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AAMFT Position on Couples and Families

AAMFT believes that all couples who willingly commit themselves to each other, and their children, have a right to expect equal support and benefits in civil society. Thus, we affirm the right of all committed couples and their families to legally equal benefits, protection, and responsibility. 

As opportunities arise, AAMFT will support public policy initiatives that strengthen marriages, couples, civil unions, and families through the provision of technical assistance. 

Motion adopted by the Board of Directors at its October 17, 2005 meeting in Kansas City, MO

What is Marriage and Family Therapy?

Marriage and Family Therapy has long been defined as an intervention aimed at ameliorating not only relationship problems but also mental and emotional disorders within the context of family and larger social systems.

Today, as many in the United States are debating issues of marriage and family composition, it is of primary importance that the American Association for Marriage and Family Therapy and marriage and family therapists make clear what we mean and wish to imply in the use of the words “marriage” and “family” as we use them in our core values, teaching, treatment, research, and code of ethics.

We assert the value and positive impact of stable, long-term, emotionally enriching relationships. We believe that society is better off when social groupings are created that allow for and support these qualities. We recognize that all family forms have inherent strengths and challenges. As marriage and family therapists we focus our study and skills on how individuals in our society couple – choosing partners and establishing households – and form family groups.

We study and intervene to assist in these relationships whether that means a marriage has occurred in the legal sense, whether there is co-habitation, or other forms of family.  We invite members of heterosexual, same-sex, culturally similar, intercultural/interracial and other forms of family composition to engage with marriage and family therapists for relational development and problem solving within their cultural contexts.  We welcome all who would seek out our services in order to build strength and health in their lives, relationships, and in society.  Our code of ethics states that “Marriage and family therapists provide professional assistance to persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, or sexual orientation.” We are an open and inclusive profession and organization.

Approved by the Board of Directors at its July 31, 2005 meeting in Santa Rosa, CA.

Statement on Nonpathologizing Sexual Orientation 

The American Association for Marriage and Family Therapy takes the position that same sex orientation is not a mental disorder.  Therefore, we do not believe that sexual orientation in and of itself requires treatment or intervention.

Rationale:  The development of the field of marriage and family therapy has included a tradition and perspective that eschewed the medical model. Historically, pathology or the diagnosis of an individual was not part of our field's heritage or practice. In light of this historical context, AAMFT never considered the possibility of making a statement that defined "pathology," or in the case of sexual orientation "non-pathology." At the same time, we have had a history of stating that discrimination based on sexual orientation (and other personal characteristics such as gender, physical ability, religion, creed, ethnicity, for example) is unethical. At this time, in our society, the debate over the health or legitimacy of same sex orientation is once again a topic of political debate. Therefore, it is time for us to clarify our own record and speak to the issue. We support that same sex orientation is a normal variant of human sexuality that takes a variety of forms and expression.

Future Considerations:  We do recognize that treatment of those clients who present feeling confused about or wanting to change their sexual orientation should be undertaken with great care, knowledge, and openness. Therefore, it is our intent as an association to provide information to our members, through clinical care guidelines or other methods, regarding these issues.

Adopted by the Board of Directors at its September 7, 2004 meeting in Atlanta, GA

Reparative/Conversion Therapy

In recent weeks the AAMFT Board has received correspondence from several members asking about the association's position on reparative or conversion therapy.  The Board believed the question to be addressed in the previous statement that "...we do not believe that sexual orientation in and of itself requires treatment or intervention."  The AAMFT Board passed the following motion to clarify the association's position.

From time to time AAMFT receives questions about a practice know as reparative or conversion therapy, which is aimed at changing a person’s sexual orientation.  As stated in previous AAMFT policy, the association does not consider homosexuality a disorder that requires treatment, and as such, we see no basis for such therapy.  AAMFT expects its members to practice based on the best research and clinical evidence available.  For a review of research on these therapies, please click here.

Adopted by the Board of Directors at its March 25, 2009 Meeting in Alexandria, VA

Statement from the AAMFT Board of Directors regarding an article in the Journal of Marital and Family Therapy (JMFT) that led to discussion among the AAMFT Board of Directors regarding the issue of treatments known as reparative or conversion therapy. 

This article was published in Family Therapy News March/April 2003.

The recent publication of an article in the Journal of Marital and Family Therapy (JMFT) led to discussion among the AAMFT Board of Directors regarding the issue of treatments known as reparative or conversion therapy. We want to address our Association's position on issues of sexual orientation, and our values related to individuals who may have a different sexual orientation than the majority. We recognize that our members hold divergent religious, political, and social views, yet are deeply concerned about the pain and potential damage that some may feel in response to the publication of this article.

The Issue of Reparative or Conversion Therapy and Journal Independence

The discussion of the Board and this statement flow from our own and others' questions about an article entitled "Motivational, Ethical, and Epistemological Foundations in the Treatment of Unwanted Homoerotic Attraction," authored by Christopher H. Rosik, and published in the January, 2003 JMFT. In that article, while Rosik does not address in detail the theoretical underpinnings or scientific evidence basis for reparative or conversion therapy per se, he does present a framework for considering "unwanted homoerotic feelings" and how therapists conceive of and might try to address these feelings in treatment.

Reparative or conversion therapy is directed toward assisting individuals away from a homosexual orientation and behaviors to a heterosexual orientation and behaviors. At least some proponents of reparative or conversion therapy hold the view that homosexuality is a mental illness with which some individuals are affected, and that therapies designed to repair or convert homosexual orientation to heterosexual orientation is not only an appropriate choice for treatment when individuals define themselves as of homosexual orientation, but is, in fact, indicated as the preferred treatment of the "disorder" of homosexuality.

The AAMFT has an independently edited scientific journal, with a highly qualified editor and a large, diverse, and expert editorial advisory board. As a Board of Directors, we have no desire to intrude into the processes of article submission, editorial review, or decisions regarding publication because we believe to do so would be to violate the independent review process in a manner that could jeopardize the reputation of independence of the Journal. We respect academic freedom, and the right-indeed the responsibility of our members to inform themselves to the best of their ability, and to use their best judgments as the basis for their treatment approaches with clients. We view the Journal as a place where a variety of perspectives, viewpoints, and research results can be reported and debated.

In acknowledging our commitment to free academic inquiry, however, we wish to make it plain that publication of any article that has been independently reviewed does not constitute an endorsement of its content or ideas. Specifically, we would note the following:

First, in the sixty-one year history of our association, we have never endorsed any specific theory, orientation, intervention, or technique in therapy, and we do not want anyone to construe that by the publication of Rosik's article in the JMFT that the organization has now decided to embark on such a path. Let us emphasize: AAMFT does not, merely through the independent publication of any article in either the Journal or Family Therapy Magazine, or by inclusion of sessions at a conference, mean to offer any endorsement of any particular therapeutic theory or intervention.

Every issue of our magazine, which also serves as our primary news outlet to members, includes the statement in the masthead, "The articles published in the Family Therapy Magazine are not necessarily the views of the association and are not to be interpreted as official AAMFT policy." Heretofore, our Board has believed that no such statement was needed in our Journal, merely on the basis of its identity as an independently edited scientific journal-it is self evident that articles, issues, and ideas designed to report research, advance theory, or generate thought and conversation should not be considered official statements of organizational policy or position. Therefore, no individual, group, or organization should construe the publication of this article as an endorsement of reparative or conversion therapy by the American Association for Marriage and Family Therapy.

Second, we recognize that our members have diverse beliefs and theories about sexuality and sexual orientation and how those beliefs should inform or be made explicit in therapy. And, while AAMFT members may have differing philosophical, theoretical, moral or religious convictions, every AAMFT member has agreed to abide by and uphold the AAMFT Code of Ethics. That code of ethics states in Principle #1 that, "Marriage and family therapists advance the welfare of families and individuals. They respect the rights of those persons seeking their assistance, and make reasonable efforts to ensure that their services are used appropriately." Subprinicple 1.1 further elucidates that overarching statement, saying, "Marriage and family therapists provide professional assistance to persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, or sexual orientation."

Therefore, as marriage and family therapists, and as an organization, we hold values of openness and inclusion, and the freedom of our clients to hold their own moral perspectives. We honor and support academic freedom that leads to increased knowledge and research, and more informed clinical practice. We believe that is part of what is reflected in subprinciple 1.1 of our ethics code.

Certainly our client's moral perspectives and understanding of right and wrong are a critical component of therapy, and those perspectives should be held in many respects as sacred themselves by therapists as part of treatment. At the same time, for example, if a person of color had been taught and came to hold the belief that he or she was deficient specifically and only because he or she were a person of color, we believe that it would be unconscionable not to address that conviction, whether as a moral, philosophical, religious, or scientific issue, as part of treatment. To take a client's current perspective or belief system as being the only legitimate perspective to be used as part of treatment would in many cases leave the therapist and the client without the knowledge, research, or possibility of new insight and/or behavior which might lead to needed change-as defined by the client's presenting issues or goals of treatment. We believe this analogy is also useful in regard to issues of unwanted homoerotic attraction as well.

The Broader Issue of Sexual Orientation

As we have come to conclude in our discussions, the larger and perhaps more personal question for the AAMFT is whether individuals who are gay or lesbian have a place in the organization, or are welcomed here. Conversely, perhaps, there may be those who hold certain religious views who would raise the same question.

We wish to make it clear: we believe that our members, and the Board of the Association have historically and repeatedly affirmed that individuals, whether heterosexual, gay, bisexual, lesbian, or transgendered, have a place and are welcomed in our Association. We welcome those as well of various religious traditions, whether Christian, Jewish, Buddhist, Hindu, Muslim, agnostic or atheist, or other. We believe that our field is enriched when we gather together to discuss, dialogue, debate, and encourage each other to excellence as clinicians, and integrity as individuals in our society. We believe there is power in that diversity, and that as mental health professionals who are attuned to systems and relationships, we should be the ones demonstrating that human compassion combined with relationship skills can provide a context where diversity means strength, not division. We believe that of all places, the AAMFT should strive to be a place where all are welcomed-recognizing there will never be total agreement-that there can be an atmosphere of respect, personal worth, and personal accountability. 

We make these assertions based on the bylaws of the AAMFT, the Code of Ethics, and the AAMFT Strategic plan. The bylaws, the organizing instruments of the Association approved by the membership, have long prohibited discrimination on the basis of race, color, creed, gender, or sexual orientation-a prohibition extends to issues of membership, nominations for office, and the hiring of staff. As outlined above, our Code of Ethics makes clear the standard that constitutes ethical behavior-one of respect regardless of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, or sexual orientation. 

The Board expanded on those standards to make a more proactive statement of inclusion, both in the previous Strategic Plan, and in the Plan just adopted in December, 2002. Specifically, the plan defines our core values (among others) as, "embodying a culture of openness and inclusion," "honoring diversity in clinical practice, research, education, and administration," and, "integrity evidenced by ethical and honest behavior." We welcome all who embrace the values of the AAMFT as defined in our bylaws and Code of Ethics, and who strive toward excellence in clinical services. 

In conclusion, as an association, we also want to acknowledge that some of our members may not have historically felt the sense of welcome that we aspire to convey. Again, we deeply regret that the publication the Rosik article in the JMFT exacerbates feelings of alienation or questions about the AAMFT and our value of inclusion. For that, as a Board, we make the commitment to continue our work toward embodying a sense of excellence, openness, and honoring of all of our members.