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A Board Task Force collaborated with CAMFT’s Prelicensee Committee to develop this statement on paying associates as a best practice of supervision.
Approved December 7, 2019
In alignment with CAMFT’s mission, this organization works to anticipate and address the professional needs of its members and to advance the Marriage and Family Therapist profession, with a foundational value of inclusion. The current employment model for Associate Marriage and Family Therapists makes it difficult for them to support themselves financially during the time period when they are accruing required supervised experience. The lack of pay can also create barriers to entry into the workforce based on socio-economic status, decreasing the potential diversity in our profession (Hoge, Morris, Daniels, Stuart, Huey, & Adams, 2007, pg 272).
When organizations offer competitive wage and benefits packages, meaningful work, and appropriate infrastructure, they are able to hire and retain qualified professionals who can provide high quality mental health services (Hoge et al., 2007, pg 18). Staff turnover is costly to employers (Hoge et al., 2007, pg 16), has negative effects on clients, and undermines quality of care (Knudsen, Johnson, & Roman, 2003; Eby, Burnk, & Maher, 2010)
There are concerns related to the rights of therapists who take unpaid or volunteer work. These workers often are not extended the legal rights afforded to employees. In truth, the Civil Rights Act, FMLA, and EEOC do not apply to unpaid positions, leaving our prelicensees at risk for discriminatory abuses (Hickman, 2014). Further, many unpaid positions are actually displacing work that other paid employees could perform, further impacting the wages of others in the field (Crain, 2016). Low wages are shown to increase turnover and burnout, leading to inconsistency in the workforce and a decrease in the quality of mental health services (SAMHSA, 2014, pg 157, Hoge 16, pp. 105-109).
Lack of pay for Associate MFTs has a longer term effect on employment for Associates. Associate MFTs may take longer to earn their MFT license, directly affecting their salary. In addition, workers who obtain unpaid internships are often required to work additional jobs or seek additional financial support. This is considered “underemployment,” which impacts up to 56% of our workforce (Abel, Deitz, & Su, 2014). Finally, when entering the job market for a paid position, these workers are often at a disadvantage to their peers who have either had a paid internship or who have had no internship experience at all (Crain, 2016, pp. 6-7). Workers who have come from unpaid internships receive fewer job offers and work for lower wages (Crain, 2016, pp. 6-7).
CAMFT calls on employers to pay Associates as a best practice in valuing equality, inclusion, and diversity in the MFT profession. CAMFT affirms that workplaces that recruit Associate Marriage and Family Therapists to provide mental health services shall, as a best practice, provide a living wage (commensurate with cost of living, education, experience, and responsibility), benefits, clear roles, appropriate caseloads, administrative support, and appropriate training and supervision.
Abel, J. R., Deitz, R., & Su, Y. (2014) Are recent college graduates finding good jobs? Current Issues in Economics and Finance, 20(1). Available at SSRN: https://ssrn.com/abstract=2378472
Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). Trauma- Informed Care in Behavioral Health Service: Treatment Improvement Protocol (TIP) Series 57. Substance Abuse and Mental Health Services Administration, Rockville, MD.
Crain, A. (2016). Understanding the impact of unpaid internships on college student career development and employment outcomes. NACE Journal. Available at https://www.naceweb.org/job-market/internships/exploring-the-implications-of-unpaid-internships/.
Eby, L. T., Burk, H., & Maher, C. P. (2010). How serious of a problem is staff turnover in substance abuse treatment? A longitudinal study of actual turnover. Journal of Substance Abuse Treatment, 39, 264–271.
Hickman, B. (2014, July 23). What we learned exploring unpaid internships. Retrieved from https://www.propublica.org/article/what-we-learned-investigating-unpaid-internships.
Hoge, M. A., Morris, J. A., Daniels, A. S., Stuart, G. W., Huey, L. Y., & Adams, N. (2007). An action plan for behavioral health workforce development. Annapolis Coalition on the Behavioral Health Workforce: Cincinnati, OH.
Knudsen, H. K., Johnson, J. A., & Roman, P. M. (2003). Retaining counseling staff at substance abuse treatment centers: Effects of management practices. Journal of Substance Abuse Treatment, 24(2), 129- 135.