At the time of the initial creation of the exam, about 1992, the field of MFT was divided into 48 areas of knowledge (now known as the Knowledge Domains) and clinical practice skills, (now known as Practice Domains). Experts in each Knowledge Domain were identified from among senior MFT’s. Each of these experts wrote questions in their area after being trained in the construction of standardized test questions. In 2005, this number was increased to 56 and then again, in 2015 to 74 Knowledge Domains and 6 Practice Domains; Family Solutions updated all our study materials to include the changes and always stays current with the AMFTRB

Each question is scored along three criteria: Its importance to the field, the level of knowledge that it tests and its validity. Only those questions meeting guidelines for all three criteria are kept. Originally a bank of about 800 questions was created. Since that time, 100 to 200 new questions are added each year. There are currently about 1500 questions in the PES / MFT exam database.