Ten Advertising Mistakes Made by Therapists Ann Tran-Lien, JD Staff Attorney The Therapist March/April 2012 Updated April 2013 Advertising is a great way to promote your business and inform the public of the services you provide. It is one of the fundamental aspects of building a business, a career, and a name for yourself in your profession. Therapists are free to advertise, but they must do so in a manner that is truthful and accurate. The topic of advertising may seem simple enough, but California law mandates specific advertising requirements that licensed therapists, registrants, and trainees must follow. Generally, it is unlawful for therapists to disseminate any form of public communication containing a false, fraudulent, misleading, or deceptive statement (Cal. Bus. & Prof. Code 651(a).) The CAMFT Code of Ethics also provides clear guidelines on ethical advertising, and states that LMFTs, interns and trainees may not use any professional identification if it includes a statement or claim that is false, fraudulent, misleading, or deceptive.1 The Board of Behavioral Sciences (BBS) may take action against your license or registration if you fail to comply with California law on advertising.2 Keep in mind that the overall theme is to avoid any advertising that is, or can be reasonably construed as false, fraudulent, misleading, or deceptive. The omission of important information, as well as the inclusion of certain words and phrases, can render an advertisement false, misleading, or deceptive. To assist you in ensuring that your advertisement is in accordance with California law and the CAMFT Code of Ethics, this article will discuss how to avoid ten advertising mistakes that therapists regularly make. 1. Not recognizing that letterheads, e-mail addresses, or other public communications distributed to clients and the public are considered advertisements under California law. Many therapists may be surprised to know that the law considers, among other forms of public communication, e-mail addresses, letterheads, and websites as advertisements, along with communications by means of mail, television, radio, motion picture, newspaper, book, list or directory of healing arts practitioners, business cards, and office signs.3 Believe it or not, the BBS has taken action (usually in the form of a citation) against licensees and registrants because of a misleading or deceptive e-mail address, website address, etc. For example, an LMFT was recently disciplined for using an e-mail address with the word doc within the address when she did not have a doctorate degree or a license to practice medicine. Thus, it is
prudent to remember that any public communication you make, including a letterhead or an email address, must comply with the advertising requirements and not be false, fraudulent, misleading, or deceptive. On occasion, you may find inaccurate information about you, your license, and/or your business in a directory or mentioned on television or radio that was not approved by you. In these circumstances, it would be wise for you to immediately, or when reasonably practicable, correct or attempt to correct the erroneous information. Keeping a paper trail documenting your attempts, or the process it took you to correct inaccuracies is advisable in the event you are challenged by the BBS at a later date. Your good faith efforts to correct any inaccuracies will be your best defense to any potential BBS inquiry. 2. Including the words psychotherapy or psychotherapist in an advertisement without complying with regulations. Example of Inappropriate Advertisement: John Doe, MA., MFTI. 7901 Raytheon Road, San Diego, CA 92111. Psychotherapy with individuals, couples, and families. The regulation on advertising, effective April 1, 2013, specifically addresses the use of the words psychotherapy and/or psychotherapist in an advertisement. If a licensee or registrant includes the following information in his or her advertisement, he or she is permitted to use the words psychotherapy and/or psychotherapist in the advertisement: The licensee s or registrant s name; The license or registration number; and The title or appropriate acronyms of the license or registration. (16 C.C.R. 1811(c)) Examples of Appropriate Advertisement: John Doe, MA. Licensed Marriage and Family Therapist. #123456. 7901 Raytheon Road, San Diego, CA 92111. Psychotherapy with individuals, couples, and families. John Doe, LCSW. #123456. A psychotherapist practicing in San Diego. Jane Bee, MA. MFT Registered Intern. #67890. Under supervision of John Doe, LMFT. Provides psychotherapy services to individuals, couples, and families. 3. Advertisements for unlicensed persons that do not disclose important and relevant information required by law. Example of Inappropriate Advertisement: ABC Counseling Center. John Doe, MA. MFTI. Registrants and trainees may advertise their services, but they should do so under the oversight and control of their supervisors and employers. Since registrants and trainees are required by law to be employees or volunteers, and not independent practitioners, it is recommended that the supervisor and employer approve any advertisements for registrant and trainee services.
The law requires advertisements for MFT Interns, trainees, Associate CSWs, and PCC Interns to include certain information to ensure that the advertisements do not give the impression that the registrant or trainee has his or her own practice. Advertisements for MFT Registered Intern services must include all of the following information: 1) he or she is a Marriage and Family Therapist Registered Intern or MFT Registered Intern ; 2) the Intern s registration number; 3) the name of his or her employer or the name of the entity for which he or she volunteers; and 4) he or she is supervised by a licensed person. In addition, if the acronym MFTI is used in an advertisement, the title Marriage and Family Therapist Registered Intern must also be written in the advertisement.4 Advertisements for MFT Trainee services must include all of the following: 1) he or she is a Marriage and Family Therapist Trainee or MFT Trainee ; 2) the name of his or her employer or the name of the entity for which he or she volunteers; and 3) he or she is supervised by a licensed person.5 Advertisements for Associate Social Worker services must include all of the following: 1) he or she is a Registered Associate Clinical Social Worker or Registered Associate CSW ; and 2) the name of his or her employer or the name of the entity for which he or she volunteers.6 Advertisements for Professional Clinical Counselor Registered Intern services must include all of the following: 1) he or she is a Professional Clinical Counselor Registered Intern or PCC Registered Intern ; and 2) the name of his or her employer or the name of the entity for which he or she volunteers.7 Websites and letterheads advertising unlicensed persons services need to adhere to the advertising laws (see #1). Also, e-mail addresses that are misleading or deceptive are unlawful (e.g. johndoemft@email.com when John Doe is an MFT Registered Intern). It is also required that all unlicensed persons inform clients, prior to the outset of treatment, of his or her unlicensed status (see #5). Examples of Appropriate Advertisements: ABC Counseling Center. John Doe, MA. MFT Registered Intern #67890. Under supervision of Jane Bee, LMFT #123456 ABC Counseling Center. John Doe, MA. MFTI, Marriage and Family Therapist Registered Intern. #67890. Under supervision of a Licensed Marriage and Family Therapist. John Doe. MFT Registered Intern #67890. Employed and supervised by Jane Bee, Licensed Clinical Social Worker. John Doe, MSW. Associate Clinical Social Worker. #987654. Employed with ABC Counseling Center.
John Doe, MA. PCC Registered Intern. #12345. Volunteer at ABC Counseling Center. 4. Failing to include the license or registration number in the advertisement. Example of Inappropriate Advertisement: John Doe, MA, LMFT. 7901 Raytheon Road, San Diego, CA 92111. Effective April 1, 2013, all licensees and registrants must always include their license or registration numbers in their advertisements. Prior to this change in the regulation, licensees, Registered Associate CSWs, and PCC Registered Interns who advertise their services were only required to include their license or registration number in their advertisements when such advertisements did not include the individual s full title of his or her licenses or registrations. Examples of Appropriate Advertisements: John Doe, MA, Licensed Marriage and Family Therapist. #12345 John Doe, MA, LCSW. #12345 John Doe, MA. Professional Clinical Counselor Registered Intern. #12345. Employed by ABC Counseling Center. John Doe. MFT Registered Intern. #12345. Employed by and under supervision of Jane Bee, LMFT. 5. Failing to provide clients with accurate information regarding an unlicensed person s unlicensed status and supervision. Prior to performing any professional services, a trainee, MFT Registered Intern, Associate CSW, and PCC Registered Intern must inform each client of their unlicensed status and provide their supervisor s information.7 The law also requires trainees and MFT Interns to provide their employer s information and interns to provide their registration numbers.8 It would be a good idea to include this information in the disclosure statement or professional service agreement so that there is written documentation that the client was accurately informed. 6. Including information about fees in an advertisement that is not exact and includes words that are prohibited by law. Example of Inappropriate Advertisement: Providing therapeutic services for as low as $60 a session! Call for more information!
Although you do not have to include your fees in your advertisements, any advertisement that includes your fees must be exact, without the use of words or phrases, including, but not limited to, as low as, and up, lowest prices, or other similar words or phrases. The law specifically states that price advertising must not be fraudulent, deceitful, or misleading, including statements or advertisements of discounts or premiums, or any statements of a similar nature. The fee for each service must also be clearly identifiable. (Cal. Bus. & Prof. Code 651(c).) Prior to beginning treatment, therapists are also required to disclose to the client or prospective client the fee to be charged for the services. If there are any variables, such as charges for missed or cancelled sessions, that information should also be made known to the client at the outset of treatment.9 Example of Appropriate Advertisement: The fee for service is $100 per therapy session. A session is 50 minutes long. To cancel an appointment, please contact the therapist 24 hours in advance of your scheduled appointment. Cancellations made less than 24 hours in advance of the scheduled appointment and missed sessions will result in a $25 charge. 7. Using a fictitious business name or a DBA that is false, misleading, or deceptive. If you choose to do business under a name different from your full legal name, you must file a Fictitious Business Name Statement otherwise known as a DBA (doing business as) with the registrar-recorder/county clerk office in the county where your business is located. LMFTs, LCSWs, and LPCCs conducting a practice under a fictitious name must not use any name that is false, misleading, or deceptive, and must inform the client, prior to rendering treatment services, of the name and license designation of the owner(s) of the practice.10 Additionally, the CAMFT Code of Ethics specifically states, LMFTs do not use a name that could mislead the public concerning the identity, responsibility, source, and status of those practicing under that name, and do not hold themselves out as being partners or associates of a firm if they are not. (CAMFT Code of Ethics Part I, 10.3.) Thus, therapists who are sole proprietors should avoid using words in a fictitious business name that may give the impression that the sole proprietorship is a joint venture comprised of more than one owner. Such inappropriate words to include in a fictitious business name of a sole proprietorship are, Center, Associates, Group, etc. For an in-depth reading on joint advertising, see David Jensen s article, Joint Advertising: Profits or Peril? (The Therapist, July/August 2006.) 8. Using the words psychological or psychologist in an advertisement when the practitioner is not a Licensed Psychologist. Example of Inappropriate Advertisement: John Doe, MA, Licensed Marriage and Family Therapist. Providing psychological services to individuals, couples, and families. Unless you have a license as a psychologist, it is unlawful to include in your advertisement words that could lead one to believe that you are a psychologist. According to California law, an individual is representing themselves as a psychologist when the person holds himself or herself
out to the public by any title or description of services including the words psychology, psychological, psychologist, psychology consultation, psychology consultant, psychometry, psychometrics or psychometrist, psychoanalysis, or psychoanalyst, or when the person holds himself or herself out to be trained, experienced, or an expert in the field of psychology.11 You may advertise your degree in the area of psychology, such as, clinical psychology or counseling psychology, but it must be done in a manner that is not misleading or deceptive. Example of Appropriate Advertisement: John Doe, MS in Counseling Psychology. Licensed Marriage and Family Therapist. Providing psychotherapy to individuals, couples, and families. 9. Making a scientific claim in an advertisement that cannot be substantiated by reliable, published scientific studies. Example of Inappropriate Advertisement: John Doe. Licensed Marriage and Family Therapist. I specialize in treating anxiety by watching stand-up comedy. Advertisements that include a scientific claim must be capable of being substantiated by reliable, peer-reviewed, published scientific studies should the advertisement be challenged.12 If you are interested in including a scientific claim in your advertisement and would like to reference peer-reviewed, published scientific studies, a good resource is EBSCO Host, which is available to CAMFT members, free of charge. For more information, log on to www.camft.org or call Membership Services at (888) 892-2638. Example of Appropriate Advertisement: John Doe. Licensed Marriage and Family Therapist. I have specialized training in Cognitive Behavioral Therapy to treat anxiety and related disorders. According to extensive studies, Cognitive Behavioral Therapy has yielded significant and large improvements concerning symptoms of anxiety and depression. 10. Soliciting testimonials from clients to include in an advertisement. Including testimonials in your advertisement does not necessarily fall under the overall theme of this article, which is to avoid advertising in a false, fraudulent, misleading, or deceptive manner; nevertheless it may be considered unethical conduct and may lead to issues of unprofessional conduct and/ or negligence. The CAMFT Code of Ethics Part I, Section 10.6 specifically provides that solicitation of testimonials from clients is unethical. Therapists and clients have a unique professional relationship, much different from the relationships the other professionals have with their clients. In a therapeutic relationship, the client is typically vulnerable and dependent upon the treating therapist. Accordingly, therapists must avoid behaviors and actions that could reasonably result in exploitation of the client. Since therapists can benefit monetarily from including client testimonials in their advertisements, it may lead to allegations of client exploitation. The client may feel obligated to provide the testimonial to the therapist, and/or feel as if he or she deserves favorable treatment from the therapist since the client has done a significant favor for the therapist (assisted in getting the therapist s good
word out). The client may feel hurt or rejected if he or she perceives that the therapist is ungrateful for the testimonial. It is also not recommended that the therapist solicit testimonials from former clients. While termination has taken place and a reasonable amount of time has passed, there may be a possibility that the client may wish to come back to therapy at a later time. Ann Tran-Lien, JD, is a staff attorney for CAMFT. Ann is available to answer member calls regarding business, legal, and ethical issues. Endnotes 1. CAMFT Code of Ethics Part I, 10. 2. Cal. Bus. & Prof. Code 4982(p). 3. Cal. Bus. & Prof. Code 651; CAMFT Code of Ethics Part I, 10.4. 4. Cal. Bus. & Prof. Code 4980.44(d). 5. Cal. Bus. & Prof. Code 4980.48. 6. 16 C.C.R. 1811(a)(3) 7. Cal. Bus. & Prof. Code 4980.44(c); 4980.48(a); 4996.18(e); 4996.18(h); 4999.36(d); 4999.45(c). 8. Cal. Bus. & Prof. Code 4980.44(c); 4980.48(a). 9. Cal. Bus. & Prof. Code 4982(n); CAMFT Code of Ethics Part I, 9.3. 10. Cal. Bus. & Prof. Code 4980.46; 4992.10; 4999.72. 11. Cal. Bus. & Prof. Code 2902(c). 12. Cal. Bus. & Prof. Code 651(b)(7).