Considering a PsyD. Help?

[ToTheLighthouse]

Hello all,

I am currently an undergraduate student, majoring in philosophy.
I have the goal of eventually setting up a private practice in psychotherapy/psychoanalysis.
I would like do therapy part-time, and with the rest pursue other interests.
I would like to a therapist that has a good name, a good reputation, and would like to steer as clear as possible from spending too much time reaching out for clients.
I feel like having a PsyD would place me above some of the other therapists in the field (those practicing with an LCSW for instance), especially with people browsing net-databases for therapists more and more.
I have two concerns,
one: That I may have to drop my major in Philosophy (which I love) and switch to Psychology (which because of a lack of experience, am not so sure I will enjoy as much).
and two: That in order to get into a respectable school for the purpose of attaining a PsyD, would require me to do many things, that I may not be otherwise interested in (certain psych. courses etc., fussing over my resume, and whether I have enough research experience etc.)

On top of that, I'm not sure that having a PsyD will be essential for what I would eventually like to achieve i.e. a successful part-time (in-home) private practice, which could financially sustain the existence of a single person in an urban setting.
Will it really give me an edge over the LCSWs in my area?

By the way, I'm relatively well-off, so the cost of schooling is not a major concern.

What do you all think?

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[happyinpsych]

Hello all,

By the way, I'm relatively well-off, so the cost of schooling is not a major concern.

What do you all think?

Is it you or your family that is relatively well off? : ) Sorry, I just couldn't resist.

Psychologists generally aren't rich. I don't know how lucrative you expect your part-time private practice to be. But, if you expect to be well off solely from a part-time practice, I don't see that happening.

 

[erg923]

Hello all,

I am currently an undergraduate student, majoring in philosophy.
I have the goal of eventually setting up a private practice in psychotherapy/psychoanalysis.
I would like do therapy part-time, and with the rest pursue other interests.
I would like to a therapist that has a good name, a good reputation, and would like to steer as clear as possible from spending too much time reaching out for clients.
I feel like having a PsyD would place me above some of the other therapists in the field (those practicing with an LCSW for instance), especially with people browsing net-databases for therapists more and more.
I have two concerns,
one: That I may have to drop my major in Philosophy (which I love) and switch to Psychology (which because of a lack of experience, am not so sure I will enjoy as much).
and two: That in order to get into a respectable school for the purpose of attaining a PsyD, would require me to do many things, that I may not be otherwise interested in (certain psych. courses etc., fussing over my resume, and whether I have enough research experience etc.)

On top of that, I'm not sure that having a PsyD will be essential for what I would eventually like to achieve i.e. a successful part-time (in-home) private practice, which could financially sustain the existence of a single person in an urban setting.
Will it really give me an edge over the LCSWs in my area?

By the way, I'm relatively well-off, so the cost of schooling is not a major concern.

What do you all think?

I think what you aspire to takes lots of psych courses, research, work, sacrifice, reading, "fusing over resumes/vita," networking, etc. All of which you show absolutely no desire to do.

PS: And for goodness sakes son, don't see clients in your home unless you like spending money on retaining lawyers and fending off lawsuits.....

 

[robinsena]

Out of curiosity, why are you not pursuing a career that is related to philosophy? What about being a therapist drives you to consider a PsyD, even though you are concerned you may not like the classes you need to take to be a Psych major and you are loving what you study right now?

Not trying to pry just for the fun of it, but you made some interesting statements that I think is really important to figure out before you do decide that a PsyD (or being a doctoral level psychologist) is right for you (aside from decent salary and reputation). With what you're willing and not willing to do, I don't know if pursuing a PsyD or a PhD in clinical psych would be right for you.

 

[livetosail]

Have you considered just becoming an LPC- Licensed Professional Counselor? A 2-year masters degree in counseling and a state-administered board exam and you're done. Pretty cheap too, and much more conducive to part-time than a Psy.D.

LPC's can work in private practice (in most states), but often work in community health settings, or under another psychologist.

Depending on what you ultimately want to do, LPC might be worth looking into.

 

[Annakei]

Agreeing with others, I am not sure that a doctoral level psychologist is what you really want or even if it's for you given what you're not willing to do. It sounds like you like the idea of becoming a psychologist to place you higher up on the totem pole but without a clear understanding and drive of what it takes to get there.

The other option is to become a masters level therapist ie LCSW or LPC and you cna practice independently.

FYI: Once you are fully licensed as a LPC, in most states this is 2 years and ~2500 hours you dont need to be supervised clinically by anyone, perhaps functionally but not clinically.

 

[jnine]

I would like to [be] a therapist that has a good name, a good reputation, and would like to steer as clear as possible from spending too much time reaching out for clients. QUOTE]

the world of clinical psych is filled with lots of intelligent therapists hustling to promote their careers. i think that you too would have to work hard to build a name and get clients. it includes resume building and buisness saavy. unless you have lots of wealthy friends who'll come to you..

 

[Jezebel09]

unless you have lots of wealthy friends who'll come to you..

Actually, that would be unethical. You cannot provide therapy or counseling to friends, relatives, etc.

 

[robinsena]

I'm pretty sure that was a joke. I agree with the point jnine was getting at though - it's naive to think people will just come to you begging for therapy without doing any outreach.

 

[Jezebel09]

I'm pretty sure that was a joke. I agree with the point jnine was getting at though - it's naive to think people will just come to you begging for therapy without doing any outreach.

I completely understand her point, and I agree with you that jnine was probably joking. BUT, some people who use this forum would not know that it is unethical, and I was just pointing it out for their benefit.

 

[phillydave]

I'm pretty sure that was a joke. I agree with the point jnine was getting at though - it's naive to think people will just come to you begging for therapy without doing any outreach.

Sarcasm is often lost via text.

As some of the more experienced doctoral students and psychologists have said on this forum a hundred times, having business knowledge and equally keen business skills as clinical skills is a must for having a successful private practice. To paraphrase t4c, there are plenty of private practice psychologists out there who make greater than 200k/year but they almost positively have to have excellent business knowledge in addition to their doctoral training.

 

[Jezebel09]

Sarcasm is often lost via text.

As some of the more experienced doctoral students and psychologists have said on this forum a hundred times, having business knowledge and equally keen business skills as clinical skills is a must for having a successful private practice. To paraphrase t4c, there are plenty of private practice psychologists out there who make greater than 200k/year but they almost positively have to have excellent business knowledge in addition to their doctoral training.

AND, they're most likely not just working part time!!!

 

[jnine]

I completely understand her point, and I agree with you that jnine was probably joking. BUT, some people who use this forum would not know that it is unethical, and I was just pointing it out for their benefit.

yeah, I was trying to joke in a poignant sorta way. jnine is not a her.

 

[Jezebel09]

yeah, I was trying to joke in a poignant sorta way. jnine is not a her.

Sorry! I heard your name in my head as "Jeanine."

 

[Schooled]

I have the goal of eventually setting up a private practice in psychotherapy/psychoanalysis.

This does not require a PsyD/PhD. You can make a great career out of doing therapy as an LCSW/LPC. Are you also tied to doing just psychoanalysis? There are many stand alone schools that offer rich psychoanalysis training at masters levels.

I would like do therapy part-time, and with the rest pursue other interests.

If you have a private practice, you set your own hours and census.

I would like to a therapist that has a good name, a good reputation, and would like to steer as clear as possible from spending too much time reaching out for clients.

You don't need "Dr." in front of your name to have a good reputation. Also, having it does not mean you will have a good reputation. (In fact, if your goal is to get a PsyD over a PhD, you might have to put up with some bad stigma). If you don't want to reach out for patients, your best bet is to work for a residential center or psychiatric hospital. However, I doubt you can do that part time.

I feel like having a PsyD would place me above some of the other therapists in the field (those practicing with an LCSW for instance), especially with people browsing net-databases for therapists more and more.

Having a PsyD does not necessarily place you above an LCSW. A search on simplyhired.com or monsterjobs.com will show you that they often compete for the same jobs. In the world of therapy and direct practice, reputation has more to do with marketing, word of mouth, networking, and, especially, ability rather than your degree.

Another thing to consider is the area where you want to live. For example, the area in Texas where I am from (I've heard this is true of all of Texas), the LCSW is WAY more marketable than an LPC. I've known LCSWs to have as many patients as psychologists in the same office building.

I have two concerns,
one: That I may have to drop my major in Philosophy (which I love) and switch to Psychology (which because of a lack of experience, am not so sure I will enjoy as much).

This is not necessary. MA and PsyD programs do have pre-requisite courses and you can take those as elective classes with your Philosophy major. I believe that most programs do not require a major in psychology nor is it a strike against you as long as you have the pre-reqs.

and two: That in order to get into a respectable school for the purpose of attaining a PsyD, would require me to do many things, that I may not be otherwise interested in (certain psych. courses etc., fussing over my resume, and whether I have enough research experience etc.)

PsyD programs do not necessarily require a lot of research experience. Also any research experience does not have to necessarily be in psychology. Published philosophy papers or published literary analysis/criticism may suffice. At the very least it would be worth mentioning.

FYI, the two PsyD programs that I would consider "respectable" (here is my bias) place a stronger emphasis on research than most PsyD programs.

On top of that, I'm not sure that having a PsyD will be essential for what I would eventually like to achieve i.e. a successful part-time (in-home) private practice, which could financially sustain the existence of a single person in an urban setting.
Will it really give me an edge over the LCSWs in my area?

A PsyD is NOT essential. Again, it does not give you any practical edge over an LCSW. If you work for an agency, most times your patients won’t know what your degree was in unless you tell them. Obviously, if you have a PsyD people will call you doctor. That might buy your some more prestige. However, to employers it will matter much less than your past experience, your resume, and all that other stuff that people fuss over.

To be sure there are things a PsyD can do that an LCSW/LPC cannot. However, this extends outside the realm of direct practice and therapy.

 

[deleted176373]

I think what you aspire to takes lots of psych courses, research, work, sacrifice, reading, "fusing over resumes/vita," networking, etc. All of which you show absolutely no desire to do.

PS: And for goodness sakes son, don't see clients in your home unless you like spending money on retaining lawyers and fending off lawsuits.....

"PS: And for goodness sakes son" <--- What's with the gender bias.

Mark

 

[ILGirl]

.

Legally, maybe so. But, within direct practice and therapy, doctoral level providers are likely more competent/knowledgeable than social workers or LPCs. QUOTE]

I disagree. There are highly competent LPCs, MSWs, PhDs, and PsyDs.

I think one of my professors said it best: It takes 10 years to become a master clinician. For those of us who choose to get PhDs, more of those 10 years are included as part of our training.

It takes time to become a solid practitioner, but I don't think we need to malign other mental health professions. (Some individuals in those professions are going to be bad providers, but some doctoral-level providers will be bad as well.)

 

[erg923]

Unfortunatey, in todays society, no one is allowed to be better than anyone else anymore (in terms of competence, knowledge, skill etc). But frankly, its just the way it is sometimes. Otherwise, there would be no point to the doctorate. Insisting that everyone is everyone equal in skill lacks deep thought about the issues, is misinformed, and devalues this degree/profession.

 

[Aura5]

I could go into a hospital, watch doctors do stuff for a couple of years, start practicing and in ten years I might be competent. Of course, no one is going to let me do that. And I probably wouldn't be as competent as the physicians, but maybe I might be as competent as some physicians. . . maybe, maybe in form. But, I wouldn't have the requisite background to really comprehend what I was doing and why. This is what I meant by devaluing mental illness. It's a complex field. A masters degree is not sufficient in my opinion. . .and definitely not sufficient to plugin lpc, lcsw, psyd, phd, interchangeably and expect equal competence. . . 10 years or not. That's a bunch of BS. That's not maligning other mental health professionals. You're selling doctoral level providers down the river by equalizing everything (your some are good some are bad statement) and by extension you're devaluing mental illness/health and in my opinion harming the profession and patients.

I've heard a lot of things the M.D. psychiatrists talk about where I work, and I have no clue what they're talking about half the time. The medication stuff is over my head. I could learn, but...eeh. When they talk about patient behavior or condition, that makes more sense...but start talkin' the drugs and all that and *woosh* (over head). No desire to be a psychiatrist, at least I've learned that. The mediation regulation and focus is not for me, even if basically without the M.D.'s there'd be no hospital.

So right I don't think just watching someone forever would be the same as undergoing the process to aquire the knowledge yourself.

I'm not going to take a firm stance to the master's level versus doctorate because I don't know. I'd think there might be some master's who just by nature are a better therapists/counselors than some doctorates who aren't by nature (or something along those lines) but as a general rule of life I think the more knowledge and learning and comprehensive understanding, the better.

 

[ILGirl]

I could go into a hospital, watch doctors do stuff for a couple of years, start practicing and in ten years I might be competent. Of course, no one is going to let me do that. And I probably wouldn't be as competent as the physicians, but maybe I might be as competent as some physicians. . . maybe, maybe in form. But, I wouldn't have the requisite background to really comprehend what I was doing and why. This is what I meant by devaluing mental illness. It's a complex field. A masters degree is not sufficient in my opinion. . .and definitely not sufficient to plugin lpc, lcsw, psyd, phd, interchangeably and expect equal competence. . . 10 years or not. That's a bunch of BS. That's not maligning other mental health professionals. You're selling doctoral level providers down the river by equalizing everything (your some are good some are bad statement) and by extension you're devaluing mental illness/health and in my opinion harming the profession and patients.

I never once said that master's level clinicians could just WATCH and learn how to be solid professionals, so I really don't understand your comparision.

It takes experience and practice and knowledge.

Some students who come from heavy research programs will be, IMO, less competent as practitioners than some of the master's level clinicians.

I believe that some PhDs are better pracititioners than other mental health professionals. But, I also believe there are some master's level clinicians that are better than some PhDs.

What exactly about the PhD in your opinion makes someone with a PhD vastly superior to someone with a master's degree?

 

[edieb]

I never once said that master's level clinicians could just WATCH and learn how to be solid professionals, so I really don't understand your comparision.

It takes experience and practice and knowledge.

Some students who come from heavy research programs will be, IMO, less competent as practitioners than some of the master's level clinicians.

I believe that some PhDs are better pracititioners than other mental health professionals. But, I also believe there are some master's level clinicians that are better than some PhDs.

What exactly about the PhD in your opinion makes someone with a PhD vastly superior to someone with a master's degree?

I don't see how years practicing as a therapist equates to increasing clinical skill. The literature demonstrates that two factors drive treatment succes are: 1) The therapeutic relationship and 2.) Effectively Using EBTs. Once you are out of school, you are no longer exposed to the clinical literature (and most SWs and LPCs never are). Therefore, unless you go home and read journal articles and texts , you are no longer assimilating new knowledge and skills. Most master's level practitioners don't learn the basics in diagnosis and EBTs fron the beginning. So they end up practicing from the same inadequate repertoire that they began with. So they become more conversant with practicing therapy, so it seems easier. However, patient outcomes are not improved in any way

 

[Aura5]

I don't see how years practicing as a therapist equates to increasing clinical skill. The literature demonstrates that two factors drive treatment succes are: 1) The therapeutic relationship and 2.) Effectively Using EBTs. Once you are out of school, you are no longer exposed to the clinical literature (and most SWs and LPCs never are). Therefore, unless you go home and read journal articles and texts , you are no longer assimilating new knowledge and skills. Most master's level practitioners don't learn the basics in diagnosis and EBTs fron the beginning. So they end up practicing from the same inadequate repertoire that they began with. So they become more conversant with practicing therapy, so it seems easier. However, patient outcomes are not improved in any way

don't people need continuing education hours to keep licenses though?

 

[ILGirl]

I don't see how years practicing as a therapist equates to increasing clinical skill. The literature demonstrates that two factors drive treatment succes are: 1) The therapeutic relationship and 2.) Effectively Using EBTs. Once you are out of school, you are no longer exposed to the clinical literature (and most SWs and LPCs never are). Therefore, unless you go home and read journal articles and texts , you are no longer assimilating new knowledge and skills. Most master's level practitioners don't learn the basics in diagnosis and EBTs fron the beginning. So they end up practicing from the same inadequate repertoire that they began with. So they become more conversant with practicing therapy, so it seems easier. However, patient outcomes are not improved in any way

I just believe that people who are dedicated to the field will stay up on current practices (regardless of their level of education). Why wouldn't a master's level practitiioner continue to read the literature and keep current on evidenced-based therapy?

And, using your line of reasoning, then after 5-6 years, a PhD will stop reading the literature and stop learning about current best practices.

Do I believe that an LPC can do everything that a PhD can do? NO. PhDs are trained and skilled in a wide variety of assessments. But, I do believe that LPCs and MSWs can keep up-to-date on EBT and can be excellent clinicians.

 

[jnine]

I think one major argument here is that PhD's are generally more capable than the master's level clinicians because they are generally more thouroughly trained with more exposure to didactic, scholarly, and supervised clinical experiences than master's level clinicians. at any rate phd's have generally been focused on the topic longer than master's level clinicians. the profession should recognize the increased focus on all aspects of the clinical psychology discipline and reward individuals for going through this training.

counterargument?

 

[erg923]

What exactly about the PhD in your opinion makes someone with a PhD vastly superior to someone with a master's degree?

Im sorry, I dont follow. What is exactly your understanding of what the ph.d is?

 

[psybee]

There are masters level students at my clinical externship (so we are both in our 2nd year, me in my PhD, them in their MA). while some are great and have taken some great courses, they are ending their degree just as I am beginning mine. If I had done my masters i would stop my training in a few months. But I have 2 more years of diverse clinical experiences, coursework, research, and service before I can start my internship (If I apply at the earliest possible time, and may do an extra year of clinical work and research). Then I'll do my internship, full time, continue research, and earn my phd. I'll still need another year of supervised clinical work (so a post-doc) to get liscenced, but even so this amount of training is the difference between me as a PhD level clinician and a masters.

Now of course if the masters level practicioner is smart and kind and compassionate and I am a royal B with little insight and few social skills, none of that education is going to help me rise above that, but unless someone is putting out that doctoral level clinicians are significantly lacking in the interpersonal factors that promote therapeutic change compared to Masters level clinicans, I'll keep on suggesting that my friends go see a psychologist when they're thinking of seeking therapy*, unless they have a recommendation for a MA/LCSW. There are great individual masters level clinicians (I've seen them myself) but when hunting in the dark for a professional, the PhD/PsyD is the stronger training and i will recommend it. I do also feel that after 5 years of researchresearchresearch EBTsEBTsEBTs we are likley to keep up with the literature as opposed to folks who were barely exposed to it, which can have clinical implications as well.

*Of course they won't be able to find any that are taking pateints on thier insurance panels so they'll end up seeing a MA/LCSW (or extern!) anyway

 

[ILGirl]

I think one major argument here is that PhD's are generally more capable than the master's level clinicians because they are generally more thouroughly trained with more exposure to didactic, scholarly, and supervised clinical experiences than master's level clinicians. at any rate phd's have generally been focused on the topic longer than master's level clinicians. the profession should recognize the increased focus on all aspects of the clinical psychology discipline and reward individuals for going through this training.

counterargument?

Jon Snow said that just because LPCs and MSWs can legally practice "doesn't mean they're actually capable". That is the comment that I am actually arguing against.

Are there some incapable MSWs and LPCs? Sure. But, there are also some incapable PhDs. . . . Thus, I appreciate that you used the word generally. I think there are some very capable LPCs (and MSWs) out there, and I don't like to diminish any profession. Isn't there room for all of us? Do we have to rail against one another's chosen professions?

I just think saying INCAPABLE is really harsh--and. for the most part. untrue.

Has any research been done on this?

 

[ILGirl]

Hmm, and perhaps some nurses are better physicians. . . no, that's not right. . . better at practicing medicine than some physicians? Sure, maybe. So what?[/QUOTE]

That was really my main point. You were insinuating that LPCs and MSWs are incapable, and I took issue with that. They aren't all incapable. Some of them are solid practitioners. Some of them are better than some PhDs.

I agree with psybee's post. When in doubt, go to a PhD. But, if I knew of a master's level practitioner who was highly skilled in a certain area (an area that I had not been trained in), I would have no issue whatsoever with referring a client to him or her.

 

[Aura5]

Jon is the main thing fueling your distaste on this whole thing the fact that some people in the field equate master's levels with Ph.D.s/Psy.D.s, watering down the fact that Ph.D.s have much more advanced training? So it's giving the wrong impression to the masses that they are comparable? I agree with that point, but also agree with ILGirls point: "I think there are some very capable LPCs (and MSWs) out there, and I don't like to diminish any profession." I mean there is definitely time and place for the master's levels clinicians and the services they provide. There are many, many more master's level clinicians at the hospital where I work...maybe only one psychologist. (The rest psychiatrists.) And I'd imagine many residential and counseling centers etc. that would need master's-level clinicians to fill the amount of skilled staff needed to provide therapy and supervision to the amount of clients. So there's definitely a use and I'd say many of them could turn someone's life around just as much as a Ph.D. might one day. And methinks you'd agree with that...there are many more nurses everywhere than physicians, like your analogy...so while there is a time and place, you just want them to stay in their place, eh?

 

[ILGirl]

. . . and my point was, it sounds ridiculous to think of a nurse practicing medicine. The same should be true of current scope of practice for our, supposed, midlevels.

QUOTE]

Actually, it is not ridiculous. They're called nurse practitioners. They can diagnose diseases and prescribe medications.

 

[psich]

Let's all just take a breather for a moment...

 

[Aura5]

Let's all just take a breather for a moment...

Group hug? Lol and I wonder if all this back-and-forth helped answer the OP at all...

 

[Aura5]

Why? I'm not even warmed up yet.

Jon did you see mine? Just wondering if I'm on the right track of your vehemence.

 

[psich]

Why? I'm not even warmed up yet.

It's clear you feel very strongly about this issue. But emotions are obviously running high…We don’t have to stop the discussion, but taking a break might help. Or does my opinion not count since I have an MA?

 

[Aura5]

It's clear you feel very strongly about this issue. But emotions are obviously running high&#8230;We don't have to stop the discussion, but taking a break might help. Or does my opinion not count since I have an MA?

You just went and inflamed it again with the last line!

 

[lookitssara]

Since we're all about research proven stuff, I'm going to take this quote and run with it:

"The literature demonstrates that two factors drive treatment succes are: 1) The therapeutic relationship and 2.) Effectively Using EBTs."

If these are the important aspects, then there is no qualitative INNATE difference in the effectiveness of an LPC and a PhD who have both. Are PhDs more likely to do B? I strongly believe so. Are PhDs *usually* more qualified to do assessment and counsel patients with serious mental illnesses then the average LPC? Yes. Does that mean that PhDs (as a blanket statement) are better in this field than LPCs? Nope.

We take each client/patient as an individual and we should do the same with clinicians before making blanketed statements. I agree with financial/political ramifications of our system (we should put an extremely high price on mental health), but that does not mean I agree with putting the LCSW or LPC below a PhD before knowing their experiences, training, and prior outcomes/failures. Although some masters+level clinicians undoubtedly perform outside of their abilities/training (medication management, assessments they haven't been taught on, etc.) it is wrong and biased to assume they all do.

Just like everything else, it's all about context. If I was getting a divorce and thought my child needed counseling to get through it? Definitely an LPC or LCSW. If I had a child who I believed was experiencing early symptoms of bipolar disorder, I would run to a PhD.

 

[psich]

That was an error on my part. I apologize for the last statement.

 

[Aura5]

Yes, it's about scope of practice. But, it's not just about impression to the "masses" it's about the future development of the field and standards of practice.

Masses help determine the direction though. If they go and find it cheaper to get what they feel is just-as-good therapy from a master's level...more might be driven to that...and thus the field might alter to adapt. So, ya know. That's what I meant by that.

 

[Aura5]

That was an error on my part. I apologize for the last statement.

Well I was kind of joking around so, I'm not really helping either.

 

[Annakei]

.

Legally, maybe so. But, within direct practice and therapy, doctoral level providers are likely more competent/knowledgeable than social workers or LPCs. Just because they have little restriction legally doesn't mean they're actually capable. I think the expansion legally of masters level providers has more to do with big business (money), lack of comprehension by politicians of the differences between fields, and lack of comprehension/devaluing of mental health in general. Also remember, reputation isn't necessarily based on skill. You (general) may have a nice rack, or party with the right crowd. Reputation, in this field, may in part be based on patient feedback, but is often more about how you present yourself (sales). That's why in law, female trial attorneys are usually smoking hot.

Jon

Please don't forget you're on trial around this very issue. It is this court's understanding that you recently softened your position, are we perjuring ourselves? Stirring the pot much?



Your Honor (PhillyDave), I request that the witness be treated as hostile. He can't keep his story straight!


All of a sudden it feels like Satan just turned the heat up in here, so much for the cool cease fire we had going on SDN

 

[psich]

Well I was kind of joking around so, I'm not really helping either.

lol I guess I wasn't sure if my last statement was too offensive.

Jon,

What I meant was I do not have a doctorate, nor am I in a doctoral program.

It's evident that some individuals (such as yourself) react so strongly to having intermediate-level mental health clinicians because they may perceive that this move weakens the field as a whole. I cannot say that I entirely disagree with that statement. However, the fact is that the master's level clinicians are here, they exist, and they are not going anywhere.

What if other professions were created to replace master's level work? What if an individual with a bachelor could come in with a semester or two of training, or with a certificate, being able to do with an LCPC, LPC, LMHC, etc. does? Segmenting the field is not working since it is creating some ambiguity, leaving lines which separate the professions unclear. I can certainly appreciate your perspective since this is what you feel is happening to you.

Someone on SDN mentioned that master's level clinicians should have the right to conduct assessments with additional training. I objected, since that is not what master's level clinicians were meant for. So, I agree we should act as supportive roles. But on the other hand, I believe that claiming master's level clinicians to be incapable of practicing is too strong a statement. Your words from before seemed to negate the very existence of master's level clinicians.

 

[psybee]

Sure, that's supportive therapy, a role for which LPC and LCSW was designed.

i do want to say that there are many amazing LPC's and LCSW's who do that and transform lives. i don't think that the master's level trains folks to practice clinically at the same level as a PhD/PsyD, but that does not need to degrade or belittle what incredible things a psychosocial oncology social worker can do for someone who is diagnosed with cancer--supporting them through their treatment, connecting them to services and helping them access care and advocate for themselves, providing psychoeducation and resources to their family, helping them deal with their changing employment situation. what a difference that can make! it can make the difference between receiving treatment or not, between hope and despair. but that still dose not mean they are qualified to work with that suicidal client with intractable depression, or the client with childhood sexual abuse and an eating disorder. and if that client with breast cancer develops clinical depression or finds them selves reliving past traumas as this current trauma unfolds, more intensive therapy by a more intensively trained clinician (PhD/PsyD) is warranted.

 

[psychmama]

I'm curious what people think of Master's level clinicians who go on to receive specialized training (e.g., family therapy; psychoanalysis). Would you be comfortable with such individuals working along side doctoral level psychologists (essentially providing similar work to clients)? Or do you think no level of advanced training other than the Phd or Psyd will make such clinicians "equivalent?"

BTW, I'm not sure where I stand on this. I'm just asking...

 

[psybee]

I'm curious what people think of Master's level clinicians who go on to receive specialized training (e.g., family therapy; psychoanalysis). Would you be comfortable with such individuals working along side doctoral level psychologists (essentially providing similar work to clients)? Or do you think no level of advanced training other than the Phd or Psyd will make such clinicians "equivalent?"

BTW, I'm not sure where I stand on this. I'm just asking...

I'm not sure how I feel about this either. I have not had great luck finding a good therapist via these advanced training institutes, but that doesn't say much. it may reflect that their training practicum (before the began the institute) was more social work than straight clinical, so even though they have a degree this may be their first real experience providing actual psychotherapy. how they are after a 5 year program or whatever I don't know--I don't think those are the ones that I keep getting that cost 40 bucks an hour!

 

[Therapist4Chnge]

You're selling doctoral level providers down the river by equalizing everything (your some are good some are bad statement) and by extension you're devaluing mental illness/health and in my opinion harming the profession and patients.

Agreed. I work in a hospital, and while I work with some great MA/MS level people, there are significant differences in how psychologists and non-doctoral level people approach various issues. Compliance is a major area that is interpreted differently. I've given the example before where a pt. was getting in trouble for not going to appointments and for getting hostile when questioned about it. The conflicts were with staff extenders, who were very good at their jobs, but they didn't know what they didn't know. When the issue came up in team, a psychologist asked about cognitive impairments based on the pt's history. I did the nuero testing and sure enough the pt. had significant short-term memory issues, so he had no idea he had appointments, and he viewed the frustration of the staff as aggression towards him, which is why he responded aggressively.

Some students who come from heavy research programs will be, IMO, less competent as practitioners than some of the master's level clinicians.

I believe that some PhDs are better pracititioners than other mental health professionals. But, I also believe there are some master's level clinicians that are better than some PhDs.

What exactly about the PhD in your opinion makes someone with a PhD vastly superior to someone with a master's degree?

How they learn what they learn, and then how they apply that to a situation. It is akin to a psychometrician v. neuropsychologist. Both can give neuropsychological assessments if trained, but then what they do with that data after collection is much different. A doctoral level person is taught a lot more about the unpinning of the assessments, the statistical significance of various assessments, and ultimately how to integrate those things to write a comprehensive report. A neuropsychologist is taught even more about the neuroanatomy and functional aspects of the brain, which better informs assessment selection and interpretation. A MA/MS level person is taught much more as a technician, and while they may have similar training at the surface, the depth of training is much different. The more time I spend working in the field, the more I notice the subtle and not so subtle differences between the trainings.

I agree with that point, but also agree with ILGirls point: "I think there are some very capable LPCs (and MSWs) out there, and I don't like to diminish any profession." I mean there is definitely time and place for the master's levels clinicians and the services they provide. There are many, many more master's level clinicians at the hospital where I work...maybe only one psychologist. (The rest psychiatrists.)

The really good ones stay up on the research, seek out additional training, utilize more mentorship, etc.....however they are definitely the minority. I work with some GREAT MA/MS/MSW level people at my hospital, and many go above and beyond the expectations. With that being said, there are also some mid-level providers out there who work in areas where they have NO formal training, and just include everything under the umbrella of "clinical skills".....including assessments.

One of my biggest areas of frustration centers around differential diagnosis. I am skeptical that a non-psychologist (MA/MS/MSW, RN, LPC, LPN, and yes...even MD/DO) can properly do a differential diagnosis without formal psych testing. Just the other day I had a consult where the Dx. was MDD, and after about 5 minutes of neuro testing it was clear that there was severe cognitive impairments. The more I dug, the greater clinical picture I gained, and the less the MDD made sense. The attending provided the primary diagnosis off of the patient's presentation, though he wanted confirmation because there were a number of complicating factors (sub. abuse, TBI, etc).

 

[Therapist4Chnge]

I agree psybee, that's case management and supportive therapy. I'm not trying to demean anyone. I'm saying that expanding beyond the above isn't what those degrees were intended for and that doing so hurts the mental health field in general, including patients. The cat is out of the bag, of course. LCSWs offer a full range of therapy services, training be damned.

Has anyone ever googled therapists in their area? It is scary what some people list they can do. I've seen lists referencing a dozen different areas of expertise, as well as a host of theoretical orientations. Is it possible the person is competent in ALL of those areas....maybe, is it probable...no. My favorite specialty area is "eating disorders", because unless that person spent at least a couple of years working at the right places, there is no way they are adequately prepared to effectively manage an ED case.

As a doctorally trained professional I wouldn't even claim half of those things, some of which I received training AND supervision in, saw dozens of cases using the interventions, and could speak intelligently about if need be. Why....because there is much more to most of those orientations and interventions that cannot be learned by reading a book or attending a weekend seminar.

I'm curious what people think of Master's level clinicians who go on to receive specialized training (e.g., family therapy; psychoanalysis). Would you be comfortable with such individuals working along side doctoral level psychologists (essentially providing similar work to clients)? Or do you think no level of advanced training other than the Phd or Psyd will make such clinicians "equivalent?"

BTW, I'm not sure where I stand on this. I'm just asking...

The devil is in the details....is this "specialized" training done at a weekend seminar or over 2-3 years at The Beck Institute? The former I would likely question why they thought that was sufficient enough training, the latter I'd probably pick their brain about a few things I always found challenging with CBT. The same can be said about the Analytic Institutes out there....they can offer great training, while other people offer "workshops" that don't have the close supervision needed to do it right.

 

[psychmama]

The devil is in the details....is this "specialized" training done at a weekend seminar or over 2-3 years at The Beck Institute? The former I would likely question why they thought that was sufficient enough training, the latter I'd probably pick their brain about a few things I always found challenging with CBT. The same can be said about the Analytic Institutes out there....they can offer great training, while other people offer "workshops" that don't have the close supervision needed to do it right.

I tend to agree. Would I dismiss the training of an MSW who went on to get a certificate in Psychoanalysis after 5 yrs of training at The White Institute, or intensive training in family work at Ackerman? No. Do most MSWs get this level of advanced training? Certainly not -- it's expensive, and if they were so inclined, most would have gotten the doctorate to begin with.

 

[JD7699]

i do want to say that there are many amazing LPC's and LCSW's who do that and transform lives. i don't think that the master's level trains folks to practice clinically at the same level as a PhD/PsyD, but that does not need to degrade or belittle what incredible things a psychosocial oncology social worker can do for someone who is diagnosed with cancer--supporting them through their treatment, connecting them to services and helping them access care and advocate for themselves, providing psychoeducation and resources to their family, helping them deal with their changing employment situation. what a difference that can make! it can make the difference between receiving treatment or not, between hope and despair. but that still dose not mean they are qualified to work with that suicidal client with intractable depression, or the client with childhood sexual abuse and an eating disorder. and if that client with breast cancer develops clinical depression or finds them selves reliving past traumas as this current trauma unfolds, more intensive therapy by a more intensively trained clinician is warranted.

I completed training and licensure at the masters level then completed a PsyD. Most of the masters level therapists I knew would never do this as they believe that a PhD/PsyD is just for psychological testing. They would never spend the time and money to improve therapy skills. In my opinion, some do become exceptional therapists and continue to study on their own.

 

[phillydave]

Jon

Please don't forget you're on trial around this very issue. It is this court's understanding that you recently softened your position, are we perjuring ourselves? Stirring the pot much?



Your Honor (PhillyDave), I request that the witness be treated as hostile. He can't keep his story straight!


All of a sudden it feels like Satan just turned the heat up in here, so much for the cool cease fire we had going on SDN

In all fairness counselor, Jon was talking about professional schools before.

But still... granted.

 

[jnine]

great and enlightening conversation folks! thanks, i feel like i got me some edification today.