PhD/PsyD Direction Question / Considering PsyD

[occupationalguy]

Hello All,

A little about me: I was an undergraduate psychology major, I've done a great deal of volunteer work in psych settings, and I have found the psych settings I have worked in to be rewarding. I am currently an occupational therapist, while I am happy overall with my career field, I am drawn to mental health work. OT jobs in mental health settings are few and far between, and reimbursement is rather poor. The problems I have encountered in most OT settings I have worked on include a constant emphasis on treatment/billing. As an OT I feel pressured by rehab directors to treat patients who don't need skilled therapy. Another problem is productivity demands: I am expected to take on so many patients that 90% of my day is "productive" - aka billing. Many work sites have a "culture" of documentation taking place before work, after work, or during your lunch break, all uncompensated time.

I am single and have mobility to move most anywhere in the US. I've been thinking I should look into PsyD part time programs; I could work during the day and go to night school. I'm able to take on a good deal of academic work. My undergraduate grades weren't fantastic, but I went to a first tier OT program and my graduate grades are excellent (3.8 ish), as are my references.

Am I ill advised to pursue a PsyD? Any well intentioned people with advice to offer - I'm all ears, and many thanks in advance.

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[WisNeuro]

If you attend a night school PsyD, you will likely be in the same boat in terms of productivity load to meet your billing needs and likely won't have a much higher salary, which, when coupled with the massive loan debt, would actually lead to a decreased net income.

 

[occupationalguy]

If you attend a night school PsyD, you will likely be in the same boat in terms of productivity load to meet your billing needs and likely won't have a much higher salary, which, when coupled with the massive loan debt, would actually lead to a decreased net income.

A funded PhD program would solve that problem, but alas, this is not a likely option due to my undergraduate grades being less than stellar. I do not have any recent research experience on which to rely upon . I am able to engage in research but I am forthright that this is not the main interest of mine.

I'm not sure I am an ideal candidate or that this is a wise road for me to go down. I like the idea of working as a psychologist and I thoroughly enjoy the mental health settings I have worked in.

 

[eremitestar]

Have you looked into funded counseling psych PhD programs? They might give your professional experience more weight (lots of people in my program had worked previously as counselors or social workers), compensating for the lack of recent research experience.

 

[Ollie123]

There are really two separate issues here - the career itself and the route you take to get there. I wouldn't completely rule out the possibility of going the PhD route just because of a low-ish undergrad GPA. Research experience can be obtained depending on your ability to delay gratification (if its low - grad school probably isn't a good option anyways). There are really only a handful of PsyD programs that I would in good conscious recommend - and that goes double if you have any debt from your OT program.

I think the bigger issue is whether its a good idea to become a psychologist and what you describe did not sound remotely compelling to me. I like the "idea" of being an astronaut, but the day-to-day is another matter. ESPECIALLY if you go the PsyD route, you would likely experience exactly the same billing/productivity pressure you do as an OT. Some settings can free you from that, but those are usually the more academic ones that will expect research (or administration) to be done in its stead. It seems like you are looking to psychology as a relatively safe "escape" from OT (given you at least have some peripheral knowledge of what it involves) rather than actively wanting to do it.

I'd first look for different OT jobs and/or maybe find ways to move into administrative roles and free up some time (since it sounds like the billing grind is really your main issue - and that is unlikely to change at all if you switch fields - and could worsen). Next, look hard at what exactly your motivation is for wanting a change. If its "I don't like being pressured to see patients 7-8 hours/day" then it would be a truly horrendous idea to spend 5+years in school (and potentially rack up $200k in debt) to end up being a psychologist who is pressured to see patients 7-8 hours/day. If its about being in a mental health setting - there are certainly SOME opportunities for OTs in those environments you could move towards. Now if you would genuinely prefer the "nature" of the work that psychologists do, that is another matter - but that wasn't what your post seemed to be saying.

 

[Sanman]

Working as a psychologist in snf and alf settings, I can tell you it is mostly the same. Have you looked into OT jobs at the VA or in different settings? Your complaint is more of a health care complaint than an OT complaint. Anyone that bills health insurance and is an employed is in the same boat... physicians and psychologists included.

 

[smalltownpsych]

If I could achieve 90% of my time spent doing billable activities, I could make a boatload of money. Actually, I am at a job where grinding the billable hours is how I make my money and it is exhausting so don't know if I would really want that. Part of why I am doing this grind right now is to pay off the student loan debt accrued from attending a PsyD program.

Also, I don't think the training to be a psychologist is really something that you can or should do part-time.

 

[Therapist4Chnge]

Also, I don't think the training to be a psychologist is really something that you can or should do part-time.

100% agree.

It needs to be an immersion experience, as much of the learning occurs outside of the classroom and isn't something someone can dabble in.

 

[FutureOT$$]

Hello All,

A little about me: I was an undergraduate psychology major, I've done a great deal of volunteer work in psych settings, and I have found the psych settings I have worked in to be rewarding. I am currently an occupational therapist, while I am happy overall with my career field, I am drawn to mental health work. OT jobs in mental health settings are few and far between, and reimbursement is rather poor. The problems I have encountered in most OT settings I have worked on include a constant emphasis on treatment/billing. As an OT I feel pressured by rehab directors to treat patients who don't need skilled therapy. Another problem is productivity demands: I am expected to take on so many patients that 90% of my day is "productive" - aka billing. Many work sites have a "culture" of documentation taking place before work, after work, or during your lunch break, all uncompensated time.

I am single and have mobility to move most anywhere in the US. I've been thinking I should look into PsyD part time programs; I could work during the day and go to night school. I'm able to take on a good deal of academic work. My undergraduate grades weren't fantastic, but I went to a first tier OT program and my graduate grades are excellent (3.8 ish), as are my references.

Am I ill advised to pursue a PsyD? Any well intentioned people with advice to offer - I'm all ears, and many thanks in advance.

I say PhD. A PsyD can be quite expensive and the salary won't be greatly different. I understand a lot of people don't pursue a PhD because they don't like research and it is certainly a research oriented degree. HOWEVER, if money is a factor, PhD programs are often funded! Plus, even though it is research oriented, you get plenty of mental health care experience. For instance, one of the labs I worked in as an undergrad was a research clinic. Though the graduate students were obviously conducting research, they were also gaining exposure to the treatment which they were investigating. They got to be in a clinical setting and work with the patients.

Just my opinion. I will be starting OT school next year, so I am not in the field. However, before OT I was considering going straight for my PhD, so I know a fair bit. I did my undergrad at an R1 school, was involved in multiple labs, and have a few conference presentations.

As for getting into a PhD program, you already have a graduate degree and plenty of experience. This can help you stand out among the other applicants so I wouldn't rule out your chances of getting in.

 

[WisNeuro]

I say PhD. A PsyD can be quite expensive and the salary won't be greatly different. I understand a lot of people don't pursue a PhD because they don't like research and it is certainly a research oriented degree.

This is simply not true at a great number of PhD programs.

 

[PsyDr]

Hello All,

A little about me: I was an undergraduate psychology major, I've done a great deal of volunteer work in psych settings, and I have found the psych settings I have worked in to be rewarding. I am currently an occupational therapist, while I am happy overall with my career field, I am drawn to mental health work. OT jobs in mental health settings are few and far between, and reimbursement is rather poor. The problems I have encountered in most OT settings I have worked on include a constant emphasis on treatment/billing. As an OT I feel pressured by rehab directors to treat patients who don't need skilled therapy. Another problem is productivity demands: I am expected to take on so many patients that 90% of my day is "productive" - aka billing. Many work sites have a "culture" of documentation taking place before work, after work, or during your lunch break, all uncompensated time.

I am single and have mobility to move most anywhere in the US. I've been thinking I should look into PsyD part time programs; I could work during the day and go to night school. I'm able to take on a good deal of academic work. My undergraduate grades weren't fantastic, but I went to a first tier OT program and my graduate grades are excellent (3.8 ish), as are my references.

Am I ill advised to pursue a PsyD? Any well intentioned people with advice to offer - I'm all ears, and many thanks in advance.

1) Anyone who is trying to sell you a night school PsyD is a liar. The only reputable program with a similar structure I have ever heard of is FDU's school psych. And I still don't like it.

2) Even if you were a rockstar and did all the readings, writings, etc after work, it still wouldn't work. Ask yourself what happens when you are required to start externships/practica. At a bare minimum, practica are nominally supposed to be 20 hrs/wk. However, there tends to be a great deal of writing, conferring, emailing, etc which extends these hours. A great way to piss off your supervisor would be to put your job ahead of the patient services.

3) The psychology market is relatively saturated. Internship is highly competitive, as is formal post docs. When directors of training are looking at a student with qualifications from a highly competitive program, and a student who graduated from night school.

4) In the working world, a minimally adequate degree is going to reduce the hell out of your potential earning power unless you are willing to live and work somewhere that most find undesirable. Again, lower bargaining power due to lower prestige.

5) ANY service based career is going to emphasize billing. It's how money is made. Billing requires specific documentation in all healthcare fields. And completing forms is not recognized as a compensable activity. which brings me to my subpoint

a. The majority of commercial insurers have not increased reimbursement rates for a long time in psychology CPT codes, let alone kept pace with inflation. IMO, there was a period of time wherein generalist psychologists were making relative bank, and enjoyed a relatively relaxed workpace. These days are long gone. But the concept continues.

b. The institutional guys get hammered with ever increasing RVU targets. I don't see any administration ever lowering those expectations. Any psychologists, with a few limited exceptions, do not have extenders which can increase productivity. The private practice people always have increasing overhead. Rent goes up? Either you work harder to equalize your income, or you make less. Office lady asks for a fair cost of living raise? Same.