TAMFT Statement on Recent Changes to Texas State Board of Social Work Examiners' Code of Conduct

TAMFT has taken note of the proposed changes approved by the Texas State Board of Social Work Examiners, in connection with certain anti-discriminatory provisions contained in their code of conduct. While we appreciate the gravity of this issue facing licensed social workers in Texas, we wanted to express our thoughts on the matter to help inform our members:

1. Our mission: TAMFT is a state association dedicated to the advancement and promotion of marriage and family therapy in Texas.
2. The Texas State Board of Social Worker Examiners does not have any governance over LMFTs or LMFT-Associates.
3. The Texas State Board of Examiners of Marriage and Family Therapists, our licensing board, at this time does not have language regarding the specific discrimination of groups and is therefore not directly affected by this particular rule change.
4. Texas MFTs have long adhered and continue to adhere to AAMFT’s code of conduct, as is taught and reiterated in our graduate coursework here in Texas, which states “Marriage and family therapists provide professional assistance to persons without discrimination on the basis of race, age, ethnicity, socioeconomic status, disability, gender, health status, religion, national origin, sexual orientation, gender identity or relationship status.”

With that said, TAMFT works very closely with the National Association of Social Workers, Texas Chapter, the Texas Society for Clinical Social Work, the Texas Counseling Association, the Texas Psychological Association, and others on a variety of state policy and regulatory issues designed to facilitate access to care, and protect the health and safety of the public. As part of the regulated community for over 29 years, TAMFT often shares its views through the public testimony process, which we believe helps inform our respective professional licensure boards on a range of substantive matters through constructive deliberation and input, as they seek to faithfully fulfill their appointed duties, by setting and enforcing appropriate qualifications and competency requirements, as well as establishing specific ethical and professional standards, which also includes the ability to modify, suspend, revoke or discipline licensees if needed. 

The Public Participation Process

TAMFT fully appreciates the discontent being expressed by National Association of Social Workers and others, over the unanimous, licensure board approval to substantively modify language, removing certain anti-discriminatory provisions that are embodied within a social worker’s code of conduct, without an opportunity for licensees and the general public to participate and provide input as typically afforded in the standard rulemaking process. We believe that substantive licensure related issues, particularly those involving scope of practice, standards of care, and ethical practices as provided for in the passage of HB 1501, be conducted in a thoughtful, publicly transparent manner that maximizes the material benefit of input from licensees and the public to avoid unintended consequences.

Code of Conduct & Ethical Standards

The Behavioral Health Executive Council (BHEC) approved the Texas State Board of Examiners of Marriage and Family Therapy's (TSBEMFT) rules at their last meeting and we readily acknowledge that LMFTs do not have the same statutory framework nor rulemaking constructs as reflected in the rule modification, promulgated by the Texas State Board of Social Work Examiners. However, all licensed mental health professionals have a high level of moral responsibility and use a code of ethics in their practices to guide them in performing their jobs and services ethically. Codes of ethics often vary by practice, but most have a similar foundation that is fundamentally grounded in the promotion of patient quality, trust, and equal treatment.

We also understand that Federal law specifically protects individuals from many forms of discrimination in the provision of health care services. For example, those who qualify for federal health insurance programs such as Medicare or Medicaid, including facilities and hospitals, may not discriminate based on gender, race, or national origin. Likewise, the Americans with Disabilities Act (ADA) offers similar discriminatory protections against people with disabilities. The principles behind these federal and other state laws, collectively influence how licensed mental health practitioners deliver care, who insurance companies may or may not decide to cover and these codes exist to ensure equal treatment under the law, while removing discrimination in the delivery of mental health services.

Unfortunately, discrimination against people with mental illness and disabilities is far too pervasive. People living with mental illness or disabilities need to have access to the same opportunities as everyone else. While broad anti-discrimination protections are provided by federal and state law, application and enforcement of those rights needs to be clear, and consistent with the ethical codes and standards of a respective mental health licensees’ training and scope of practice. Establishing “boutique” standards could have serious repercussions to interstate compacts and individual licensure reciprocity at a time when there is a shortage of qualified mental health providers.

Course of Action 

Please know that a representative of TAMFT will be at the BHEC meeting on 10/27/20 to share these comments publicly as well as offering recommendations on how to proceed in this matter and future matters regarding rulemaking by the Texas State licensing boards. We also encourage any members who feel led to join the meeting and provide their own public comment on these matters. View the meeting agenda, link, and materials here. 

As always, we thank you for the privilege of representing you and welcome any and all feedback on these matters.

On behalf of the TAMFT Board of Directors,

Linda Metcalf, Ph.D.

President, TAMFT Board of Directors