Revised CAMFT Code of Ethics: How will it affect your licensing exam? Part 3 of 3

2019 CAMFT Code of Ethics

At this time, any questions on the exam that are about the 2019 CAMFT Code of Ethics are pretest questions. Questions regarding the 2019 CAMFT Code of Ethics  will not be scored until the next cycle for the law and or ethics or clinical (written) exams. The new cycle for law and ethics starts October 1st and the next cycle for the clinical (written) exam starts December 1st. As we’ve noted in parts 1 and 2 of this blog series, the changes to the Code of Ethics, while important, do not substantially alter how you would answer questions on the exam. Following is a review of the final sections of the Code of Ethics (CoE), Sections 10 through 13.

Section 10

Responsibility to the Legal System: The fundamentals of this section remain the same, though the new CoE embellishes on the language that previously existed. It appears the added language is designed to provide greater clarity and guidance for MFTs engaged with the legal system. 

Preamble in the past, the introduction simply stated the need to “remain objective and truthful” if engaged with the legal system. The updated language emphasizes the importance of considering potential conflicts. It also clarifies the role of the therapist as a neutral individual who speaks truth regardless of the outcome for their client.

• 10.1 Testimony similar to the preamble, this section offers additional guidance to MFTs. This section now emphasizes the need of MFTs to “inform the court of any conflicts between the expectations of the court and their ethical obligations or role limitations.” In addition, the new language specifies that MFTs only answer questions that are within their scope of competence and knowledge.

• 10.2 Expert Witness again, this section expands on the language included in past versions of the CoE. It makes clear that MFTs must clarify their role to all parties involved (treating therapist vs. forensic expert). This section also clarifies the roles of treating therapists vs. forensic experts:

• • Treating therapists primarily provide opinions on the assessment, diagnosis, treatment progress and recommendations, and prognosis of their clients/patients,”  The information shared by the treating therapist should understand that their role is to facilitate successful psychological functioning, and not to promote a predetermined legal outcome.

• • Forensic experts are retained to offer opinions and make recommendations in a variety of legal contexts, including specific parenting and custody plans or decision-making authority in legal proceedings.
• 10.3 Conflicting Roles there are minimal changes to this section and those made just provide greater clarity to what already existed. The new CoE adds language regarding who therapists should disclose potential conflicts to when engaged in the legal system and the need to address the therapist’s limitations. 
• 10.4 Dual Roles the added language clarifies that dual roles should be avoided, whether concurrently or sequentially. In addition, if existing clients become involved in legal proceedings, MFTs should review potential consequences and clarify their role.
• 10.5 Impartiality the new language reminds MFTs of the profound effect their testimony and opinions can have in legal proceedings and reminds therapists to take care when sharing their opinions or expressing judgments with limited information or direct observation.

• 10.6 Minors and Privilege the changes here are a bit more substantial. Previously, the CoE stated that the therapist had an ethical obligation to confirm the holder of privilege. Now, the responsibility is to determine the holder of privilege for a minor. This points to a more active role when working with minors in identifying the holder of privilege. In addition, the new CoE states it is the therapist’s responsibility to determine the legal recipients of privileged information and what information can be shared. Finally, added language highlights the importance of informing the minor’s parents/guardians, when legally permissible, of what information will be shared with the court and how it will be provided.
• 10.9 Consequences of Changes in Therapist Role an additional sentence was added to encourage therapists to seek consultation before changing roles. 
• 10.11 Custody Disputes  this section is new. This is a positive addition, since it is a frequent point of confusion for many MFTs. MFTs should understand what led to the minor’s engagement in therapy; who made the decision and the expectations of parents, court, or other parties. MFTs must determine who can legally consent to treatment and are encouraged to obtain legal documentation verifying this prior to commencing treatment or releasing information. In an effort to protect minor clients, MFTs limit information shared in legal proceedings. Finally, MFTs should proceed with caution if interpreting anything produced by the minor (art/writing) or their behavior and communications.
• 10.12 Professional Communications this section is also new. MFTs are careful in what they communicate, ensuring the legal authority to share information, and provide accurate, neutral information. MFTs avoid communicating information if  they lack sufficient data or if sharing would be in conflict with their role. 

**Exam Implications: We believe several of the changes in this section could affect how you answer exam questions. 

• 10.2 Expert Witness you could see questions on the exam that test your knowledge on the differences between the roles of a treating therapist and a forensic expert. 
• 10.4 Dual Roles We could have inferred this from pulling together different sections of the last version of the CoE, but the language here makes it clear that we would avoid dual roles when treating the client, as well as following termination. 
• 10.6 Minors and Privilege You could see language on the exam that asks about the therapist’s responsibilities when minors are involved in court proceedings. MFTs ethically determine the holder of privilege for the minor. MFTs determine what information can be shared and with whom. In addition, they should discuss this with parents/guardians when legally authorized to do so. In making these determinations, the therapist may seek consultation or speak directly with the minor’s legal counsel.
• 10.9 Changing Roles Ethically, we are encouraged to seek consultation if changing roles, so this could be a good answer to questions asking how to proceed. 
• 10.11 Custody Disputes based on our exam prep, the new ethical guidelines really reinforce what we’ve always taught. MFTs should understand the referral source and their role. MFTs should determine who can consent to treatment and obtain documentation to verify legal rights. In addition, MFTs are ethically permitted to interpret what the minor presents in therapy, but should do so with caution.
• 10.12 Professional Communications this section is new, but would not change how we would answer questions on the exam. In the past, we would have pulled from various sections of the CoE to arrive at the same answer

Section 11

Responsibility to Research Participants: This section remains the same.

Section 12

Financial Arrangements: This section remains largely the same, though the subsection regarding bartering has changed.

Section 12.5 Bartering new language has been added to this section to provide further guidance to MFTs who might consider bartering. The new CoE makes it clear that the client initiates bartering. In addition, the therapist must ensure the agreement is not exploitative or harmful to the therapeutic relationship. And, finally, the agreement must be in writing. 

**Exam Implications: You could see questions that ensure you know the client, not the therapist should initiate a bartering arrangement and that the agreement should be in writing.

Section 13 

Advertising: This section remains the same.

This is the final portion of the three part series. As you can see, the recent changes will not have a significant impact on your exam. There is no cause for concern. In fact, the updated Code of Ethics provides MFTs with improved guidance and clarity. These changes will help MFTs move through the ethical decision making process. 

 Therapist Development Center can help you learn the CAMFT Code of Ethics! Our California MFT Law & Ethics and Clinical exam prep courses give you everything you need to pass your exam! We prepare you for all aspects of the exam without overwhelming you. Coaches are available to help you along the way. TDC has helped thousands of MFTs across California PASS their exams. Are you next?