AAMFT California Newsletter, Summer 2014

HEADLINES

AAMFT-CA 2nd Annual Gala
Advocacy Update
Member to Member
Clinical Corner
Book Review

 

AAMFT-CA 2nd ANNUAL GALA

Olivia Loewy, PhD
AAMFT-CA Executive Director

AAMFT-CA Division held its 2nd Annual Gala Fundraiser on June 22 at the L.A. Tennis Club. The event was sponsored by the California School of Professional Psychology at Alliant International University, Linda Cukier, Esq., Kahn Institute for Self-Injury and TrackYourHours.

The Gala is designed to raise funds that will support the work of AAMFT-CA Division as we take part in shaping the future of healthcare in California. Our mission is to ensure the provision of effective mental health services through advancement and protection of the profession of Marriage and Family Therapy.

With our growing visibility as an advocacy force in Sacramento, AAMFT-CA is able to influence policy and legislative decisions. In the professional community, AAMFT-CA is able to develop resources and offer cutting-edge training to prepare educators and clinicians for health care reform, as systems continue to evolve.

The Gala also provides an opportunity for AAMFT-CA to recognize and honor individuals whose work has contributed to the advancement of our profession:

Gala 2014

• Helen Meek (above, 2nd on left) was honored with the Mentor Award, given to a clinician whose commitment to excellence in training and supervision has inspired others in the work of marriage and family therapy.

• The Educator Award was given to Dr. Stan Tatkin (above, 4th from left), who has demonstrated a profound expertise, commitment to the field and leadership that has helped shape the practice of marriage and family therapy in our community.

• Shannon Minter, Esq. (above, 1st on right), Ally Award recipient, is a non-clinician who has made significant contributions to our field and to the delivery of mental health services to individuals, couples and families in the state of California.

 

The Gala is an elegant event in a beautiful setting, featuring live music, drinks, delicious hors d’oeuvres and an exciting silent auction. The CA Division is grateful to Event Chair Ralph Bruneau and his “dream team” committee members Larry Zucker, Alejandra Trujillo, Matilde Bengato, Sahar Aboutalebi and Vived Gonzalez, for the hours of planning, preparing and so skillfully attending to all the details. Thanks to all of you who were there to celebrate with us. We’re already looking forward to next year’s Gala!

AAMFT-CA is the MFT association in California that is focused on providing the information and resources you need to ensure your professional stability in the future. For more information, do not hesitate to contact Olivia Loewy:  olivialoewy@aamftca.org.

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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ADVOCACY UPDATE
Bills would change requirements for recordkeeping, suicide prevention training, and more

Benjamin E. Caldwell, PsyD
AAMFT-CA Legislative and Advocacy Chair

The 2014 California legislative session has seen a significant number of bills that would directly impact MFTs. Here are a few of the bills on which AAMFT-CA has been active this year (links point to full text of the bills on the legislature’s web site):

 

Assembly Bill 1505 (Garcia) would clarify the reporting requirements surrounding consensual sexual activity among minors. Current law is complex, confusing, and discriminatory, and AAMFT-CA has been fighting to put a clearer, more consistent standard in place. In response to our efforts, the Department of Consumer Affairs, which oversees the BBS and Board of Psychology among others, issued a legal opinion last year that allows professionals some discretion in reporting. However, it is not clear that this opinion would survive a court challenge, making the current landscape even more confusing for therapists in practice. This bill did not survive in committee, but the author is committed to continuing to work with us and other stakeholders toward a solution.

Assembly Bill 2198 (Levine) would require all MFT training programs to include at least 15 hours of training on suicide assessment, intervention, and prevention, and would require all licensed MFTs to take a six-hour CE course on the same. The same would apply to LCSWs, LPCCs, and Psychologists. While there is no doubt that suicide is a major public health concern, we are opposed to this bill in its current form. It imposes an unfounded new training requirement on those who already receive the most training on suicide, while ignoring much more serious and immediate issues impacting the state’s suicide rate, including the lack of available inpatient mental health beds. As such, we do not believe it will have any demonstrable impact on suicide. The bill is scheduled to be heard in the Senate Appropriations Committee on August 4.

Senate Bill 570 (DeSaulnier) would create the “Licensed Advanced Alcohol and Drug Counselor” license in California. It would not interfere with MFTs’ ability to perform assessment and intervention related to substance use, and has grandparenting provisions that would allow MFTs currently trained and working in this area to obtain the LAADC license. We are not opposed in principle to a specific license for drug and alcohol counselors. However, we are opposed to this bill in its current form. Of greatest concern is language in the LAADC scope that would force them to use only abstinence-based approaches, in spite of clear and convincing scientific evidence supporting harm-reduction approaches to substance use treatment. We are also concerned about discussion of putting this license under the purview of the BBS, which is already overburdened and understaffed. The bill is awaiting hearing in the Assembly Appropriations Committee.

Senate Bill 578 (Wyland) would require mental health practitioners, including MFTs, to retain treatment records for at least seven years after the last professional contact. When working with minors, the records would need to be retained for seven years after the minor turns 18. We requested a clarifying amendment that the law would apply only to treatment ending on or after January 1, 2015, to ensure that no MFTs were unduly punished if they had retained records for shorter periods prior to the law taking effect. CAMFT, the bill’s sponsor, made the amendment, and we are happy to support the bill. The bill is awaiting an Assembly Floor vote.

Senate Bill 1012 (Wyland) would allow MFT interns to count up to six hours of supervision in a week toward licensure, rather than the current cap of five. This bill will particularly benefit interns working at more than one location, where each site provides weekly group and individual supervision. We are in support of this CAMFT-sponsored bill. The bill is awaiting an Assembly Floor vote.

This is just a sampling of the work of our Legislative and Advocacy Committee this year; we’ve taken positions on 16 bills that would impact MFTs and the clients we serve. We’re also working closely with CAMFT and the BBS Supervision Committee on possible 2015 legislation that would dramatically change the structure by which hours of experience are counted toward licensure, getting rid of many of the “buckets” of hours that currently make the process needlessly long and complex. Look for more on this issue in the weeks ahead.

You can reach Ben Caldwell directly at bcaldwell@alliant.edu

Image source: Courtesy of Ben Caldwell, PhD

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MEMBER TO MEMBER
Preparing ourselves for the future

Linda Buck

Linda Buck, CSJ, LMFT
AAMFT-CA eNews Editor

There has been a lot of changes in healthcare over the past years, with the advent of the Affordable Care Act, and most recently the passing of the Excellence in Mental Health Act. What does this mean for our profession as Marriage and Family Therapists? To better acquaint myself with these changes, I have recently attended two of the offerings through AAMFT-CA: Forum for Educators and Supervisors (May) and the California Council of Community Mental Health Agencies (CCCMHA) Policy Forum (June). Both provided a comprehensive overview of the trajectory for the field of behavioral health, including marriage and family therapy.

The May event was for educators and supervisors to explore what students and interns may experience when they begin looking for site placement. Most important were the conversations around how these pre-licensed individuals need to be prepared. Throughout the day there was an overview of the Affordable Care Act and implications for our field, emergent structures and trends within community mental health (viewed through the lens of Los Angeles County Department of Mental Health), innovative programs using telemedicine for forensic recovery reintegration (through Telecare Corp), and the unique situation of California in terms of COAMFTE.

The June event was collaboration between AAMFT-CA and CCCMH. CCCMH is the agency behind Proposition 63. Members of AAMFT-CA were invited to participate in one day of their conference. During this day, Charles Ingoglia, MSW (VP, Public Policy and Practice Improvement) from the National Council for Behavioral Health, provided a National Healthcare Update. This was an invaluable overview of emerging trends throughout the nation regarding healthcare and behavioral health.

The content of both events had very similar threads. A few highlights include:

  • Healthcare, including mental health and substance use treatment (together called “behavioral health), is moving toward an integrated model of community health.
  • The use of technology to reach marginalized and/or remote populations is essential and cost-effective.
  • The idea of training students and interns solely from a framework to succeed in private practice is misguided. Students and interns (and licensed therapists) need to shift our reference to embrace different delivery systems and view our work from a more integrative model.

Part of our responsibility as Marriage and Family Therapists is to stay abreast with the trends and trajectory of our field. This enables us to advocate for our clients and ourselves. In addition, if we are clinical supervisors and/or educators, it is imperative that we remain knowledgeable regarding what our students and interns need to know to be successful. The take away from these two events in which I continue to ponder is the reality that there is definitely a shift from developing skills for private practice (and training pre-licensed therapists for this type of work) to embracing the reality of community mental health and the skills needed to work within this system.

Linda Buck, CSJ, LMFT is an AAMFT-approved clinical supervisor, educator and has a private practice in Santa Ana, CA.  In addition, she is involved in healthcare through St. Joseph Health as a Board Member for Mission Hospital and an advocate for developing programs to serve marginalized populations. She can be reached at lbuckmft@gmail.com

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CLINICAL CORNER
Fortifying Growth in a Couple-Ship after insight

Joan Shaver

Joan Shaver, LMFT
Author, Lipstick and Soul
Private Practice in Santa Monica

After thirty five years in private practice, a challenge that still intrigues me is how to help intellectual clients, sophisticated in relationship parlance, see beyond the limited perception paradigm they operate in. For example, “How do you help clients come to know, deep in their bones, that their intellectual approach to the world is possibly a relationship barrier? How do you help them see that their issue is not an under-developed communication skill set, it is the inability to recognize and own their authentic emotional experience apart from the protective system they live in and view the world from?” Most importantly, and the focus of this article, is once a client gets an inkling of their “relationship blind spot”, the question becomes, “How do you encourage such a well-intentioned person to take the risk to step into the experiential void, especially when the client has a history of trauma and is prone to emotional triggers?” With the help of clients who report back to me that the reframing interventions with “specific positive language” benefit them the most, I now have ideas to share with you.

The intervention under discussion focuses on the moments after a therapeutic break-through when one person in the couple-ship gains insight into how their “previous” lack of awareness contributes to the relationship difficulties the couple is experiencing. Getting to this point includes making a conscious agreement with the clients that, if necessary, I, you, the therapist have permission to facilitate corrective experiences to repair misguided interactions, as well as support new positive behavior patterns as they emerge in the couple-ship.

For instance, let’s take a look at Karl and Mary, a successful married couple, both in their mid- thirties. Karl and Mary have been caught in a power struggle brought on by an inability to see eye to eye on an issue they are trying to resolve. Karl, who has been in denial about the role his hyper-vigilance plays in the communication breakdown, has a history of attachment trauma in his background. His denial has contributed to the therapeutic impasse. In this instance, Karl has just become aware of his “blind spot” and the impact his inability “to see” has had on the couples’ capacity to move forward. A look of shock registers on Karl’s face. He starts to turn his head downward, while uttering self-admonishing words.

This is the moment you wait for; the one to catch. Like a surgeon who makes a deft incision to clear away infected tissue from a healthy organ, you, the therapist make a clear move to facilitate the clients’ orientation toward the success of achieving new self-awareness. Especially in the case of trauma, the idea is to separate out, uncouple, the two co-existing experiences, the old and the new, so that the default mechanism of self-criticism does not get completely triggered and become the focus of attention. At this point, there are two goals in mind; the first is to normalize the paradoxical experience of Karl. The second goal is to provide Karl with a personal moment of triumph, as well as vis-à-vis Mary.

To achieve the first goal, the therapist mirrors back to the client, in a compassionate voice, the accuracy of their self-assessment. Like, telling Karl that he is seeing clearly. To stabilize the progress, the therapist begins the positive reframing process by saying, “Karl, let’s take a look, because just as you are becoming aware of (name in their words the blind spot), something else is also happening. In this room, right now, you are demonstrating optimal health.” To provide a reality check, the therapist, in a nurturing tone, slowly continues, “Right now, you are checked in. You are present as you acknowledge to yourself and to Mary a very difficult truth. This takes courage.” To keep Mary, the spouse, in the recovery process, she is directed to add some positive words to Karl about what it is like to have an open and emotionally available partner to communicate with. The positive declarations keep the “awaking client”, in this case Karl, in relationship, thus fortifying the couple-ship as well as providing them with a sense of mastery.

To strengthen awareness of a mind-body connection, which is imperative when dealing with trauma, the therapist might add observations about an area that is being worked on, like “Karl, you have good eye contact with Mary. Your whole body is turned towards her.” Pause. “You are here is in this room, right now, whole and healthy… And Karl, also take a moment to really look at Mary. Notice how she is here with you.” After some process work, the therapist can begin closure of the segment by saying in a conversational tone, “What more could anyone ask for than the capacity to remain in healthy relationship with the one you love, while processing difficult material?” More words that matter are: “This is health in action”.

To empower the couple-ship and provide incentive for future work, the therapist might end the segment with, “Remember, you both succeeded together! Karl you took a risk and opened up. Mary, you were present for Karl while he was processing difficult material. This is relationship at is finest. Good for the both of you.” At this point, it is common to hear sighs of relief.

Joan Shaver MS, LMFT (#7275) is in private practice in Santa Monica, CA. She is a BBS, (CA) CEU provider for LMFT’S and LCSW’S (#3514). In addition to working with individuals and couples, her specialties include: addiction recovery and trauma. Her passion is working with women to help them transcend their over-identification with the role of nurturer. She authored her first book, “Lipstick and Soul, An invitation to women: open your heart to the mysterious feminine and let love in”, a synthesis of her work, to address this issue. Her website is: www.lipstickandsoul.com.

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BOOK REVIEW
Basics of California law for LMFTS, LPCCS, and LCSWS

normaAuthor: Benjamin E. Caldwell, PsyD, LMFT

2014 Edition
Click here for print version (Amazon)
Click here for e-book version (CALawBook)

Reviewed by Brent A. Taylor, PhD, LMFT
Associate Professor, San Diego State University
MFT Program Director

Whether you are new to the counseling profession in California or are a seasoned therapist, this book is an essential guide to navigating the labyrinth of laws that dictate the practices of this profession. This book is the most user friendly, easily comprehensible book I have read regarding legal matters. The content is organized into ten areas so that you can quickly find specific information about any legal matter you are seeking in a matter of seconds. While there are many books about ethical issues in our profession, there are not books regarding state law, and this text more than adequately fills this void. The author explicitly states that this book does not replace legal advice, nor does it cover every legal situation, but is meant as a guide for informational purposes only.

For MFT trainees and interns, the text provides clear, concise guidelines to help them practice in a legal and ethical manner. Common questions, such as what is reportable in a suspected abuse case, are clearly outlined. Definitions for each term are effectively defined to provide greater comprehension. Newly licensed MFT’s will find the section on advertising useful in developing a practice.

This book covers the latest information about laws and provides a legal understanding of changes that affect our profession. For example, the section on technology explains key issues such as telehealth, providing services by phone or internet, and online advertising.

My favorite section of the book is the concluding chapter that discusses the importance of advocacy for our field. Many therapists are reluctant to involve themselves in policy and law changes. However, the author passionately claims it is “our calling” to be involved. The process of what it takes to be a successful advocate is succinctly outlined. The advocacy process is described as a seven step process including 1) recognizing a problem or concern, 2) identifying a specific policy issue, 3) gathering information, 4) strategizing, 5) taking action, 6) adapting and sometimes compromising, and 7) repeating the process as needed. Three pertinent examples of the advocacy process are given: the “couple and family therapy” degree title, the LPCC license, and interns paying for supervision. After reading this chapter, you will want to get involved in the policy-making process that so greatly affect this profession.

While we often ignore the appendices in books, they should not be ignored in this case. There is a directory of key stakeholder groups providing information about government, state professional organizations, and consumer/family/provider organizations.

In sum, I strongly recommend this book for clinicians at any level in their career. I am confident it will become a great resource for classroom use in MFT training programs, as well as an often used book in the offices of interns, licensed therapists, and supervisors. By understanding the laws outlined in this book, you can be assured that you are practicing in a legal and ethical matter in California.

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JOBS POSTED FOR CA MEMBERS

Check out the Members Only section of www.aamftca.org and find current job opportunities listed under the heading:  California Position Announcements.  Members may log in using the code: aamftca123

Thank you to the E-News editorial team: Linda Buck, Steve Brown, Mary Moline, Marilyn Davis, Blessing Okoro Rellias, and Heather Laird Jackson. We encourage you to provide feedback and send us a note. Let us know how we are doing, share an article idea you’d like published, or submit one of your own. Want a greater stake in the publication process? You can join the editorial team. Contact: olivialoewy@aamftca.org

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