The AAMFT Blog

The Journal of Martial and Family Therapy Celebrates 50 Years

 

2024 marks the 50th volume of the Journal of Marital and Family Therapy. It’s hard to believe it’s been half a century since the very first issue of JMFT rolled off the printing press.  

Some of you may be aware that the first article in Volume 1 in 1975 was Jay Haley’s “Why a Mental Health Clinic Should Avoid Family Therapy.” Haley’s tongue-in-cheek jab was fitting for the founders of the day, who often used humor to bring home a point. The piece begins with an editorial note suggesting that adding family therapy procedures to a health clinic might include consequences that are “likely to include disorientation of the staff, radically changed administrative procedures, and others, including service to larger numbers of people and better treatment outcome.” How appropriate for the journal to begin its life cycle with a wink and a nudge to incorporate systemic therapy into the realm of general healthcare; a reminder that so much progress has been made, but there is much left to do! 

The second article to appear in Volume 1 was written by another founder, James Framo. His “Personal Reflections of a Family Therapist” reads like a literary time capsule, painting a picture of life as an early family therapist in the 70s: covering his reflections on the politics of a systems approach in conventional settings, resistances to family and marital therapy by other professionals, whether family or marital therapy works, the satisfactions, frustrations, and stresses of being a family therapist, and how one's own personal family relationships impact and are impacted by this work. It is as much a look back in history as it is a reflection of challenges MFTs still face today. 

In the spirit of reflecting on the rich history of the journal, JMFT is pleased to offer a special 50th anniversary virtual issue. This curation highlights nearly 40 noteworthy and milestone articles from the past 50 years. Articles were selected based on the impact on the practice of family therapy, the advancement of the profession, and those that created a positive “buzz” for the practice and profession. 

JMFT editor Lenore McWey, PhD, of Florida State University commented:  

When we asked colleagues to share suggestions for papers that help shape our field, I wasn’t fully prepared for the volume, depth, and range of articles nominated for the JMFT 50th anniversary special virtual issue. The collection features early theoretical works, research that helped substantiate the legitimacy of systemic family therapy, measurement development, ideas about common factors, considerations for cultural humility, and evidence on the current state of the field. For some, this collection might feel like a walk down memory lane. For others, it may spur ideas for continued progress. Regardless, I hope this collection evokes inspiration. We hope you enjoy!  

The issue is broken into sections like Seminal Works Demonstrating the Significance of Systemic Family Therapy, featuring works including the 1995 “The Efficacy and Effectiveness of Marital and Family Therapy: A Perspective From Meta-Analysis,” by William R. Shadish, Kevin Ragsdale, Renita R. Glaser, and Linda M. Montgomery. 

The section on Historical Hot Takes: Manuscripts that Generated a Systemic Buzz, includes the 1980 article “Prescribing the Families’ Own Dysfunctional Rules as a Therapeutic Strategy” by Maurizio Andolfi. 
 
In the category of Assessment in Systemic Family Therapy: Works that Moved the Field Forward, the 1981 article “Assessing Intimacy: The Pair Inventory” by Mark T. Schaefer and David H. Olson is featured. 
 
The section covering Diversity, Equity, and Inclusion and Systemic Family Therapy includes “Different and Same: Family Therapy with Asian-American Families” by Insoo Kim Berg and Ajakai Jaya, published in 1993. 

And the final section, The Current State of the Field: Research and Clinical Implications, includes “Reducing Mental Health Disparities Among Racially and Ethnically Diverse Populations: A Review of Couple and Family Intervention Research Methods (2010–2019), published in 2022 by Lekie Dwanyen, Kendal Holtrop, and Ruben Parra-Cardona. 

The JMFT advisory council is excited to invite you to join us in celebrating the many years of high-quality content focusing on systemic therapy. All articles in the special issue are open to the public until July 2024. Please feel free to share with peers and others interested in mental health research. 
 
We hope you enjoy the selections! 

 

January 20 is Martin Luther King, Jr. Day

“Everybody can be great, because everybody can serve.” —MLK

The observance of the Dr. Martin Luther King, Jr. holiday in January is a time for us to reflect on the life and achievements of an extraordinary leader in American history. Dr. King devoted his life to advancing equality, social justice, and economic opportunity through service to others. He also linked the quest for equality to healthcare and talked about the importance of being first in moral excellence and generosity. He taught us that everyone has a role to play.

Martin Luther King Jr. faced significant mental health challenges, particularly related to the immense stress and emotional toll of his leadership in the Civil Rights Movement. He experienced episodes of depression, anxiety, and deep personal doubts, often stemming from the constant threats on his life, the pressure of being a public figure, and the heavy responsibility he bore for the movement’s success. King’s close associates and family members noted his periods of fatigue, insomnia, and a sense of isolation. Despite these challenges, he remained dedicated to his cause, seeking solace through his faith, family, and close circle of friends. While King was not publicly open about his mental health struggles, it’s clear that the emotional strain of his work, combined with the personal risks he faced, had a significant impact on his well-being. King was concerned that people opposed to the Civil Rights Movement would use his depression to discredit him, as the stigma against people with mental illness was more pronounced in the 1950s and 1960s.

On this special day of remembrance, we can all hold ourselves accountable to acknowledging the work that remains to fulfill his dream. Many will mark the King holiday by volunteering in their neighborhoods—service is a powerful tool for strengthening our communities. Beyond volunteer service, there is much that can be done to improve the conditions in which all Americans are born, grow, work, live, and age.

Overall, we have made considerable progress improving health and healthcare for racial and ethnic minorities and disadvantaged populations. The life expectancy gap between Blacks and whites is at its narrowest point over the last three decades; cancer disparities are improving for all minority groups, including Asian Americans and Pacific Islanders, and teen birth rates have dropped for all races and Hispanic groups.

However, persistent and pervasive health disparities remain and addressing them will require not just a federal response, but also state and local organizations dedicated to achieving health equity. Issues like serious mental illness, the opioid epidemic, and childhood obesity are just some of the pervasive problems that continue to challenge us. Every day, 115 Americans die from drug overdoses due to opioids. One in five children in the United States is overweight or obese, and the rates are higher among African American and Latino children. And about 10 million American adults experience serious mental illness conditions each year.

Throughout the country, many communities will participate in the MLK Day of Service on January 20. The holiday remains the only federal holiday observed as a National Day of Service—a “day on, not a day off.”

Wherever you live, we hope you will join the hundreds of thousands of Americans who will spend the MLK Day of Service volunteering for a good cause or community activity. Some ideas are below.

Volunteer at an organization: 

• Volunteer at a local animal shelter or food bank
• Volunteer at a local, state, or national park
• Mentor a young person
• Participate in a social justice or anti-racism workshop

Help a neighbor

• Reach out to a neighbor in need
• Collect and donate non-perishable food items 
• Donate old linens like bath towels, blankets, and sheets to an animal shelter 
• Read letters, newspapers, or magazines to residents in a nursing home 
  
  

Beautify a community space 

• Clean up a public space
• Plant trees, grass, and flowers to create community green spaces
• Reclaim an abandoned space or park for community use
• Organize a classroom

You can find more information about Martin Luther King Jr. and MLK Day of Service activities here.

Your Private Practice Vision for 2025

This content is provided by zynnyme, an affinity partner of AAMFT. This information is not necessarily the view of AAMFT and should not be interpreted as official policy.

Your vision is the heart and soul of your private practice—it’s the why behind everything you do. It’s like the GPS for your business decisions: no vision, no clear direction. Instead, you’re left - winging it, chasing random ideas, and maybe even wondering, "How did I end up here?" But here’s the secret sauce: your vision isn’t some rigid thing you set once and never touch again. It’s alive and ever-changing because, hey, life happens! The best part? Your business is meant to fit into your life, not the other way around.

So, as 2025 approaches, let’s shake things up a bit. It’s time to dream bigger, ditch what’s not working, and craft a vision that feels like a hug for your soul and a rocket for your business. And, this isn’t just for 2025, you can circle back here anytime you feel stuck, drained, or overwhelmed because your vision is what can give you the fuel to move forward and create a private practice you love. Let’s break it down step by step.

Step 1: Permission to Dream Big (and I Mean Big) 

Okay, first things first—let’s get rid of the idea that you’re stuck with what you’ve already built. Just because it worked for you last year (or kind of worked, or maybe didn’t work at all) doesn’t mean it’s your forever plan. You’re allowed to change your mind. You’re allowed to want more, less, or something completely different.

Sound like something you tell your clients also? I thought so.

Close your eyes and imagine your dream practice—no rules, no limits. What does your ideal day look like? Who are you working with? How are you feeling at the end of the day? Let yourself go wild here. You don’t have to commit to anything yet; this is just about seeing what’s possible. So go ahead, give yourself permission to dream, even if it feels a little scary or out there.

Step 2: Check In with Your Body (Yep, Your Body!)

Your body is smarter than you think. It’s constantly sending you signals about what’s working and what’s not. Take a moment to reflect on your practice as it is right now. What lights you up? What makes you want to hit the snooze button on Monday morning?

Notice where you feel energized and where you feel drained. Is there tightness in your chest every time you look at your calendar? Do you feel a spark of excitement when you think about a certain client population? These physical clues are like a cheat sheet to help you figure out what’s really going on beneath the surface.

Step 3: Have a heartfelt celebration!

You might be wondering why I want you to celebrate and from the heart. Too often we reflect, and we move on to fixing things. Before you fix or change a thing, take that information you got from your body and celebrate all the learning and the wins. We bet you can find that something did work for you, even if it was imperfect.

Step 4: Identify What’s Not Working (and Imagine What Could Be)

Now that you’ve tuned in, and celebrated, it’s time to get real about what’s not working. Is your schedule too packed? Are you spending hours on admin work that makes you want to scream? Maybe you’re attracting clients who aren’t your ideal fit. Whatever it is, name it. Call it out.

Then, here comes the fun part: ask yourself, what would better look like? Maybe it’s working fewer hours, focusing on a specific niche, or finally hiring someone to handle the stuff you hate. Whatever "better" looks like, this is your chance to start dreaming up solutions.

If you’ve ever had that feeling of wanting to burn the whole thing down, take a breath and consider making some smaller changes first. With small changes, you can start to find the breathing room you need for a clearer vision.

Step 4: Find Your Dream Team (or Tools) 

Spoiler alert: you don’t have to figure this out alone. Whether it’s a coach, a mentor, a tech tool, or even your best friend cheering you on, support makes all the difference. Who do you need in your corner to make this vision happen?

Our culture loves to tell us that we can figure these things out on our own. But that keeps us isolated and often in a traumatized state. Just like your clients reach out to you, you might need to reach out to someone too to help you take your vision and make it a reality.

Maybe it’s a business coach to help you strategize, a virtual assistant to take admin off your plate, or a therapist to help you tackle imposter syndrome. Identify the tools, resources, or people who can help you bridge the gap between where you are now and where you want to be.

Examples of Re-Visioning Your Private Practice 

We have helped hundreds of thousands of therapists to create a vision for their private practices. We bring this topic up now because the landscape of Marriage and Family Therapy is changing as tech companies and AI come on the scene. Private practice is needed now more than ever, but your vision is what helps you stand out and be seen by the people who need you most.

In recent months we have been seeing more group practice owners switch to solo practices because their bodies were telling them that it wasn’t physically sustainable to carry the group practice work. We have seen solo practitioners move to intensive-only models, no longer seeing weekly therapy clients, and instead focusing on services that get the highest clinical outcomes. We have seen hybrid practices successfully negotiating a better fee from insurance companies. We have seen therapists take a month off from work, save for retirement, and have a schedule that isn’t the traditional therapy schedule but one that allows them to show up to their kids’ events and family gatherings.

The options are endless, if you give yourself the time and space to create from your heart, with your body’s wisdom. 

Your private practice vision isn’t just a business exercise—it’s your chance to design a life and business you love. Remember, your vision is allowed to grow and change just like you do. Give yourself the freedom to dream, tune in to what’s working (and what’s not), and don’t be afraid to ask for help along the way. 2025 is the year to create a practice that lights you up, supports your life, and feels oh-so-aligned. Let’s make it happen!

We’ve created a cool tool for you to use with a custom report on how you can make more and work less in 2025. This tool will show you the areas that need some support so you can bring your vision to fruition.

Check them out below so you can start making more and working less in private practice!

- Make More, Work Less (Solo Practice) Calculator

- Make More, Work Less (Group Practice) Calculator

Post-Election, Holiday Stress and A New Year: A Systemic Look at Using Self-Compassion to Manage Our Anxiety in Stressful Times

Written by: Vanessa Bradden, LMFT

Strengthening family connections during the holiday season and in trying times is essential. Yet, it can become complicated by the pressures of gift buying, election results, and goals for the new year. Additionally, we may be coping with the loss of a loved one or loved ones and other significant life pressures like the loss of a marriage or a job. For many of us, this can cause great distress, made worse by the prospect of having to attend various holiday parties and family gatherings.

While these difficulties are real for many, hope is not lost if we take the time to understand ourselves better and the limitations of being human. As marriage and family therapists, we know that it is possible to overcome some of our stress and build better familial relationships (even if only small gains are made) by using Family Systems Theory alongside self-compassion and compassion for others. This approach helps us better understand our relationships and offers stress management tools. By focusing on kindness to ourselves and others, we can create a supportive environment for everyone during challenging moments.

Family Systems Theory is the foundation of the Marriage and Family Therapy (MFT) profession. When applied correctly, it becomes a valuable tool for therapists and clients, aiding in self-understanding, particularly during stressful situations. By utilizing systems theory, clients can develop a broader sense of compassion for themselves and others. Compassion not only fosters empathy but also encourages positivity toward those around us. Ultimately, it helps us manage the tension and anxiety often accompanying the holiday season.

Let's be honest: holidays can evoke many emotions, especially regarding our family of origin. Regardless of the complexities within your family tree—ranging from playful banter to deep-seated emotional wounds—everyone has triggers that can be activated by family members, irrespective of age or stage in life. Family gatherings can cause us to revert to unhealthy behaviors we prefer to avoid. Murray Bowen, a pioneer of family systems theory, aptly notes that families profoundly influence their members' thoughts, feelings, and actions, often making it seem like individuals live under the same "emotional skin." Family members seek each other's attention, approval, and support while reacting to needs, expectations, and upsets.

Our shared emotional history complicates the process of breaking free from established roles and negative patterns learned during childhood, yet it also connects us through shared experiences. So, what does this mean as we approach an already stressful time of year?

One approach to the season's difficulties is to cultivate self-compassion, which, in turn, allows us to have compassion for others. To do so, we need to understand our role within our family of origin, its influences, and how we contribute to its dynamics. For example, suppose you are the eldest sibling who took on a parental role. In that case, you might find it difficult to view your younger siblings as independent adults, which can lead to infantilizing behavior. Conversely, younger siblings may struggle to appreciate your support, resulting in misunderstandings and unnecessary resentment.

Engaging in sensitive discussions within family dynamics can often trigger anxiety, leading to hurt feelings and a pervasive sense of injustice that is hard to resolve. If political concerns dominate your thoughts this year, this may heighten the family's reactive tendencies. However, if we can take a step back and view these dynamics through a lens of compassion for ourselves and others, we are more likely to respond with empathy rather than contempt. At a minimum, it can prevent escalating something unlikely to be resolved. In the best-case scenario, this approach can facilitate personal growth and enhance our relationships,

Self-compassion can be a powerful tool in managing anxiety. If used properly, it will lessen the intensity of negative feelings that can come up when we are with our families over the holidays and beyond. 

Here are several ways it helps:

1. Reducing Self-Criticism: When feeling anxious, it's common to engage in harsh self-criticism. Practicing self-compassion encourages kindness toward oneself, helping to combat negative self-talk. By treating ourselves with the same understanding we would offer a friend, we can reduce feelings of inadequacy and shame.

2. Normalizing Feelings: Self-compassion allows us to recognize that anxiety is a common human experience. When we understand that others also struggle, we break the isolation that anxiety can create. This normalization can lessen our feelings of being alone in our distress.

3. Encouraging Mindfulness: Self-compassion involves being present with our feelings without judgment. This Mindfulness helps us acknowledge anxiety without becoming overwhelmed by it. Rather than suppressing or avoiding these feelings, we learn to accept them, which can reduce their intensity.

4. Promoting Emotional Resilience: We build resilience when we approach our anxiety with compassion. This resilience allows us to face challenges with greater strength and flexibility rather than feeling defeated by them.

5. Enhancing Coping Skills: Self-compassion encourages us to explore helpful coping strategies when faced with anxiety. Instead of resorting to avoidance or negative behaviors, we're more likely to engage in healthy behaviors such as seeking support, practicing relaxation techniques, or pursuing activities that bring joy.

6. Fostering a Positive Mindset: Practicing self-compassion can help shift our perspective from fear and anxiety to hope and possibility. This shift can lead to a more optimistic outlook, reducing feelings of helplessness.

7. Building Healthy Relationships: When we practice self-compassion, we're often more compassionate toward others, which can strengthen our relationships and create a supportive network, which is vital during anxious times.

In essence, self-compassion provides a powerful antidote to anxiety's harshness. It allows for a gentler, more supportive internal dialogue that fosters healing and growth. By cultivating self-compassion, we can navigate anxious moments with greater ease and grace.

MFTs are uniquely trained to work with family dynamics and are an excellent resource for those struggling with complex familial relationships. AAMFTs therapist locator is a great place to find an LMFT in your area.

Be kind to yourself this holiday season, and remember that everyone has anxious thoughts and feelings, even if we can't see them.

Sliding Scales and Accessibility in Private Practice

This content is provided by zynnyme, an affinity partner of AAMFT. This information is not necessarily the view of AAMFT and should not be interpreted as official policy.

Therapists are helpers at heart. We got into this work because we genuinely care about people and want to make a difference. We all believe in the power of therapy and its impact on not just the individual but also the family and the legacy left by each person we work with. Therapy is something that we want everyone to have access to, but how do we do that within the current context of our healthcare system?

The Truth No One Wants to Admit: Being Underpaid Can Impact Clinical Outcomes

Fees that don’t lead to a livable wage, inconsistent income, and the creeping dread of burnout don’t exactly make for a thriving private practice—or a happy, healthy therapist. And a burnt-out therapist does NOT lead to great clinical outcomes. Therapists who are struggling to live on an unlivable wage also often do not have access to consultation, training, rest, or sustainable caseloads. And yes, all of these impact clinical outcomes.

Bridging the Gap in the Healthcare System

The current landscape of mental health care in the United States is a challenging one for therapists and clients alike. Insurance companies, which are supposed to bridge the gap between care and affordability, often make it harder for both parties. Therapists are grappling with clawbacks—where insurers retroactively recoup payments for services already provided—and steadily declining reimbursement rates. These practices not only undervalue the work of mental health professionals but also discourage many from accepting insurance altogether. As a result, clients seeking affordable care are left navigating a shrinking pool of in-network providers, while therapists face increased pressure to balance accessibility with their financial and professional sustainability. This cycle perpetuates a broken system where both clients and clinicians pay the price.

For years, mental health has been underfunded and overlooked, leaving therapists to play the role of superhero—minus the cape, plus the student loans. The truth is individual therapists can’t fix systemic problems like inadequate funding or insurance barriers. Yet we’re often left holding the bag.

What’s the takeaway? We shouldn’t be the only ones patching the holes in a broken system. Advocacy and systemic change are where the real magic happens.

But what do we do at an individual level? How do we keep helping without helping ourselves into exhaustion? Let’s dig in.

Sliding Scale Fees in Private Practice

Ah, the sliding scale: the DIY solution therapists often turn to when we want to make therapy more affordable. Essentially, it’s a fee structure where clients pay based on what they can afford. Seems simple, right?

Sliding scale fees might seem like the hero we need, but they can come with some sneaky ethical dilemmas. For starters, charging different client's different rates for the same service can make things feel a little… wobbly. Imagine a client paying full price finding out someone else gets the same care for less—awkward, right? It could create feelings of unfairness or even erode trust in the therapeutic relationship.

Plus, therapists are human, and let’s be real—there’s a chance you might subconsciously invest differently in someone paying less versus someone paying your full rate (even if you don’t mean to!). Could resentment arise in the therapeutic relationship if you hear about something that infers to you that the client could pay the fee for therapy? We think it could.

This variability can conflict with the ethical principles of fairness, transparency, and maintaining the value of therapy. The result? Sliding scales can unintentionally slide right into murky territory, making it essential for therapists to tread carefully and consider alternatives that feel fair and aligned with their values. Sliding scales are not always the knight in shining armor they appear to be.

The Ethics of Using a Sliding Scale

AAMFT emphasizes fairness and transparency. If you’re using a sliding scale, it better be clear, consistent, and above all, ethical. This means that if you choose to use a sliding scale you need to remove bias from your process, so that every person that comes through your door gets the same access based on the same factors.

In a CPH Insurance Avoiding Liability Bulletin it was mentioned by Richard Leslie, “My view is that a "sliding fee scale” is unnecessary, unwise and problematic." Most sliding fee scales used by nonprofits and other entities base the fee on the financial condition of the patient. In order to properly implement such a policy, entities must ask for certain information and perhaps supporting documentation, like tax returns. Most private practitioners do not want to get into that kind of detail in their practices. Psychotherapists usually establish fees that they are comfortable charging and stay with those fees until they decide to raise their fees. Physicians and other practitioners likewise establish a “usual and customary fee” and typically do not change their fee for different patients. If the patient can’t afford the fee, he or she can be referred elsewhere."

Sliding scales aren’t a no-no, but they’re not exactly a “yes-yes” either.

Let’s think outside the sliding-scale box and explore some fresh alternatives that keep therapy accessible without leaving therapists feeling like overworked superheroes.

First up, there’s the Privilege-Based Sliding Scale. An example of this would be the Green Bottle Method created by Alex J. Cunningfolk. This spin on the traditional sliding scale puts the power in your clients’ hands. Instead of awkward financial disclosures, clients self-select their fee based on their resources, privilege, and ability to pay. It’s judgment-free, transparent, and as a bonus—way less paperwork for you! This approach empowers clients while taking the emotional and administrative weight off your shoulders. Yet, what will you do if you find that this process doesn’t lead to a sustainable wage? Or, if clients that appear to have more financial privilege are consistently self-selecting for a sliding scale, while clients who are struggling do not?

Then there’s Group Therapy, the ultimate win-win solution. Group therapy gives clients a built-in support system, reducing feelings of isolation while being budget friendly. For therapists, it’s a great way to maximize impact without burning out. Pro tip? Market it as a unique, collaborative feature of your practice—because group therapy is seriously underrated and underutilized.

Another option is Tiered Service Models, which are like a buffet of therapy offerings. You can create a range of options: lower-cost services such as workshops, self-guided programs, or one-off consultations for budget-conscious clients, while reserving your one-on-one sessions for full-fee clients. This approach not only protects your time and energy but also gives clients more ways to access your expertise.

You can also choose to Give Back, as our AAMFT ethics mention, and improve accessibility, changing the system from within through lobbying, advocacy and volunteering at a government level to affect change.

And sometimes, you just have to pass the baton. Build Advocacy and Referral Networks by connecting with nonprofits or other clinicians who offer sliding scale or low-cost options. It’s okay to acknowledge when a client’s needs fall outside your financial or professional capacity. Bonus points for getting involved in advocacy efforts to push for systemic changes like better insurance reimbursements and increased mental health funding—because real change happens when we shift the system, not just our individual practices.

Finally, there’s the all-in strategy of Lower Fees Across the Board. While it might sound like an easy fix, it comes with a big red flag: burnout. If you decide to reduce rates for all clients, make sure you’ve got a rock-solid self-care plan and a realistic client load. Remember, being a therapist isn’t about self-sacrifice—it’s about sustainable care for both you and your clients.

Redefining Accessibility and Sustainability

Sliding scales aren’t inherently bad, but they’re not the only (or always the best) solution. Whether it’s privilege-based models, group therapy, or tiered services, there are plenty of creative ways to balance accessibility with sustainability.

And let’s not forget the bigger picture: systemic change is the real game-changer. So, while you’re doing the amazing work of supporting your clients, don’t forget to advocate for a system that supports you, too.

because at the end of the day, the best therapy happens when both client and therapist are thriving.

Celebrating Pioneers - LGBTQ+ Advocates in Family Therapy

Written by Ivonne Harting (She/Her) LAC, LPCC, MFTC, NCC

Diversity has always existed; it’s an intrinsic part of the human condition. Why is understanding diversity crucial in today's society? There isn’t a single person on Earth who is exactly like another. Yet, we often choose to rival our differences instead of rejoicing in them. Although we recognize the importance of support and acceptance as a society, hesitation still exists. Fortunately, we have made significant strides in celebrating diversity, particularly within the LGBTQIA+ community, which has relied on brave pioneers to advocate for our rights and illuminate the battles we face.

In honor of LGBTQIA+ History Month, I want to highlight one such pioneer: Dr. Deborah Coolhart. She is a prominent voice in family therapy, especially known for her work with trans and gender-expansive youth. Dr. Coolhart has made significant contributions to gender-affirmative therapy, centering the needs and voices of LGBTQIA+ youth in family therapy practices.

Dr. Coolhart emphasizes the critical importance of support—especially family support—in fostering positive mental health outcomes for LGBTQIA+ individuals. In her work, she discusses how dysphoria affects not just the mental health of trans masculine individuals, but also their physical and relational well-being. She states, “Because your dysphoria gets in the way of you…it affects everything.” This highlights the profound impact body dysphoria can have on a person’s identity and daily functioning. Addressing dysphoria through gender-affirming practices in therapy is essential, as it not only validates the experiences of trans individuals but also creates an environment where families can learn to support their loved ones effectively.

Dr. Coolhart’s work resonates deeply with me, especially as I reflect on my own experiences as a queer therapist. I remember the fear I felt when contemplating coming out to my family. Growing up in Venezuela—a society that lacks inclusivity regarding anything outside of heteronormativity—having a safe space that normalized discussions about gender and sexuality would have been life-changing. Such an environment would have allowed my family to understand my experiences from a different perspective and receive psychoeducation on how to support and accept me. This is what I believe our current society needs more of: education—not just about tolerance and acceptance, but about love and empathy. Community workshops and educational programs can play a vital role in fostering this understanding.

The progress we have seen in our field is monumental! We have transitioned from homosexuality being classified as a disorder in the DSM-I in 1952, to professionals like Dr. Coolhart advocating for and researching gender-affirming care, driving positive change in family therapy. It is clear that there is nothing we need to change about gender-diverse individuals. Conversion therapy is not the answer. Inclusion is. Let history be a reminder of how far we’ve come and where we are yet to go. Let’s continue to find ways to contribute as professionals, fostering environments that celebrate diversity and support all individuals in their journeys.

With love and pride,

Ivonne