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Vermont Marriage & Family Therapy — Requirements & Free Practice

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Licensed Marriage and Family Therapist

The ordinary Vermont license for marriage and family therapy, including examination, endorsement, renewal and reinstatement pathways.

Licensing authority: Vermont Board of Allied Mental Health Practitioners / Office of Professional Regulation · Application information

Endorsement based on substantially equivalent standards
AMFTRB Marital and Family Therapy National Examination
Documentation
Submit an online application, fee, direct license verification from the initial and most recent licensing authorities, and the other jurisdiction’s governing statutes and rules.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Other License
Hold a marriage and family therapy license or certification in good standing in a U.S. or Canadian jurisdiction whose regulatory standards and qualifications the Board finds substantially equivalent to Vermont requirements.
Waiver
Under 26 V.S.A. § 4039 and Rule 4.25, the Board may license without requiring all professional competency examinations. A waiver is an applicant condition; it does not remove the identified currently offered national examination from this route.
Endorsement based on five years of active practice
AMFTRB Marital and Family Therapy National Examination
Active Practice
At least five years in active practice, averaging more than 20 hours weekly for 48 weeks per year. The current Board application page specifies the five years before application.
Documentation
Follow endorsement application steps and upload the active-practice letter. The January 2026 instructions cite Rule 4.23(b); the pinned rules place this pathway at Rule 4.25(b).
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Other License
Be licensed or certified to practice independently with no encumbrance in a U.S. or Canadian jurisdiction, regardless of its licensing standards.
Waiver
Under 26 V.S.A. § 4039 and Rule 4.25, the Board may license without requiring all professional competency examinations. A waiver is an applicant condition; it does not remove the identified currently offered national examination from this route.
Endorsement from an otherwise equivalent jurisdiction without the national examination
AMFTRB Marital and Family Therapy National Examination
Documentation
Submit the application, fee, direct official license verifications and the jurisdiction’s statutes and rules.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
National Exam
Rule 4.25(a)(2) requires successful completion of the national marriage and family therapist examination.
Other License
Hold a marriage and family therapy license or certification in good standing in an otherwise substantially equivalent U.S. or Canadian jurisdiction that does not require the national marriage and family therapist examination.
Licensure by examination
AMFTRB Marital and Family Therapy National Examination
Application Currency
The January 2026 application page states that licensing requirements must be completed within five years from application. Rule 1.5 states that an application expires after five years without a progress report. Both instructions are recorded as applicant conditions rather than changing examination references.
Documentation
Submit the online application, fee, official transcripts and, for non-COAMFTE applicants, course descriptions and syllabi. Supervisors submit supervision reports directly; verify supervisor licenses when supervisors are not licensed in Vermont. Education must be approved before examination registration.
Education
Meet 26 V.S.A. § 4037(1) and Rules 4.7–4.14: a qualifying COAMFTE graduate degree or a Board-approved graduate degree focusing on marriage and family therapy with the required curriculum. Non-COAMFTE degrees need at least 36 graduate credits, including at least 18 relational/systemic MFT credits; licensure requires at least 48 graduate credits and every prescribed subject. Required stand-alone courses include diagnosis/treatment (3 credits within the degree), MFT theory (6), MFT skills (3), a treatment modality (3), human development (3), diversity (3), research (3), professional ethics (3), and at least two listed electives (3 credits each).
Exam Recency
For applicants not previously licensed, the national examination result must be within five years of the final licensure decision, under Rule 4.15(b); a passing result obtained before application remains an examination requirement.
Foreign Education
Under Rule 1.2(c)(2), a non-U.S. institution must have maintained training substantially equivalent to the specified U.S. accredited institutions when the applicant enrolled and graduated; the MFT degree and curriculum requirements still apply.
Internship
The qualifying degree must include at least 500 supervised internship hours. A degree with fewer than 500 internship hours cannot be supplemented after graduation. If fewer than 500 hours were direct service, add the direct-service shortfall to the 3,000-hour post-degree practice requirement.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Roster
Before any post-degree supervised practice in Vermont, register on the Roster of Nonlicensed and Noncertified Psychotherapists; off-roster hours are not accepted.
Supervised Practice
Complete 3,000 hours over at least two years; only hours acquired within five years of the final licensing decision are accepted under Rule 4.16. At least 2,000 hours are direct service, half with couples or families; the remaining 1,000 hours are clinical practice or supporting indirect service.
Supervision Contact
At least 100 hours of face-to-face supervision, including at least 50 individual hours; never accumulate more than 30 practice hours without one supervision hour. Group supervision has no more than six trainees.
Supervisor
A supervisor must hold an unencumbered qualifying license and have at least three years of unencumbered licensure when supervision begins. Rules 4.20–4.23 specify qualifying MFT, clinical social worker, mental health counselor, psychologist or board-certified psychiatrist licenses and exclude family members, financially interested supervisors and nonclinical arrangements.
Fast Track Endorsement
No examination is required for this applicant pathway.
Documentation
Submit an online application and fee; have the licensing authority directly verify continuous good standing for the preceding three years.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Other License
Be actively licensed or certified to practice marriage and family therapy independently, without supervision, and in good standing for at least three years immediately before applying; 3 V.S.A. § 136a(a) supplies the U.S. interstate process.
Practice Waiver
The Director may waive the practice requirement under 3 V.S.A. § 136a(c) when consistent with State policy and adequate public protection.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement of a license lapsed more than five years while licensed and practicing elsewhere
No examination is required for this applicant pathway.
Practice
The license lapsed more than five years, but the applicant practiced under a license in another U.S. or Canadian jurisdiction; the no-outside-practice trigger in Rule 4.37(b) does not apply.
Renewal
Pay the current renewal fee and reinstatement penalty and satisfy renewal requirements. For actual absence from practice of five or more years, the Director’s competency determination under 3 V.S.A. § 135 also applies.

Official no-examination sources

Effective from 2026-09-22.

Reapplication after extended absence when ordered to reapply as a new applicant
AMFTRB Marital and Family Therapy National Examination
Application Currency
The January 2026 application page states that licensing requirements must be completed within five years from application. Rule 1.5 states that an application expires after five years without a progress report. Both instructions are recorded as applicant conditions rather than changing examination references.
Director Determination
After five or more years of absence, the Director finds not all required professional competencies retained and requires reapplication like a new applicant under 3 V.S.A. § 135(b)(2).
Documentation
Submit the online application, fee, official transcripts and, for non-COAMFTE applicants, course descriptions and syllabi. Supervisors submit supervision reports directly; verify supervisor licenses when supervisors are not licensed in Vermont. Education must be approved before examination registration.
Education
Meet 26 V.S.A. § 4037(1) and Rules 4.7–4.14: a qualifying COAMFTE graduate degree or a Board-approved graduate degree focusing on marriage and family therapy with the required curriculum. Non-COAMFTE degrees need at least 36 graduate credits, including at least 18 relational/systemic MFT credits; licensure requires at least 48 graduate credits and every prescribed subject. Required stand-alone courses include diagnosis/treatment (3 credits within the degree), MFT theory (6), MFT skills (3), a treatment modality (3), human development (3), diversity (3), research (3), professional ethics (3), and at least two listed electives (3 credits each).
Exam Recency
For applicants not previously licensed, the national examination result must be within five years of the final licensure decision, under Rule 4.15(b); a passing result obtained before application remains an examination requirement.
Foreign Education
Under Rule 1.2(c)(2), a non-U.S. institution must have maintained training substantially equivalent to the specified U.S. accredited institutions when the applicant enrolled and graduated; the MFT degree and curriculum requirements still apply.
Internship
The qualifying degree must include at least 500 supervised internship hours. A degree with fewer than 500 internship hours cannot be supplemented after graduation. If fewer than 500 hours were direct service, add the direct-service shortfall to the 3,000-hour post-degree practice requirement.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Roster
Before any post-degree supervised practice in Vermont, register on the Roster of Nonlicensed and Noncertified Psychotherapists; off-roster hours are not accepted.
Supervised Practice
Complete 3,000 hours over at least two years; only hours acquired within five years of the final licensing decision are accepted under Rule 4.16. At least 2,000 hours are direct service, half with couples or families; the remaining 1,000 hours are clinical practice or supporting indirect service.
Supervision Contact
At least 100 hours of face-to-face supervision, including at least 50 individual hours; never accumulate more than 30 practice hours without one supervision hour. Group supervision has no more than six trainees.
Supervisor
A supervisor must hold an unencumbered qualifying license and have at least three years of unencumbered licensure when supervision begins. Rules 4.20–4.23 specify qualifying MFT, clinical social worker, mental health counselor, psychologist or board-certified psychiatrist licenses and exclude family members, financially interested supervisors and nonclinical arrangements.
Renewal after extended absence with demonstrated retention of competence
No examination is required for this applicant pathway.
Absence
Five or more years of absence from practice.
Director Determination
The Director determines under 3 V.S.A. § 135(b)(1) that required professional competencies have been retained and permits an unencumbered license. This statutory determination operates notwithstanding contrary law or rules.
Renewal
Satisfy the renewal terms and fees applicable to the Director’s determination.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement after fewer than five years of absence from practice
No examination is required for this applicant pathway.
Absence
Fewer than five years absent from practice. Under 3 V.S.A. § 135(a), readiness is inferred from the CE that would have been required during continuous licensure, or a less burdensome showing permitted by rule or the Director.
Fees
Pay the current renewal fee and reinstatement penalty and satisfy applicable renewal requirements; no renewal fees are owed for lapsed years.

Official no-examination sources

Effective from 2026-09-22.

Biennial renewal
No examination is required for this applicant pathway.
Continuing Education
Complete 20 Board-approved hours in the preceding two-year period, including four professional-ethics hours and one systematic-oppression/anti-oppressive-practice hour. The statutory first-renewal exemption applies; synchronous virtual CE is accepted as live training. Upload completion certificates as required by February 2026 renewal instructions.
Other Mental Health Credentials
Under 26 V.S.A. § 4040(a)(2), CE completed for another licensed mental health profession under Title 26 counts toward this profession’s CE requirement.
Renewal Cycle
Renew biennially through the online system before expiration and pay the renewal fee. Practice with an expired license is unlawful.

Official no-examination sources

Effective from 2026-09-22.

Reinstatement of a revoked license
No examination is required for this applicant pathway.
Board Terms
The Board may reinstate a revoked license on the terms and conditions it deems proper under 26 V.S.A. § 4042(c). This provision does not identify an examination; any individualized Board terms must be met.

Official no-examination sources

Effective from 2026-09-22.

Provisional License

A 90-day provisional marriage and family therapist license pending final determination of a completed application for full licensure; the Director may extend it under 3 V.S.A. § 130(e).

Licensing authority: Vermont Board of Allied Mental Health Practitioners / Office of Professional Regulation · Application information

Provisional licensure pending background check through fast track
No examination is required for this applicant pathway.
Agreement
Enter the voluntary OPR provisional-license agreement, forgo traditional procedural rights pending final determination, and accept summary withdrawal for any inaccurate or inconsistent application facts.
Documentation
Submit an online application and fee; have the licensing authority directly verify continuous good standing for the preceding three years.
Duration
Initially 90 days; the Director may extend if the qualifying reason remains unresolved.
Full Application
Complete a full MFT licensure application and attest to material facts consistent with full licensure, including standing in other jurisdictions, criminal history and disciplinary history.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Other License
Be actively licensed or certified to practice marriage and family therapy independently, without supervision, and in good standing for at least three years immediately before applying; 3 V.S.A. § 136a(a) supplies the U.S. interstate process.
Practice Waiver
The Director may waive the practice requirement under 3 V.S.A. § 136a(c) when consistent with State policy and adequate public protection.
Provisional Eligibility
Eligibility is contingent on completion of a background check under 3 V.S.A. § 130(a)(2).

Official no-examination sources

Effective from 2026-09-22.

Provisional licensure pending background check through ordinary
AMFTRB Marital and Family Therapy National Examination
Agreement
Enter the voluntary OPR provisional-license agreement, forgo traditional procedural rights pending final determination, and accept summary withdrawal for any inaccurate or inconsistent application facts.
Duration
Initially 90 days; the Director may extend if the qualifying reason remains unresolved.
Full Application
Complete a full MFT licensure application and attest to material facts consistent with full licensure, including standing in other jurisdictions, criminal history and disciplinary history.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Provisional Eligibility
Eligibility is contingent on completion of a background check under 3 V.S.A. § 130(a)(2).
Underlying Pathway
Qualify through examination or traditional endorsement. The currently offered national examination is retained even when already passed or when the Board exercises an endorsement waiver. Meet the education, supervision or other-license conditions of that underlying pathway.
Waiver
Under 26 V.S.A. § 4039 and Rule 4.25, the Board may license without requiring all professional competency examinations. A waiver is an applicant condition; it does not remove the identified currently offered national examination from this route.
Extension of provisional licensure
No examination is required for this applicant pathway.
Extension
The Director may extend the provisional license beyond 90 days while the verification, background-check or military reason under § 130(a) remains unresolved. The original provisional agreement and accuracy obligations continue.

Official no-examination sources

Effective from 2026-09-22.

Provisional licensure pending military through fast track
No examination is required for this applicant pathway.
Agreement
Enter the voluntary OPR provisional-license agreement, forgo traditional procedural rights pending final determination, and accept summary withdrawal for any inaccurate or inconsistent application facts.
Documentation
Submit an online application and fee; have the licensing authority directly verify continuous good standing for the preceding three years.
Duration
Initially 90 days; the Director may extend if the qualifying reason remains unresolved.
Full Application
Complete a full MFT licensure application and attest to material facts consistent with full licensure, including standing in other jurisdictions, criminal history and disciplinary history.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Other License
Be actively licensed or certified to practice marriage and family therapy independently, without supervision, and in good standing for at least three years immediately before applying; 3 V.S.A. § 136a(a) supplies the U.S. interstate process.
Practice Waiver
The Director may waive the practice requirement under 3 V.S.A. § 136a(c) when consistent with State policy and adequate public protection.
Provisional Eligibility
The applicant is an active-duty U.S. Armed Forces member assigned to Vermont or that member’s spouse under 3 V.S.A. § 130(a)(3).

Official no-examination sources

Effective from 2026-09-22.

Provisional licensure pending military through ordinary
AMFTRB Marital and Family Therapy National Examination
Agreement
Enter the voluntary OPR provisional-license agreement, forgo traditional procedural rights pending final determination, and accept summary withdrawal for any inaccurate or inconsistent application facts.
Duration
Initially 90 days; the Director may extend if the qualifying reason remains unresolved.
Full Application
Complete a full MFT licensure application and attest to material facts consistent with full licensure, including standing in other jurisdictions, criminal history and disciplinary history.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Provisional Eligibility
The applicant is an active-duty U.S. Armed Forces member assigned to Vermont or that member’s spouse under 3 V.S.A. § 130(a)(3).
Underlying Pathway
Qualify through examination or traditional endorsement. The currently offered national examination is retained even when already passed or when the Board exercises an endorsement waiver. Meet the education, supervision or other-license conditions of that underlying pathway.
Waiver
Under 26 V.S.A. § 4039 and Rule 4.25, the Board may license without requiring all professional competency examinations. A waiver is an applicant condition; it does not remove the identified currently offered national examination from this route.
Provisional licensure pending verification through fast track
No examination is required for this applicant pathway.
Agreement
Enter the voluntary OPR provisional-license agreement, forgo traditional procedural rights pending final determination, and accept summary withdrawal for any inaccurate or inconsistent application facts.
Documentation
Submit an online application and fee; have the licensing authority directly verify continuous good standing for the preceding three years.
Duration
Initially 90 days; the Director may extend if the qualifying reason remains unresolved.
Full Application
Complete a full MFT licensure application and attest to material facts consistent with full licensure, including standing in other jurisdictions, criminal history and disciplinary history.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Other License
Be actively licensed or certified to practice marriage and family therapy independently, without supervision, and in good standing for at least three years immediately before applying; 3 V.S.A. § 136a(a) supplies the U.S. interstate process.
Practice Waiver
The Director may waive the practice requirement under 3 V.S.A. § 136a(c) when consistent with State policy and adequate public protection.
Provisional Eligibility
Eligibility is contingent on acceptable official verification of another jurisdiction’s license. Current MFT instructions require all other requirements, including Board review, to be complete.

Official no-examination sources

Effective from 2026-09-22.

Provisional licensure pending verification through ordinary
AMFTRB Marital and Family Therapy National Examination
Agreement
Enter the voluntary OPR provisional-license agreement, forgo traditional procedural rights pending final determination, and accept summary withdrawal for any inaccurate or inconsistent application facts.
Duration
Initially 90 days; the Director may extend if the qualifying reason remains unresolved.
Full Application
Complete a full MFT licensure application and attest to material facts consistent with full licensure, including standing in other jurisdictions, criminal history and disciplinary history.
Jurisprudence Adoption
Rule 4.4(c) states: "All applicants must successfully complete, after one is adopted, the Board’s jurisprudence examination before a license will be issued." The supplied and retrieved current implementing materials do not establish adoption or a currently offered examination. This is retained as a contingent applicant condition; the survey makes no finding that this examination does not exist.
Provisional Eligibility
Eligibility is contingent on acceptable official verification of another jurisdiction’s license. Current MFT instructions require all other requirements, including Board review, to be complete.
Underlying Pathway
Qualify through examination or traditional endorsement. The currently offered national examination is retained even when already passed or when the Board exercises an endorsement waiver. Meet the education, supervision or other-license conditions of that underlying pathway.
Waiver
Under 26 V.S.A. § 4039 and Rule 4.25, the Board may license without requiring all professional competency examinations. A waiver is an applicant condition; it does not remove the identified currently offered national examination from this route.

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