Court ruling upholds therapists’ right to diagnose

Rebecca Cobb, Ph.D., LMFT, talks with students at Seattle University. (Seattle University School of Theology and Ministry)

After a seven-year court battle that had implications for mental health patients throughout the country, the Texas State Supreme Court ruled in February that Marriage and Family Therapists would retain their right to diagnose. The Texas Medical Association, which brought the lawsuit, had argued that only medical doctors should have the ability to diagnose mental, emotional, and behavioral problems.

Therapists in the Puget Sound region are breathing a sigh of relief knowing that their patient care will not be disrupted. One in four Americans receives treatment from a mental health professional. In Washington, there are 1,555 licensed marriage and family therapists and 554 licensed marriage and family therapy associates. These numbers continue to grow as employment of MFTs rises much faster than the average of other occupations.

The Texas Medical Association had argued that diagnosis equated to the practice of medicine when it sued the Texas State Board of Examiners of MFTs, according to Psychotherapy Notes. In the Puget Sound region, MFTs have been diagnosing patients since 2001, a practice Seattle University’s Rebecca Cobb, Ph.D., LMFT, says is an essential part of treatment.

“Mental health assessment and diagnosis can be a sensitive topic. It requires a level of vulnerability on the part of the client in order to make an accurate diagnosis. To elicit honest and transparent responses, clinicians must maintain therapeutic skills that go above and beyond textbook knowledge,” says Cobb, assistant clinical professor and clinical coordinator at Seattle University’s School of Theology and Ministry.

Students in Seattle University’s Master of Arts in Couples and Family Therapy program take courses on assessment and diagnosis that train competent clinicians to make informed mental health diagnoses. Additionally, students learn therapeutic skills throughout the program that allow for the establishment of trusting relationships, which facilitate accurate diagnoses and accompanying treatment.”

Spencer Byl, a student in the MACFT program, explains how thorough training is preparing him as a therapist.

“In the MACFT program, you spend your first year learning about theory and the techniques of therapy. You have the opportunity to learn a great deal of information; however, eventually you will be challenged to take what you learn into your clinical internship. I now hold skills which help create a direction in therapy, skills which help me look beyond the content of a person’s story, while working to explore the process they bring to a situation.”

The MFT license was established in Washington State law by the Legislature in 2001. Before that time, similar services were provided by registered counselors.

To learn more about Seattle University’s Master of Arts in Couples and Family Therapy program visit

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