The BBS has confirmed with CAMFT that the new Code of Ethics has been added as pretest questions to the Law and Ethics exam (as of July 1st) and will be included as pretest questions in the MFT Clinical exam with the new cycle that starts August 1st. As we mentioned in Part 1, we do not believe this change should cause you any anxiety.
Following is a review of Sections 4 through 9.
Dual/Multiple Relationships: This section is new and the changes included are probably the most consequential for the MFT exams. This new section expands on the topic of dual/multiple relationships. It also provides guidance to assist therapists in the process of ethical decision-making.
- 4.1 Dual/Multiple Relationships expands on what constitutes a dual relationship and reinforces the notion that not all dual relationships are unethical. In addition, it provides some clear examples of ethical dual relationships, “including those that are due to geographic proximity, diverse communities, recognized marriage and family therapy treatment models, community activities, or that fall within the context of culturally congruent relationships.”
- 4.2 Assessment Regarding Dual/Multiple Relationships this new addition to the Code of Ethics offers guidance on precautions therapists can take to avoid causing harm or exploitation of clients. A few examples provided include obtaining informed consent, seeking consultation or supervision, exploring alternatives for the client.
- 4.4 Non-professional Relationships with Former Clients/Patients this new addition removes time considerations and focuses on the therapist’s responsibility to avoid exploitation or harm of former clients.
- 4.5 Sexual Contact this section broadens what constitutes sexual contact to include, “sexually explicit communications,” and now requires therapists to take precautions to avoid exploitation or harm of clients or former clients.
- 4.6 Prior Sexual Relationship one simple word was added, but the implication is important, so it’s included here. The new Code of Ethics clarifies that it is unethical to knowingly enter into a therapeutic relationship with someone with whom the therapist has had a sexual relationship. This change acknowledges that a therapist unaware of a conflict cannot be accused of behaving unethically.
**Exam Implications: This section, as noted earlier, could have implications for the exam questions. There is a clear emphasis on the possibility of ethical dual relationships and examples of such. TDC always taught this, and it is now explicitly stated in the Code of Ethics. In addition, the language around sexual contact including communications is explicit as well.
Professional Competency and Integrity: The vast majority of changes in this section were organizational, while most of the content remained the same. However, there are a few additions we want to highlight for you.
- 5.8 Gifts this new addition to the CoE provides guidance on the receiving and the offering of gifts to and from clients. Previously, we had to rely on other sections of the CoEs for guidance.
- 5.12 Duplication of Therapy this part of the CoE was previously entitled, Patient Seeing Two Therapists. The updated version provides additional guidance in ethical decision making when considering the appropriateness of more than one therapist seeing a client. In addition, it specifically addresses the need to discuss this decision with the client and consider the appropriateness of consultation with the other therapist.
- 5.13 Public Statements the new CoE incorporates new language to address the tremendous expansion of the internet and social media since the last revision was published.
Exam Implications: As with many of the other changes, we do not believe that the changes here will strongly affect the exam questions or answers. The section with the greatest implications is regarding duplication of therapy. The new CoE offers a blueprint that would allow duplication of therapy if it is clinically appropriate and the therapist discusses the decision with the client.
Telehealth: This section is completely new, and although it is now a separate and distinct section of the revised CoE, the changes are actually not substantial.
- 6.1 Telehealth the new CoE expands on what the therapist should specifically consider when determining appropriateness and suitability of telehealth. This includes considerations such as:
- client’s familiarity with telehealth
- presenting issues
- therapist’s therapeutic orientation
- 6.2 Compliance with Telehealth Laws previously, the CoE noted the need to comply with the informed consent requirements of the California Telemedicine Act. The revised CoE is more explicit and requires MFTs to comply with state and federal laws pertaining to telehealth.
- 6.4 Electronic Media this section is the same, but was shifted from the Confidentiality section to this new section of the CoE.
Exam Implications: As you’ve probably already noticed, the revisions in the updated CoE do not have tremendous exam implications. This section makes it clear that it is both legal and ethical to comply with telehealth laws. It also provides additional factors to consider when determining the appropriateness of using this modality.
Supervisor, Supervisee, Educator, and Student Responsibilities: There were several changes made to this section. These changes build on the old language and provide additional clarity and guidance. The preamble now includes clear expectations for “effective and respectful communication” when working in our professional capacity. In addition, the preamble specifically states that supervisors protect the interests of their supervisees’ clients.
- 7.1 Maintaining Professional Boundaries with Supervisees and Students previously entitled Dual Relationships. Other than the name change, the language here is the same. The content regarding sexual engagement in the supervisory relationship is now in its own section (see next bullet point).
- 7.2 Sexual Contact with Supervisees and Students this section was separated from the former section. In addition, it adds, “sexually explicit communications without a sound clinical, supervisory, or educational basis,” is unethical.
- 7.3 Sexual Harassment of Supervisees and Students similar to section 7.2, this section was previously included under Dual Relationships. The content is the same.
- 7.4 Competence of Supervisees CAMFT strengthened the language included in this section to ensure supervisors provide the level of support commensurate with the supervisee’s education, training, and experience.
- 7.12 Bartering with Supervisees this section is new to the CoE. We should avoid barif there is a chance of exploitation, harm, or it is coerced. In addition, a clear written agreement should be created and the social/cultural implications should be considered.
Exam Implications: We do not believe anything in this section would change how you would answer an exam question. The ethical responsibility to avoid harm and/or exploitation of a supervisee would likely have led to the same answer.
Responsibility to Colleagues: This section remains largely the same.
- 8.3 Ethical Complaints against Colleagues this was previously entitled Frivolous Complaints. The new section provides previously lacking guidance when there is conflict between colleagues. We should try to address the dispute with the colleague, seek consultation or pursue mediation before filing an ethics complaint.
Exam Implications: This added language continues to align with what TDC has always taught in our exam prep and we do not believe it would not change how you answer a question on the exam.
Responsibility to the Profession: This section remains the same.
Similar to our conclusion in Part 1, you can see that the recent changes will not have a significant impact on your exam prep. There is no reason to worry!
Therapist Development Center can help you to learn the CAMFT Code of Ethics. With this knowledge, you will be able to answer exam questions with ease! 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?