I am focusing this column on the identity of family psychologists and those who work in the area of family psychology but do not necessarily identify as being one. There are several areas of concern that hopefully will be addressed in the field of couple and family psychology in the next few years, especially as family psychology comes up for renewal as a specialty area in the American Psychological Association. Some of the issues include the role and expertise required to do family psychology work, such as conducting evaluations for courts in child custody or family violence cases, ethical issues of working with families without having sufficient training in family psychology and the dynamics of dysfunctional families, and the way family issues and family therapy are addressed in DSM 5 and by insurance companies. It would be interesting to do a survey of clinical psychologists, forensic psychologists, child psychologists, and trauma psychologists, whether working in agencies, clinics, hospitals, or in independent practice, to see how many of them do some type of clinical, evaluative, or forensic work with couples or families.
Then it would be of interest to see how many of these professionals identify themselves as a family psychologist, not necessarily exclusively but as one of their roles. As a final question, it would be important to see how many of those professionals are actually trained as family psychologists and understand the dynamics of dysfunctional, abusive, traumatized, or conflicted family members.
I identify myself in several roles, having practiced and been trained in trauma, family, forensic, clinical and neuropsychology. However, I would venture to say that not all those who do some type of work involving families in various settings do identify themselves as a family psychologist along with their other roles. That is a concern as we move forward with our specialty certification and attempting to ensure that family psychology is an important, recognized specialty in psychology. There are thousands of marriage and family therapists licensed in this country as well as licensed psychologists who work in the family psychology field, many of whom also have advanced degrees in different areas of psychology, and evaluate and/or treat couples, families, or children. However, most do not identify themselves as family psychologists even with a doctorate in family psychology or marriage and family therapy. This is an interesting dilemma for the specialty in family psychology. We would be much stronger if we did all identify with a more unified specialty when we did deal with family members in one capacity or another.
This raises additional points. What do we actually mean by family psychology? In the comments above, I am obviously taking a broad view that includes all family situations, whether from a diagnostic, treatment, or forensic perspective. Taking such a perspective would imply that family psychologists who are able to work with such varied situations as marriage therapy, child abuse, intimate partner abuse, divorce, parenting, etc. would really need to be trained in many areas to do a good, competent job. For example, many of the above situations involve trauma, child forensic issues if it ends up in some court. This is complicated! But so are all of the situations noted above. These involve many different areas of training and specialization.
So, do all those professionals who do the types of work noted above have adequate training in all of these areas? I would worry that many may not, which would imply that such professionals would likely need to work with others to do some of the work collaboratively or in conjunction with each other, depending upon the type of case. However, that is somewhat contrary to the HMO mentality of quick intervention, without many referrals or the multiple use of professionals. In addition, if we are doing family work of one type of another, and we are not really adequately trained in all of the areas, what does that say about our levels of competence to actually diagnose or treat such families? This is not just speculation. In my nearly 40 years of practice, I have seen complex cases of child abuse, divorce, intimate partner abuse, sexual assault, and traumatized adult and child victims within families, and have realized how complex this can be. However, I have also seen professionals with various credentials work with such cases, make diagnoses, and even testify in court, when they obviously have not received the training noted above in all of the needed areas. How can I tell? Well, we know from years of research and practice that adult victims of abuse can become quite angry as they move through recovery and gradually become more empowered. This is not surprising. However, there are numerous times when their anger is labeled and diagnosed inappropriately by clinicians, and not viewed as a symptom of the abuse and trauma. Or as another example staying in the family violence arena, a child abuse victim who runs up to the parent who is the perpetrator of the abuse, hugs them, tells them how much they love them, and seeks out their attention, and the professional then testifies that the child therefore cannot be a victim of abuse nor that the parent could be the perpetrator.
These are just a couple of examples that we encounter too often by professionals working with families or in forensic cases who are not really trained adequately no matter how long they may have been in practice. These also involve serious ethical issues of pr area of expertise and training. However, ethical enforcement has not been adequate in many of these situations. If it was, perhaps we would not see so many of these situations.
Thus, identifying as a family psychologist if one is working in some area of this specialty is important, as is obtaining the needed training and expertise. We need to emphasize the need for identifying oneself in this way if one is going to deal with any of the situations I mentioned above, no matter what the setting. Then we need to enforce the requirement to obtain the necessary training as well as the ethical consequences if these are not achieved. Perhaps these issues will be clarified and emphasized in the coming years.
Until next time,
Bob Geffner, Ph.D., ABPP, ABN, President