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South Carolina Marriage & Family Therapy — Requirements & Free Practice

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Licenses, application pathways and examination requirements

Each license and applicant pathway has its own requirements and exemptions. Choosing practice questions does not determine your eligibility.

Licensed Marriage and Family Therapy Associate

Post-degree supervised practice license issued after education and examination requirements; supervised experience remains to be completed.

Licensing authority: South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, Addiction Counselors and Psycho-Educational Specialists · Application information

Restoration following a court incompetency suspension
No examination is required for this applicant pathway.
Board terms
Satisfy the Board order governing restoration and ability to practice. Court and health-capacity determinations are conditions, not licensing examinations.
Court status
The license was automatically suspended after a court adjudged the holder mentally incompetent; subsequently obtain a competent-jurisdiction court adjudication of competency.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after suspension for dishonored fee payment
No examination is required for this applicant pathway.
Payment
Pay the required fee and applicable statutory or regulatory penalties to reinstate.
Suspension
The Department suspended this license after a dishonored payment and notice.

Official no-examination sources

Effective from 2026-09-22.

Extension of the two year associate license
No examination is required for this applicant pathway.
Application
Apply for an extension before expiration and explain the reason. The existing license and examination history are conditions of continuation.
Existing associate
Already hold an associate license and have not finished post-master clinical requirements within two years.
Supervision documents
Submit the completed-hours confirmation, supervision log and updated plan. The Board page excuses the MFTA plan, confirmation and log forms when continuing with the same supervisor; when changing supervisors, request removal of the former supervisor and submit the new documents.

Official no-examination sources

Effective from 2026-09-22.

Associate licensure with Board approved foreign education
AMFTRB Marital and Family Therapy National Examination
Application
Submit the Board application, fee, identity and Social Security documentation, applicable legal name-change documents and lawful-presence verification.
Education
Satisfy Regulation 36-07: a minimum 60 graduate semester-hour COAMFTE-accredited or CACREP marriage, couple and family counseling specialty program, or its listed graduate/post-degree and substantially similar educational standards approved by the Board. Submit official transcripts and, when applicable, coursework and clinical-contact verification.
Exam timing
Pass the National Marriage and Family Therapy Examination. Previously passed scores may be submitted; PTC examination registration instructions are sent after the Board approves education and the application.
Foreign education
The Board may accept foreign education only when all Article 1 requirements are met and experience, command of English and the academic program meet a relevant accredited United States program standard. Acceptance treats the education as accredited; it does not waive the examination.
Military education credit
Section 40-1-640 applies satisfactory military education, training and experience in the manner most favorable toward qualifications; other licensing and examination requirements remain applicable.
Supervision plan
A Board-satisfactory clinical supervision plan may accompany the application or follow employment, but must be approved before providing therapy services as an associate.
Reinstatement after impairment related suspension
No examination is required for this applicant pathway.
Disciplinary ineligibility
Complete any definite period of ineligibility, or the requirements and Board determination for an indefinite period, when disciplinary action was initiated.
Health assessment
Mental or physical examinations ordered under Regulation 36-20 are health evaluations: applicant conditions rather than currently offered marriage and family therapy examinations.
Monitoring
Comply with continuing monitoring, Board conditions and at least two years of annual sworn progress reports after the consent agreement ends.
Practice fitness
Demonstrate safe resumption of practice, with approved-provider certification of required inpatient treatment, compliance with aftercare/consent agreement and two approved reports assessing capacity to practice.

Official no-examination sources

Effective from 2026-09-22.

Initial associate licensure by examination
AMFTRB Marital and Family Therapy National Examination
Application
Submit the Board application, fee, identity and Social Security documentation, applicable legal name-change documents and lawful-presence verification.
Education
Satisfy Regulation 36-07: a minimum 60 graduate semester-hour COAMFTE-accredited or CACREP marriage, couple and family counseling specialty program, or its listed graduate/post-degree and substantially similar educational standards approved by the Board. Submit official transcripts and, when applicable, coursework and clinical-contact verification.
Exam timing
Pass the National Marriage and Family Therapy Examination. Previously passed scores may be submitted; PTC examination registration instructions are sent after the Board approves education and the application.
Military education credit
Section 40-1-640 applies satisfactory military education, training and experience in the manner most favorable toward qualifications; other licensing and examination requirements remain applicable.
Supervision plan
A Board-satisfactory clinical supervision plan may accompany the application or follow employment, but must be approved before providing therapy services as an associate.
Reinstatement after voluntary surrender
No examination is required for this applicant pathway.
Board decision
The Board must reinstate by majority vote; meet any conditions imposed by its order.
Practice limit
Do not practice during surrender; surrender does not prevent disciplinary action.
Prior license
Previously held and voluntarily surrendered this South Carolina license while under investigation.

Official no-examination sources

Effective from 2026-09-22.

Licensed Marriage and Family Therapist

Independent marriage and family therapy licensure.

Licensing authority: South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, Addiction Counselors and Psycho-Educational Specialists · Application information

Restoration following a court incompetency suspension
No examination is required for this applicant pathway.
Board terms
Satisfy the Board order governing restoration and ability to practice. Court and health-capacity determinations are conditions, not licensing examinations.
Court status
The license was automatically suspended after a court adjudged the holder mentally incompetent; subsequently obtain a competent-jurisdiction court adjudication of competency.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after suspension for dishonored fee payment
No examination is required for this applicant pathway.
Payment
Pay the required fee and applicable statutory or regulatory penalties to reinstate.
Suspension
The Department suspended this license after a dishonored payment and notice.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement
No examination is required for this applicant pathway.
Application
Submit the approved application and fee, certify reading and understanding the Board statutes, regulations and applicable ethics code, provide lawful-presence verification and other Board-required documents.
Investigations
Have no current or pending investigations where currently licensed; section 40-75-260 prevents licensure during an unresolved disqualifying investigation.
License held elsewhere
Hold a current, active and unrestricted marriage and family therapist license in good standing from another state at an equivalent credential level. The license held elsewhere is an applicant condition.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure with Board approved foreign education
AMFTRB Marital and Family Therapy National Examination
Application
Submit the Board application, fee, identity and Social Security documentation, applicable legal name-change documents and lawful-presence verification.
Associate license
Hold a current, active and unrestricted South Carolina Marriage and Family Therapy Associate license for the ordinary progression route.
Education
Satisfy Regulation 36-07: a minimum 60 graduate semester-hour COAMFTE-accredited or CACREP marriage, couple and family counseling specialty program, or its listed graduate/post-degree and substantially similar educational standards approved by the Board. Submit official transcripts and, when applicable, coursework and clinical-contact verification.
Exam timing
Pass the National Marriage and Family Therapy Examination. Previously passed scores may be submitted; PTC examination registration instructions are sent after the Board approves education and the application.
Foreign education
The Board may accept foreign education only when all Article 1 requirements are met and experience, command of English and the academic program meet a relevant accredited United States program standard. Acceptance treats the education as accredited; it does not waive the examination.
Full license application
Submit the full-license application, fee and completed clinical supervision confirmations and logs.
Military education credit
Section 40-1-640 applies satisfactory military education, training and experience in the manner most favorable toward qualifications; other licensing and examination requirements remain applicable.
Post masters experience
Complete at least 1,500 post-master clinical experience and supervision hours over at least two years: at least 1,380 direct-client hours and 120 supervision hours, including diagnosis and treatment of serious problems.
Supervision format
At least 60 supervision hours must be individual/triadic; the remaining 60 may be individual/triadic or group.
Supervision plan
A Board-satisfactory clinical supervision plan may accompany the application or follow employment, but must be approved before providing therapy services as an associate.
Supervisor approval
A licensed marriage and family therapy supervisor or qualified licensed mental health practitioner must be Board-approved before supervision begins.
Reinstatement after impairment related suspension
No examination is required for this applicant pathway.
Disciplinary ineligibility
Complete any definite period of ineligibility, or the requirements and Board determination for an indefinite period, when disciplinary action was initiated.
Health assessment
Mental or physical examinations ordered under Regulation 36-20 are health evaluations: applicant conditions rather than currently offered marriage and family therapy examinations.
Monitoring
Comply with continuing monitoring, Board conditions and at least two years of annual sworn progress reports after the consent agreement ends.
Practice fitness
Demonstrate safe resumption of practice, with approved-provider certification of required inpatient treatment, compliance with aftercare/consent agreement and two approved reports assessing capacity to practice.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by examination and completion of associate supervised experience
AMFTRB Marital and Family Therapy National Examination
Application
Submit the Board application, fee, identity and Social Security documentation, applicable legal name-change documents and lawful-presence verification.
Associate license
Hold a current, active and unrestricted South Carolina Marriage and Family Therapy Associate license for the ordinary progression route.
Education
Satisfy Regulation 36-07: a minimum 60 graduate semester-hour COAMFTE-accredited or CACREP marriage, couple and family counseling specialty program, or its listed graduate/post-degree and substantially similar educational standards approved by the Board. Submit official transcripts and, when applicable, coursework and clinical-contact verification.
Exam timing
Pass the National Marriage and Family Therapy Examination. Previously passed scores may be submitted; PTC examination registration instructions are sent after the Board approves education and the application.
Full license application
Submit the full-license application, fee and completed clinical supervision confirmations and logs.
Military education credit
Section 40-1-640 applies satisfactory military education, training and experience in the manner most favorable toward qualifications; other licensing and examination requirements remain applicable.
Post masters experience
Complete at least 1,500 post-master clinical experience and supervision hours over at least two years: at least 1,380 direct-client hours and 120 supervision hours, including diagnosis and treatment of serious problems.
Supervision format
At least 60 supervision hours must be individual/triadic; the remaining 60 may be individual/triadic or group.
Supervision plan
A Board-satisfactory clinical supervision plan may accompany the application or follow employment, but must be approved before providing therapy services as an associate.
Supervisor approval
A licensed marriage and family therapy supervisor or qualified licensed mental health practitioner must be Board-approved before supervision begins.
Reinstatement after a lapse of exactly five years
No examination is required for this applicant pathway.
Administrative handling
Regulation 36-15 says fewer than five years and more than five years. Neither phrase includes exactly five. The general statutory reinstatement authority remains applicable; Board handling and additional requirements are conditions, with no identified currently offered licensing examination.
Lapse duration
Exactly five years of lapse.
No unlicensed practice
Provide the notarized no-practice affidavit required of any reinstatement applicant by Regulation 36-15(3).
Statutory authority
Section 40-75-250(E) authorizes reinstatement upon payment of reinstatement and current renewal fees; additional requirements may be imposed by regulation.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after a lapse longer than five years
No examination is required for this applicant pathway.
Application and fees
Submit the reinstatement application, reinstatement fee and current renewal fee.
Board appearance
Appear before the Board, which decides whether to reinstate and sets terms; unspecified terms and discretion are conditions, not invented examinations.
Lapse duration
The license has lapsed for more than five years.
No unlicensed practice
Provide a notarized affidavit that the relevant therapy or supervision practice was not performed while the license was inactive.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after a lapse shorter than five years
No examination is required for this applicant pathway.
Application and fees
Submit the reinstatement application, fees for each lapsed licensing period and the reinstatement fee.
Continuing education
Provide satisfactory proof of required continuing education for each lapsed year; the Board may waive any portion for good cause with appropriate conditions.
Lapse duration
The license has lapsed for fewer than five years.
No unlicensed practice
Provide a notarized affidavit that the relevant therapy or supervision practice was not performed while the license was inactive.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal
No examination is required for this applicant pathway.
Active duty relief
Sections 40-1-610 and 40-1-620 exempt active-duty licensees from continuing education while serving and license fees for a calendar year containing any active-duty service.
Continuing education
Therapists complete 40 hours each biennium: 33 related to the license, six ethics and one suicide assessment, treatment and management hour. First-time licensees are exempt in their initial period. Multiple professional licenses require 50 hours divided as Regulation 36-16 prescribes. Supervisors additionally complete 10 discipline-specific supervision hours; multiple supervision licenses divide those hours among disciplines.
Renewal
Renew every two years with the fee and Board-required continuing education; the Board lists August 31, 2027 as the next deadline.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after voluntary surrender
No examination is required for this applicant pathway.
Board decision
The Board must reinstate by majority vote; meet any conditions imposed by its order.
Practice limit
Do not practice during surrender; surrender does not prevent disciplinary action.
Prior license
Previously held and voluntarily surrendered this South Carolina license while under investigation.

Official no-examination sources

Effective from 2026-09-22.

Temporary Professional License — Marriage and Family Therapy

Temporary military-spouse professional license; the requested credential level and all applicable state-law licensing requirements must be met.

Licensing authority: South Carolina Board of Examiners for Licensure of Professional Counselors, Marriage and Family Therapists, Addiction Counselors and Psycho-Educational Specialists · Application information

Temporary military spouse license at the associate credential level
AMFTRB Marital and Family Therapy National Examination
Application
Submit the Board application, fee, identity and Social Security documentation, applicable legal name-change documents and lawful-presence verification.
Background checks
Section 40-1-630(B)(1)(d) fingerprint checks apply only if similar checks are required for ordinary licensure in this profession.
Credential level
The requested temporary level is marriage and family therapy associate; statutory education and examination requirements and the supervised-practice restriction remain applicable.
Duration
The temporary license expires one year after issuance and may not be renewed.
Education
Satisfy Regulation 36-07: a minimum 60 graduate semester-hour COAMFTE-accredited or CACREP marriage, couple and family counseling specialty program, or its listed graduate/post-degree and substantially similar educational standards approved by the Board. Submit official transcripts and, when applicable, coursework and clinical-contact verification.
Exam timing
Pass the National Marriage and Family Therapy Examination. Previously passed scores may be submitted; PTC examination registration instructions are sent after the Board approves education and the application.
Existing license
Hold a valid professional license in good standing issued by another state, District of Columbia, a United States possession or territory, or a foreign jurisdiction; provide its certificate of good standing.
License eligibility
The applicant must hold the valid good-standing license required by section 40-1-630. The Board must verify its equivalent professional level and all state requirements.
Military education credit
Section 40-1-640 applies satisfactory military education, training and experience in the manner most favorable toward qualifications; other licensing and examination requirements remain applicable.
Military spouse
Be married to an active-duty United States Armed Forces member assigned to a South Carolina duty station under official military orders.
State requirements
All applicable South Carolina requirements at the requested professional credential level must be met; section 40-1-630 does not excuse them.
Supervision plan
A Board-satisfactory clinical supervision plan may accompany the application or follow employment, but must be approved before providing therapy services as an associate.
Temporary application
Submit the temporary-license application, marriage documents, duty-station orders and license verifications. The LLR military-spouse request process prioritizes applications and identifies further documents.
Temporary military spouse license at the supervisor credential level
No examination is required for this applicant pathway.
Application
Submit the supervisor application and fee, identity and Social Security documentation, lawful-presence verification, education/supervision records and required personal-history explanations and supporting documents.
Background checks
Section 40-1-630(B)(1)(d) fingerprint checks apply only if similar checks are required for ordinary licensure in this profession.
Credential level
The requested temporary level is marriage and family therapy supervisor; meet section 40-75-230 and Regulation 36-09, or equivalent domestic supervisor endorsement requirements when applicable.
Doctoral alternative
Regulation 36-09(3)(a) supplies the doctorate alternative to its subsection (3)(b) supervision/training package but does not override the statutory five-year practice requirement.
Duration
The temporary license expires one year after issuance and may not be renewed.
Endorsement alternative
An equivalent domestic supervisor license may be evaluated under Regulation 36-14(B); maintain the underlying South Carolina therapist license and provide required certifications and documents.
Existing license
Hold a valid professional license in good standing issued by another state, District of Columbia, a United States possession or territory, or a foreign jurisdiction; provide its certificate of good standing.
Five year statutory experience
Section 40-75-230 requires at least five years of practice. The Board page and current supervisor application require five years of continuous clinical experience immediately preceding application.
Military spouse
Be married to an active-duty United States Armed Forces member assigned to a South Carolina duty station under official military orders.
State requirements
All applicable South Carolina requirements at the requested professional credential level must be met; section 40-1-630 does not excuse them.
Supervision education
Provide at least three graduate semester hours in supervision or Board-approved training. The current application states that 45 hours of Board-approved supervision coursework or training may satisfy its training requirement.
Supervision of supervision
Document at least 36 individual/triadic hours over at least two years with a Board-approved supervisor or qualified mental health practitioner, supervising at least two and no more than six marriage and family therapy associates.
Temporary application
Submit the temporary-license application, marriage documents, duty-station orders and license verifications. The LLR military-spouse request process prioritizes applications and identifies further documents.
Underlying license
Hold and maintain a current, active and unrestricted South Carolina Marriage and Family Therapy license; it is an applicant condition.

Official no-examination sources

Effective from 2026-09-22.

Temporary military spouse therapist license with equivalent domestic licensure
No examination is required for this applicant pathway.
Application
Submit the approved application and fee, certify reading and understanding the Board statutes, regulations and applicable ethics code, provide lawful-presence verification and other Board-required documents.
Background checks
Section 40-1-630(B)(1)(d) fingerprint checks apply only if similar checks are required for ordinary licensure in this profession.
Credential level
The requested temporary level is marriage and family therapist; meet the equivalent domestic endorsement requirements in Regulation 36-14(A).
Duration
The temporary license expires one year after issuance and may not be renewed.
Existing license
Hold a valid professional license in good standing issued by another state, District of Columbia, a United States possession or territory, or a foreign jurisdiction; provide its certificate of good standing.
Investigations
Have no current or pending investigations where currently licensed; section 40-75-260 prevents licensure during an unresolved disqualifying investigation.
License held elsewhere
Hold a current, active and unrestricted marriage and family therapist license in good standing from another state at an equivalent credential level. The license held elsewhere is an applicant condition.
Military spouse
Be married to an active-duty United States Armed Forces member assigned to a South Carolina duty station under official military orders.
State requirements
All applicable South Carolina requirements at the requested professional credential level must be met; section 40-1-630 does not excuse them.
Temporary application
Submit the temporary-license application, marriage documents, duty-station orders and license verifications. The LLR military-spouse request process prioritizes applications and identifies further documents.

Official no-examination sources

Effective from 2026-09-22.

Temporary military spouse therapist license with foreign professional licensure
AMFTRB Marital and Family Therapy National Examination
Application
Submit the Board application, fee, identity and Social Security documentation, applicable legal name-change documents and lawful-presence verification.
Associate license
Hold a current, active and unrestricted South Carolina Marriage and Family Therapy Associate license for the ordinary progression route.
Background checks
Section 40-1-630(B)(1)(d) fingerprint checks apply only if similar checks are required for ordinary licensure in this profession.
Credential level
The requested temporary level is marriage and family therapist. A foreign professional license satisfies temporary-license eligibility, but Regulation 36-14 domestic endorsement cannot replace ordinary education, examination and experience requirements.
Duration
The temporary license expires one year after issuance and may not be renewed.
Education
Satisfy Regulation 36-07: a minimum 60 graduate semester-hour COAMFTE-accredited or CACREP marriage, couple and family counseling specialty program, or its listed graduate/post-degree and substantially similar educational standards approved by the Board. Submit official transcripts and, when applicable, coursework and clinical-contact verification.
Exam timing
Pass the National Marriage and Family Therapy Examination. Previously passed scores may be submitted; PTC examination registration instructions are sent after the Board approves education and the application.
Existing license
Hold a valid professional license in good standing issued by another state, District of Columbia, a United States possession or territory, or a foreign jurisdiction; provide its certificate of good standing.
Foreign education
The Board may accept foreign education only when all Article 1 requirements are met and experience, command of English and the academic program meet a relevant accredited United States program standard. Acceptance treats the education as accredited; it does not waive the examination.
Full license application
Submit the full-license application, fee and completed clinical supervision confirmations and logs.
Military education credit
Section 40-1-640 applies satisfactory military education, training and experience in the manner most favorable toward qualifications; other licensing and examination requirements remain applicable.
Military spouse
Be married to an active-duty United States Armed Forces member assigned to a South Carolina duty station under official military orders.
Post masters experience
Complete at least 1,500 post-master clinical experience and supervision hours over at least two years: at least 1,380 direct-client hours and 120 supervision hours, including diagnosis and treatment of serious problems.
State requirements
All applicable South Carolina requirements at the requested professional credential level must be met; section 40-1-630 does not excuse them.
Supervision format
At least 60 supervision hours must be individual/triadic; the remaining 60 may be individual/triadic or group.
Supervision plan
A Board-satisfactory clinical supervision plan may accompany the application or follow employment, but must be approved before providing therapy services as an associate.
Supervisor approval
A licensed marriage and family therapy supervisor or qualified licensed mental health practitioner must be Board-approved before supervision begins.
Temporary application
Submit the temporary-license application, marriage documents, duty-station orders and license verifications. The LLR military-spouse request process prioritizes applications and identifies further documents.

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