Question From a Social Work Student

[neurom]

Hello all! I have posted here countless times in the past trying to decide whether to major in psychology or social work and whether to go for LMHC or an MSW program. I am currently a BSW student going into my second to last semester in the program and I am confident that I will be able to get into an advanced-standing MSW program (1 year) directly after my graduation in December 2024. I absolutely love the values and perspectives of social work and I have liked the introduction to therapy I have had in the program, so I am also confident about getting my MSW.

I will list my goals and then my question. So, I have a goal of working with children, adolescents, and young adults - particularly those who are going through first episode psychosis or serious mental illnesses as I have personal experience with these. I want to conduct private practice therapy as an LCSW after training and licensing, but I also want to conduct research and non-profit work, as well as advocate for schools to implement more resources and education surrounding mental health and illness (for students and teachers). I want to conduct research on social topics like stigma and biases, but I also want to conduct research on schizophrenia and other psychotic illnesses and serious mental illnesses from a more science-based perspective. I specifically want to research or develop new therapeutic treatment approaches for these disorders based on the way the brain responds to them in patients with these disorders. I also want to see if there needs to be a specific treatment plan/therapeutic approach for those going through first-episode psychosis as opposed to those who have been living with the disorder for an extended period of time. And I want to research more into delusions as well.

I am getting involved in research this semester and I will have an entire year to dedicate to research (all of 2024) plus my year of my MSW since I plan to stay at the same school. My question is - with these research goals, should I pursue a PhD in psychology down the road? I know that a PhD is quite far away, but I like to have an idea about what I need to do for my future goals. I am also not just referring to a clinical psych PhD. I am a Florida resident, and the University of South Florida offers a "CNS psychology PhD" program that has a focus in either cognitive science/neuroscience, behavioral neuroscience, or social psychology. This route does not allow you to become licensed as a psychologist, but I do not think that would be a big deal to me as my goal of a PhD is to conduct research and I would continue to conduct private practice as an LCSW if I wanted to. However, I wonder if a clinical psych PhD may be better suited for me as my research interests are about therapeutic approaches and mental disorders. I have talked with my professors about these things and I have gotten mixed answers. Some suggest psych PhD all the way, some suggest a social work PhD, some suggest public health... it has been a mix.

If I were to pursue either of these routes (the CNS psych PhD or clinical psych PhD), what should I focus my free time on? Should I go back and take science/math courses once I complete my MSW? How much research would I need and in what field? And also, if anyone has suggestions on other PhD programs that would suit my interests, please let me know. I am pretty much set on completing a PhD one day, and I also have no problem working in academia as I would have private practice to fall back on. I know that I can conduct research with just an MSW, but I absolutely love school, I love learning, I love writing, and all of my professors have told me (those that have PhDs) that I could do well in a PhD program with the skills and drive that I have. Of course that may be different once I am in a program, but it has truly always been a dream to complete a PhD program. I am also looking at a few years down the line, as I will complete my MSW at the end of 2025 and then I will probably get my LCSW before applying to programs. Not sure though.

Thank you for any help you can offer me. I love reading these forums and learning about all of the career options available for social workers and psychologists. Hope you all have a great day.

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[PsyDr]

1) The CNS PhD will do nothing for your goals. It is a research degree that will not allow you to practice. It looks like a atypical area of study, which may make a research career harder than usual.

2) Your goals need a LOT more specificity. Likely, they are too ambitious. The way your goals are phrased right now is probably incompatible with the desires of PhD program interviewers. It's not a real research question, or setting as it stands. What is the specific research question? Usually people involved in research have a very narrow area of study, that has greater implications (e.g., no one is studying "live cancer". They are studying HLA haplotype correlations with HBV related cancers"). What specifically are you studying about how treatment affects psychosis? What modality are using to measure "brain response"? What is the financial outlook in a PP, including paying rent, for limited time? Who is funding the research and how quickly could you run subjects in that timeframe, and analyze data, and write so you can publish in a year? What is the money source for the school based project, and why would schools want to take on another burden (i.e., you have to make them want to do extra work)? What are you going to do in the schools (e.g., is this a unit that teachers use, or a presentation you do, or ?)? What is the funding source for treatment development? What does your day look like (e.g., 9-12 =PP, 12-2=research 2-3=school, 3-5 developing a treatment)? How does that compare to the usual schedule where they either do clinical work nearly full time at an AMC, and have some research work at the AMC OR they do research nearly full time and have a small PP on the outside. If you can define some of these things with much greater specificity, you'll learn about more details, and you will increase your chances for either a PhD program, or just general success.

3) The trouble with treating or studying people with psychosis, is that they don't have money, an organized life, or good insurance. If you are trying to work with them, you have problems with getting them to show up and/or complying with research protocols (e.g., "hey, are you paranoid? I'm a stranger, let me do all sorts of strange tests on you"; "do you have disorganized thoughts? I need you to show up at 123 Main St. at 3:15 on Wednesday for therapy"). If you read Turkington's works, it comes through. That being said, individuals with psychotic disorders usually end up in the hospital. Hospitals tend to be staffed with a plethora of MSWs, with the occasional psychologist. That may make clinical work with that population easier. However, the average length of stay in a psych hospital in the USA would probably make doing research hard and/or unethical (i.e., you usually can't get informed consent to participate in research from someone who is floridly psychotic)

4) MPH programs are usually more concerned with larger scale data. That might be less clinically inclined than you want.

5) The trouble with social work, is that the approach is bound to specific theories. IMO, it's why social work research is contained in its own world. For example, you don't see social workers publishing in medical journals too often. That may make a social work PhD a bit incompatible with some of your more brain based research goals, but not with your social stigma and program planning goals.

6) I'm not sure if you are aware of the institutional requirements for research. You can't just "research" something. You need an IRB, human research subjects training, grants, etc. That is why most research comes out of AMCs and other formal institutions. When you see a research person with a PP, it's usually someone who is a research staffer at an AMC, who has a side PP. Usually, an AMC wouldn't just let an unaffiliated person come to them and do research through their institution.

7) If you can define your goals a bit more specifically, it would almost seem like you want to attend a research based PhD program on a part time basis, while doing PP. I'm not sure that exists, but it might.

 

[summerbabe]

I want to conduct private practice therapy as an LCSW after training and licensing, but I also want to conduct research and non-profit work, as well as advocate for schools to implement more resources and education surrounding mental health and illness (for students and teachers). I want to conduct research on social topics like stigma and biases, but I also want to conduct research on schizophrenia and other psychotic illnesses and serious mental illnesses from a more science-based perspective.

I think it’s great that you have lots of passions. But multiple passions are really hard to pursue simultaneously as a professional.

Take somebody who is passionate about food. They love to cook but they also want to run their own restaurant that follows their culinary ideals.

But they also want to grow their own food so that their restaurant is sourced properly. And they also want to create content to actively share their passions with others.

Are there some well known local and national chefs/entrepreneurs who do all of this? Yes! But they are probably many years into their career, have had lots of luck and are absolutely maniacal workaholics.

The average person with food passions becomes a chef. Or tries their hand at being a restaurant operator once they accumulate some capital (but doesn’t cook or cook much). Or they go into upscale farming. Or they make YouTube videos or write in the media.

I think this same principle applies to mental health. To be a clinician, a researcher and an advocate is a lot to ask of a single person, especially if they want any semblance of a personal or family life.

So ultimately, most of us choose one area to focus on and try to get really good at. And find sporadic opportunities to do other stuff. But those are more like a side quest in a video game & not the primary objective.

 

[Ollie123]

I'm familiar with the USF program. The degree isn't "CNS Psychology" it is just that the Cognitive (C), Neuroscience (N) and Social (S) Psych programs are all comparatively smaller relative to the clinical and I/O programs so they rolled them under one administrative umbrella. That said, it isn't the right choice for what you want to do. Even the clinical program doesn't have anyone studying psychosis unless there was a recent hire I didn't hear about.

I largely agree with PsyDr that you need better defined goals. I see at least 3-4 full-time jobs listed and you aren't going to be able to do them all. Do you want to be a faculty member who primarily does research with a side practice where you see a few patients a week? Have a PP and maybe have some occasional research involvement? Do you want to study the neural basis of psychosis, stigma of mental health or develop new interventions? Those are three very different paths. No program will prepare you to do all three of those things well, so you basically need to pick one and then find ways to self-teach the others later.

Lots of people do research on psychosis. While PsyDr is right about some of the major challenges to it, obviously there are ways to get it done. If "Psychosis" is the ultimate goal though, you want to work with someone who knows how to get it done for that population. I would strongly advise against working with a social psychologist who studies stigma and gender discrimination in the workplace (random example) and then trying to study stigma and discrimination among people with SMI. That path can work well in some situations, but I don't think this is one of them.

A social work PhD is an option, but again - you need to narrow down your interests. I'm not sure I've ever seen someone studying the neural basis of schizophrenia in a social work department. That isn't to say it is impossible but...not typical.

It is tough to advise on a path forward right now given what you've laid out. I'd focus on deciding what you want your day-to-day career to look like and then we can better advise how to get there.

Edit: I really like the restaurant analogy above. Please don't take this the wrong way, but your post comes across a bit as asking how to launch an Italian-Mexican-Ethiopian-Carolina BBQ Fusion Gastropub while holding a political office and being a professional race car driver I'm....not really sure how to advise on that. Keep in mind that careers evolve and a training path doesn't commit you 100% to doing one thing the rest of your life, but you generally need to dive into one and then branch out vs trying to do the all simultaneously.

 

[Sanman]

I'm familiar with the USF program. The degree isn't "CNS Psychology" it is just that the Cognitive (C), Neuroscience (N) and Social (S) Psych programs are all comparatively smaller relative to the clinical and I/O programs so they rolled them under one administrative umbrella. That said, it isn't the right choice for what you want to do. Even the clinical program doesn't have anyone studying psychosis unless there was a recent hire I didn't hear about.

I largely agree with PsyDr that you need better defined goals. I see at least 3-4 full-time jobs listed and you aren't going to be able to do them all. Do you want to be a faculty member who primarily does research with a side practice where you see a few patients a week? Have a PP and maybe have some occasional research involvement? Do you want to study the neural basis of psychosis, stigma of mental health or develop new interventions? Those are three very different paths. No program will prepare you to do all three of those things well, so you basically need to pick one and then find ways to self-teach the others later.

Lots of people do research on psychosis. While PsyDr is right about some of the major challenges to it, obviously there are ways to get it done. If "Psychosis" is the ultimate goal though, you want to work with someone who knows how to get it done for that population. I would strongly advise against working with a social psychologist who studies stigma and gender discrimination in the workplace (random example) and then trying to study stigma and discrimination among people with SMI. That path can work well in some situations, but I don't think this is one of them.

A social work PhD is an option, but again - you need to narrow down your interests. I'm not sure I've ever seen someone studying the neural basis of schizophrenia in a social work department. That isn't to say it is impossible but...not typical.

It is tough to advise on a path forward right now given what you've laid out. I'd focus on deciding what you want your day-to-day career to look like and then we can better advise how to get there.

Edit: I really like the restaurant analogy above. Please don't take this the wrong way, but your post comes across a bit as asking how to launch an Italian-Mexican-Ethiopian-Carolina BBQ Fusion Gastropub while holding a political office and being a professional race car driver I'm....not really sure how to advise on that. Keep in mind that careers evolve and a training path doesn't commit you 100% to doing one thing the rest of your life, but you generally need to dive into one and then branch out vs trying to do the all simultaneously.

In fairness, only one of those is a job (albeit not a realistic one). The other two are pass times of really rich people. Arguably, all three are pass times.

That said, some of what the OP mentioned are also pass times, such as the advocacy efforts and some of the research ideas.

So, the first question I think we need to ask the OP is, are you independently wealthy and looking for a hobby or are you an average person looking for a job?