In a major victory for marriage and family therapists, the Texas Supreme Court today ruled that MFTs can independently diagnose in accordance with the DSM. The ruling was surprising, given that the Court had denied review of the case last year. In an unusual move, the court agreed to reconsider the case last fall.
The Texas Medical Association argued that the Texas MFT licensing board overstepped its legal authority by allowing MFTs to diagnose. The TMA said that diagnosis equated to the practice of medicine, which should be reserved for physicians. The MFT board, meanwhile, said that diagnosis was an essential part of MFT practice. The court agreed with the MFT board, saying in part:
[E]very act that a physician may do is not automatically the unlawful practice of medicine when done by a non-physician, and terminology in one field may overlap with that of another. That the diagnosis of physical and mental diseases and disorders lies within the province of physicians does not preclude MFTs from making diagnostic assessments of emotional, mental, and behavioral problems as part of their efforts to evaluate and remediate mental dysfunctions within the marriage and family setting. Although MFTs’ authority to provide a diagnostic assessment is subject to real and meaningful limitations, we conclude that the Therapists Act authorizes the diagnostic-assessment rule and the Medical Practice Act does not prohibit it.
The case potentially had far-reaching consequences. In many states, master’s level mental health professions do not have the word “diagnosis” specifically included in their scope of practice, but are allowed to diagnose based on other statutes or interpretations of the existing scope language. A victory for TMA could have led to similar battles in other states. In places where therapists lost, consumer access to mental health care could have been dramatically limited.
The AAMFT had dedicated significant resources to this case over several years. Understanding the potential impacts of it, the California Association of Marriage and Family Therapists and the Association of Marriage and Family Therapy Regulatory Boards each submitted amicus briefs supporting the Texas board.