I wanted to call this post “advice for taking and passing the LMFT exam” but it turns out, having passed last week, that I don’t have much advice to give. The problem is that the ways the exam is hard are not things you can prepare for. I’ll describe that situation, for what it’s worth, then describe the process of taking the test, and give the few pieces of advice I can offer. Take that advice with several grains of salt, though, because when you pass, they don’t tell you your score. I have no idea if I passed with flying colors or barely scraped by. For reasons I’m about to get into, I wouldn’t be surprised either way. I really can’t say if I over-prepared and rocked it or underprepared and got lucky.

The material you have to know is not that hard. With a few exceptions, it’s the same stuff you learned in your grad school program, the same stuff you’ve been drilling in your internship. The test is hard mostly because the writing is terrible. Have you ever read something that has been passed through several languages in a translator program, then back into English? That is how the questions, and especially the answers, read. Most of them. They often barely make sense and some of it is complete nonsense. I doubt they used the translator trick, so it may be that they looked up the most obscure synonym for each word and then garbled up the grammar a bit to top it off. I would be ashamed to be associated with the writing of that exam. I do not consider it an ethical way to make an exam difficult. Unfortunately, that is the situation.

The second reason it is hard is that you have to read and comprehend all of that garble at lightning speed. I read at a slightly above average speed with high comprehension and I had twelve minutes left at the end to review my marked questions. Twelve minutes left at the end of a four hour test.

So that’s my first piece of advice: If you’re a slower than average reader, see what you can do for special accommodations on time, and definitely if English is your second language. I don’t know what’s available in that way, but look into it and take what you can get.

The third reason is that it’s just difficult to sit and concentrate that hard for four hours without stopping. Your body will hurt, if it has that tendency. If you have body or pain issues I would look into what accommodations they have to offer.

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The process of taking the test: I took mine in Riverside, so this may vary, and because you have to take the ethics exam right away now, you probably know all of this stuff already. You can skip this and the next paragraphs. PSI, the testing company has a suite in an office building. You walk into their lobby and the staff signs you in, takes your photo, and you wait a bit. The staff is very nice and professional. There is a rack to hang your coat and you can get a locker. (The PSI materials say that you don’t get a locker, but you can.) They let me take my migraine meds in on a tissue, but you can’t take anything else. I wished I’d worn a long sleeve shirt because it was a bit cool for me and I couldn’t take my sweatshirt in. They provide a pencil and scratch paper. You sit in one of fifteen or twenty cubicles with a PC computer, mouse, and keyboard. It’s pretty quiet. They offer you earplugs but I didn’t need them, and I’m pretty sensitive to noise. You run through some instructions and practice questions to get the hang of it. It’s pretty easy. Then you start the test and have four hours to finish 170 questions. That’s less than 90 seconds per question. There are three or four counters at the top of your screen, counting questions, up and down, and time. I can’t remember if the timer counted up or down or both, but I remember it being pretty easy to use. I would occasionally multiply my number of questions answered by 1.5 to make sure I was on track to get through every question. For example, after answering question 40, I could check that I was well under one hour into the exam. You can take breaks whenever you want, but the clock won’t stop. I took two breaks. The first was about a minute, to eat a few bites of a date bar I left in my coat pocket, about an hour and a half into the exam. The second was to pee, at about three hours in. That took five or six minutes, because the bathroom is down the hall and the staff has to escort you. I’m glad I took the breaks. I imagine that seven or eight extra minutes at the end of the exam would not have been very useful after hours of low blood sugar and holding pee.

If you have any time left, you can go back and look at questions you marked. I had time to look at a few and changed one answer. Then you finish. They make you click “yes” on a few versions of “Yes, I understand this will end my test and I can’t go back” before ending, so you can’t end the test accidentally. You walk back out into the lobby, grab your stuff, and get your results. I think if you fail they tell you your score, but I’m not sure. There is also the possibility that the BBS is re-analyzing how the exam is performing and you won’t find out if you passed for another month or so. That happened to me for my ethics exam, and it’s much nicer to know immediately how you did. I was in a bit of a daze after the exam and walked around the roads near the test center for a while before I felt like driving.

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To prepare for the exam, I bought the Therapist Development Center’s MFT Clinical Exam package and did their 65 hour (versus 110 hour) track. I can’t say how it compares to Grossman or AATBS because I’ve never seen those packages. I can say that I used a Grossman practice-test package to study for the ethics exam and passed, but I’m pretty sure that I spent too much time studying that way. I basically tried to reverse-engineer the test using the practice tests plus the legal statutes and CAMFT Code of Ethics, which took a long time—a little over 70 hours of dedicated studying. The TDC package helped me avoid rabbit holes and working too long. TDC’s 65-hour track took me 68 hours to complete, plus I did an extra eight hours of study on the DSM-5, having been trained exclusively on the DSM-IV-TR. I made two outlines of the DSM-5, one of timeline information, like how long you need symptoms for each diagnosis, and one for age limit information. (I put those up here and here.) I also spent about four hours reading (and rereading) the CAMFT Code of Ethics, California statutes, and legal/ethics articles from CAMFT’s Therapist magazine archives.

Again, I have no idea how I would have done without studying that way, but I went in feeling as well-prepared as I could have. I barely studied the last couple days before the test because I felt like I knew the material. I remember thinking, “If I don’t pass, I’m not sure what I will do for the next four months, because I already know this stuff.”

So I can recommend the Therapist Development Center material. The extra DSM study didn’t help me that I remember on the exam—the TDC coverage would have been enough. I could probably say the same for the Code of Ethics and statutes reading. I don’t recall the test getting very nit-picky about any of that stuff. That’s not how they made the exam difficult, though I would have preferred it that way. Even if it was extra studying, I feel good about having done it. We MFTs should know that stuff cold.

That was likely the last multi-hour multiple choice exam I’ll ever have to take. I’m fine with that. Now it’s time to focus on setting up my private practice!

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