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1. WHO ARE MARRIAGE AND FAMILY THERAPISTS?
Marriage and family therapists are highly trained mental health professionals who bring a family-oriented perspective to health care. Marriage and family therapists evaluate and treat mental and emotional disorders and other health and behavioral problems, and address a wide array of relationship issues, all within the context of the family system. They pioneered brief, solution-focused, family-centered treatment. Their treatment seeks to pinpoint problems and conclude as soon as specific, attainable therapeutic goals are met. Trained in family systems theory, marriage and family therapists believe that individuals and their problems must be seen in context and that the most important context is the family. Marriage and family therapy is one of five professions, along with psychiatry, psychology, social work and professional counseling, authorized by Georgia law to practice psychotherapy and counseling. The National Institute of Mental Health (NIMH) identifies five core mental health professions: marriage and family therapy, psychiatry, psychology, social work, and psychiatric nursing. Marriage and family therapy traineeships compete on an equal basis with the other disciplines for funding through the NIMH. Nationally, the more than 23,000 members of the American Association for Marriage and Family Therapy (AAMFT) have fulfilled stringent education and training requirements and subscribe to a strict code of ethics. In Georgia, licensed marriage and family therapists must have a minimum of a master's degree, including specific graduate training in family studies and family therapy, along with three years of post-master's supervised clinical practice. Marriage and family therapists work in a variety of settings including inpatient facilities, employee assistance programs, health maintenance organizations, community mental health centers, social service agencies, courts and prisons, universities, research centers, and in private practice. 2. HOW IS MARRIAGE AND FAMILY THERAPY DIFFERENT FROM OTHER ALTERNATIVES? Marriage and family therapy usually requires only a limited number of therapy sessions. Family therapists are particularly effective at matching their interventions to the special cost and time factors associated with each client's situation. A 1992 Minnesota study identified that the median cost per hour of service charged by marriage and family therapists was $75-$85, and the average duration of treatment was 10 to 12 sessions. Here in Georgia, a 1993 study indicated that the average cost per session was $75- $80 and the median duration of treatment was 12 sessions. Family therapists focus on changing behavior and communication among people through active interventions. They may assign members particular tasks or "homework" to accomplish between sessions. In this way, family therapists help to change the patterns of interaction in a family that contribute to their difficulties. Family therapists typically involve other members of the family in treatment. They often include parents, children, or grandparents. They may also involve significant others in the community such as teachers, welfare workers, clergy and probation officers. Marriage and family therapists are leaders in collaboration within teams of caregivers. Contrary to most people's expectations however, marriage and family therapists do not work only with whole family units; they frequently treat individuals by themselves, couples, and other family sub-units. Generally marriage and family therapists focus on the present. They work to understand the problem as it exists now, and focus on solutions or actions which might help to resolve the problem. They typically ask questions about family roles, patterns, rules, goals and stages of development. They generally view the problems or issues brought to therapy in the context of the family. Marriage and family therapists are committed to improving outcomes and reducing hospital utilization and costs. Consumers increasingly seek the services of marriage and family therapists. According to a 1992 study published in American Psychologist, consumers said that marriage and family therapists are the mental health professionals they would most likely recommend to friends. 3. HOW EFFECTIVE IS MARRIAGE AND FAMILY THERAPY? When compared to other treatments, marriage and family therapy has consistently been more effective in improving family interaction patterns and individual patient behavior, especially for problems that involve marital and family conflict. One 1992 study found that first offenders who received family therapy after release from prison were twice as likely to be arrest-free a year later as those in a control group who received no therapy. A 1993 review of family therapy research examined its long-term effects and found that, in follow-up periods ranging from six weeks to three years, only 36% of patients in family therapy required further treatment, as compared with 58% of those undergoing alternative therapies. When measures of recidivism are examined, such as hospitalization, family therapy also shows a higher success rate than alternative treatments. Studies have shown that marriage and family therapy has been successful in treating alcoholism, anorexia and other eating disorders, psychosomatic asthma, overly aggressive children, juvenile delinquency, and other problems. The use of marriage and family therapists has increased dramatically in recent years. The military's Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) has routinely reimbursed marriage and family therapists since 1966. Many major private insurers and managed care programs in Georgia, including Bell South Enterprises, use marriage and family therapists as key providers of mental health care. In 1993, 52% of employee assistance programs and 62% of managed mental health care providers employed marriage and family therapists as staff members or contracted providers. 4. HOW CAN THE USE OF MARRIAGE AND FAMILY THERAPY REDUCE HEALTH CARE COSTS? Study after study demonstrates the cost-effectiveness of marriage and family therapy. For example: Many studies show dramatic decreases of up to 80% in medical health use following appropriate mental health care, including family therapy. Early intervention has been estimated by the National Institute of Mental Health to cost society less than one-third the cost of late-stage crisis intervention. Family therapy has been more successful than any other form of outpatient therapy in retaining adolescents with drug abuse problems in treatment and in reducing their drug abuse, thereby preventing costly hospitalization. |