I just finished another phone call where I made a referral to another professional rather than taking the case myself. This was a personal referral, a medical doctor who sends couples to me and children for assessment suggested my name to a young woman with an eating disorder. I have never felt I had enough background in eating disorders to treat this disorder and simply told this woman that. I then helped her find a therapist with an appropriate background, education and training to help her. Every psychologist, and every therapist, is not trained or prepared to deal with every situation. I also refer assessments for children under 4, even though I have many years of experience with children and adolescents, I just don't feel competent to assess a 4 year old, but I know someone who is.
Couple and family therapy is like that. Not every therapist, counsellor or psychologist is really prepared to work with a couple or family. Here in British Columbia we have a special situation with there being registered professionals (Registered Psychologists and Registered Social Workers) and then, as odd as it may seem, people who list themselves as "registered" such as Registered Clinical Counsellors, who really are not registered at all!
What? How can that be? Well Registered Clinical Counsellors, RCCs, are not regulated by the government. "Registered" in British Columbia means you are able to practice because you have been granted permission to practice based upon education, experience and a professional examination administered by or acceptable to the REGULATORY AGENCY. The College of Psychologists is one such body here.
RCC's have a professional association, but unlike a regulatory body they do not have a separate government sanctioned process for certifying competence to the public. This doesn't mean that an RCC might not be a very well trained and experienced counsellor. Some are. But howe do you know who is well trained, especially in couple and family therapy, and who isn't?
Usually people look at titles, degrees and make a choice about who they should see, but with couple and marriage problems, this is not necessarily a good idea. An individual may say they provide family or couple therapy, but in reality have very little experience or educational background in the field. Marriage and Family Therapy is a regulated profession in all 50 states in the United States, and is in some parts of Canada (It is usually considered a specialty and requires specially training and education). In British Columbia it is not under the control of a regulatory body at present, so anyone, that's ANYONE, can call themselves a marriage and family therapist. How can you make sure you are seeing someone who has adequate training and experience?
Some therapists here in British Columbia belong to the professional association called the British Columbia Association for Marriage and Family Therapy (BCMFT). ALL of these individuals have graduate degree's in marriage and family therapy that meet the standards that those licensed in the United States and other parts of Canada meet. All members of BCAMFT have one or two years of full time supervised experience in marriage and family therapy (RCCs need only one hundred hours of supervision and might say they do marriage and couple work after a weekend workshop. There is no law or regulation protecting the title Marriage and Couple Therapist). So my advice is that if you are going to look for a couple, marriage or family therapist you check with BCAMFT and find someone who has meet their standards. Their web page can be found here BCAMFT.
BCAMFT is seeking to organize a "regulatory body" here in BC, and it will just be a matter of time before they do. What I know is that your best bet for finding an experienced family therapist is checking their website. You can also note that many of the clinical members of BCAMFT are also registered psychologists! Yes, you could find someone who has both registrations and this will often help with your insurance company.
After you locate two or three individuals you would like to contact prepare a list of questions to help you make a decision on who would be best for you. I'd write these questions down, so that you ask the same questions to all three people you are contacting. Here are some suggested questions to help you pick the right therapist for you:
1. Can you tell me about your background and training in marriage therapy? (Are they AAMFT or BCAMFT members? Did they attend a program that specialized and focused on marriage and family therapy? How many hours of experience were part of their training? Was their supervisor an "approved AAMFT supervisor?"
A simple follow-up question, which helps because many counsellors say they are trained in the field when they have minimal training and experience, is this:
"What professional association do you belong to that trains and supports marriage and couple counselling?"
If they are working in the field, and are really meet the criteria to be a marriage and family therapist, they should either belong to the American Association of Marriage and Family Therapy (AAMFT) or the British Columbia Association for Marriage and Family Therapy (BCAMFT). If they are a Registered Marriage and Family Therapist they belong, if they don't belong it's most likely because they don't meet the standards for registration.
2. How much of your practice is in marriage and family therapy? Marriage therapy requires special skills, and someone who does mostly individual work would not be my choice. Some therapists try to have a balance of individual, testing and couples work. A good marriage or couple therapist should be seeing several couples every week. Couples therapy requires a mindset that individual therapy does not.
3. Of the couples you see, how many stay together? Usually about 70% of couples stay together. If your therapist says 90% it's something to wonder about. The research doesn't say that's likely (Read Dr. John Gottman's page for some insight into the therapy process. It can be found by clicking here.)
4. What is your experience helping couples like us? And how do you determine your goals?
5. What theories, therapist or books do you recommend to people? Most family therapists are what are known as "systemic" or "systems" therapists. Some are Cognitive behaviour therapists, and many these days will note the writings and techniques of John Gottman, a leading researcher in the field. A lot of therapists take theories and procedures from individual therapy and simply apply it to couples, but couples are a system, and families are complex systems. That's why AAMFT and BCAMFT require one to two years of full time supervised clinical experience working in the field.
I hope this has helped you if you are looking for a couple or marriage therapist. This is an important decision, and you need to find a competent and experienced therapist for this complex task. More information about my own practice can be found at www.relatedminds.com. You are welcome to contact me by phone (778.998-7975) or email (drjimroche@gmail.com) if you would like more information.
