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Monday, September 12, 2011

Four myths about MFT licensing exams

Go ahead and be anxious about your licensing exam process -- it's a big deal! But don't buy into grumbling falsehoods about it. Test items are written by actual MFTs, and there are no trick questions.                                                                                                                                                                                                                                                                                                            

Every person who becomes a licensed marriage and family therapist has to go through an examination process. In most states, that means passing the National MFT Exam. Many states also supplement the national exam with a second exam covering areas of state law (for example, ensuring that therapists are familiar with that state's requirements for child abuse reporting). In California, the exam process is a bit different; California MFTs must pass two state-run exams, the MFT Standard Written Exam and the MFT Written Clinical Vignette Exam. The overall content and structure of California's exams are similar to the National MFT Exam -- they're multiple-choice tests that use a combination of factual questions and case-vignette-based questions.

Regardless of what state you're in, if you haven't taken the exam(s) yet, you may be dreading them. Even if you have gone through the exam process, you may not have fond memories of it. I hear complaints about the licensing exam process on a regular basis -- most of them based on total mythology. It's as if we (quite understandably) have anxiety-based associations with our testing process, past or future, and then (far less understandably) conjure up rational-sounding but totally baseless complaints about the process in an attempt to justify those fears.

It's okay to be anxious about the process on its own merits. The exams are high-stakes; if you fail, you typically have to wait several months to try again. That impacts your standing among your peers, your employment options, and potentially your income. I still remember completing California's Written Clinical Vignette exam and feeling certain I had failed. In a matter of moments, I was mentally planning how I would explain the failure to my employer, and how I would plan to do better next time. It turned out I had passed, but the memory of those anxious moments before getting my results stays with me.

If I had failed, I wanted to blame someone else: How dare that test be too hard for me! It must be the test's fault! I'm glad I didn't take much of a walk down that road, but if I had, I would have had plenty of company. Once a rumor has started that serves to explain why the tests feel so frightening and why we feel so unsure of ourselves going into them, it is easy for that rumor to be perpetuated. Such stories are factually wrong, and ultimately do more of a disservice to future test-takers by making the exams look cruel and unpredictable. But to someone who has failed a test (or is worried they might), the stories offer comfort -- and someone else to blame. So they live on each year.

Here are the four myths I hear about MFT licensing exams the most:

  1. There are trick questions. Simply put, a licensing exam that uses trick questions would not be legally defensible. Test developers go to tremendous lengths to make sure any potential exam item works well, through several layers of review and pilot testing. If too many people are missing a question, it gets flagged for even more review. If a question appears to be tricking people, either by design or by accident, it is removed.
  2. There is secret knowledge. Test-prep companies make a lot of money perpetuating the mythology that they can provide you with "secrets" or other insider knowledge to help you pass the tests. Nonsense. Both California and AMFTRB (developers of the national exam) offer study guides that say what will be covered on the exams, and they ultimately draw their questions from the same textbooks and journal articles that graduate programs use to teach their students.
  3. They are meant to assess whether you are a good therapist. If I may be blunt, your licensing board does not care whether you are a great therapist or a lousy one. They only care about whether you can practice marriage and family therapy competently enough so as to not be a danger to the public. That's what the exams are meant to assess. Yes, it is sometimes true that ineffective therapists pass their licensing exams, and effective therapists fail. But effectiveness and potential dangerousness are two different things. If you want an outside evaluation of your quality as a therapist, look elsewhere. (Back in 2008, I examined in more detail the question of whether licensing exams lead to better quality therapists.)
  4. They are written by people who aren't therapists. Both California and the AMFTRB use licensed therapists to write their test items. In California, you can apply to be a subject matter expert involved in writing the exams. Elsewhere in the country, AMFTRB intermittently recruits MFTs with relevant expertise. Every test item on both the California and National MFT Exams is written by one or more practicing MFTs.
If you're anxious about your own upcoming exams, instead of buying into the falsehoods above, you'll likely be better off to do something about that anxiety. Maybe that means simply more studying, or maybe it means more directly addressing the anxiety through meditation, therapy, or other means. (Test-prep programs may be of questionable value overall, but if they can help you feel more knowledgeable and less anxious as you take the tests, they may well be worth your time and money.) Rest assured the exam process, and those who designed it, are not out to get you or to trick you. With the right preparation, you can do well on exam day.

If you know someone else who is anxious about their exams, or even who has failed an exam, by all means, comfort them and empathize with them. Sometimes we just have bad days. But please don't support any of the mythology above -- those ideas just make the testing process look bigger, scarier, and less under your control than it really is.

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Since we're talking about mythology, I kept looking for a way to work Greek or Roman myths into this somewhere, and was unsuccessful. So send your lightning-bolt emails to me at ben[at], post a Herculean comment below, or send something to my Pegasus-winged Twitter feed.


Oleeta said...

Good information here. Thank you. I have taken the MFT exam in California 8 or 9 times now and fail each time. I have been close and then I digress even after taking private tutoring. Right now just feeling discouraged and let down by the tutoring process. I have spent a ton of money I don't really have and now am thinking it's time to call it quits with this altogether. Would appreciate any thoughts or comments about it. I keeping hearing "mental block," but I can't really afford to do this any more. Thanks!

Anonymous said...

I just took (and passed) the California Standard Written Exam for MFTs, and I agree that none of the "myths" you write about were true. What was true, in my experience, is that the exam questions seemed to be written by people of questionable intelligence/education, with limited writing skills. Many of the questions and answer choices were very difficult to understand and made little sense. They also frequently used language that I've never heard any clinicians use when they talk about symptoms, interventions, or treatment modalities. The experience was harrowing, and because you never find out how well (or not) you did, there was no opportunity to discover if I had indeed understood the "logic" of the exam questions and guessed correctly, or simply passed by 1 question. I would say that the overall quality of the exam was extremely poor, and the whole experience gave me yet another reason to resent the CA Board of Behavioral Sciences.

Zezy said...

I have to agree with Anonyous... I took the written examination last March and missed passing by 3 questions. As you stated, the "myths" you mentioned are just myths. However, I personally had tremendous difficulty reading and understanding the logic behind questions and answers provided, as well as their grammatical structure. This forced me to go back a few times in order to make sure I understood what I was reading correctly. Needless to say, I wasted precious time during the examination process, which prevented me from going back to review my marked answers. Because English is my second language, I knew I was going to take more time than usual for the examination; however, I did not have any doubt of my English proficiency level to pass this exam. I had learned proper English from higher education and was able to do very well in my Masters program. This helped to recognize the limited writing skills of those who wrote the exam and edited it. Its quality seemed as poor as the DMV written examination. I would advise those who are planning to take the exam to prepare for reading poor English that they would never find on a practice test.

Anonymous said...

try therapist development center. they are amazing.
I am not the best test taker and was becoming overwhelmed with all the Gerry grossman materials so I purchased the TDC. smartest thing I ever did and passed the written the first time.

Anonymous said...

This article is SO misleading. There are ABSOLUTELY trick questions, and even almost identical questions with different answers. Stop lying to people.

Ben Caldwell said...

@Anonymous (12/27) - With all due respect, how familiar are you with the exam development process? If you were familiar with it, you would know just how hard both the BBS and AMFTRB work to make sure that their questions are specific and straightforward.
Of course it is true that there can be almost-identical questions with different answers; the questions "Which of the following is an intervention used in the early stage of Bowen therapy?" and "Which of the following is an intervention used in the middle stage of Bowen therapy?" are almost identical but would have very different answers. Questions need to be read carefully, of course, but they are designed to assess actual knowledge -- not to trick.

Anonymous said...

the test is a bi#@%. that is all.

Heather and Sean Allred said...

If you think the questions are not trick questions you are probably getting some cut of the money that people pay to prepare and take this "EXAMINATION" of our knowledge of the field. Yes, maybe 1/3 of the questions are straight forward. Many are not. Good luck picking the "most correct" or "Best" answer then! Interestingly, people in the field could reasonably argue that several of the answers are "best." The test makers get to decide though of course. On the trick questions you can usually narrow out two and then guess which right answer the test writers favor. In a normal test for knowledge it is based on knowing what is the right answer (with only one clear answer)as well as having clear questions that state the question rather than (for example) a question that "implies" what the question is they are supposedly trying to indicate. Also watch for the games they play with the words "and" and "or." TRICK EXAM NO DOUBT - Consider that 50% of the educated professionals fail this test the first time and have to pay more and more. Seems like a MONEY hungry scam to me. Obviously legal and guess "ethical" according to the test). I do appreciate the irony of being tested on ethics in such a fashion.

I did not fail.... Still a SCAM for money.

Ben Caldwell said...

@Heather and Sean - Sorry, you're simply wrong here. 50% fail the first time? Not even close. A large majority pass each test on their first attempt, according to these statistics from the California licensing board. My impression is that the stats on the National MFT Exam are similar. The test makers do NOT get to decide what answer is best based on subjective opinion -- every test question has to be referenced to common teaching materials in the field.
I am glad to hear that you passed your exams. I hope at some point in your career you take part in exam development, so you can see just how responsibly the process is done. No test is perfect, of course, and even the top experts in the field will disagree among themselves about some answers. Some of the questions on the exams I took were janky. But a test that was developed the way you wrongly claim would not be legally defensible.
You're demonstrating my point nicely, though -- in the absence of facts about testing, people tend to make up their own. And the facts they make up lead others to believe the testing process is much scarier and more evil than it actually is.

Anonymous said...

I just took the national exam yesterday, and anxiously await my results in four-eight weeks.

Prior to studying for, and taking, the exam, I spent many hours researching the best process for preparation. This included clocking in my hours of study: which came to 185 hours. I am not sure, in comparison to other students, how much for how little this was, but it will be good for reference once I receive my results.

I have no "gut feeling" as to whether or not I passed, after completion of the exam yesterday. Despite the hours of group and individual study, flash cards, case reviews, and test exams.

I read this post prior to taking the exam- and I agree now, post exam, that these are all myths. What I will say about the questions- in regards to whether or not the intention is to "trick"- I would say that though the intention may have been assessing knowledge vs. memorization- some of the questions left me in a state of total confusion as to what they were asking. I left scratching my head on the wording of some, and the relevance of others. Interesting experience.

Kathy McElroy said...

Just passed the written exam, and felt that the questions on the exam were much easier than the Gerry Grossman test bank questions, now those were some trick questions! MFT exam is straight forward easy to understand and NO TRICK questions, in my opinion

Anonymous said...

I just passed the CA MFT Standard exam. The test is the hardest test I ever sat for.
In some ways it is an amazing feat to create an exam in which people (going off info teamed from test prep companies findings) don't have an accurate sense of if they are passing or not during the exam.
I count myself as one of the lucky few who are good test takers. I scored in the high 90s in national exams for financial service and trading licensure. Exams that i would have been fired if I failed.
But this hard...and no friggin clue if one is on the test creators wave length or not.

Maybe if you are a CBT/Brief therapy dude through and through this test is a cake sure is a mystery to me how cone can defend this test.

There may not be trick questions, but the difference btn the choices in many situations are so minuscule it boarders on ridiculous.

I found it particularly amusing that I was at a loss for most of the questioned related to my own specialty. I am a couples counselor with a full practice and waiting list....I absolutely love my work, am dedicated to constant advancement of my clinical skills through advanced and specialized training and the questions to test my ability to work with couples clinically, legally and ethically just left me scratching my head.

I prepared and prepared and prepared for this exam...and I can only imagine I jet about scrapped by.

Btw, I also sent quiries about test question answers I was struggling with during my prep to two different test prep companies. The two questions were about when to report to cps/aps and when to assess further.

Both companies responded and gave different answers to the same questions.

Ben Caldwell if the questions are so straight forward how come the test prep companies are also confused about what the examiners actually want? And on an issue as central to the test as legal mandates????

Again this test was the most grueling experience of my professional life. I would rather go back to trading stocks and options with the sharks then deal with least in that cut throat environment you know what you can expect.

Ben, you may be right in terms of their being no trick questions, but I think the test is not a fair and accurate way to assess people's competence and their ability to competently care for the public who come to their psychotherapy offices.

Sad..that people are made to go through this after all the hurdles one has to jump through to get to this stage.

Also Ben the tone of your article is rather harsh...if you are one of those writing questions I guess it helps shed some light on why the test is such an ordeal.

Cynthia said...

After practicing in CA for 23 years I find myself having to study for and take the National MFT Exam in MA. I recently purchased the Gerry Grossman test banks and am experiencing a lot of anxiety over the kinds of confusing questions and focus on minutia. Some people have commented that the exam questions are very different, but how do we know? I feel like I've spend hundreds of dollars on self torment…which is OK if it actually represents the exam accurately. Does anyone know?

Anonymous said...

I just passed the Standard Written Exam. I'm historically a very good test taker, but, this was 4 hours and it was tuff. Oh, and at first it indicated I failed the test by 3 points, and I was just sick and agonized about how I let that happen as I studied a lot... but then I got a letter from the BBS a month later stating it say they had re-scored my test and I passed, after all! Wow...a month of agony and then, oh, never passed. Now I am studying for the CV. I recommend using The Therapist Development Center, also, for preparation. No, the tests aren't 'tricky' in the sense that they are purposefully deceitful...but in my opinion they ARE tricky (intentionally difficult and challenging) because they focus so much on your ability to think on your feet in a detailed manner and your reading comprehension is tested and timed and it really gets to the point where you are left with an overall feeling sense that is rigged to be as hard as possible. If you are not using a good prep-company I think it could be even more confusing. Example: I got an answer wrong because one sentence used the word "manage' instead of "monitor', eg; I monitor a client for safety, but I don't "manage" their safety. This is the level of nuance you are tested on, over and over again, in a variety of different ways throughout the test(s). If you miss that kind of thing a few could easily fail, even if you are in practice a very good therapist.

Mary D said...

I took and passed both California tests the first time and then the national exam for my license here in Hawaii I passed that one first time as well. There is nothing tricky about any of the three nor are there any misleading questions. This is true if you know the material cold and have it down in your memory. The tests are challenging, although I finished both the standard written California exam in slightly under 2 hours and the National exam about the same. It was a while ago and I don't exactly remember the length of time, just that it was significantly less time than the amount of time allowed for them. I found that the national exam focuses a bit more on treatment paradigms and clinical interventions, probably because there is only one exam to cover all areas. But again, they are looking for an awareness of the testee's ability to practice safely not competently. Conversely though I think that if you are a good therapist you will pass the exams. "Bad" (but safe to practice) therapists pass but so do almost all good ones. Neither California BBS nor the national board has any interest in keeping people from getting licensed. But they do have a stake in keeping the public safe. Good luck to everyone. I am preparing for the EPPP, psych license exam now. The material I had to learn for the MFT has been really helpful.

Anonymous said...

I took the test and didn't pass by 6 points. Is It worth paying the fee for a rescore. I have heard some people fail and then get a letter stating they passed several weeks later?

Anonymous said...

As I let my MFT licenses become cancelled because entered another profession and didn't foresee needing it again, I have had to take all 3 license exams over again.. Last Wednesday i took and passed the California std written. On August 11 I will take the clinical vignettes exam. Then it's on to Hawaii and the National MFT exam. I took the clinical vignette exam when it was still in front of two examiners in a hotel room before.. I don't know how much more difficult it will be with the computer but I don't think it could possibly be more difficult than in front of two other people. I plan to pass it first time also. The exams are not that difficult if you remember to focus on the important elements of any case --assess for safety, crisis assessment, legal and ethical issues, etc. The whole process really is about determining if you are safe to unleash upon the public.
To Anonymous who just wrote about not passing by six points, it is true that there was an error a few years ago that indicated that some people had not passed by 1 pt. but that on review there was some problem and a whole group of people had missed by 1 pt. but on review were given pass scores. I if it doesn't cost anything to ask for a review, ask for it. You never know. Six points seems high for it to have been errors in either computer system or question, but you don't know till you ask. Good luck.

Anonymous said...

I'm a licensed MFT for 18 years, taking the national exam because I'm moving to another state. I don't find that there are trick questions, but I do find almost no relationship between the practice of psychotherapy and the questions on the exam. Most are theoretical, related to remembering inane details about how certain family therapy approaches conceptualize certain stereotyped interventions. In addition, many of the answers in prep materials (AATBS, for example) are just flat out incorrect or were correct 10 years ago but are no longer correct. My basic assessment of the exam process is that the national MFT exam has extremely poor content and criterion validity. These tests DO NOT measure whether an individual is safe and effective to practice.

Anonymous said...

Same here in Florida. I have taken 3 times and fail each time. Scored between 6.4 and 6.8. I thought I fail because English Is my second language. However, I understand from other comments that it is difficult and confused with identical questions and all the studies does not help with interventions. One of the anonymous said " Most are theoretical, related to remembering inane details about how certain family therapy approaches conceptualize certain stereotyped interventions". How true!!! I have been practicing for 6 years as a couples counselor and I have full practice and a waiting list. To keep me update and learn most of the interventions I make sure that I take specialization courses often through out the year.

Abigail Marateck said...

I am currently studying for the MFT National Exam and cannot figure out what the "passing" score is? Is this information not published? Wondering what I should be aiming for as I take these practice exams.

Urania Roquevanyo said...

oriEach state determines a different passing score in MN it is typically 75% but in the last window it was 65% I am sitting to take it for the 3rd time next week. I havent taken the test in 9 years due to moves out of area..Im interested to see how it has changed and praying hard I pass

Anonymous said...

If in fact there is no hidden agenda by the BBS, please explain the 50% on going failure rate? The numbers do not lie. I say the issue is with testing format. There is an ASSUMPTION on the part of the BBS that everyone can demonstrate their knowledge in the same way. No one addresses the fact that we experience, learn and understand our world differently as human beings. I am kinesthetic learner...I do not understand the world from "TEXT" or the written word...nor did I do much reading in my M.A program and still graduated with a 3.4 gpa. And, I'm force to demonstrate my knowledge in a format that does not fit for me. I have not passed the WCA test after 8 attempts...does mean I do not know what I'm doing as a therapist...No it does not...just that there is something amiss with the testing format.

Ben Caldwell said...

@Anonymous (November 11) - Um, there is no "50% ongoing failure rate." The BBS regularly publishes exam pass rate statistics right here: As that data clearly shows, the large majority of examinees pass on their first attempt. Pass rates go down for subsequent attempts, which shows that the exam is doing what it is supposed to be doing -- separating those who can pass from those who cannot. If the pass rate stayed the same on second and later attempts, then it would give the appearance that passing or not passing was happening at random.
I would be the first to agree that people learn in different ways and that the testing process is imperfect, and I'm sorry to hear you've had such a struggle with the process. But you can't just make up statistics in support of your point, especially when real, accurate numbers are readily available.