A Career as a Marriage and Family Therapist

What is a marriage and family therapist?
Marriage and family therapists (MFTs) are highly-trained mental health professionals who bring a family-oriented perspective to health care. They evaluate and treat mental and emotional disorders and other health and behavioral problems, and address a wide array of relationship issues within the context of the family system. MFTs believe that individuals and their problems must be seen in context, and that the most important context is the family.

How do MFTs work?
MFTs pioneered brief, solution-focused, family-centered treatment. They work to understand the problem as it exists now, and focus on solutions or actions which might help to resolve the problem. They may typically ask questions about family roles patterns, rules, goals, and stages of development. A family's patterns may influence an individual's health condition or problem, are usually affected by the disorder, and therefore need to be a part of the treatment plan. The unit of treatment is no longer the person - even if only a single person is interviewed - it is the set of relationships in which the person is imbedded.

Who do MFTs treat?

• Families facing severe mental illnesses and emotional disorders, such as schizophrenia, depression and anorexia/bulimia
• Substance abusers and their families
• Sexual abuse victims and perpetrators
• Children and families in the foster care system
• Juvenile offenders and others in the criminal justice system
• Couples in crisis
• Young children and their parents

Where do MFTs work?
Marriage and family therapists work in a variety of settings including:

• Inpatient facilities
• Employee Assistance Programs
• Health Maintenance Organizations
• Community Mental Health Centers
• Business and Consulting Companies
• Schools and Head Start Centers
• Social Service Agencies
• Universities and Research Centers
• Courts and Prisons
• Private Practice

Sometimes MFTs work in teams with other health care professionals, such as family physicians. And some are involved in family research and public policy analysis from a family perspective.

Marriage and family therapy is one of the fastest growing mental health disciplines.
Marriage and family therapy's prominence in the mental health field has increased due to its brief, solution-focused treatment, its family-centered approach, and its demonstrated effectiveness. MFTs are licensed or certified in 46 states and are recognized by the federal government as members of a distinct mental health discipline.

Today, more than 50,000 MFTs treat individuals, couples and families nationwide. And Membership in the American Association for Marriage and Family Therapy (AAMFT) has grown from 237 members in 1960 to 9,000 in 1982 to more than 23,000 in 2000. This growth is a result, in part, of renewed public awareness of the value of family life and concern about the increased stresses on families in a rapidly changing world.

MFTs are needed
Everyday families throughout our society are affected by mental disorders and relationship difficulties - problems that are often too large, too complex, and too destructive to handle without professional help. These situations can arise unexpectedly and can have devastating outcomes if not dealt with quickly and properly. The effects can be far-reaching, leading to further problems that hurt not only the individual and family facing the disorder, but can impact the entire community.

• Alcohol, drug abuse and mental health disorders are costly in terms of health, productivity and crime. In 1990, loss of productivity due to injury or illness cost the U.S. $108 billion; health care costs, which include the treatment of disorders and their medical consequences, cost about $81 billion; and crime, criminal justice costs, and property damage cost about $68 billion (U.S. Department of Health and Human Services)
• Persons with untreated mental illnesses consume almost twice as much medical care as the average individual (American Psychological Association)

MFTs are in demand
The use of marriage and family therapists has increased dramatically in recent years. Consumers increasingly seek the services of MFTs:

• Sixty-two percent of managed mental health care providers and 52 percent of employee assistance programs (EAPs) employ MFTs as staff members or contracted providers (Business Insurance. 1993).
• In 1994, the AAMFT Research and Education Foundation received a $300,000 grant from the Prudential Foundation to make grants to several marriage and family therapy training programs to develop on-site training for students at local Head Start centers.
• In 1992, 91 percent of graduates from COAMFTE-accredited programs found jobs shortly after graduation.

How does one become an MFT?
Two options are available for those interested in becoming a marriage and family therapist. You could choose to complete an accredited* master's or doctoral program in marriage and family therapy.
Master's degree programs take 2 to 3 years, providing you with broad areas of theory and practice in marriage and family therapy. These programs will provide you with entry level education requirements for independent clinical practice in the profession. They are designed to prepare you for beginning a career in marriage and family therapy by providing basic didactic and clinical skills, as well as professional development and socialization.
Doctoral degree programs take 3 to 5 years - depending on whether or not you have a master's degree in MFT - and will prepare you for an academic career, research, advanced clinical practice and supervision. The doctoral curriculum provides you with advanced instruction in marriage and family therapy research, theory construction and supervision.

The second way to become an MFT begins by earning a graduate degree in another mental health field - psychiatry, psychology, clinical social work, psychiatric nursing, etc. After earning a degree you may decide to study MFT in depth at one of the accredited* post-graduate degree clinical training programs that provide clinical education in marriage and family therapy. A program may allow you to receive specialized training in a particular modality or treatment population.

Whichever path you choose you will be trained in the diagnosis and treatment of mental and nervous disorders and in such areas as human growth and development, behavioral patterns, marital and family interaction, sexual dysfunction, parent-child relationships, and the dynamics of family systems. You will also learn to use a variety of therapeutic techniques and processes.

*In 1978, the Department of Education recognized the AAMFT Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) as the national accrediting body for graduate and post-graduate educational and training programs in the field of marriage and family therapy - the number of accredited programs has grown from 24 in 1983 to 75 in 1996.

Advice for those interested in MFT programs
Get clinical experience - Because it is essential that MFTs have good interpersonal skills and emotional maturity, graduate programs will be looking for evidence that you have been successful in working with people. Many colleges and universities offer internship or externship programs or you can volunteer at local teen homes, women's shelters, crisis hotlines, or mental health centers. Choose a place where you will have direct contact with clients.
Get research experience - Because many universities require graduate professors to conduct original research, programs will look for applicants who have experience conducting psychological research and have an interest in helping professors with their research. Try to take at least one research course and one statistics course prior to applying to admission into a graduate program in marriage and family therapy.
Identify and emphasize your strengths - If you are concerned that your grades will not gain you admission into the program, take time to think about what other aspects of your experience could make up for your grades. Make sure to emphasize these aspects of your experience in your application and during your interviews.
Be a good consumer - Not only do you need to sell yourself to the programs, but you also need to determine which programs will be a good fit for you. If you are honest with yourself and are clear about your desires, you will succeed in selecting a program that allows you to learn the art of marriage and family therapy in a comfortable and supportive atmosphere.

Check with the accredited programs you are interested in to find out about its admission requirements. Most programs don't require a specific undergraduate degree, however, some programs may require applicants to have taken specific courses to be eligible for admission.

Licensure
Currently 46 states license or certify MFTs. The regulatory requirements in most states are substantially equivalent to the AAMFT Clinical Membership standards. After graduation from an accredited program, a period - usually two years - of post-degree supervised clinical experience is necessary before you are eligible for licensure or certification. When the supervision period is completed, you may have to take a state licensing exam conducted by The Association of Marriage and Family Therapy Regulatory Boards (AMFTRB). You should check with the licensure board in your state for its licensure or certification requirements.

Opportunities for continued professional development
AAMFT membership
The American Association for Marriage and Family Therapy (AAMFT) represents more than 23,000 qualified MFTs in the U.S., Canada, and abroad. Membership in the AAMFT provides individuals with the marriage and family therapy tools and resources that are needed to succeed as an MFT. The AAMFT offers professional recognition, educational programs, practice and professional development tools, managed care information, publications and advocacy - specifically tailored for the marriage and family therapist. As an AAMFT member, individuals have the opportunity to learn, network, and share with a community of 23,000 other mental health professionals dedicated to helping families. AAMFT Clinical Members have a minimum of a master's degree in marriage and family therapy and two years of post-graduate experience. The training of MFTs includes direct clinical supervision by experienced clinicians, which is unique among the mental health disciplines. MFTs subscribe to a strict code of ethics, covering responsibilities to clients, the profession and the community.

For more information about a career in marriage and family therapy or to receive a list of accredited programs, please contact:

The American Association for Marriage and Family Therapy
112 South Alfred Street
Alexandria, VA  22314
(703) 838-9808

Extra Information:
MFT traineeships compete on an equal basis with the other mental health disciplines - psychiatry, psychology, social work and psychiatric nursing - for funding through the National Institute of Mental Health.