VAMFT Frequently Asked Questions (FAQ)

Q How are licensed marriage and family therapists different from licensed professional counselors, licensed substance abuse treatment professionals, licensed clinical social workers, licensed psychologists, and psychiatrists?

A Licensed marriage and family therapists differ from these other mental health professions in that they are specifically trained to practice marriage and family therapy, and have a license from the state they reside in to do so.

Presently, forty-two states recognize and regulate marriage and family therapists as independent mental health care providers.

In Virginia, each professional license has different educational and experiential qualifications and all of them require at least a master's degree.

VAMFT is planning the creation of a document comparing the various qualifications for these licenses in Virginia.

Q How is marriage and family therapy different from the other approaches to psychotherapy?

A Marriage and family therapists are trained in various models of therapy in order to prepare them for work with families, couples, individuals, and larger human systems. Marriage and family therapy differs from the other approaches to mental health by thinking about people as being part of a larger system, such as their family. It is an interpersonal approach to psychotherapy, focusing on working with the relationships between members of a system. (For this reason some have suggested that more appropriate terms to describe this approach might be "relationship therapy" or "systemic therapy.") Other approaches to psychotherapy are traditionally intrapersonal, focusing on working with the internal processes (usually, a specific structural deficit) of an individual.

While some practitioners of the other approaches to psychotherapy may also incorporate some interpersonal techniques into their work, only an AAMFT Clinical Member is required to have had extensive specialized training and supervision in such an approach and to think in systemic terms. AAMFT Clinical members also observe a strict code of ethics which take family issues into consideration.

The systemic orientation and relational ethic, coupled with the rigorous training requirements, make those licensed marriage and family therapists who are also AAMFT Clinical Members uniquely qualified to provide mental health services.

Q What are the benefits of marriage and family therapy, over the other approaches to mental health available?

A More than any other approach to mental health, marriage and family therapy looks at people in the context of their relationships and helps to change that context. Trained in psychotherapy and family systems, MFTs focus on understanding their clients' symptoms and the interaction patterns with family and friends that may contribute to the problem. MFTs will typically ask questions about roles, patterns, rules, goals, beliefs and stages of development. The marriage and family therapist then works with the individual, couple and/or family to change interaction patterns so that the problem can be resolved.

Q How effective is marriage and family therapy?

A Researchers have found that clients report high satisfaction with marriage and family therapy, with significant improvements in areas of emotional and physical health, functioning, and relationships.

• 98.1% of MFT clients surveyed rated services as good or excellent
• 98.0% indicated that they felt they had been helped in dealing more effectively with problems
• 97.1% indicated they got the kind of help they desired
• 96.9% indicated they would recommend their therapist to a friend

• Liddle (1993) found that family therapy has been more successful than any other form of outpatient therapy in keeping adolescents with drug use problems in treatment and in reducing their drug use, thereby preventing costly hospitalizations.
• Goldstein (1987) found that the rehospitalization rate for patients with schizophrenia in a 6 month period was 0% when family therapy was part of the treatment plan, but 30% for patients who used drug treatment alone.
• Retzer, et al. (1991) found that relapse rates were reduced by 77% for patients with manic depressive or schizoaffective psychoses after receiving brief family therapy (6 sessions). One-half of these patients were able to function without major medication 3 years later.

Q How long does marriage and family therapy usually take?

A The length of time someone is in therapy depends upon various factors, including the seriousness of the problem. Generally, marriage and family therapy tends to be short term. Research shows that the median length is 12 sessions, with 65% of cases being completed within 20 sessions. Although length of therapy differs from case to case, marriage and family therapy tends to be briefer than many other types of therapy.

Q What are some problems marriage and family therapists treat?

A Although not all marriage and family therapists work with people with all types of problems, examples of the sorts of problems a marriage and family therapist might treat from a systems perspective include:

• Problems with anger, hostility, or violence
• Difficulties in setting and reaching goals
• Eating disorders
• Interpersonal/family problems related to the use or abuse of alcohol or drugs
• Difficulties with a child's behavior, school adjustment, or performance
• Family stress due to chronic illness or illnesses in which stress plays a major role
• Difficulties in talking with your partner, spouse, children, parents, other family members, friends, or co-workers
• Feelings of loneliness, moodiness, depression, sadness, failure, stress, and/or anxiety
• Sexual problems or concerns
• Difficulties with sexual orientation
• Frequent conflicts over financial issues
• Work difficulties, frequent job changes, problems with co-workers
• Premarital issues
• Divorce and separation issues
• Post-divorce adjustments

Q Do I have to be married to go to a marriage and family therapist?

A No. Individuals, couples, siblings, co-workers, roommates, and others often seek family therapy for help with relationship issues, health-related issues, or mental and emotional disorders. People do not need not be married to seek or benefit from family therapy. Anybody who wants to clarify, change, improve, or redefine their relationships can benefit from marriage and family therapy.

Q Do I have to be heterosexual to go to a marriage and family therapist?

A No. Anybody who wants to clarify, change, improve, or redefine their relationships can benefit from marriage and family therapy. But it is always a good idea to ask a therapist about his or her qualifications to treat your particular concerns.

Q What if we're not "sick" or "crazy," but have ordinary problems like everybody else - problems we do not think are serious enough to need therapy?

A The idea that only those with a mental illness can benefit from therapy is a myth. All of us traverse a series of normal changes and difficulties as we go through life, each of which pose challenges and possible pitfalls. For example, as adults move from productive employment into retirement, the family may need special support to make necessary changes and adjustments.

Changes, stress, and problems can be expected in any relationship, and therapy can help to prevent small problems from becoming serious. Marriage and family therapists are trained to ameliorate problems, strengthen relationships, and prevent difficulties from becoming a crisis.

Q What if my spouse and/or whole family won't participate?

A Not all family members have to take part in marriage and family therapy for it to be effective. When people decide to see a therapist for a problem, there is usually someone who is the most interested in seeking help and who initiates contact with a therapist. If there is a least one motivated person going to therapy, then family members who aren't initially interested may get involved later.

Q What qualifications should I look for in a marriage and family therapist?

A First, you should look for a Licensed Marriage and Family Therapist. Only therapists who hold a marriage and family therapist license meet the professional standards of MFTs in the Commonwealth of Virginia.

Second, you should look for Clinical Membership in the American Association for Marriage and Family Therapy (AAMFT). AAMFT has developed national standards (which are even more rigorous than the requirements for licensure in Virginia) for the education and training of marriage and family therapists. The U.S. federal government and many states have utilized AAMFT's standards when drafting laws regarding marriage and family therapists.

All AAMFT Members are held to the high standards of the AAMFT Code of Ethics (which take family issues into consideration), and clients have the recourse of a grievance procedure if their therapist has acted unethically.

AAMFT Clinical Members have a minimum of a masters degree, including specific graduate training in marriage and family therapy. Clinical members have also completed at least 1,000 hours of supervised clinical practice with couples and families.

AAMFT Clinical members are specifically trained from a family systems perspective in diagnosis, assessment, and treatment. They are also trained to use a variety of psychotherapeutic techniques and processes. AAMFT Clinical Members welcome inquiries about their training, experience, theoretical orientation, and fees.

Q How do I find a marriage and family therapist?

A If your employer participates in a managed care plan or provides health insurance, your first action should be to see if you can get referrals to marriage and family therapists from your Primary Care Physician, if any marriage and family therapists are included in your list of Preferred Providers, or if marriage and family therapy is covered under your health insurance plan. When looking in a directory, marriage and family therapists should be listed under a heading similar to "Mental Health and Substance Abuse Care Providers." Under this heading, look under individual listings for the words "AAMFT Clinical Member."

If you don't find any marriage and family therapists or AAMFT Clinical Members listed, we hope you will ask your managed care or health insurance company why they don't use such proven providers of mental health services, and consider asking your employer why they utilize a managed care or health insurance company that does not provide marriage and family therapy services.

Please know that the Virginia Department of Health's Center for Quality Health Care Services and Consumer Protection wants to hear about complaints and problems Virginians are having with their HMO providers. The Center for Quality Health Care Services and Consumer Protection can be reached at 1-800-955-1819.

Other ways of locating marriage and family therapists include:

• use TherapistLocator.Net (which is the official AAMFT Referral Directory)
• ask your friends, primary care physician, or clergy for recommendations
• check your local Yellow Pages directory under a heading similar to "Marriage & Family Therapist" (Under this heading, look for the American Association for Marriage and Family Therapy listing or look under individual listings for the words "AAMFT Clinical Member." and/or the AAMFT Clinical Member logo.)

As you go through this process, try to get the names of several marriage and family therapists, so that you can interview them all and choose the one which will best satisfy your and your family's needs.

Q How should I pick or choose a marriage and family therapist?

A Once you have found one or more potential therapists, you should call them to set up a brief telephone interview. This interview will allow you to find out which therapist will best satisfy your and your family's needs. Some questions you might consider asking include:

• Is the therapist a Licensed Marriage and Family Therapist in Virginia? Only therapists who hold a marriage and family therapist license meet the professional standards of MFTs in the Commonwealth of Virginia.
• Is the therapist a Clinical Member of the American Association for Marriage and Family Therapy (AAMFT)? Clinical Membership in AAMFT means that the therapist has met the stringent standards of the Association for a practitioner of marriage and family therapy (which are even more rigorous than the requirements for licensure in Virginia), that the therapist is bound by the strict AAMFT Code of Ethics which takes family issues into consideration, and that you will have recourse to a grievance procedure in the event your therapist does act unethically.
• What is the therapist's educational and training background? In most cases, the professional will answer this question in terms of their graduate education. The therapist might have a doctorate or a master's degree in marriage and family therapy or an allied discipline such as psychology, clinical social work, medicine/psychiatry, psychiatric nursing, or the ministry. If the professional's degree is not in marriage and family therapy, you could ask about additional post-graduate training they have completed in marriage and family therapy.
• Does the therapist have experience treating the kind of problem you are experiencing; for example, marital stress, intimacy or sexual problems, infidelity, domestic violence, depression, child's behavior, alcohol or drug abuse?
• How much does the therapist charge?
• (If you are looking to use health insurance.) Are the therapist's services covered by your health insurance plan?
• Where are the therapy sessions held, and what are the office hours? Therapists often have several offices. In addition to regular business hours, some therapists have evening or weekend office hours available.
• How long do sessions last? The length of sessions often vary between therapists. Frequently they are 45 to 50 minutes in length, but they can sometimes be shorter or longer.
• How often are sessions scheduled? One session per week is common, while in some cases sessions are scheduled more or less frequently.
• What is the therapist's appointment cancellation policy? Some therapists charge regular fees for missed appointments that are not cancelled early enough for them to reschedule other clients.
• Will the therapist be available by phone in times of crisis? Many therapists are available for emergency phone calls or appointments. Some therapists arrange for other professionals to be available during times when they cannot be reached (for example, during illness, vacations, or holidays).
• If you or any family members are not proficient in English, ask the therapist if they are fluent in your native language.