What's in a name? "Couple" v "Marriage" and family therapy

Marriage and family therapists (MFTs) work with individuals, families, and couples of all types. We assess, diagnose and treat the full range of mental and emotional disorders. So, the title "marriage and family therapist" doesn't provide the whole picture of what we do.

Should the name of the license be changed?

Several MFT programs have changed the name of their degree or even their department to "Couple and family therapy." This is much more reflective of the broad scope of couples with whom we are trained to work. But there would be major tradeoffs involved in changing the name of the license:

Advocacy work for the profession relies on educating legislators and their staff about who MFTs are and what we do, building our reputation and their sense of MFTs' qualifications. Changing the name of the license would set back our name recognition among those legislators, and require us to start again on that process of educating them about what may seem to them to be a brand new profession. It also would mean that a massive number of state and federal laws and regulations would need to be updated with the new name, a process that would divert resources away from advancing the profession to focus instead on preserving it.

Educating the public would be equally challenging. Our current title does do a nice job of differentiating our history and philosophy from other mental health licenses. For tens of thousands of clients and referral sources, the confidence they have in seeing or referring to MFTs may be undermined if the license name were to change. (However, many within mental health are quick to say that clients do not care about a therapist's license type; they only care whether the therapist can help them in their particular circumstances.)

On the other side, there are two arguments to be made in favor of changing the name:

One is essentially the scope of practice argument I raised in the opening paragraph. MFTs do much more work with individuals, couples, and families of all kinds than the name implies. Changing the word "marriage" to "couple" does not fully resolve this, but it steps in the right direction.

The other argument ties in closely with the ongoing debate around same-sex marriage; no matter how clearly we state that all couples who commit to each other and their children deserve equal protection under the law, it can appear discriminatory to have the word "marriage" in our title when some couples are not allowed to legally marry.

While the marriage equality debate will likely be eventually resolved, the first point seems to me to be a fairly permanent one. And I must admit, given the strong arguments that can be rightly made on both sides here, I have not reached a point where I can confidently say either that we should, or should not, change the name of our license.

I'd welcome your thoughts.

CAMFT director apologies for articles opposing same-sex marriage

In a message on the organization's web site, CAMFT Executive Director Mary Riemersma has apologized for the association's publication of several articles opposing same-sex marriage. The apology is sincere, but the bigger issue remains: CAMFT is alone in the mental health world in its refusal to seriously address same-sex marriage.

As background, CAMFT (the California Association of Marriage and Family Therapists, which is has no affiliation with AAMFT or its California Division) has been harshly and rightly criticized by members, educational institutions, and in the media for their failure to make any kind of comment on same-sex marriage. Every other major mental health organization (APA | American Psychiatric Association | NASW | AAMFT) has taken a stand on the issue, and it is especially relevant to marriage and family therapists. The CAMFT board response has been underwhelming in the face of such criticism, issuing only a broad non-discrimination statement (members only) that sidestepped the important questions entirely.

In order to look like they were doing something on the issue without actually doing anything about it, CAMFT chose to publish a variety of articles supporting and opposing same-sex marriage in the May/June 2009 issue of its magazine, The Therapist. The sections were accompanied by a clear statement that while the articles presented a variety of viewpoints, the organization was not endorsing any of them.

The "pro" articles in the magazine were largely culled from scientific journals, as the science around the issue is quite clear. The origin of the "con" articles is unclear. Whatever their origin, their logic was horrible, and their arguments ranged from the potentially-worth-discussing to the blatantly homophobic and inflammatory.

Executive Director Mary Riemersma has now apologized for the publication of the "con" articles, and the entire issue of the magazine has been removed from their web site. (The next logical question, "Why were the 'pro' articles removed too, when there wasn't a problem with them?" actually is answered in CAMFT's non-stance on the issue. Leaving up the "pro" articles while taking down the "con" would appear to be endorsing the pro-same-sex-marriage point of view. As long as CAMFT is refusing to take a position, they were obligated to take down both sides.) The apology, which appears on the organization's web site but is restricted to members, reads:

I am sorry that the objectionable articles appeared in the prior issue of The Therapist and that many found them offensive. I too found them distasteful and did not think they were credible. We were trying to create a balance of views and there was a paucity of articles submitted opposing marriage equality. If I had it to do over, we would have rejected the articles. Our ethics for the profession do not condone homophobia, I do not tolerate homophobia, and neither does the CAMFT Board. Let me know what we can do to overcome the unintended harm that some believe we have caused.

It's not an outstanding apology, as apologies go (the phrase "these articles were homophobic," or anything to that effect, is conspicuously absent, and "some believe" is a little grating), but it's about as far as Riemersma can go. She's responsible for the operations of the magazine, but the board determines CAMFT policies. And by staying silent on such an important issue, the CAMFT board wades father out of the mental health mainstream by the day, and harms the reputation of the profession of marriage and family therapy around the country.

Who will apologize for that?

Update: Apparently -- and to their great credit -- CAMFT will.