Student impairment and remediation in accredited marriage and family therapy programs

Journal of Marital and Family Therapy, Jul 2003 by Russell, Candyce S, Peterson, Colleen M

a painstaking, gradual process where there are periodic benchmarks and detailed discussions of progress and possible means for remediation. When handled with such care, it may be possible to have students reach the desired conclusion that they do not belong in the field or need to take extensive time off for personal therapy, (p. 251)

Our limited data would appear to support Todd's conclusion. The process that program directors described was often gradual and sometimes resulted in the student making the final decision about how to address impairment in a way that was respectful of the needs of all stakeholders: the student, clients, the program, and the profession.

LIMITATIONS AND SUGGESTIONS FOR FUTURE RESEARCH

The prevalence of student impairment can be expressed as a frequency (number of impaired students per program) or as a rate (number of impaired students in program divided by all students in the program). Both expressions can be found in the training literature. Our quantitative data are limited in that they include only a report of frequency of student impairment. We selected frequency, rather than rate, to make it easier for program directors to respond to the questionnaire. We were concerned that busy program directors would be put off by a questionnaire asking them to dig into program files. An additional reason for our decision to ask only for the number of impaired students in the last 5 years was that Burgess (1994) was able to obtain more complete data for her sample on frequency than rate. Thus, we were able to compare our frequency data with similar data from counseling psychology. Nevertheless, we wish we had asked respondents to report on the size of the typical entering class as a way of estimating program size. We also could have asked program directors to estimate the extent of impairment in a typical training year.

It is important to note that the objectives of training at the master's and doctoral levels are different. Master's programs prepare students to be clinicians, whereas doctoral programs prepare researchers and clinical supervisors. Accordingly, one might expect impairment to develop and be identified differently at these two levels of training. Our data are not adequate to explore that possibility, because they are heavily weighted with master's programs, and because level of program confounds data from dual degree-granting institutions. Program directors were not asked to report data separately for each degree offered. This is a limitation of our research that may be addressed in future research.

We need additional research to determine what remediation methods are most appropriate for which kinds of student impairment. For instance, when is personal therapy useful, and how might it be structured so that concerns of the program are addressed while still respecting the privacy of the remediated student? How effective is increased supervision in enhancing the clinical skills of students? Can some impairments, such as ethical lapses, be addressed successfully via coursework? We need guidance on how to balance the needs of impaired students with our obligations to the public and to the profession. Additionally, we need to know if the extent of impairment varies by type of program (master's, doctoral or post-degree) and if the type of impairment varies by program type.