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.
Discussions about value-based care among therapists are often confusing and unproductive. In my experience, that seems to be because a lot of us simply don’t know what the term means. So it gets either dismissed as just a new term for things many of us already do (like measuring outcomes), or it gets framed as the boogeyman intent on destroying therapy as we know it.
In response to mass shootings, wildfires, and other disasters, many therapists and counselors have sought to support impacted areas. One way they have done so is with free services. Marketing therapy after disasters can be difficult, though. Done well, it reinforces our roles as community caregivers. It shows off the best of who we are as professionals. With some common mistakes, it can instead come off as a tacky form of marketing, accidentally pushing people in need away from help. Here’s how to tastefully and effectively offer counseling and therapy services to those in need.