As of 2025, the average MFT caseload is composed of:
- 61% Individuals
- 29% Couples
- 10% Families
Only 1% of MFTs work exclusively with couples, and none reported exclusively treating families.
Despite being trained to treat individuals, couples, and families, many MFTs find that insurance reimbursement favors individual therapy. Among MFTs who accept insurance, 59% report that individual sessions are reimbursed at higher rates than couple or family therapy — an economic incentive that may contribute to the caseload imbalance.
With these challenges in mind, a growing number of MFTs are opting out of insurance altogether. In 2025, one in three MFTs reported operating as private-pay only.
Emerging Client Trends
Over the past five years, MFTs have observed notable shifts in who is seeking care:
- More couples are entering therapy.
- More men, gender-diverse clients (including trans, non-binary, and gender-expansive individuals), and older adults are seeking support.
- Fewer families, children, and adolescents are in care — raising concerns about access for younger populations.
When it comes to presenting issues:
- 62% of MFTs are seeing more clients impacted by political, economic, and social stressors.
- 56% report increases in anxiety-related concerns, including trauma and work-related stress.
For more insights from the 2025 MFT Industry Workforce Study, access the full research, presented in two companion reports, at www.aamft.org/workforcestudy.
