Prelicensed therapists and counselors face a difficult road. Getting to licensure is a long and expensive process, so much so that even many well-qualified people drop out.
All of us here at Psychotherapy Notes want to make your path to licensure a little easier. So we’ve collected resources here that can help you along the way. You may already be familiar with some, but hopefully some are new and useful to you. Here are some essential resources for prelicensed therapists.
Senate Bill 1172 would stop licensed therapists from providing reparative therapy to minors. It awaits Governor Brown’s signature or veto.
Updated 9/30/12 – Governor Brown signed the bill into law. It takes effect January 1, 2013.
Senate Bill 1172, a proposed California law that would prevent licensed therapists from offering so-called “reparative therapy” to minors, has passed the state Assembly and Senate and is currently on Governor Jerry Brown’s desk. The Governor has until the end of this month — less than a week away — to sign or veto the bill.
If he signs it, California would be the first state in the US to take such action. Other states are eyeing the California bill closely, with some planning to propose similar bills. Gay rights organizations are also paying close attention to the bill, and have been pushing the Governor to sign it.
“Reparative therapy,” also sometimes known as “conversion therapy” and referred to in the bill as “sexual orientation change efforts,” is a form of therapy that aims to help people distressed by same-sex attraction change those attractions and ultimately become more heterosexual. The therapy was pioneered by Dr. Joseph Nicolosi, who suggests in his original book on the topic that same-sex attractions are unhealthy.
All the major professional associations in mental health have issued statements discouraging their members from using reparative therapy, though none has gone so far as to declare the practice inherently unethical. (See statements from the AAMFT, ACA, APA, CAMFT, and NASW; there’s a nice history of associations’ stances on the topic here.) These statements typically cite the lack of research support for any therapy succeeding in altering sexual orientation, and the serious risk of harm that comes to gay and lesbian clients when a therapist tells them that their sexuality is wrong or unhealthy.
However, the therapy remains practiced by a number of mental health professionals, who offer anecdotal reports of clients who say they were helped by the approach.
While professional associations are usually loath to accept government intrusion into clinical practice, it is noteworthy that all of the major professional associations in mental health in California are now either neutral on the bill or actively supporting it. All were initially opposed, but as the language of the bill has been amended, all have dropped their opposition. Here is where the major mental health professional associations currently stand:
AAMFT-CA: Support
The American Association for Marriage and Family Therapy, California Division was (with NASW-CA) one of the first associations to move from opposition to support. (Full disclosure: I’m the current Legislative and Advocacy Committee Chair for AAMFT-CA, and I’ve worked a great deal on this bill.)
NASW-CA: Support
The National Association of Social Workers, California Division was (with AAMFT-CA) one of the first associations to move from opposition to support.
CPA (Psychologists): Support
The The California Psychological Association had initially joined three other organizations (Psychiatrists, CAMFT, and CALPCC) in jointly oposing the bill. While all four organizations have since dropped their opposition, CPA appears to be the only one of the four to move to a position of support.
CALPCC: Neutral
The California Association of Licensed Professional Clinical Counselors has dropped its opposition, though the bill is not currently mentioned anywhere on the group’s web site.
CAMFT: Neutral
The California Association of Marriage and Family Therapists has dropped its opposition to the bill. The CAMFT web site includes a relatively soft caution to its members about the use of reparative therapy (referred to here as “sexual orientation change efforts”) but otherwise does not address the bill.
CPA (Psychiatrists): Neutral
The California Psychiatric Association has officially withdrawn its opposition to the bill, citing a 1998 statement of the American Psychiatric Association which reads in part, “The American Psychiatric Association opposes any psychiatric treatment, such as ‘reparative’ or ‘conversion’ therapy, which is based upon the assumption that homosexuality per se is a mental disorder.”
Whatever your stance on the bill, both sides are suggesting you contact Governor Brown’s office directly to let him know. The Governor’s office can be reached by phone at 916-445-2841, by email here, or on Twitter at @JerryBrownGov.
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Your comments are welcome. You may post them in the comments section below, via email to ben [at] bencaldwell [dot] com, or to my Twitter feed.
MFT Call for Change group responds to my previous post, where I highlighted several of their erroneous statements about California.
The group calling themselves “MFTs Call for Change” (CFC) has posted a lengthy rebuttal to my earlier post criticizing CFC misstatements about California, specifically in areas related to the LPCC license and its development here.
Notably, they rarely, if ever, challenge my statements of fact. They claim that my post included “misinformation,” but their arguments are more often of the moving-the-target (“yes, but”) variety than they are factual disagreement. And they add at least one to the list of factual errors of their own.
As I said previously, the CFC group seems to be well-meaning. I just don’t understand their dogged pursuit of this line of criticism. It is not supported by facts, and makes CFC look more interested in finding fault with AAMFT than actually supporting or developing the profession.
A group of well-meaning MFTs has been trying to make AAMFT more transparent and accountable. But their latest report about the LPCC license in California, which claims to have found deception by AAMFT, gets the important facts wrong.
* See updates below.
If you’re a member of AAMFT or have been connected in any way with the “Call for Change,” you may have received an email with an unsettling headline:
Unsubstantiated Rumor Influences AAMFT’s Strategic Plan
The email goes on to say that this “unsubstantiated rumor” was the notion that there was a threat to MFT licensure in California connected to the development of the state’s Professional Clinical Counselor (LPCC) license. You can read the CFC’s complete report online: CA LPC Deception Revealed.
Because the threat posed by LPCC licensure was all “unsubstantiated rumor,” the CFC logic goes, perhaps someone at AAMFT knowingly ginned it up for political reasons:
What could be the motives behind generating such rumors, fear, and speculation within our membership in relation to a document and process as significant as a long range Strategic Plan? Since the truth of this matter was already known by AAMFT leadership, could the reason be political?
For anyone unfamiliar, the CFC group is made up largely of well-meaning MFTs who want a more open, accountable professional association. That’s a laudable goal, and they have pushed AAMFT into making some much-needed changes, especially around organizational transparency. There is surely more work to be done on that front, and for that reason, a subgroup like CFC can sometimes ultimately be a positive thing for the larger association they criticize.
In this case, though, CFC gets the important facts wrong, and loses a great deal of its own credibility in the process. It starts by reporting that Kim Madsen, the California Board of Behavioral Sciences Executive Director, told them “there had been no current or past discussions regarding replacing the LMFT license in California with the LPC license” (I’m quoting the CFC’s paraphrase of Ms. Madsen). I of course was not in on this phone call, but I suspect what Ms. Madsen said was that no such discussion took place at the BBS. And, with that kind-of-important detail, that’s true — the BBS never had a public meeting or vote where replacing the MFT license was discussed or voted on.
For the CFC to extrapolate that to the notion that no one in California ever discussed eliminating the MFT license, however, is a rather significant error. CAMFT (which is not affiliated with AAMFT or its California Division) specifically discussed replacing the MFT license. You can see it in page 14 of this California legislative committee report, and the same text was in an email to members that CAMFT sent in May 2007 (emphasis mine):
CAMFT states, “At some time in the future, we project that there will only be one masters level profession in California, with individuals specializing within that license. Thus, those who wish to specialize in systems work will do so; those who wish to specialize in art therapy will do so, etc. The current system with a variety of acronyms is confusing for consumers who just want to be helped and do not perceive greater value from one professional compared to the next.”
When CAMFT was negotiating changes to various versions of the LPCC bill, they sought to make MFTs and LPCCs as indistinguishable as possible. And without distinctiveness between professions, it becomes much harder to argue that distinct licensure should be maintained. Sure enough, the following language was inserted into a version of the 2008 LPCC bill (which ultimately failed; again, emphasis mine):
The Department of Consumer Affairs and the Board of Behavioral Sciences shall collaboratively evaluate the licensing requirements and scope of practice for licensed professional
counselors, licensed clinical social workers, licensed educational psychologists, and marriage and family therapists. The evaluation shall include a recommendation on whether or not these licensed professions should become a general license category, and if such a recommendation is made, how it is proposed to occur.
CAMFT projected a one-license future, and that proposal found its way into proposed legislation. These are facts on the public record. They are indisputable. That legislation may have become law had AAMFT-CA and the California Psychological Association not worked diligently in opposition. For CFC to dismiss the threat to California MFT licensure as “unsubstantiated rumor” is clearly and demonstrably incorrect.
CFC goes on to question how CAMFT could possibly have any influence over license transitions, since it is the BBS and not any professional association that enforces licensure standards. This is shockingly naive. CAMFT does a tremendous amount of work (often very good and beneficial) on state legislation, and the licensure standards the BBS exists to enforce are written in state law; the BBS has no right or authority to refuse to enforce a law once it takes effect. Almost every major piece of state legislation that has impacted California MFTs in a generation has had CAMFT’s fingerprints on it. If CAMFT wanted MFTs to become LPCs, they wouldn’t politely ask the BBS to make it happen. They would seek to change the law, and they have the resources to do so. As you can see above, a change in the law is precisely what could have happened.
Even after the final version of the LPCC law passed in California, CAMFT has continued to work hard at making MFTs and LPCCs seem indistinguishable. When even the relatively minor barrier of a “gap exam” for MFTs seeking grandparenting into LPCC licensure arose, CAMFT not only fought it, they sued the BBS — a suit that could have, among other things, led to a court ruling that the professions are not distinct.
Thankfully, CAMFT largely lost that suit. There will be a gap exam, and the BBS is supporting distinctiveness between MFTs and LPCCs in other ways. But for CFC to suggest that there never was a threat to the MFT license in California — or indeed, to even suggest that threat has fully abated now — is simply out of line with reality.
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Full disclosure: I have served as a consultant to AAMFT in the past (not currently), and still volunteer regularly for the California Division, though I hold no official role there. I was part of the AAMFT-CA negotiating team on California LPCC legislation. I’m a former CAMFT member; their lawsuit against the BBS led me out the door.
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Updated 3-16-2011: The Call for Change folks have posted a rebuttal to my post here. See: CFC rebuttal // My response
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The image above is the semaphore sign for “error.”
Court finds the BBS must consult with Office of Professional Examination Services to determine whether a “gap exam” is needed for MFTs seeking LPCC licensure.
At 11:00 this morning, the California Superior Court for Sacramento County issued a tentative ruling in the CAMFT-BBS lawsuit over MFTs who wish to be grandparented into LPCC licensure. It leaves hanging the question of whether there will actually be such an exam — though it appears highly likely.
I’ve previously written about the issue here and here, the first of which offers a better review of the details.
Today’s ruling is mixed, siding with the BBS on two key questions and with CAMFT on one:
Ultimately, the court orders that the decision to require a “gap exam” be set aside until the OPES consultation has taken place (which must be within 60 days) and the BBS makes a determination based in part upon the results of that consultation. Since the BBS and its contracted consultant both previously concluded that there were meaningful differences between the professions, the court ruling on the first two questions above suggests a strong likelihood that the BBS will go forward with an exam, but it is not fully certain.
You can read the ruling in full here.
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Updated 1-30-2011: The court heard oral argument on Friday, to no effect — it adopted what had been the tentative ruling. The BBS now has 60 days to consult with OPES and make a final determination on the need for a gap exam.
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Update 2-6-2011: CAMFT has released their spin on the Gap Exam ruling, which seems sure to mislead at least some readers. There’s nothing there that’s technically incorrect, but it takes a fair amount of reading to get the full picture. People who just read the headline, or even the headline and the first couple of paragraphs, will likely come away believing there will be no Gap Exam. Since CAMFT lost on the two substantive arguments that would suggest the exam is unnecessary, it still seems likely that an exam will be given.
Also updated the headline, as the court adopted its tentative ruling.