What is CARF: A Guide for Therapists
If you are a mental or behavioral health provider, there’s a good chance you’ve heard of CARF. However, you might not know what it is, why it matters, or how to obtain accreditation. Whether you’re looking to demonstrate commitment to quality or responding to payer requirements, understanding CARF can be an essential step for your practice.
This guide will help you gain a more comprehensive understanding of CARF. It covers everything from its history down through the step-by-step accreditation process.
What is CARF?
CARF stands for the Commission on Accreditation of Rehabilitation Facilities and is an independent, nonprofit accreditor of health and human services organizations. Founded in 1966, CARF provides accreditation for a broad range of programs and services. These programs promote quality, value, and optimal outcomes for people receiving services in behavioral health, rehabilitation, and related fields.
While accreditation is voluntary, for many organizations it’s a symbol of credibility and excellence. It shows your clients, payers, and stakeholders that your practice meets internationally recognized standards of care and business operations.
🔗 Learn more about CARF’s mission and values
A Brief History
CARF was originally established to evaluate rehabilitation facilities serving people with disabilities. Over time, it expanded its reach to include behavioral health, child and youth services, employment services, and aging services. Today, it accredits more than 65,000 programs and services across the globe.
For mental health providers, CARF’s standards cover areas like:
- Outpatient treatment
- Crisis intervention
- Case management
- Residential services
- Medication-assisted treatment (MAT)
- Integrated behavioral health and primary care
Who is CARF For?
CARF accreditation is designed for organizations offering a wide range of health and human services, including:
- Mental health clinics
- Substance use disorder treatment programs
- Residential treatment centers
- Community mental health centers
- Integrated care providers
- Private behavioral health practices with multiple clinicians or service lines
If your practice offers different levels of care, accepts Medicaid, or works with government agencies, you may need accreditation.
Why CARF Accreditation Matters
CARF accreditation demonstrates that your organization is:
- Committed to quality and accountability
- Focused on outcomes and continuous improvement
- Providing services in alignment with evidence-based practices
- Qualified for contracting with certain funders, including Medicaid and VA services
- Better positioned to compete for grants, referrals, and insurance panels
It also helps build trust with clients and families. In a time when mental health services are in high demand, being CARF-accredited can help your agency stand out.
📝 Fun fact: A 2016 report showed that CARF-accredited providers in behavioral health improved their business and client results.
The Mental Health CARF Accreditation Process: Step by Step
Here’s a general roadmap for mental health therapists and agency owners interested in becoming accredited:
1. Determine Eligibility
First, confirm that your organization offers services within one or more of CARF’s accreditation areas. If you’re a solo private practice, CARF may not be the right fit unless you offer multiple programs or services.
🔗 Explore CARF’s program areas
2. Contact CARF
Contact CARF to discuss the services your practice offers. Ask for a copy of the standards manual for your organization. CARF tailors each manual to the specific types of services you provide (e.g., Behavioral Health, Opioid Treatment Programs, etc.).
3. Self-Evaluation & Preparation
This is often the most time-consuming step. You’ll compare your current policies, procedures, and documentation against CARF’s standards. Most organizations spend 6 to 12 months preparing for the survey.
You’ll need to:
- Develop or update policies and procedures
- Implement staff training and quality assurance systems
- Conduct mock audits
- Gather supporting documentation
Common documents required include:
- Clinical documentation samples
- Staff credentials and job descriptions
- Risk management plans
- Emergency preparedness protocols
- Client satisfaction survey results
4. Apply for a Survey
Once you’re ready, submit your Intent to Survey along with payment. CARF will assign surveyors—usually professionals with experience in your service area—who will conduct a site visit.
5. On-Site Survey
Surveyors come to your organization for 2 to 3 days. They review documents, watch operations, interview staff and clients, and check compliance with CARF standards. This is both a validation and educational process, often including consultation and feedback.
6. Receive Accreditation Decision
CARF offers different levels of accreditation:
- Three-Year Accreditation – highest level
- One-Year Accreditation – awarded when some standards need improvement
- Provisional Accreditation – indicates potential but requires further review
- No Accreditation – significant deficiencies found
You’ll receive a detailed survey report with feedback and recommendations for continuous improvement.
🔗 More about the survey process
Timeline and Accreditation Cycle
- Preparation Time: 6–12 months (varies by organization size and readiness)
- On-Site Survey: Scheduled within 6 months of application
- Accreditation Duration: 1 or 3 years
- Reaccreditation: Must begin preparation again prior to expiration
Maintaining accreditation involves ongoing compliance, tracking quality improvement data, and submitting updates to CARF as needed.
Is It Worth It for Your Practice?
For small private practices with only one or two behavioral health therapists, this process can be cumbersome. The cost of accreditation may simply outweigh the benefits. However, for larger group practices that bill insurance or Medicaid, accreditation can make a sizable difference.
Mental health CARF-accredited organizations report:
- Increased funding opportunities
- Better clinical outcomes
- Improved risk management
- Higher staff satisfaction and training consistency
Final Thoughts: How to Get Started
If you are thinking about CARF for your therapy practice or behavioral health organization, start with research and consultation. Connect with other providers who’ve been through the process, attend webinars, and thoroughly review the applicable standards manual.
Your team can access training, support, and even a “readiness assessment” to help you get your practice started.
🔗 Request a standards manual or consultation
TL;DR – Quick Recap
- CARF = Commission on Accreditation of Rehabilitation Facilities
- Offers voluntary, internationally recognized accreditation
- Ideal for behavioral health, SUD, residential, and community services
- Benefits include credibility, improved outcomes, and funding access
- Process includes self-evaluation, on-site survey, and ongoing compliance
- Best for organizations (rather than solo providers)
Behavioral health CARF accreditation is more than just a stamp of approval, but an investment into your practice. If quality, growth, and integrity are priorities for your practice, this may be the next significant advancement worth exploring.