DORA Summaries

Regulatory Updates: Key Takeaways from the Department of Regulatory Affairs Meeting

Colorado State Board of Marriage and Family Therapist Examiners – April 18, 2025

The Colorado DORA Board met on April 18, 2025, to review complaints, rulemaking updates, and licensure applications related to MFTs, MFT candidates, and credentialing non-MFT licensed individuals to sign-off on MFTC supervision hours. This summary outlines complaint trends, regulatory decision-making patterns, and practical guidance for MFTs, MFTCs, and supervisors.

🔹 Common Complaints

The following complaint categories emerged as themes in the meeting:

• Dual Relationships and Boundary Violations
  Allegations included therapists forming intimate or overly personal relationships with clients during or after therapy, sharing personal photos and stories, and blurring roles in complex relational dynamics. One therapist attended a Make-a-Wish trip with a client’s family; another continued communication post-termination, leading to questions of ethical appropriateness. 

• Supervision Deficiencies and MFTC Oversight
  Several complaints highlighted inadequate or missing supervision for MFT candidates. One candidate had no listed supervisor despite serious client complaints. Another candidate’s supervisor failed to intervene in a relationship that evolved into a dual relationship, prompting legal review.

• Unlicensed Practice and Credential Misrepresentation
  DORA reviewed multiple cases of individuals providing psychotherapy or advertising as licensed MFTs without credentials. Some promoted themselves as “intimacy coaches” or “sex therapists” online without sufficient education, licensure, or legal scope to practice.

• Cultural Competency Concerns
  Complaints included insensitivity to cultural identities, lack of curiosity about clients’ backgrounds, and failure to apply culturally informed treatment models. While many were dismissed due to insufficient evidence of ethical violations, these concerns highlight the need for ongoing education.

• Client Safety and Reporting Obligations
  Several complaints involved allegations of failure to report suspected child abuse, manage client safety risks, or respond to safety disclosures during therapy. One case involved supporting a client through a psychedelic journey, raising ethical concerns about consent, qualifications, and role clarity.

🔹 Decision-Making Patterns

The Board demonstrated consistent decision-making criteria across complaint reviews:

• Dismissals occurred when there was a lack of direct evidence, jurisdictional authority, or when complaints were deemed retaliatory or third-hand. Documentation and context were critical factors.

• Executive Sessions were called for complex ethical issues, particularly around:

• Dual relationships evolving into romantic or exploitative dynamics

• Improper or absent supervision

• Unregulated or emerging treatment practices (e.g., psychedelic facilitation)

• Cease-and-Desist Orders were issued for unlicensed practice or misrepresentation of MFT credentials.

🔹 Best Practices for MFTs, MFTCs, and Supervisors

✅ Maintain Clear Documentation
Document supervisory involvement, treatment transitions, and rationale for clinical decisions. Include client complaints and therapist addressing of client complaints. Lack of clear records in dual role cases or license applications was a recurring issue.

✅ Protect Ethical Boundaries
Avoid post-termination friendships or romantic relationships. Clearly define your role and boundaries in writing, especially during high-conflict or emotionally intense cases, and continue throughout the therapeutic alliance when there are transitions or additions to the treatment unit. When using self-disclosure, consider impact to familiarity and dual-role development. Review the literature on when it is appropriate, be able to document rationale/intentionality, monitor for and document client response to therapist’s self-disclosures. 

✅ Clarify Supervision Requirements
Supervisors must maintain oversight of MFTC work at all times. Candidates are responsible for disclosing and documenting supervision arrangements. Supervisory failures were a major factor in multiple escalated cases.

✅ Ensure Culturally Responsive Care
While not always leading to formal action, several cases highlighted the need for stronger cultural competency. Therapists are encouraged to pursue continuing education and approach cross-cultural work with humility and openness. Consider use of the Cultural Formulation Interview. 

✅ Know Your Scope
Emerging modalities like psychedelic support or coaching roles must be approached with caution. Providing services outside of one's licensure or without adequate training can result in ethical and legal concerns.

🔎 Case Spotlight: Psychedelic Journey and Ethical Boundaries

A complaint was filed against a licensed MFT for participating in a psychedelic journey with an active client. The therapist did not prescribe or administer the substance but claimed to act in a supportive role due to the client’s history of self-harm. The therapist’s wife was also present as the second support person.

• Key Issues Raised:

• Lack of formal informed consent documentation

• Role ambiguity: Was the therapist acting as a clinician, guide, or friend?

• Potential dual relationship: Involving the therapist's spouse blurred personal and professional roles

• Fee structure and transparency concerns

• Board Action:
  The case was tabled and referred to the Natural Medicine Board for jurisdictional review. If disciplinary action is taken there, the matter may return to the MFT Board.

• Takeaway:
  Therapists engaging in non-traditional or unregulated practices—even in a non-clinical role—must carefully consider licensure boundaries, ethical risks, and documentation standards. If you're unsure whether a service aligns with your scope of practice, consult with legal or ethical advisors before proceeding.

How DORA Evaluates Complaints Against MFTs: Key Considerations & Guidance

Understanding how the Colorado Department of Regulatory Agencies (DORA) evaluates complaints can help Marriage and Family Therapists, candidates, and supervisors respond effectively and protect their professional standing. Based on attending a few of these meetings, below is a breakdown of insights gleaned from observation of the Board’s evaluation process. 

🔍 Complaint Evaluation Framework

1. Application of the Practice Act

• DORA asks: Does this complaint fall under the MFT Practice Act?

• If the provider is not licensed or acting outside their licensed scope, the case is either:

• Referred to the appropriate licensing board (if licensed elsewhere), or

• Issued a Cease and Desist Order (if unlicensed).

2. Clarity of Professional Role

• What was your role in the case (therapist, CFI, coach, etc.)?

• Did you switch roles during treatment (e.g., from individual to couple/family work)?

• Are your communications between sessions (including tone) and actions consistent with your theoretical orientation and clear professional boundaries?

3. Client Understanding & Agreement

• Who was involved in treatment? What was their understanding of the process?

• Did you document the treatment plan, expectations, and informed consent clearly?

4. Clinical Decision-Making

• What was your rationale for decisions made in response to the client’s concerns or behavior?

• How did you apply your clinical judgment, and is that decision-making process clearly documented? 

• Is this consistent with standards of care?

5. Documentation & Evidence

• What’s documented in the clinical file, and what was provided in the complaint and your response?

• Are your records consistent, timely, and complete? 

• Do records detail the development of the relationship & treatment progress with relevant contextual factors?

6. Supervision Matters

• Who was your supervisor (if applicable), and were they appropriately credentialed?

• Was supervision ongoing, consistent, and documented?

• For MFTCs: DORA evaluates the quality and presence of supervision as a central factor in candidate complaints.

7. Ethical Frameworks & Conflicts of Interest

• What code of ethics are you operating under (e.g., AAMFT)?

• Could any of your actions be interpreted as impairment, conflict of interest, or over-identification with a client?

8. Professional Response 

• How you respond to a complaint is scrutinized as part of the evaluation. The Board looks for responses that:

• Directly answer the complaint with clarity and professionalism

• Include appropriate documentation (but avoid overexplaining or oversharing)

• Demonstrate an understanding of aspirational ethics and the standards of care

• Show evidence of current licensure, supervision records, and ongoing competency

• Respondents represented by legal counsel are noted, adding a layer of professionalism and streamlines resolution.

• Pro tip: Aim to make it easy for the Board to dismiss your case by showing thoughtful, well-documented, ethical practice from the start.