BILL ANALYSIS
SB 33
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Date of Hearing: June 16, 2009
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
SB 33 (Correa) - As Amended: June 8, 2009
SENATE VOTE : 36-0
SUBJECT : Marriage and family therapy: licensure and
registration.
SUMMARY : Recasts the educational curriculum requirements for
marriage and family therapists (MFTs), as specified.
Specifically, this bill :
1)Recasts the required curriculum to obtain an MFT license
for persons who begin graduate study after August 1,
2012, and makes the following changes:
a) Increases the graduate degree's total unit
requirement from 48 to 60 semester units (72 to 90
quarter units).
b) Specifies fewer requirements for specific hours or
units for particular coursework within the curriculum
requirements, thereby allowing for flexibility and
innovation in curriculum design.
c) Revises the required practicum to:
i) Increase the face-to-face counseling hours from
150 to 225 hours, and provide that 75 of those hours
may be gained performing client centered advocacy.
ii) Require training in the applied use of theory
and psychotherapeutic techniques, working with
families, documentation skills, and how to find and
use resources.
d) Recasts certain coursework requirements, such as
California law and ethics and child abuse assessment
and reporting, which are currently required prior to
licensure (and permitted to be taken outside of the
degree program) to instead be completed within the
degree program and thus, prior to registration as an
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intern.
e) Requires various elements to be integrated
throughout the curriculum, including:
i) Recovery oriented care and related methods of
service delivery.
ii) Greater emphasis on understanding various
cultures.
iii) Greater understanding of the impact of
socioeconomic position.
iv) Provide students the opportunity to meet with
consumers and family members.
f) Adds instruction in areas needed for practice in a
public mental health environment which may be provided
in credit level coursework or through extension
programs, including the following:
i) Case management;
ii) Working with the severely mentally ill;
iii) Collaborative treatment; and,
iv) Disaster and trauma response.
g) Requires degree program content to include
instruction in:
i) Evidence based practices;
ii) End of life and grief;
iii) Behavioral addiction, substance abuse,
co-occurring mental and addiction disorders;
iv) Human sexuality and psychosexual dysfunction;
v) Differences in legal and ethical standards for
different types of work settings; and,
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vi) Licensing law and licensing process.
2)Specifies that applicants for licensure or registration
who begin graduate study before August 1, 2012 at a
school meeting previous MFT curriculum requirements must
graduate before December 31, 2018 in order to be eligible
for licensure or registration under this bill.
3)Repeals the current MFT educational requirements January
1, 2019.
4)Revises the requirements for persons who earned a degree
outside of California effective January 1, 2014,
including accepting substantially equivalent education
that meets the following:
a) The degree meets the following minimum
requirements:
i) 48 semester units (72 quarter units);
ii) 6 semester units of practicum (9 quarter
units);
iii) 150 hours in practicum providing face-to-face
counseling; and,
iv) 12 semester units (18 quarter units) of
marriage, family, and child counseling and related
approaches to treatment.
b) The applicant remediates any deficiencies in
content and units.
c) The applicant completes credit level coursework in
the following areas:
i) Recovery oriented care;
ii) Understanding various California cultures and
the social and psychological implications of
socioeconomic position;
iii) Structured meetings with consumers and family
members;
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iv) Behavioral addiction;
v) Co-occurring mental health and substance abuse
disorders; and,
vi) California law and ethics.
5)Eliminates the requirement that an applicant licensed as
an MFT for less than two years in another state complete
250 hours of experience in California as an intern prior
to applying for licensure effective January 1, 2014.
6)Permits applicants for an MFT license to count experience
for performing "client centered advocacy" activities
toward licensure.
7)Permits MFT interns to gain a portion of the required
supervision via teleconferencing.
8)Requires applicants for MFT licensure to verify that
supervised experience was gained as an employee or
volunteer and not as an independent contractor.
9)Makes conforming and clarifying changes.
EXISTING LAW
1)Provides for the licensing and regulation MFTs by the
Board of Behavioral Sciences (BBS) within the Department
of Consumer Affairs.
2)Specifies certain educational requirements necessary to
obtain an MFT license, to generally include the
following:
a) A specified master's or doctorate degree from an
accredited or state-approved school.
b) An integrated course of study consisting of a
minimum 48-semester or 72- quarter units of
instruction.
c) Six-semester or nine-quarter units of practicum
including 150 hours of face-to-face counseling
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experience.
d) 12-semester or 18-quarter units of marriage,
family, and child counseling and related approaches to
treatment.
e) Specifies the number of hours or units required for
certain courses.
f) Permits certain coursework, such as child abuse
assessment and reporting, to be taken outside of the
degree program and prior to licensure (not prior to
registration as an intern).
g) Requires specific content to be integrated
throughout the program, including:
i) Diagnosis, assessment, prognosis, and treatment
of mental disorders;
ii) The broad range of matters that may arise
within marriage and family relationships;
iii) The application of marriage and family
relationship counseling principles and methods;
iv) Development of personal qualities intimately
related to the counseling situation;
v) A variety of psychotherapeutic techniques and
modalities; and,
vi) Cross-cultural mores and values.
h) Requires the following specific course content:
i) A variety of MFT-related psychotherapeutic
techniques and modalities;
ii) Developmental issues;
iii) Treatment of children;
iv) Aging and long-term care;
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v) Alcoholism and substance abuse;
vi) Spousal and partner abuse assessment,
detection, and intervention;
vii) Psychological testing; and,
viii) Psychopharmacology.
3)Requires each applicant, prior to making application for
the licensing examination, to complete specific
supervised experience requirements, which includes:
a) 3,000 hours of supervised experience over a period
of at least 104 weeks, composed of the following
activities:
i) Counseling and direct supervisor contact (not
more than 750 hours);
ii)Professional enrichment activities, including
workshops, seminars, training sessions, or
conferences (not more than 250 hours);
iii)Personal psychotherapy (not more than 100 hours);
iv)Group therapy or group counseling (not more than
500 hours);
v) Administering and evaluating psychological
tests, writing clinical reports, writing progress or
process notes (not more than 250 hours);
vi)Telephone or crisis counseling (not more than 250
hours);
vii) Couples, family, and children (not less than 500
hours); and,
viii)Telemedicine counseling (not more than 125
hours).
b) Supervision must be provided weekly and consists of
one hour of individual, direct supervisor contact, or
two hours in a group.
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c) Of the 3,000 hours, 1,300 may be gained during the
degree program as a trainee, and 1,700 must be gained
post-degree as an intern.
d) Interns and trainees are prohibited from working as
an independent contractor and from accepting payments
directly from clients.
4)Establishes certain requirements for persons who obtained
education or experience outside of California as follows:
a) If an applicant has been licensed for at least two
years in another state as an MFT and his or her
education and experience is substantially equivalent
to California requirements, a license shall be issued
after the person passes BBS's licensing examinations
and completes additional coursework or training.
b) If an applicant is not licensed in another state as
a MFT or has been licensed for less than two years,
the following is required:
i) Experience must be substantially equivalent to
California requirements.
ii) The applicant must register as an intern and
gain 250 hours of supervised experience in
California.
iii) Education must meet core requirements and the
applicant must make up for any deficiencies in
coursework and content.
iv) The applicant must complete additional
coursework or training.
v) The applicant must pass the BBS's licensing
examinations.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . BBS, the sponsor of this bill, states,
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"The MFT educational requirements have not been substantively
changed since 1988. Practice and issues have evolved over the
past 20 years, and there is a growing body of evidence-based and
best practices in treatment. Employment opportunities are
increasing and work settings are shifting from private practices
to the public sector."
Background . According to BBS, the California Mental Health
Services Act of 2004 is transforming mental health services in
California in a number of ways. This includes placing greater
attention on serious mental illness, reducing adverse impacts
resulting from untreated mental illness, expanding successful
innovative services, emphasizing culturally and linguistically
competent approaches, and involving people with mental illness
in the system as stakeholders with an equal voice. These new
services are guided by a promise to do 'whatever it takes' to
help people fully recover from mental illness, and is typically
referred to as 'recovery oriented care.' This transformation
demands that those employed in public mental health, including
MFTs, have a different perspective and can provide different
approaches to treatment. BBS states the proposed changes to the
educational requirements make it necessary that the BBS's
requirements for applicants who completed their education
outside of California also change for consistency with those new
requirements.
This bill is the result of the work of the BBS's MFT Education
Committee (Committee) which met seven times, beginning in July
2006. The Committee was charged with reviewing the current
curriculum requirements and determining their appropriateness
for today's MFT practice. The Committee also reviewed
different studies of competencies necessary for MFT practice as
well as workforce data in order to determine ways in which the
profession has evolved. The Committee involved a number and
variety of stakeholders throughout this process and
benefited greatly from the participation and feedback from more
than 138 people involved in the meetings. Stakeholders involved
included schools, agencies, consumers, and students. BBS also
established a webpage to post the Committee's materials and
minutes, and further created a webpage as a resource for schools
to help them implement the proposed new requirements.
Arguments in support . The California Association of Marriage
and Family Therapists writes in support, "Consumer protection is
best assured when the education for a profession keeps pace with
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the evolving demands of a profession. The purpose of this bill
is to once again assure that MFTs are being trained to
effectively practice their profession with consumers in
California. While MFTs are well-trained clinically, typical MFT
educational content prepares the MFT to work in the private
sector. Currently, there is an increasing need for mental
health professionals in the public and community sector. MFTs
are filling many of these positions."
Arguments in opposition . Capitol Resource Family Impact writes
in opposition, "This bill would place unnecessary mandates on
therapy and counseling students. SB 33 requires marriage and
family therapists to study 'multicultural development and
cross-cultural interaction.' It is not necessary for therapists
to study such topics in order to be an effective empathetic
counselor. Cultural training, required simply to counsel people
about their marriages or families, is too ambiguous. It would
also be unnecessary in many situations. Furthermore, it is not
he legislature's place to determine the curriculum of private
graduate institutions. By requiring licensed therapists to take
certain courses, this law effectively controls their curriculum.
Previous legislation . This bill is the reintroduction of SB
1218 (Correa) of 2008, which updates and recasts the educational
curriculum requirements for MFTs. SB 1218 was substantially
similar to this bill; however, was one of several measures
vetoed by the Governor, citing that due to the 2008-2009 State
Budget delay, only bills of the highest priority for California
would be signed.
REGISTERED SUPPORT / OPPOSITION :
Support
Board of Behavioral Sciences (sponsor)
American Association for Marriage and Family Therapy
California Association of Marriage and Family Therapists
California Coalition for Counselor Licensure
California Commission on Aging
California Communities United Institute
California Southern University
Education Management Corporation
University of Phoenix
University of Southern California, Rossier School of Education
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Opposition
Local 2620, American Federation of State, County, and Municipal
Employees, AFL-CIO
Capitol Resource Family Impact
Analysis Prepared by : Rebecca May / B. & P. / (916) 319-3301