Transcript from Licensing Board Meeting in Jan 2012

I promised it a while back, but have just now gotten around to typing up the audio file from my appeal to the licensing standards committee of the Texas State Board of Examiners of Marriage and Family Therapists in January.

I spent a good part of this afternoon trying to decipher the letter I was sent detailing what I have to resubmit and how many hours I have yet to accumulate.  I had in my mind that the board had essentially said they would accept half of the hours that they had originally declined from my non-profit agency job.  If that was the case, by my reckoning, I would only have to finish 514 hours, which, by my estimate, I would finish by March!  Woo hoo!  

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Then I sat down and transcribed the audio file of the actual recording of the meeting and that is NOT what was decided by the committee.  Instead of counting all the hours I'd accumulated from September 2011 through Dec 2011 and adding them to HALF of the hours they'd denied.... the actual ruling was that from Jan 13th on, I would have to get ANOTHER 1000 hours... 500 of which have to be direct clinical hours and 250 of those have to be hours to couples and families. 

The practical difference between my recollection of the event and the actual recording of what happens amounts to about 3 months or more of my life before I can upgrade my license.  *sigh*  Instead of being able to finish and upgrade in March, I will be lucky to finish by the end of May or June.

Just yesterday, I learned that another friend from the MFT program at ACU found herself in the same pickle with the board.  They denied her 2000 hours (presumably half of those are direct clinical hours and the rest are paperwork and such).  Learning about her situation incensed me again about the whole situation. 

They board has blatantly admitted that the rule about submitting paperwork for additional sites was unclear, as evidenced by the fact that THEY HAVE CLARIFIED THE RULE and changed the form to include a HUGE paragraph in BOLD print explaining it.  And yet, if a licensee doesn't submit the correct form, it is somehow the licensee's fault and apparently, we deserve to be punished.  The board doesn't say that the hours accumulated that are not board-approved are somehow invalid.  In fact, by accepting a portion of my 'uncontracted' hours, they are essentially admitting that they are perfectly valid and that it is within the purview of the board to approve and accept them if they were so inclined.  Instead, the board feels that it must force the licensee to admit that they 'had a lack of clarity about the rules.'  

Anyhow, here is a copy of the transcript in .PDF form if you want to download it.  I obtained it using the open records law and received a CD with the entire 1.5 hour session on it, but only transcribed the portion pertaining to my appeal. : CLICK HERE

For others who would rather just read it here, scroll on.
 

Transcript from my portion of the Licensing Standards Committee meeting on 1-13-12.

Carol Miller, Executive Officer from the Licensing office, Sandra DeSobe presiding.  Beverly Womack, Sean Stokes, George Francis attending.

(about 10:32 from the start of the recording)

Sandra: Next we will hear from Jeff Emery.  And there is a little more information available here…

Carol: There is.  We have received three emails of support for approval of Mr. Emery’s appeal.  (distributes copies of the email to committee members)

Jeff: I also printed some… I wanted to make sure they had some… if you need extras…There are several that weren’t emailed, but were handed to me…

(sounds of papers being handed out and looked over)

George: If you don’t mind, I’ll take a copy of those, please.

Jeff: Sure.

George: Thank you, sir.

Jeff: Anybody else?

(long pause while committee members ostensibly read over the support letters)

Sandra: Are there any questions from committee members for Mr. Emery?

(pause, with no questions)

Carol: Okay, I just wanted to be sure everyone had time to read.  Um… Mr. Emery is an LMFT-Associate.  He gained LMFT-A status on 9-17 of 2009.  He submitted an application for LMFT upgrade to licensure which was received by the board office on 9-20-11.  But the application was denied because Mr. Emery did not meet minimum requirements for supervised experience under a board-approved plan.  Mr. Emery had previously been approved to begin supervision at Texas Family Institute with John McLen on 9-17-09 for part-time work.  Mr. Emery has credit for supervision and supervised experience at this location for the time period submitted.  Um.. and for a specified number of hours.  According to the Licensed Supervision Experience Verification Form submitted with the application for upgrade, Mr. Emery also, apparently practiced with the same supervisor at New Horizons Ranch and Center with a start date of 12-1 of 09.  And that was for the number of hours that were there on the form… um… these hours at New Horizons Ranch and Center were denied by staff.  Mr. Emery says in his appeal letter that he had, quote “missed a step two years ago and all of the hours at the agency are being denied” unquote, and requests that you count the hours at New Horizons Ranch and Center towards fulfilling the requirements for licensure as an LMFT.  He has submitted new Supervisory Agreement Forms to work at both locations with a board approved start date of 9-17-11 for New Horizons and 10-16-11 for Texas Family Institute.  He listed the Texas Administrative code for requirements related to .. um.. ah.. submission of… um… Supervisory (indistinct word ) to the board… at 801402(?) and 801202.  And that is the information.

Sandra: …To clarify, Mr. Emery, You filed a supervisory agreement form with your first supervisor…

Jeff: With my only supervisor, yes, ma’am.

Sandra: So he supervised your work at both sites.

Jeff: Yes.  The step that was missed was when I started a month later at New Horizons, um, they didn’t have an LMFT supervisor there and I asked John (Rusty), if he would agree to do both and he said that was fine.  And because it was with the same supervisor, it didn’t click that I needed to do a new Supervisory Agreement.  But both locations were aware that the hours I was getting at New Horizons were being supervised by Rusty.  They gave me time off for professional development so I could attend supervision. 

Sandra: And are you still working there?

Jeff: Yes, Ma’am.  I am still currently employed there. 

George: And that was my question, Mr. Emery.  So, you knew to file for the Supervisory… for the first position…

Jeff: Yes, sir.

George: … But not for the second one?

Jeff: Well, um, when I filed for the upgrade, and I was filling out the paperwork, in the upgrade packet, it has the verification of supervisory experience where you list every location that you have provided services at.  And I did, because that is where I knew I’d provided services at two locations.  But on the original Supervisory Agreement Form, there is a spot for the licensee, where you’ll be providing services and the supervisor.  And so there wasn’t anything intuitive there that said, “hey, if you’re going to have it at another location…” to fill out another one for the SAME supervisor. And that…

George: For another location or for another position, because this was another position, correct? 

Jeff: Yeah.  Um.. ah… That was the step that I missed … that because I was utilizing the same supervisor, I didn’t understand that I needed a new Supervisory Agreement.  I didn’t realize that it was per location…

George: So you thought that it was tied to supervisor and not to job?  Or to job AND supervisor?

Jeff: Well, it seemed to be pretty conclusive that if there was going to be a new supervisor, that I would need a new supervisory agreement.  And I did have friends in my cohort that were getting hours at different locations where a supervisor was provided, so if there is a new supervisor, it would make sense that you would need a new supervisory agreement.  But intuitively, because I was using the same supervisor, it didn’t click that I would need a new supervisory agreement. 

George: Ah, thank you.

(long pause)

Sandra: Any other questions for Mr. Emery?

Womack: Did you file for a new supervisory agreement in a different location now?

Jeff: Yes!  Yeah, as soon as I discovered from the board that that was the step that I missed, they recommended that I go ahead and extend my LMFT-A, which I did.  I filed it as soon as possible for that, and managed to get all the forms signed to get that sent in.  Which has allowed me to continue practicing at both locations and gain hours and I counted up through my billing at both locations that I’ve garnered almost another 200 hours since then.  But I have continued, as recommended by the staff. 

Sandra: Okay, so how many hours are you gonna be short? Of the face to face time?

Jeff:  Lacking all of the New Horizons hours?

Sandra: Yes.

Jeff: 2410.

Sandra: That’s not face to face time…

Jeff: I’m sorry… the face to face time… um…

Sandra: Counting the hours you have accumulated since September… when you discovered this… problem.  That would give you what you need?  If you accumulated about 700 more hours?  Is that correct?

Carol: What is currently approved is 730 practice hours, 365 of which were direct clinical and of those 156 were to couples and families.  So there ….

Sandra: But that was before… September?

Carol: Correct.

Sandra: So… we’ve got that.  So far. 

Carol: So, of 3000, he has 730.  Of the 1500 that have to be direct clinical he has 365.  And of the 750 that have to be to couples and families, he has 156. 

Sandra: Now, can you give us that run down of hours that you’ve completed since September?  How many total hours have you accumulated since September?  Clock hours?

Jeff: Um… as of September.. face to face clock hours?

Sandra: Not Face to face… total.

Jeff: Um… I only kept track of the face to face hours.

Sandra: Okay, so how many face to face hours have you accumulated since September? 

Jeff: Um… Through my December billing, not counting January, 199 face to face hours. 

Sandra: And how many of those are for couples and families?

Jeff: Well, I’d have to … I … didn’t delineate those when I was counting them up. 

Sandra: (long pause while she does math on a scratch paper)  So you are about 936 just to pick a number… ah… hours short of what you need to get your license.  (pause) But we don’t know that for sure because we don’t know how many are client, couple and family hours. 

Jeff: Ah… the work that I do at New Horizons… I provide prevention counseling for at risk families.  Part of our program is that we have to meet with primary caregivers as well as the target youth, so a lot of the hours I get at New Horizons are, ah… count as family hours.

Sandra: Yes.  I can see that.  Okay. 

Beverly: And you are a full time employee there now, yes?

Jeff: Yes.

Sandra: And about how many clients are you seeing a week? 

Jeff: I generally carry a caseload of 15-20 clients a month at New Horizons…

Sandra: A month?  Or a week?

Jeff: Oh, well, on my caseload, it rotates out.  On a weekly basis, I generally meet with about 14-15 hours. 

Sandra: So you’re not really going to have any trouble at all accumulating the ah… non face to face hours. 

Jeff: As far as paperwork and …

Sandra: Right.

Jeff: That’s not a problem at all.

Sandra: No one really has trouble accumulating that!  Well, Mr. Emery.  This may be your lucky day.  Not as lucky as you think, but I’m going to make a recommendation that because we have had this problem and this precedent, the board has taken action to correct this so it will not be a problem in the future, that we will accept part of those hours that were done without the contract.  And, so, committee… He’s about a third of the way there.  If we accept another third from the uncontracted and let him get one more third accumulated under supervision… Essentially cut his mistake in half…

George: Is that a motion?

Beverly: But can we do that?  Because everyone is going to be saying that we’ve got to waiver the plan. 

Sean: Well, we *have*.

Carol: We … have inconsistently … waived or not waived

Jeff: Um… before a motion is made I just wanted to offer some information, or at least a perspective…

Sandra:  Yeah.   (clears throat) Dig yourself a grave here….

Jeff: Well, I hope I won’t be digging a grave… necessarily.  I appreciate the policies and procedures that are in place and I understand that this is not a … I’ve very diligently tried not to strike a tone that I’m deserving in some way because I know that I missed a step on this and that any action taken by the board is an action of grace.  And I do appreciate all the consideration you’ve given it.  However, I’ve talked to several of my colleagues and I’ve heard that this is something that has come up in the past… one of my cohort actually told me that she had the same problem when she applied, but in her case it was a secondary site and she said it was about 100 hours and she said “I was upset about it and I cried about it and then I just earned the hours back again.”  But in this case, it represents about two years of accumulating hours.  In that time, in addition to the work that I’ve done with New Horizons, a non-profit agency, and TFI, doing private counseling there, I’ve had the opportunity to be a part of the community and utilize my talents and services in ways that have benefited the community.  I serve on several coalitions… one of them provides training for child care providers so that they can continue to provide that service to our community.  Another one works with Teen Drug prevention and we offer a support group for teens who are involved in drug or alcohol abuse.  And I understand that any motion that’s made or decision that is made that extends the time that I will remain an associate in some was impacts not only my professional development but also the ability to further any opportunities to help the community.  So… I can see this as a win-win, since it is in the purview of the committee to accept all the hours or some portion of them, obviously it would be personally beneficial to me but I think also, in addition to professionally, I think it would be good for our community.  And since the board has already taken action to make sure that it doesn’t happen for future folks, ….

George: Mr. Emery, what were you looking for?

Jeff: Um… as I mentioned , I was looking for some grace. 

George: I’m just asking, what are you looking for from the board?

Jeff: Best case scenario?  Since it was something that was on the last agenda and it has been handled before, I was hoping that it would be something like, “Hey, we’ve already fixed it.  We’re sorry that it has caused some confusion for you….”  Next level down, I was looking for: “We’ll take the hours you’ve accumulated over the past three months and say that that is the number of hours you needed to get, so we’ll call it even since you have…. like I said, I’ve tried to be compliant with everything the board staff have asked me to do as far as extending things and continuing to work on those hours…. BUT, I was prepared that if there was a need to go ahead and continue to get some hours, that that is something I would go ahead and have to do.  Because I love what I do.  I’m intending to pursue this and this is what I want to be my career… so… whatever it takes in order to make it happen is what I’m going to do.  In order, that was kind of my preference of how I’d like to see this happen. 

Sandra: I’m suggesting that we split the difference.  And because we are acknowledging that we had some problems with a lack of clarity about our form, we would like for you to acknowledge that you had a lack of clarity about the rules.  And part of our job here, in protecting the public is making sure our… our therapists are competent.  And one of the ways we evaluate that is whether or not they can follow the rules … and… (crackling of a food wrapper near the mic) .  I am chairing this committee, so can someone make that motion?

George: I make the motion that we split the difference and go for one third of the hours that still need to be accumulated by Mr. Emery.

Sandra: So, what would mean is that you would still have 500 hours.  Face to face hours to show to the committee.  Do I have a second?

Sean: I second.

Sandra: Any discussion?  Yes, George?

George: Is that consistent with our … inconsistencies previously?  (laughter)

Carol: It has been an evolving process.  In the beginning, all were denied, that have done this.  But then this is consistent in that it is partial credit.  And that is consistent …

Sandra: That is a precedent that this committee set in July of last year.  So… we’re kind of stuck with that right now.

George: I’m comfortable with it.

Sandra: Okay.  All in favor?

George, Sean and Beverly: Aye.

Sandra: So… keep practicing. (more crackling from food wrappings obscure the sound)

Jeff: So, 500 beyond the three months I’ve already done… the 200 I’ve already gathered?

Sandra: Starting from now.

Jeff: Starting from now… about 500.  And when it gets to that point as far as…. do I just submit for upgrade again?  As I’ve done, or…

Carol: Your application, um…yeah, I don’t think that it is going to be realistic for you… the application will expire 9/20 of 2012.  So I don’t think it is going to be realistic to get those hours…

Jeff: I think it is.

Sandra: Yep.  He’s gotten 200 in the last three months.

Carol: Yeah.  Oh.  So.  I’ll send you a letter outlining the details, okay?

Jeff: Thank you very much.

(ending at about 30:12 from the beginning of the recording

I know everything I need to succeed in life...

Occasionally, I run across family systems that are heartbreaking.  Consider the following: my client: a middle-school aged kid.  His mom requested I work with him because of his behavior at home and at school.  Seems that all he wanted to do was play his Xbox.  He is very smart and schoolwork holds no interest for him, so he sometimes refuses to go to school.  His mom says that he often throws tantrums when he doesn't get his way.  He is close to neither parent and his siblings are old enough that he may as well be an only child. 
Using open ended questions, I discovered that he considers himself to be decently happy and content with himself, but has few friends.  Asking about the presenting issue as described by his mom, he admitted that he is spoiled.  I asked him to finish the following statement, "The most important thing in life is..."  his answer: to not be bored.  Though he is not a child of the 1990's, my brain sparked and connected to the grunge band, Nirvana and their hit, "Smells Like Teen Spirit."  Part of the chorus pleads, "here we are now, entertain us!", helping the song to be hailed as the anthem of an apathetic generation who only wanted to be entertained.  As I continued to dialog with the kid, I learned that he described his relationship with both his mother and father as distant and faint.  Developmentally, it is my understanding that most children find their identity and sense of self through their connection with their family.  At his age, he should be starting to develop his identity apart from his family, but it seems like his family identity was never really formed, as he feels no attachment or connection, only entitlement.  Trying again to get a sense of his value system, I asked him to evaluate the following quote: "Show me the person you emulate and I shall know by this measure, better than any other, who you are yourself."  The young man was quick to analyze the sentence and reflected to me that he understood its meaning.  But when I followed up with, "So, who do you admire?  Who in your life is someone that you can see yourself growing up to be?"  He thought for a few minutes and then shrugged and said, "No one, really.  I think I know everything I need to succeed in life."
At first, I had to stifle an urge to laugh at the seemingly preposterous statement I'd heard.  My bemusement quickly turned to pity when I realized that far from being cocky or feeling entitled, this young man's problem was not a character flaw in himself, but a failure in his family system.  I felt sad for him because his parents don't know enough to challenge him or help him have a healthy sense of self. 
I have come to understand, as I work with various families, that kids' behaviors and beliefs are generally a response to their environment.  So, as I am presented with a kid whose troubled behavior or attitude is labeled by their parent as the presenting issue, I am always careful to examine the family system and try to work with the parent to depathologize the kid and help the parent to accept some responsibility for the resulting behavior which they say they don't want.
Anyhow, I am saddened because my role in working with this boy is limited and in order to really address the core issues, the needed work is with the family system, something that is unlikely to happen.  I think the best I can hope for in this situation is relationship triage, not relationship repair (as it relates to helping this young man to have a healthy connection to his family).

The situation invites me to reflect on my own family functioning.  How would my children be affected if I viewed their behavior as a function of their response to the environment that I create for them in our home?  Now, I don't want to take absolute responsibility for their actions, but do I really recognize and honor the influence I have on my children, or do I discount it?  If I have generally happy children, how am I influencing their happiness?  If I have generally anxious children, how is our home environment encouraging them to be anxious?  If my children are generally angry and hateful, what kind of environment am I providing for them?

Nietzsche wrote, "When you look into the Abyss, the Abyss looks into you," reminding me that I do not remain unaffected by the families that I encounter in treatment.  Even as I hope to influence them, I recognize that I am influenced in return.  Hopefully, I will embrace the opposite philosophy that my young friend espoused and will find freedom to grow by knowing that far from having everything I need to succeed in life, I recognize that I know nothing.  And that is the beginning of wisdom.

 

Obstacles, Barriers and Hoops to Jump Through: Bureaucracy at work

I started on my journey to become a therapist several years ago, when I decided to go back to school and get my Master's in Marriage and Family Therapy.  Just getting a degree isn't the end of the process, though.  Once one has one's diploma in hand, one must obtain a license from the state to practice as a therapist.  Licensing and regulation are as old as government and serve to protect the public from any old person labeling themselves a therapist and setting up shop.  However, whenever you have government regulating things, you will inevitably experience red tape and bureaucracy.  Here is a narrative of my troubles so far: Jeff's Licensing Journey.

So, I requested to have my situation brought before the Licensing Standards Committee of the Texas State Board of Examiners of Marriage and Family Therapy and was added to the agenda for the meeting on Friday, January 13th, 2012.  The outcome of the meeting was that the Committee is requiring me to accrue an additional 700 hours of client contact before I can be awarded my license.  That is the short story.  If  you want to know details and my opinion of the situation, read on.

Here are the facts to keep in mind:
1) The critical step that I missed was that the Board requires a Supervisory Agreement Form (Form III) to be on file and approved by the board for each location that a LMFT-A will be providing services.  I had one on file for my hours at TFI, but not for New Horizons.
2) Over the past year or so, the Licensing Standards Committee has had so many LMFT-As  appear before them for a waiver of that rule, they have changed the wording of the rule to be more clear and added a block of text on the FORM III at the top of the form, in all caps and in bold, so it can't be missed. See a copy of the revised form HERE.  Here is the previous form, for comparison: HERE.

The problem is that the rule that was violated was unclear in the first place, as evidenced by the fact that so many people have missed it and by the fact that the board apparently felt the need to change it for clarity.  Here is the wording of the rule as it appears in the Texas Code:
Texas Administrative Code, Title 22, Part 35, Chapter 801, Subchapter G, Rule 801.142(D) “Supervision must be conducted under a supervision contract, which must be submitted to the board on the official form within 60 days of the initiation of supervision. The supervision contract submitted to the board must be approved by the board. Fees charged by a supervisor during the course of supervision, which occurred without a board-approved supervision contract in place and subsequently resulted in the supervised experience hours of the supervisee being denied by the board solely on the basis that there was no board approved supervision contract in place within 60 days of the initiation of supervision, must be reimbursed to the supervisee.” 

 So, according to this rule, I had to have a supervision contract in place within 60 days of the initiation of supervision.  Check!  I did that.  I submitted the official form (Form III) and happily started seeing clients on a part-time basis at Texas Family Institute.  The form (Form III), has a spot for the licensee information (that is me) and where services will be provided (TFI).  Then it has a spot for the supervisor's information and the supervision schedule.  Then, it has spots for a notary to sign off and volia!  You are done!  Now, I will grant that the inclusion of a line on the form asking where services will be provided does indicate that the information is important to the board.  However, there is nothing explicit on the form that indicates that if you provide services at a second location, it would necessitate filling out a new form.  On the other hand, if you have a second supervisor, it makes logical sense that you would need an additional supervisory form on file.  In fact, there are other rules that state a supervisee can only have two supervisors at any given time in the process.  So, not only is it a logical thought process, but there are multiple rules that discuss how to handle having multiple supervisors, but none that specify what to do if you have more than one location that is being supervised by only one supervisor, as was my case.
A month after I started working at TFI, I was hired by another non-profit organization where my job would allow me to accrue hours toward my license, but they had no LMFT supervisor available, so I asked my original supervisor if he would supervise those hours as well.  He agreed to do so and my new job allowed me to take time each week to attend supervision sessions with him.

So, did I fail to turn in a form that was required by the board?  Yes.  Was I at fault for my negligence?  Well, kind of... you see if I was the only one who misunderstood, then it would stand to reason that it was my own lack of diligence or intelligence that was at fault.  However, by the board's own admission, this rule is unclear and confusing to people in my situation.  So they changed the rule.  They changed the form.  And it is at this point that I feel that the Supervisory Committee handled my appeal poorly.

When time came to address my appeal, the Executive Director informed the board of my situation, gave them time to look over my narrative (linked above) and some support letters from colleagues who knew my situation.  The members of the committee asked a few questions for clarification.  There was some discussion between the committee members wherein they acknowledged that my case was not the first time they had heard about this situation.  They mentioned that each time, the details were examined and that the board had made some inconsistent rulings about other's cases and they joked about needing to be consistent in their inconsistency.  Then the chair called for someone to motion that they look at the how many hours I still had remaining that weren't approved and that they split the difference with me, accepting half of them and requiring me to make up half of them.  I interrupted and asked if I might speak and give further details.  The chairperson sat back in her chair and said, "Okay... dig yourself a grave."  That comment was offensive to me, as it indicated to me that her mind was already made up and that whatever I was about to say would only serve to damage my appeal.  I spoke for a few moments about my perspective on the situation and acknowledged that the decision was in their hands, but also the power to grant my hours, all of them.  I noted my service to the community, the fact that the rule was unclear, that my supervisor knew he was supervising the hours and that I had complied with everything else that was required of me, including renewing my LMFT-A for the three months between my denial of hours and the chance to appeal.  After I spoke, the chairperson picked up where she left off, as if nothing in my statement held merit and again requested a motion for splitting the difference of my remaining hours.  The chairperson looked at me and said that the board was willing to admit that the wording of the rule was unclear, but that I had to admit that I'd done something wrong by not filing the paperwork.  So essentially, the committee was asking me to admit that I had deliberately not filed a paper that I didn't know I was supposed to file because by their own admission, it was unclear and confusing.  This seemed to make sense to her and when I protested that it was unclear, she told me that it was my responsibility to make sure I knew everything I needed to know to file things correctly.  She said it was the Board's responsibility to protect the public from incompetent therapists.  Again, I was offended by her suggestion that because I didn't file a form that was required because I didn't know I needed to because the rule was unclear and confusing in the first place... that somehow made me an incompetent therapist.  I was nonplussed and didn't reply.  The chairperson pressed forward and put pencil to paper with the numbers for the hours I had documented previously and had been accepted and calculated how many remained and told me that I would need to complete 700 hours more of face to face hours and then re-submit my application for upgrade.  Another committee member made a motion to that effect, it was voted on and I was done.

As I drove home, during my 4 hours on the road, I was able to mull over what had happened.  I feel that although I did have a chance to appeal the staff decision, that my appeal was not really considered.  I feel that due to all the previous cases they'd seen, the mindset of the committee was that I needed to be held responsible for the crime of not filing a form and that I somehow should have known I needed to file it despite it being unclear and confusing, given my circumstance.  I further feel that the mindset of the committee was driven by the chair, as the only other committee member to ask any questions about my situation was the public member, a MBA, who had never been through the licensure process himself.  The rest of the committee seemed to follow the chairperson's lead.

With just a little effort, I can think of several outcomes that would have been much better for the committee and for myself and my community.
1) Acknowledge that there is a situation where the wording is unclear and in those cases, simply require the licensee to fill out the form, have their supervisor sign it and have it notarized and applied retroactively.  After all, if the purpose of a board-approved supervisor is to monitor the supervisee in the first place and ultimately, it is the supervisor who signs off on everything anyhow, why make this more complicated than it has to be?
2) If the board felt that there needed to be some accountability on my part for not filing the form, they could have required me to continue in supervision for a set period, a fine, the denial of some of my hours ( a reasonable amount, not all of them)  In fact, because I'd renewed my LMFT-A while waiting for my appeal, they could have accepted the 200+ hours I'd accumulated in the meantime and counted that as recompense for not filing the 2nd Form III.
3) As the committee repeated bemoaned the fact that there were so many licensees who were coming before them with this problem, they could have granted my appeal and then enlisted my help in informing others who had not yet completed their hours to contact the board and rectify the potential problem before it had to turn into an appeal.  After all, I am in contact with my cohort and other licensees who are in a similar position.  I have anecdotal evidence of several others who have experienced a denial of hours, to different degrees, because of the same set of circumstances.

At any rate, I feel that the mindset of the committee led to this appeal being handled unprofessionally, and, according to their own comments and my anecdotal evidence, it was handled inconsistently.  The end result is not just a faceless licensee having to do a few more hours toward a license.  The end result of this appeal has numerous consequences for me, my family, my community and the practice of MFT in the state of Texas.  Consider these consequences:
1) My career is delayed for 5-7 months (or more) while I continue to strive toward these hours.  I am having to work several jobs at pay scales below my education level as a result of only being provisionally licensed.  I can't get on insurance panels with a LMFT-A.  I have to be fully licensed.  So, in the mean time, I can only accept private-pay clients.  Current economic conditions notwithstanding, most folk can't afford $80/session and so I am forced to accept low-paying clients.  I don't mind helping with that, but it is hard to feed my family and pay off my school loans when I can't charge a reasonable rate for my services.
2) Clients who have state insurance can't utilize my services because I can't accept their insurance.
3) The non-profits, and coalitions that I serve who may have benefited from my credentials are also forced to wait until the hours are completed.
4) As other students and provisionally licensed people hear about how the board handles situations like this, it can influence them to seek other avenues of licensure.  I know of several in my cohort from school who opted to get LPCs instead of LMFTs because of difficulties in obtaining a MFT license.  How can our profession continue to advance itself in the state if those who are trained in Systems Thinking and MFT modalities opt to practice under LPCs and LCDCs and Social Work instead of working toward MFT credentialing?

So, while I am primarily disappointed because of the effect on me, my family and my practice, I recognize that the implications go beyond me.  700 hours represents approximately 5-7 months for me and in the mean time, opportunities that require a full license, which I have already earned, pass me by.  I have already spent three months waiting, so in effect, a year of my life, livelihood and career are gone due to a confusing, unclear rule and the hard-heartedness of a panel of MFTs.


-Jeff

Rituals

My favorite Christmas gift this year was not found at Best Buy.  Several days before Christmas, I was told that my presence at Nana's house would not be appreciated.  Apparently the kids were hard at work painting and preparing the letters for a present they wanted me to have.  It was a simple block of wood, painted matte black with letters that spelled out a simple message: "I love you... more".  Like most precious gifts, the value to me is not in the price of the wood, or the effort that went into mounting the letters.  Rather, the gift is in the symbolism. 

"More" is the name of a song by Matthew West.  It is part of a ritual I have with my kids.  We often exchange the endearment, "Love you!" when taking leave of each other and it grew into a kind of send off every morning when I drop them off at school:
Me: Bye, kids.  Learn a lot today!  I love you!
Ethan: I love you, too!
MH: I love you, more!
Ele: ... than the sun...
Me: ... and the stars...
MH: ... That I taught how to shine...
Ethan: ... you are mine, and you SHINE for me, too!

and on and on till we've sung out the chorus to each other.  So, this present they made for me is more than just a cute remembrance.  It is evidence to me that I have succeeded in impacting my children with a ritual.  This will be a "my dad used to say this to me all the time" kind of thing for the rest of their lives.  When they hear the song on the radio, they'll think of this connection and know they are loved.

Rituals are important for families.  For some, sitting down to a family meal is a ritual that binds them together.  Vacations, road trips, traditions, they can all be sorts of rituals.  I think of the sacred rituals that connect us at church: the singing, the prayers, the sharing of the Lord's supper.  Our congregation has a ritual where we close each worship service by singing, "Doxology".

Parents, if you don't have some sort of "I love you" ritual with your children, I urge you to develop one.  They help to deepen our children's sense of attachment and belonging to family and are part of a healthy way to build emotional safety in the family.  A child's sense of self-worth and identity are formed, in large part, by the relationships from their family of origin.  I can't think of a better gift that we can bestow upon our children than a deep and long lasting sense of being loved and cared for.  Maybe, it'll mean so much to them, they'll make a plaque to commemorate it. >grin<

-I love you, dear reader... more.

-jeff

My Christmas Wish

One Christmas tradition is to tell Santa what you want for Christmas.  Some travel to a shopping mall or event to see a 'Santa', some write letters and send them to the 'North Pole'.  I figured blogging my list was a legitimate as either of those options.  So, here goes:

Dear Santa,
I would like for the people who love and care about me to know how much I value them and care for them.  I'd like for the important people in my life to know that they hold a place in my heart and mind.  I would like to be able so demonstrate this to each of them this year either in word or deed. 

For my family, I would like to give them the gift of my time and presence, both physical and emotional.  Too often, I feel pulled by the obligations I have made that I neglect the desire to become the husband and father I want to be.

For my friends, I would like to give them support and camaraderie we shared in days gone by.  I know that we have all grown and changed and have various claims on our time, but I'd like to be able to stay connected in a more direct fashion.

For my clients and the families I serve, I would like to be able to give them my best efforts in helping to uncover their own strengths and remarkable qualities.  I would like insight to help them to get 'unstuck' and moving toward their goals and dreams again.  I would like the compassion to comfort their hurts and help them heal themselves and their relationships.

Finally, I would like to have the mindset that I need to have to see all of these gifts through a lens of trying to bring glory to God in my life.  I would like to be ever mindful of the fact that I want these things not only for myself, but because I believe that the people in my life matter to God and he is using me to reach them and draw them nearer to himself.

I know people sometimes add in "peace on earth" and the "goodwill toward men" as afterthoughts to their Christmas wish list... so I'll add to my list something that is just as likely: I'd also like an iPhone4s.  Just sayin'

Merry Christmas, Santa!

Thoughts on becoming self aware

Today is my 35th birthday.  I've been contemplating the implications and wanted to share some of the thoughts that have been bouncing around inside my head.  They all seem to come back to the idea of knowing myself... so here is a collection of the ideas:

The Matrix (1999) depicted the main character, Neo, as a man who had been trapped inside a virtual world his entire life, never knowing that his 'reality' was just a computer generated world.  When he got out of the Matrix and into the real world, he learned that nothing was as it seemed, not even himself.  By technological means, his mind is able to interact with the Matrix and he learns that he has a 'mental image' of himself, or a way of thinking about himself that affects how he looks and behaves.  It is called his 'residual self image', a kind of  sub-conscious way of thinking about one's self.  In my mind, I'm about 19 years old and 180 lbs.  I've got drive and stamina and the world is my oyster.  In reality, I can't do what a 19 year old can do... I've managed to find an extra 80 lbs or so and my get up and go got up and went. 


Orson Scott Card's 'Speaker for the Dead' (1986) introduces a profession, a sort of Eulogist.  The role of a Speaker for the Dead is to research the life of the deceased and then speak about it.  The speech is not to persuade, but rather to reveal, without bias, the person.  The Speaker tries to describe the life of the person as that person tried to live it, the good and the bad, the sterling moments and the flaws.  The deceased will hopefully have the honor of being seen in the entirety of who he/she was, a person.  In addition to being a key theme in the Ender Series of books, this ability to see past a person's actions and see the person themselves is appealing to me.  I don't know if I'm honest enough to see all of my flaws, but I like to think that I am open enough to be able to accept them when they are revealed to me.  Not to be comfortable with having those flaws, but comfortable enough to own them and be able to work on them to be a healthier person.

In the Eragon Series, the structure of the magic that binds the universe together is such that names of things have power.  This is a common enough theme in fantasy fiction, but Paolini utilizes a deeper structure, giving each item in his universe a 'true name'.  Knowing a thing's 'true name' is a form of power over that thing.  Knowing a person's 'true name' gives the knower power over that person.  Knowing one's own 'true name' gives one a special understanding or insight into one's self.  In 'Inheritance' (2011), Eragon is forced to examine himself so he can discover his 'true name' and, in doing so, learns that at least for sentient beings, a 'true name' is both defining and empowering because it is not permanent.  As a person grows, develops and changes, so does one's 'true name' because it is a reflection of the person.  It is the sum of what a person is: the good, the bad and the ugly.  I recall that in a moment of insight in my mid-twenties, I admitted that I was perpetually fearful that someone would look at me and point out that I had no clue what I was doing in ministry and would call me on it.  Every Sunday was shooting from the hip, every interaction was relying on my talent and education to make it look like I was confident that I had a plan.  I didn't always feel that way, of course, but it was an honest feeling.  It wasn't until I hit about 30 that I felt like I finally entered adulthood, that I belonged among capable, responsible adults.  In reading about the 'true name' idea, I wonder what mine would look like if I was able to really see myself as a person and not try to be what I thought others expected me to be.

In psychology, therapists sometimes work to help an individual gain insight into their thought process and how they learned to see themselves a certain way.  Frequently, I'll ask someone who has come to me for counseling how they see themselves... if they like who they are.  Frequently, I'll receive a reply that no, they don't like who they are.  Some are just unhappy with themselves.  Some hate themselves.  Some think of themselves as undeserving of love or friendship.  Interestingly enough, many of these same people are able to have compassion on others, to be gracious to others' failings or flaws and be forgiving to those who have harmed them while at the same time, not be able to be gracious to themselves or see themselves as being worthy of forgiveness.  And so part of the therapeutic journey to healing is learning to see one's self as a person.  No more and no less.

Biblically, I believe that God has a lot to say about how I think about myself.  My self-awareness begins and ends with my God-awareness.  It seems to me that God said I was a lot like him.  Made in his image, in fact.  So, I am a relational being, designed to be in relationship, to crave it and thrive in it.  In Christ, I am given an even deeper way to identify with my creator.  Turns out, I've done a crummy job of staying in relationship with God because of my sin.  Through Christ, I am able to have my sins forgiven and washed away so I can be restored to relationship!  Actually, I am brought in closer relationship with God.  Not only his creation, now I am his beloved child!  What a way to re-write my identity and ground it in relational language!  As a human parent, I have a small taste of what it means to love a child.  But not only a child, I am part of God's family as the bride of Christ.  Being married, I know the intimate relationship of a spouse.  What a way to re-write my identity and ground it in relational language!  Every time I turn around, God is revealing to me how much he values me.  Adopted child!  Beloved friend! I am bombarded with valuing terminology by which God reshapes me, day by day.  My limited ways of thinking of myself are shattered by the powerful evidence that God sees me, accepts me and refines me for his purposes.

I pray that my 'residual self image' is a projection of how God sees me: a broken vessel, refined by his grace to be used in his service.  My hope is that if anyone researches my life, they will be able to use it as a testimony of God's redemptive power for his beloved creation.  If ever I learn my true name, it will be the new name that I'm promised when God is done with me (Rev 2:17).  At 35, I hope I can remember that I'm not just a human being.  I am a human becoming.  It is a process.

-jeff

You wanna fight about it?

The supreme art of war is to subdue the enemy without fighting.
-Sun Tzu 

I need some help understanding a way of thinking that I run across weekly as I work with teens and their parents.  My supervisor once told me that people's knee-jerk reaction to emotional stress most often is either: avoidance or aggression.  I seem to be accumulating anecdotal evidence to verify this claim.  I am an avoidance person, mostly.

I, personally, recall only one time where I decided to try aggression.  I was about 11, I think, and I got my tail handed to me.  Luckily the kid I tried to fight decided I wasn't worth getting in trouble for and let me go.  So, I really don't understand the whole aggression stance.  I've worked with many teens who tell me about the fights they've gotten into and, from my perspective, they were all avoidable.  Usually, the cause of the fight has something to do with the teen feeling disrespected or hurt in some way.  However, their worldview has validated that physical fighting solves problems and so they don't ever develop other resources or options.  To them, fighting the other person is THE way to solve their problem.  Except that it is not... because there is always another fight about (whatever), so the problem isn't ever really solved.

It seems that Hollywood glamorizes and validates this worldview.  I think about movies like Rocky and The Karate Kid, to name a few (and date myself).  Sure, they discourage out and out street fights, but even with the structure of Boxing or Karate Tournaments, the message is still: beat up the other guy and you'll have respect.

Talking to a kid about his fighting, I tried to help him think through the consequences of his worldview.
Me: So, let's say you felt like some guy was talking smack about you... how would you handle it?
Him: I don't let people talk about me like that!
Me: Yes, I know... we're just pretending right now.
Him: I'd let him know he'd better stop. (an attempt to preserve his self-image as tough and fearless)
Me: Or else...
Him: I'd whoop his @$$!
Me: Okay.  So let's say that you fight him and teach him the lesson.  But... he's just like you and doesn't want people to think he is a wuss.  What might he do in return?
Him: Probably get his homies and try to jump me.  But it wouldn't be a fair fight (there seems to be a misguided attempt to believe in some sort of honor code among tough guy teens) and even if he beats me, people will know he's a chump because he couldn't take me one on one.
Me: Let's pretend that even in a two-on-one scenario, you manage to beat both of them.  If he still feels wronged, what might he do?
Him: I don't know, use a knife or something like that.
Me: So, if he used a knife on you, what would you do?
Him: I would make sure my homeboys got my back.  It'd be on!
(I draw a quick flow chart noting the escalation of the argument)
Me: So... when does this scenario end, if it keeps escalating?
Him: With someone dead, I guess.  But it wouldn't be me...

So, I have a meeting with his dad...
Me: So, in talking with your son, I noted that he seems to have a way of thinking about solving his problems that gets him into a position where he thinks the only way out is to fight with someone else.  I'm trying to challenge that thinking and plant some seeds that there are other options.
Dad: Yeah, I know.  I mean, I try to help him with that, too.  I guess he learned it from me.  I mean, he has seen me fight before when I was drunk.  I mean, I don't always fight, but sometimes.
Me: Well, I wanted to let you know so you could give him support and talk with him about looking at other options.
Dad: Well, yeah.  But sometimes, you know, you have to fight it out.  I mean, if you try and the other guy won't back down...
Me: I'm not advocating that he doesn't need to defend himself if someone attacks him, but I think that you're hitting on the mentality he's demonstrated.  It is one thing to say that when faced with the choice of defending yourself or letting yourself get beat up, you shouldn't fight.  I'm talking about making choices BEFORE you get to the point that some guy is angry enough to fight with you.  For instance, choosing to drink to drunkedness is a good way to put yourself in a situation where you might be forced to defend yourself against an angry drunk.  But if you make the choice NOT to drink, or hang around with people who get drunk and fight, you are less likely to have to fight.
Dad: Well, sure.  I try to make sure that he makes good choices and support him.  One time, this boy and his whole family came to the house and wanted to fight my son.  Their kid was bigger then my son, so I told him it was his choice to fight or not.  I knew my son could fight well, though, because I taught him some good boxing, so he started to fight anyhow.  By the time the cops showed up, he'd got in some good hits.  The cops stopped the fight and was all asking everyone questions.  One cop said, "The next person to say a word, except to me, is going to jail!"  Well, this guy from the other family was all flipping me off and stuff so I cussed at him and I ended up getting arrested.  Anyhow, I try to tell my son, that you'll never know how things are going to turn out.  Him and that other boy are pretty good friends now, so I told him he should find out other ways to solve problems than fighting.  Because, if they'd hurt each other somehow, they wouldn't be able to be friends now.
Me: ...
Dad: But also, I get you.  I stopped drinking because I know it is bad for me.  The last time I drank was this weekend. (It was a Thursday and he'd missed a session with his son on Tuesday because he was hungover - according to his son, anyhow)

I understand that I am not going to change a person's worldview in a short period of time, but I am still astounded from time to time.  So, I looked up some stats on teen fighting:
(source: http://www.keepschoolssafe.org/students/fighting.htm)

A survey asked teens to identify the causes of fights they'd seen:

• Someone insulted someone else or treated them disrespectfully (54 percent).
• There was an ongoing feud or disagreement (44 percent).
• Someone was hit, pushed, shoved, or bumped (42 percent).
• Someone spread rumors or said things about someone else (40 percent).
• Someone could not control his or her anger (39 percent).
• Other people were watching or encouraging the fight (34 percent).
• Someone who likes to fight a lot was involved (26 percent).
• Someone didn't want to look like a loser (21 percent).
• There was an argument over a boyfriend or girlfriend (19 percent).
• Someone wanted to keep a reputation or get a name (17 percent).

 These assumptions fit with my anecdotal evidence and go to reinforce that worldview of "might makes right".
Further, the website mentions: 

Teens who are frequently involved in fights often don't know how to control their anger and prevent or avoid conflicts. They often believe that fighting is the only acceptable solution.

For example, students who fight at school are much less likely than other students to believe that it is effective to apologize or avoid or walk away from someone who wants to fight. They are also more likely to believe their families would want them to hit back if someone hit them first.¹⁷

Students who have trouble controlling their anger or who are predisposed toward fighting (agreeing with statements such as, "If I am challenged, I am going to fight," or "Avoiding fights is a sign of weakness") are at least 50 percent more likely to get in fights.¹⁸

^{Anyhow, there are all sorts of ways to think about this sociological phenomenon.  I'm just curious, dear reader, what is your worldview or how would you go about convincing someone who has this worldview to adjust their way of thinking?}

^{"Blessed are the peacemakers, for they will be called Children of God" Matthew 5:9}