The California Board of Behavioral Sciences will discuss clinical exams this Friday. My colleague Tony Rousmaniere and I decided to dig into these exams, beyond just the horrifying report ASWB released this summer. (TLDR: Wildly disparate passing rates by race/ethnicity.) While I’m previously on record as not a fan of clinical exams, they’re widely accepted. We figured we would follow where the data leads us. And so here it is:
I just took the California MFT Clinical Exam and the National MFT Exam within a month of each other. When scheduling both of these exams, my hope was that I could study once, and then ace both. Here, I’ll outline the similarities and differences I noticed between the two exams.
If you are soon to be taking your state’s MFT licensing exams, congratulations! Here are five tips on how to study and prepare.
Licensing exams are a major milestone in the professional development of a marriage and family therapist (MFT). While there are differences from state to state, every state except California uses the National MFT Exam, and most states require that exams be taken at the completion of at least two years of full-time, post-masters experience in supervised practice. (California uses exclusively its own exams.) As you approach completion of the supervised experience necessary to take the exams, how can you best prepare? Here are five things that can help:
California’s licensing exam restructure for marriage and family therapists (MFTs) takes effect January 1, 2016. Here’s how the new exam process will affect you.
Go ahead and be anxious about your licensing exam process — it’s a big deal! But don’t buy into grumbling falsehoods about it. Test items are written by actual MFTs, and there are no trick questions.
Every person who becomes a licensed marriage and family therapist has to go through an examination process. In most states, that means passing the National MFT Exam. Many states also supplement the national exam with a second exam covering areas of state law (for example, ensuring that therapists are familiar with that state’s requirements for child abuse reporting). In California, the exam process is a bit different; California MFTs must pass two state-run exams, the MFT Standard Written Exam and the MFT Written Clinical Vignette Exam. [Update: The California MFT licensing exams change structure on January 1, 2016.] The overall content and structure of California’s exams are similar to the National MFT Exam — they’re multiple-choice tests that use a combination of factual questions and case-vignette-based questions.
Regardless of what state you’re in, if you haven’t taken the exam(s) yet, you may be dreading them. Even if you have gone through the exam process, you may not have fond memories of it. I hear complaints about the licensing exam process on a regular basis — most of them based on total mythology. It’s as if we (quite understandably) have anxiety-based associations with our testing process, past or future, and then (far less understandably) conjure up rational-sounding but totally baseless complaints about the process in an attempt to justify those fears.
It’s okay to be anxious about the process on its own merits. The exams are high-stakes; if you fail, you typically have to wait several months to try again. That impacts your standing among your peers, your employment options, and potentially your income. I still remember completing California’s Written Clinical Vignette exam and feeling certain I had failed. In a matter of moments, I was mentally planning how I would explain the failure to my employer, and how I would plan to do better next time. It turned out I had passed, but the memory of those anxious moments before getting my results stays with me.
If I had failed, I wanted to blame someone else: How dare that test be too hard for me! It must be the test’s fault! I’m glad I didn’t take much of a walk down that road, but if I had, I would have had plenty of company. Once a rumor has started that serves to explain why the tests feel so frightening and why we feel so unsure of ourselves going into them, it is easy for that rumor to be perpetuated. Such stories are factually wrong, and ultimately do more of a disservice to future test-takers by making the exams look cruel and unpredictable. But to someone who has failed a test (or is worried they might), the stories offer comfort — and someone else to blame. So they live on each year.
Here are the four myths I hear about MFT licensing exams the most:
- There are trick questions. Simply put, a licensing exam that uses trick questions would not be legally defensible. Test developers go to tremendous lengths to make sure any potential exam item works well, through several layers of review and pilot testing. If too many people are missing a question, it gets flagged for even more review. If a question appears to be tricking people, either by design or by accident, it is removed.
- There is secret knowledge. Test-prep companies make a lot of money perpetuating the mythology that they can provide you with “secrets” or other insider knowledge to help you pass the tests. Nonsense. Both California and AMFTRB (developers of the national exam) offer study guides that say what will be covered on the exams, and they ultimately draw their questions from the same textbooks and journal articles that graduate programs use to teach their students.
- They are meant to assess whether you are a good therapist. If I may be blunt, your licensing board does not care whether you are a great therapist or a lousy one. They only care about whether you can practice marriage and family therapy competently enough so as to not be a danger to the public. That’s what the exams are meant to assess. Yes, it is sometimes true that ineffective therapists pass their licensing exams, and effective therapists fail. But effectiveness and potential dangerousness are two different things. If you want an outside evaluation of your quality as a therapist, look elsewhere. (Back in 2008, I examined in more detail the question of whether licensing exams lead to better quality therapists.)
- They are written by people who aren’t therapists. Both California and the AMFTRB use licensed therapists to write their test items. In California, you can apply to be a subject matter expert involved in writing the exams. Elsewhere in the country, AMFTRB intermittently recruits MFTs with relevant expertise. Every test item on both the California and National MFT Exams is written by one or more practicing MFTs.
If you’re anxious about your own upcoming exams, instead of buying into the falsehoods above, you’ll likely be better off to do something about that anxiety. Maybe that means simply more studying, or maybe it means more directly addressing the anxiety through meditation, therapy, or other means. (Test-prep programs may be of questionable value overall, but if they can help you feel more knowledgeable and less anxious as you take the tests, they may well be worth your time and money.) Rest assured the exam process, and those who designed it, are not out to get you or to trick you. With the right preparation, you can do well on exam day.
If you know someone else who is anxious about their exams, or even who has failed an exam, by all means, comfort them and empathize with them. Sometimes we just have bad days. But please don’t support any of the mythology above — those ideas just make the testing process look bigger, scarier, and less under your control than it really is.