Catherine Atkins, JD
Deputy Executive Director
The Therapist
July/August 2015

Over the last few years, it has become increasingly difficult to become a Licensed Marriage and Family Therapist (LMFT) in California. The specific categories of hours for licensure (aka “buckets”) have increased in complexity and shifted in composition to the point where Board of Behavioral Sciences (BBS) evaluators need special training above and beyond their training for other licensure evaluation, and some pre-licensees seek the assistance of private companies to help navigate this challenging system. Moreover, each time there is a hiring freeze or work furlough within the BBS, the backlog of examination eligibility review for LMFTs becomes draconian, most recently reaching 11 months to review each application.

LMFTs have a complex matrix of maximums, minimums, incentive-countings, and various other ratios with no real purpose related to consumer protection. Despite the fact that LMFTs are the only licensure that can count 1,300 hours pre-degree, the BBS estimates it is taking LMFTs 3.4 years after registration to complete their hours. In comparison, it only takes LCSWs 3.1 years (with no hours gained prior to graduation).

License Type Supervised Experience Requirements

Based on concerns mentioned, there has been discussion by the BBS, as well as affected professional organizations, that the current road to licensure for LMFTs is over complicated and inefficient without any substantial policy or consumer protection reason. Therefore, in November 2013, a Supervision Committee was appointed by the BBS to conduct a holistic review of the current requirements for supervised work experience and requirements for supervisors. The result of this year-long stakeholder review are the following changes, which have been embodied in SB 620 (2015):

• Minimum of 1,750 hours of Direct Counseling with Individuals, Groups, Couples or Families. This is the mental health counseling or psychotherapy that a pre-licensee provides his/her client(s).
   
• Maximum of 1,250 hours of Non-Clinical Experience. These hours may be gained performing any combination of the following activities:
  • Direct Supervisor Contact (Removes maximum of 1,000 hours)
  • Administering/Evaluating Psychological Tests (Removes maximum of 500 hours)
  • Writing Clinical Reports (Removes maximum of 500 hours)
  • Writing Progress or Process Notes (Removes maximum of 500 hours)
  • Client-Centered Advocacy (Removes maximum of 500 hours)
  • Workshops, Seminars, Training, Conferences (Removes maximum of 250 hours)
     
• Maximum of 750 hours of counseling and supervisory contact for Trainees.
   
• Maximum of 1,300 pre-degree hours for Trainees.
   
• Minimum of 500 hours of experience in treating couples, families, and children.
   
• Removes the maximum of 500 hours of group therapy.
   
• Removes the maximum of 375 hours gained via tele-health.
   
• Removes the incentive for double-counting hours performed providing treatment of couples or families toward the total hours required in the category of “Diagnosing and Treating Couples, Families or Children.”
   
• Removes incentive for personal psychotherapy hours obtained by the applicant.

If passed, this bill would take effect January 1, 2016 and would change how experience is evaluated immediately. Although the requirements are not changing in a way that would impact most applicants’ ability to qualify, a phase-in period is necessary. The language includes a grace period that would ensure that no applicant is disenfranchised by the change in requirements by needing to earn additional hours. This bill was amended, at CAMFT’s request, to allow an individual who submits an application for examination eligibility between January 1, 2016 and December 31, 2020, to alternatively qualify under the experience requirements that were in place on January 1, 2015. CAMFT will monitor the phase-in period timeframes to assess whether in fact the new system does streamline the process as expected.

When this bill was first introduced there was concern expressed about the removal of the double counting of couples and families, as well as the triple counting of personal psychotherapy hours. The double counting of couples and families hours was actually inserted into the licensing law in January 1, 2010, temporarily to assist in determining applicants desire to focus on couples and family work specifically (versus individual) and was slated to be removed in the following few years. Accordingly, it is an appropriate time to remove this incentive.

While CAMFT generally believes that personal psychotherapy does in fact positively impact an applicant’s training, whether that acquired personal psychotherapy should count towards licensure has been highly debated both by members and stakeholders. There is agreement that personal psychotherapy can be a helpful method for shaping well-rounded and experienced psychotherapists, however, those who advocate against counting personal psychotherapy hours argue it is difficult to advocate parity for LMFTs when LMFTs are the only licensees whose personal psychotherapy applies toward licensure (with a triple count incentive)—the argument is that the LMFT has less experience than other licensures. Moreover, most states will not recognize personal psychotherapy as acceptable hours towards licensure, making it more difficult for those attempting to transfer their license outside of California. Given these two arguments, the BBS determined it was in the best interests of LMFTs, and the consumer, to remove the personal psychotherapy hours incentive. CAMFT is hopeful that Master’s programs will continue to encourage Trainees to obtain personal psychotherapy as we believe it is a benefit to both provider and patient.

The BBS believes the benefits of this overhaul include the following: supervisors having additional flexibility when determining type of experience, less complexity facilitating a better understanding of experience and supervision requirements, applicants could better obtain and track hours of experience, the requirements would be more in-line with the other therapy professions, and the BBS could evaluate/process applications more efficiently.

The 2014/2015 Board of Directors voted to support this legislation based on the belief that the bill’s pros outweighed its cons. To review the legislation in its entirety, visit www.leginfo.ca.gov.

As of July 2, 2015, the bill had passed the Senate and was at the Assembly Appropriations Committee.

For questions about SB 620, please feel free to call CAMFT and ask to speak to the legal department.

Catherine L. Atkins, JD, is a Staff Attorney and the Deputy Executive Director at CAMFT. Cathy is available to answer members’ questions regarding legal, ethical, and licensure issues.