AAMFT Code of Ethics, the 2026 edition

A male MFT realizes that the boyfriend his client often talks about is a man he met on a dating app and has been messaging about meeting. What should the therapist do FIRST?

1. Ask the boyfriend not to mention it
   Asking the boyfriend to keep quiet adds secrecy to the conflict and enlists a third party in hiding it from the client.
2. Keep chatting but avoid meeting in person
   Continuing to chat while skipping the meeting keeps the prohibited connection alive; the risk lies in the relationship, not only in meeting in person.
3. End his contact with the boyfriend
   Contact with a known member of the client's relational world is a prohibited multiple relationship (AAMFT 1.3, 1.4), so the first step is to stop it; consultation about the case comes next.
4. Tell the client about the messages
   Telling the client right away puts the therapist's personal life into her therapy before he has stopped the contact or consulted about whether and how to disclose; it is a later decision, not the first move.

Several months into family therapy, an MFT learns that the mother has a severe eating disorder that needs treatment she has never been trained to provide. What should the therapist do?

1. Coordinate a specialist referral for the mother
   A severe eating disorder is outside this therapist's training (AAMFT 3.10), so the mother gets a specialist referral while the family work, which is within competence, continues in coordination.
2. End family therapy and refer everyone out
   Ending all family therapy overcorrects: only one problem is beyond her competence, and the family still benefits from the systemic work.
3. Refer the mother without explaining why
   Referring without explaining why fails informed consent; the mother needs to understand the referral and how the two treatments fit together.
4. Treat the eating disorder herself
   Treating the eating disorder herself is practicing outside competence (AAMFT 3.10) on a condition that can be medically dangerous.

After three sessions, a client asks her MFT for a letter supporting an emotional support animal. The MFT has not yet evaluated whether a disability-related need exists. What is the MOST appropriate response?

1. Write it based on the client's own report
   Writing it from the client's own report alone presents an unassessed claim as a clinical finding.
2. Refer her to an online letter provider
   Online letter mills often issue attestations without a real clinical relationship; sending her there sidesteps the problem instead of handling it.
3. Write it to protect the therapeutic alliance
   Writing the letter to protect the alliance trades accuracy for comfort; a professional statement must rest on assessment, not on the wish to please the client.
4. Explain that further assessment is needed
   A support-animal letter attests to a disability-related need, which requires an assessment the therapist has not yet done, so she explains that more evaluation comes first.

The AAMFT Code was revised effective January 2026. An MFT who never reviewed it faces a complaint under a new provision and says she was unaware of the change. This defense:

1. Succeeds for one year after a revision
   There is no one-year grace period after a revision; the revised Code applies from its effective date, January 1, 2026.
2. Fails because ignorance of a standard is no excuse
   The 2026 Code says plainly that lack of awareness or misunderstanding of a standard is not a defense, and members must know the Code.
3. Succeeds if her state has not adopted it
   The AAMFT Code binds members and applicants through membership; state adoption decides licensing-board rules, not whether the Code applies to a member.
4. Succeeds if no client was actually harmed
   Harm to a client is not an element of an ethics violation; conduct can breach the Code even when no one was hurt.

A prospective client turns out to be someone the MFT dated briefly, including a sexual relationship, about ten years ago. He says it is "ancient history." What should the MFT do?

1. Accept him for short-term work only
   Limiting the work to short-term sessions changes the length of treatment, not the multiple-relationship problem.
2. Accept him after ten years have passed
   Ten years passing does not erase the history; the conflict comes from the prior intimacy itself, not from how recent it was.
3. Accept him if he signs a written waiver
   A signed waiver documents the client's wish but does not remove the risk to the therapist's judgment; the client cannot waive the therapist's duty to avoid it.
4. Decline and offer him referrals
   A past sexual relationship makes a close personal relationship that would compromise objectivity (AAMFT 1.3), so she declines and offers referrals (1.9).

At a dinner party, a friend describes her son's panic attacks in detail and asks an MFT, "What should I do with him?" What is the MOST appropriate response?

1. Offer to see the son for a few sessions
   Offering to see a friend's son creates a multiple relationship (AAMFT 1.3); a referral to an unconnected clinician avoids it.
2. Give a diagnosis and a plan to use at home
   A diagnosis and home plan for a child she has never assessed is advice outside any professional relationship, with no assessment, consent or record.
3. Share general facts and suggest a referral
   General information plus a suggestion to get a professional evaluation helps the friend without creating an informal therapy role with her son.
4. Refuse to discuss anything about mental health
   Refusing to discuss mental health at all is an overcorrection; general information and a referral are both appropriate.

During a family session, a mother reveals that she is undocumented and fears deportation. She asks whether the therapist has to tell anyone. What is the MOST appropriate response?

1. Explain that therapists must report it to immigration authorities
   No law requires therapists to report clients to immigration authorities; reporting would be an unauthorized disclosure.
2. Explain that her immigration status stays confidential
   Therapists have no duty to report immigration status, and her confidentiality does not depend on citizenship (AAMFT 1.1 names citizenship status).
3. Explain that her status limits her confidentiality rights
   Confidentiality protections do not shrink with immigration status; telling her otherwise would be false and would damage trust.
4. Refer her to a therapist who specializes in immigrant families
   Referring her out is unnecessary: migration stress is part of the family's context and within the MFT's work.

Which billing practice by a marriage and family therapist would MOST clearly constitute insurance fraud?

1. Recording a Z-code that the plan does not reimburse
   Recording an accurate Z-code that the plan does not reimburse is honest documentation; fraud would be changing the code to get paid.
2. Billing a 45-minute session with the standard therapy code
   A 45-minute session falls within the time range of the standard psychotherapy code, so billing it that way is accurate.
3. Billing the plan for a missed session as if held
   Billing a health plan for a session that did not happen is a claim for a service not rendered, which is fraud (AAMFT 8.4).
4. Charging the client the disclosed missed-session fee
   A missed-session fee charged to the client is allowed when it was disclosed in writing before services began (AAMFT 8.2).

A former client files a complaint with the licensing board alleging that the marriage and family therapist was negligent. How may the therapist use the client's information in responding?

1. Disclose nothing without the client's written consent
   Waiting for the complainant's consent would leave the therapist unable to answer the board; a disclosure to an oversight body handling the complaint is permitted by law.
2. Disclose what is necessary to respond to the board
   By filing the complaint the client puts the treatment at issue, and the law permits disclosures to an oversight body (AAMFT 2.2 allows disclosure 'permitted by law'), so the therapist shares what the board reasonably needs and no more.
3. Share the full record with the board and with colleagues
   Colleagues have no role in the investigation, and sending the whole record goes beyond what the response requires.
4. Post a public response correcting the client's account
   A public reply discloses confidential information to everyone; the complaint opens the door only to the board.

A supervisee continues to leave progress notes incomplete despite repeated verbal feedback from the marriage and family therapy supervisor. What is the MOST appropriate NEXT step?

1. Continue giving verbal feedback each session
   Repeating verbal feedback is the approach that has already failed; the supervisor stays responsible for the quality of the notes (AAMFT 4.5).
2. Report the supervisee to the state licensing board
   Incomplete notes are a training issue, not yet a matter for the board; reporting skips the remediation step.
3. End the supervisory relationship immediately
   Ending supervision at once skips remediation for a correctable problem and leaves the supervisee's clients without oversight.
4. Set a written remediation plan with deadlines
   Verbal feedback has already failed, so the proportionate next step is a written remediation plan with clear expectations and deadlines, which also documents due process.

A marriage and family therapist begins therapy with two parents and their 14- and 16-year-old children and plans some individual sessions. Which step at intake BEST addresses confidentiality?

1. Agree on a written policy for individual disclosures
   Agreeing at intake on a written policy for what individual disclosures will and will not be shared, within legal and safety limits, sets expectations before any secret arises (AAMFT 2.1, 2.2).
2. Have the parent who scheduled therapy sign for the whole family
   One parent cannot sign for everyone: each competent member's authorization matters, and the teens' consent and assent need their own attention.
3. State that all individual disclosures will be shared with parents
   Promising parents everything from the teens' sessions undermines the adolescents' trust and the value of individual time.
4. Promise each member that individual disclosures stay private
   Promising each member total privacy ignores the legal and safety exceptions and can trap the therapist in a harmful secret.

A marriage and family therapist who speaks only English will begin therapy with a Spanish-speaking family. The family's bilingual 12-year-old offers to interpret. What is the MOST appropriate course?

1. Accept the child's offer at the family's request
   Family preference does not remove the harm: a 12-year-old interpreter is parentified, hears adult material and holds power over what the parents hear.
2. Have the parents sign a waiver so the child can interpret
   A waiver records the parents' agreement but does not stop the child from being parentified or exposed to adult content.
3. Use a smartphone translation app during sessions
   Consumer translation apps miss clinical nuance and may not protect confidential information (AAMFT 6.1, 6.5).
4. Arrange a trained interpreter bound by confidentiality
   A trained interpreter bound by confidentiality gives accurate interpretation and protects privacy without putting a child in the middle.

A marriage and family therapist sees a former client at a crowded community festival. The client is with friends. What is the MOST appropriate response?

1. Leave the festival to protect the client's privacy
   Leaving the festival is an overreaction that can feel rejecting; the therapist can simply let the client take the lead.
2. Greet the client warmly to show continued support
   A warm greeting initiated by the therapist can reveal the therapy relationship to the client's friends.
3. Greet the client briefly without mentioning therapy
   Even a brief greeting started by the therapist takes the choice away from the client and can prompt questions from the friends.
4. Let the client decide whether to acknowledge them
   Letting the former client decide whether to acknowledge the therapist protects the confidentiality of the relationship, ideally as agreed at intake.

A new clinician tells the marriage and family therapy supervisor about feeling sexually attracted to a client. The clinician has not acted on it. What is the MOST appropriate initial supervisory response?

1. Normalize it and explore its effect on treatment
   Attraction that has not been acted on is common; supervision normalizes it and examines how it affects the treatment, so the supervisee neither acts on it nor hides it (AAMFT 3.3).
2. Transfer the client to another clinician now
   Immediate transfer treats a feeling as misconduct and disrupts the client's care; transfer becomes an option only if objectivity cannot be restored.
3. Advise the supervisee to set the feeling aside
   Telling the supervisee to set the feeling aside pushes it underground, where it is more likely to affect judgment.
4. Report the supervisee to the licensing board
   Nothing reportable has happened; a feeling disclosed in supervision is the process working as intended.

A marriage and family therapist wants to present a detailed family case at a conference. The family's unusual circumstances could make them recognizable even with names removed. Which approach meets the AAMFT Code?

1. Remove names for a professional audience
   Removing names does not protect a family that can be recognized from its circumstances, and a professional audience is still a disclosure outside treatment.
2. Obtain written authorization from each member or guardian
   When unusual details make a family recognizable, de-identification is not enough, so the therapist needs written authorization from each member, or a guardian for a minor (AAMFT 2.2, 2.4).
3. State that some details are fictional
   Saying some details are fictional does not protect the family; real identifying facts are still presented.
4. Obtain verbal permission from both parents for the talk
   Verbal permission falls short of the written authorization the Code requires outside emergencies, and two parents cannot authorize for every member.

A marriage and family therapist plans to raise session fees by 15 percent for current clients. What does the AAMFT Code require?

1. Post the new rates only in the waiting room
   A waiting-room sign may never reach some clients (for example, telehealth clients) and is not direct notice.
2. Apply the new fee beginning with the very next session
   Charging the new fee at the very next session gives clients no real notice to plan or discuss alternatives.
3. Give the clients reasonable notice before it applies
   Once services have begun, AAMFT 8.2 requires reasonable notice of any change in fees, so clients learn of the increase before it applies.
4. Tell clients verbally when it takes effect
   Telling clients only when the increase takes effect is notice after the fact, not advance notice.

After several months of family therapy, a father mentions that he has been secretly recording the sessions on his phone. What is the MOST appropriate response?

1. Explore the reasons and agree on a recording policy
   A secret recording means something (distrust, a wish to review sessions, a possible legal use), so the therapist explores why and agrees on a clear policy that also protects the other members' privacy.
2. Let the recording continue without further discussion
   Letting it continue ignores that the other members never agreed to being recorded and leaves the meaning of the secrecy unexplored.
3. Report the client to police for violating privacy laws
   Recording laws differ by state, and reporting a client to police breaks confidentiality before the issue has even been discussed.
4. End therapy over the boundary violation
   Ending therapy treats a workable issue as grounds for termination and leaves the whole family without treatment.

A colleague at the MFT's agency, whom she sees daily at staff meetings, asks to begin couple therapy with her. What is the MOST appropriate response?

1. Accept him as a client
   Accepting him outright overlooks that daily work contact with a coworker is itself a second relationship that risks objectivity and confidentiality.
2. Decline and help him find another clinician
   Treating a coworker she sees daily is a multiple relationship that risks objectivity and confidentiality (AAMFT 1.3), so she declines and helps him find another therapist.
3. Accept, but avoid the topic at staff meetings
   Avoiding the topic at staff meetings does not undo the ongoing work relationship or the risk to confidentiality.
4. Accept if the agency director approves
   A director's approval is administrative; it does not remove the conflict of interest the Code asks her to avoid.

A marriage and family therapy supervisor notices strong irritation toward a supervisee who reminds the supervisor of an estranged adult child. What is the MOST appropriate response?

1. Tell the supervisee about the personal resemblance
   Telling the supervisee about the resemblance burdens them with the supervisor's personal material and confuses the roles.
2. Ignore it and continue supervising as usual
   Carrying on as usual leaves the reaction unexamined, which can lead to unfair feedback and a harmful parallel process in supervision.
3. Seek consultation on how it affects supervision
   A personal reaction that could bias evaluation of a supervisee calls for consultation, so the supervisor can examine and manage it (AAMFT 3.3).
4. Transfer the supervisee to another supervisor now
   Transferring the supervisee at once is premature before the reaction has been examined, and disrupts the supervisee's training.

A state law permits a marriage and family therapist to disclose certain client information that the AAMFT Code would require written authorization to share. Which standard should the therapist follow?

1. The AAMFT Code, since it sets the higher standard
   When the Code is stricter than the law, AAMFT requires meeting the higher standard; a law that merely permits disclosure does not force it, so there is no true conflict.
2. State law, as long as the disclosure is documented
   Documenting a disclosure that the Code forbids without written authorization does not make it permissible.
3. Whichever standard the employer's policy manual prefers
   An employer's manual cannot lower the ethical standard; AAMFT asks therapists to resolve organizational conflicts in favor of the Code.
4. State law, since law always overrides ethics codes
   Law does not always override ethics; it does only when obeying the Code would actually violate a legal mandate, and a permission is not a mandate.