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Montana Marriage & Family Therapy — Requirements & Free Practice

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Licensed Marriage and Family Therapist (LMFT)

Full Montana marriage and family therapy license. Statutory practice exemptions are governed by 37-39-303; emergency volunteer recognition is separately registered under 10-3-118.

Licensing authority: Montana Board of Behavioral Health · Application information

Annual active license renewal
No examination is required for this applicant pathway.
Continuing education
Obtain 20 CE hours annually after the first renewal; carry forward at most 20 hours. At least two hours must address suicide risk assessment and safety planning in each odd year. The first renewal is exempt from CE under ARM 24.219.435(5). Retain CE documentation and comply with audits and cure requirements.
Renewal
Submit a completed timely renewal with the fee by December 31 each year.

Official no-examination sources

Effective from 2026-09-22.

Full licensure following candidacy
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Candidate status
Hold an LMFT candidate license, complete the supervised work experience, and apply for full licensure on passage of an approved examination, as required by 37-39-307(5).
Education
Meet ARM 24.219.701: at least a master’s degree in marriage and family counseling from a CACREP- or COAMFTE-accredited program, or a master’s degree from an accredited institution with at least 60 semester/90 quarter hours, including at least 48 semester/72 quarter hours covering each of the six specified subject areas. A graduate allied-field program that the Board finds equivalent is permitted by 37-39-311(2)(a)(ii).
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Supervisor
Use an active, good-standing LCSW, LCPC, LMFT, licensed psychologist, or licensed and board-certified psychiatrist. New supervisors from August 22, 2026 must have three post-candidate licensed years and Board-approved supervision training of one graduate semester credit or 20 hours, taken after their graduate program and candidacy. Supervisors who supervised in Montana before August 22, 2026 retain the training exception in ARM 24.219.421(3).
Conversion to inactive status
No examination is required for this applicant pathway.
Current license
Hold an active LMFT license.
Maintenance
Notify address changes and pay the inactive renewal fee annually.
Practice
Inactive licensees may not practise.
Request
Request inactive status on the renewal form or inform the department.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement with an education deficiency
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Board review
The Board determines whether the applicant’s actual qualifications and experience address the deficiency under 37-1-304(2). The checklist lists no additional examination sitting for Option 3; 37-39-311(2)(b) and ARM 24.219.403 identify the approved examination.
Education
Hold a master’s degree in this profession from an accredited institution with at least 48 semester/72 quarter credits.
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
Existing license
Hold a current, active LMFT license in good standing in another jurisdiction.
Experience equivalence
Complete 10,000 hours of post-degree professional experience in addition to the supervised work experience, under ARM 24.219.402(4), effective August 22, 2026. This replaces the five-year wording of the July 17, 2025 checklist.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Licensure by endorsement from a substantially equivalent jurisdiction
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Checklist statement
The July 17, 2025 checklist, LMFT Option 2, states: "Equivalent out-of-state license Current, active, in good standing from a state with standards substantially equivalent to Montana’s." It lists no additional examination sitting in that option. Examination passage is retained under 37-39-311(2)(b), with the approved examination identified by ARM 24.219.403(1)(e).
Equivalence
The Board assesses comparable education, examination, and experience qualifications at the time of application under 37-1-304. ARM 24.219.413(3) treats applications from substantially equivalent jurisdictions as routine on those three requirements; other nonroutine issues remain possible.
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
Existing license
Hold a current, active LMFT license in good standing in another jurisdiction.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Licensure by endorsement with other non equivalent qualifications
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Board review
Under 37-1-304(2), the Board must determine whether the applicant’s actual qualifications and work experience address a deficiency in substantial equivalence. The July 17, 2025 checklist, LMFT Option 4, states: "Other non-equivalent out-of-state license Subject to board review and approval."
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
Examination evidence
The current approved LMFT examination remains AMFTRB under 37-39-311(2)(b) and ARM 24.219.403(1)(e); the Board evaluates the applicant’s actual examination qualifications as part of endorsement.
Existing license
Hold a current, active LMFT license in good standing in another jurisdiction.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Annual renewal in inactive status
No examination is required for this applicant pathway.
Renewal
Pay the inactive renewal fee annually and inform the department of address changes to avoid expiration or termination.
Status
Hold an inactive LMFT license and do not practise.

Official no-examination sources

Effective from 2026-09-22.

Conversion of inactive license to active status
No examination is required for this applicant pathway.
Active practice
Must not have been out of active practice for more than five years.
Continuing education
Complete ten CE hours for every inactive year within the 24 months before conversion, as required by ARM 24.219.430(4).
Form statement
The May 5, 2025 Board form asks for CE for each year or partial year, licence verifications for licences held during the inactive period, disciplinary documents if applicable, and staff requests. Its reference to respective renewal cycles does not replace the controlling rule’s 24-month window.
Request
Request conversion and pay the required fee.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure with experience substituted for educational requirements
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Education equivalence
Under 37-39-311(2)(a)(iii), additional postdegree experience defined by Board rule may substitute for the specified degree requirements. The July 17, 2025 LMFT Option 1 checklist states: "Lesser education plus experience Subject to board review and approval."
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Supervisor
Use an active, good-standing LCSW, LCPC, LMFT, licensed psychologist, or licensed and board-certified psychiatrist. New supervisors from August 22, 2026 must have three post-candidate licensed years and Board-approved supervision training of one graduate semester credit or 20 hours, taken after their graduate program and candidacy. Supervisors who supervised in Montana before August 22, 2026 retain the training exception in ARM 24.219.421(3).
Initial licensure by examination
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Education
Meet ARM 24.219.701: at least a master’s degree in marriage and family counseling from a CACREP- or COAMFTE-accredited program, or a master’s degree from an accredited institution with at least 60 semester/90 quarter hours, including at least 48 semester/72 quarter hours covering each of the six specified subject areas. A graduate allied-field program that the Board finds equivalent is permitted by 37-39-311(2)(a)(ii).
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Supervisor
Use an active, good-standing LCSW, LCPC, LMFT, licensed psychologist, or licensed and board-certified psychiatrist. New supervisors from August 22, 2026 must have three post-candidate licensed years and Board-approved supervision training of one graduate semester credit or 20 hours, taken after their graduate program and candidacy. Supervisors who supervised in Montana before August 22, 2026 retain the training exception in ARM 24.219.421(3).
Reactivation of an expired license
No examination is required for this applicant pathway.
Ongoing qualifications
Obtain 20 CE hours annually after the first renewal; carry forward at most 20 hours. At least two hours must address suicide risk assessment and safety planning in each odd year. The first renewal is exempt from CE under ARM 24.219.435(5). Retain CE documentation and comply with audits and cure requirements.
Prior status
Previously held the corresponding Montana LMFT license.
Reactivation
Reactivate within two years after renewal; submit completed renewal, current and late fees, and meet accrued certification and education requirements. An expired license may not be used to practise; a mandatory CE audit applies under 37-1-306(2).

Official no-examination sources

Effective from 2026-09-22.

Reactivation of a lapsed license
No examination is required for this applicant pathway.
Ongoing qualifications
Obtain 20 CE hours annually after the first renewal; carry forward at most 20 hours. At least two hours must address suicide risk assessment and safety planning in each odd year. The first renewal is exempt from CE under ARM 24.219.435(5). Retain CE documentation and comply with audits and cure requirements.
Prior status
Previously held the corresponding Montana LMFT license.
Reactivation
Reactivate within 45 days after renewal; submit the completed renewal, current fee, late fee, and applicable certification and education compliance.

Official no-examination sources

Effective from 2026-09-22.

New original licensure after termination
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Education
Meet ARM 24.219.701: at least a master’s degree in marriage and family counseling from a CACREP- or COAMFTE-accredited program, or a master’s degree from an accredited institution with at least 60 semester/90 quarter hours, including at least 48 semester/72 quarter hours covering each of the six specified subject areas. A graduate allied-field program that the Board finds equivalent is permitted by 37-39-311(2)(a)(ii).
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Termination
A license not renewed within two years terminates and cannot be reactivated. Apply for a new original license and satisfy current new-application requirements, including the applicable licensing examination under ARM 24.101.408(2)(c).
Restoration following activated reservist inactive status
No examination is required for this applicant pathway.
Activation
For an activated reservist with federal orders for at least 90 consecutive days, report activation with a copy of orders and request inactive status.
During service
For the documented active-duty period, the agency may not collect licensing or CE fees, require CE reports or classes, or permit lapse for failure to meet those requirements.
Return
Send discharge documents. The Board compares military position, duties and time in service to licensing requirements and may restore the license, attach individual conditions, or suspend or revoke it. Individual conditions and hearing rights under 37-1-138(5) apply.

Official no-examination sources

Effective from 2026-09-22.

Full licensure by military reciprocity
No examination is required for this applicant pathway.
Equivalence
For full licensure under 37-1-147(2)(a), the Board determines the other jurisdiction’s licensure requirements are substantially equivalent. Section 37-1-304(1) expressly excepts the 37-1-147 military route.
Existing license
Hold a professional licence or certification in good standing in another state or United States territory. Pending charges, final disciplinary action, or lack of good standing disqualify this statutory route.
Military eligibility
Meet the military member, military spouse, transfer/relocation, or honorable-discharge eligibility described in 37-1-147(1)(b)-(d).

Official no-examination sources

Effective from 2026-09-22.

Full licensure following a military temporary license
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Education
Meet ARM 24.219.701: at least a master’s degree in marriage and family counseling from a CACREP- or COAMFTE-accredited program, or a master’s degree from an accredited institution with at least 60 semester/90 quarter hours, including at least 48 semester/72 quarter hours covering each of the six specified subject areas. A graduate allied-field program that the Board finds equivalent is permitted by 37-39-311(2)(a)(ii).
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
Examination condition
When full licensure is established as a new LMFT applicant, the approved examination is AMFTRB under 37-39-311 and ARM 24.219.403; the Board determines which deficiencies the applicant must remedy.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Temporary license
Hold the temporary license authorized by 37-1-147(2)(b) and complete the Board’s specific requirements for full licensure.

Provisional Marriage and Family Therapist License with Reservation of Rights

The Board describes an active, full provisional license for 60 days while licence verification is completed, once all other licensing requirements are met.

Licensing authority: Montana Board of Behavioral Health · Application information

Provisional issuance pending verification — education deficient endorsement
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Board review
The Board determines whether the applicant’s actual qualifications and experience address the deficiency under 37-1-304(2). The checklist lists no additional examination sitting for Option 3; 37-39-311(2)(b) and ARM 24.219.403 identify the approved examination.
Education
Hold a master’s degree in this profession from an accredited institution with at least 48 semester/72 quarter credits.
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
Existing license
Hold a current, active LMFT license in good standing in another jurisdiction.
Experience equivalence
Complete 10,000 hours of post-degree professional experience in addition to the supervised work experience, under ARM 24.219.402(4), effective August 22, 2026. This replaces the five-year wording of the July 17, 2025 checklist.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Pending verification
All other licensing requirements must be met. The Board may issue a provisional license with a reservation of rights while completing license verification; the Board describes it as an active, full license for 60 days.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Provisional issuance pending verification — equivalent endorsement
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Checklist statement
The July 17, 2025 checklist, LMFT Option 2, states: "Equivalent out-of-state license Current, active, in good standing from a state with standards substantially equivalent to Montana’s." It lists no additional examination sitting in that option. Examination passage is retained under 37-39-311(2)(b), with the approved examination identified by ARM 24.219.403(1)(e).
Equivalence
The Board assesses comparable education, examination, and experience qualifications at the time of application under 37-1-304. ARM 24.219.413(3) treats applications from substantially equivalent jurisdictions as routine on those three requirements; other nonroutine issues remain possible.
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
Existing license
Hold a current, active LMFT license in good standing in another jurisdiction.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Pending verification
All other licensing requirements must be met. The Board may issue a provisional license with a reservation of rights while completing license verification; the Board describes it as an active, full license for 60 days.
Provisional issuance pending verification — initial
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Education
Meet ARM 24.219.701: at least a master’s degree in marriage and family counseling from a CACREP- or COAMFTE-accredited program, or a master’s degree from an accredited institution with at least 60 semester/90 quarter hours, including at least 48 semester/72 quarter hours covering each of the six specified subject areas. A graduate allied-field program that the Board finds equivalent is permitted by 37-39-311(2)(a)(ii).
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Pending verification
All other licensing requirements must be met. The Board may issue a provisional license with a reservation of rights while completing license verification; the Board describes it as an active, full license for 60 days.
Supervised experience
Complete 3,000 supervised practice hours, including 1,000 face-to-face client-contact hours. Up to 500 approved degree-program hours may be pre-degree. Current ARM 24.219.704 additionally requires at least 1,000 post-degree client-contact hours, at least half with couples and families, a 20:1 contact-to-supervision ratio, the 25-hour individual supervision requirement with at least 75% individual supervision, groups of no more than six candidates, at least 40 face-to-face supervision hours including 38 individual hours and at least 20 with each supervisor, and 25 supervision hours using raw clinical data.
Provisional military reciprocity issuance pending verification
No examination is required for this applicant pathway.
Equivalence
For full licensure under 37-1-147(2)(a), the Board determines the other jurisdiction’s licensure requirements are substantially equivalent. Section 37-1-304(1) expressly excepts the 37-1-147 military route.
Existing license
Hold a professional licence or certification in good standing in another state or United States territory. Pending charges, final disciplinary action, or lack of good standing disqualify this statutory route.
Military eligibility
Meet the military member, military spouse, transfer/relocation, or honorable-discharge eligibility described in 37-1-147(1)(b)-(d).
Pending verification
All other military reciprocity requirements are met; the Board may issue the 60-day provisional license while completing the outstanding license verification.

Official no-examination sources

Effective from 2026-09-22.

Provisional issuance pending verification — other deficient endorsement
AMFTRB Marital and Family Therapy National Examination
Application
Submit a completed application and initial licence fee, with verification of applicable education, examination, and experience requirements.
Background check
Complete an FBI fingerprint background check within six months of the application date; the Board determines suitability for licensure.
Board review
Under 37-1-304(2), the Board must determine whether the applicant’s actual qualifications and work experience address a deficiency in substantial equivalence. The July 17, 2025 checklist, LMFT Option 4, states: "Other non-equivalent out-of-state license Subject to board review and approval."
Exam approval
A complete applicant or issued candidate may request examination registration approval. Examination-owner standards and timelines apply. More than three attempts require approval and a specific study plan.
Examination evidence
The current approved LMFT examination remains AMFTRB under 37-39-311(2)(b) and ARM 24.219.403(1)(e); the Board evaluates the applicant’s actual examination qualifications as part of endorsement.
Existing license
Hold a current, active LMFT license in good standing in another jurisdiction.
License verification
Every jurisdiction in which the applicant has ever been licensed must send current verification directly to the Board.
Pending verification
All other licensing requirements must be met. The Board may issue a provisional license with a reservation of rights while completing license verification; the Board describes it as an active, full license for 60 days.

AMFTRB Marital and Family Therapy National Examination

Provider
Association of Marital and Family Therapy Regulatory Boards (AMFTRB); administered for AMFTRB by Professional Testing Corporation (PTC) at Prometric computer-based testing centers
Format
Computer-based examination of objective multiple-choice questions, each with four alternative answers of which only one is correct; given during a one-week testing window every month; scores on the six domains and the total examination are reported after the window closes
Exam questions
180 multiple-choice items
Time limit
4 hours total testing time
Passing score
Criterion-referenced passing score set on an anchor examination by a modified Angoff method and adjusted across forms by equating; the reported score equals the total number of correct responses
Exam fee
US $370.00 examination fee (includes testing center fees)
Examination outline
  • Domain 01 — The Practice of Systemic Therapy — Tasks related to incorporating systemic theory and perspectives into practice activities, and establishing and maintaining ongoing therapeutic relationships with the client system inclusive of diverse cultural contexts. (16%; 29 items) (16%)
    • 01.01 Conceptualize therapy consistent with the philosophical perspectives of systemic theory.
    • 01.02 Maintain consistency between systemic theory and clinical practice.
    • 01.03 Integrate individual treatment approaches with systemic treatment approaches.
    • 01.04 Integrate multiple dimensions of diversity and social justice theories with systemic treatment approaches.
    • 01.05 Use a systemic perspective to co-create a safe, inclusive, and non-judgmental space.
    • 01.06 Use a systemic perspective to co-create a therapeutic relationship with the client system.
    • 01.07 Use a systemic perspective to understand the complexities inherent in therapeutic interactions (e.g., family homeostasis, self of the therapist).
  • Domain 02 — Assessing, Hypothesizing, and Diagnosing — Tasks related to assessing and conceptualizing the various dimensions of the client system inclusive of diverse cultural contexts, including forming and reformulating systemic hypotheses and diagnosing the client system to guide therapeutic activities and interventions, including use of artificial intelligence (AI) as appropriate. (16%; 29 items) (16%)
    • 02.01 Assess the client system’s verbal and non-verbal communication styles to develop hypotheses about relationship patterns, perceptions, and responses to the reciprocal influence of relational patterns and the presenting issues.
    • 02.02 Assess the mental status of clients.
    • 02.03 Assess historic and current self-injurious behavior, suicidal ideation and intent, and/or homicidal ideation and intent.
    • 02.04 Identify and assess behavioral dynamics, processes, and interactional patterns (e.g., boundaries, roles, rules, alliances, coalitions, and hierarchies) within the client system to determine systemic functioning.
    • 02.05 Formulate and continually assess hypotheses regarding the client system that consider and incorporate diverse contexts.
    • 02.06 Assess appropriateness of potential treatment and therapeutic delivery modalities for the client system.
    • 02.07 Assess environmental factors (e.g., discrimination, gang violence, migration) affecting the client system.
    • 02.08 Assess the client system’s levels of economic, social, emotional, physical, spiritual, and cognitive functioning.
    • 02.09 Assess historic and current effects of substance use disorders on the functioning of the client system.
    • 02.10 Assess historic and current effects of violence or trauma, including vicarious trauma, on the client system.
    • 02.11 Assess historic and current effects of childhood experiences and traumas on the client system.
    • 02.12 Assess historic and current effects of impact of process use disorders (e.g., gambling, internet use, technology use, shopping) on functioning of the client system.
    • 02.13 Assess historic and current effects of sexual functioning on the client system.
    • 02.14 Assess how the developmental and family life cycle stages of the client system impact problem formation, maintenance, and resolution.
    • 02.15 Assess strengths, resources, coping skills, and resilience within and available to the client system.
    • 02.16 Select, administer, review, and/or interpret results of standardized instruments within the therapist’s training, competence, and scope of practice.
    • 02.17 Assess and diagnose clients in accordance with current DSM and ICD diagnostic criteria while maintaining a systems perspective.
    • 02.18 Formulate treatment hypotheses that integrate systemic perspectives, assessment inventories, and diagnostic impressions.
    • 02.19 Assess effects of occupational issues on the client system (e.g., military personnel, workers in geographically dispersed locations, first responders).
    • 02.20 Collaborate with the client system to determine need for evaluation by other professional and community systems.
    • 02.21 Collaborate with professional and community systems as appropriate in making diagnoses and establishing treatment priorities.
    • 02.22 Collaborate with the client system to refer as appropriate based on diagnoses and treatment priorities.
  • Domain 03 — Designing and Conducting Treatment — Tasks related to developing and implementing a course of culturally responsive treatment with the client system, including identifying possible therapeutic models, implementing associated interventions, and treatment planning, including use of artificial intelligence (AI) as appropriate. (17%; 30 items) (17%)
    • 03.01 Evaluate and maintain a quality therapeutic alliance with the client system.
    • 03.02 Establish therapeutic contracts.
    • 03.03 Utilize assessment information to develop a treatment plan that reflects a contextual understanding of the presenting issue.
    • 03.04 Determine relevant short-term goals, long-term goals and objectives for treatment, as well as criteria for successful completion of treatment.
    • 03.05 Identify the client system’s previous and current attempts to resolve the presenting issues.
    • 03.06 Identify members of client and collateral systems involved in resolving issues.
    • 03.07 Develop and monitor ongoing safety plan to address identified safety risks for the client in all therapeutic delivery contexts.
    • 03.08 Engage in therapeutic interventions based on theory and current research and a shared contextual understanding of the client system and presenting issues.
    • 03.09 Clarify with the client system the rationale for selecting therapeutic interventions as appropriate.
    • 03.10 Collaborate with the client system to determine sequence of treatment and identify which members will be involved.
    • 03.11 Develop and monitor recovery-oriented systemic care for treatment of substance use disorders.
    • 03.12 Use genograms and/or family mapping as therapeutic interventions as indicated.
    • 03.13 Facilitate client system change through restructuring and reorganization.
    • 03.14 Collaborate with the client system to identify and explore competing priorities of client issues to be addressed in treatment.
    • 03.15 Assist the client system in developing decision-making, coping, and effective verbal and non-verbal communication skills in their relational contexts.
    • 03.16 Attend to the homeostatic process and its impact on the client system’s ability to attain therapeutic goals.
    • 03.17 Assist the client system in developing alternative perspectives of the presenting issues to facilitate solutions.
    • 03.18 Influence client behavior and perceptions through use of metaphor, rewriting narratives, mindfulness, etc.
    • 03.19 Integrate cultural, spiritual, social, intellectual, and biological characteristics and strengths of the client system when devising effective treatment strategies.
    • 03.20 Recognize and support client autonomy when devising effective treatment strategies.
    • 03.21 Maintain awareness of common side effects of medications, monitor client system for these within the boundaries of professional competence, and coordinate care with any relevant prescribers.
    • 03.22 Adapt therapeutic stance and interventions to accommodate the process and structure of all therapeutic delivery modalities.
  • Domain 04 — Evaluating Ongoing Process and Terminating Treatment — Tasks related to continuously evaluating the therapeutic process, incorporating feedback into the course of treatment, and planning for termination, inclusive of different cultural contexts and use of artificial intelligence (AI) as appropriate. (16%; 29 items) (16%)
    • 04.01 Use theory and current research in the ongoing evaluation of process, outcomes, and termination.
    • 04.02 Evaluate the progress of therapy in collaboration with client and collateral systems as indicated.
    • 04.03 Modify treatment plan in collaboration with client and collateral systems as indicated.
    • 04.04 Continually evaluate client system appropriateness for all therapeutic delivery modalities.
    • 04.05 Develop a termination plan in collaboration with the client and collateral systems to maintain therapeutic gains after treatment has ended.
    • 04.06 Terminate therapeutic relationship in a professional and culturally responsive manner.
  • Domain 05 — Managing Crisis Situations — Tasks related to assessing and managing emergency situations, inclusive of different cultural contexts, and intervening when clinically indicated and/or legally mandated. (16%; 29 items) (16%)
    • 05.01 Assess impairment in the client system during crisis situations to determine if and what immediate interventions may be needed.
    • 05.02 Assess for presence of suicidal ideation and determine the level of intervention.
    • 05.03 Assess for risk of violence toward the client from others to determine the need for intervention.
    • 05.04 Assess the client’s potential for self-injurious behavior to determine level of intervention.
    • 05.05 Assess the client’s potential for violence or harm toward others, including the therapist, to determine level of intervention.
    • 05.06 Assess risk of violence toward therapist from sources outside of the client system and develop a safety plan.
    • 05.07 Assess impact of community-level crisis on client system and develop interventions as they pertain to that crisis.
    • 05.08 Assess the impact of client system’s trauma history and other relevant contextual factors on current crisis.
    • 05.09 Collaborate with other relevant stakeholders in managing client system’s crisis.
    • 05.10 Respond to emerging crisis as appropriate to the therapeutic delivery modality and use relevant crisis resources.
  • Domain 06 — Maintaining Ethical, Legal, and Professional Standards — Tasks related to ongoing adherence to legal and ethical codes and treatment agreements, maintaining culturally responsive competency, upholding professional standards, and utilizing artificial intelligence (AI) in clinical practice. (19%; 34 items) (19%)
    • 06.01 Demonstrate professional responsibility and competence regarding legal issues and regulations across therapeutic delivery modalities, including use of artificial intelligence (AI).
    • 06.02 Compare agency and employment policies with relevant ethics code, statutes, case law, and regulations and privilege the higher standard.
    • 06.03 Integrate current ethical codes of licensing boards, relevant professional organizations, and associations into appropriate professional practice.
    • 06.04 Adhere to relevant business laws related to clinical practice (e.g., Stark Law, Anti-Kickback Statute, False Claims Act, etc.)
    • 06.05 Practice within therapist’s scope of competence.
    • 06.06 Maintain awareness of and effectively manage how the therapist’s personal issues, life experiences, values and morals, and previous trauma impact the therapeutic process.
    • 06.07 Maintain awareness of and effectively manage how the supervisors’ personal issues, life experiences, values and morals, and previous trauma influence the supervisory process
    • 06.08 Adhere to treatment agreements with client systems and respect the rights of clients.
    • 06.09 Provide the client system with written professional disclosures regarding fees, credentials, reporting complaints, confidentiality, privileged communication, and providing technologically assisted services, including use of artificial intelligence (AI), etc.
    • 06.10 Confirm the client system’s identities, locations, and safety levels at the beginning of each teletherapy session.
    • 06.11 Monitor and mitigate risk for potential exploitation of the client system by the therapist.
    • 06.12 Consult with colleagues and other professionals as necessary regarding ethical and legal issues, and document these consultations.
    • 06.13 Respect the roles and responsibilities of other professionals involved in the client system’s treatment process as they relate to ethical and legal issues.
    • 06.14 Maintain accurate and timely records including long-term safe and confidential storage and plan record transfer and/or disposal within timeframes specified by current statutes.
    • 06.15 Adhere to ethical and regulatory guidelines for engaging in the supervisor-supervisee relationship across modalities.
Examination sources