety of topics and issues. In the past, these requests have ranged from statements on popular television shows to court cases or op-eds. Historically, it has been clear when to respond: situations where the profession of marriage and family therapy is involved and issues related to legislation or policy changes.

But the environment Americans are living in today is much different. There is no doubt that the current White House administration operates beyond what is considered traditional communications processes for government. Creating even more unease and concern in our society, these actions seem to circumvent the established processes of policy development and implementation. It is difficult for even experienced advocacy professionals to determine the real priorities of this administration. Compounding this lack of clarity is our 24-hour news cycle and the increasing “competition” for unique insights and perspectives. Although there appears to be a greater volume of news than ever before, there is also much more clutter and noise that we must all sort through.

AAMFT is an association that primarily advocates for the profession of marriage and family therapy. That being said, AAMFT is also extremely sensitive to policies affecting individuals and families spanning a wide range of issues. Therefore, it is vital that when AAMFT offers comment it is definitive and heard.

AAMFT has an active and aggressive advocacy agenda that requires cooperative efforts between different parties, branches, and levels of governments and it is vital that the association remain non-partisan to foster these relationships. We also have a number of existing position statements and our Code of Ethics which provide definitive guidance as to where the association is positioned on some issues as well as an established process through which we develop new statements when necessary. Still, balancing AAMFT’s position in the behavioral health industry with our diverse membership (and diverse families served by our membership) and our established positions in our current environment can be like walking a tightrope.

In order to navigate these times, as an organization, we must set standards for when issues rise to a level at which AAMFT’s strong voice is needed. As demonstrated by our statement on the executive order enacting immigration policy change earlier this year, we are swift and responsive when our government takes action that has a substantial impact on the lives of our members, their clients, and their families.

AAMFT recently received a handful of member inquiries about our stance on the President’s tweets regarding transgender Americans in the military. AAMFT has been clear and vocal in its position for over a decade that as an association discrimination will not be tolerated (What is Marriage and Family Therapy?, and the AAMFT Code of Ethics). While President Trump’s statements raise a variety of concerns for those our members serve and certainly creates a situation that we are closely monitoring, at this time based on all feedback from the leaders of the armed forces and the Pentagon, there has been no formal policy change.

AAMFT’s goal is to ensure we are not just part of the noise that reacts to this administration’s unorthodox method of governing and communicating without delineating what is actual policy and what is political posturing. At times that may create a situation, understandably, where members ask, “Where is AAMFT?” Please do not interpret a lack of contribution as being unaware or insensitive. Instead, it is a deliberate attempt to not dilute our voice within the political cacophony and confusion of today’s climate. Sometimes our discernment might be spot on, other times, maybe not so much. Yet, we will always be attentive and mindful of our responses. Doing so ensures that when advocacy needs arise, AAMFT is able to act quickly, decisively and strategically thereby leveraging our voice to positively influence change.

Tracy Todd, PhD

CEO AAMFT

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

Mindful Self-Care Post Election

Imagine this scenario, Beth (an MFT and Secretary Clinton supporter) consults with a new client remarking on their indication of work-related problems, specifically relationship issues with co-workers. When questioned about the start of these issues, her client responds, “After the election. I am so sick and tired of hearing about the ‘wrong’ candidate winning. I believe in our new President-Elect and I grew tired of biting my tongue and decided to speak up. Which I suppose they interpreted as my antagonizing them.”

In another office, Randall (an MFT and President-Elect Trump supporter) notes that his new client listed their partner’s anxiety and panic attacks as having an adverse impact on their relationship. When asked for more details, Randall’s client indicates, “The anxiety and panic attacks have really accelerated since Donald Trump’s election. We are both having a difficult time with this election but he is really torn up. We are scared for our kid’s future and the future of everyone who felt threatened by his negative comments on the campaign trail.”

Regardless of how you may have voted in the recent Presidential election, one thing is for certain, you are likely to experience your own professional challenges related to the outcomes. What will guide you when you have an excited supporter and you firmly backed the other candidate in your own life? How will you remain compassionate when the opinions expressed differ so vastly from your own? What will the impacts of a new administration be on our profession and industry as a whole? These challenges are real and undoubtedly you will at some point be affected by them.

Clinical issues – that may involve unpleasant political discourse -  must be differentiated from the rancorous rhetoric of the recent campaign. AAMFT has no tolerance for discrimination and our Code of Ethics clearly states so:

Standard 1.1. Non-Discrimination that marriage and family therapists provide professional assistance to persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, sexual orientation, gender identity or relationship status. Communicating to clients that, as an AAMFT member, you believe in and abide by the Code helps establish your therapeutic relationship fundamentals.

As emotionally intense political conversations continue with our clients, peers, and legislators our professional and personal values will undoubtedly get tested. Taking time for self-care and reflection is vitally important.  We must remain mindful that our anxieties and turmoil are NOT our clients’ challenges.  We have an obligation when feeling therapeutically compromised or impaired to seek peer to peer consultation, engage in self of therapist work, work with an AAMFT Approved Supervisor, or pursue our own MFT services.

Systemically, we must keep in mind that change, regardless of pain and disruption, can provide opportunity at best. At worst, change creates obligations and responsibilities to act as protective agents for those needing protection. We share a responsibility to remain diligent regarding policy changes that threaten equality and inclusiveness. If there ever was a time, it is now, for you to support the Family TEAM so that AAMFT can rely on your actions in times of advocacy needs.

Tracy Todd, PhD, LMFT is the Executive Director of AAMFT.

 

Include MFTs in Medicare Reimbursement

Previously I have talked about how the profession of marriage and family therapy is overlooked or not accurately categorized. This is especially true when it comes to Medicare reimbursement. Of the five federally recognized mental health professions, MFTs are the only ones excluded from Medicare. AAMFT has been working diligently to change that.

In May 2015, the Senate Finance Committee, which has jurisdiction over health care, launched the Chronic Care Working Group to discuss ideas that improve the way care is delivered to Medicare beneficiaries with chronic diseases. After a number of hearings the working group recently released a white paper on chronic care titled, “Bipartisan Chronic Care Working Group Policy Options Document.” The group has also asked for associations and health care organizations to comment and provide feedback on the white paper. Working with our partners at the American Counseling Association, American Mental Health Counselors Association, California Association of Marriage and Family Therapists and National Board for Certified Counselors, we have submitted comments to the committee with our recommendations to finally include counselors and MFTs to be accepted as Medicare providers (see the full letter here).

It makes no sense when you talk about the mental health shortage areas in this country that the two groups who are excluded from being reimbursed by Medicare, make up over 40 percent of the nation’s mental health workforce.

The statistics in the letter are stark:

Over half of Medicare beneficiaries have one of six chronic conditions that include depression. Direct medical care cost for people with chronic conditions accounted for approximately 83% of U.S. health care dollars in 2001, a per person average that is five times higher than for those without a chronic condition.

The average Medicare beneficiary payment per year for someone with depression is $16,869, compared to $2,820 for someone without the six condition. Fifty-five present (55%) of Medicare beneficiaries with depression have multiple chronic condition (29% with two conditions, 26.1% with three or more).  Medicaid expenditures show there are significant savings that may accrue from decreasing the costs of depression.

Including MFTs in Medicare is the logical next step. There is no opposition to the legislation, and it has already passed both the House and the senate, just not during the same session. While we remain optimistic that mental health legislation will move through this congress in the coming months, we continue to work to include language that will include MFTs as Medicare providers, as they should be. 

We also need your help, by asking for your voice. Reach out to your member of congress today, either via email, phone call, or social media, and tell them to support MFTs in Medicare. We have prepared scripts that you can use by clicking here, but feel free to personalize them any way you want to help them stand out.

Tracy Todd, PhD, LMFT

Executive Director

Marriage and Family Therapy is a Profession. Period.

Too often, the profession of marriage and family therapy is overlooked or not accurately categorized. Ask any MFT how many times they have been referenced as a different behavioral health care professional and the answer is typically, "often." We see it frequently, on a local news channel when our member MFTs are interviewed and the attributed credentials indicate the person is a “mental health counselor.” Even when the MFT specifically provides accurate credentials to the news agency, inaccuracies continue. On a more macro level, we see this occuring with agencies who are familiar with our profession, however errors of categorization are still made.

Marriage and family therapy is frequently tucked neatly behind such phrases as “family based interventions,” “parenting intervention education,” “family therapeutic support.” Certainly, there are differences between educational programs and therapy, but when therapy is being provided, rarely are marriage and family therapists identified by profession. I understand why another behavioral health profession may not want to identify that a segment of research was conducted by marriage and family therapists or that MFT type services were provided by researchers not trained in marriage and family therapy.

In a recent Twitter Chat, I emphasized that it is vital that is recognized that marriage and family therapy is more than a skill set – as it is often referred to- but rather the vibrant and distinct profession that it is. As a reminder, marriage and family therapy is recognized by many groups:

• The United States federal government has designated marriage and family therapy as a core mental health profession.
• Currently all 50 states and the District of Columbia support and regulate the profession by licensing marriage and family therapists.
• There is an International Family Therapy Association, European Family Therapy Association, Australian Family Therapy Association and a Canadian Association for Marriage and Family Therapy just to name a few associations.
• The Department of Education, in the Individuals with Disabilities Education Act, designates marriage and family therapists as qualified providers of early intervention services to infants and toddlers with a disability.
• The Department of Transportation has opened up eligibility for the Substance Abuse Program to all licensed or certified Marriage and Family Therapists. 
• In 2011 the profession of marriage and family therapy was invited to participate in field trials for the DSM-5 by the American Psychiatric Association.

I may sound a bit defensive in this blog about the profession that I am part and proud of– because frankly, defending our profession is something I am extremely proud of and think is vital that we all engage in. Despite this partial list of impressive credentials and recognition of our work, our profession is often still overlooked. And this is why establishing a strong professional identity is so important. When marriage and family therapy is dismissed or overlooked the impact is profound:

• MFTs can experience loss of income opportunities in the form of employment and occupational eligibility;
• MFTs can experience diminishment of professional opportunities in the form of grant applications (privately and publicly)
• Continued misidentification of the profession, especially in mass media, hurts each and every MFT in private practice.

These are just a few examples of the harm that the profession experiences when our identity is not nurtured and protected. Disregarding the profession, at any level, is simply unacceptable to me, and should be to each of us. Please join me in my quest to clarify inaccuracies when encountered, advance the profession through constant promotion of marriage and family therapy (similes are not acceptable), and the accurate portrayal of MFT credentials when necessary. Even an act as simply as clarifying an introduction when you are not accurately introduced in a professional environment or educating an employer who identifies other behavioral healthcare professions without including marriage and family therapy is a wonderful step. Sharing our MFT identity video to expand knowledge and understanding is another simple way to take action. Speaking up to advocate every time you see a phrase similar to “other mental health professional,” or “ancillary healthcare professional” you can help to distinguish and educate everyone about our great profession and helps protect us for the future.

AAMFT, through the work of so many of our past and current members, has worked exceptionally hard to establish this profession. We must all remain diligent and mindful that while we have come a long way, there are challenges and barriers that can swiftly relegate our profession to the sidelines of behavioral health care.

Tracy Todd, PhD is Executive Director of AAMFT. He is a licensed marriage and family therapist, receiving his PhD from Iowa State University and his masters from Texas Tech University. Prior to joining the staff of AAMFT, Tracy was the Director/Owner of the Brief Therapy Institute of Denver, Inc.