Since 2019, CenterLink (the Community of LGBT Centers) and the Yale LGBTQ Mental Health Initiative have been offering comprehensive trainings in LGBTQ-affirmative cognitive-behavioral therapy (CBT) for mental health providers serving LGBTQ clients.
Developed, tested, and refined over more than a decade by Yale researchers, LGBTQ-affirmative CBT is the first treatment shown across large-scale clinical trials to reduce depression, anxiety, substance use, and sexual risk among diverse LGBTQ community members. The treatment improves mental health and builds resilience by targeting the specific internal and psychosocial vulnerabilities that research shows are elevated among LGBTQ people due to early and ongoing exposure to LGBTQ-related stress.
Those who participate in one or more offerings of the Yale-Centerlink Training Program will gain the knowledge, hands-on skills, and confidence to implement LGBTQ-affirmative CBT. Most training offerings are open to professionals and trainees, including individuals for whom CBT is not their primary therapeutic modality.
The Yale LGBTQ Mental Health Initiative provides a home for scholars and scholarship devoted to understanding and improving the mental health of LGBTQ populations in the US and around the world.
LGBTQ individuals experience substantial disparities in mental health problems, from suicide to substance use. The Initiative applies Yale’s strengths in mental health, LGBTQ studies, and global health to solving this pressing public health challenge.
We achieve this mission through fostering highly collaborative research across schools and departments; sponsoring academic events meant to spark innovation in this field; and training and educating diverse future leaders in LGBTQ mental health research.
Our Initiative
The Initiative is housed within the Yale School of Public Health and Yale School of Medicine, Department of Psychiatry, and draws upon Yale’s interdisciplinary expertise to advance its mission.
Andrew Benesh, PhD, LMFT-Behavioral Health Education and Community Development Professional comments on drafted rule changes.
I know there’s a lot of anxiety floating around regarding upcoming changes to student loan rules, and their anticipated effects on students.
The Department of Education (ED) is moving forward with draft rules that will fundamentally change how graduate students finance their education. Under the rule ED will propose, many healthcare professions are not classified as professional programs, but instead as graduate programs. “Graduate programs” will have a $20,500 annual limit, with a $100,000 total cap, while programs defined as “professional programs” will have a $50,000 annual limit, and $200,000 total cap. This means that many students, including MFT students, would be subject to significantly lower loan limits. This change will take effect on July 1, 2026, and will apply to new borrowers. The ED is expected to open this proposed rule up for public comment early next year, most likely in January.
AAMFT has been actively advocating for the inclusion of MFTs in the professional degree definition throughout the rulemaking process, including joining coalitions of health professionals advocating for a more expansive definition of professional degree. AAMFT and many other healthcare associations will be submitting public comments to ED on this proposed rule. AAMFT will alert members once the public comment period begins.
What can be done before the public comment period begins?
It is important for Members of Congress to hear from their constituents on this important issue, and to ask Members of Congress to make sure that ED includes MFTs and other healthcare professions under the professional degree definition in the final rule. Use this link to contact your Member: https://lnkd.in/eZ6qQmaj
In addition, AAMFT wants to hear how federal graduate student loan program has supported your path to licensure and how these proposed limits would impact future students. Your stories will help show Congress the real-world impacts of these changes on current and future MFT students, as well as how these changes will exacerbate the shortage of behavioral health providers. Share your story here: https://lnkd.in/eBFKMdZh
The above is based Original Message: Sent: 11-24-2025 04:04 PM From: Neal Sombke
Hello Family TEAM members,
Thank you for your comments on this important issue. AAMFT has been actively advocating for the inclusion of MFTs in the professional degree definition throughout the rulemaking process, including joining coalitions of health professionals advocating for a more expansive definition of professional degree.
We have linked here two coalition statements AAMFT has signed on to within the last month that urge the Department of Education to classify MFT degrees and other healthcare degrees under a more inclusive professional degree definition.
The Department of Education (ED) is moving forward with draft rules that will fundamentally change how graduate students finance their education. Under the rule ED will propose, many healthcare professions are not classified as professional programs, but instead as graduate programs. “Graduate programs” will have a $20,500 annual limit, with a $100,000 total cap, while programs defined as “professional programs” will have a $50,000 annual limit, and $200,000 total cap. This means that many students, including MFT students, would be subject to significantly lower loan limits. This change will take effect on July 1, 2026, and will apply to new borrowers.
The ED is expected to open this proposed rule up for public comment early next year, most likely in January. AAMFT and many other healthcare associations will be submitting public comments to ED on this proposed rule. AAMFT will alert members once the public comment period begins.
What can be done before the public comment period begins? The federal bureaucracy does listen to Congress. Therefore, it is important for Members of Congress to hear from their constituents on this important issue, and to ask Members of Congress to make sure that ED includes MFTs and other healthcare professions under the professional degree definition in the final rule. AAMFT has developed a grassroots message that you can send to your Members of Congress.
In addition, AAMFT wants to hear how federal graduate student loan program has supported your path to licensure and how these proposed limits would impact future students. Your stories will help us show Congress the real-world impacts of these changes on current and future MFT students, as well as how these changes will exacerbate the shortage of behavioral health providers. Please click here to share your story.
AAMFT continues to monitor the situation and how these changes will affect MFTs. If you would like to read about how these changes will affect MFTs, you can click this article. Please contact AAMFT at FamilyTEAM@aamft.org if you have any questions.
In her 1985 article in PsycCRITIQUES, “Reaching Inward: A Way of Training in Human Systems Thinking,” Marion Lindblad-Goldberg presented a method for training people to think systemically about human behavior. The core of her work relates to family therapy and ecosystemic structural family therapy (ESFT), a model that considers how family members and their broader social context are interconnected.
Key concepts of the article
Training in systems thinking: The article discusses a training program designed to help individuals move beyond a linear, cause-and-effect understanding of behavior. Systems thinking involves seeing individuals and their actions as part of a larger, dynamic network of relationships and patterns.
Focus on internal context: The training emphasizes self-reflection and an examination of one’s own role within a system. This contrasts with a “system-as-effect” perspective, which blames external forces for a system’s behavior.
Emphasis on family systems: The article focuses on applying systems thinking to family relationships. Her later work emphasizes that a family is its own best resource for change, suggesting her training method helped therapists see the innate strengths of families.
A “way of being”: The training is not merely a set of tools but a fundamental shift in perception—a “way of being” that fosters curiosity, compassion, and courage.
Focus on relationships: The article explored how to help trainees understand the patterns of interaction and structural relationships that define human systems, rather than just focusing on individual actions.
The article is an early piece from Lindblad-Goldberg’s distinguished career, which heavily influenced the field of family therapy.
Pioneered ecosystemic structural family therapy (ESFT): Lindblad-Goldberg is credited with developing the ESFT model, which helps therapists work with families to identify dysfunctional patterns of interaction and connect families with community resources.
Founding of a training center: She is currently the Director Emeritus of the Philadelphia Child and Family Therapy Training Center (PCFTTC), which trains therapists in the ESFT model.
Informed later publications: Her exploration of systems thinking in this 1985 article provided a foundational basis for her later books and papers, such as Creating Competence from Chaos (1998) and Ecosystemic Structural Family Therapy: Theoretical and Clinical Foundations (2013).
YOU MUST BE SUBSCRIBED TO THE BLOG FOR YOUR ENTRY TO COUNT
Enter the family assessment tool competition to win free access to one HOMESTUDY CE PROGRAM from the PCFTTC store (APA or ACE category).
Using the movies Wicket Part 1 and Part 2 (or the Broadway production), and Elphaba as the identified patient complete at least two family assessment tools from this list:
Structural map with identified family type
Negative Interactional Pattern with at least three people in the pattern.
Ecomap
Genogram
Critical Events Timeline
Entries can use their imagination to fill in the gaps of information not provided during the films. The most creative information and with the most assessment tools accuracy wins!
Entries are accepted until 11:59am on December 19th. Entries should be electronically submitted to training@pcfttc.com .
For generations, helping professionals, educators, and even family members have been trained to ask, “What’s wrong with you?” when someone behaves in ways that seem confusing, defiant, or self-destructive. It’s a question rooted in problem identification, but it often carries an unintended message—that something inside the person is broken, defective, or in need of fixing. In Ecosystemic Structural Family Therapy (ESFT), we take a different approach. We ask, “What happened to you?”
This question changes the entire frame of understanding. Instead of pathologizing behavior, it invites curiosity, compassion, and context. It shifts our focus from the individual as the source of dysfunction to the system—the web of relationships, environments, and experiences that have shaped the person’s current way of coping.
When we ask, “What happened to you?”, we are not excusing behavior; we are explaining it. We begin to see behavior as communication, not simply as a symptom to be eliminated. A child’s aggression, withdrawal, or defiance may no longer appear as “bad behavior,” but as an adaptive response to chronic stress, trauma, or unmet emotional needs.
This reframing is also healing for caregivers. Parents often feel blamed or powerless when a child struggles. But when professionals help them see the child’s behavior in context—through the lens of what happened—they can respond with empathy and leadership instead of frustration and guilt. This approach restores the caregiver’s confidence and invites them into collaboration, rather than correction.
From a clinical perspective, “what happened to you” thinking leads to interventions that are relational, not punitive. It allows for joining, reframing, enactment, and anchoring—the hallmarks of ESFT—to take root in a way that promotes lasting change.
Ultimately, asking “What happened to you?” honors the truth that all behavior makes sense in context. It opens the door to healing by helping individuals and families see themselves not as problems to be fixed, but as systems capable of resilience, repair, and growth.
When we lead with curiosity instead of judgment, we don’t just change our questions—we change lives.
“Every voice matters. Even the quietest one can change the whole story.”
Systemic family therapy is built on the belief that families are ecosystems, and in ecosystems, every part plays a role. Yet in many families, certain voices—children, quieter siblings, caregivers, and even natural supports—can get lost in the noise. When that happens, the system adapts in ways that often reinforce imbalance and distress. This results in dislocation.
Therapists
As systemic family therapists, our responsibility is to ensure that every voice is heard. This may mean slowing down to notice the child who rarely speaks, or asking a question that allows a caregiver to share their untold story. It may mean restructuring a session so the quieter members are elevated, reminding the family that healing comes from inclusion, not exclusion. Or, it may mean calling attention to the impact of a family member is still having on how people relate, even if they are gone or deceased.
Supervisors
Supervisors can carry this forward by how they engage supervisees. When early-career clinicians hesitate to speak up, supervisors can invite their perspectives and validate their observations. Often, those voices carry insights others have overlooked. This can be used as part of the prepared plan for what will happen in the next session. Or, maybe the supervisors connects the insights to the family assessment tools.
Summary
Families change when silenced voices are given space. Teams strengthen when quieter members are encouraged to lead. In systemic practice, the smallest shift—one voice being heard—can transform the whole story. In honoring every voice, we honor the heart of systemic therapy: belonging, connection, and the belief that everyone has a role in shaping the system’s future.
Check our CE program Store to learn more about systemic family therapy and ecosystemic structural family therapy.
To learn about our Certification Programs click here.
Two Systemic Truths Every Family Therapist Should Know
In Ecosystemic Structural Family Therapy (ESFT), we understand that human behavior doesn’t occur in isolation—it’s shaped by a complex network of relationships, histories, and environments. Two foundational ideas that help us make sense of this complexity are equifinality and equipotentiality. These concepts remind us that there is never just one path to a problem—or to healing.
Equifinality: Many Roads, One Destination
Definition: Different starting points can lead to the same outcome.
In practice, this means that families with very different structures, histories, or stressors can arrive at similar patterns of functioning or symptoms.
For example, one child’s depression might emerge from a divorce, another’s from high parental conflict, and a third’s from overprotection. Though their paths differ, the presenting concern—emotional withdrawal—looks similar.
For the ESFT clinician, equifinality invites curiosity. Rather than assuming causality, we look systemically: What relational patterns have formed around this symptom?What role does it serve in maintaining family balance? Understanding these dynamics helps therapists move from surface behaviors to deeper systemic change.
Equipotentiality: One Road, Many Possible Destinations
Definition: The same starting point can lead to different outcomes.
This concept highlights the variability of human resilience. Two siblings may grow up in the same family and experience the same parental conflict, yet one develops anxiety while the other becomes highly independent.
For the ESFT therapist, this principle emphasizes context and meaning.
Families are not defined by what happens to them, but by how they organize around it.
Equipotentiality reminds us that every experience holds multiple possible outcomes—and that therapy can influence which path unfolds.
Why These Concepts Matter in ESFT
Both principles underscore a central truth: change in families is dynamic, relational, and contextual. Equifinality encourages therapists to avoid simplistic explanations, while equipotentiality keeps hope alive—even in challenging cases. Together, they form the foundation of systemic thinking: honoring diversity, complexity, and the endless potential for transformation within every family system.
