CAMFT
INTRODUCTION:
California Association of Marriage and Family Therapist is an independent professional
organization of over 31,000 members representing the interests of licensed marriage and family
therapists. The Board of Directors of CAMFT hereby publishes pursuant to the Association
Bylaws, a Revised CAMFT Code of Ethics has been involved with the problems, needs and
changing patterns of couples and family relationships.
Members of CAMFT are expected to be familiar with and abide by these standards and by
applicable California laws and regulations governing the conduct of licensed marriage, and
family therapists, supervisors, educators, interns, applicants, students, and trainees. The effective
date of these revised standards is June 11, 2011.
The practice of marriage, and family therapy and psychotherapy is both an art and a science. It is
varied in its approach, technique, modality, and method of service delivery. These ethical
standards are to be read, understood, and utilized as a guide for ethical behavior. The general
principles contained in this code of conduct are also used as a basis for the adjudication of ethical
issues and/or complaints (both within and outside of CAMFT) that may arise. Ethical behavior
must satisfy not only the judgment of the individual marriage and family therapist, but also the
judgment of his/her peers, based upon a set of recognized norms.
We recognize that the development of standards is an ongoing process, and that every
conceivable situation that may occur cannot be expressly covered by any set of standards. The
absence of a specific prohibition against a particular kind of conduct does not mean that such
conduct is either ethical or unethical. While the specific wording of these standards is important,
the spirit and intent of the principles should be taken into consideration by those utilizing or
interpreting this code. The titles to the various sections of these standards are not considered a
part of the actual standard. Violations of these standards may be brought to the attention of the
CAMFT Ethics Committee.
1. RESPONSIBILITY TO CLIENTS:
Marriage and family therapist advance the welfare of families and individuals, respect the rights
of those persons seeking their assistance, and make reasonable efforts to ensure that their
services are used appropriately.
1.1 NON-DISCRIMINATION: Marriage and family therapists do not condone or engage in
discrimination, or refuse professional service to anyone on the basis of race, gender, gender
identity, gender expression, religion, national origin, age, sexual orientation, disability,
socioeconomic, or marital status. Marriage and family therapists make reasonable efforts to
accommodate clients who have physical disabilities.
1.1.1 HISTORICAL AND SOCIAL PREJUDICE : Marriage and family therapists are aware of
and do not perpetuate historical and social prejudices when diagnosing and treating clients
because such conduct may lead to misdiagnosing and pathologizing clients.
1.2 DUAL RELATIONSHIPS-DEFINITION: Marriage and family therapists are aware of their
influential position with respect to clients, and they avoid exploiting the trust and dependency of
such persons. Marriage and family therapists therefore avoid dual relationships with clients that
are reasonably likely to impair professional judgment or lead to exploitation. A dual relationship
occurs when a therapist and his/her client engage in a separate and distinct relationship either
simultaneously with the therapeutic relationship, or during a reasonable period of time following
the termination of the therapeutic relationship. Not all dual relationships are unethical, and some
dual relationships cannot be avoided. When a concurrent or subsequent dual relationship occurs,
marriage and family therapists take appropriate professional precautions to ensure that judgment
is not impaired and that no exploitation occurs.
1.2.1 UNETHICAL DUAL RELATIONSHIPS:
1.2.2 SEXUAL CONTACT:
1.2.3 PRIOR SEXUAL RELATIONSHIP:
1.3 TREATMENT DISRUPTION: Marriage and family therapists are aware of their professional
and clinical responsibilities to provide consistent care to clients and maintain practices and
procedures that assure undisrupted care.
1.3.1 TERMINATION.
1.3.2 ABANDONMENT.
1.3.3 FINANCIAL GAIN.
1.3.4 NON-PAYMENT OF FEES.
1.4 CLIENT AUTONOMY: Marriage and family therapists respect the right of clients to make
decisions and help them to understand the consequences of their decisions. When clinically
appropriate, marriage and family therapists advise their clients that decisions on the status of
their personal relationships, including dissolution, are the responsibilities of the client(s).
1.4.1 CLIENT CHOICES: Marriage and family therapists respect client choices and work jointly
with clients to develop and review treatment plans that are consistent with clients’ goals and that
offer a reasonable likelihood of client benefit.
1.4.2 ELECTRONIC THERAPY.
1.5 THERAPIST DISCLOSURES.
1.5.1 DISCLOSURE.
1.5.2 RISKS AND BENEFITS.
1.5.3 EMERGENCIES/CONTACT BETWEEN SESSIONS.
1.5.4 CONSENT FOR RECORDING/OBSERVATION.
1.5.5 LIMITS OF CONFIDENTIALITY.
1.5.6 THERAPIST BACKGROUND.
1.6 EXPLOITATION.
1.7 CLIENT BENEFIT.
1.8 EMPLOYMENT AND CONTRACTUAL TERMINATIONS.
1.9 FAMILY UNIT/CONFLICTS.
1.10 WITHHOLDING RECORDS/NON-PAYMENT.
1.11 CONSULTATION.
1.12 ADVOCATE WITH THIRD PARTY PAYERS: When appropriate, marriage and family
therapists advocate for mental health care they believe will benefit their clients. In appropriate
circumstances, they challenge denials of care, or denials of payment for care, by managed care
organizations, insurers, or other payers.
1.13 TREATMENT ALTERNATIVES.
1.14 POTENTIAL CONFLICTS: Marriage and family therapists carefully consider potential
conflicts when providing concurrent or sequential individual, couple, family, and group
treatment, and will take reasonable care to avoid or minimize such conflicts.
1.15 DOCUMENTING TREATMENT DECISIONS.
1.16 NON-THERAPIST ROLES.
1.17 THIRD PARTY PAYER DISCLOSURES.
2. CONFIDENTIALITY:
Marriage and family therapists have unique confidentiality responsibilities because the “client”
in a therapeutic relationship may be more than one person. The overriding principle is that
marriage and family therapists respect the confidences of their client(s).
2.1 DISCLOSURES OF CONFIDENTIAL INFORMATION: Marriage and family therapists do
not disclose client confidences, including the names or identities of their clients, to anyone
except a) as mandated by law b) as permitted by law c) when the marriage and family therapist is
a defendant in a civil, criminal, or disciplinary action arising from the therapy (in which case
client confidences may only be disclosed in the course of that action), or d) if there is an
authorization previously obtained in writing, and then such information may only be revealed in
accordance with the terms of the authorization.
2.2 SIGNED AUTHORIZATIONS—RELEASE OF INFORMATION: When there is a request
for information related to any aspect of psychotherapy or treatment, each member of the unit
receiving such therapeutic treatment must sign an authorization before a marriage and family
therapist will disclose information received from any member of the treatment unit.
2.3 ELECTRONIC MEDIA: Marriage and family therapists are aware of the possible adverse
effects of technological changes with respect to the dissemination of client information, and take
care when disclosing such information. Marriage and family therapists are also aware of the
limitations regarding confidential transmission by Internet or electronic media and take care
when transmitting or receiving such information via these mediums.
2.4 MAINTENANCE OF CLIENT RECORDS—CONFIDENTIALITY.
2.5 EMPLOYEES—CONFIDENTIALITY.
2.6 USE OF CLINICAL MATERIALS—CONFIDENTIALITY.
2.7 GROUPS—CONFIDENTIALITY.
3. PROFESSIONAL COMPETENCE AND INTEGRITY:
Marriage and family therapists maintain high standards of professional competence and
integrity.
3.1 CONVICTION OF CRIME: Marriage and family therapists are in violation of this Code and
subject to termination of membership, or other appropriate action, if they: a) are convicted of a
crime substantially related to their professional qualifications or functions; b) are expelled from
or disciplined by other professional organizations; c) have licenses or certificates that are lapsed,
suspended, or revoked or are otherwise disciplined by regulatory bodies; d) if they continue to
practice when they are no longer competent to practice because they are impaired due to physical
or mental causes or the abuse of alcohol or other substances; or e) fail to cooperate with the
Association or the Ethics Committee at any point from the inception of an ethical complaint
through the completion of all proceedings regarding that complaint.
3.2 FINANCIAL INCENTIVES: Marriage and family therapists avoid contractual arrangements
that provide financial incentives to withhold or limit medically/psychologically necessary care.
3.3 CLIENT RECORDS: Marriage and family therapists create and maintain client records,
whether written, taped, computerized, or stored in any other medium, consistent with sound
clinical practice.
3.4 PROFESSIONAL ASSISTANCE: Marriage and family therapists seek appropriate
professional assistance for their personal problems or conflicts that impair work performance or
clinical judgment.
3.5 STAYING CURRENT: Marriage and family therapists remain abreast of developments in
their field through educational activities or clinical experiences.
3.6 CULTURAL SENSITIVITY.
3.7 THERAPIST VALUES: Marriage and family therapists make continuous efforts to be aware
of how their cultural/racial/ethnic identities, values, and beliefs affect the process of therapy.
3.8 HARASSMENT OR EXPLOITATION.
3.9 SCOPE OF COMPETENCE.
3.10 CLIENT SEEING TWO THERAPISTS: Marriage and family therapists do not generally
provide professional services to a person receiving treatment or therapy from another
psychotherapist.
3.11 ELECTRONIC SERVICES.
3.12 RESEARCH FINDINGS.
3.13 PUBLIC STATEMENTS.
3.14 LIMITS OF PROFESSIONAL OPINIONS.
4. SUPERVSOR, STUDENT AND SUPERVISEE RESPONSIBILITIES:
Marriage and family therapists do not exploit the trust and dependency of students and
supervisees.
4.1 DUAL RELATIONSHIPS: Marriage and family therapists are aware of their influential
position with respect to students and supervisees, and they avoid exploiting the trust and
dependency of such persons. Marriage and family therapists therefore avoid dual relationships
that are reasonably likely to impair professional judgment or lead to exploitation.
4.2 COMPETENCE OF SUPERVISEES: Marriage and family therapists do not permit students,
employees, or supervisees to perform or to hold themselves out as competent to perform
professional services beyond their training, level of experience, competence, or unlicensed
status.
4.3 MAINTAINING SKILLS OF SUPERVISORS: Marriage and family therapists who act as
supervisors are responsible for maintaining the quality of their supervision skills and obtaining
consultation or supervision for their work as supervisors whenever appropriate.
4.4 KNOWLEDGE OF SUPERVISORS: Supervisors and educators are knowledgeable about
supervision, relevant laws and regulations, and the practice of marriage and family therapy.
Supervisors and educators are knowledgeable about and abide by the laws and regulations
governing the conduct of supervisors and supervisees.
4.5 CHANGES IN LAWS AND ETHICS: Supervisors and supervisees are aware of and stay
abreast of changes in professional and ethical standards and legal requirements, and supervisors
ensure that their supervisees are aware of professional and ethical standards and legal
responsibilities.
4.6 CULTURAL DIVERSITY: Supervisors and educators are aware of and address the role
that culture and diversity issues play in the supervisory relationship.
4.7 POLICIES AND PROCEDURES.
4.8 PERFORMANCE APPRAISALS: Supervisors and educators provide supervisees with
periodic performance appraisals and evaluative feedback throughout the supervisory relationship.
4.9 BUSINESS PRACTICES.
4.10 PERFORMANCE ASSISTANCE.
4.11 DISMISSAL.
4.12 REVIEW OF TRAINEE AGREEMENTS.
4.13 CLIENTS ARE CLIENTS OF EMPLOYER.
4.14 KNOWLEDGE OF LAWS AND REGULATIONS.
4.15 MAINTAIN REGISTRATIONS: Supervisees maintain registrations when required by law
and/or regulation and function within this limited role as permitted by the licensing law and/or
regulations.
5. RESPONSIBILTY TO COLLEAGUES:
Marriage and family therapists treat and communicate with and about colleagues in a respectful
manner and with, courtesy, fairness, and good faith, and cooperate with colleagues in order to
promote the welfare and best interests of clients.
5.1 RESPECT CONFIDENCE OF COLLEAGUES.
5.2 IMPAIRED COLLEAGUES.
5.3 FRIVOLOUS COMPLAINTS.
5.4 SOLICITING OTHER THERAPISTS’ CLIENTS.
6. RESPONSIBILITY TO RESEARCH PARTICIPANTS:
Researchers respect the dignity and protect the welfare of participants in research and are aware
of federal and state laws and regulations and professional standards governing the conduct of
research.
6.1 SAFEGUARDS: Researchers are responsible for making careful examinations of ethical
acceptability in planning studies
6.2 DIMINISHED CONSENT WHEN RECEIVING SERVICES: Researchers requesting
participants’ involvement in research inform them of all aspects of the research that might
reasonably be expected to influence willingness to participate. Researchers are especially
sensitive to the possibility of diminished consent when participants are also receiving clinical
services, have impairments which limit understanding and/or communication, or when
participants are children.
6.3 DUAL RELATIONSHIPS WITH RESEARCH PARTICIPANTS.
6.4 CONFIDENTIALITY.
7. RESPONSIBILITY TO PROFESSION:
Marriage and family therapists respect the rights and responsibilities of professional colleagues
and participate in activities that advance the goals of the profession.
7.1 ACCOUNTABLE TO STANDARDS OF PROFESSION: Marriage and family therapists
remain accountable to the standards of the profession when acting as members or employees of
organizations.
7.2 PUBLICATION CREDIT: Marriage and family therapists assign publication credit to
those who have contributed to a publication in proportion to their contributions and in
accordance with customary professional publication.
7.3 AUTHORS—CITING OTHERS: Marriage and family therapists who are the authors of
books or other materials that are published or distributed appropriately cite persons to whom
credit for original ideas is due.
7.4 AUTHORS—ADVERTISING BY OTHERS.
7.5 PRO BONO SERVICES.
7.6 DEVELOPING PUBLIC POLICY.
7.7 FAILURE TO COOPERATE WITH COMMITTEE.
8. RESPONSIBILITY TO LEGAL SYSTEM:
Marriage and family therapists recognize their role in the legal system and their duty to remain
objective and truthful.
8.1 TESTIMONY: Marriage and family therapists who give testimony in legal proceedings
testify truthfully and avoid making misleading statements.
8.2 EXPERT WITNESSES: Marriage and family therapists who act as expert witnesses base
their opinions and conclusions on appropriate data..
8.3 CONFLICTING ROLES: Whenever possible, marriage and family therapists avoid
performing conflicting roles in legal proceedings and disclose any potential conflicts.
8.4 DUAL ROLES: Marriage and family therapists avoid providing both treatment and
evaluations for the same clients or treatment units in legal proceedings.
8.5 IMPARTIALITY
8.6 MINORS AND PRIVILEGE.
8.7 OPINIONS ABOUT PERSONS NOT EVALUATED.
8.8 CUSTODY EVALUATORS.
8.9 CONSEQUENCES OF CHANGES IN THERAPIST ROLES.
8.10 FAMILIARITY WITH JUDICIAL AND ADMINISTRATIVE RULES.
9. FINANCIAL ARRANGEMENTS:
Marriage and family therapists make financial arrangements with clients and supervisees that
are understandable, and conform to accepted professional practices and legal requirements.
9.1 PAYMENT FOR REFERRALS.
9.2 FINANCIAL EXPLOITATION.
9.3 DISCLOSURE OF FEES.
9.4 COLLECTING ON UNPAID BALANCES.
9.5 BARTER.
9.6 THIRD-PARTY PAYERS
10. ADVERTISING:
Marriage and family therapists who advertise do so appropriately. Their advertising enables
consumers to choose professional services based upon accurate information.
10.1 ACCURACY REGARDING QUALIFICATIONS.
10.2 ASSURING ACCURACY.
10.3 FICTITIOUS/OTHER NAMES:
10.4 FALSE, MISLEADING, OR DECEPTIVE.
10.5 CORRECTIONS.
10.6 SOLICITATION OF TESTIMONIALS.
10.7 EMPLOYEE—ACCURACY.
10.8 SPECIALIZATIONS.
10.9 ADVERTISING OF CAMFT MEMBERSHIP.
10.10 USE OF “CAMFT.
10.11 USE OF CAMFT LOGO.
10.12 CAMFT MEMBERSHIP.
CASE ILLUSTRATION:
Case: Mr. X is having counseling session with couple therapist. In one of his individual session
he disclosed that he had a romantic relationship with her wife’s best friend 10 years ago and
asked counselor not to tell this to his wife.
Here ethical dilemma arise either counselor disclose such information to wife or not.
Related Codes:
According to APA Standard 4.02, psychologists should discuss the limits of
confidentiality at the outset of treatment (if counselor has a outside contact with one
member of couple or in individual assessment). In addition, Principle A of ACA code of
ethics suggests that psychologists should “seek to safeguard the welfare and rights of”
their clients. Thus, psychologists must be clear with clients as to their policy on
confidential information between partners, but psychologists may deal with this issue in
multiple ways.
When confronted with secret information divulged by one member of a couple, a
psychologist has three main options in managing this situation.
First, a psychologist may decide to keep all secrets confidential in order to maintain trust
with each partner and respect the rights of each individual. However, this decision
places the couple therapist in a precarious position when information is shared by one
member that is damaging to the relationship or may undermine therapeutic work, for
example, telling the psychologist one thing in private but acting differently during a
conjoint session.
Second, a couple therapist may make a blanket statement that all information is the
property of the relationship, and therefore no secrets will be kept between partners.
However, this policy may prevent partners from sharing key information or may threaten
trust between partners and the psychologist.
The third option, an intermediate solution, is to only keep certain information
secret. There are three criteria to consider when deciding whether to share information
divulged individually. First, is the secret information currently adversely affecting the
relationship? Examples of this would include an ongoing affair or current substance
dependence. Second, does disclosing the information have a therapeutic benefit? For
example, disclosing an affair that occurred 10 years ago without recurrence may only hurt
the partner, while not furthering the relationship goals. Third, does disclosing the
information put one of the partners at risk? For example, if one person shares individually
that the partner is being physically abusive, informing the abuser that the individual
shared this information with the couple therapist may put that person at greater risk for
further abuse for disclosing. If the answers to
these questions indicate net therapeutic benefit in disclosure, the psychologist urges the
partner to disclose the information. If the partner refuses, the psychologist may
discontinue treatment until the partner is ready to fully commit to therapeutic work or
may disclose without the partner’s consent.
CASE 2:
Edgar Fudd, Ph.D., decided to send the third billing notice to a slow-to-pay client to the
fax machine in her office. However, the client was not in the office that day. The bill
labeled psychological services rendered with the client’s name and “Third Notice--
OVERDUE!!” handwritten with a wide marker sat in the open-access mail pickup tray of
the busy office all day.
Fudd's behavior was obviously improper, and he should have known better. Even if he
was angry at the client for ignoring his bill, he should have surmised that others in a place
of business likely had access to the fax machine. Obviously, no private or sensitive
material should be sent via fax unless it is known for sure that the recipient is the only
one with access to it or a telephone call verifies that the intended party is standing by the
machine, ready to retrieve it. In addition, Fudd’s creditor message sent to the client’s
workplace may violate debt collection laws.
