Frequently Asked Questions

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From the CAMFT Scope of Practice (2024): Recently the California Association of Marriage and Family Therapists (CAMFT) made amendments to formally modernize and clarify the scope of practice. As such, the marriage and family therapy scope of practice now reads as follows:

BPC §4980.02

(a) For the purposes of this chapter, the practice of marriage and family therapy shall mean the application of psychotherapeutic and family systems theories, principles, and methods in the delivery of services to individuals, couples, or groups in order to assess, evaluate, and treat relational issues, emotional disorders, behavioral problems, mental illness, alcohol and substance use, and to modify intrapersonal and interpersonal behaviors.

(b) The application of marriage and family therapy principles and methods includes, but is not limited to, all of the following:

(1) Assessment, evaluation, and prognosis.

(2) Treatment, planning, and evaluation.

(3) Individual, relationship, family, or group therapeutic interventions.

(4) Relational therapy.

(5) Psychotherapy.

(6) Client education.

(7) Clinical case management.

(8) Consultation.

(9) Supervision.

(10) Use, application, and integration of the coursework and training required by Sections 4980.36, 4980.37, and 4980.41, as applicable.

(c) The amendments to this section made by the act adding this subdivision do not constitute a change in, but are declaratory of, existing law. It is the intent of the Legislature that these amendments shall not be construed to expand or constrict the existing scope of practice of a person licensed pursuant to this chapter.

This passage is an excerpt from the article, "Who are LMFTs?" found on www.camft.org the official website of the California Association of Marriage & Family Therapists:

“Who are LMFTs?” 

Licensed Marriage and Family Therapists are relationship experts. They work in private practice as well as various other settings with individuals, couples, families, children and adolescents, and the elderly, providing support and perspective as patients struggle with life's challenges.

Marriage and family therapists (LMFTs) practice early crisis intervention and brief, focused psychotherapy to reduce non-severe symptoms and resolve mild to moderate emotional and interpersonal impairments with the most efficiency possible. LMFTs also have the expertise and skills necessary to treat people diagnosed with severe and persistent mental illness who may require more intensive, long-term interventions. 

LMFTs work in California's courts and schools as well as its health institutions, child protective services, mental health treatment centers, research centers, organizations and businesses.

Patients who are treated by marriage and family therapists are more productive at work, visit their doctors less often, and have lower average lengths of stay at in-patient facilities.

Marriage and family therapists are licensed by the State of California. They must undergo extensive education, training, clinical fieldwork and pass two rigorous exams to demonstrate professional competency.

In California, record numbers of citizens are seeking treatment for mental disorders that affect their work performance and personal lives. Personal and family stresses are greater, expectations for quality of life are higher, and access to qualified mental healthcare providers has improved as society has come to recognize the impact of mental health on physical well being.

Marriage and family therapists are core mental health practitioners educated and trained to help with relationship difficulties, and diagnose and treat the mental disorders and emotional problems of individuals, couples, families and groups. Marriage and family therapy is highly effective because of the "systemic" orientation that its therapists bring to treatment. In other words, they believe that an individual's mental or emotional problems must be treated within the context of his or her current or prior relationships if the gains are to be meaningful and productive for the patient. This treatment philosophy is consistent with current thinking in the healthcare field, which increasingly emphasizes inter-agency cooperation, involvement of the family, integration and coordination of services. Our health care system is now moving toward a more systemic approach and is increasingly rejecting individually focused care.

As a result, Marriage and Family Therapists are often able to treat a patient's condition quickly, which is a cost-effective and practical approach to mental healthcare. This efficient approach to treatment is often the reason many physicians refer patients to LMFTs, who value a team-based approach and frequently seek to collaborate with other health professionals whenever it is clinically appropriate.

California Telehealth Statute (Business & Professions Code §2290.5)

Telehealth Defined:

In California, “telehealth” is defined as a method to deliver health care services using information and communication technologies to facilitate the diagnosis, consultation, treatment, and care management while the patient and provider are at two different sites. The two most common modes of telehealth for psychotherapy are via 1) live videoconferencing, and 2) telephone.

In 2016, the Board of Behavioral Sciences (BBS) promulgated regulations for the Standard of Practice for Telehealth for LMFTs. Review all the regulations here.

Division 18 of Title 16 of the California Code of Regulations, as follows: 

ARTICLE 1. GENERAL PROVISIONS ADD §1815.5. Standards of Practice for Telehealth

(a) All persons engaging in the practice of marriage and family therapy, educational psychology, clinical social work, or professional clinical counseling via telehealth, as defined in Section 2290.5 of the Code, with a client who is physically located in this State must have a valid and current license or registration issued by the Board.

(b) All psychotherapy services offered by board licensees and registrants via telehealth fall within the jurisdiction of the board just as traditional face-to-face services do. Therefore, all psychotherapy services offered via telehealth are subject to the board’s statutes and regulations.

(c) Upon initiation of telehealth services, a licensee or registrant shall do the following:

1. Obtain informed consent from the client consistent with Section 2290.5 of the Code.
2. Inform the client of the potential risks and limitations of receiving treatment via telehealth.
3. Provide the client with his or her license or registration number and the type of license or registration.
4. Document reasonable efforts made to ascertain the contact information of relevant resources, including emergency services, in the patient’s geographic area.

(d) Each time a licensee or registrant provides services via telehealth, he or she shall do the following:

1. Verbally obtain from the client and document the client’s full name and address of present location, at the beginning of each telehealth session.
2. Assess whether the client is appropriate for telehealth, including, but not limited to, consideration of the client’s psychosocial situation.
3. Utilize industry best practices for telehealth to ensure both client confidentiality and the security of the communication medium.

(e) A licensee or registrant of this state may provide telehealth services to clients located in another jurisdiction only if the California licensee or registrant meets the requirements to lawfully provide services in that jurisdiction, and delivery of services via telehealth is allowed by that jurisdiction.

(f) Failure to comply with these provisions shall be considered unprofessional conduct.

NOTE: Authority cited: Sections 4980.60, and 4990.20, Business and Professions Code. Reference: Sections 2290.5, 4980, 4989.50, 4996, 4999.30, and 4999.82, Business and Professions Code.

Evidence-based practices (EBPs) have become ubiquitous in mental health treatment over the last 20 years -- but what are they? To establish an "evidence base" through research, a practice is evaluated using scientific methods that measure the impact of the practice on treatment outcomes. Furthermore, when the term “evidence-based practice” is used to describe a treatment or service, it means that the treatment or service has been studied, usually in an academic or community setting, and has been shown to be effective, in repeated studies of the same practice and conducted by several investigative teams. Once an EBP is established, it typically uses uniform training and an instruction manual to guide providers in the treatment. In addition, supervision and oversight are included to help ensure that providers follow the treatment protocol and procedures. While there are a number of empirically supported treatments for various issues, the majority are variations of Cognitive Behavioral Therapy (CBT); this is because the effectiveness of CBT has been demonstrated for a wide range of problems in adults, adolescents, and children. 

Many therapists who do not provide EBPs are still very capable and competent; conversely, many therapists who do provide EBPs are not capable or competent -- it is important to ascertain a therapist's ability to help you on a case-by-case basis. That said, most therapists' have online profiles where you can typically find out if they are proficient, trained, and/or certified in any EBPs. And how do you know which EBPs are best for you or your family member? Using the internet to do your own research can  quickly become overwhelming and confusing. The following is a list of questions you should pose to every prospective therapist who claims to provide a specific form of treatment:

1. How does the recommended treatment work and what is involved?
2. Is there research or evidence to support the use of this treatment?  If so, are you following a manual that describes how it works?
3. If you are not recommending an evidence or research-supported treatment, why not? 
4. Is the recommended treatment covered by my insurance, and what is the share of cost?
5. What training and experience do you have with the recommended treatment?  
6. What are the risks and benefits associated with the recommended treatment? 
7. What is the goal of the treatment being recommended? Will this treatment help me get the outcomes I want? (Share the outcomes you want, such as improved work performance, less emotional distress, improved relationships, improved functioning, and any others.)
8. How will I know if I'm reaching my treatment goals?  
9. Why are you recommending this treatment and what are the alternative treatments, if any?
10. Is there research showing that the recommended treatment works for someone with my presenting problem(s)? Tell me about the research supporting the recommended treatment.
11. How does the recommended treatment promote my strengths, capabilities, and interests? 
12. How will my family be involved in the recommended treatment and how can they best support the treatment? 
13. What changes can I expect to see and how long will it take before I see those changes? 
14. How do you measure and monitor progress?
15. What should I do if my problems get worse, or if I don't see an improvement?
16. How do I reach you after hours or in an emergency? If I cannot reach you, will someone else from your office be available. If so, who?

A strong relationship with one's therapist is called a "therapeutic alliance," and it is vital to successful mental health treatment. For that reason, it's extremely important to make an informed decision when choosing a therapist. If you are planning to use mental health services in California, the Board of Behavioral Sciences has prepared a booklet to help you feel comfortable asking basic questions while choosing a therapist.  

Download Self Empowerment Booklet

Disclaimer: The questions and recommendations contained in this brochure are for the purpose of educating consumers about typical patient experiences with mental health treatment. Every individual’s experience with mental health treatment is unique. This brochure only offers suggestions; your specific treatment experience may differ from these descriptions. Differences are to be expected and do not necessarily mean your provider is not following a responsible course of treatment. 

 In their groundbreaking books, Breaking Free of the Codependency Trap and The Flight from Intimacy, Janae and Barry Weinhold provide the following detailed list to help people find the most qualified therapist to treat them:

1. Therapists should be able to model energetically what they are able to do with you. They should be able to serve as a personal example of what they hope to help you become.
2. Therapists should be able to listen for verbal signals and watch for nonverbal signals that reveal the presence of incomplete developmental processes, and then give specific concrete examples of what they hope you will learn to do on your own.
3. Therapists must avoid leading you and taking away your personal power by giving advice or by asking questions. They must give you feedback instead, which tells you how well they are paying attention to your needs.
4. Therapists must teach you how to recognize incomplete developmental processes that are causing dysfunction in your relationships or organization.
5. Therapists must avoid interjecting solutions and trying to fix things too quickly.
6. Therapists must teach you how to look for clues to identify unhealed traumas contained in your verbal and nonverbal behaviors.
7. Therapists must provide you with a "toolbox" of techniques and activities that help you access personal information or information outside of your conscious awareness about incomplete developmental processes from your childhood.
8. Therapists must teach you how to make effective contracts with yourself and others to meet your needs and to complete your developmental processes from the past.