Vice-President for Education

The accidental family therapist

How do we close the postlicensure training gap in couple and family psychology?

By Christina Wise, PhD, and Jessica Gomez, PsyD

Shelley Riggs, PhD Introduction from Shelley Riggs, PhD, vice-president for education:

This TFP (The Family Psychologist) Education Column explores challenges of (couple and family psychology) CFP training across stages of training by reflecting on the experiences of specific programs and institutions. Christina Wise, PhD, and Jessica Gomez, PsyD, reflect on postlicensure training in CFP at Momentous Institute and make recommendations for next steps in closing the gap between systems and family therapy identity and organizational expectations and training. 

Christina Wise is the director of clinical research and a licensed psychologist at Momentous Institute. She serves as a member of the APA-accredited doctoral psychology internship program at Momentous Institute and is the current continuing education chair and an Education and Training Committee member for Div. 43. 

Jessica Gomez is the director of clinical innovation and a licensed psychologist at Momentous Institute. She is a primary supervisor with the APA-accredited doctoral psychology internship program at Momentous Institute and a committee member of the Education and Training Committee for Div. 43.



Momentous Institute has provided clinical services to children and families for almost 100 years. Our work has been deeply influenced by and has sometimes helped to shape national clinical norms and standards. For example, beginning in the 1950s, we were best known for our work in residential, therapeutic camping. Our staff was small and closely aligned on conceptualization and treatment approaches and family therapists with postmodern and systemic theoretical underpinnings defined our culture. Hiring priorities evolved over the decades as new programs were developed, services expanded and staff and client demographics changed. Today, we find that hiring priorities have evolved in response to program-driven needs, but we have nevertheless held firm to the same systemic lens and postmodern goals and approaches. This has left a gap between our wished-for therapeutic culture and our actual clinical practices, posture and training.

This gap in training and perspectives is present in the wider field of couple and family therapy (Dutch & Ratanasiripong, 2016; Nelson, et al., 2007). To be APA-accredited, doctoral programs and internships must follow rigorous guidelines and meet strict requirements, leaving little room for specialization (APACOA, 2015). There are few graduate programs available with an emphasis on CFP, and often programs only offer one CFP course. However, despite a lack of training opportunities, practicing psychologists are regularly faced with couple and family concerns (Kaslow, Celano & Stanton, 2005). Psychologists must often manage co-parenting issues in their work with children, couple conflicts in individual services to adults and family dynamics in trauma work. As training opportunities are limited, the work continues to become more complex, mirroring the wider cultural perspectives such as the diversity in the definition of family, culturally competent care in the face of political agendas and demands from a global community (Larner, 2004). These factors highlight the critical need for high-quality training in the foundations of CFP as well as a standard to evaluate competencies.

Couple and family psychologists often find their way to family therapy work postlicensure as a reaction to the clients sitting across from them. Although the program models for doctoral-level and postdoctoral-level training were created to inform the fundamental knowledge for couple and family psychologists in the last 20 years, a postlicensure model is not yet formalized (Kaslow, Gottlieb, Grossman & Turner, 2003; Stanton & Welsh, 2011). As part of the Div. 43 Education and Training Committee, we are formalizing a postlicensure program model to provide recommendations and criteria for specialization in CFP. Recommendations will focus on specific continuing education content, supervision and direct services utilizing couple and family therapy interventions. This training model will align with Div. 43 objectives, the Taxonomy for Education and Training in Professional Psychology Health Service Specialties and the American Board of Professional Psychology-CFP guidelines (APA, 2012; ABCFP, 2016). Although the goal is to create a framework to meet foundational standards for board certification, there are currently not specific training opportunities developed to meet these expectations for psychologists. We at Momentous Institute find it is much easier to meet training goals in our structured APA-accredited training program than translating this structure to the onboarding of our licensed staff and their ongoing professional development in a couple, family and systems framework. We imagine this is a shared experience for others in practice.

At Momentous Institute, we aim to use the postlicensure program model being developed by Div. 43 to address the gap between a culture that intentionally promotes best practices in couple and family therapy and the day-to-day demands of a practice-based setting. Given the challenges outlined above, our recommendations to address this gap in our setting and other practice-based organizations are to move toward a consistent understanding of competence for CFP postlicensure: first, a program model for postlicensure will be confirmed, after consultation and review, to outline specific requirements of CFP specialization; secondly, a continuing education library will be made available through Div. 43 for the purpose of meeting requirements for mastery and board certification in CFP; finally, individuals and organizations focused predominantly on therapy with couples and families will be encouraged to consider this program model when making choices about program development, organization hiring processes and professional development experiences to gain a consistent understanding of specialized practice and a common definition of mastery.

It is through thoughtful, intentional steps like these that individuals and organizations can remain responsive to current demands while meeting best practices in the field of couple and family psychology.

References

American Board of Couple and Family Psychology. (2016). Manual for obtaining board certification. Retrieved from https://abpp.org/BlankSite/media/Couple-and-Family-Psychology-Documents/ABCFP-Manual.pdf (PDF, 808KB).

American Psychological Association, Commission on Accreditation. (2015). Standards of accreditation for health service psychology. Retrieved from http://www.apa.org/ed/accreditation/about/policies/standards-of-accreditation.pdf (PDF, 1.24MB).

American Psychological Association. (2012). Education and training guidelines: A taxonomy for education and training in professional psychology health service specialties. Retrieved from http://www.apa.org/ed/graduate/specialize/taxonomy.pdf (PDF, 160KB).

Dutch, M.S., & Ratanasiripong, P. (2016, January 11). Marriage Family Therapist's Attitudes Toward Evidence-Based Treatments and Readiness for Change. Journal of Psychotherapy Integration. Advance online publication. http://dx.doi.org/10.1037/a0040054.

Kaslow, N.J., Celano, M.P., & Stanton, M. (2005). Training in Family Psychology: A Competencies — Based Approach. Family Process44 (3), 337-353.

Kaslow, F., Gottlieb, M.C., Grossman, N.S. and Turner, N. (2003). Model for the development of postdoctoral programs in family psychology. Special Counsel on Post-Doctoral Training, Division of Family Psychology, American Psychological Association.

Larner, G. (2004), Family therapy and the politics of evidence. Journal of Family Therapy, 26: 17-39. doi: 10.1111/j.1467-6427.2004.00265.x.

Nelson, T.S., Chenail, R.J., Alexander, J.F., Crane, D.R., Johnson, S.M. and Schwallie, L. (2007), The Development of Core Competencies for the Practice of Marriage and Family Therapy. Journal of Marital and Family Therapy, 33: 417-438 . doi: 10.1111/j.1752-0606.2007.00042.x.

Stanton, M., & Welsh, R. (2011).  Specialty competencies in professional psychology. Specialty competencies in couple and family psychology. New York, U.S.: Oxford University Press.