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Licensed Marriage and Family Therapists (LMFTs) are psychotherapists and healing arts practitioners licensed by the State of California. They are trained to assess, diagnose and treat individuals, couples, families and groups to help those who are struggling achieve more adequate, satisfying and productive lives. LMFTs work in many different settings including private practice, treatment clinics, probation centers and schools, and they can specialize in working with depression, anxiety, substance use disorders, child and adolescent issues, marital and relationship issues, existential issues, eating disorders, severe mental illness and more. Requirements for licensure include a related doctoral or two-year master's degree, passage of two comprehensive written examinations and at least 3,000 hours of supervised experience.
Psychotherapy services of licensed marriage and family therapists are, in many instances, eligible for insurance reimbursement. Licensed Marriage and Family Therapists are providers under the TRICARE program, and many are participating providers with Blue Shield of California as well as many other preferred provider organizations.
If you would like to read more about how the qualifications of Licensed Marriage and Family Therapists compare to other mental health practitioners, such as Clinical Social Workers and Psychologists, read How Do LMFTs Stack Up below.
Licensed Marriage and Family Therapists are Professional Psychotherapists. They work in private practice as well as various other settings with individuals, couples, families, children and adolescents, and the elderly, providing support and perspective as patients struggle with life's challenges.
Marriage and family therapists (LMFTs) practice early crisis intervention and brief, focused psychotherapy to resolve problems or reduce symptoms in the shortest time possible. They also have the expertise and skills to work with persons where more intensive, long-term treatment is necessary to cure or relieve mental or emotional conditions. They work in California's courts and schools as well as its health institutions, child protective services, mental health treatment centers, research centers, organizations and businesses. Patients who are treated by marriage and family therapists are more productive at work, visit their doctors less often, and have lower average lengths of stay at in-patient facilities.
Marriage and family therapists are licensed by the State of California. They must undergo extensive education, training, clinical fieldwork and pass two rigorous exams to demonstrate professional competency. In California, record numbers of citizens are seeking treatment for mental disorders that affect their work performance and personal lives. Personal and family stresses are greater, expectations for quality of life are higher, and access to qualified mental healthcare providers has improved as society has come to recognize the impact of mental health on physical well being.
Marriage and family therapists are core mental health practitioners educated and trained to help with relationship difficulties, and diagnose and treat the mental disorders and emotional problems of individuals, couples, families and groups. Marriage and family therapy is highly effective because of the "systemic" orientation that its therapists bring to treatment. In other words, they believe that an individual's mental or emotional problems must be treated within the context of his or her current or prior relationships if the gains are to be meaningful and productive for the patient. This treatment philosophy is consistent with current thinking in the health care field, which increasingly emphasizes inter-agency cooperation, involvement of the family, integration and coordination of services. Our health care system is now moving toward a more systemic approach and is increasingly rejecting individually focused care.
As a result, marriage and family therapists are often able to treat a patient's condition quickly - a cost-effective and practical approach to mental healthcare and a prime reason so many physicians and others refer patients to marriage and family therapists. When it is in the best interest of the patient or outside the scope of the marriage and family therapist's license, therapists collaborate with and refer to other health professionals, such as physicians or psychiatrists in the case of prescribing medication.
Policy-makers, both in business and government, are beginning to understand and support the notion that mental health services play a critical role in prevention. Healthy individuals and families promote socially acceptable behaviors, increased self-esteem, more tolerance for society in general, increased capacity for intimacy, work, maturity and responsible functioning. This ultimately results in less unnecessary utilization of medical services.
A competent Marriage and Family Therapist in California will:
Competent therapists do not offer solutions or take sides. They help clients work out solutions according to individual values and lifestyles. Seeking professional assistance is a sign of courage and a willingness to deal with life's many changes.
Distress signals where Marriage and Family Therapists can help:
A Marriage and Family Therapist helps individuals, couples, families and children explore and solve problems.
Clients can expect that discussions will be kept confidential, except as otherwise required or permitted by law. Examples of times when confidentiality must be broken are when child abuse has occurred or where the patient threatens violence against another person.
It is common for Licensed Marriage and Family Therapists (LMFT) to be challenged about their credentials and qualifications for independent practice as mental health professionals and psychotherapists. In a highly competitive and changing health care environment, professional groups are often jockeying for position and are apt to cast aspersions on other licensed practitioners. Some may still be unfamiliar with the Licensed Marriage and Family Therapist profession in California, even though LMFTs have been licensed in California for approximately forty-seven years.
This article will explore and compare the licensing laws and regulations of the Licensed Marriage and Family Therapist profession, the Licensed Clinical Social Worker (LCSW) profession, the Licensed Professional Clinical Counselor (LPCC) profession, and the Psychologist profession. Psychiatrists have intentionally not been included in this comparison because the educational and experiential requirements are not easily comparable. Psychiatrists are first educated, trained, tested and licensed as physicians, and such comparisons are beyond the scope and intent of this article. This article is not intended to attack or demean any profession, nor is it intended to escalate LMFTs beyond their appropriate place amongst the healing arts professions. It is intended, however, to describe the key requirements for licensure in each of the four mental health professions.
It is important to remember that licensing laws are passed to assure that the public health, safety and welfare is protected by setting minimum standards, and that licensing alone does not determine which therapists are effective and helpful, and which are marginal or dangerous. Consumers, purchasers, insurers, employers and others should look at a variety of factors when selecting mental health professionals, and should not rely solely upon the license held. New efforts in the emerging health care delivery system to measure quality, effectiveness and value may prove helpful in this regard.
Licensed Marriage and Family Therapists are licensed by the Board of Behavioral Sciences, as are Licensed Clinical Social Workers and Licensed Professional Clinical Counselors. Psychologists are licensed by the Board of Psychology. Both licensing boards are within the Department of Consumer Affairs and all four licensing laws are found within Division 2 (Healing Arts Division) of the Business and Professions Code. The LMFT, CSW, and PCC licensing laws require a master’s degree, while the Psychologist licensing law requires a doctorate degree. The LMFT, CSW, and Psychologist licensing laws require approximately the same amount of supervised experience, and all three currently require passage of two examinations prior to licensure. The PCC licensing law requires passage of national exams, or national exams plus one or more Board-developed exams, or just one or more Board-developed exams.
A. Licensed Marriage and Family Therapists
The Marriage and Family Therapist licensing law, specifically Section 4980.40 of the Business and Professions Code, requires that an applicant for licensure shall satisfy all of the following qualifications: a) meet the education requirements; b) be at least 18 years of age; c) have at least two years of supervised experience; d) successfully pass a California law and ethics examination and a clinical examination; and e) not have committed acts or crimes constituting grounds for denial of licensure. Section 4980.43 further defines this requirement by specifying that two calendar years of supervised experience is required, consisting of at least 3,000 hours obtained over a period of at least 104 weeks. Hours of experience shall not have been gained more than six years prior to the date the application for licensure was received by the board, except that up to 500 hours of clinical experience fained in the supervised practicum.
Experience may be gained only when the applicant is employed or volunteering in a setting that lawfully and regularly provides mental health counseling or psychotherapy. A private practice, as defined by Section 4980.06, means a type of nonexempt setting that meets all of the following requirements: a) the practice is owned by a health professional independently or jointly who is licensed, and; b) the practices provides clinical mental health services, and c) one or more of the licensed health professions are responsible for the practice and client payment/reimbursement. Only individuals who have received their qualifying master’s degree and are registered as associates may work in a private practice setting. Applicants must keep weekly logs of all hours of experience gained and may claim no more than a total of 40 hours of experience in any seven consecutive days. (Cal. Bus. & Prof. Code § 4980.43.)
The supervised work experience breaks down into the following categories: a minimum of 1,750 hours of direct counseling with individuals, groups, couples or families, that includes not less than 500 total hours of experience in diagnosing and treating couples, families, and children; and a maximum of 1,250 hours of nonclinical practice, consisting of direct supervisor contact administering and evaluating psychological tests, writing clinical reports, writing progress or process notes, client-centered advocacy, and workshops, seminars, training sessions, or conferences directly related to marriage and family therapy that have been approved by the applicant’s supervisor (Cal. Bus. & Prof. Code § 4980.43.)
With respect to supervision, Section 4980.03 of the Business and Professions Code specifies that applicants for the MFT license may be supervised by an LMFT, an LCSW, an LPCC, an LEP (so long as they are only supervising only educationally related mental health services), a licensed psychologist, or a physician or surgeon certified in psychiatry by the American Board of Psychiatry and Neurology. Each of these supervisors must meet additional criteria. The regulations provide that the supervisor must be licensed for at least two years prior to commencing any supervision, that his/her license must be in good standing (i.e., his/her license is not on probation or suspension), and that he/she must have practiced psychotherapy or supervised marriage and family therapist trainees, associate marriage and family therapists, associate professional clinical counselors, or associate clinical social workers for at least two years within the five year period immediately preceding any supervision.
The supervisor is required to provide at least one hour of individual, one hour of triadic, or two hours of group supervision in each week where any qualifying experience is gained. The regulations require a one to five ratio for counseling/psychotherapy hours of experience gained by trainees, and one unit (one individual, one triadic or two group hours) of supervision for the first ten client hours and another unit of supervision for any additional hour above ten in a week gained by registered associate. Applicants for the license must have at least 52 hours of individual or triadic supervision (gained in at least 52 separate weeks). The remainder of supervision may be either individual, triadic or group. Supervision may not be obtained from one’s spouse or relative, nor may it be obtained from a former therapist or from someone with whom the applicant has a personal relationship which undermines the authority or effectiveness of the supervisor. Applicants who work in an exempt setting may receive supervision via videoconferencing. Applicants working in a non-exempt setting may receive supervision via videoconferencing until January 1st, 2026, at which time it will be reviewed for continuation. Applicants are required to have their supervisor sign a Supervision Agreement within 60 days of the commencement of supervision.
The Supervision Agreement is intended to make supervisors and supervisees aware of the responsibilities the supervisor has to the supervisees and the licensing board. Additionally, the regulation requires supervisors to take reasonable steps to ensure that a supervisee properly assesses and examines the patient, implements an appropriate treatment plan, and is acting both within the scope of his/her license and competence. The supervisor is required to monitor the quality of counseling/psychotherapy performed by direct observation, audio or video recording, review of progress and process notes or records, or by any other means deemed appropriate by the supervisor.
B. Licensed Clinical Social Workers
The Clinical Social Worker licensing law, in Section 4996.2 of the Business and Professions Code, requires two years of supervised post-graduate experience. Section 4996.23 further defines this requirement by specifying that the applicant must have at least 3,000 hours of experience, which must be completed within a minimum of two years, in providing clinical social work services consisting of psychosocial diagnosis, assessment, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, research, direct supervisor contact, and workshops, seminars, training sessions or conferences directly related to clinical social work that have been approved by the applicant’s supervisor. The applicant should have a minimum of two years of supervised experience to be obtained over a period of not less than 104 weeks and shall have been gained within the six years immediately preceding the date of which the application for licensure was received by the board.
Students and post-graduate applicants, prior to registration, may work at governmental entities, schools, colleges or universities, nonprofit and charitable corporations and licensed health facilities. Only Registered Associate Clinical Social Workers (ASW) may work in private practice settings. All required supervised experience must be accrued by the applicant while registered with the Board as an ASW. (Cal. Bus. & Prof. Code § 4996.23.)
To qualify for the LCSW license, the law requires a minimum of 2,000 hours of experience in clinical psychosocial diagnosis, assessment, and treatment, including psychotherapy or counseling. Of these 2,000 hours, a minimum of 750 must be face-to-face individual or group psychotherapy. A maximum of 1,000 hours may be gained in client-centered advocacy, consultation, evaluation, and research, direct supervisor contact, and workshops, seminars, training sessions or conferences directly related to clinical social work that have been approved by the applicant’s supervisor. No more than 40 hours of experience may be gained in any given week. ASWs must have at least 52 weeks of individual or triadic supervision, thirteen of which must be supervised by an LCSW. (Cal. Bus. & Prof. Code § 4996.23.1)
Supervision is defined in Section 4996.20 as “ensuring the extend, kind, and quality of counseling performed consistent with the education, training, and experience of the supervisee.” Similar to the MFT licensing laws, ASWs must keep weekly logs of their hours, and must have their supervisors complete the Supervision Agreement. Further, ASWs and supervisors, like MFTs, who assume responsibility for providing supervision to those working toward a license are required to complete and sign a supervisory plan. (16 C.C.R. § 1869.)
To gain hours of experience in a given week, either one hour of individual or triadic supervision or two hours of group supervision is required in that week. An ASW must receive one unit (one individual or two group hours) of supervision for the first ten client hours and another unit of supervision for any additional hour above ten in a week. Applicants who work for exempt settings may receive supervision via video-conferencing. Applicants working in a non-exempt setting may receive supervision via videoconferencing until January 1st, 2026, at which time it will be reviewed for continuation. Insofar as eligible supervisors are concerned, Section 4996.23 specifies that 1,700 hours of experience must be gained under the supervision of an LCSW, and the remaining 1,300 hours may be gained under the supervision of a licensed mental health professional acceptable to the BBS. These mental health professionals are defined in the Regulations as Licensed Marriage and Family Therapists, Licensed Professional Clinical Counselor, Licensed Psychologists, an Licensed Educational Psychologist (up to 1,200 hours so long as they are only supervising only educationally related mental health services), or physicians and surgeon certified in psychiatry by the American Board of Psychiatry and Neurology.
Like the MFT licensing law, supervision may not be obtained from a spouse or relative, nor may it be obtained from someone with whom the applicant has a personal relationship which undermines the authority or effectiveness of the supervision.
C. Licensed Professional Clinical Counselors
The Professional Clinical Counselor licensing laws (Cal. Bus. & Prof. Code § 4999.46) require that supervised work experience be gained post-degree. All hours of supervised work experience must be gained while registered as an active associate professional clinical counselor. The one exception is the supervised work hours gained immediately after graduation, but prior to registration as a PCC intern. These hours may be credited towards licensure experience requirements if the individual applies for registration within 90 days of the qualifying degree conferral date and the experience is obtained at a workplace that, prior to the registration applicant gaining supervised experience hours, requires a completed Live Scan fingerprinting. The individual actually has to receive the registration number in order to count the hours. APCCs cannot work in a private practice setting until officially been issued an associate registration by the board.
Similar to the MFT licensing laws, the PCC licensing laws require PCC interns to complete 3,000 hours of supervised experience in no less than 104 weeks. To gain hours of experience in a given week, either one hour of individual or triadic supervision or two hours of group supervision is required in that week. An APCC must receive one unit (one individual/triadic or two group hours) of supervision for the first ten client hours and another unit of supervision for any additional hour above ten in a week. Of the 104 weeks of supervision, at least 52 weeks must be weeks in which the intern received at least one hour of individual or triadic supervision. A maximum of 40 hours of work experience may be gained in a week. Applicants working in a governmental entity, a school, a college, or a university, or an institution that is both non-profit and charitable may obtain the required direct supervisor contact via videoconferencing. Applicants working in a non-exempt setting may receive supervision via videoconferencing until January 1st, 2026, at which time it will be reviewed for continuation The supervised work experience breaks down into the following categories: a minimum of 1,750 hours of direct counseling with individuals, groups, couples or families; and a maximum of 1,250 hours of nonclinical practice, consisting of direct supervisor contact administering and evaluating psychological tests, writing clinical reports, writing progress or process notes, client-centered advocacy, and workshops, seminars, training sessions, or conferences directly related to professional clinical counseling that have been approved by the applicant’s supervisor (Cal. Bus. & Prof. Code § 4999.46.)
Experience may not be gained under the supervision of a spouse or relative by blood or marriage. Also, experience that is obtained under the supervision of a supervisor with whom the applicant has had or currently has a personal, professional, or business relationship that undermines the authority or effectiveness of the supervision will not be credited toward licensure. (Cal. Bus. & Prof. Code § 4999.12).
The Psychologist licensing law, particularly Section 2914 of the Business and Professions Code, specifies that applicants for the license must complete 3,000 hours of supervised experience, which must be completed within a minimum of two years. (16 C.C.R. § 1387.) At least one year of this experience must be gained after being awarded the doctorate in psychology. A year of supervised professional experience shall consist of not less than 1,500 hours.
The year of supervised experience (1,500 hours) must be completed within thirty consecutive months. When an applicant accumulates all the required experience post- doctorally, it must be completed within a period of sixty consecutive months. With respect to pre-doctoral hours, supervised professional experience may not be accumulated until the applicant has completed 48 semester/trimester or 72 quarter units of graduate level coursework in psychology not including thesis, internship, or dissertation. (16 C.C.R § 1387).
The 1,500 hours of supervised experience that may be obtained prior to the awarding of the doctorate degree may be obtained in a training program approved by a university, college or school that has a training agreement with the educational institution to provide such supervised experience. Predoctoral SPE may be accrued: a) in a formal internship placement accredited by the American Psychological Association (APA), or which is a member of the Association of Psychology Postdoctoral and Internship Centers (APPIC) or the California Psychology Internship Council (CAPIC) and registration with the board is not required, or b) as an employee of an exempt setting (registration with the board is not required); or c) as a registered psychological associate (registration with the board is required); or d) pursuant to a Department of Mental Health Waiver. If the applicant has his or her doctorate and is accruing hours post-doctorally, registration with the Board of Psychology is required unless the applicant is working at one of the exempt settings mentioned above. (16 C.C.R § 1387.
Most post-graduate applicants will need to register with the Board as a Registered Psychological Associate (RPA). A Registered Psychological Associate may gain hours of experience under employment and supervision of a Psychologist. (Cal. Bus. & Prof. Code § 1391.5.)
A Registered Psychological Associate must be under the direction and supervision of a licensed Psychologist who is employed in the same setting as the RPA is employed and be available to the RPA100 percent of the time the RPA is accruing experience hours (16 C.C.R § 1391.6) The supervisor must provide a minimum of one hour per week of individual face-to-face supervision to the RPA. The supervisor must not have a disciplinary action pending against his or her license, is not on probation, has no familial or interpersonal relationship with the supervisee and is otherwise in compliance with the Psychology Licensing Law or the Medical Practice Act and their respective regulations. (16 C.C.R § 1387.1)
For Registered Psychologists, the “primary supervisor” is allowed to delegate a portion of the required supervision to another licensed Psychologist or to suitable alternative supervisors, including LMFTs. (16 C.C.R § 1387 (c).) The primary supervisor shall provide at least 1 hour of face-to-face, direct, individual supervison each week. The trainee should be provided with supervision for 10% of the total time worked each week. Like the MFT licensing law and regulations, a supervisor may not supervise a supervisee who has been a psychotherapy client of the supervisor, and the supervisee must maintain a weekly log of all hours of experience gained toward licensure. (16 C.C.R § 1387.)
With respect to the specific kinds of hours that may be obtained, (i.e., psychotherapy, diagnosis and treatment) the law and regulations do not, in much detail, delineate the required 3,000 hours. The experience gained must, of course, be within the scope of practice of a licensed Psychologist, which is rather broad. For instance, the practice of psychology includes psychological testing and psychological services rendered to organizations (i.e., organizational psychology), and the licensing law specifies that the application of psychological principles and methods is not necessarily restricted to the diagnosis, prevention, and treatment of psychological problems and emotional and mental disorders of individuals and groups.
Additionally, regulations require that the applicant’s supervised professional experience consists of a “planned, structured and administered sequence of professionally supervised, comprehensive clinical training experiences.” The regulations also provide that the professional experience includes “socialization into the profession of psychology and shall be augmented by integrated modalities, including mentoring, didactic exposure, role-modeling, enactment, observational/vicarious learning, and consultative guidance” and “activities which address the integration of psychological concepts and current and evolving scientific knowledge, principles, and theories to the professional delivery of psychological services to the consumer public.” The regulations also provide that the supervised professional experience does not include custodial tasks such as filing, transcribing, or other clerical duties. The lack of specificity as to required kinds of hours permits licensure as a Psychologist without demonstrated experience in the diagnosis and treatment of mental and emotional conditions/disorders. (16 C.C.R § 1387.)
Before obtaining the MFT license, Marriage and Family Therapists must first complete a two-year masters or doctoral degree program accredited by a regionally accepted body such as the Western Association of Schools and Colleges or approved by the California Bureau on Private Post-Secondary and Vocational Education. The law specifies an integrated course of study that includes "marital and family systems approaches to treatment," "developmental issues and life events from infancy to old age," and "a variety of approaches to the treatment of children."
Marriage and family therapists earn their license through a rigorous education, training and licensing process similar to other mental health professionals.
Applicants for the license must also complete 3,000 hours of supervised experience. Many often choose to complete a portion of the hours during the degree program to integrate their coursework with insights born of practical experience and apply the coursework while it is being learned. Post-degree registered interns may train with a qualified supervisor in governmental entities, schools, colleges, or universities as well as licensed health facilities, non-profit and charitable corporations and private practices.;
An emphasis of the marriage and family therapist's training is diagnosis and treatment of psychopathology from a family system and relationship perspective. The MFT's integrated course of study also trains generally in a variety of other theoretical frameworks and in the use of various psychotherapeutic techniques. Students also have specific training, amongest other things in alcoholism and chemical dependency issues, human sexuality, psychopharmacology and child abuse detection and treatment. They may also obtain experience in administering and evaluating psychological tests.
Marriage and Family Therapists are licensed by the State of California pursuant to the Healing Arts Division of the California Business and Professions Code (beginning with Section 4980). The Board of Behavioral Sciences (BBS) is the licensing and regulatory body for LMFTs as well as for clinical social workers and educational psychologists. The MFT licensing exams, which are occupationally-oriented competency-based tests, are a challenging undertaking. Among other key competencies, applicants are tested for their ability to assess, diagnose and treat a range of presenting problems.;
If you would like to read more about how the qualifications of Licensed Marriage and Family Therapists compare to other mental health practitioners, such as Clinical Social Workers and Psychologists, read How Do LMFTs Stack Up.
CAMFT Members have met the stringent education and training requirements that qualify them for Marriage and Family Therapist licensure. Membership in CAMFT indicates a Marriage and Family Therapist's dedication to their professional development. Members of CAMFT are expected to be familiar with and abide by the CAMFT Ethical Standards for Marriage and Family Therapists and by applicable California laws and regulations governing the conduct of Marriage and Family Therapists, Associate MFTs and trainees.
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