The California BBS recently voted to transition from the California MFT Clinical Exam to the National MFT Exam. Since then, I’ve gotten lots of great questions. Here’s a rundown of what people have been asking about the most.
When will the switch actually happen?
Let’s be clear up front: There’s a lot that still needs to happen for this transition to take place. The BBS will need to go through a rulemaking process, which commonly takes 18 months or more. They may also need to run legislation, which operates on a specific annual calendar. And some logistical elements, like expanding the testing window for the National MFT Exam (currently one week out of every month), need to be addressed as well.
With all of those tasks in mind, BBS staff estimated that even in a best-case scenario, the actual changeover wouldn’t happen until January 2027. And of course, if anything goes wrong along the way, it could take longer. The BBS also retains the ability to stop the transition process entirely if they find it necessary.
Are the tests similar?
They're not identical, but they're pretty similar. In terms of structure, the current California MFT Clinical Exam is 170 questions over 4 hours. (It will shorten to 150 questions in September 2024.) The current National MFT Exam is 180 questions over 4 hours. In terms of content, they cover largely the same content areas, with differences in emphasis. The current national exam places more emphasis on systemic concepts and models; the current California test places more emphasis on assessment. An upcoming routine survey of the profession, which is used to set content for the national exam, should increase the similarity of content even before the switch takes place.
What’s the benefit of this change for currently-California-licensed MFTs?
There isn’t one, really. No benefit, and also no drawback. You wouldn’t need to take a second clinical exam. And if you were to try to pursue licensure in another state, that other state would retain all of their rules about portability.
This change in California processes doesn’t obligate any other state in any way. Some states presently recognize passing scores on the California MFT Exam as equivalent to passing scores on the National MFT Exam; others don’t. Some states place rules on how old a passing score on a clinical exam can be to be considered valid; others don’t. Those rules would continue.
Some folks have asked questions about "grandparenting" for California licensed MFTs. That concept doesn't really apply here. If you're already licensed in California when the change happens, you will not need to do anything in relation to this change. You will not need to take another exam.
What’s the benefit of this change for MFTs licensed outside of California, wishing to be licensed in California?
California’s portability rules are already pretty generous. If you’ve been licensed in another state for at least two years at the highest level of licensure that state offers, and you’re in good standing with your board, you can achieve California MFT licensure relatively easily. You do not need to take another clinical exam, and you do not have your degree or supervised experience re-evaluated. You just need to take some California-specific CE and pass the California MFT Law & Ethics Exam. Those rules would not change.
The main benefit for out-of-state folks would be for those licensed in their home state for less than two years, who wish to pursue California MFT Licensure. In those cases, California would recognize scores on the National MFT Exam rather than requiring the individual to take California’s exam. As is the case in other states, California may choose to apply restrictions. For example, the state may choose to recognize passing scores only if they were received less than a certain number of years ago.
What’s the benefit of this change for students and associates pursuing California MFT licensure?
This is the group that will benefit the most. If you pass the National MFT Exam as part of the process of achieving California licensure, it greatly reduces the likelihood that you’ll need to take another clinical exam to get licensed in other states. As noted above, some states currently recognize scores on the California MFT Exam as equivalent to the national exam, but some do not. This transition will remove that barrier to portability in those states that do not recognize California MFT Clinical Exam results.
What’s the benefit to the MFT profession?
The profession benefits when there’s a singular, national standard for licensure. I continue to think that standard shouldn’t be an exam, but having a singular, national exam is better than having one test for California and a different one for the rest of the country.And importantly, the switch will provide increased accountability for fairness and equity in the testing process. As I’ve been discussing for a couple of years, clinical exams in mental health care show wildly disparate outcomes on the basis of race and ethnicity. That’s a problem with the exams, not the examinees. California’s clinical exam has never even been tested for bias, since the data necessary to run such checks isn’t even collected. The National MFT Exam does collect this data, and according to the BBS, is tested for bias. That doesn’t solve all of the problems related to clinical exams, but is a meaningful step forward for California.
