What is a Licensed Marriage and Family Therapist?

Licensed Marriage and Family Therapists (LMFT's) are pretty rare in Eastern NC. I am often asked what it means to be an LMFT, and how treatment might differ from that offered by a social worker, professional counselor, or psychologist. Here I offer three areas of difference that come to mind.

First, LMFT's think about their clients' issues in terms of developmental psychology and family interactions, rather than in terms of diagnosis. Whether seeing an individual, a family, a troubled child, or a married couple, family therapists understand that the most important factor is the life journey that brought the client to the therapy office. While LMFT's are licensed to diagnose, I believe that one of the most hurtful things we do is to label ourselves, or to accept others' labels--including those given to us by a therapist. LMFT's try to help the client by drawing on strengths rather than treating the client as a problem to solve.

Second, LMFT's do, in fact, come out of graduate school with specific, professional-level training in marriage and family therapy. This is unlike any other therapy discipline. Other therapists may advertise that they do marriage therapy, but do they have a specialized training? Probably not. While I have advanced, formal training in treating individuals also, and that forms most of my work, being an LMFT means that I don't try to treat the client out of context. For instance, most therapists will leave parents of young children in the waiting area, as though treating a child is like doing an oil change. LMFT's always include parents, because unless change occurs throughout the family system, how can a child be expected to have different behavior when he goes home?

Third, LMFT's have more intensive post-graduate supervision requirements than most other disciplines, in which long hours with an AAMFT-approved supervisor ensure that the MFT student is competent in many types of therapy before being unleashed on the world. Some disciplines only focus on one type of therapy, some do not require supervision by a trained supervisor, and some don't require very much experience to get a license. You can be sure that your LMFT therapist has been held to a very high standard in training.

I want to stress that while I believe the LMFT approach is the best approach, I know for a fact that there are many talented social workers and professional counselors (several of whom I share an office building with!) who through talent and experience do amazing work. When looking for a therapist, remember that the most important factor in treatment success is your relationship with your therapist, not the letters after his or her name.