Yes, Tweets can be considered advertisements

For California therapists promoting their practices on Twitter, there isn’t enough room to include legally-required disclosures on every tweet. Here’s what to do.                                                                                                                                                                                                                                                                                                            

Twitter is a web site that allows for “micro-blogging,” or posting of messages that are 140 characters or less. Because of Twitter’s open and social nature, it can be a good platform for sharing news about your practice. However, as you can imagine, 140 characters is often not enough room to include both your legally-required disclosures and whatever meaningful content you had hoped to include in a post on the site (otherwise known as a “tweet”).

If you are an LMFT, LPCC, or LCSW in California (other state laws vary), you can advertise your practice on Twitter, you just need to use caution in doing so. The California Board of Behavioral Sciences reported in a committee meeting that they had consulted with legal counsel on therapists’ use of Twitter [page 6 of linked PDF]. If the BBS were to receive a complaint about such advertising, they said they would consider advertising “as a whole.” In other words, if your tweet only links to your web site, they would consider the tweet and the site together. As long as a potential client must have seen your legally-mandated disclosures in at least one of those places, you should be safe.

Another way to think of it is, do NOT include any direct contact information – like your phone number, email address, or office location – in a tweet or on your Twitter profile. If you do that, a potential client could come to you just from the tweet, never having seen your required disclosures. Instead, make sure your Twitter profile and individual tweets ONLY include a link to a web site or other resource where you do meet all of California’s advertising standards.

Standard caveat applies here: I’m not a lawyer, so if you are in need of legal advice, this isn’t that. Talk with someone who has actually, like, gone to law school. I’m giving my best clinician’s understanding of both the law and what the BBS has said about it.

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.

Call for Change group offers non-rebuttal rebuttal

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.

  • CFC criticizes my statement that “When CAMFT was negotiating changes to various versions of the LPCC bill, they sought to make MFTs and LPCCs as indistinguishable as possible.” They would prefer I label this as my own belief, or an opinion of AAMFT-CA. But there’s no need. I saw, firsthand, CAMFT’s opposition to language supporting distinctiveness of professions during the negotiation process. Remember, CAMFT wanted grandparenting to be automatic for licensed MFTs based just on coursework (this version of the bill allowed exactly that), and indeed, CAMFT has continued to argue there are no meaningful differences in practice between the MFT and LPCC professions (as CAMFT themselves said, they believe “LMFTs and LCSWs may do in practice everything LPCCs may do“) — which would make the licenses effectively indistinguishable. That’s not my belief, that’s an argument CAMFT itself is continuing to make and act upon.
  • Along similar lines, CFC calls my discussion of CAMFT’s lawsuit against the BBS “patently irresponsible” because… well, I can’t tell why, exactly. I’m not even sure which part they’re taking issue with. CAMFT sued the BBS to try to make the “gap exam” for MFT grandparenting go away, based on their belief that the practices of the professions are indistinguishable. They have very clearly said so. That the lawsuit attempted to use technical means (like the BBS’s failure to consult with a state agency on exams, the one point of three in the lawsuit on which CAMFT won) to reach their desired ends (no gap exam) does not change those desired ends or the publicly-stated rationale behind them.
  • AAMFT-CA and AAMFT have not been “against the LPCC bill since its inception,” as CFC newly and falsely claims. Primary sources here tell the tale. California counselor legislation was first introduced in February 2005. In November 2005, nine months later, I first spoke to a legislative committee about AAMFT-CA’s concerns with bill language. Even then, AAMFT-CA took no formal position, as we understood the bill would be further amended. AAMFT-CA only formally opposed LPCC legislation in 2007 (this legislative committee analysis is the first mention of AAMFT-CA opposition), after it became clear that the legislation was moving in a direction that would hurt the MFT profession. Furthermore, in 2009, once we worked out the compromise language that became the LPCC law, AAMFT-CA’s opposition was removed [page 2], helping the bill pass. The larger AAMFT never took any formal position at all on the bill.
  • In discussing Kim Madsen, the BBS Executive Director, the CFC rebuttal suggests that in my post, “The reader has been lead [sic] to believe Ms. Madsen would be less than forthcoming” when discussing licensure issues. Nonsense. Ms. Madsen has been, in my experience, extremely professional, highly ethical, and very forthcoming, even when we have disagreed on policy. In my earlier post, what I suggested was that CFC, not Ms. Madsen, was being less than forthcoming by leaving out important details. This should have been evident in my preface “I suspect what Ms. Madsen said was…” Given my experiences with each of them, I trust her to be complete and forthcoming much more than I presently trust CFC to do so.

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.

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If I did make any errors of fact — there or here — I would like to correct them. Email me at ben[at]bencaldwell.com, post a comment, or call for a change to my Twitter feed.

CAMFT changing therapist-referral site to “Counseling”

CAMFT is rebranding their therapist-referral site as CounselingCalifornia.com. The change, and how it was announced, continue CAMFT’s pattern of treating MFTs and LPCCs as indistinguishable.

In an announcement on November 1, the California Association of Marriage and Family Therapists (CAMFT) said it would be re-branding its therapist-referral web site as CounselingCalifornia.com. While their email described this as an effort largely to improve search engine optimization, it also fits their pattern of making marriage and family therapy (and the MFT license) indistinguishable from counseling (and the LPCC license). The change will take effect on January 4, exactly three days after the Board of Behavioral Sciences begins accepting applications for LPCC licensure through grandparenting.

Notably, not once in CAMFT’s email announcement did they refer to their own clinical members as what they are by licensure: “marriage and family therapists.” Instead, the clinicians who would gain referrals through the site (limited to CAMFT’s Clinical Members, which at this time means just MFTs) were referred to only as “therapists” or “licensed therapists.” The words “marriage” and “family” were nowhere to be found. The name change for the referral site, and the announcement of that change, certainly leave the door open for the site to be a referral site for both MFTs and LPCCs.

I can understand that, from an organizational-numbers point of view, it may benefit CAMFT to be as welcoming as possible to LPCCs as that license opens in California. However, CAMFT’s continuing efforts to make MFTs and LPCCs indistinguishable work against the best interests of both professions, who should collaborate effectively when it benefits us (lobbying for Medicare reimbursement, for example) and be able to advance our unique professions when it benefits us (publishing journals or holding conferences, for example). The constant push to make us indistinguishable, culminating in a lawsuit against the BBS, was enough for me to finally cancel my CAMFT membership. It will be interesting to see how other MFTs who value the MFT title will respond, especially if this pattern continues.

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Another reason CAMFT likely changed the name: The existing name has earned them the unlucky honor of being regularly counted among the unintentionally worst company URLs on many a list.

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CAMFT is separate and independent from both AAMFT and its California Division.

CAMFT sues California licensing board

CAMFT is suing the Board of Behavioral Sciences (BBS), demanding a ruling that the practice of marriage and family therapy has nothing unique to offer.

See updates below: The court sided with the BBS on two out of three legal questions and CAMFT on the other. The ruling required the BBS to consult with the state’s Office of Professional Examination Services prior to determining whether a gap exam was necessary. OPES recommended doing the exam, and the BBS voted unanimously to do a gap exam.

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The California Association of Marriage and Family Therapists (CAMFT) followed through on an earlier threat and filed suit this week against the state’s licensing board, the Board of Behavioral Sciences (BBS). CAMFT is seeking a ruling that marriage and family therapists who wish to be grandparented into licensure as Professional Clinical Counselors (LPCCs) will not need to take an exam on the differences in practice between those professions. But the issue is bigger than it may sound: Such a ruling would require the BBS to first determine that there are no differences in practice between the professions, a ruling that would have major implications for the future of professional licensing in mental health.

But let’s start with where this is now. The law that brings the LPCC license into the state is quite clear (emphasis mine):

The board and the Office of Professional Examination Services shall jointly develop an examination on the differences, if any differences exist, between the following:
   (A) The practice of professional clinical counseling and the practice of marriage and family therapy.
   (B) The practice of professional clinical counseling and the practice of clinical social work.
– California Business & Professions Code section 4999.54(b)(1)

CAMFT argues in its suit, as it has in BBS meetings, that there may be differences between the professions, but that these do not amount to differences in practice. So they do not believe that an exam on differences between MFT and LPCC (a “gap exam”) is necessary. That argument has now lost twice: The BBS ruled on July 28 that there should be a gap exam, based on the language of the law. CAMFT threatened to sue (page 6), and the BBS vacated all earlier discussion and took the issue up again on September 9. Again they ruled that there must be a test. In a suit filed on Monday, CAMFT argues that requiring a gap exam amounts to an unlawful restraint of trade for MFTs seeking LPCC licensure. They ask to have the BBS decision again vacated, and an injunction issued preventing the BBS from requiring a gap exam.

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While I am trying to present these facts as neutrally as possible, I am hardly an objective observer. I co-signed AAMFT-CA’s letter to the BBS encouraging them to revisit their initial decision in May that no gap exam would be needed. And, fundamentally, I believe there are significant differences between the professions — that’s why we have distinct educational programs and are distinctly licensed. Arguing that the professions may be different but their practices — the doing of the professions — is the same is a giant leap of both language and logic. Indeed, as Dean Porter, head of the California Coalition for Counselor Licensure, has said, proving LPCCs’ distinctiveness [currently-third item, “AMHCA lauds…”] was one of their biggest challenges in achieving licensure in California.

There is no need for a separate license if the professional group in question has nothing new or different to offer. That is why this is such a concern for me — if CAMFT gets their way, and the BBS or a court rules that there are no differences in practice between the professions, it is an extremely short logical walk to an argument that MFTs and LPCCs (and even LCSWs) should not be separately licensed. I worry that that’s the idea. CAMFT has stopped publicly advocating such a shift (they openly projected such a “one-license future” to members and to the California legislature in 2007), but they still seem to be walking down that road. Having earlier removed their opposition to LPCC licensing legislation, they appear to have taken no action when a 2008 version of the LPCC bill proposed to study eliminating the MFT license entirely (see Section 6, at the bottom of the next-to-last page; that version of the bill, thankfully, failed). This week’s legal action seems to be a continuation of the “we have nothing unique to offer, so let’s all combine licenses” philosophy. Why an association of marriage and family therapists would continue taking stances that appear to act against keeping the MFT license distinct is beyond my understanding.

I would love a different explanation, but cannot seem to come up with one.

The legal complaint and related documents can be downloaded here *. They are referenced by case number (34-2010-80000689).

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I know I say this over to the right, but it bears repeating: On this blog, I speak strictly for myself, and not my employers or contractors or anyone else. It also bears repeating, for those of you from outside California, that CAMFT is an independent organization with no ties to the American Association for Marriage and Family Therapy (AAMFT) or its California Division (AAMFT-CA).

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* Updated 1-11-2011: Updated link.

Updated 2-3-2011: The court has issued its ruling, which sides with the BBS on two out of three legal questions and CAMFT on the other. See this post for details: Ruling mixed on CAMFT-BBS “gap exam” lawsuit.

Updated 2-27-2011: OPES recommended doing the exam, and the BBS has voted unanimously to do a gap exam.