board of directors of CAMFT hereby promulgates, pursuant to Article VI,
Section A 1. and 2. and Article VII, Section B 3. of the Association Bylaws,
a Revised Code of Ethical Standards for Marriage and Family Therapists.
Members of CAMFT are expected to be familiar with and abide by these standards
and by applicable California laws and regulations governing the conduct
of licensed marriage, and family therapists, interns and trainees. The effective
date of these revised standards is May 1, 2002.
PART I - STANDARDS
The practice of marriage, and family therapy and psychotherapyi
is both an art and a science. It is varied and often complex in its approach,
technique, modality and method of service delivery. These ethical standards
are to be read, understood, and utilized as a guide for ethical behavior.
The general principles contained in this code of conduct are also used as
a basis for the adjudication
of ethical issues and/or complaints (both within and outside of CAMFT) that
may arise. Ethical behavior, in a given situation, must satisfy not only
the judgment of the individual marriage and family therapist, but also the
judgment of his/her peers, based upon a set of recognized norms.
We recognize that the development of standards is an ongoing process, and
that every conceivable situation that may occur cannot be expressly covered
by any set of standards. The absence of a specific prohibition against a
particular kind of conduct does not mean that such conduct is either ethical
or unethical. While the specific wording of these standards is important,
the spirit and intent of the principles should always be taken into consideration
by those utilizing or interpreting this code. Violations of these standards
should be brought to the attention of the CAMFT Ethics Committee, in writing,
at CAMFT's administrative office, 7901 Raytheon Road, San Diego, CA 92111-1606,
or at such other address as may be necessary because of a change in location
of the administrative office.
RESPONSIBILITY TO PATIENTSii
Marriage and family therapistsiii advance
the welfare of families and individuals, respect the rights of those persons
seeking their assistance, and make reasonable efforts to ensure that their
services are used appropriately. When patients are not physically present
(e.g., therapy by telephone or Internet) during the provision of therapy,
marriage and family therapists take extra precautions to meet their responsibilities
and family therapists do not condone, engage in discrimination,
or refuse professional service to anyone on the basis of race, gender,
religion, national origin, age, sexual orientation, disability,
socioeconomic or marital status. Marriage and family therapists
make reasonable efforts to accommodate patients who have physical
and family therapists are aware of their influential position with
respect to patients, and they avoid exploiting the trust and dependency
of such persons. Marriage and family therapists therefore avoid
dual relationshipsiv with patients
that are reasonably likely to impair professional judgment or lead
to exploitation. A dual relationship occurs when a therapist and
his/her patient engage in a separate and distinct relationship either
simultaneously with the therapeutic relationship, or during a reasonable
period of time following the termination of the therapeutic relationship.
Not all dual relationships are unethical, and some dual relationships
cannot be avoided. When a dual relationship cannot be avoided, therapists
take appropriate professional precautions to insure that judgment
is not impaired and that no exploitation occurs.
intercourse, sexual contact or sexual intimacy with a patient, or
a patient's spouse or partner, during the therapeutic relationship,
or during the two years following the termination of the therapeutic
relationship, is unethical.
acts which would result in unethical dual relationships include,
but are not limited to, borrowing money from a patient, hiring a
patient, engaging in a business venture with a patient, or engaging
in a close personal relationship with a patient. Such acts with
a patient's spouse, partner or family member may also be considered
unethical dual relationships.
and family therapists do not enter into therapeutic relationships
with persons with whom they have had sexual relationships.
and family therapists are aware of their professional and clinical
responsibilities to provide consistent care to patients and do not
abandon or neglect patients. Marriage and family therapists, therefore,
maintain practices and procedures that assure undisrupted care.
Such practices and procedures may include, but are not limited to,
providing contact information and specified procedures in case of
emergency, or therapist absence, conducting appropriate terminations,
and providing for a professional will.
and family therapists terminate therapeutic relationships for clinically
sound reasons and in an appropriate manner. Reasons for termination
may include, but are not limited to, the patient is not benefiting
from treatment, continuing treatment is not clinically appropriate,
the therapist is unable to provide treatment due to physical or
mental illness, or the treatment becomes ethically questionable.
and family therapists assist patients when terminating relationships
by making reasonable arrangements for continuation of necessary
is unethical to maintain therapeutic relationships solely for financial
may be ethical to terminate a patient relationship for non-payment
and family therapists respect the right of patients to make decisions
and help them to understand the consequences of these decisions.
Marriage and family therapists provide adequate information to patients
so that patients can make meaningful decisions about their therapy.
and family therapists inform patients of the potential risks and
benefits of service consistent with sound clinical practice.
and family therapists inform patients of the extent of their availability
for emergencies and for other contacts between sessions.
and family therapists advise their patient(s) that decisions on
the status of their personal relationships are the responsibilities
of the patient(s).
and family therapists obtain written informed consent from clients
before videotaping, audio recording, or permitting third party observation.
and family therapists are encouraged to inform patients as to the
limits of confidentiality.
and family therapists are encouraged to inform patients at an appropriate
time and within the context of the psychotherapeutic relationship
of their experience, education, specialties, theoretical and professional
orientation and any other information deemed appropriate by the
therapy occurs by electronic means, marriage and family therapists
inform patients of the potential risks and benefits, including but
not limited to, issues of confidentiality, clinical limitations,
transmission difficulties, and ability to respond to emergencies.
and family therapists inform patients of fee and fee arrangements
prior to the provision of therapy.
Marriage and family therapists do not use their professional relationships
with patients to further their own interests.
and family therapists continue therapeutic relationships only so
long as it is reasonably clear that patients are benefiting from
Marriage and family therapists assist persons in obtaining other
therapeutic services if a therapist is unable or unwilling to provide
and family therapists do not abandon or neglect patients in treatment.
If a therapist is unable to continue to provide care, the therapist
will assist the patient in making reasonable arrangements for continuation
terminating employment or contractual relationships, marriage and
family therapists primarily consider the best interests of the patient
when resolving issues of continued responsibility for patient care.
and family therapists, when treating a family unit(s), shall carefully
consider the potential conflict that may arise between the family
unit(s) and each individual. Marriage and family therapists clarify
at the commencement of therapy which person or persons are clients
and the nature of the relationship(s) the therapist will have with
each person involved in the treatment.
and family therapists do not withhold patient records or information
solely because the therapist has not been paid for prior therapy
and family therapists consult, associate, collaborate with, and
refer to physicians, other health care professionals, and community
resources in order to improve and protect the health and welfare
of the patient.
and family therapists advocate for mental health care they believe
will benefit their patients. In appropriate circumstances, they
challenge denials of care, or denials of payment for care, by managed
care organizations, insurers, or other payers.
and family therapists disclose treatment alternatives to patients,
whether or not there is coverage for such treatment under the terms
of a managed care plan, insurance policy, or other health care plan.
therapy is provided by Internet or other electronic media, marriage
and family therapists ensure that patients are intellectually, emotionally,
and physically capable of engaging in therapy by such means.
a marriage and family therapist is not located in the same geographic
area as the patient, he/she shall provide a name of another qualified
mental health care professional and/or entity in the patient's locale
for contact in case of emergency.
Marriage and family therapists have unique confidentiality responsibilities
because the "patient" in a therapeutic relationship may be more
than one person. The overriding principle is that marriage and family
therapists respect the confidences of their patient(s).
and family therapists do not disclose patient confidences, including
the names or identities of their patients, to anyone except a) as
mandated by law b) as permitted by law c) when the marriage and
family therapist is a defendant in a civil, criminal or disciplinary
action arising from the therapy (in which case patient confidences
may only be disclosed in the course of that action), or d) if there
is an authorization previously obtained in writing, and then such
information may only be revealed in accordance with the terms of
there is a request for information related to any aspect of psychotherapy
or treatment, each member of the unit receiving such therapeutic
treatment must sign an authorization before a marriage and family
therapist will disclose information received from any member of
the treatment unit.
and family therapists are aware of the possible adverse effects
of technological changes with respect to the dissemination of patient
information, and take reasonable care when disclosing such information.
Marriage and family therapists are also aware of the limitations
regarding confidential transmission by Internet or electronic media
and take extra care when transmitting or receiving such information
via these mediums.
and family therapists store, transfer, transmit, and/or dispose
of patient records in ways that protect confidentiality.
and family therapists take appropriate steps to ensure, insofar
as possible, that the confidentiality of patients is maintained
by their employees, supervisees, assistants and volunteers.
Marriage and family therapists use clinical materials in teaching,
writing, and public presentations only if a written authorization
has been previously obtained in accordance with 2.1 d, or when appropriate
steps have been taken to protect patient identity.
and family therapists, when working with a group, explain to the
group the importance of maintaining confidentiality, and are encouraged
to obtain agreement from group participants to respect the confidentiality
of other members of the group.
PROFESSIONAL COMPETENCE AND INTEGRITY
Marriage and family therapists maintain high standards of professional
competence and integrity.
and family therapists are in violation of this Code and subject
to termination of membership, or other appropriate action, if they:
a) are convicted of a crime substantially related to their professional
qualifications or functions; b) are expelled from or disciplined
by other professional organizations; c) have their licenses or certificates
suspended or revoked or are otherwise disciplined by regulatory
bodies; d) if they continue to practice when they are no longer
competent to practice because they are impaired due to physical
or mental causes or the abuse of alcohol or other substances; or
e) fail to cooperate with the Association or the Ethics Committee
at any point from the inception of an ethical complaint through
the completion of all proceedings regarding that complaint.
and family therapists avoid contractual arrangements which provide
financial incentives to withhold or limit medically/psychologically
and family therapists maintain patient records, whether written,
taped, computerized, or stored in any other medium, consistent with
sound clinical practice.
and family therapists seek appropriate professional assistance for
their personal problems or conflicts that impair work performance
or clinical judgment.
and family therapists as teachers, supervisors, and researchers,
maintain high standards of scholarship and present accurate information.
and family therapists actively strive to understand the diverse
cultural backgrounds of their clients by gaining knowledge, personal
awareness, and developing sensitivity and skills pertinent to working
with a diverse client population. Marriage and family therapists
who provide therapy over the Internet or by other electronic media
take extra measures to identify and understand the diversity, ethnicity,
and cultural sensitivity of such patients.
and family therapists are aware of how their cultural/racial/ethnic
identity, values and beliefs affect the process of therapy.
and family therapists remain abreast of developments in their field
through educational activities and clinical experiences.
Marriage and family therapists do not engage in sexual or other
harassment or exploitation of patients, students, interns, trainees,
supervisees, employees or colleagues.
and family therapists do not assess, test, diagnose, treat, or advise
on problems beyond the level of their competence as determined by
their education, training and experience. While developing new areas
of practice, marriage and family therapists take steps to ensure
the competence of their work through education, training, consultation,
and family therapists do not generally provide professional services
to a person receiving treatment or therapy from another psychotherapist,
except by agreement with such other psychotherapist or after the
termination of the patient's relationship with the other psychotherapist.
and family therapists initiate services by Internet or other electronic
media to patients located only in jurisdictions where the therapist
may lawfully provide such services.
and family therapists take reasonable steps to prevent the distortion
or misuse of their clinical and research findings.
and family therapists, because of their ability to influence and
alter the lives of others, exercise special care when making public
their professional recommendations and opinions through testimony
or other public statements.
RESPONSIBILITY TO STUDENTS AND SUPERVISEES
Marriage and family therapists do not exploit the trust and dependency
of students and supervisees.
and family therapists are aware of their influential position with
respect to students and supervisees, and they avoid exploiting the
trust and dependency of such persons. Marriage and family therapists
therefore avoid dual relationships that are reasonably likely to
impair professional judgment or lead to exploitation. Provision
of therapy to students or supervisees is unethical. Provision of
marriage and family therapy supervision to clients is unethical.
Sexual intercourse, sexual contact or sexual intimacy and/or harassment
of any kind with students or supervisees is unethical.
and family therapists do not permit students, employees or supervisees
to perform or to hold themselves out as competent to perform professional
services beyond their training, level of experience, and competence.
and family therapists who act as supervisors are responsible for
maintaining the quality of their supervision skills, and obtaining
consultation or supervision for their work as supervisors whenever
RESPONSIBILITY TO COLLEAGUES
Marriage and family therapists treat colleagues with respect, courtesy,
fairness, and good faith, and cooperate with colleagues in order to promote
the welfare and best interests of the patient.
Marriage and family therapists respect the confidences of colleagues
that are shared in the course of their professional relationships.
and family therapists are encouraged to assist colleagues who are
impaired due to substance abuse, emotional problems, or mental illness.
and family therapists do not file or encourage the filing of ethics
or other complaints that they know, or reasonably should know, are
6. RESPONSIBILITY TO RESEARCH PARTICIPANTS
Investigators respect the dignity and protect the welfare of participants
in research and are aware of federal and state laws and regulations and
professional standards governing the conduct of research.
are responsible for making careful examinations of ethical acceptability
in planning studies. To the extent that services to research participants
may be compromised by participation in research, investigators seek
the ethical advice of qualified professionals not directly involved
in the investigation and observe safeguards to protect the rights
of research participants.
requesting participants' involvement in research inform them of
all aspects of the research that might reasonably be expected to
influence willingness to participate. Investigators are especially
sensitive to the possibility of diminished consent when participants
are also receiving clinical services, have impairments which limit
understanding and/or communication, or when participants are children.
respect participants' freedom to decline participation in or to
withdraw from a research study at any time. This obligation requires
special thought and consideration when investigators or other members
of the research team are in positions of authority or influence
over participants. Marriage and family therapists, therefore, make
every effort to avoid dual relationships with research participants
that could impair professional judgment or increase the risk of
obtained about a research participant during the course of an investigation
is confidential unless there is an authorization previously obtained
in writing. When the possibility exists that others, including family
members, may obtain access to such information, this possibility,
together with the plan for protecting confidentiality, is explained
as part of the procedure for obtaining informed consent.
RESPONSIBILITY TO THE PROFESSION
Marriage and family therapists respect the rights and responsibilities
of professional colleagues and participate in activities which advance
the goals of the profession.
Marriage and family therapists remain accountable to the standards
of the profession when acting as members or employees of organizations.
and family therapists assign publication credit to those who have
contributed to a publication in proportion to their contributions
and in accordance with customary professional publication practices.
Marriage and family therapists who are the authors of books or other
materials that are published or distributed appropriately cite persons
to whom credit for original ideas is due.
and family therapists who are the authors of books or other materials
published or distributed by an organization take reasonable steps
to ensure that the organization promotes and advertises the materials
accurately and factually.
Marriage and family therapists recognize a responsibility to participate
in activities that contribute to a better community and society,
including devoting a portion of their professional activity to services
for which there is little or no financial return.
and family therapists are concerned with developing laws and regulations
pertaining to marriage and family therapy that serve the public
interest, and with altering such laws and regulations that are not
in the public interest.
and family therapists cooperate with the Ethics Committee and truthfully
represent facts to the Ethics Committee. Failure to cooperate with
the Ethics Committee is itself a violation of these standards.
RESPONSIBILITY TO THE LEGAL SYSTEM
Marriage and family therapists recognize their role in the legal system
and their duty to remain objective and truthful.
and family therapists who give testimony in legal proceedings testify
truthfully and avoid making misleading statements.
and family therapists who act as expert witnesses base their opinions
and conclusions on appropriate data, and are careful to acknowledge
the limits of their data or conclusions in order to avoid providing
misleading testimony or reports.
and family therapists avoid, wherever possible, performing conflicting
roles in legal proceedings and disclose any potential conflicts
to prospective clients, to the courts, or to others as appropriate.
and family therapists, regardless of their role in a legal proceeding,
remain objective and do not compromise their professional judgment
Marriage and family therapists do not express professional opinions
about an individual's mental or emotional condition unless they
have conducted an examination of the individual, or unless they
reveal the limits of the information upon which their professional
opinions are based, with appropriate cautions as to the effects
of such limited information upon their opinions.
9. FINANCIAL ARRANGEMENTS
Marriage and family therapists make financial arrangements with patients
and supervisees that are understandable, and conform to accepted professional
practices and legal requirements.
Marriage and family therapists do not offer or accept payment for
and family therapists do not financially exploit their patients.
and family therapists disclose, in advance, their fees and the basis
upon which they are computed, including, but not limited to, charges
for canceled or missed appointments and any interest to be charged
on unpaid balances, at the beginning of treatment and give reasonable
notice of any changes in fees or other charges.
and family therapists give reasonable notice to patients with unpaid
balances of their intent to sue, or to refer for collection. Whenever
legal action is taken, therapists will avoid disclosure of clinical
information. Whenever unpaid balances are referred to collection
agencies, therapists will exercise care in selecting collection
agencies and will avoid disclosure of clinical information.
and family therapists ordinarily refrain from accepting goods, services,
or other non-monetary remuneration from patients in return for professional
services. Such arrangements often create conflicts and may lead
to exploitation or distortion of the professional relationship.
and family therapists represent facts regarding services rendered
fully and truthfully to third party payers.
Marriage and family therapists engage in appropriate informational activities,
including those that enable lay persons to choose professional services
on an informed basis.
and family therapists accurately represent their competence, education,
training, and experience relevant to their professional practice.
and family therapists assure that advertisements and publications,
whether in directories, announcement cards, newspapers, radio, television,
Internet or any other electronic media, are formulated to accurately
convey information that is necessary for the public to make an appropriate
and family therapists do not use a name which could mislead the
public concerning the identity, responsibility, source, and status
of those practicing under that name and do not hold themselves out
as being partners or associates of a firm if they are not.
and family therapists do not use any professional identification,
including but not limited to: a business card, office sign, letterhead,
telephone or association directory listing, Internet or any other
electronic media, if it includes a statement or claim that is false,
fraudulent, misleading, or deceptive. A statement is false, fraudulent,
misleading, or deceptive if it a) contains a material misrepresentation
of fact; b) fails to state any material fact necessary to make the
statement, in light of all circumstances, not misleading; or c)
is intended to or is likely to create an unjustified expectation.
and family therapists correct, wherever possible, false, misleading,
or inaccurate information and representations made by others concerning
the therapist's qualifications, services, or products.
and family therapists do not solicit testimonials from patients.
and family therapists make certain that the qualifications of persons
in their employ are represented in a manner that is not false, misleading,
and family therapists may represent themselves as specializing within
a limited area of marriage and family therapy, but only if they
have the education, training, and experience which meet recognized
professional standards to practice in that specialty area.
clinical, associate and prelicensed members may identify such membership
in CAMFT in public information or advertising materials, but they
must clearly and accurately represent whether they are clinical,
associate, or prelicensed members.
and family therapists may not use the initials CAMFT following their
name in the manner of an academic degree.
and family therapists may use the CAMFT logo only after receiving
permission in writing from the Association. Permission will be granted
by the Association to CAMFT members in good standing in accordance
with Association policy on use of CAMFT logo. The Association (which
is the sole owner of its name, logo, and the abbreviated initials
CAMFT) may grant permission to CAMFT committees and chartered chapters
in good standing, operating as such, to use the CAMFT logo. Such
permission will be granted in accordance with Association policy
on use of the CAMFT logo.
and family therapists use their membership in CAMFT only in connection
with their clinical and professional activities.
of these standards should be brought to the attention of the CAMFT Ethics
Committee, in writing, at CAMFT's administrative office, 7901 Raytheon
Road, San Diego, CA 92111-1606, or at such other address as may be necessary
because of a change in location of the administrative office.
The terms psychotherapy, therapy and counseling are used interchangeably
throughout the Ethical Standards.
The word "patient," as used herein, is synonymous with such
words as "client" or "counselee."
The term "marriage and family therapist," as used herein, is
synonymous with the term "licensed marriage, family and child counselor,"
and is intended to cover registered interns and trainees doing marriage,
family and child counseling under supervision.
Dual relationships include multiple relationships with patients.
known dates of ethical standards revisions: 5/02, 4/97, 4/92, 10/87, 9/78,