We finally know which MFT ethics code is "correct"

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We finally know which MFT ethics code is "correct"

For more than seven years, California MFTs have been tested on their knowledge of professional ethics through the California MFT Law & Ethics Exam. To this day, neither the exam developer (the state Office of Professional Examination Services) nor the Board of Behavioral Sciences has publicly said which code of ethics is the one they use in exam development -- the "correct" one for the test. But we do now know the answer.

One test, two ethics codes

First, a bit more explanation. This lack of referencing is no small thing. MFTs have two codes of ethics, one from CAMFT and one from AAMFT. Both would seem to apply to Californians (California being in America). Both claim to set standards for the profession. 

The two codes have always had some meaningful differences, and even as the codes have both evolved, some differences have gone away while new ones have emerged. To this day, I count more than two dozen areas of substantive disagreement between the two, where a certain behavior could be considered ethical under one code and unethical under the other.

Seeking an answer

I hounded BBS staff about this during the transition to the current exam process. In March 2016, OPES sent staffers to a BBS meeting. I couldn’t get them or anyone else to answer this question on the record, but BBS staff told me during a break that both codes were used as points of reference for disciplinary action, so they believed that both were used in exam development as well. I made note of that for my study guide for the exam, the first edition of which came out soon after the meeting.

It never quite sat right, though. Using both codes is, at best, a vague construction -- would one take priority over the other? Do practitioners always have to comply with both? And why couldn't anyone just answer the question on the record?

Of course, in situations where the codes conflict, the safest bet for a clinician – and the likely best answer on the Law & Ethics Exam – would seem to have been to choose a behavior that’s ethical under both codes. Because, while the codes do have differences in what they identify as problematic, I’m unaware of any instance where the two are in direct opposition. There’s nothing, to my knowledge, that one code says you must do but the other code says you can’t do.

In any case, I’ve continued to provide clarity in my book and online program about key areas of difference between the codes. But I finally got fed up enough with the lack of clarity that, earlier this year, I raised the lack of clarity about whose ethics code is treated as "correct" as a possible issue with the legal defensibility of the exam.

That got a response.

The "right" answer

According to the Office of Professional Examination Services, the CAMFT Code of Ethics is currently the one they defer to when writing the California Law & Ethics Exam.

I’ve already updated my California MFT Law & Ethics Exam Prep course to reflect this new guidance, and I’ll update next year’s edition of the guidebook similarly.

I’m not sure why it took seven years to get such a basic issue of exam content clarified. When I went to that March 2016 meeting, my oldest daughter hadn't been born yet. She’s in second grade now. And still, neither OPES nor the BBS have put anything online to clarify for examinees which code of ethics forms the basis for the exam. (They’ve committed to doing so in the future, but without a specific timeline.)

A bigger issue

This specific problem of referencing an ethics code is unique to this particular test. But it fits into a larger issue of construct clarity that is a common problem in mental health exams for licensure, as most exams don't adequately cite their source material. So there's no way for examinees to know for sure what they should be studying.

For example, a list of treatment models covered on an exam is helpful. But different authors have different ideas, even about models they created together. What documents are considered the "source of truth" for each specific model?

When an exam says it covers Strategic Therapy, do they mean the MRI version, or the Milan group's version? Without such clarity, these exams don't assess a candidate's knowledge of a profession so much as they assess "agreement with the anchoring of the item writers," as I put it in a manuscript currently under review for journal publication.

Suffice to say the larger issue isn't going away. But every little bit of clarity where we can get it sure helps. For the California MFT Law & Ethics Exam, it only took seven years.

By Benjamin Caldwell