Road to Licensure: Law and Ethics

Goals for the Class

• The goals are to identify, engage, and resolve legal and ethical issues.
• Practice ethical decision making
• Preparation for the state Law and Ethics Exam is provided, a state licensure requirement.
• This exam is taken during the first year of associateship after graduation.
• The class is a comprehensive overview, so further study and experience is still needed at practicum sites with supervisors.

Road to Licensure

• An individual completes graduate education and practicum hours under a licensed professional
• An individual completes an application for associateship after graduation
• All hours are completed under the supervision of a licensed professional.
• One must complete 3,000 required hours under supervision of a licensed person, and one must pass the state Law and Ethics exam during this time.
• After completing these steps one can apply for the clinical exam.
• After passing the clinical exam the individual will achieve LMFT/LPCC status.

LMFT vs. LPCC

• Licensed Marriage & Family Therapists (LMFT) focus on behavior in a social and relational context and problems in relationships and work to improve a client's relationships.
• Licensed Professional Clinical Counselor (LPCC) focuses on psychological and social development, problems stemming from developmental issues, and improving a client's development and wellness.

Scope of Practice vs. Scope of Competence

• Scope of practice is what one is legally allowed to do, applicable to everyone in their profession, and cannot be expanded except by law.
• Scope of competence is defined by education, training, and experience, specific to each person and can be expanded with further education and training.

California Board of Behavioral Sciences (BBS)

• The BBS outlines the standards of the profession
• The BBS screens those who are applying for licensure.
• The BBS facilitates disciplinary proceedings when violations occur.
• The BBS protects the public by regulating the practice of psychotherapy.
• The BBS is a resource for changes in laws, regulations, guidelines, and waivers.
• The BBS provides guidance on licensure.
• The BBS website can be used to verify licenses, file complaints, review guidelines, and access exam information and forms.
• It is each practitioner’s responsibility to keep up with the BBS.

Regulators of the Profession:

• Mental health professionals are guided and regulated by laws, ethics, and standards of care.
• All three are needed to protect the public and benefit mental health professionals.

Key Considerations

• The Law is established by state and federal governments, enforced by the government/BBS and establishes the minimum standard
• The Code of Ethics is established and enforced by Professional Associations (CAMFT, AMFT, NASW, ACA), which established the ideal standard
• The Standard of Care is established by other professionals and establishes the scope of competency
• The law must be considered above everything and can conflict with the ethics code.
• At times, professional association codes can be more narrow or more aspirational
• Standard of Care can vary by discipline, theoretical orientation, and asks the question "What would another therapist do?"

Benefits for Mental Health Professionals

• Laws and ethics clarify standards
• Laws and ethics help to address frivolous complaints and lawsuits.
• Laws and ethics create clear standards and expectations and demonstrate to the public that high standards are upheld

Introduction to Ethics Codes

• The California Association of Marriage & Family Therapists (CAMFT) expects all of its members to abide by the CODE and the LAWs, and a lack of understanding does not justify or excuse violations
• CAMFT stresses the importance of reading, understanding and using the code for ethical decision making, which will be used in adjudication of all ethical issues and complaints.
• Ethical behavior must meet two criteria with consideration given to the judgement of individual therapist, and peers based on the set of recognized norms.
• Clinicians are admonished to consider, and use, the spirit and intent of the code when making ethical decisions due to the fact that no code can cover ever possible situation

Ethical Decision Making

• When facing an ethical question, it is important to consider The Law, Ethics Code, and Standard of Care.
• It's important to identify both the problem and any potential issues
• Review the ethics codes, and know and apply all relevant laws and regulations
• Consultation is important, and therapists should never work alone.
• Consider the possible outcomes/ consequences of the decision
• Choose the best course of action.

Time to Practice

• Bill, an LPCC with 35 years of experiences, prescribes anti-anxiety medication to a client suffering daily panic attacks.
• Sandy, an Associate MFT, advertises that she serves couples, despite only having two weeks of training on EFT and no additional training, or supervision in that area.
• Sarah, an MFT Trainee, begins using psychedelics with clients to treat those who are experiencing complex PTSD, prior to consulting her supervisor
• Phoebe, an LMFT, begins getting referrals for refugees from Ukraine, however does not have trauma training beyond what she learned in grad school.
• Bob and Frank are seeing a therapist for couples therapy, and they decide that a divorce is best. During a heated session they ask the therapist what to do about custody, and the therapist explains the law surrounding custody agreements in their state. The therapist notes that in their experience, the law is not favorable to gay couples, and advises that the couple try mediation.