Social, environmental, and contextual stressors can lower students’ academic pursuit for post-secondary education and professionals’ engagement with the field and AAMFT, and often create barriers to success. I [NI] believe within the field of marriage and family therapy, the question of “why it matters who the services come from?” needs to be addressed in depth to understand the barriers around retention and recruitment of diverse students and practitioners.
As a clinician and educator in the field, I’ve often questioned: What if the barriers to care that underrepresented communities experience are related to a lack of providers with whom these individuals can identify? Multiple communities have historically faced unjust and biased treatment from clinical and medical institutions. Thus, understanding disparities in medical care requires an appreciation of the ways in which oppression has operated and continues to operate in society (Williams & Rucker, 2000). The practice of psychotherapy often embodies the concept of White, heteronormative, cisgender, able-bodied, middle-class space as the contemporary definitions of healthy mental functioning. For the denizens of these spaces, these factors are hegemonic: the images they consume, the knowledge they produce, and the institutions that structure their social world are shaped by White, heteronormative, cisgender, able-bodied, middle-class values and ideology (Huebner, 2020). Hence, these spaces are areas that are considered off limits for people of color, minorities, and other marginalized communities. Marginalized communities learn explicitly via discrimination and microaggressions about their racial and cultural positionality and how to accommodate the status and emotions of people considered in dominant groups to stay within the limits of the dominant space.
Noteworthily, this notion also impacts students’ and practitioners’ positionality within the field of marriage and family therapy. Immigrant therapists, students with multicultural backgrounds, and people of color in clinical training may be expecting to experience xenophobic and discriminatory encounters in their professional and academic lives which constitutes a barrier to recruitment and retention of these individuals. Hence, the mental health organizations’ efforts in adapting culturally sensitive policies in their recruitment processes impact diverse communities’ interest in seeking employment opportunities within our field.
Moreover, in academia, the emphasis on competition and individual academic success may take precedence over celebrating students’ dimensions of culture and identities. I believe the bureaucracy of academic institutions presents barriers to the type of flexibility that may be necessary to incorporate a social justice lens that would increase recruitment of diverse students. As a theory-oriented field, academic institutions offering marriage and family therapy programs need to emphasize their willingness to revisit and question the existing theories. This willingness will inspire diverse individuals’ commitment to become active in the field as it would be a step towards academic inclusivity.
Practical suggestions to retain students
As academics who are in clinical training programs, gatekeeping means protecting the public from students who are highly likely to cause harm to clients or engage in unethical behavior, if they have not done so already. Gatekeeping does not mean embodying elitist values about who deserves and does not deserve to be in graduate programs based on the student’s social location. We can do better in creating a climate of safety and belonging for students. Below are simple and practical ways to retain students in MFT programs.
Be approachable. We know you are amazing, accomplished professionals; therefore there is no need to be pretentious or condescending towards students. Do not threaten students’ future careers because they may disagree with you, or they do not placate to your ego. They do not need to prove their worth or humanity to us. They just need to prove that they know the information we are teaching them.
Recognize and amplify students’ strengths. Students enter our programs with knowledge, skills, talents, and lived experiences. Having a myopic view of characteristics that make a good therapist could lead to untapped, unnourished potential in your students. Get to know the students, actually see them, and help them use their strengths professionally.
Demonstrate representation. Let students know they belong in this field by showing them other professionals who look like them and/or write about shared interests. Send messages related to workshops, conferences, journal articles, books, and campus and/or community events that may be relevant to the demographics of your students.
Support their decision to work with populations with shared experiences. It is our duty to train students to work clinically with a variety of populations and/or how to conduct research. However, we can also help them gain access to resources to support their desire to work with specific populations. Although it may seem to come with good intentions, refrain from telling doctoral students that they do not want to be known as the [insert historically marginalized community] scholar. For many of us, research is not conducted for research’s sake, yet it is a welcomed obligation to use our resources to better our communities. Instead, tell them what to add to get a paper published or a grant funded.
>Online CE: Exploring Experiences of Diversity and Multiculturalism
Programs can be rigorous without being hostile or unwelcoming. It may be helpful to analyze your definitions and processes of rigor. Are they based on ideas of classism and elitism? Are there different ways to get to similar outcomes that help students feel supported? What support do you give students to help them manage the rigor?
“Having a myopic view of characteristics that make a good therapist could lead to untapped, unnourished potential in your students.”
Practical suggestions to retain professionals at various career levels
When we think about retaining professionals in our field, we must think about the diversity of our marriage and family therapists, couple therapists, and/or relational therapists. We must think about the global population who no longer wishes to be silent or are deeply impacted by trauma or systems of oppression. We have people who have been historically marginalized and left out of the representation within the mental health profession who can add value and their lived experiences to the healing and prosperity of people.
Retaining early career professionals requires us to understand that they may not value the milestones and accomplishments that once marked this field. They learned from watching professors, supervisors, and seasoned therapists that the “grind” is not worth experiencing burnout, limited time with family and friends, and low pay. They have and are finding ways to use their MFT knowledge, skills, and talents while having something of a work/life balance. We should support this new generation of systemic professionals who are and will continue to innovate and be creative in the field. It is okay if their career trajectory does not mimic your career trajectory. If you are having difficulty accepting their version of a systemic professional, then keep telling yourself: equifinality, equifinality, equifinality.
We can also support early career professionals by developing ideas around fundraising to help support costs for seeking supervision and professional membership. Supervisors can also be thoughtful in considering their rate for supervision. We can also encourage more writing and the voice of early thought leaders in the profession who may not possess strong research and academic skills but possess years of clinical experience that is notable. We can be intentional about creating a space within our professional association that connects researchers/academics with clinicians in the field. This may also be a way to recruit and retain clinicians as members of our association.
We are losing the knowledge and talent of some of our early career BIPOC/ LGBTQIA+ members because other mental health professional organizations give them the space to present research or clinical work that may have been rejected by our journals or conferences. We must realize that professionals are going to put their time, knowledge, resources, and money where they are nourished and celebrated. Mental health professionals have choices. Professionals are choosing spaces where they feel a sense of belonging that are outside of our association and field.
Retaining mid-career professionals means focusing on transitions to leadership and monitoring responsibilities. Mid-career professionals deserve to have leadership roles within professional associations, boards, programs, agencies, etc. However, the transition to these roles should come with mentorship and a stable organizational environment. Women, BIPOC, and LGBTQIA+ mid-career professionals are intentionally recruited to serve or are hired in leadership positions when an organization, agency, or program is in disarray. Instead of using their knowledge, skills, and talents to enhance an organization, they expend unnecessary emotional energy and time cleaning up someone else’s mess.
Administrators should also be okay with hearing the word no from mid-career professionals and maybe even encouraging it. Mid-career professionals should not have to devise strategic, indirect ways of saying “no, I already have too many responsibilities.” They also should not be penalized for prioritizing their health and well-being over another task, client, or committee.
Mentorship is another way to retain early and mid-career professionals. Those who have been in the field for a while can intentionally create pathways for historically marginalized groups to have a voice, experiences, and resources to help them succeed in their careers. We are eager to learn from those who have the wisdom we lack. The association could also create a mentoring program outside of the leadership certificate to connect early and mid-career professionals with members they may not readily have access to.
Conclusion
It would greatly benefit us all if we started treating students and professionals as if they are the future of our field and association. Our field and our professional association may not grow if we are not more welcoming and open to diversity of thought, diversity of voices, and diversity of perspectives. The authors in this article are dedicated and committed to the field of marriage and family therapy. We hope that the readers can hear and receive the suggestions as coming from a place of love and a desire to see the longevity of the field and the professional association.
April Lancit-Harmon, LMFT, is an AAMFT Professional member holding the Clinical Fellow and Approved Supervisor designations, and a 2 time degree holder from LA Salle University in which she earned an Associate of Arts in Liberal Arts and her bachelor’s degree in Clinical Psychology. She earned a master’s degree in Marriage & Family Therapy from Drexel University. As CEO and executive clinical director of April Lancit and Associates, her specialization includes couples therapy, individual therapy, and black mental health and wellness practices. She is currently the director of the marriage and family therapy program at LA Salle University.
Nisan Ilkmen, PhD, LMFT, is the Clinical Training Director and Clinical Assistant Professor of Marriage and Family Therapy at Northern Illinois University. Dr. Ilkmen’s teaching and clinical interests are related to attachment in romantic relationships and issues of social justice in the field of psychotherapy. Dr. Ilkmen grew up in Turkey, has lived in Canada, and now resides in the U.S. Her immigration experience and multi-cultural background allowed her to become a culturally-sensitive clinician and professor.
DeAnna Harris-McKoy is a licensed marriage and family therapist, AAMFT Professional member holding the Clinical Fellow and Approved Supervisor designations, professor, researcher, and social justice advocate. She is currently an Associate Professor and Specialization in Marriage and Family Therapy Program Director at Northern Illinois University. She has presented research at various local, national, and international conferences concerning Black mental health, adolescents, and social justice within the field of marriage and family therapy.
References
Huebner, B. (2020). The dangers of White spaces. Washington, DC: Georgetown University. Retrieved from https://faculty.georgetown.edu/lbh24/Whitespaces.pdf
Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health. Health Care Financing Review, 21, 75-90.
