Politics over policy

For the last two weeks, I've spent at least some amount of time every day working on legislative issues for the Michigan Association for Marriage and Family Therapy (MAMFT). I work for the MAMFT President, and I willingly agreed to do what I could to help her advance the MFT profession in Michigan. We are attempting to clarify the scope of practice for MFTs to better reflect what we do and how we are trained. As the MFT licensure law currently stands, it does not mention anything about doing psychotherapy, working with individuals, or assessment/diagnosis/treatment of mental/emotional/behavioral disorders. We are trained and experienced in each of those, but the law does not reflect it. Therefore, we are often unable to bill for these services and in some cases, we can't even see the client. Obviously, we're doing everything we can to change this, but we have been met with more resistance than I had anticipated.

It seems that a few other mental health professional groups (mainly the psychologists and social workers) do not think that this law should pass. They have problems with this because:

1. They do not believe we are trained to treat individuals. (We are. The title "marriage and family therapist" may be misleading, but it refers to our theoretical approach, not scope of practice."
2. They do not think we are trained to do psychotherapy. (Frankly, if we aren't trained to do psychotherapy, then what are we trained to do? Psychotherapy in its various forms is PRIMARILY how we are trained.)
3. They do not think we are trained to assess, diagnose, and treat mental, emotional, and behavioral disorders. (This is the big one. They are pointing to the social workers' training in psychopathology as the minimum standard for this. After thoroughly researching those requirements and comparing them to the requirements for MFTs, however, I can confidently state that we not only meet, but exceed those standards. After all, what were all of those classes on psychopathology and DSM diagnosis for?)

Essentially, we aren't trying to overstep our qualifications or get an advantage over other mental health professionals. Rather, we are simply attempting to get the State of Michigan to legally acknowledge what it is we do, which would give us legitimacy in the state in the eyes of many Michiganers.

We believe that this is good policy, but we are being met with the politics that exist in the world. The social workers and psychologists hold a lot of sway with some key state senators (for instance, the chair of the senate committee that we must go through was the sponsor of social work's recent licensure bill). Those key Senators, while very forthright and well-meaning, are faced with whether to adhere to the politics of the issue (social work and psychology have much larger constituencies) or the policy, which we believe we support with irrefutable evidence.

This has shown me a lot about the political system. I don't mean to sound like I'm blaming government or even the legislative system. I'm not. I understand that they are trying to do what is in the best interest of all the people, not just a relatively small group of MFTs. I just wish that the facts and the truth could win out over the politics and conflict. And maybe it will, but it will be a much larger struggle than it should be.