URI Couple and Family Therapy program to increase family therapy in addiction treatment, improve patient and family outcomes

The only RI workforce development program that recruits, trains and supervises family therapists takes burden off treatment centers statewide

URI is working to help fill the shortage of licensed marriage and family therapists in Rhode Island who are qualified to treat substance use disorders. (istock image)

KINGSTON, R.I. — March 21, 2024 — Substance use disorder, particularly involving opioids, is a continuing crisis in the country, impacting not just the person suffering from addiction, but also those closest to them. While treatment is naturally focused on the person facing the disorder, it is critical to include the patient’s family members, who are also impacted by addiction and play a key role in recovery.

Despite the importance of familial involvement, Rhode Island has a shortage of Licensed Marriage and Family Therapists who are qualified to treat substance use disorders. The University of Rhode Island Department of Human Development and Family Science is working to fill that gap, launching a workforce development initiative that will guide marriage and family therapists from training to full licensure to serve families in Rhode Island affected by substance use disorders. The initiative will allow therapists with provisional licenses to provide supervised treatment while working toward their full licenses, significantly adding to the pipeline of therapists qualified to treat those facing addiction and their family members.

“When someone with a substance use disorder is treated as an individual, of course that can be helpful and effective to help them heal, but what happens when that person goes back into an unchanged family system, or an unchanged social support system? Sometimes it doesn’t stick,” said Assistant Professor Jessica Cless, who leads the program. “What is important as part of that process is the involvement of the family. Couple and family therapists see the entire system that person lives in—and you really have to address the whole system in order to give people a more effective chance at healing. It is less common for a treatment center to have family services embedded into the treatment. There’s this gap of need.”

Cless has secured a $250,000 contract through the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals to build a network of family therapists trained to treat substance use disorders. As the only accredited trainer of Licensed Marriage and Family Therapists in the state, URI professors Cless, Tiffani Kisler, Gina MacLure and Kate Wolfe will prepare graduating students to be associate LMFTs. They are recruiting family therapists and student family therapists, providing the accredited training, and helping place them in substance use treatment facilities around the state. Critically, the URI professors will also provide supervision of the associate therapists, lifting an additional burden from the often over-extended therapy centers.

“That’s an important piece because there are not enough supervisors for these positions,” Cless said. “As the only accredited LMFT training program, we already have the capacity to provide this supervision, and we have a pipeline of eligible students. So when the state put out this call for expanding family therapy, it really made sense for URI to respond.”

The state’s granting of associate licenses to trained therapists is important in ensuring insurance companies will cover the treatment for patients. Previously, therapists would have to complete 2,000 hours of supervised training before they could get a license in order to bill insurance. The associate license allows them to work with patients, under supervision, while continuing work on their 2,000 hours, adding to the therapist workforce.

“Our students qualify for an associate license as soon as they graduate,” Cless said. “Being licensed enables them to provide supervised care, and for insurance companies to cover the treatment. LMFTs and LMFT-As are in such high demand today, as is mental health treatment, especially for substance use problems. There just aren’t enough clinicians, so this associate level license is really a game changer.”

With only about 20 total licensed marriage and family therapist associates in Rhode Island, Cless is hoping this program becomes a model going forward, and that incorporating family therapy into substance use disorder treatment becomes the norm.

“Addiction is a crisis in the country. We’ve got a lot of families out there that are hurting,” Cless said. “There are lots of resources for the people themselves who are addicted, but we know the family system is also significantly impacted by addiction. Family therapy can help uncover dynamics that are barriers to successful treatment, or those that could be part of the solution. So we’re really trying to increase services and support for those families, both for their sake and for the ultimate success of the person who has the addiction.”

Cless continues to recruit therapists and seek treatment centers interested in benefiting from the program. Any therapist or treatment center interested in taking part can contact Cless at jcless@uri.edu.