BILL ANALYSIS �
-----------------------------------------------------------------------
|Hearing Date:April 11, 2011 |Bill No:SB |
| |363 |
-----------------------------------------------------------------------
SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: SB 363Author:Emmerson
As Amended:March 21, 2011 Fiscal: Yes
SUBJECT: Marriage and family therapists.
SUMMARY: Allows marriage and family therapist trainees to continue
counseling clients while not enrolled in a practicum if the lapse in
enrollment is less than 45 days; limits the number of client-centered
advocacy hours for a marriage and family therapist intern to 500
hours; and allows professional clinical counselors to supervise
marriage and family therapist interns if they meet additional training
and education requirements to treat couples and families.
Existing law:
1) Licenses and regulates the practice of marriage and family
therapists (MFTs), licensed educational psychologists (LEPs), and
licensed clinical social workers (LCSWs) by the Board of Behavioral
Sciences (BBS) within the Department of Consumer Affairs.
Beginning
January 1, 2012, the BBS will additionally license professional
clinical counselors (LPCCs).
2) Establishes education requirements for MFT licensure, including a
requirement for a practicum completed by an MFT intern that
involves certain types and hours of experience, and specifies that
not more than a combined total of 1,250 of experience may be gained
in the following:
a) Direct supervisor contact.
b) Professional enrichment activities, including workshops,
seminars, training sessions, conferences, or personal
SB 363
Page 2
psychotherapy, as specified.
c) Client centered advocacy, generally defined as activities,
related to obtaining or providing services and supports for
clients. (BPC � 4980.43)
1) Authorizes MFT interns and trainees to perform counseling
activities and services in certain work settings; and requires that
a trainee or intern shall at all times be under the supervision of
a supervisor.
a) Requires the supervisor to be responsible for ensuring that
the counseling performed is consistent with the training and
experience of the person being supervised, requires the
supervisor to be responsible to the BBS for compliance with all
laws, rules, and regulations governing the practice of marriage
and family therapy. (BPC � 4980.43)
b) Defines "supervisor" to include an MFT, LCSW, licensed
psychologist, or licensed physician certified in psychiatry.
(BPC � 4980.03)
2) Authorizes trainees to gain hours of experience outside the
required practicum under certain conditions, but requires trainees
who gain experience outside the required practicum to be enrolled
in a practicum in order to counsel clients. (BPC � 4980.42)
3) Prohibits a LPCC from engaging in the assessment or treatment of
couples or families unless the LPCC meets additional training and
education requirements beyond that required for licensure,
including:
a) Six semester units or nine quarter units in marriage and
family therapy or a specialization in marriage and family
therapy, as specified.
b) No less than 500 hours of documented supervised experience
working directly with couples, families or children.
c) A minimum of six hours of continuing education specific to
marriage and family therapy in each license renewal cycle. (BPC
� 4999.20)
This bill:
1) Provides that an MFT trainee may also counsel clients while not
SB 363
Page 3
enrolled in a practicum if the period of lapsed enrollment is less
than 45 calendar days.
2) Recasts the provisions of No. 2, above, to instead provide that an
MFT intern practicum must involve certain types and hours of
experience, and specifies that not more than a combined total of
1,000 hours of experience may be gained in the following:
a) Direct supervisor contact.
b) Professional enrichment activities, including workshops,
seminars, training sessions, conferences, or personal
psychotherapy, as specified.
c) Limits to 500 hours, the number of experience hours that may
be gained from client-centered advocacy, administering and
evaluating psychological tests, and writing clinical reports and
notes.
1) Authorizes an LPCC to act as a supervisor of a MFT intern or
trainee if he or she meets the additional training and education
requirements required for a LPCC to counsel couples or families.
2) Makes technical cleanup, and conforming changes.
FISCAL EFFECT: Unknown. This bill has been keyed "fiscal" by
Legislative Counsel.
COMMENTS:
1. Purpose. This bill is sponsored by the Board of Behavioral
Sciences (Sponsor) to clarify and amend supervision and experience
requirements for those seeking licensure as an MFT. According to
the Sponsor, the bill contains three provisions. First, allows an
MFT trainee to continue counseling clients while not enrolled in a
practicum if that lapse in enrollment is less than 45 days.
Second, limits the number of client-centered advocacy hours for an
MFT intern to 500 hours. Third, allows LPCCs to supervise MFT
interns if they meet additional training and education requirements
to treat couples and families.
2. Background. Revisions made in the MFT law by SB 33 (Correa,
Chapter 26, Statutes of 2009) require MFT trainees to be enrolled
SB 363
Page 4
in a practicum course while counseling clients. According to BBS,
a number of schools have voiced concern on how the practicum course
requirement would operate during intersession and summer break when
students may not be able to enroll in a practicum course. This
could create continuity of care issues when the trainee goes on
summer break leaving the client with another practitioner or even
without care. Additionally, there are barriers to licensure if the
trainee is not able to gain direct client hours due to not being
enrolled in practicum. Therefore, allowing a trainee to continue
counseling clients while not enrolled in a practicum if that lapse
in enrollment is less than 45 days will help address these
concerns, according to the BBS.
BBS further indicates that under current law, the number of
client-centered advocacy hours that a marriage and family therapist
intern can obtain is only limited by the amount of direct
supervisor contact hours acquired by the intern. For example, if
an intern received the minimum number of direct supervisor contact
hours for 104 weeks, that individual could potentially receive
credit for 1,146 hours for client-centered advocacy. The BBS
believes that the majority of the MFT intern's experience hours
should be gained through a variety of training activities other
than client-centered advocacy, therefore, the bill proposes to
limit the client centered advocacy allowed for an MFT intern to 500
hours.
Currently, BBS states, licensed professional clinical counselors are
not allowed to supervise marriage and family therapist interns.
However, the law authorizes all other licensees of the BBS to
supervise these interns. Therefore, the bill would authorize LPCCs
to supervise marriage and family therapist interns if they meet
additional training and education requirements to treat couples and
families.
3. Related Legislation. SB 33 (Correa, Chapter 26, Statutes of 2009)
updated and recast the educational curriculum requirements for MFTs
to require persons who begin graduate study after August 1, 2012,
to meet increased total unit requirements, increased practicum
hours for face-to-face counseling, integrates specified elements,
including public mental health practices, throughout the
curriculum, revised MFT educational requirements and revised
requirements for applicants licensed or educated outside of
California.
SB 788 (Wyland, Chapter 619, Statutes of 2009) established the
licensing and regulation of professional clinical counselors in
SB 363
Page 5
California. Stated that LPCCs practice is a separate and distinct
profession from licensed marriage and family therapy (MFT) and
licensed clinical social work (LCSW). Authorized BBS to begin
accepting applications for examination eligibility on January 1,
2012, and issue LPCC licenses to applicants who meet certain
education, experience and examination requirements.
SB 146 (Wyland) revises various provisions relating to the practice of
mental health professionals to also include the practice of
licensed professional clinical counselors, clinical counselor
trainees, and clinical counselor interns; makes technical updating
and conforming changes. This measure is set for hearing in this
Committee on April 11, 2011.
SB 704 (Negrete McLeod) revises and recasts examination requirements
for marriage and family therapists and interns and for licensed
clinical social workers and associate social workers; makes
technical cleanup and conforming changes. This measure was
approved on Consent by this Committee on April 4, 2011.
4. Arguments in Support. American Association for Marriage and Family
Therapy (AAMFT-CA) argues the bill ensures proper university
supervision for graduate MFT students who are seeking clients and
expands the pool of eligible supervisors for MFT interns and
trainees to include LPCCs who meet state requirements to assist and
treat couples and families.
AAMFT-CA further argues that the Board worked with graduate programs
over two years to revise the MFT curriculum. Those changes, made
in SB 33 in 2009, did not increase the academic unit requirement
for practicum, but instead included a requirement that students
must be enrolled in a practicum course while seeing clients. This
allowed practicum hours to be expanded without adding mandatory
units to the curriculum, and at the same time meeting the public-
protection need for trainees to receive adequate university
oversight of their work. AAMFT-CA suggests that the bill's 45-day
allowance for academic breaks, ensures that client care is not
unduly impacted by breaks between academic terms, while maintaining
appropriate school oversight for trainees.
AFMFT-CA argues that it is fully appropriate to require LPCCs to
complete specific coursework and supervised experience in order to
supervise MFT interns and trainees since MFT interns and trainees
under supervision are likely to be working with couples and
families. To remove this requirement would allow LPCCs to
supervise an activity (assessing or treating couples or families)
SB 363
Page 6
that the supervisor is legally prohibited from conducting, which
makes no sense according to AAMFT-CA. Proponents further suggest
that adding a previously-unrecognized category of supervisors,
would expand the opportunities for MFT interns to receive
supervision, while ensuring that the supervisors are appropriately
qualified.
5. Arguments in Opposition. The California Association for Licensed
Professional Clinical Counselors (CALPCC) opposes this bill's
amendments which would require LPCCs who supervise MFT Interns to
meet additional training and education requirements. CALPCC
believes the provision discriminates against LPCCs, since none of
the other professions are singled out with special requirements in
order to supervise MFTs, and suggests that if it is necessary for
supervisors to have specialized training, then the other
professions, which supervise MFTs, should meet the same
requirements. CALPCC believes that the bill would make it even
more difficult for MFTs to find internships if LPCCs cannot
supervise them.
As an alternative, CALPCC suggests amendments to authorize a
supervisor to abide by his or her scope of competence instead of
requiring the additional education and training. Specifically, the
amendment would do the following:
On page 4, lines 10 through 12, strike out: "(2) If a licensed
professional clinical counselor, the individual shall meet the
additional training and education requirements specified in
paragraph (3) of subdivision (a) of Section 4999.20." and insert:
(2) Abides by his or her scope of competence.
California Association of Marriage and Family Therapists (CAMFT) has
taken an oppose unless amended position on the bill, expressing
several concerns with the bill. First CAMFT argues that the
requirement for a trainee to be enrolled in a practicum course to
counsel clients, does not address any public health, safety or
welfare issue, and states that since 1995, there has been no problem
with hours gained by MFT trainees apart from the practicum course so
long as the hours were obtained under the jurisdiction of their
schools.
CAMFT further disagrees with restricting to 45 days the period
during which MFT trainees may counsel clients while not enrolled in
a practicum, and argues that the 45-day time period is a random
SB 363
Page 7
number. Often, a summer recess is longer than 45 days, and the
proposed 45-day limit is disruptive to the needs of clients and
agencies where trainees work, places a hardship on trainees, and is
not based upon any identified problems. Instead of placing a cap of
45 days, CAMFT suggests the law should allow trainees to gain hours
of experience outside of their practicum assignments, without a
45-day limitation, as long as there is sufficient oversight by their
schools for the services they are providing.
CAMFT additionally opposes the limitations which would allow a LPCC
to supervise an MFT intern only if the supervisor meets additional
education and training requirements. CAMFT opposes the limitations,
especially for persons who will be "grand-parented" into the LPCC
profession. CAMFT indicates it would be willing to accept those
limitations if they are applicable to those persons who begin
graduate study on or after January 1, 2012.
SUPPORT AND OPPOSITION:
Support :
Board of Behavioral Sciences (Sponsor)
American Association for Marriage and Family Therapy
Oppose Unless Amended :
California Association for Licensed Professional Clinical
Counselors
California Association of Marriage and Family Therapists (CAMFT)
Consultant:G. V. Ayers