AAMFT Approved Supervisor Training
Name of Entry
AAMFT Approved Supervisor Training
For more than 75 years, the American Association for Marriage and Family Therapy (AAMFT) voluntarily established its professional identity developing formalized education and training standards and responsibilities for the field of marriage and family therapy (MFT; AAMFT 2016; Kosinski 1982) and marriage and family counseling (MFC; Stevens-Smith et al. 1993). In the early beginnings of the field, more specifically in 1949, the accrediting body of the AAMFT, later titled the Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE), identified and established what constituted a competent MFT/MFC (Kosinski 1982). In 1971, the AAMFT further legitimized and added value to the field by initiating rigorous trainings for the AAMFT Approved Supervisor status* (Lee et al. 2004). At the turn of the century, the field of MFT was one of only two fields requiring additional training to “designate supervisors, define supervisors’ qualifications, and require supervisor training” (Todd and Storm 2002, p. 4). This training process offers professional development options for AAMFT Supervisors-in-Training (SIT)* and future AAMFT Approved Supervisors* at both the masters and doctoral levels. The AAMFT Supervisor Designation* and distinction is a hallmark of COAMFTE accreditation.
Members of the AAMFT, initially the American Association of Marriage and Family Counselors (AAMFC; Kosinski 1982; Stevens-Smith et al. 1993), believed the field of MFT/MFC deserved a distinct professional identity in contrast to mainstream theoretical and clinical fields at the time. In 1974, the AAMFT became the first official body that enforced accreditation standards for graduate and post-degree training (Kosinski 1982; Stevens-Smith et al. 1993) to reflect the autonomous theoretical and clinical discipline of MFT/MFCs. This was possible through the institution of COAMFTE (Stevens-Smith et al. 1993), the establishment of licensure requirements for the profession (Kosinski 1982; West et al. 2013), as well as the development of supervisory standards through the AAMFT Approved Supervisor Program* (Kosinski 1982). Since then, it has become one of a handful of credentialing organizations by which to obtain the education, training, and certification necessary to ensure quality supervisory skills, primarily those around the evaluation of students’ basic as well as advanced professional and clinical competencies to ensure ethical and effective therapeutic care.
The AAMFT has evolved and thrived, from tentatively drawing lines in the sand to establishing the gold standard for the field of MFT. The AAMFT succeeded at creating and regulating stringent training and supervision standards to ensure both students and professors were validating a terminal degree. Members of the AAMFT realized that their systemic approach to accreditation processes through COAMFTE, in addition to clinical and supervisory professionals working in collaboration along with licensing boards, professors, and students, would ensure the systemic process could succeed. The following sections expand upon the successes of this process.
AAMFT Accreditation Process
The AAMFT provides recognition of MFT-related education through COAMFTE grounded in a 2-year, at minimum, terminal master’s degree in MFT. The degree adheres to AAMFT curricular guidelines for students and clinical training expertise of supervisors (West et al. 2013). Unsurprisingly, the curriculum in COAMFTE programs reflects the foundation of MFT and involves a systemic and interactional lens with consideration to case conceptualization, assessment and evaluation, diagnosis, treatment, and attention to diversity issues facing individuals, couples, and families. These guidelines ensure the most comprehensive experience for students beginning their careers in the field and preparing for future autonomous clinical practice (Stevens-Smith et al. 1993). COAMFTE also accredits doctoral-level programs with advanced specialization in curricula and training in the field of MFT. These programs commonly require a COAMFTE accredited master’s degree curriculum as a prerequisite (Stevens-Smith et al. 1993). The doctoral curriculum focuses on “emphasizing research, theory construction, supervision, and advanced clinical skills” (Stevens-Smith et al. 1993, para. 19). Thus, it is unsurprising that obtaining a COAMFTE accredited degree is beneficial for the licensure or certification process at the local and national level.
AAMFT and Licensure
Licensure is the legal privilege to practice within a particular field (West et al. 2013); it provides the basis for regulatory oversight and reimbursement (AAMFT 2016). A vast majority of MFT professionals believe licensure is the crowning achievement after years of effort and hard work in the field. With regard to licensure, AAMFT state divisions collaborated to establish the Department of Divisional Affairs (West et al. 2013) and, in 1987, provided seed money to establish the Association of Marital and Family Therapy Regulatory Boards (AMFTRB; West et al. 2013). In the early 1990s, the AAMFT, through the AMFTRB, succeeded in obtaining licensure and certification statuses for MFTs nationally (West et al. 2013). While the AAMFT initially took a leadership role in establishing professional standards, state licensure boards began taking on a leadership and regulatory role in all 50 states and the District of Columbia (West et al. 2013). Due to the independent needs of each state, West et al. found that prelicensing requirements for individual states and the AAMFT in comparison data for 2007 and 2012 differed and, at times, would conflict. Despite best efforts to collaborate between the AAMFT and state regulatory boards, the authors found that AAMFT guidelines were commonly more stringent reflecting quality graduate guidelines and providing stronger opportunities for licensure at the national level. These ongoing conflicts led in small part to the AAMFT membership passing legislation to restructure the AAMFT and dissolve state divisions in 2018 with the desire to reestablish the AAMFT as the central regulatory organization. The restructure also provided opportunities to create personal interest groups based on the needs of each particular state.
In the meantime, California currently is an exception to this rule due in large part to differing regulatory values as well as the concentrated number of MFTs in the state comparable to the combined number of MFTs nationwide. Thus, California maintained the AAMFT professional relationship while withdrawing from the AAMFT as its regulating body for licensure, and the state is not currently included in the national exam. The Board of Behavioral Sciences is currently tasked with regulating MFT licensure in the State of California. Additionally, in 1998, advocates for California licensure regulation established the California Association of Marriage and Family Therapists (CAMFT) to bridge this gap between profession and licensure.
The AAMFT offers several membership opportunities for individuals specializing in MFT in the USA: student, preclinical fellow, and clinical fellow (AAMFT 2018b). Affiliates may join the AAMFT; however, this category includes professionals licensed in alternative fields/disciplines with specializations/emphases in MFT/MFC (AAMFT 2018b). The AAMFT offers the student category to those enrolled in a graduate or postgraduate certificate program; the preclinical fellow is for master’s graduates working toward licensure in any US state; and the clinical fellow is for those who are fully licensed MFTs in any US state (AAMFT 2018b). AAMFT members in any of the above categories, with the exception of affiliates, are eligible to pursue the AAMFT Approved Supervisor Training process and must be a preclinical fellow or clinical fellow to obtain their AAMFT Approved Supervisor Designation* (AAMFT 2016).
Todd and Storm (2002) viewed the supervisory experience as a developmental process within a large continuously evolving supervisory system. In other words, supervision is the relationship by which the supervisor monitors and evaluates the quality of the supervisee’s professional and clinical development, competencies, and services (West et al. 2013) within the immediate supervisory relationship as well as the larger practice setting (Todd and Storm 2002). Supervisors then act as gatekeepers by ensuring students graduate with the requisite skills and competencies needed toward licensure (West et al. 2013). Thus, the AAMFT supervisory guidelines are essential components of the training experience working toward higher-quality graduate and postgraduate work in consideration of COAMFTE regulation.
AAMFT Approved Supervision Training
The field of MFT has considerably evolved. Quality supervision by skilled and proficient clinicians is essential to shape MFT professionals and influence the growing mental health profession in multiple aspects of professional identity. In order to ensure quality and rigor, the AAMFT believed creating a supervision credential would contribute to the growth and development of therapists in both prelicensure (i.e., obtaining supervision during practice and development as a Supervisor-in-Training* [SIT*]) and post-licensure (i.e., providing mentorship supervision for developing clinicians and SITs) experiences. Smith et al. (2002, see also AAMFT 2016) reported that pursuing the SIT* credentialing process allows those wanting to become AAMFT Approved Supervisors* to (1) develop an understanding of the various models of supervision, (2) develop a personal philosophy of supervision, (3) forge relationships with other professionals in the form of supervisor/supervisee relationships, (4) use and review cases (verbal, audio, video, and/or live), and (5) expand the systemic unit of supervision from a dyad to multiple systems (i.e., supervisor of supervision/mentor as well as supervisees). SITs* are simultaneously advocates, witnesses, and participants of multiculturalism (race, ethnicity, etc.) and diversity (e.g., gender, sexual orientation, socioeconomic status, religio-spiritual identification, ability, etc.) in addition to explicit attention to the AAMFT ethical codes, federal and state regulations, and the values of the AAMFT membership and organization as a part of the contextual supervision process.
The SIT* is also available to doctoral students in COAMFTE accredited programs offering supervision courses. Students are required to take 30 h of applicable supervision courses in the form of two classes (i.e., Fundamentals of MFT Supervision and Advanced Supervision in MFT; AAMFT 2016). Doctoral students can then complete all other requirements of the AAMFT Supervision Designation* while completing their degree or thereafter within 5 years of starting the Fundamentals of MFT Supervision course. At the culmination of SIT hours, the AAMFT Approved Supervisor* candidate would have completed the following: (1) a 30-h supervision course; (2) 36 h of supervision, where 18 of the hours are completed within the last 2 years of training; (3) a minimum of 9 months of continuous supervision with at least 2 AAMFT trainees; (4) 180 h of supervision of trainees, with 90 of the hours completed within the last 2 years of training; and (5) a philosophy of supervision paper that is reviewed and approved by the SIT’s supervisor. Candidates must ensure they join the preclinical fellow or clinical fellow category before applying for the SIT* designation. For further requirements, see the most current version of the AAMFT Approved Supervision Designation: Standards Handbook (AAMFT 2016).
Challenges with Access to AAMFT Approved Supervisors*
While there is strength and backing to the AAMFT Supervisor Designation* credential, there are a few roadblocks. There are tens of thousands of licensed MFTs nationwide; however, only a few are AAMFT qualified supervisors, and fewer are available for trainee and intern supervisory mentorship. This creates a challenge around replicability and reliability. Restrictive graduate programs may assign preapproved practicum sites and supervisors to interns and trainees without consideration for goodness of fit. There may not even be enough AAMFT Approved Supervisors* or AAMFT Approved Equivalent Supervisors to go around. Nevertheless, supervisors with an AAMFT Supervisor Designation* have completed all necessary training to comprehensively mentor SITs through the supervisory process.
Additional roadblocks include AAMFT’s lessening control over the initial requirements of those pursuing a degree in MFT. The education and training experiences are increasingly difficult to evaluate, both in quality and uniformity, especially in non-COAMFTE accredited MFT programs (West et al. 2013). This includes differences in practicum and state requirements and the fact that agencies are less likely to be able to provide AAMFT Approved Supervisors* on staff (West et al. 2013). Thus, MFT advocates encourage more support for the AAMFT Supervisor Designation* as well as what it stands for due to its established foundation for quality clinical training and supervision.
Significance and Uniqueness of the AAMFT Supervisor Training
An area of distinction with the AAMFT Approved Supervisor Designation* is the emphasis on diversity and multiculturalism. The AAMFT Code of Ethics (AAMFT 2018a) and principles has a section on nondiscrimination as follows: “Marriage and family therapists provide professional assistance to persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, sexual orientation, gender identity or relationship status” (p. 3). Designation as an AAMFT Approved Supervisor* inherently emphasizes attention to interactional and contextual influences around diversity. Despite these multicultural emphases and contextual values, Northey (2004) highlighted that MFTs in his study were predominantly Caucasian, and this presence automatically influences supervisory experiences when extended systems do not reflect national representations. Based on this, the encouragement is for supervisors to explore these dynamics and be sensitive to how supervision attends to multicultural and diversity issues and needs. They further emphasized that other forms of diversity need to also be acknowledged (e.g., socioeconomic status, sexual orientation, gender, etc.) as well as power dynamics.
Lastly, as the field of MFT evolves with the turn of the century, AAMFT has provided more opportunities for technology by including it as an aspect of supervision, i.e., providing the supervision and refresher courses online (AAMFT 2018b). The commitment to technological accessibility is evidenced by AAMFT’s official provider status for online courses since June 2015. They have also added a supervisor directory for both students, clinicians, and supervisors who are AAMFT members as a form of networking and connection. Members can view this link after signing into the AAMFT website: https://www.aamft.org/AAMFT/supervision/AS_Designation.aspx. Other resources for supervisors on the website include samples of informed consent with SIT, ways to structure supervision, and a supervisor’s theoretical orientation.
- AAMFT. (2016). Approved supervision designation: Standards handbook. Retrieved from https://www.aamft.org/Documents/Supervision/2016%20Supervision%20Forms/Jan_2014_AS_Handbook_ver_Oct_%202016.pdf.
- AAMFT. (2018a). Code of ethics. Retrieved from https://www.aamft.org/Documents/Legal%20Ethics/AAMFT-code-of-ethics.pdf.
- AAMFT. (2018b). Join/reinstate/upgrade today! Retrieved from https://www.aamft.org/AAMFT/Membership/Join_AAMFT/Shared_Content/Membership/New_Join_Application/Join_AAMFT.aspx?hkey=b16a4aa7-0e1e-47d4-b47f-5fb8ebdd28a9.
- Lee, R. E., Nichols, D. P., Nichols, W. C., & Odom, T. (2004). Trends in family therapy supervision: The past 25 years and into the future. Journal of Marital and Family Therapy, 30(1), 61–70. https://doi.org/10.1111/j.1752-0606.2004.tb01222.x.CrossRefPubMedGoogle Scholar
- Northey, W. (2004). Who are marriage and family therapists? Family Therapy Magazine, 3(6), 10–13.Google Scholar
- Stevens-Smith, P., Hinkle, J. S., & Stahmann, R. F. (1993). A comparison of professional accreditation standards in marriage and family counseling and therapy. Counselor Education and Supervision, 33(2), 116–126. https://doi.org/10.1002/j.1556-6978.1993.tb00274.x.CrossRefGoogle Scholar
- Todd, T. C., & Storm, C. L. (Eds.). (2002). The complete systemic supervisor: Context, philosophy, and pragmatics. Lincoln: Authors Choice Press.Google Scholar