Article archive / November 1, 2012
Originally published: . Volume 4, No. 3. Source pages: 1, 3.
The Louisiana Attorney General issued an Opinion on October 12, 2012 after reviewing objections submitted last year by the Louisiana State Board of Examiners of Psychologists (LSBEP) about rules for Licensed Marriage and Family Therapists (LMFTs), put forth by the Counselors state board.
The Attorney General (AG) found no problem with the rules, and summarized, “The permitted scope of practice of licensed marriage and family therapists includes the assessment and treatment of emotional, behavioral, personality, and mental disorders, subject to the specific limitations …” And that “The training require- ments set forth” in the rules “are consistent with the statutory scope of practice of licensed marriage and family therapists, do not expand said statutory scope of practice by rule, are not violative of the prohibition on the unlicensed practice of psychology, and do not require training in areas that an LMFTs would be prohibited from exercising.” The original request was submitted last year, according to LSBEP Executive Director Kelly Parker. It was signed by then Chair Dr. Tony Young and listed four objections:
“(1) the rules impose training requirements that are inconsistent with the statutory definition, treatment population, and scope of practice of an LMFT; (2) the rules expand the scope of practice of LMFTs by rule; (3) the rules constitute a violation of the statutes that govern the practice of psychology; and (4) the rules require training to qualify for licensure in areas that LMFTs would be prohibited from exercising.”
According to the AG, the LSBEP’s main reasoning for the objections was that “the proposed coursework requirements would expand, by rule, the scope of practice of LMFTs to include assessment, treatment planning, and treatment of mental, intellectual, emotional, or behavioral disorders. The LSBEP avers that this expanded scope of practice is outside the therapeutic focus of an LMFT …”
The AG examined the issue of scope of practice for LMFTs, noting “The definition very clearly includes assessment and treatment, but omits diagnosis from the scope of practice.”
Then, by comparing the definition of MFT with the definition of mental health counseling services, “which is found in the same statute, we see that the latter specifically includes mental and emotional disorders in the scope of practice of Licensed Professional Counselors (“LPCs”): …” wrote Charles Belsom, on behalf of James Caldwell.
The AG sets out a detailed argument including, “First, the statute does not use the term therapeutic; rather, it uses the term ‘psychotherapeutic.’” And, “Furthermore, the statute does not limit the scope of practice to marriage and family systems and the treatment thereof; the statute includes ‘psychotherapeutic and family systems theories and techniques.’ Id. (emphasis added). Finally, the statute quite plainly includes ‘assessment and treatment’ within the scope of practice of an LMFT. Id.”
The AG writes that “It is apparent that the term psychotherapeutic by its very definition involves emotional, behavioral, personality, and mental disorders. The inclusion of psychotherapeutic in the definition of marriage and family therapy therefore indicates that the scope of practice for LMFTs does include the assessment and treatment of emotional, behavioral, personality, and mental disorders.”
And that, “LMFTs cannot independently assess or treat persons with serious mental disorders. The regulatory scheme for LMFTs is found in Chapter 13 of Title 37 of the Louisiana Revised Statutes. The definition of “[m]ental health counseling services” within that chapter specifies that no person licensed under Chapter 13 can work with an individual suffering from a serious mental illness unless the individual is under the concurrent care of a psychiatrist (or other qualified practitioner), and the licensee is collaborating with said qualified practitioner: …”
The AG found no evidence that training set out in the rules should be a concern, writing“ … an LMFT is likely to treat patients who are on medication that has been prescribed by a qualified individual, and is likely to treat patients with serious mental illnesses concurrently with a psychiatrist or other qualified person in accordance with La. R.S. 37:1103(7). In these cases, instruction in psychopharmacology and the full content of the Diagnostic and Statistical Manual of Mental Disorders would prove useful, and perhaps necessary, to an LMFT.”
“It is true that the LPC Board cannot expand the statutory scope of practice of LMFTs by rule. Nevertheless, as explained in the preceding paragraphs, these rules do not require instruction in any matters that are outside the statutory scope of practice of an LMFT.”
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