Profession and Practice

In the AAMFT Governance Policies (December 2019)—and on the AAMFT website—there is a Core Purpose statement of AAMFT that reads, “Recognizing that relationships are fundamental to the health and well-being of individuals, couples, families, and communities, AAMFT exists to advance the profession and the practice of marriage and family therapy.”

Have you ever considered what this means? Other than the first blush of impression that might lead you to, “Of course! That’s why I’m a member.” What does it mean that “AAMFT exists to advance the profession and the practice of marriage and family therapy”? How does one conceptualize this and what is the difference?

Some would say that without the profession there is no practice. Some—usually in other mental health fields—might say that the practice happens even without the profession. What do both mean? Which reflects a more accurate accounting of who we are as systemic professionals and why is it important (even essential) that the Association hold as its number one priority the advocacy for the profession? Put plainly, would it matter if the profession went away? Would there still be the practice of marriage and family therapy and systemic relational therapies?

To unpack this, it’s helpful to revisit this Association’s history. Founded by psychiatrists, psychologists, social workers and others from a broad array of disciplines who discovered they conceptualized mental health from a relational, systemic view, the field of marriage and family therapy was born. As these mental health professionals were challenged by the way their fields approached mental health, they formed a new profession. Although our field journeyed through some name changes, the rejection of the DSM and pathologizing patients, it landed squarely—where it is now—in the realm of truly holding the both-and. Systemic therapists understand that relationships are impacted—and impact—mental health and therefore, aid patients/clients in understanding their personal contexts and the metasystemic aspects that may be aiding to—or challenging—their well-being. This, ironically, is not a rejection of science but rather the embrace of how science and social interact, shaping individuals, couples, families, and communities. I’m not telling you anything that you do not know, but I am compelled, as a systemic AAMFT member, to lay the context of the profession and the practice.

This new profession shaped and ushered in a practice that was a new, exciting, and micro to meta transformation; striving for second and third order change for lasting impact through a systemic approach. As AAMFT forged the profession of Marriage and Family Therapy and worked for decades to ensure our ability to be recognized as a mental health profession, gaining licensure throughout all 50 states in the USA and regulation in some Canadian provinces, the establishment of a unique mental health profession brought us to today. In application of the question, which came first: the chicken or the egg as it applies to profession or practice, we might say that the need for a practice birthed a profession. In reverse, we might recognize therefore, that without the profession the practice is at risk.

We all know wonderful systemic clinicians in other mental health fields and now, with the new bylaws and membership categories, these brothers and sisters of systemic thinking can be included as AAMFT members. This is an exciting opening, as it can further strengthen the profession of marriage and family/systemic therapies through mutual learning and application/s of systemic education, research, and interventions. If you are conversing with systemic clinicians from other fields, you also may have heard the restraints they may experience within their field because it is a different profession. For example, you are seeing a couple who struggle over parenting issues and they tell you their two teens are sneaking out at night: Send the teens to two different other therapists? Send both teens to one therapist together? Invite the teens to join for family therapy? What options lie before you in our profession? How has this profession established and allowed for your practice?

The practice itself is the clinical application of our education that set our course with systemic theories, interventions, and diagnosis. It is how we meet the patients/clients. It is how—in private and with full confidentiality—we are invited into what I consider the sacred: individuals, couples and families’ greatest fears, struggles, mental health disorders, heartaches, as well as dreams, goals and ambitions. It is how we meet them for their growth and health. As marriage and family therapists—and systemic relational therapists—we have several systemic ways we can engage our patients/clients that respect their systems simultaneously.

The SARS-COVID-19 worldwide pandemic is a metasystemic factor for every person on the planet. From Nairobi to Taiwan to Mumbai to Detroit to Vienna to Los Angeles to Toronto. We have been, and are, in this together. This issue is focusing on body image and food challenges for Black communities. Wherever we reside, as Heather McGhee (2021) points out in her seminal work The Sum of Us, it is part of the system/s we live in; we are part of the system. It may be that there has never been a more significant time for the profession—that established your ability to have a practice—to impact the world through systemic interventions that contextualize not only the individual, but the dyad, the family, the community, and the world.

AAMFT and the Board of Directors are steadfastly committed to advance the profession of marriage and family therapy and systemic relational therapies so that the lived-out practice can continue to have inroads of health in families everywhere.

In kind regard to every member on behalf of the AAMFT Board of Directors,

I wish you well.

References

McGhee, H. (2021). The sum of us. New York: Penguin Random House.