The Clinical Fellow designation is granted to Professional Members of AAMFT who have met the highest level of MFT licensure in the United States or have been reviewed and approved as having met AAMFT standards for education in MFT or systemic family therapy as well as rigorous standards of training in marriage and family therapy. This designation must be renewed every 2 years by submitting proof of 20 hours of continuing education which includes 3 hours of professional ethics and 1 hour devoted to cultural competence.