New Graduate to Licensure

Three Paths to Becoming an LMFT in WI: A Brief Overview
by Bruce Kuehl, Ph.D.
MFT Section Board Member

The following is an attempt to clarify the WI MFT licensing process. It is provided courtesy of UW-Stout’s MFT Program as well as the MFT section of the Marriage and Family Therapy, Professional Counselor and Social Work (MPSW) Board at the WI Department of Regulation and Licensing. The reader should note that the process/requirements for licensing can change at any time. For links to the most accurate, detailed and current licensing and practice information, including application forms, the DRL encourages applicants and credential holders to go to http://drl.wi.gov/prof/marr/cred.htm. In fact, it would be most useful to the reader to access the identified web links concurrent with reading this article.

On the web page listed above, the reader will see: “Individuals who wish to practice marriage and family therapy or who wish to use the title "marriage and family therapist" must be licensed as a marriage and family therapist or hold a marriage and family therapist training license, pursuant to s. 457.04(5) and s. 457.11 (2) of the Wisconsin Statues.” (Wisconsin rules and statutes can be accessed by clicking on “Rules” or “Statutes” on the webpage.) Thus, obtaining a state MFT license should be every MFT’s first priority. All application forms can be found at: http://drl.wi.gov/prof/marr/app.htm. Furthermore, once you are in the licensing process, the DRL has an electronic system that allows you to verify what forms you have submitted and which are still outstanding. Keep records of all your forms/transactions with the DRL to provide as evidence if you claim that you submitted a form/paid a fee for which the DRL has no record. The DRL cannot act without hard evidence.

Path One, the Training License, is the most common path to licensure and is intended for applicants who have completed the educational requirements but have not completed the post-graduate client contact/supervision hours. Any person who wishes to acquire the 3000 postgraduate clinical hours which are part of the requirements to become licensed must due so while holding a valid Training License. An applicant who has (a) acquired the required experience under the Training License, (b) passed the AMFTRB exam (also called the “national exam”) and the WI Statute and Rule exam, and (c) submitted all supporting documentation and paid all fees, may then be granted a license.

A second path, the Temporary License, is an option that only some applicants will utilize and is not a required part of the licensing process. The only advantage of a Temporary License is that it indicates that the holder has met all licensing requirements except having completed one or both exams (the AMFTRB and WI statute and rule exams). Its purpose is to reflect a credential holder’s higher level of experience, but it carries a risk in that it is revoked immediately if a person fails to pass their exam.

The third path is Reciprocity. This route is for credentialed applicants from outside of WI. It allows them to compare their qualifications to WI licensing requirements in order to identify if their experience is equivalent, at which point they are granted a license, or if there are areas they need to take further action, such as taking and passing the AMFTRB exam or the state statute and rule exam.

New Graduates
For new graduates, it takes a minimum of two years to meet state licensing requirements. This is a typical standard in the field and is required of all other master’s level therapy-type license holders, including Professional Counselors and Clinical Social Workers. Holding a full license means that a person is ready to be an independent practitioner (i.e.: able to practice without supervision). Neither the state nor the profession (AAMFT) believes that new graduates are ready to practice without supervision prior to gaining this postgraduate experience. That is why new graduates must begin with a Training License. The following is an outline of how a new graduate would typically proceed:

Complete required master’s level MFT academic work.
Submit all forms required for a “MFT Training License” through the Department of Regulation and Licensing upon graduation.
Choose whether to take the AMFTRB and state exams (options are listed on the application form).
Gather 3000 hours of supervised postgraduate clinical experience (1000 of the 3000 must be face-to-face client contact) over a minimum of two years.
Gather 1 hour of supervision for every 10 hours of face-to-face client contact by any of the following: AAMFT Approved Supervisor; Licensed Doctoral level MFT; Licensed Master’s level MFT with five years clinical experience; a doctoral level Psychologist or a Psychiatrist; or someone pre-approved by the MFT section of the DRL.
When requirements are met, apply for an MFT license (again using the “forms” link).
Pass the AMFTRB (“national”) MFT exam and the WI Statute and Rule exam (if not completed sooner).
Pay all fees.

Taking the WI Statute and Rule Exam and the AMFTRB Exam (i.e.: the “National Exam”). Both exams must be passed before an applicant will be granted a license. As mentioned, the Training License is for new graduates and offers the applicant the option of taking the AMFTRB (“National”) and State Statute and Rule exams early or waiting to take them at the end of the licensing process. The AMFTRB exam requires traveling to a designated regional exam center on a specified date in order to take a multiple choice exam that examines the test-taker’s overall knowledge of MFT. The state "Statutes and Rules" exam is an “open book” multiple choice exam that the test taker completes on-line using the on-line WI statutes and rules to inform her/his answers. Links to exam information and answers to other common questions can be found by clicking on the DRL’s “Practice FAQs.” If they fail their exam, Training License holders are allowed to retake it while those who hold a Temporary License may not. Therefore, Training License holders who are considering applying for a Temporary License are advised to weigh the risks and benefits.

The “Confusing” Years
As with many bureaucratic processes, meeting the requirements for credentialing can be confusing. The drawbacks are the time, money and energy needed to meet the requirements. The advantage is consumer protection and legitimacy in the eyes of consumers and third-party payers, such as managed care and various state and federal programs. This is why many mental health clinics are reluctant to hire MFTs until they are licensed. MFTs are not alone in this. Masters level Professional Counselors and Clinical Social Workers go through an almost identical process. Thus, becoming licensed is a prerequisite to many post-graduate employment opportunities. Licensing also allows a person to practice independently as an MFT. Great strides have been made over the years in terms of insurance, managed care and other providers recognizing LMFTs. While licensing does not require third party payers to recognize an LMFT as a qualified/reimbursable professional, it certainly increases the likelihood. Becoming an LMFT also qualifies a practitioner for employment in DHFS certified clinics, but some DHFS practice requirements may be slightly different than those for individual DRL MFT license holders who practice outside of a clinic. While the “gap” between DHFS and DRL practice standards is decreasing, it is still important for all WI practitioners to visit the DHFS website to review the requirements/qualifications necessary for working in various treatment settings. This can be done by linking off of http://dhfs.wisconsin.gov/rl_DSL/MentalHealth/MHprovs.htm.

Finally, AAMFT recognizes many state licenses (incl. WI) as meeting its requirements for advancing to “Clinical Membership,” and being a member of AAMFT is the best way to insure that your practice remains up-to-date (www.aamft.org). Furthermore, under Administrative Code MPSW 19.02(1-4), LMFTs are required to gather 30 CEUs every two years in order to renew their license. AAMFT/WAMFT approved training events qualify as CEUs for license holders.

Types of Employment to Seek Upon Graduation and Prior to Licensure.
As already mentioned, the chances of getting hired as a therapist in a mental health clinic increases -- as does salary potential -- once a person is state licensed and better able to bill/collect from third parties, such as managed care, insurance, etc. (At the risk of being repetitive, this is also true of other master’s level therapists such as Mental Health Counselors and Clinical Social Workers.) As also mentioned, this requires a minimum of two years post-graduate experience. This leads to the common question, “How do I get the experience I need to become licensed and earn an income if clinics are reluctant to hire someone who is not licensed?” Training License holders work in a wide variety of positions. The key is to be sure that the hours qualify toward state licensure. This means face-to-face, supervised psychotherapy/psychoeducation/human service type work. Training License holders are often employed in settings (often nonprofit) that depend on other sources of funding, such as state and federal money, private funding, self-pay, grants and donations. Common examples include such positions as in-home family therapist, day-treatment therapist, residential care provider (e.g.: adolescent treatment settings, drug treatment centers, psychiatric settings, etc.), human service agencies, crisis worker, therapist in a religious setting, therapist in an alternative school, domestic violence therapist, family psychoeducator, military mental health provider, and some mix of therapist/administrator. Salaries and benefits vary widely depending on the type of job, geographic area and current market. Some graduates step quickly into high paying jobs while others work part-time as therapists and part-time at another better paying job until they become licensed and can pursue a higher salary. Few jobs will advertise specifically for an MFT. Apply to any job that seems appropriate for your skills/training. Employers often do not know they are looking for an MFT until they see your resume/qualifications on their desk!

In conclusion, all of this can make your head spin. Even experienced therapists get confused. The above process can seem overwhelming and sometimes discouraging, but it is important to recognize that this is a process that ALL clinicians go through and that many people have already successfully completed journeys similar to yours. Keep your chin up, keep going forward and the prize will be yours.