From Private Practice to Academia: Integrating social and political advocacy into every MFT Identity

While advocacy was essential to establishing the field of marriage and family therapy, at present a social and political advocacy skill set is lacking for the typical marriage and family therapist (MFT). This article reviews the importance of being active in social and political advocacy and highlights the attributes of MFTs’ professional identity that uniquely position us for success in these areas. Other mental health fields’ pedagogical approaches to training and education are explored, and recommendations are made for how MFTs can begin to increase their competency in advocacy. Ideas for incorporating advocacy into a professional identity are presented for MFTs at every level of professional experience. Finally, the concept self‐of‐the‐advocate is introduced and discussed.     

DOES ACADEMIC TRAINING BACKGROUND MAKE A DIFFERENCE AMONG PRACTICING MARRIAGE AND FAMILY THERAPISTS?

Using a national sample of practicing marriage and family therapists (MFTs) and their clients, this study investigated whether academic training background is associated with differences in pracice patterns and client outcomes. Clinical members of the American Association for Marriage and Family Therapy with academic training in psychology, social work, counseling, and marriage and family therapy were compared on a wide range of clinical practice variables, and their clients were surveyed about thier satisfaction and outcomes. Results showed highly similar practice patterns and client outcomes across all four disciplinary groups. Although the findings showed little evidence for the uniqueness of academic marriage and family therapy training among experienced MFTs, they also refute the notion that therapists trained in MFT degree programs practice in unusual or inferior ways compared to MFTs trained originally in other mental health disciplines.     

Use of simulated clients in marriage and family therapy education

Knowledge of how one should manage suicidal, homicidal, child maltreatment, and domestic violence situations is paramount in the training of marriage and family therapists (MFTs). Simulated patient modules were created to help clinical faculty address these crisis situations in a protected learning environment. The modules were implemented by the MFT faculty in collaboration with the Office of Clinical Skills Assessment and Education at East Carolina University's Brody School of Medicine. Qualitative data over the course of 2 years revealed six thematic domains regarding therapists' performance, therapists' emotions, the simulation experiences, and lessons learned. Educational, clinical, and research recommendations include tools to implement simulation exercises into marriage and family therapy programs as well as suggestions to assess for teaching effectiveness.     

Social Work Student Learning Experiences of Family Therapy: Improving Competency in Pedagogy Through Qualitative Research

The purpose of this qualitative study is to evaluate graduate social work student experiences of pedagogy intended to improve competency in family therapy practice. Students from two classes (N = 37) completed open‐ended surveys assessing: perceptions of most helpful pedagogical practices; understanding of needed competencies; and perceived opportunities offered to them during their graduate training for learning about work with couples and families. Results, analysed using grounded theory methodology, revealed that students: (1) believed that experiential activities were especially critical for learning how to do clinical practice with couples and families; (2) understood important competencies related to professional development, therapeutic engagement with the family, and how to approach family practice; and (3) believed they were ‘somewhat prepared’ for practice. Implications include improving understanding of abstract skills in practice with couples and families, and emphasising relationship dynamics more in graduate social work education and training.     

Experiences of Family Therapists Working with Families in a Transitional Homeless Community

The purpose of this study was to explore the experiences and observations of marriage and family therapists (MFTs) conducting an empirically supported parenting program at a transitional homeless community. A diary method was used in recording five MFTs' observations and reactions to implementing the psychoeducational groups. Fifty‐one recordings were collected from three different parenting groups over the course of 20 weeks. Constant comparative method was used to identify themes related to MFTs' experiences of conducting the parenting program. These themes included the needs of at‐risk families, confidentiality, and role ambivalence and boundary ambiguity. We provide recommendations for best practices and an example of therapists' decision‐making process using Kitchener's (1984) model.     

Social support networks,instant messaging,and gender equity in refugee education

ABSTRACT

This paper addresses the role of instant messaging chat groups to support teacher training and gender equity initiatives in Kenyan refugee camps. Our findings are based on survey data with refugee teachers in Dadaab and Kakuma refugee camps (n?=?203), group interviews with refugee teachers in Kakuma (n?=?21), and interviews with international instructors of teacher training programs in Nairobi, Toronto, and Vancouver (n?=?14). In our analysis, we apply amplification theory, feminist science and technology studies paradigms, and considerations of transnational approaches to understand the use of instant messaging among refugee teacher communities. Our framework explores how social and cultural norms are amplified through transnational text and instant messaging related to teacher training and in support of gender equity. Peer-to-peer group chats draw on transnational learning opportunities and expand these engagements through group chats between men and women refugee teachers across camps as well as through community engagement about gender equity initiatives in education. International instructors identify both value and hesitation in navigating the quantity and content of these communications, such as learning more about refugee teachers’ daily lives in the camps and concern about following and managing the amount of communication that can ensue over chat groups. Our work has practical implications for transnational teacher training programs in refugee camps, illuminates how mobile technology and chat groups allow women and men in the community to engage and support girls’ education, and questions how text messaging affects the lived and day-to-day experiences of women refugee teachers.     

Comparisons of marriage and family therapists, psychologists, psychiatrists, and social workers on job-related measures and reactions to managed care in Iowa

This study compares marriage and family therapists (MFTs) to psychologists, psychiatrists, and social workers on job-related measures, such as job autonomy, job satisfaction, burnout, and intention to stay in their present position, as well as on reactions to a managed care initiative in the state of Iowa. Findings indicate that MFTs scored significantly lower than other practitioners on job autonomy and intention to stay in their present position, but there were no differences in job satisfaction or burnout. Marital and family therapists also reported less dissatisfaction with the managed care initiative than psychiatrists, although virtually all practitioners were dissatisfied with the managed-care program. These findings indicate some dissatisfaction within the MFT profession and may be relevant to practitioners seeking to change or expand their practice, as well as to the needs of MFTs in their training programs.     

The Impact of the Within My Reach Relationship Training on Relationship Skills and Outcomes for Low‐Income Individuals

A federal grant was awarded to provide the Within My Reach healthy relationships curriculum to low‐income, at‐risk individuals involved with various social service agencies. The effectiveness of this curriculum was evaluated for 202 participants through measures of training and relationship outcomes pre‐, immediately post‐ and 6 months posttraining. Participants experienced high levels of training satisfaction; significant increases in knowledge, communication/conflict resolution skills, and relationship quality; as well as a trend in the reduction of relationship violence. An important implication of this research is that MFTs may broaden their service delivery to at‐risk individuals by collaborating with community agencies to adapt established relationship enhancement programs, evidence‐based tools, and principles that complement traditional couples therapy.     

A National Survey of Family Physicians: Perspectives on Collaboration With Marriage and Family Therapists

Recognizing the fit between family medicine and marriage and family therapy (MFT), members of both fields have made significant advances in collaborative health research and practice. To add to this work, we surveyed a nationwide random sample of 240 family physicians (FPs) and asked about their perspectives and experiences of collaboration with MFTs. We found that FPs frequently perceive a need for their patients to receive MFT-related care, but their referral to and collaboration with MFTs were limited. Through responses to an open-ended question, we gained valuable information as to how MFTs could more effectively initiate collaboration with FPs.     

“Being a Therapist Doesn't Exclude You From Real Life”: Family Therapists’ Beliefs and Barriers to Political Action

A crucial and overlooked facet of social justice in family therapy is political and policy advocacy. Family therapists have unique insight into how social policies and political discourse shapes clients’ lives and the life of our profession. Such knowledge can inform policymakers and political debate, yet few family therapists are trained to engage in political action. In this randomized, national survey of licensed family therapists’ (N = 174), we explore beliefs about and barriers to engagement in political and policy processes. The findings suggest that there are significant barriers and uncertainties surrounding family therapists’ engagement, including time, feelings of efficacy, and interest. Given these barriers we discuss practical suggestions for clinicians and family therapy training programs.     

Training experiences of international doctoral students in marriage and family therapy

Recognizing mental health needs of diverse populations, emphasizing cultural diversity, and recruiting ethnic minority students are important foci of current of marriage and family therapy training programs. However, the profession has made little progress in identifying the needs and experiences of its international students and practitioners. This research examines the experiences of doctoral-level international students across the areas of theory, clinical training, supervision, practice, and research. A qualitative methodological approach was used to explore the research questions. Thirteen in-depth interviews were conducted. Findings revealed that most respondents experienced some adjustment problems, want more academic and career support, and need increased recognition for their cultural differences. Recommendations for training international students are included.     

COMPARING MEDICAL AND GRADUATE SCHOOL TRAINING: A PERSONAL PERSPECTIVE

In this paper the author subjectively compares his experiences in medicla school, psychiatric residency training, and an AAMFT -accredited PhD program in marriage and family therapy. The goal is to stimulate thinking on the nature of training and professional identity. This is done by marking assumptions regarding training overt which usually go unrecognized and unchallenged, Differences and similarities between the two programs of training are high-lighted and discussed. It is proposed that the primary objective of professional traininjg is to learn how to apply knowledge while the primary objective of graduate training is to learn how to question knowledge.     

Action‐Oriented Research: Strategies for Engaged Scholarship

Action‐oriented research is a methodological approach for doing collaborative research with practitioners and community partners that can inform practice, programs, community development, and policy while contributing to the scientific knowledge base. This article discusses how family scholars can use action‐oriented research to work together with community partners to address their need for useful information about their practices and programs. We present some practical strategies that can help guide the action‐oriented research process including how to develop collaborative relationships with community partners; suggestions for determining sound, action‐oriented research questions; guidelines for selecting and implementing appropriate research designs; and considerations regarding data collection and the dissemination of findings.     

SYSTEMS CONSULTATION AND HEAD START: AN ALTERNATIVE TO TRADITIONAL FAMILY THERAPY

As Marriage and Family Therapists (MFTs) enter Head Start programs, systems consultation emerges as a viable alternative to providing therapy to enrolled children and families. As systems consultants, family therapists can offer organizational consultation, training, and support to Head Start staff, classroom interventions, and direct work with families. This article describes a multidimensional model for providing comprehensive mental health consultation to Head Start programs. It explores the skills necessary for MFTs to work effectively as systems consultants. Finally, recommendations are made for applying the model in both university and private settings.     

A FAMILY THERAPY INTERNSHIP IN A MULTIDISCIPLINARY HEALTHCARE SETTING: TRAINEES' AND SUPERVISOR'S REFLECTIONS

Family therapy doctoral students from American Association for Marriage and Family Therapy-accredited programs are required to complete a full-time clinical internship. The literature provides little information about these internship experiences. Two doctoral-level marriage and family therapists summarize their professional and personal experiences in their internships located within a multidisciplinary healthcare setting. In addition, their supervisor reports on her experiences working with marriage and family therapy doctoral interns. We hope that this case report will stimulate all interns and their supervisors to provide feedback to their internship sites and graduate programs about their clinical training and the extent to which the programs prepared them for their marriage and family therapy careers in the larger health and mental health community.     

Reflections and Learning From an Agency‐Wide Implementation of Single Session Work in Family Therapy

In November 2009, the Bouverie Centre, a centre for training, research, and clinical family therapy in Melbourne, Australia, embarked on a 12‐month trial involving the implementation of single session work as our main model of service provision for all new family appointments. We were interested in evaluating clients' and therapists' experiences of this change in our clinical service delivery. This article discusses some clinical dilemmas that arose for staff in this process, and how they were addressed. Clients' responses to single session work are outlined, followed by a discussion of outcomes of the implementation for our organisation.     

Attitudes,Perceptions and Concerns of Student Social Workers: First Two Years of a Longitudinal Study

A longitudinal study was initiated by the authors in September 2001 to monitor the changing attitudes, perceptions, concerns and experiences of 32 social work students during their two‐year MSW training at University College Dublin, subsequently following the students into their first three years of practice. This paper reports on the findings from the first two years of the study, exploring how much the attitudes of the respondents changed towards different areas of social work practice while they were full‐time students. Both quantitative and qualitative data have been collected by means of mixed method questionnaires, taken at four points over a two‐year period, and a focus group. Issues examined included the students' changing perceptions of stress, job satisfaction and levels of expertise in different areas of social work practice. The study also monitored their willingness to work in specific areas of social work after graduation. Statistical analysis revealed that students consistently rated social work in the areas of child protection and welfare as requiring high levels of expertise, but they associated the area with higher levels of perceived stress and lower levels of job satisfaction. These attitudes remain relatively stable throughout their two‐year professional training. However, the study revealed greater changes in the students' willingness to work in different areas. For example, specialist family services such as fostering and child/adolescent became more popular choices for future work settings. This change was noted to have occurred between the start and end of the course. Also noteworthy was that general medical, probation and welfare showed the most negative change.     

THE AAMFT-HEAD START TRAINING PARTNERSHIP PROJECT: ENHANCING MFT CAPACITIES BEYOND THE FAMILY SYSTEM

This paper summarizes the experience of a two-year project to promote partnerships between 12 graduate Marriage and Family Therapy (MFT) training programs and their 12 local Head Start partners. The American Association for Marriage and Family Therapy (AAMFT) awarded 9 grants to MFT-Head Start partnerships that had established relationships with each other prior to the project. Three MFT-Head Start pairs that had no preexisting relationship but wanted to develop one received planning grants. The partnership project provided an exciting opportunity for MFT faculty and interns to integrate family systems theory into larger organizational settings and to enhance the capacity of MFTs to serve disadvantaged, low-income, culturally diverse families and the community agencies that work with them. Preparing MFT students to intervene and respond systemically both in organizations and with the families they serve represents a viable alternative to more traditional approaches to MFT that limit the focus to the family system. Survey results and interview data reflect the rich experiences of MFT faculty and supervisors, MFT interns, and Head Start staff. Implementation issues are discussed and recommendations are made to improve the collaboration between MFTs and community-based agencies such as Head Start.     

Measuring the Effectiveness of the Emotionally Focused Therapy Externship Training in Hungary done through Translation

Our study adds to the rising field of dissemination and implementation research on Emotionally Focused Therapy. We evaluated the psychometric characteristics of the Hungarian EFT‐KACS, examined the impact of the EFT Externship training done through translation on Hungarian therapists, and we investigated how therapist background characteristics related to outcomes. A total of 340 Hungarian professionals completed the questionnaires (N = 152 in 2016; and N = 188 in 2018) at three data collecting points—prior to (N = 329), after the training (N = 254), and 6 months later (N = 101). Results suggest the Hungarian EFT‐KACS has similar psychometric properties as the original English version and shows high internal consistency. The 4‐day EFT Externship trainings done through translation provided significant, lasting increases in perceived EFT‐specific knowledge and competency, and in alliance, similar to findings in English‐ and Spanish‐speaking countries. Externship outcomes were also found to be related to specific therapist experience and background characteristics.