The Story of the Tennessee Association for Marriage and Family Therapy
Presented at the Board of Directors Workshop,
March 17, 2005 - Scarritt-Bennett Center, Nashville, Tennessee
The first written record of organization is correspondence from C. Ray Fowler, Ph.D., then Executive Director of AAMFC located in Claremont, CA outlining a planned meeting with the members that has been cancelled due to lack of space available in Nashville because it is a “football weekend”! The meeting actually took place on February 1 and 1, 1974 at the Holiday Inn on Murfreesboro Road in Nashville. Interestingly, the discussion of licensure for MFCs was a topic during this intial meeting! Barbara Devaney, State Council Coordinator, NASW, reviewed the social workers’ bid for licensure and answered questions about the possibility of MFCs joining the bill. She suggested a representative should attend the next task force meeting on March 1, 1974 to discuss that possibility.
Balch remembers the discussions with social workers to explore the possibilities of a joint bill for licensure. The joint bill was introduced and members of both groups appeared before committee. Those working on the bill for TAMFC other than Balch, included Eugene Anderson, Johnson City; Louis Nelson, Johnson City; and Myrtle Qualls, president in the early 1980’s, from Hendersonville, among others.
The bill failed to come out of committee and later the social workers introduced an independent licensure bill that passed. It was later learned that the social workers were afraid that our organization had too many ministers and religious overtones to be taken seriously as mental health professionals.
Also at the February organizational meeting, Ray Jerkins reviewed his activity in the organization of the Tennessee Association of Marriage Counselors, Inc. and agreed to allow his organization to become dormant and recognize the regional group developed by AAMFC members for Tennessee. Louis Nelson, of Johnson City, was elected president Stan Williams was elected vice president and Myrtle Qualls was elected secretary/treasurer. Leon Smith was selected chairperson of the Recruitment Committee.
The first annual conference was held May 28, 1974 at East Tennessee State University with Dr. Will F. Eastman presenting on “Increasing Intimate Family Relations Through Counseling Services.” The ten members who attended the business meeting held the next evening discussed proposed bylaws and revisions, approving dues of $65 per year suggested by AAMFC, with $25 returning to the division.
The Tennessee Association of Marriage and Family Counselors, Inc. was issued a certificate of incorporation by the state of Tennessee on October 17, 1974. Original members listed in the application were: Eugene Anderson, William H. Balch, Fred Bean, Richard Bruehl, Richard Diemer, Don Ferguson, Jerry Harber, John Jamison, Ray Jerkins, Diane Compara, Samuel Longenecker, Herbert J. Miles, Roy Neeley, Louis Nelson, Robert Phillips, Myrtle Qualls, Leon Smith, Terushi Tomita, Samuel David Tomlin, Luis Vazquez, Stanley Williams and William J. Wilson.
I remember when I moved to Nashville in 1970 and doubled the TAMFC membership! (Leon Smith, Nashville, 1980)
The purpose was stated as: to establish and maintain professional standards in marriage counseling by meetings and support of publications, education and training and research in this field. Our long struggle to achieve recognition in the mental health field by other professionals and the public was just beginning.
At the annual meeting held March 22, 1975 in Chattanooga at the Read House Hotel, it was reported that the membership had risen to 26 members, an increase of four since the incorporation of the charter. Bill Balch was elected president. Jack Wilson was elected vice president and Myrtle Qualls was elected secretary/treasurer. Also at that meeting, Bill Balch voiced concerns about the use of the term “marriage and family counselors” in the social worker’s licensing bill.
By April 22, 1975, the constitution had been completed, the organization was incorporated by the state and three state wide meetings had been held. Continuing matters that needed attention according to a memo from Past President Nelson were: “changing the vice presidency to a president-elect, implementing a regional newsletter, developing a system whereby we have better input into the selection of clinical members and licensing of marriage and family counselors in the State of Tennessee.”
It was very frustrating being president of an organization which was unknown and trying to be recognized. Other professional groups did not see us as a separate discipline and the public did not recognize the distinction of mental health delivery from a systemic standpoint. ( Bill Balch, Knoxville, president from 1975-77).
The change to the present board of directors composition was begun during the business meeting discussion on May 27, 1976 when Jerry Harber suggested “that the state membership be divided into geographically feasible region to facilitate better communication and more comprehensive input”. The state was divided into four regions—East, Chattanooga, Nashville and West.
Licensure efforts continued under each president, with years passing as people traveled to the legislature appearing before committees. Our first effort in the direction that met with success was when TAMFC under the presidency of Bill Flatt, Memphis, worked together with the Tennessee Association for Counseling and Development to introduce a bill for certification for Marriage and Family Therapists and Professional Counselors in 1984. Jack Redden, of Memphis, was legislative chair for this effort and the bill passed with some opposition that was fairly easily resolved. We pursued the certification bill because our legislators told us that going for certification initially would make our efforts toward licensure easier in the future.
The main thing I did was to organize the effort and help push it through. There was lots of cooperation across the state to create a groundswell of grass root efforts. The timing was tremendous. It was a good time. There was a lot of compromising and last minute phone calls. The thing I feel best about is the cooperation of all who were involved. ( Bill Flatt, Memphis, president 1982-84)
We changed the name of the association to Tennessee Association for Marriage and Family Therapy on September 16, 1989.
Also in 1989, we decided to make the push for licensure. The board members were Jeanne Williams, president; Dan Hammer, president elect; Joel Johnson, past president; Linda Behel, secretary-treasurer, and Kent Lewis, Robert Pugh and Sara Cawood, regional representatives. The Legislative Committee was Celia Ferguson, Bill Balch and Jack Redden. Lulled by ease of the passage of the certification bill, the board moved toward a licensure bill as a matter of course with expectations of little resistance. Much to our surprise and chagrin, this was not the case.
I remember that legislators sometimes attacked us with an accusation that had we been real professionals, we would have submitted a licensure bill first rather than the certification! This was exactly opposite of what we had been told initially about going to the legislature to ask for certification first! (Sara Cawood, Legislative Committee, 1989)
Many trips to Nashville by the legislative committee to confer with our legislators who were carrying the bill were necessary. Sometimes we would work late into the night revising and editing to meet objections or to clarify a point. Several overnight stays were necessary to provide the continued monitoring of the bill. Karen Williams, (R) Shelby County, serving her third term carried our bill in the house. “She is an attorney, highly competent and well thought of”. Leonard Dunnavant (R) Shelby County, “long term, well thought of” legislator carried in the senate.
One draft from the TACD and TAMFT bill came down so late at night, that Jack Redden and I decided we weren’t fit for editing, and went on to our hotel rooms, planning to meet in the morning for breakfast where we would go over the bill with a fine tooth comb. The next morning, we went to breakfast together at the hotel and the only table available for a rather large table, where Jack and I sat at either end, reading the bill very intently. Suddenly, Jack started to chuckle and when I looked up, he said that we reminded him of a couple in a long term marriage, reading the newspaper together at the breakfast table! (Jeanne Williams, on lobbying experiences in Nashville, 1989)
After the introduction of our licensure bill in the House in 1989, we began to hear rumblings (and sometimes shouts) of dissension and opposition. These took various forms and were sometimes oppositional to each other. In other words, sometimes in pleasing one group, we would alienate another .
All of the following were expected if we were to have total support:
• All persons who were currently certified could move directly to licensure.
• Requirements for licensure would be more rigid than for certification, thus insuring that all who were currently certified would not be able to move directly into licensure
• The law would contain a scope of practice definition
• The law would leave a scope of practice open for the regulatory board to decide.
• The law would exempt other professions, such as psychologists, social workers, clergy, etc. from being restricted from using the title Marriage and Family Therapist.
• The law would present a strong professional definition of Marriage and Family Therapists without exemption,
. . . . .and so on…seemingly ad infinitum. (Jeanne Williams, President 1988-90)
We tried working again with the Tennessee Association for Counseling and Development and met increasingly strong resistance. Several letters were written from President Jeanne Williams to the TACD requesting clarification and support, with little positive response. There were communication problems and a lack of agreement regarding the upgrading of certified counselors to licensed therapists.
This past weekend at our state conference, I learned of the negative reaction of some of your membership in general and of Bob Crawford (former legislative chair of TACD) in particular to the third provision stated above (A five year period during which less than minimally qualified grandparented certified people could upgrade their skills). To assure the best possibility for passage of this legislation, it is imperative that we present a bill which both TACD and TAMFT can and will support. Because of this recent objection from your members, TAMFT’s board has approved, if necessary, a change in Section 19 so that the upgrading of grandparented certified persons will apply only to marriage and family therapists, rather than to both professional counselors and marriage and family therapists….I am asking, is the controversy between our organizations or within the TACD? (Letter from Jeanne Williams to Countess Guiles, TACD, February 27, 1989)
A very weary group left Capitol Hill in March, 1989, after being soundly defeated in the General Welfare Committee of the House. The bill had been amended twice; amendments that had virtually left us powerless, and in fact so much so that we were glad the bill didn’t leave committee. One amendment stated that no testing would be done by anyone regulated by the bill and the second amendment disallowed any DSM-III-R diagnoses except for V-codes.
“Greetings from the swamps of summer! Are your bugs bad there? As I survey my spot-marked legs and sadly choose not to sit on the deck for the sake of comfort, I remember also feeling “bug bitten” after the house general welfare committee meeting in April. Now it is time for us to make a big decision: When do we return to the legislature with our licensure bill and in what form?…I intend to have another famous conference call on August 7….Our choices are to present the bill in January 1990 or use 1990 as a planning time and present the bill in January 1991. Enclosed are the pros and cons. (Memorandum from Jeanne Williams to board members and legislative committee dated July 27, 1989)
After the defeat, it was determined that therapeutic skills of compromising and kindness were not the necessary skills for passing laws! Determined to use what we had learned during the previous year, TAMFT spent many hours deciding just how far we could compromise and where and when we would stand firm and fight. We also did much homework with other organizations to either hear and respond to their opposition or to listen and stand firm, thus learning where we would be opposed. There was a meeting held at Kent Lewis’ office in Tullahoma in early December with Mike Bowers, then the division affairs manager of AAMFT, all the board and the legislative committee to plan strategy and make decisions regarding the timeline for the licensure bill’s introduction. Stuart Bonnington, Jerry Harber and Esco McBay were newly elected or appointed members who began with with the group at this time. Esco McBay became the legislative chair upon the resignation of Jack Redden. Stuart and Jerry were board members. Celia Ferguson joined the group as the AAMFT Division Affairs Student Representative.
Sara Cawood and Celia Ferguson formed the nucleus of the committee to draft the bill and compose and edit a position paper to be used during the struggle. Other legislative committee members were: Esco McBay, Stuart Bonnington and Jerry Harber. It was decided to submit the bill to the legislature in the 1990 term. We were upgrading existing law TCA 63-22-101 through 63-22-113 from certification to licensure.
The scope of practice was a big issue with the psychologist’s lobby, as was the upgrade from certification to licensure.
To bring you up to date, the board’s past emphasis has been on the importance of a scope of practice and confidentiality. You will find that the controversy around the scope of practice will surround the words, either specifically or in principle, “diagnosis and treatment” which sometimes is also called “assessment” but at any rate refers to our being able to diagnose and treat mental and emotional disorders. The closer we can get to some language like that in our scope of practice, the safer we’ll be in terms of being able to use DSM-IIIR language. Also, the closer we get to those kinds of words, the more opposition we can expect from clinical psychology. (Letter from Jeanne Williams to Esco McBay, dated December 14, 1989)
Frequent conference calls became a means by which TAMFT board members reminded one another of where we were in a balancing act as decision points in the negotiation process came. Esco McBay had an office just three blocks from the state house, and provided a presence for weeks in legislators’ offices that helped make the difference in the unanimous votes with which our bill passed in every committee and on both floors in the capitol. Having Jim Holcomb, an AAMFT clinical member, who served in the house sponsor the bill was a great help. Curtis Person was our senate sponsor.
Previously, I had misjudged my sponsorship, thinking it would be seen as self-serving. However, in retrospect, we learned that my lack of sponsorship had cast a long shadow on the credibility of the legislation. (Jim Holcomb, Tennessee State House of Representatives, 1989)
Neverthless, we knew that we had to work as though it all depended on us alone without Jim’s help. We talked with legislators and let them become acquainted with us. Organizing our grassroots support included phone trees for members and letterwriting from professional colleagues, ministers and clients. The in-capitol visits provided the information we needed to know regarding which legislators needed communication from his or her constituents. By the time we hired a lobbyist (primarily for the Senate effort, where we felt less certain), Jim Holcomb’s word to us was that we had already done most of his work.
We dealt with many objections throughout the struggle. Some of the more interesting ones were: this bill would put the preachers out of business, it would raise the cost of insurance by requiring mandatory coverage for insurance companies, doctors should be the ones doing therapy (this came from the doctor’s wives organization), turf battles with psychologist and social workers, ability/inability to do testing. Throughout we continued to prove our competence and put out fires (simultaneously)! (Celia Ferguson and Sara Cawood, on remembering the struggle for licensure, February, 2005).
The licensure bill achieved in 1991 was the culmination of a long struggle beginning back long before many of us were clinical members, or perhaps before we even knew what marriage and family therapists (or TAMFT) were!
How different is the place where we currently find ourselves?
--Jeanne R. Williams, MS
March 15, 2005