2021 Changes to the California MFT Clinical Exam

Matthew Henry / Burst / Used under licenseStarting January 1, 2021, there are meaningful changes to the California MFT Clinical Exam, set forth in the new BBS Exam Plan. At Ben Caldwell Labs, we’re adding some video segments to our online prep program to address some new content areas. However, the most notable changes are in the balance of content on the exam.

Compare the old breakdown of question topics to the new one:

Clinical Evaluation20%Clinical Evaluation27%
Managing Crisis12%Diagnosis11%
Treatment Planning20%Managing Crisis11%
Treatment20%Treatment Planning12%
Law12%Law and Ethics10%

Newly emphasized

As you can see, there’s newly specific emphasis on Diagnosis. As of 2021, you can now expect roughly 19 exam items (out of 170 total) to focus on DSM diagnosis. Since Diagnosis is now broken out separately from Clinical Evaluation (it used to be included within that category), it means that the non-diagnostic parts of clinical evaluation now take up about twice as much of the exam as they used to (27% versus prior 14%). This includes understanding diversity factors, strengths, stressors, interaction patterns, and so on, and being able to assess things like developmental level, cognitive functioning, mental status, and so on.

There’s also greater emphasis in the new exam on treatment, specifically applying interventions associated with particular theories. Several theories are specifically called out in the Exam Plan for the first time, including Self Psychology, Dialectical Behavior Therapy (DBT), and Rational-Emotive Behavior Therapy (REBT). We’re in the process of adding video segments specifically addressing these models.

Newly de-emphasized

To make room for these new areas, you’ll also see that coverage of Law and Ethics is meaningfully reduced, from 28% of the exam down to 10%. This makes sense, considering that the BBS now uses a separate Law and Ethics Exam, though they of course want to make sure your legal and ethical knowledge remains current. 

Treatment Planning is also de-emphasized on the new test relative to the old one, although it may be helpful to think of Treatment Planning and Treatment as a combined category that is remaining at about 40% of the test. They both require you to understand and apply various theoretical models in specific clinical situations. The Treatment Planning category focuses on the development of a case conceptualization and treatment plan, while the Treatment category focuses on carrying out that plan through specific actions in therapy. It is notable that of these two, the balance is shifting more toward interventions and away from case conceptualization.

If you’re testing in January or after, don’t worry that anything within our (or any other) current program isn’t going to still be useful — the BBS made a lot of additions to the exam plan, but they didn’t take much out.

For more on our prep program and to enroll, visit the Ben Caldwell Labs California MFT Clinical Exam Prep course.