Tonight (March 22, 2026) I downloaded the AMFTRB candidate handbook for those preparing to take the National MFT Exam. That’s pretty routine. At High Pass Education, we’re working on a prep program for the national exam, and of course we want to make our content and our practice exams consistent with what examinees might see on the actual test.
According to the National MFT Exam handbook that I just downloaded, here’s the breakdown of exam content:
Are fewer people seeking out therapy? Good nationwide data is hard to come by, but we have some signals. Online therapy provider BetterHelp reports a dwindling subscriber base, down about 20% from its peak two years ago, even as they continue to spend millions of dollars on advertising. And anecdotally, we’re hearing lots of individual therapists report that they’re struggling to bring in new clients over the last few months.
If your practice has been struggling with fewer therapy referrals, here are three possible reasons for it – and solutions for each.
I’ve been reading and enjoying Blind Spots, a 2011 book about why people make choices that go against their own genuinely-held values. It’s a good read, full of insights that I hope to bring to my work in ethics and policy going forward. One unexpected nugget for therapists: Your late cancellation fee might actually be encouraging late cancellations.
I wrote this poem several years ago, and republish it each fall as a welcome to students beginning their graduate studies in the mental health professions.
Every fall, the university where I teach enrolls dozens of new students into our graduate programs in mental health care. Our new students tend to be immensely talented, and many of them (as at any school) are also immensely anxious as they begin their journey.
In 2022, ASWB released exam data that they had long denied even possessing. That data showed significant disparities in exam performance on the basis of race and ethnicity, leading to calls that their exams should be suspended or abolished. Some states have done so, at least at some licensure levels.
Since those 2022 revelations, ASWB has made two significant promises about how they would move forward with greater transparency around their exams: 1, They would continue to provide data broken down by demographic factors like race, and 2, They would release all of their psychometric validation studies.
So far, they haven’t fulfilled either promise.