New93 role standards, now public
MedTality
Role standards

Behavioral health

Marriage and family therapist

What a marriage and family therapist must be able to do when first licensed: assess and treat couples and families as systems, recognise the violence and abuse that make joint work unsafe, and meet the consent and reporting duties that multi-person therapy creates, drawn from the national examination US state boards use for MFT licensure.

Practice this assessmentHire for this role
Expectations
10
Safety red lines
3
Sources
3
Version
1

Built from Association of Marital and Family Therapy Regulatory Boards and Professional Testing Corporation, Association of Marital and Family Therapy Regulatory Boards, American Association for Marriage and Family Therapy. Reviewed by clinicians, last on .

01What the role is measured on#

Every verdict is made of the same five dimensions. Each is scored on its own, so a candidate sees where they are strong and where to work.

  • Clinical skillsThe hands-on and judgement work of the role: recognising what matters, acting in the right order, and knowing when something cannot wait.
  • Workflow and toolsGetting the work done in a real setting: the systems, records, equipment and handoffs the role runs on, used correctly and on time.
  • Patient communicationHow the role talks with patients, families and colleagues: listening, explaining plainly, and confirming what was understood.
  • Compliance and safetyThe rules that protect people: privacy, consent, infection control, reporting duties and the safety checks the role is accountable for.
  • Role knowledgeKnowing the job itself: what the role is responsible for, where its scope ends, and who to bring in when it does.

02What a ready hire does#

What a competent marriage and family therapist does on day one, dimension by dimension.

Clinical skills

  • Assesses each member and the relational system together - interactional patterns, individual symptoms, substance use and risk - and reaches a systemic formulation alongside any DSM-5-TR diagnosis.
  • Delivers a couple or family therapy model with evidence for the problem, keeps an alliance with every member, and adjusts from measured progress.

Workflow and tools

  • Plans who is seen, in what format and sequence, with measurable goals agreed with the client system, safety conditions and court orders checked, and reviews the plan.
  • Keeps records that capture the system, each member's risk and the plan, and manages access to multi-person records lawfully.

Patient communication

  • Holds charged conversations - an affair disclosed, a separation decided, a finding one member does not want to hear - honestly, without taking sides or losing the room.
  • Explains, to every member, who the client is, how confidentiality works between members, how secrets are handled, the limits of confidentiality and who can access records, and confirms each member's understanding and consent.

Compliance and safety

  • Screens every partner for violence, fear and coercive control separately and in private, assesses danger when it is present, and does not do conjoint work that would put a partner at risk.
  • Asks directly about suicide, including in joint and family sessions, assesses the risk and acts on it with a safety plan that uses the family safely.

Role knowledge

  • Reports suspected child, elder or dependent adult abuse promptly as the law requires, including when it surfaces in family sessions, and handles duty-to-protect situations under their jurisdiction's law.
  • Avoids multiple relationships that impair judgment or risk exploitation of any member of the client system, and stays out of dual roles such as custody evaluator for their own clients.

03Safety red lines#

Any one of these keeps a candidate from Ready Day One, whatever the rest of the score. They are published so nobody meets them for the first time in the assessment.

  • Starts or continues joint couple sessions after a partner discloses fear of the other, coercive control, or severe violence such as strangulation, weapons or injury, or raises one partner's private disclosure of violence in front of the other.

    Joint sessions can expose what a victim said to the person who controls them, and retaliation after sessions is a known cause of serious injury and death.

  • Schedules or allows joint sessions that bring a child or partner into contact with a person barred by a protective order or no-contact condition, or under an open abuse allegation, without checking the order and the child protective plan.

    Therapy becomes the route by which a protected person meets the person they are protected from, in breach of a court order.

  • Does not report reasonable suspicion of child abuse or neglect within the legal timeline - waits for proof, handles it within family therapy, asks the parent to self-report, or keeps it confidential at the family's request.

    The child stays exposed to further harm, and failure to report is an offence for mandated reporters in every US state.

04Outside the role#

Knowing where the role stops is part of the standard. Going past it is not extra credit.

  • Does not prescribe, or advise on starting or stopping medication.Coordinates with the prescriber and monitors for side effects within their competence.
  • Does not provide custody evaluations or expert opinions for current or former therapy clients unless ordered by a court.Provides information about the minor to the court or the evaluator with proper authorisation, and refers the evaluation to an independent professional.
  • Does not use couple therapy as treatment for abusive behaviour, or do joint work where one partner fears the other.Refers the partner who uses violence to an accountability or intervention programme, supports the partner at risk individually with safety planning and specialist advocacy, and considers joint work only after safety is established.
  • Does not assume that the reporting, duty-to-protect and minor consent laws of one US state apply in another, or outside the US, where MFT licensure and titles differ.Practises under the law of the jurisdiction where the client is located, including for teletherapy, and consults when unsure.

05How it is assessed#

  • A spoken assessment

    An examiner talks the candidate through realistic cases from this role, and follows up the way a senior colleague would.

  • Five dimensions

    Each answer is read against the expectations above and rated on the same four-level scale.

  • The 70 bar

    Every scorecard shows the score against 70, overall and for each dimension, with the reason for the verdict.

  • Safety first

    Crossing one of the safety red lines holds a pass back, however strong the rest was.

The four levels

  1. Not yet
  2. Developing
  3. Proficient
  4. Exemplary
How a verdict is made

06Sources and review#

Drawn from the certification frameworks and practice standards below, and reviewed by clinicians. Version 1, last reviewed .

Cited as sources. Not an endorsement by the organizations named.

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