{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/marriage-and-family-therapists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Marriage and Family Therapists",
    "soc_code": "21-1013",
    "category": "Social Service",
    "us_employment": 66740,
    "median_annual_wage": 66940
  },
  "verdict": "SAFE",
  "risk_resistance": 74,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 15,
    "embodiment": 9,
    "liability_shield": 15,
    "trust_premium": 19,
    "judgment_accountability": 16
  },
  "reasoning": {
    "task_resistance": "Genogram work, structural interventions like enactments where you deliberately let a couple fight in front of you and redirect it mid-sentence, and de-escalating a suicidal adolescent while the parents are in the room are sequential judgment calls with no scriptable next step — the 15 rather than 18 reflects that intake screening, PHQ-9/GAD-7 administration, treatment-plan boilerplate, progress-note drafting, and psychoeducation handouts are already being generated for you.",
    "embodiment": "The 9 sits above desk-only because you read shifted posture, a partner's withdrawal to the far end of the couch, alcohol on someone's breath, and bruises on a child, and you manage physical room dynamics — seating, who sits where, separating a couple — plus school meetings, court appearances, and occasional home visits; it stops at 9 because telehealth-delivered MFT is reimbursed and clinically established, so the body in the room is an advantage, not a requirement.",
    "liability_shield": "State LMFT licensure with 3,000-odd supervised hours, a named clinician on every insurance claim and treatment plan, mandatory reporting duties under state child- and elder-abuse statutes, Tarasoff-line duty-to-warn exposure, and board complaints that can end the career mean the risk attaches to a person; it is 15 not 19 because scope of practice overlaps heavily with LPCs, LCSWs, and psychologists, so the license protects the title more than it monopolizes the work.",
    "trust_premium": "Clients disclose affairs, addictions, and abuse only after weeks of testing whether you will stay neutral between a husband and wife, and the therapeutic alliance is itself the strongest predictor of outcome — the 19 reflects that a client who likes their therapist will not switch to a cheaper or faster alternative, and referrals come almost entirely from prior clients and physicians who know your name.",
    "judgment_accountability": "You decide whether reported conflict crosses into intimate-partner violence that makes conjoint therapy unsafe, whether a disclosure triggers a report that will blow up the family you are treating, when to break confidentiality for imminent risk, and when to terminate or refer — calls made in the room without a second opinion; 16 rather than 19 because you work inside diagnostic criteria, agency protocols, and utilization review rather than setting the terms yourself."
  },
  "rationale": "The core work — sitting with a couple mid-conflict, tracking what each partner isn't saying, interrupting a destructive pattern in real time, and holding a family's trust across months — is exactly what language models cannot do, because the product is a relationship with an accountable human, not a transcript. LMFT licensure, mandatory reporting duties, and insurance credentialing require a named clinician to own the treatment plan and the risk assessment. Chatbots will absorb the low-acuity, low-cost end of counseling demand and the paperwork layer (notes, treatment-plan drafts, intake summaries), which compresses fees more than headcount.",
  "outlook": "Demand holds and licensure protects the role, but AI counseling apps take the entry-level and self-pay low-acuity market, pushing MFTs toward higher-acuity, court-involved, and supervisory work.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "Extension of the Illinois Wellness and Oversight for Psychological Resources Act (HB1806, 2025) model — which bars AI from delivering therapy or making therapeutic decisions absent a licensed clinician — to more states, plus Nevada AB406 and Utah HB452-style rules; if boards additionally require a named LMFT to review and countersign any AI-generated treatment plan, risk assessment, or progress note used for insurance billing, the shield tightens",
        "plausibility": "already happening",
        "would_add": 3
      },
      {
        "dimension": "liability_shield",
        "change": "Malpractice carriers (CPH & Associates, HPSO) writing exclusions that void coverage unless a licensed clinician personally conducts suicide/violence risk assessment and safety planning, making the licensed signature non-delegable in practice as well as in statute",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "Courts and child-welfare agencies continuing to require a licensed human for custody evaluations, reunification recommendations, and court-ordered family therapy reports — plus state rules explicitly barring AI-generated input into mandated-reporter determinations, so the consequential calls (report or not, break confidentiality or not, hospitalize or not) stay owned by a named clinician",
        "plausibility": "plausible",
        "would_add": 2
      },
      {
        "dimension": "task_resistance",
        "change": "Task-mix shift: chatbots absorb low-acuity single-person coaching and the documentation layer, leaving the remaining caseload concentrated in high-acuity work AI is worst at — multi-party conflict in the room, domestic-violence screening where a joint session is contraindicated, active infidelity disclosure, family systems with a child protection concern. This is a genuine two-tier occupation and the judgment tier is what remains",
        "plausibility": "already happening",
        "would_add": 2
      }
    ],
    "ceiling_note": "trust_premium at 19 is effectively maxed — buyers already pay specifically for a human relationship and there is no realistic route higher. Embodiment cannot rise; presence in a room is not the same as physical manipulation of an unpredictable environment. The real exposure here is fee compression and payer substitution of chatbots for low-acuity covered benefits, which the score does not capture and no lever above prevents."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2017,
        "emp": 42880,
        "wage": 48790
      },
      {
        "y": 2018,
        "emp": 48520,
        "wage": 50090
      },
      {
        "y": 2019,
        "emp": 59050,
        "wage": 49610
      },
      {
        "y": 2020,
        "emp": 60850,
        "wage": 51340
      },
      {
        "y": 2021,
        "emp": 54800,
        "wage": 49880
      },
      {
        "y": 2022,
        "emp": 62080,
        "wage": 56570
      },
      {
        "y": 2023,
        "emp": 63340,
        "wage": 58510
      },
      {
        "y": 2024,
        "emp": 65870,
        "wage": 63780
      },
      {
        "y": 2025,
        "emp": 66740,
        "wage": 66940
      }
    ],
    "from": 2017,
    "to": 2025,
    "change_pct": 55.6,
    "comparable_from": 2019,
    "spans_soc_revision": true
  },
  "pivots": [],
  "license": "https://cookedindex.com/terms"
}