Laws and regulations are subject to change. You must verify the specifics for your state using the resources you provided (AMFTRB, state board websites) to ensure accuracy. I will provide a general framework and examples, but the details will vary.

1. Process to Obtain Licensure in My State

• (General Process – You must specify for your state):
  • Educational Requirements: Typically, a master’s degree (and sometimes a doctoral degree) in Marriage and Family Therapy from an accredited program. Coursework usually includes family systems theory, psychopathology, research methods, ethics, and clinical practice.
  • Supervised Clinical Experience: Most states require a specific number of supervised clinical hours post-master’s. This involves providing therapy under the supervision of a licensed MFT. The number of hours varies significantly by state.
  • Examination: Passing a national examination, such as the National Examination in Marriage and Family Therapy, administered by the AMFTRB.
  • Application: Submitting a formal application to the state licensing board, including transcripts, proof of supervised experience, and exam scores.
  • Continuing Education: Maintaining licensure typically requires ongoing continuing education to stay updated on the latest research, ethical standards, and clinical practices.
• (Example – Please Replace with Your State’s Specifics):
  • In California, the process involves completing a master’s degree, accruing 3,000 hours of supervised experience (1,750 with clients), passing the California Law and Ethics Examination and the National MFT Examination, and applying to the Board of Behavioral Sciences.

2. State’s Limits to Confidentiality and AAMFT Code of Ethics on Confidentiality

• State’s Limits to Confidentiality:
  • (General Principles – You must specify for your state):
    • Most states have laws that limit confidentiality in situations involving:
      • Child abuse or neglect: Therapists are mandated reporters.
      • Elder abuse or abuse of vulnerable adults: Similar to child abuse reporting.
      • Threats of harm to self (suicide): Therapists may be required to take steps to prevent self-harm, including contacting emergency services or family members.
      • Threats of harm to others (homicide): The Tarasoff duty to warn and protect potential victims.
      • Court orders or legal proceedings: Confidential information may be disclosed under a court order.
  • (Example – Please Replace with Your State’s Specifics):
    • In Texas, confidentiality is limited by mandatory reporting laws for child abuse, elder abuse, and threats of imminent harm to self or others. Texas also has specific statutes regarding the release of records in legal proceedings.
• AAMFT Code of Ethics on Confidentiality:
  • The AAMFT Code of Ethics emphasizes the importance of confidentiality. Key principles include:
    • Principle 2: Confidentiality: Marriage and family therapists have a primary obligation to respect the confidentiality of client information.
    • Standard 2.1: Marriage and family therapists do not disclose client confidences except by written authorization or waiver, or when mandated or permitted by law.
    • Standard 2.2: Marriage and family therapists discuss with clients, as early as possible in the therapeutic relationship, the safeguards and limitations of confidentiality.
    • Standard 2.3: Marriage and family therapists do not use client confidences for personal gain.
    • Standard 2.4: Marriage and family therapists disclose client confidences when required by law, including, without limitation, laws related to the reporting of abuse, neglect, domestic violence, and other crimes.
    • Standard 2.5: When ordered by a court or other legally authorized person, marriage and family therapists cooperate fully, providing only the information requested, or what is legally required. Marriage and family therapists should protect the confidentiality rights of the client.
  • Comparison: Both state laws and the AAMFT Code of Ethics prioritize client confidentiality but recognize that there are legal and ethical limits when the safety of the client or others is at risk. The AAMFT Code provides a strong ethical framework, while state laws provide the legal mandates.

3. Using the AAMFT Code of Ethics to Advocate for Change

• The AAMFT Code of Ethics can be a powerful tool for advocacy. Here’s how:
  • Identifying Inequities: The Code’s emphasis on non-discrimination (Principle 1.1) can be used to advocate for policy changes that address disparities in access to mental health care for marginalized populations (e.g., LGBTQIA+ individuals, people experiencing homelessness).
  • Promoting Best Practices: The Code outlines standards for competent and ethical practice. Advocates can use these standards to push for legislation or regulations that ensure MFTs are adequately trained and held accountable.
  • Protecting Client Rights: The Code’s focus on client autonomy and informed consent can be used to advocate for laws that protect client rights in the therapeutic process.
  • Example: If a state’s laws make it difficult for transgender individuals to access necessary mental health care, MFTs can use the AAMFT Code of Ethics to argue that this violates the principle of non-discrimination and the ethical obligation to provide competent care. They can lobby lawmakers, work with professional organizations, and raise public awareness.

4. Evaluating Personal Value System and Potential Conflicts with Ethical Obligations

• This requires careful self-reflection. Here’s the process:
  • Identify Core Values: Consider your personal beliefs about relationships, family, individual autonomy, and morality.
  • Review AAMFT Code of Ethics: Familiarize yourself with the Code’s principles and standards.
  • Identify Potential Conflicts: Consider scenarios where your personal values might clash with your ethical duties.
    • Example 1: A therapist with strong religious beliefs against same-sex marriage might work with a gay couple seeking therapy. The AAMFT Code (1.1) requires non-discrimination, potentially creating a conflict.
    • Example 2: A therapist who values marital preservation above all else might work with a client seeking a divorce due to abuse. The AAMFT Code (1.8) emphasizes client autonomy in decision-making.
  • Ethical Resolution: The AAMFT Code provides guidance for resolving ethical dilemmas. Therapists are expected to:
    • Prioritize the client’s welfare.
    • Act in accordance with the Code, even if it conflicts with personal values.
    • Seek consultation when necessary.
    • Document the decision-making process.
• It’s crucial to recognize that the AAMFT Code of Ethics is the guiding framework. While therapists’ values are important, the ethical obligations to the client must take precedence in the therapeutic relationship.

5. Comparing AAMFT Code of Ethics and State Statutes on Privileged Communication

• (General Principles – You must specify for your state):
  • Privileged Communication: A legal concept that protects the confidentiality of communications between a therapist and client in legal proceedings. It gives the client the right to prevent the therapist from disclosing confidential information in court.
  • AAMFT Code of Ethics: The AAMFT Code supports privileged communication but acknowledges its limitations as defined by law.
    • The Code emphasizes the therapist’s responsibility to protect client confidentiality but recognizes that legal mandates, including court orders, may require disclosure.
  • State Statutes: State laws define the specifics of privileged communication, including:
    • Who holds the privilege (usually the client).
    • Exceptions to the privilege (e.g., in cases of abuse, threats, or legal proceedings).
    • How the privilege can be waived.
• (Example – Please Replace with Your State’s Specifics):
  • In some states, the privilege belongs to both the client and the therapist, while in others, it belongs solely to the client. State laws also vary on whether the privilege applies in all legal proceedings or only in certain types of cases. You’ll need to check your state’s statutes for the precise definition and limitations.

6. Duty to Warn or Protect (Tarasoff) in My State

• (General Principles – You must specify for your state):
  • The Tarasoff duty originated from a California court case and has influenced laws across the United States. It generally requires therapists to take steps to protect potential victims when a client communicates a serious threat of harm.
  • State laws vary on the specifics of the duty to warn/protect, including:
    • Whether it’s a “duty to warn” (notify the potential victim) or a “duty to protect” (take other steps to prevent harm, such as hospitalizing the client).
    • The standard for determining the seriousness of the threat (e.g., “reasonable belief,” “clear and imminent danger”).
    • The specific actions required of the therapist.
    • Limitations of liability
• (Example – Please Replace with Your State’s Specifics):
  • Some states have a very clear and explicit duty to warn, while others have a broader duty to protect and may allow for more therapist discretion in how to respond to a threat. Some states may limit the therapist’s liability if they act in good faith to protect a potential victim. Provide the specifics of your state.

7. How Ethical Complaints Are Handled in My State

• (General Process – You must specify for your state):
  • Each state has a licensing board that oversees the practice of MFTs and handles ethical complaints. The process typically involves:
    • Filing a Complaint: A client, another professional, or a member of the public can file a complaint with the licensing board.
    • Investigation: The board investigates the complaint to determine if there has been a violation of state laws or regulations.