AAMFT California Newsletter Spring 2013

HEADLINES

AAMFT-CA Division Goes to Washington
AAMFT-CA Legislation Weigh-in
CANRA Understanding Update
Licensing Exam Update
Providing Systemically Oriented & Contextually Sensitive Supervision
Surviving the Doctoral Process: Rewards, Costs, and Benefits
In Memoriam: Bonnie K. Anderson, LMFT

 

Dear Reader,

It is with great pleasure that we offer a newsletter that piques the interest of all our of members. Our goal is to produce a newsletter that will serve as one of many exceptional tools offered by AMFT-CA that can take you into the future as a prepared professional. Should you wish to contribute to the future success of our newsletter or profession, forward your comment(s), idea(s), or article title(s) to me here. We look forward to hearing from you.

Warm regards,

David Clark, MA
Editor

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AAMFT-CA Division Goes to Washington

Olivia Loewy, PhD

Every Spring AAMFT Division leaders from across the country meet for four days of Leadership Training and Capitol Hill visits. This year, the AAMFT-CA Division participants included: Board President Norma Scarborough; President Elect Naveen Jonathan; Minority Fellow Carizma Chapman and Executive Director Olivia Loewy. In the months prior to the Hill visits, AAMFT Central staff identified those key legislators who are in a position to influence decisions that will be made in relation to our national Advocacy Agenda priorities. CA Division meetings focused either on Medicare inclusion for MFTs or the V.A. prohibitive hiring regulations.

Medicare

In our Medicare-focused meetings, we asked legislators to improve access to covered mental health services by including Marriage and Family Therapists among the list of providers who can deliver those services at the same pay rate as clinical social workers. We explained that Marriage and Family Therapists are not seeking to expand the scope of mental health services covered by Medicare, nor are we seeking to expand our own scope of practice. Instead, MFTs are simply trying to correct an inequity that restricts beneficiaries’ access to a particular type of qualified mental health provider.

While we were in D.C. Senator Wyden (D-OR) introduced S 562, a bi-partisan bill to provide for the coverage of marriage and family therapist services and mental health counselor services under part B of the Medicare program and for other purposes. This act is cited as the “Seniors Mental Health Access Improvement Act of 2013”.

Department of Veterans’ Affairs

In our V.A.–focused meetings we asked that Congress prod the Department of Veteran’s Affairs (VA) to improve access to mental health services provided by licensed Marriage and Family Therapists at V.A. facilities by eliminating specific bureaucratic obstacles. More specifically, half of all licensed MFTs are barred from eligibility for VA jobs because they do not hold advanced degrees from academic programs that were accredited by COAMFTE at the time those degrees were granted, with no alternative deemed acceptable by the VA. This is despite the fact that COAMFTE was not established until 1978, so paradoxically MFTs with the most clinical experience are ineligible for VA. In California, about 95% or all MFTs are ineligible for VA jobs.

In addition, we addressed concerns related to the following:

  • All advanced MFT students are barred from VA internship stipends, although Social Work and Psychology students are eligible.
  • VA’s MFT jobs to date are concentrated in Vet Centers despite major mental-health needs in VA Medical Centers and Clinics.

At these meetings we asked legislators to improve access to VA mental health services by urging VA to: 1) establish an alternative to its COAMFTE degree requirement (such as licensure for three or more years); 2) make MFT interns in COAMFTE degree programs eligible for VA stipends; and 3) urge its Regional Networks (VISNs) to include MFTs as eligible for positions in VA hospitals and clinics.

Leadership Training

Following our lobby day, Division leaders spent the weekend in training led by AAMFT staff and the new Executive Director, Tracy Todd.  Learning labs addressed:  Division Advocacy; Social Media; Finance; Membership Engagement, Recruitment and Retention.  There was ample opportunity during this time to connect and share with other Division leaders as well as open Q and A built into each section of training.

We are Making Progress

I have seen some great progress since I first began participating in the Capitol Hill meetings with legislators nine years ago.

  • Most notable: the legislators and their office staff now seem to know who we are and understand what Marriage and Family Therapists do. While we may still need to clarify our expertise and credentials, there has been substantial improvement in the past couple of years related to our profession’s visibility.
  • Another notable gain for the CA Division: in the past few years, we have actively communicated with CAMFT in order to provide consistency of message. This year, CAMFT conducted Hill visits the week after ours, armed with information about who we met with and what we discussed. A coordinated approach is important to enhance clarity, as both associations meet with our CA legislators.

Olivia Loewy, PhD is Executive Director of AAMFT-CA.  She can be reached at olivialoewy@aamftca.org

Image source: Courtesy of Olivia Loewy, PhD

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AAMFT-CA Weighs in on Proposed Laws

Benjamin E. Caldwell, PsyD

The AAMFT-CA Legislative and Advocacy Committee has been making its presence felt in Sacramento again this year. We have taken the following positions on proposed legislation:

AB252 (Yamada) would restrict the title “social worker,” making it illegal for any individual or employer to use the title for any position that does not require an accredited degree in social work. While we would be quick to agree that current job titles, especially in public settings such as child welfare agencies, can be confusing to the public and even to professionals, this bill risks shutting MFTs and MFT interns out of positions for which they are well-qualified. While we do not believe this is the sponsor’s intent, it is a significant potential result. AAMFT-CA has taken a position of Oppose Unless Amended on this bill, in hopes that the title confusion can be resolved without the negative impact on practitioners.

AB760 (Dickinson) would use a small tax on retail ammunition sales to fund early childhood mental health intervention programs. While current science is inconclusive as to whether such programs ultimately reduce gun-related violence, they have been shown to have a number of other significant positive impacts on children’s well-being. AAMFT-CA supports this bill.

SB282 (Beall) would require health insurers to take a number of steps to evaluate their level of compliance with mental health parity law, and to inform the public of the results of those evaluations. AAMFT-CA supports this bill.

SB578 (Wyland) is a CAMFT-sponsored bill that seeks to clarify in state law what kinds of dual relationships qualify as unprofessional conduct. We at AAMFT-CA have concerns that the current draft language could lead some dual relationships to be declared unprofessional conduct even when they would be within ethical standards. However, we have thus far refrained from taking an official position, and CAMFT has been cooperative with us in working on the specific language. We will likely support this bill once the language can be amended to address our concerns.

This list just hits a few highlights; we have taken formal positions on more than a dozen proposed bills so far, and will likely be weighing in on more as bills we are currently watching are amended. The legislative process can move swiftly, and so our stances on these and other bills may change. We will continue to keep you updated as the legislative calendar progresses.

Benjamin E. Caldwell, PsyD chairs the AAMFT-CA Legislative and Advocacy Committee. He can be reached at bcaldwell@alliant.edu

Image source: Courtesy of Ben Caldwell, PhD

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Legal Opinion Shifts Understanding of Child Abuse Reporting Laws

Benjamin E. Caldwell, PsyD

According to a legal opinion prepared for the Board of Behavioral Sciences and released Thursday, therapists do not need to report consensual oral or anal sex among minors of similar ages as child abuse, unless there is evidence of “force, undue influence, coercion, or other indicators of abuse.”

This is a welcome change, and runs counter to what has been commonly taught in MFT programs for years. We at AAMFT-CA, our colleagues at CAMFT, and even the state’s Board of Psychology have shared an understanding of current law that suggests consensual oral or anal sex is treated differently from heterosexual intercourse for the purposes of child abuse reporting. The new DCA opinion interprets case law, which had previously been applied primarily to those under 14, as applying to minors of all ages.

Under the opinion, therapists would still need to review state law to see how “similar ages” is defined. For example, if both partners are under age 14 and of similar chronological and maturational age, and there is no evidence of force or abuse within the minors’ consensual activity, a report would not be required. However, if one minor were under 14 and the other 14 or older, a report would be necessary. The opinion does not change how the law defines “similar ages,” but rather applies those age combinations to all forms of sexual activity, and not just intercourse.

BBS Executive Officer Kim Madsen announced at Thursday’s meeting of the BBS Policy and Advocacy Committee, where the opinion was first revealed, that she would be making the full legal opinion public.

Understanding that therapists have struggled for years with the law’s apparent distinction between intercourse and other forms of sexual activity, AAMFT-CA had made fixing California’s Child Abuse and Neglect Reporting Act a legislative priority for 2013. This opinion provides a swift and very positive outcome to that effort. While the DCA opinion does not carry the weight of state law, it does provide a strong defense for those therapists who seek to treat minors fairly and without discrimination when determining whether specific actions qualify as abuse.

Benjamin E. Caldwell, PsyD chairs the AAMFT-CA Legislative and Advocacy Committee. He can be reached at bcaldwell@alliant.edu

Image source: Courtesy of Ben Caldwell, PhD

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Licensing Exam Restructure may be Pushed to 2016

Benjamin E. Caldwell, PsyD

Citing delays in the launch of an updated database system that promises to make licensing applications and renewals easier, the BBS announced on Thursday that it would be further pushing back planned changes in the MFT licensing exam structure. The BBS said it plans to ask the Legislature to delay the new testing process to January 1, 2016.

The updated exam structure – originally scheduled to take effect January 1, 2013, but pushed to January 2014 by legislation last year – would have MFT interns taking a Law and Ethics exam in their first year of intern registration, and then a Clinical exam at the end of their 3,000 hours of supervised experience. The BBS has been working with the Association of Marital and Family Therapy Regulatory Boards on the possibility of using the National MFT Exam as California’s Clinical Exam once the new testing process takes effect.

The Legislature does not have to go along with the BBS request, but if the law requires a change in the testing process before the new database system can effectively track licensure candidates through the process, the result would be that licensure exams would not be offered at all until the new database is ready. So the Legislature is likely to allow the BBS to push the changes back, continuing the current testing process in the meantime.

We at AAMFT-CA were disappointed to hear this news, and have encouraged the BBS to frame any proposed legislative language in such a way that they can transition to the new exam process as soon as possible once the updated database system is ready. We will continue working with the BBS toward implementation of the National MFT Exam in California.

Benjamin E. Caldwell, PsyD chairs the AAMFT-CA Legislative and Advocacy Committee. He can be reached at bcaldwell@alliant.edu

Image source: Courtesy of Ben Caldwell, PhD

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Providing Systemically Oriented & Contextually Sensitive Supervision

Jeff Jackson, PhD

The purpose of supervision is to (a) help supervisees improve their ability to provide quality, effective, and ethical therapeutic services to their clients, and (b) ensure that clients are receiving quality, effective, and ethical therapeutic services (Storm, Todd, Sprenkle, & Morgan, 2001). Therefore, supervision is the fundamental vehicle for assisting pre-licensed therapists in developing, implementing, and refining the art and skills associated with successful clinical practice. This brief article explores the value of providing systemically-oriented and contextually sensitive supervision in an effort to assist pre-licensed therapists in their clinical development.

Systemically Oriented Supervision
Systems theory asserts that interactional patterns which exist in one relational context affect other interconnected relational contexts (White & Klein, 2002). As such, supervisors need to simultaneously monitor interactions between client family members, clients and supervisees, and themselves and their supervisees. For example, not only can interaction patterns which exist between client family members such as triangulation and pursuing-distancing be replicated between supervisee and supervisor, relationship patterns which exist between supervisor and supervisee can also be replicated between the supervisee and her or his clients (Gardner, Bobele, & Biever, 2002; Reiner, 2002; Roberto, 2002; Todd, 2002; White & Russell, 1997). Directly observing the therapeutic process between supervisees and clients through live and video supervision is in harmony with a systemic supervision orientation because they facilitate focusing on process over content (DeRoma, Hickey, & Stanek, 2007; Roberts, Winek, & Mulgrew, 1999). It is not surprising that supervises indicate that the most helpful supervision occurs in live supervision and video supervision over verbal report supervision (Anderson, Schlossberg, & Rigazio-DiGilio, 2000).

Contextually Sensitivity Supervision
Supervisors have an ethical responsibility to protect clients’ welfare, rights, and best interest, and to train supervisees in the importance of contextual understanding and sensitivity (Storm & Haug, 2002). Exploring the influence of contextual issues like age, class, culture, education, family-of-origin issues, gender, nationality, physical and cognitive abilities, power, race, religion, and sexuality on and between clients, supervisees, and supervisor opens doors for learning and growth for all involved (Thomas, 2003). In fact, supervisees stress that a supervisor’s ability to be understanding of differences is one of the major protective factors against having a negative supervisory experience (Magnuson et al., 2000 Taylor, Hernández, Deri, Rankin, & Siegel, 2007).

Because awareness is central to ethical practices (Storm & Haug, 2002), an overarching knowledge of contextual issues is essential. Adopting an informed not-knowing therapeutic stance (Shapiro, 1995) helps preserve the individuality and unique experiences of both supervisees and clients while concurrently incorporating the supervisor’s knowledge and experience. First and foremost, an informed not-knowing approach emphasizes that each person is the expert on his or her life. The more we are informed about what might be expected for a person in a certain situation, of a particular culture, or at a specific developmental stage, the more likely it is that we are able to (1) listen, (2) provide more attuned empathy, (3) recognize narratives, (4) generate questions that enrich understanding, (5) guide the focus of treatment and supervision, (6) realize our own personal biases, and (7) respect and honor the experiences of clients and supervisees (Laird, 1998).

Because personal values, beliefs, biases, and life experiences influence the way we see and comprehend the world around us, the better we understand ourselves, the more effective we are as clinicians and supervisors. In addition, to be effective supervisors we must persistently broaden our understanding of others through continuing education, training, clinical literature, media reports, and openness to being taught directly by clients and supervisees.

Image source: Courtesy of Jeff Jackson, PhD

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Surviving the Doctoral Process: Rewards, Costs, and Benefits

Kate Wilson, M.A., Psy.D Student

One of the scariest times in my life was deciding whether to earn a Master’s or Doctoral degree.  There are so many questions to answer, for example:  Should I enroll in a cohort or individual program model?  How will my social life be affected?  What benefits might I experience with a Doctoral degree versus a Master’s degree?  What financial considerations must I account for?  As I write this I’m currently in the 4th year of a Psychology Doctoral program, and share what I found to be true for myself and students in Doctoral programs at my university.  Throughout this time I’ve come to learn that I’m surviving quite well and my family is amazingly resilient.  There are, however, tidbits of information that would have helped greatly to ease anxiety in the beginning of my journey, some of which I share with you here.

When I considered a Doctoral program I had thought that my social life would suffer.  I discovered through the cohort model that my life became incredibly enriched by the meaningful friendships I made.  My classmates are people I bonded with over laughter and tears.  The friendships enriched my social life more than I had ever imagined, and afforded me more friendships than ever before.  Additionally, my experience has been fortunate in that I have met and bonded with students from diverse populations.  From them I have learned as much as I have from those charged with my instruction at the Master’s and Doctoral level.

Oftentimes, people will ask why I didn’t stop at the Master’s level or why I am bothering with a Doctorate.  I typically respond by citing the greater opportunity available with a Doctoral degree.  For those of us interested in management, teaching, specialties, and research, a Doctoral degree will allow for a greater likelihood of these aspirations.  However, there are a number of placements for those with a Master’s degree and licensure.  Alternatively, my experience has been that finding an internship site that can accommodate the requirements of a Doctoral student can be difficult.  Persistence and an open mind can help greatly in finding a site, so don’t be afraid to network out of your comfort zone.  For example, volunteering for a professional organization can greatly increase your visibility to potential employers and internships that offer an income.

Of course, financial considerations must be made.  Paying for graduate school is no cheap adventure.  When I investigated graduate schools I realized that after paying tuition, books, others supplies, and basic living expenses, I was looking at what amounted to a down payment on a very nice home, and in some places the price of a home itself.  Financial aid forms were easy to complete, but I strongly also recommend looking for stipends and grants to help pay your way.

A cost I had to discuss with my partner was the possible toll on my family life.  With a pre-teen and an adolescent, determining how to rearrange responsibilities and time to spend with my children has been challenging at times.  I was concerned that working toward a Doctoral degree could cause us to become alienated.  However, through the program the most surprising and valuable benefit I’ve been afforded is personal growth.  The support of my cohort and instructors engendered an environment that increased my academic knowledge as well as refined my emotional intelligence.  Greater understanding helped me better connect with my family, and I believe has helped my family grow as well.  Emotional growth is an asset that cannot be priced.  Thus, I focus on the intangible benefits knowing I will be able to manage the tangible costs of a Doctoral degree.

Of course, your experience may significantly differ from mine, so be sure to consider interviewing others in different Doctoral programs and answer questions specific to your circumstances to make an informed decision.  Most important of all, don’t forget to take care of yourself.

kate@katewilsonmfti.com

Image source: Courtesy of Kate Wilson, M.A., Psy.D Student

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In Memoriam: Bonnie K. Anderson, LMFT

Always with a ready smile, Bonnie was a wonderful friend, a supportive ear, and a lover of life. She was a connoisseur of human moments, the good, the anxious, and the profound. Bonnie loved going to movies, having dinner or lunch with friends, and reading and discussing good books.

A native Californian, Bonnie studied at the University of Arizona, in Phoenix, and ended up settling there. She was a well-respected Instructor at the University of Phoenix both in Arizona and in California.

Bonnie was the loving mother of Greg and Marnie, and the loving grandmother of Sam and Nina. Bonnie moved back to California to be with her family, after the untimely death of her son Greg.

Bonnie was a Family Therapist extraordinaire, she supervised and mentored many students, trainees, and interns. A follower of Allan Schore, she had studied his methods fully. She also studied with David Schnarch. Bonnie was a member of the Leadership Team of the Sacramento Networking District, AAMFT-CA. She embodied the warmth of equality and human rights to such a degree that in her presence you would feel held and respected, even in the face of adversity.

Bonnie was a woman who had wisdom, compassion, humor, courage, and vitality. The word spoken over and over that described Bonnie was Loving.

Bonnie left us on 19th March, 2013. She is greatly missed.

Gabrielle M. Guedet, Ph.D., LMFT
Darlene Davis, LMFT

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