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West Virginia 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 Therapist-Associate (LMFTA)

Supervised associate licensure under the current 2026 rule, called provisional licensure in earlier Board materials.

Licensing authority: West Virginia Board of Examiners in Counseling · Application information

One associate license extension
No examination is required for this applicant pathway.
Eligibility
Supervised experience incomplete after 36-month initial term.
Extension
One additional 24 months by written request and fee equal to the current initial application fee.
Supervision
Continue approved supervision and associate practice restrictions.

Official no-examination sources

Effective from 2026-09-22.

Associate issuance — doctoral degree
AMFTRB Marital and Family Therapy National Examination
Application
Completed Board application dated within six months, fee, official transcripts sent by the school or clearinghouse, supervisor registration contract and applicable supervision verification forms. Board directs electronic application.
Coursework
60 semester or 90 quarter graduate hours in an approved MFT or equivalent mental-health program; the eight areas in §6.1.1.c, four advanced MFT courses under §6.1.1.d, and twelve-month practicum with 300 direct-contact hours, at least half with couples and families.
Criminal History
Meet §30-31-9(a)(7), including its rehabilitation and present-fitness procedure where applicable.
Degree
Board-approved doctoral degree or equivalent.
Duration
Initial term 36 months.
Examination Attempts
Three attempts within twelve months without additional permission; reapply after three failures.
Examination Score
Passing score valid five years. Prior passage of the currently offered registered examination remains an exam leaf. If not passed, apply and obtain Board eligibility before testing.
Experience Currency
§3.5 excludes documentation three years old or older and permits consideration of up to 500 hours from elsewhere with proof at application; §7.3 separately allows consideration of qualifying documented post-degree experience from another jurisdiction.
Legal Employment
United States citizen or eligible for United States employment.
Minimum Age
At least eighteen.
Moral Character
Good moral character; three personal references and two graduate-level licensed professional recommendations dated within six months; authors of the personal references and professional recommendations must differ.
Other Approved Examination
§4.1 permits an examination approved by the Board; this unnamed open alternative is an applicant condition.
Practice Restriction
No ownership, operation or independent-contractor private practice; only approved supervised experience.
Substance Use
Meet §30-31-9(a)(8); Board may consider an applicant after at least two continuous years of sobriety in active recovery.
Supervised Status
Associate license issued before supervisory experience after the academic requirements and examination are satisfied. Continuous supervision; report interruptions exceeding six weeks within thirty days and obtain advance approval of supervisor/job changes.
Supervision
Board-approved supervisor and successful supervision endorsement; minimum one hour of direct individual supervision per twenty practice hours, at least twice monthly if the supervisor is not full-time in the same practice. Additional supervision may be required if not endorsed.
Associate issuance — master degree
AMFTRB Marital and Family Therapy National Examination
Application
Completed Board application dated within six months, fee, official transcripts sent by the school or clearinghouse, supervisor registration contract and applicable supervision verification forms. Board directs electronic application.
Coursework
60 semester or 90 quarter graduate hours in an approved MFT or equivalent mental-health program; the eight areas in §6.1.1.c, four advanced MFT courses under §6.1.1.d, and twelve-month practicum with 300 direct-contact hours, at least half with couples and families.
Criminal History
Meet §30-31-9(a)(7), including its rehabilitation and present-fitness procedure where applicable.
Degree
Board-approved master degree or equivalent.
Duration
Initial term 36 months.
Examination Attempts
Three attempts within twelve months without additional permission; reapply after three failures.
Examination Score
Passing score valid five years. Prior passage of the currently offered registered examination remains an exam leaf. If not passed, apply and obtain Board eligibility before testing.
Experience Currency
§3.5 excludes documentation three years old or older and permits consideration of up to 500 hours from elsewhere with proof at application; §7.3 separately allows consideration of qualifying documented post-degree experience from another jurisdiction.
Legal Employment
United States citizen or eligible for United States employment.
Minimum Age
At least eighteen.
Moral Character
Good moral character; three personal references and two graduate-level licensed professional recommendations dated within six months; authors of the personal references and professional recommendations must differ.
Other Approved Examination
§4.1 permits an examination approved by the Board; this unnamed open alternative is an applicant condition.
Practice Restriction
No ownership, operation or independent-contractor private practice; only approved supervised experience.
Substance Use
Meet §30-31-9(a)(8); Board may consider an applicant after at least two continuous years of sobriety in active recovery.
Supervised Status
Associate license issued before supervisory experience after the academic requirements and examination are satisfied. Continuous supervision; report interruptions exceeding six weeks within thirty days and obtain advance approval of supervisor/job changes.
Supervision
Board-approved supervisor and successful supervision endorsement; minimum one hour of direct individual supervision per twenty practice hours, at least twice monthly if the supervisor is not full-time in the same practice. Additional supervision may be required if not endorsed.
Universal recognition — military spouse
No examination is required for this applicant pathway.
Criminal History
No disqualifying criminal history; authorized criminal-history checks remain applicable.
Discipline
No revocation or surrender while under investigation; other discipline must be corrected and fully resolved to Board satisfaction.
Eligibility
Married to an active-duty United States armed-forces member and accompanied the member on an official permanent change of station to a military installation in West Virginia.
Existing License
Current same-discipline and same-practice-level license elsewhere, good standing in every licensing state, and verification of that state’s minimum education and applicable experience/supervision requirements.
Fees
All applicable West Virginia fees.
Law Examination Reservation
§30-1-27(d) permits a state-law examination where a Board administers one. It names no examination for ordinary LMFT/LMFTA issuance. The supervisor-specific examination in §27-8-6.2.1.f is not a general initial-licensure requirement.
Prior Examination
Prior passage of any examination required by the issuing state is a condition under §30-1-27(b)(5). This West Virginia text names no particular exam; none is inferred by researching another state.

Official no-examination sources

Effective from 2026-09-22.

Universal recognition — resident
No examination is required for this applicant pathway.
Criminal History
No disqualifying criminal history; authorized criminal-history checks remain applicable.
Discipline
No revocation or surrender while under investigation; other discipline must be corrected and fully resolved to Board satisfaction.
Eligibility
Establish West Virginia residence.
Existing License
Current same-discipline and same-practice-level license elsewhere, good standing in every licensing state, and verification of that state’s minimum education and applicable experience/supervision requirements.
Fees
All applicable West Virginia fees.
Law Examination Reservation
§30-1-27(d) permits a state-law examination where a Board administers one. It names no examination for ordinary LMFT/LMFTA issuance. The supervisor-specific examination in §27-8-6.2.1.f is not a general initial-licensure requirement.
Prior Examination
Prior passage of any examination required by the issuing state is a condition under §30-1-27(b)(5). This West Virginia text names no particular exam; none is inferred by researching another state.

Official no-examination sources

Effective from 2026-09-22.

Licensed Marriage and Family Therapist

Independent LMFT licensure; initial examination, endorsement and statutory universal recognition routes.

Licensing authority: West Virginia Board of Examiners in Counseling · Application information

Reinstatement after removal of child support sanction
No examination is required for this applicant pathway.
Court Order
Board must receive a valid circuit-court order to reinstate or renew the previously sanctioned license.
Prior Sanction
License sanctioned by a valid circuit-court child-support order.

Official no-examination sources

Effective from 2026-09-22.

Discretionary reinstatement of suspended or revoked licensure
No examination is required for this applicant pathway.
Discretion
Board may consider reinstatement; case-specific order conditions apply. §30-1-8a identifies no examination.
Fitness
Show reasonable skill and safety to resume practice.
Prior License
Suspended or revoked LMFT license.

Official no-examination sources

Effective from 2026-09-22.

Licensure by endorsement
AMFTRB Marital and Family Therapy National Examination
Application
Completed West Virginia application and nonrefundable fee.
Existing License
Currently licensed at the highest independent clinical practice level elsewhere; licensing requirements equal to or greater than this rule as determined by the Board.
Good Standing
Verification and good-standing evidence from all current and former licensing jurisdictions, including discipline and pending actions or investigations.
Older Packet
The linked undated packet cites earlier rule numbering and offers documentation waivers for five years of active practice in the previous seven. Current §5 uses highest-level independent licensure and current application/good-standing requirements. Those current rules control, with the packet preserved as Board score-submission instructions.
Open Alternative
The unnamed other approved certification examination is a condition.
Passing Score
Board-linked endorsement packet requires official proof of a passing Examination in Marital and Family Therapy or another Board-approved certification examination; the named current AMFTRB examination remains a leaf when passed before application.
Reinstatement after sixty days and within two years
No examination is required for this applicant pathway.
Continuing Education
Board may require proof of completed CE.
Fees
2017 SOS rule states renewal and reinstatement fees; Board-published 2026 rule additionally states a late fee.
Practice
Do not practice while expired.
Timing
After sixty days but within two years of expiration.

Official no-examination sources

Effective from 2026-09-22.

Renewal of grandfathered licensure
No examination is required for this applicant pathway.
Continuing Education
35 approved CE hours per biennium, including three ethics and two veterans/family mental health; retain records six years and provide requested audit documentation.
Deadline
Annual renewal by June 30 with prescribed application and fee.
Edition Difference
SOS lists 2017 Series 10 Active while the Board publishes an edition stating April 14, 2026. Both obtained texts set renewal requirements without a new licensure examination.
Eligibility
Existing license issued under §30-31-9(d); grandfather issuance ended July 1, 2012, while renewal under §30-31-10 remains available.
Reporting Schedule
Current Board page says no CE evidence submission for 2026; submit for 2027 using courses completed July 1, 2025 through June 30, 2027.

Official no-examination sources

Effective from 2026-09-22.

Initial licensure by examination — doctoral degree
AMFTRB Marital and Family Therapy National Examination
Application
Completed Board application dated within six months, fee, official transcripts sent by the school or clearinghouse, supervisor registration contract and applicable supervision verification forms. Board directs electronic application.
Coursework
60 semester or 90 quarter graduate hours in an approved MFT or equivalent mental-health program; the eight areas in §6.1.1.c, four advanced MFT courses under §6.1.1.d, and twelve-month practicum with 300 direct-contact hours, at least half with couples and families.
Criminal History
Meet §30-31-9(a)(7), including its rehabilitation and present-fitness procedure where applicable.
Degree
Board-approved doctoral degree or equivalent.
Direct Experience
At least half of supervised experience is direct therapy; at least half of the 1500 hours described in §6.2.1.c.1 must be with couples and families present.
Examination Attempts
Three attempts within twelve months without additional permission; reapply after three failures.
Examination Score
Passing score valid five years. Prior passage of the currently offered registered examination remains an exam leaf. If not passed, apply and obtain Board eligibility before testing.
Experience Currency
§3.5 excludes documentation three years old or older and permits consideration of up to 500 hours from elsewhere with proof at application; §7.3 separately allows consideration of qualifying documented post-degree experience from another jurisdiction.
Legal Employment
United States citizen or eligible for United States employment.
Minimum Age
At least eighteen.
Moral Character
Good moral character; three personal references and two graduate-level licensed professional recommendations dated within six months; authors of the personal references and professional recommendations must differ.
Other Approved Examination
§4.1 permits an examination approved by the Board; this unnamed open alternative is an applicant condition.
Postgraduate Experience
1500 postgraduate supervised hours over at least 1 year(s); at most 1500 credited in twelve months; associate licensure before supervision, subject to statutory temporary-permit hours.
Practicum Credit
Committee may credit up to 600 practicum/internship hours toward master-level 3000 hours; no doctoral credit.
Substance Use
Meet §30-31-9(a)(8); Board may consider an applicant after at least two continuous years of sobriety in active recovery.
Supervision
Board-approved supervisor and successful supervision endorsement; minimum one hour of direct individual supervision per twenty practice hours, at least twice monthly if the supervisor is not full-time in the same practice. Additional supervision may be required if not endorsed.
Initial licensure by examination — master degree
AMFTRB Marital and Family Therapy National Examination
Application
Completed Board application dated within six months, fee, official transcripts sent by the school or clearinghouse, supervisor registration contract and applicable supervision verification forms. Board directs electronic application.
Coursework
60 semester or 90 quarter graduate hours in an approved MFT or equivalent mental-health program; the eight areas in §6.1.1.c, four advanced MFT courses under §6.1.1.d, and twelve-month practicum with 300 direct-contact hours, at least half with couples and families.
Criminal History
Meet §30-31-9(a)(7), including its rehabilitation and present-fitness procedure where applicable.
Degree
Board-approved master degree or equivalent.
Direct Experience
At least half of supervised experience is direct therapy; at least half of the 1500 hours described in §6.2.1.c.1 must be with couples and families present.
Examination Attempts
Three attempts within twelve months without additional permission; reapply after three failures.
Examination Score
Passing score valid five years. Prior passage of the currently offered registered examination remains an exam leaf. If not passed, apply and obtain Board eligibility before testing.
Experience Currency
§3.5 excludes documentation three years old or older and permits consideration of up to 500 hours from elsewhere with proof at application; §7.3 separately allows consideration of qualifying documented post-degree experience from another jurisdiction.
Legal Employment
United States citizen or eligible for United States employment.
Minimum Age
At least eighteen.
Moral Character
Good moral character; three personal references and two graduate-level licensed professional recommendations dated within six months; authors of the personal references and professional recommendations must differ.
Other Approved Examination
§4.1 permits an examination approved by the Board; this unnamed open alternative is an applicant condition.
Postgraduate Experience
3000 postgraduate supervised hours over at least 2 year(s); at most 1500 credited in twelve months; associate licensure before supervision, subject to statutory temporary-permit hours.
Practicum Credit
Committee may credit up to 600 practicum/internship hours toward master-level 3000 hours; no doctoral credit.
Substance Use
Meet §30-31-9(a)(8); Board may consider an applicant after at least two continuous years of sobriety in active recovery.
Supervision
Board-approved supervisor and successful supervision endorsement; minimum one hour of direct individual supervision per twenty practice hours, at least twice monthly if the supervisor is not full-time in the same practice. Additional supervision may be required if not endorsed.
Late renewal within sixty days
No examination is required for this applicant pathway.
Continuing Education
Board may require proof of completed CE.
Fees
Renewal fee and late fee.
Practice
Do not practice while expired.
Timing
Within sixty days after the renewal date.

Official no-examination sources

Effective from 2026-09-22.

Universal recognition — military spouse
No examination is required for this applicant pathway.
Criminal History
No disqualifying criminal history; authorized criminal-history checks remain applicable.
Discipline
No revocation or surrender while under investigation; other discipline must be corrected and fully resolved to Board satisfaction.
Eligibility
Married to an active-duty United States armed-forces member and accompanied the member on an official permanent change of station to a military installation in West Virginia.
Existing License
Current same-discipline and same-practice-level license elsewhere, good standing in every licensing state, and verification of that state’s minimum education and applicable experience/supervision requirements.
Fees
All applicable West Virginia fees.
Law Examination Reservation
§30-1-27(d) permits a state-law examination where a Board administers one. It names no examination for ordinary LMFT/LMFTA issuance. The supervisor-specific examination in §27-8-6.2.1.f is not a general initial-licensure requirement.
Prior Examination
Prior passage of any examination required by the issuing state is a condition under §30-1-27(b)(5). This West Virginia text names no particular exam; none is inferred by researching another state.

Official no-examination sources

Effective from 2026-09-22.

Universal recognition — resident
No examination is required for this applicant pathway.
Criminal History
No disqualifying criminal history; authorized criminal-history checks remain applicable.
Discipline
No revocation or surrender while under investigation; other discipline must be corrected and fully resolved to Board satisfaction.
Eligibility
Establish West Virginia residence.
Existing License
Current same-discipline and same-practice-level license elsewhere, good standing in every licensing state, and verification of that state’s minimum education and applicable experience/supervision requirements.
Fees
All applicable West Virginia fees.
Law Examination Reservation
§30-1-27(d) permits a state-law examination where a Board administers one. It names no examination for ordinary LMFT/LMFTA issuance. The supervisor-specific examination in §27-8-6.2.1.f is not a general initial-licensure requirement.
Prior Examination
Prior passage of any examination required by the issuing state is a condition under §30-1-27(b)(5). This West Virginia text names no particular exam; none is inferred by researching another state.

Official no-examination sources

Effective from 2026-09-22.

New licensure after more than two years expired — doctoral degree
AMFTRB Marital and Family Therapy National Examination
Application
Completed Board application dated within six months, fee, official transcripts sent by the school or clearinghouse, supervisor registration contract and applicable supervision verification forms. Board directs electronic application.
Coursework
60 semester or 90 quarter graduate hours in an approved MFT or equivalent mental-health program; the eight areas in §6.1.1.c, four advanced MFT courses under §6.1.1.d, and twelve-month practicum with 300 direct-contact hours, at least half with couples and families.
Criminal History
Meet §30-31-9(a)(7), including its rehabilitation and present-fitness procedure where applicable.
Degree
Board-approved doctoral degree or equivalent.
Direct Experience
At least half of supervised experience is direct therapy; at least half of the 1500 hours described in §6.2.1.c.1 must be with couples and families present.
Examination Attempts
Three attempts within twelve months without additional permission; reapply after three failures.
Examination Score
Passing score valid five years. Prior passage of the currently offered registered examination remains an exam leaf. If not passed, apply and obtain Board eligibility before testing.
Experience
1500 supervised postgraduate hours over at least 1 year(s), subject to current Board documentation requirements.
Experience Currency
§3.5 excludes documentation three years old or older and permits consideration of up to 500 hours from elsewhere with proof at application; §7.3 separately allows consideration of qualifying documented post-degree experience from another jurisdiction.
Legal Employment
United States citizen or eligible for United States employment.
Minimum Age
At least eighteen.
Moral Character
Good moral character; three personal references and two graduate-level licensed professional recommendations dated within six months; authors of the personal references and professional recommendations must differ.
Other Approved Examination
§4.1 permits an examination approved by the Board; this unnamed open alternative is an applicant condition.
Practicum Credit
Committee may credit up to 600 practicum/internship hours toward master-level 3000 hours; no doctoral credit.
Prior License
Not reinstated within two years after expiration; apply for a new license under current Series 8.
Substance Use
Meet §30-31-9(a)(8); Board may consider an applicant after at least two continuous years of sobriety in active recovery.
Supervision
Board-approved supervisor and successful supervision endorsement; minimum one hour of direct individual supervision per twenty practice hours, at least twice monthly if the supervisor is not full-time in the same practice. Additional supervision may be required if not endorsed.
New licensure after more than two years expired — master degree
AMFTRB Marital and Family Therapy National Examination
Application
Completed Board application dated within six months, fee, official transcripts sent by the school or clearinghouse, supervisor registration contract and applicable supervision verification forms. Board directs electronic application.
Coursework
60 semester or 90 quarter graduate hours in an approved MFT or equivalent mental-health program; the eight areas in §6.1.1.c, four advanced MFT courses under §6.1.1.d, and twelve-month practicum with 300 direct-contact hours, at least half with couples and families.
Criminal History
Meet §30-31-9(a)(7), including its rehabilitation and present-fitness procedure where applicable.
Degree
Board-approved master degree or equivalent.
Direct Experience
At least half of supervised experience is direct therapy; at least half of the 1500 hours described in §6.2.1.c.1 must be with couples and families present.
Examination Attempts
Three attempts within twelve months without additional permission; reapply after three failures.
Examination Score
Passing score valid five years. Prior passage of the currently offered registered examination remains an exam leaf. If not passed, apply and obtain Board eligibility before testing.
Experience
3000 supervised postgraduate hours over at least 2 year(s), subject to current Board documentation requirements.
Experience Currency
§3.5 excludes documentation three years old or older and permits consideration of up to 500 hours from elsewhere with proof at application; §7.3 separately allows consideration of qualifying documented post-degree experience from another jurisdiction.
Legal Employment
United States citizen or eligible for United States employment.
Minimum Age
At least eighteen.
Moral Character
Good moral character; three personal references and two graduate-level licensed professional recommendations dated within six months; authors of the personal references and professional recommendations must differ.
Other Approved Examination
§4.1 permits an examination approved by the Board; this unnamed open alternative is an applicant condition.
Practicum Credit
Committee may credit up to 600 practicum/internship hours toward master-level 3000 hours; no doctoral credit.
Prior License
Not reinstated within two years after expiration; apply for a new license under current Series 8.
Substance Use
Meet §30-31-9(a)(8); Board may consider an applicant after at least two continuous years of sobriety in active recovery.
Supervision
Board-approved supervisor and successful supervision endorsement; minimum one hour of direct individual supervision per twenty practice hours, at least twice monthly if the supervisor is not full-time in the same practice. Additional supervision may be required if not endorsed.
Annual license renewal
No examination is required for this applicant pathway.
Continuing Education
35 approved CE hours per biennium, including three ethics and two veterans/family mental health; retain records six years and provide requested audit documentation.
Deadline
Annual renewal by June 30 with prescribed application and fee.
Edition Difference
SOS lists 2017 Series 10 Active while the Board publishes an edition stating April 14, 2026. Both obtained texts set renewal requirements without a new licensure examination.
Reporting Schedule
Current Board page says no CE evidence submission for 2026; submit for 2027 using courses completed July 1, 2025 through June 30, 2027.

Official no-examination sources

Effective from 2026-09-22.

Return from inactive to active licensure
No examination is required for this applicant pathway.
Continuing Education
35 hours in the preceding two years, including three AAMFT ethics and two veterans/family mental health.
Fees
Appropriate 27CSR9 fee.
Long Inactive Period
After more than five years, Board may require further CE, supervision and/or coursework.
Prior Status
Approved inactive LMFT.

Official no-examination sources

Effective from 2026-09-22.

Temporary Permit to Practice Marriage and Family Therapy

Single nonrenewable permit for up to six months, accompanying a licensure application while the applicant takes the required exam.

Licensing authority: West Virginia Board of Examiners in Counseling · Application information

Temporary permit with initial licensure application
AMFTRB Marital and Family Therapy National Examination
Application
Must accompany an initial licensure application; not stand-alone.
Duration
One permit only, at most six months, not renewable.
Examination Timing
Issued before national exam passage while preparing for and taking that exam. The current AMFTRB examination is retained as a leaf although passage follows issuance.
Fee
Statute states a $50 permit fee.
Supervision
Approved professional supervisor; supervision hours count toward licensure. Stop services and pause supervision if the permit expires before exam passage.

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