Studying for MFT licensing 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.

[Ed. note: This post initially published October 27, 2010. Updated in November 2016 to update the list of companies offering test prep products and services.]

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:

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Counselor and therapist licensure: Does testing raise quality?

Whenever I get into conversations about the licensing process, a number of the same questions keep coming up. Many of these questions revolve around the value of having a license exam. It’s perhaps the most pesky, the-answer-should-be-obvious-but-isn’t question: Do licensure examinations make for better therapists?

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The myth of the portable license

California’s new LPCC isn’t any more of a “national license” than the MFT license is: not at all. Why do rumors persist that it is?                                                                                                                                                                                                                                                                                                            

Cloth SuitcaseHere in California, we’re currently in the middle of the grandparenting period for licensed MFTs and LCSWs who want the state’s new Licensed Professional Clinical Counselor (LPCC) license. One of the most common reasons I hear from MFTs for wanting the LPCC is the notion that it, unlike the MFT, is a “national license.”

Except it isn’t.

For clarity: An LPCC license is no more of a national license than an MFT license, which is to say, neither is a national license at all. Both are state licenses only. Both professions now have licensure laws in all of the 50 United States (and DC), but for both, the licensing laws from state to state differ. How portable your license is — that is, how easily you could get licensed in a new state once you move — depends on a number of factors, including which state you move to. (For more on this, see my earlier post on MFTs and license portability.) But neither license has true reciprocity, which is automatic recognition of another state’s license.

The only reason I know of that could explain the myth of a portable LPCC license is that California’s Board of Behavioral Sciences is recognizing the National Clinical Mental Health Counselor Exam for LPCCs, while for MFTs, we use state-based exams. Admittedly, that can make moving into or out of California with an MFT license slightly more challenging: If you move into California, even if you have been licensed elsewhere for decades, you will need to take California’s MFT licensing exams. And if you move out of California, even if you have been licensed here for decades, you will need to take the National MFT Exam (many states also require a state-based law and ethics exam) to get licensed in your new home state. But the BBS has already gotten legislative approval to restructure the MFT license exam process, and is working with the folks who develop the National MFT Exam to have that exam offered and recognized in California. So that difference between the professions will hopefully be vanishing in the not-too-distant future.

There are good reasons for some MFTs to pursue the California LPCC license. Unfortunately, the ones I hear most often from MFTs as their motivators are falsehoods, and this portability issue is a great example.

If you are interested in hearing more about the LPCC license (including debunking of more myths!), differences between the philosophies of MFT and LPCC, scopes of practice, legal and workplace recognition, and much, much more, please consider attending “The California LPCC,” a presentation I’m giving with Angela Kahn, MA. Angela has helped develop the LPCC curriculum for Antioch University in Los Angeles, and is going through the grandparenting process; I helped AAMFT-CA negotiate what became the LPCC licensing bill, and I’m probably not going to go through grandparenting. So we present an informed perspective from both sides of that question. We’re giving the talk at Antioch in LA this Saturday, November 19 (that one’s just for Antioch students, faculty and alumni, so contact the school for more info or to RSVP). We’re also giving the talk in San Diego on December 3. Use this link for more information or to register: The California LPCC, Dec. 3, San Diego.

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Your comments are always free to cross state lines. Offer them here, by email to ben[at]bencaldwell[dot]com, or through my easily-portable Twitter feed.

Four myths about MFT licensing exams

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:

  1. 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.
  2. 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.
  3. 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.)
  4. 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.

Insights from 5 1/2 years of California MFT license exam data: A defense of underperforming programs

Some MFT programs’ graduates perform poorly on California’s MFT licensing exams. Don’t assume that means the program is of poor quality; there may be good reasons.

Graduation hat1We’ve seen that there are huge differences in performance on the California marriage and family therapy licensing exams based on what graduate program the test-takers attended. We’ve also seen that for-profit MFT programs should not be dismissed simply because they aim to make money; Argosy graduates do particularly well on the exams, while University of Phoenix graduates do not. I’ve said before, though, that there are lots of things to consider when choosing a graduate program in MFT, and that graduates’ exam performance should only be one of many such considerations. Indeed, there are some major problems with putting too much stock in exam data.

If you are looking at graduate programs, and are concerned about your prospective MFT program’s exam pass rate, here are three reasons why you may want to ignore the exam data:

  • Programs can and do improve. Exam data reflects students who graduated years earlier. Remember, it takes the average MFT intern in California more than four years to move from graduation to the licensing exams. That number is a bit lower for graduates of COAMFTE-accredited programs, primarily because they do more practicum hours while still in school. Nonetheless, if you are looking at MFT licensing exam data from 2009 and earlier, you will find very little information on anyone who graduated much past 2005, and nothing to tell you which programs have gotten better or worse since then. Consider the recently-COAMFTE-accredited programs at Chapman University and Hope International University. Their national accreditation should arguably make them more appealing (and thus competitive) programs for prospective students and faculty alike. That’s important, and simply is not reflected in currently-available exam data.
  • Programs seek to give students opportunities. Consider for a moment the state’s worst-performing program, according to a table that appeared in Part I of this series: Pacific Oaks College. Based on the pass-rate statistic alone, one might presume that the Pacific Oaks program is not very good. But that conclusion can’t safely be made from that data. Pacific Oaks, over the past few years, has specifically sought to provide opportunities to historically underserved populations, creating cohorts specifically for African-American Family Therapy and Latino Family Therapy. (This outreach is vital: Lots of evidence suggests that the mental health workforce is not meeting the needs of minority populations, either in California or around the US.) Students in these cohorts may lack the family, economic, and social support, as well as the earlier educational opportunities, that other students often have. Pacific Oaks goes to great length to remediate these earlier deficits, and may be doing more, with less, than programs who start with more economically- and educationally-advantaged students. When financial and accreditation concerns threatened to close the Pacific Oaks in 2009, I was one of many who stood up in defense of keeping the program alive, and have no reservations about having done so.
  • Programs have no control over what students do after graduation. A program can really only control what happens from the time students are in the program to the time they graduate — and even then, programs have limited control over how well their students prepare themselves. A great supervisor can help an MFT Intern/Associate make up for deficiencies in their education, and help get them ready for licensing exams. Poor supervision may leave the Intern/Associate on their own to prepare, or even offer incorrect information that ultimately harms one’s chance of passing the exams. And of course, programs have no control over whether their graduates use MFT exam prep programs, although there is little evidence that these prep classes actually impact MFT exam pass rates.

Of course, before you do go dismissing a program’s exam pass rate, take some steps to get reassurance that you are making that decision wisely. If you are considering attending a program whose graduates have not performed well on recent licensing exams, ask the program (1) why, (2) what they’re doing about it, and (3) what evidence they have that they’re getting better. If the program can’t pass that test, then it’s time to wonder whether you would be able to pass yours.