PsyD or masters-level degree?

[slice79]

Hi All,

I have been working in public health for the past 10 years, doing international HIV research. I already have an MPH, but recently have been wishing that I had more direct skills to do one-on-one clinical work with people. To that end, I applied to the PsyD program at the Wright Institute and was accepted. I am now wondering if it will be worth it to undergo a 5-6 year program when my end goal is not to be a full-time clinician. I still want to do public health practice and research, but would like to supplement my work with part-time counseling work, probably in a communty mental health setting. If that is my goal, is it worth it to get a PsyD, or will an MFT or LCSW be sufficient? I know that the clinical training is obviously way more in-depth in a PsyD program, but if I don't intend on only doing clinical work, is that necessary? Any advice or thoughts would be much appreciated!

Thanks!

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[ikibah]

If your main goal is to conduct therapy and nothing else, i.e testing, like it sounds like, I would tell you the msw/lcsw route should be the way to go.

 

[JeyRo]

What ikibah said.

Also, while the Wright Institute doesn't have the worst internship match statistics out there, they are pretty bad on that score - and also they're completely unfunded, so you'd end up with 4-figure monthly payments at the end of the experience, for the next (what is it?) 25 years after you graduate. Not worth it on any level. Check out this thread:

http://forums.studentdoctor.net/threads/wright-institute.876561/

If I was in the OPs position, I would opt for a quality LCSW as my first choice, and MFT as my second choice. If you end up wanting doctoral training in clinical psychology afterall, take the advice of another veteran SDN member who I like quoting - pretend that all unfunded programs don't exist and proceed accordingly.

 

[Doctor Eliza]

If you are interested in a doctorate and want to do research, why not a PhD?

 

[WisNeuro]

Yeah, a PsyD sounds like a terrible option for the situation you described. Why rack up 100k+ in bills when you won't use the degree and/or you have much better degree options available with more prestige and far less debt.

 

[slice79]

I thought about a PhD program, but was not able to find any reputable ones in the Bay Area in California. Also, I wasn't sure how likely I would be to be accepted to a fully-funded program in Clinical Psychology given that I don't have a psychology background, and from what I've heard they have hundreds of applicants and only accept a handful. I've been accepted into fully funded doctoral programs in public health, and I'm currently thinking that a doctorate in public heath plus a masters in counseling if I still feel that I want those skills might be the cheaper and better way to go.

 

[Therapist4Chnge]

It sounds like you would be best served with a Masters level program because your goals do not include research, academics, etc. I still believe that doctorally-trained clinicians are the best trained clinicians (and researchers)….but it often isn't' a realistic fit for many who want to primarily focus on therapy. Being in the Bay Area just makes it that much harder, as the market is flooded and the only decent Ph.D. programs are very very hard to get into out there.

 

[smalltownpsych]

I tried to say this before and it ended up in a flame war, so here goes again, hopefully with better result. I believe that it is important for a person to have a certain amount of drive, passion, or commitment to being a psychologist and all that entails (as covered in previous posts) if they are going to pursue the doctorate degree. I didn't fully comprehend the difference before I entered the field so am not surprised that so many misunderstandings exist. My belief is that a psychologist has a unique set of skills and we often mention our skill set with research, assessment, and psychotherapy, but I find that knowledge of law and ethics and working collaboratively within organizations is often overlooked.

One more point to the OP, it sounds like you do have some of the skills to be an excellent psychologist and if it is what you want to do, then go for it. i think our profession would benefit from your experience.

 

[LMK]

Get an MSW.

 

[Qwerk]

Just wanted to note one thing if you're still reading, OP. We tend (okay, I tend) to recommend M.S.W. programs as an alternative to Ph.D./Psy.D. programs, but clinical social work is not psychology-lite. Different culture, different philosophy, different skill set, different ethical framework, different types of jobs available. Though there's certainly overlap, we social workers have skills and training that psychologists don't, just as psychologists have skills that social workers don't. Talk to master's-level social workers already in the field and make sure that it's the right fit.

Also, institute training is a good option if you find yourself wanting to further your psychotherapy training post-master's, assuming you have access to a major city. It's usually pretty cost-effective and is almost always attractive to potential employers.

 

[CaliMac]

Qwerk, please forgive the newbie question. Institute training? Do you mean something like training in specific modalities?

 

[slice79]

I am still reading Qwerk, thanks for your response. What do you mean by insitute training? Is that continuing education? And when you say different skill set, if someone's goal is to do direct service as a therapist in a community mental health setting, what would be the advantages of having an LCSW, and what would be the advantages of having a PsyD or an MFT? I realize that there is different training in the different programs, ie psychologists can do assessment and testing, and social workers are trained more in structural/policy/social service systems, but as far as the clinical skills, im interested in hearing what the pros and cons of a PsyD vs master's level are?

 

[smalltownpsych]

As a PsyD who has supervised and hired doctoral level providers, social workers, and other master's level folks, I can assure you that the best clinical training and expertise comes with the doctoral degree. This is because clinical expertise also draws from our other skill sets in research, knowledge of law and ethics, and assessment. Also, keep in mind, when I got my degree, I had about 4,000 clinical hours with about 4 hours of supervision per week, and this is typical. I have never seen that level of supervised experience from a master's level provider. I get frustrated by responses in this forum that basically say, "if you just want to be a therapist, then it makes more sense to get a masters because it is "cheaper, quicker, or all you really need." To me that discounts what a highly trained psychologist brings to the table and also neglects to point out that if you want to aspire for the best, wouldn't you want to try and be a psychologist? Case in point, when my daughter needed some psychotherapy, I did not even consider master's level providers. If a family member needed medication management, I would want to refer them to a psychiatrist, even though a PA or NP can "do the same thing". It is like the Walmart-ization of America. I hate it! :end rant:

p.s. I think the main reason so many on these forums recommend getting a masters to do therapy is because of the damn FSPS problem. Specifically, they are making it too easy for people to get doctorates and watering down our profession. Which I do agree is a problem, but steering potential psychologists into a lesser degree, is not the solution, IMHO.

 

[ikibah]

Look at the end of the day, there are tons of lcsw's who are more qualified to do therapy than many phd's and psyd's as well as vice versa, I don't think you are arguing about that. However, I don't believe that a doctorate is "going for the best". In my opinion it boils down to your perspective on therapy and treatment and matching with a program that fits. In most cases social workers and psychologists are trained differently, having different perspectives. So while you are correct in that one shouldn't say "hey you want to be a psychologist! there's no point in getting a doctorate- get an MSW!" I don't think it is true to say that a doctorate is the best option......they are TWO different fields.

PS. in the op's specific scenario, I would recommend the masters route being therapy is something he wants to "supplement" his career with and a five year commitment of becoming a psychologist doesn't seem practical.

 

[smalltownpsych]

Look at the end of the day, there are tons of lcsw's who are more qualified to do therapy than many phd's and psyd's as well as vice versa, I don't think you are arguing about that. However, I don't believe that a doctorate is "going for the best". In my opinion it boils down to your perspective on therapy and treatment and matching with a program that fits. In most cases social workers and psychologists are trained differently, having different perspectives. So while you are correct in that one shouldn't say "hey you want to be a psychologist! there's no point in getting a doctorate- get an MSW!" I don't think it is true to say that a doctorate is the best option......they are TWO different fields.

PS. in the op's specific scenario, I would recommend the masters route being therapy is something he wants to "supplement" his career with and a five year commitment of becoming a psychologist doesn't seem practical.

I agree that they are two different specialties, I think I am mainly referring to the various counseling degrees and the general pursuit of equivalency to the point of the lowest common denominator. One of the best therapists I have met was an LPC who worked for me and he valued what my additional experience and education as a psychologist brought to the table, and I think that if he is ever able to pursue the doctorate, he would definitely agree that would be beneficial.

 

[erg923]

Also, keep in mind, when I got my degree, I had about 4,000 clinical hours with about 4 hours of supervision per week, and this is typical. .

Well, in all fairness, objective data suggests that this is NOT at all the norm, especially not for PsyD students.

 

[erg923]

Moreover, while the integration of the knowledge and skills we have can undoubtedly make us better therapists, quanitty of supervised experience during grad school does NOT. At least we don’t see differential outcomes because of it in the literature that has examined this question. This is big thrust behind Delaware Model/clinical science model training, right? Number of hours matters much less than quality and training overall...

I am certainly not convinced that the modal psychiatrist is better at psychopharm managment than the modal psych nurse practitioner either.

 

[smalltownpsych]

Well, in all fairness, objective data suggests that this is NOT at all the norm, especially not for PsyD students.

2000 of those hours were obtained at my APA internship which I believe requires 4 hours per week. Some can be group supervision, as well. During my three years in practicums, I garnered about 2100 hours or so. At two of my sites, one a VA and the other a private inpatient, they were both full year positions where I believe I accrued 800 hours apiece, and my first site was about 600 hours. In retrospect, I overstated when I said this was typical, I was a bit ahead of many in my cohort, but not by much. maybe my fears of not matching made me think everyone had more experience than me. Isn't there a term for that cognitive distortion?

 

[smalltownpsych]

Moreover, while the integration of the knowledge and skills we have can undoubtedly make us better therapists, quanitty of supervised experience during grad school does NOT. At least we don’t see differential outcomes because of it in the literature that has examined this question. This is big thrust behind Delaware Model/clinical science model training, right? Number of hours matters much less than quality and training overall...

I am certainly not convinced that the modal psychiatrist is better at psychopharm managment than the modal psych nurse practitioner either.

My understanding is that the comparisons of efficacy of treatment verses experience is from a fairly old study. There has been such rapid growth in our field, that is often pointed to as the confound. Measuring effectiveness of psychotherapy is extremely challenging. The flaws in medication research, which is relatively straightforward compared to psychotherapy, points to how far we are from being able to answer some of these questions.

 

[ikibah]

Okay. I think that's a different conversation. I was just giving my opinion that psyd/phd > lcsw is not true.

 

[WisNeuro]

Hell, some PsyD's are not > B.Sc.

 

[Therapist4Chnge]

Thanks WisNeuro. That can be said about many degrees and license designations.

 

[WisNeuro]

I wholeheartedly agree T4C. There are a handful of PhD's, within and without our field, that I would say the same about. There are PsyD's that I truly respect, I was thinking of the Alliant/Argosy/Fielding group with my comment.