DVel

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I recently got my license to practice in California passing the EPPP and CPSE. I graduated from a great graduate program and was fortunate to place in an APA accredited internship and even a post-doc. However, the job market in Los Angeles seems bare.

Most positions look for LCSWs or MFTs and add on LCPs only as an afterthought. I respect masters level clinicans for their areas of expertise, but I am beginning to get annoyed when I see yet another position posting for clinical assessments, yet they are seeking LCSWs or MFTs. I always thought this was at least was in the realm of PhDs. How did degrees focusing on social work and marriage and family therapy begin diagnosing DSM disorders, and providing testing and treatment for DSM disorders?

Are my job search problems a reflection of the current economic times, or is it an indication that Clinical PhDs are becoming obsolete and a waste of time?
 
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DVel

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Are you limited to just LA?
I would prefer to be in LA, but I've kept my eye open for positions in San Diego and San Francisco as well. There seems to be a little more in those areas and I might apply if the position appeals to me or if it seems completely hopeless in LA.
 

psychmama

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This is a discouraging post, and I hope it's not a trend for the future. I guess the sad fact is that many clinics, hospitals and the like try to use master's level employees whenever they can in order to save money. It's especially upsetting if these clinicians are being relied upon to conduct assessments. I wonder if psychologists are at least reviewing them and writing the final reports?:confused:

Good luck in your job search. As someone starting my internship, I'm right behind you in the job market.:) (But I'm probably staying put on the east coast).
 

erg923

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Yes, but I would add that the OP is limiting his search to the 3 most psychology saturated areas of the entire country, LA, SD, and SF. Did you know Marin county (the county north of the golden gate Bridge and north of downtown SF) has more psychs per capita than any area of the country. The only thing this person left off was NYC. I think this speaks to the need to be highly niched of highly skilled at something in particular in the huge urban markets.

Although salaries are a real problem these days, I do not think psychs are having severe difficulty finding empoyment in most areas of the country.
 

psychmama

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Good to hear that only certain markets are saturated. Unfortunately I'm stuck in one of those markets (NYC/NJ). Oh well, I will just hope for the best and try to develop some niche skills to set me apart.

Underwater scuba-diving psychotherapy anyone?:rolleyes:
 
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DVel

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Yes, but I would add that the OP is limiting his search to the 3 most psychology saturated areas of the entire country, LA, SD, and SF.

Although salaries are a real problem these days, I do not think psychs are having severe difficulty finding empoyment in most areas of the country.
I hope you are right, that it's easier to find employment elsewhere. I just did not want to deal with reapplying for licensure in a different state, just after getting one in Cali. I may be more open to other states eventually, but I do prefer to live in a larger city.

This, however, does not change the fact that the field appears to be dominated by master's level therapists in the greater Los Angeles area (including San Bernardino, Irvine, Riverside and other surrounding cities and counties).
 

cara susanna

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I actually encountered scope creep's impact myself when finding a therapist for someone I know (they asked me to because I "know" about this sort of thing). Pretty much everyone at the place this person's insurance covered was an MSW or Masters in Counseling. There were two PhDs, but they were extremely specialized.

Then when my dad found out that people with Masters could practice, he asked me why I didn't just do that. x___x
 

Therapist4Chnge

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Scope Creep + Lowered Insurance Reimbursements = Problems.

OP...unfortunately you are looking in a very competitive market where there are people with more experience who are willing to work for less. It is definitely an employer's market, so they will keep salaries lower and still have their pick of over-qualified applicants. I know people who do well out there, though they either specialized or they worked their butts off. The only jobs I hear that pay consistently well in CA are forensic assessment jobs.

There have been on-going discussions on a number of listservs about job prospects and post-docs, and they both seem to be getting more and more competitive. Many people are taking MA/MS level pay to do doctoral level work, which is a shame....but a growing reality. I'm already concerned about securing a quality (paid) and hopefully formalized post-doc, and I'm still a year off. I'm hoping it will get better, but realistically it will be as competitive or more competitive by the time I get out.
 

Jon Snow

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Yep, it's a mess out there.

I'm contemplating other career paths. I wouldn't recommend anyone enter this career at this point. We have:

- massive encroachment from other professionals and pseudoprofessionals from all angles (neurologists, psychiatrists, social workers, masters level therapists).

- declining incomes over the last decade

- limited outcomes studies

- oncoming universal healthcare

- flooding from our own ranks (professional schools)

It's suicidal to enter this career now.

Sure, my income is good relative to the general populace. . . though insulting given the hurdles to get into the career. But, how long can that last given the above? Even in the relatively insulated world of academia, devaluing of the profession devalues the professional.
 
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HeyJude

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This thread is extremely frightening to me. I recently applied for my first practicum, and many of the sites that normally take students from our program were reducing the number of students they were taking, or exclusively taking bilingual students, etc. I was lucky to get a great position, but I just kept thinking "this is only practicum, and I'm working for free!" This is just one of many many hurdles that I'll be facing in the near future. When I look at salaries and demand for masters level positions such as nurses, or OT/PT positions, I'm frankly puzzled as to why I went this direction. I truly love the field and enjoy what I'm doing, but I have this strange feeling like I've been taken advantage of. By my undergrad institution who encouraged me to major in psych perhaps? By APA who accredits so many schools?

It's not simply the state of the job market or measly salaries that irk me, but I went into this field to help others, not sit on the couch frantically looking for people to "help." Not to sound egotistical, but I truly hope my skills, and intelligence are not wasted in this field.
 

73BARMYPgsp

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Yep, it's a mess out there.

I'm contemplating other career paths. I wouldn't recommend anyone enter this career at this point. We have:

- massive encroachment from other professionals and pseudoprofessionals from all angles (neurologists, psychiatrists, social workers, masters level therapists).

- declining incomes over the last decade

- limited outcomes studies

- oncoming universal healthcare

- flooding from our own ranks (professional schools)

It's suicidal to enter this career now.

Sure, my income is good relative to the general populace. . . though insulting given the hurdles to get into the career. But, how long can that last given the above? Even in the relatively insulated world of academia, devaluing of the profession devalues the professional.
At least this time you listed professional schools last. I would assent that you are getting softer. :)
 

HeyJude

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At least this time you listed professional schools last. I would assent that you are getting softer. :)
...because not getting jobs after spending years and years in grad school is such a light-hearted subject.
 

daydreaming

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First off, my condolences to those faced (or soon to be faced) with a bleak job market after so much time and energy!

I also have two questions.

For those of us hoping to do mostly research, are academic positions being affected by the saturation/blurring of boundaries discussed in this thread?

How, specifically, would universal health care, should some form of it be instated into America, affect salary, job options, and competition?
 

JockNerd

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For those of us hoping to do mostly research, are academic positions being affected by the saturation/blurring of boundaries discussed in this thread?
It does affect us. If there were a more reasonable number of psychologists in practice, and if the APA lobbied properly, the income of psychologists in practice would be much higher. Then, academia would have to offer better pay and benefits to attract people away from private practice/consulting/whatever and into academic roles. Something sort of like that happens in business schools, which have to attract professors away from full-time consultation with very high pay.

Also, many academics still do assessment or therapy on the side, even at R1s.
 

Markp

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I hope you are right, that it's easier to find employment elsewhere. I just did not want to deal with reapplying for licensure in a different state, just after getting one in Cali. I may be more open to other states eventually, but I do prefer to live in a larger city.

This, however, does not change the fact that the field appears to be dominated by master's level therapists in the greater Los Angeles area (including San Bernardino, Irvine, Riverside and other surrounding cities and counties).
There always is the Military, the Navy is offering huge incentives to come on board. If you have the credentials for CA you will not have to get licensed anywhere else and you can practice anywhere in the military while on active duty. Depends on how adventurous you are feeling and whether you meet the physical requirements.

Something to consider.

Mark
 

Markp

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Good to hear that only certain markets are saturated. Unfortunately I'm stuck in one of those markets (NYC/NJ). Oh well, I will just hope for the best and try to develop some niche skills to set me apart.

Underwater scuba-diving psychotherapy anyone?:rolleyes:
LOL, See above... Life in the Navy anyone. ;)

Mark
 

cara susanna

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I was also told that you can do consulting for the military, which pays very well and lets you stay a civilian.
 

Therapist4Chnge

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There always is the Military, the Navy is offering huge incentives to come on board. If you have the credentials for CA you will not have to get licensed anywhere else and you can practice anywhere in the military while on active duty. Depends on how adventurous you are feeling and whether you meet the physical requirements.

Something to consider.

Mark
I've heard that they are also looking to civilians to cover the gap in enlisted psychologists......though I'm not sure if this is still the case
 

Markp

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I've heard that they are also looking to civilians to cover the gap in enlisted psychologists......though I'm not sure if this is still the case
Psychologists don't enlist, they are offered commissions... While the different may seem to noise to you there is a major difference for us who are commissioned. The military is very much a caste system, those who are enlisted and those who are commissioned. I have been on both sides of the caste, both have their advantages and disadvantages. That said, I prefer being a commissioned officer over being an enlisted NCO.

Yes, they are looking for civilians I am sure, but then you have to be licensed in the state that you are practicing in. Military psychologists only have to be licensed in any one state... Seems odd, but that's the way it is.

Looks like the Military and VA are paying anywhere from 80k-120k per year for civilians depending on location. Some places in the mid west are a bit lower... but the coasts are 80-120k.

Mark
 
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73BARMYPgsp

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Psychologists don't enlist, they are offered commissions... While the different may seem to noise to you there is a major difference for us who are commissioned. The military is very much a caste system, those who are enlisted and those who are commissioned. I have been on both sides of the caste, both have their advantages and disadvantages. That said, I prefer being a commissioned officer over being an enlisted NCO.

Yes, they are looking for civilians I am sure, but then you have to be licensed in the state that you are practicing in. Military psychologists only have to be licensed in any one state... Seems odd, but that's the way it is.

Looks like the Military and VA are paying anywhere from 80k-120k per year for civilians depending on location. Some places in the mid west are a bit lower... but the coasts are 80-120k.

Mark
Hey Mark-

My plan is to retire after 20 (probably 0-5) then go to the VA in a state like Wyoming, Montana, etc. So are you saying I need to get a license in [which ever state I end up] to make that transition?
 

Markp

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Hey Mark-

My plan is to retire after 20 (probably 0-5) then go to the VA in a state like Wyoming, Montana, etc. So are you saying I need to get a license in [which ever state I end up] to make that transition?
That depends on whether they have reciprocity with the state you are licensed in initially. It's a messy situation, many states will accept your credentials from other states, but certain states will not. You still need a license in the new state, but in many cases it's a matter of showing that you are already licensed in the one state and getting the new license issued in the new state.

Mark
 

Cosmo75

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I heard from someone the other day that the VA is now accepting masters level clinicians with the LCPC. This is unverified. Anyone else know about this?

There goes the VA as a secure place if that's the case....
 

Jon Snow

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I don't know about the LPC thing, but I did see a VA advertise a neuropsychology position starting at $56,000. That's distressing.

I really would think 3 or 4 times before entering this field. If I could go back in time, I would.
 

73BARMYPgsp

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I don't know about the LPC thing, but I did see a VA advertise a neuropsychology position starting at $56,000. That's distressing.

I really would think 3 or 4 times before entering this field. If I could go back in time, I would.
What would I do differently if I could go back in time would be a fantastic thread all by itself.
 

edieb

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Yes, the V.A. now hires LPCs. The NAPPP has an article about this in one of their PDF newsletters (nappp.org) but I am not sure which issue.

One of my internship supervisors, a psychologist, says she would never hire doctoral-level clincians because they cannot bill that much more than master's level clinicians, and, hence, being that PhDs/PsyDs don't bring in that much more revenue, she cannot justify a PhDs/PsyDs salary . In the medical school where I am interning, there are 20 psychiatrists, 2 PhD psychologists and like 40 social workers. One psychologist recently left for the V.A. and was replaces by an MSW. On one of my primary rotations, I was supervised by an LPC. Not sure if this is permitted in APA guidelines, but this was what was being done

Even more distressing is that neuropsychological batteries for subjects being admitted to a research study being conducted here are being conducted and interpreted by an LPC. Even more distressing than this is the fact that doctoral level psychologists (Master's level personnel are also called "psychologist" in my state) are called "Mr" and "Mrs" while the M.D.s are always addressed as "Dr." Today, an intake was coming in for the PhD and the secretary told the patient, "Oh, you won't be seeing a doctor. The intake coordinator assigned you to a psychologist."

It's sad but, in the end, the patient, who many times is being incorrectly diagnosed or treated with non-EBTs, is the one who comes out the loser
 
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alansda

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Considering proposed (if any) mental health legislation changes, should someone like me that's considering applying to a PhD in Psych now, which means I'll be looking for a psych job in about 6+ years, change to a MSW, or what?
 

shiva1008

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I have a couple of questions about this:

1) How much of the trouble new graduates are having finding employment is just because of the current economic situation in general? What are the job prospects for someone graduating with a PhD in Chemistry or Biology right now, compared to Psychology? Does anyone have any info about this (anecdotal or otherwise)?

2) Can a PhD clinical psychologist apply for jobs intended for an LPC or MSW if they are willing to take a pay cut? It would be pretty silly for a psychologist not to be able to apply for a job intended for an LPC, but then again it wouldn't surprise me. Honestly I would consider myself lucky to be making 30-40K in this economic climate, even if it took me 10 years of training to get there.

The reason I am getting in to psychology is because I am learning about life and human nature by following this path. And this knowledge can be applied to other areas, even outside of work. A PhD in clinical, though taking a lot of time, is basically free if you're smart and determined enough to make it happen. So that's how I'm looking at it right now. But I'm still in undergrad. Maybe I will become jaded like other people after some time.

Now please don't flame me everyone. I admit I'm not very knowledgeable about the field; that's why I read a lot more than I post. :)

thx peace
 
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Jon Snow

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1) How much of the trouble new graduates are having finding employment is just because of the current economic situation in general? What are the job prospects for someone graduating with a PhD in Chemistry or Biology right now, compared to Psychology? Does anyone have any info about this (anecdotal or otherwise)?
I don't know to pretty much all of that. Anecdotally, there are jobs.


Can a PhD clinical psychologist apply for jobs intended for an LPC or MSW if they are willing to take a pay cut? It would be pretty silly for a psychologist not to be able to get a job intended for an LPC, but then again it wouldn't surprise me. Honestly I would consider myself lucky to be making 30-40K in this economic climate, even if it took me 10 years of training to get there.

No, horrible plan. 30-40K for the amount of work we do is insulting. But, beyond that, it's not worth the energy expenditure.


A PhD in clinical, though taking a lot of time, is mostly free if you're smart and determined enough to make it happen. So that's how I'm looking at it right now. But I'm still in undergrad. Maybe I will become jaded like other people after some time.
If you're smart enough to get a PhD, tuition free, you are smart enough to go to medical school. Why worry yourself about competing with LPCs and being willing to work for peanuts? 30K is a joke of an income.


I think in general, the jury is out on clinical psychology. I am very curious to see what the future holds. As you said, there's a lot of interesting thing in psychology. I agree. I hope the future is good.
 

JockNerd

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I sometimes find myself wishing I'd gone to med school. It's usually fleeting. I know I wouldn't be happy there, and if I just wanted money I could have been a great corporate lawyer.

I agree. I hope the future is good.
Some of us are determined to MAKE the future of Psychology good, whether it likes it or not.

;)
 

shiva1008

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OK thanks for the responses.

Jon - you seem to have a way of saying things that are very contrary without being inflammatory. I enjoy reading your posts about being jaded with the current state of the field, and I think it adds a much needed counterbalance.

I could probably go to med school, but I don't think I'd like it nearly as much as doing a PhD psych program or practicing psychology. So far I find that the people in psych tend to be very smart and insightful, and probably less competitive on the whole than what you'd find in med school--another reason why I am drawn to the field. My back up plan right now is to become a Physician Assistant with a specialization in psychiatry, after doing a PhD in clinical. I am reluctant to let go of the clinical psych idea because I really want to have that in-depth training, rather than do something like psychiatry or social work where therapy and psych research are not the main focus.
 

Ollie123

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I'm with JN.

I went into this field knowing I'd make piss compared to the other options I strongly considered pursuing (Law, CS, and Medicine). It sucks, but I also know that I'm the sort where a job that earned me substantially more would result in little change in lifestyle beyond more money sitting in the bank collecting dust.

The job market is in the toilet pretty much across the board right now, so I'm not convinced we're any more screwed than the rest of the world. This is undoubtedly a more difficult path then say...my friends in accounting who basically just had to pick where they want to live and then ask for a job.

That said, I love my research. I love the fact that I can basically study whatever the hell I want and call it psychology. Research training is one thing you don't get in any of those other fields - even in medicine you are often doing a very different type of research. I can count on one hand the number of MDs I see doing experimental psychopathology-type work. Clinical training I could take it or leave. We really do have a pretty unique field, and I consider some struggles well worth it to get involved.

When in doubt, I have zero debt so far. I don't want to, but I could go back and hammer out the rest of my CS degree in a year or two.
 

Jon Snow

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That said, I love my research. I love the fact that I can basically study whatever the hell I want and call it psychology. Research training is one thing you don't get in any of those other fields - even in medicine you are often doing a very different type of research.
agree. . . but you can do it as an MD. If I were constructing a career from ground zero, knowing what I know now, I think I could do it from the MD angle and triple my income. It would take about as long.
 

Therapist4Chnge

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agree. . . but you can do it as an MD. If I were constructing a career from ground zero, knowing what I know now, I think I could do it from the MD angle and triple my income. It would take about as long.
I looked at Ph.D/M.D. programs, and if I knew what I know now....I would have gone that route, even though medicine is only really an academic interest of mine; I wouldn't want to practice in a clinical area.

Sadly most psychologists will have to look outside of the profession to make any substantial money. I'd like to be able to afford to do clinical work, but when 3x+ the income is available outside of core clinical areas, it doesn't make sense to take a job for $60k-$70k. I think I have a niche that will be both clinically and financially rewarding, it just depends how far away from clinical work I am willing to drift. If I could teach a couple of classes, research, mentor, and do a bit of consulting....that would be my ideal mix, but I may have to sacrafice a few of those areas for financial freedom.
 

psychmama

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Sadly most psychologists will have to look outside of the profession to make any substantial money. I'd like to be able to afford to do clinical work, but when 3x+ the income is available outside of core clinical areas, it doesn't make sense to take a job for $60k-$70k.
I get your reasoning, but i think I'd be unwilling to accept having made this career change if I don't get to do what I love -- which is clinical work. The sad fact is that persons on the front-lines of human service rarely make the big money. Even though I'd certainly classify clinical psychology as much more than human service -- I think this reasoning still applies. In some ways I wish I was more interested in consulting or research. But I must be honest and admit this is never going to be my first love. Given that I left a perfectly good career to do what I love, I guess I'm stuck with the consequences. For me, thay may mean doing with less money. Of course, I may yet discover niche areas where I can earn more. OR I might be one of those kick-ass private practitioners with the super-prosperous client base. Although I doubt it. We'll see...
 

Ollie123

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Oh Jon, believe me I'm not arguing entering this field was a good financial decision. There are plenty of fields that require way less time and effort for equal or greater pay.

As for the MD - I think it probably depends on what kind of research you want to do. I'd probably be getting weird looks if I was an MD doing this kind of research. Research training in a straight MD seems to start at nonexistant, and pretty much cap out at piss poor. That's not a knock on doctors, its just a different training model and they have enough stuff to learn. Even research-focused MDs often don't have the stats knowledge of a first year grad student.

I'm way more interested in the theory behind psychopathology then anything else. Treatment interests me only to the extent that it tells us more about how the brain works. I have precisely zero interest in racing pills against eachother. It might be possible to make this work as an MD (a few have...Volkow does some work that's more my style, but "I want to do what Nora Volkow does" seems a bit too aspirational and unrealistic), Regardless, its definitely rare and something I'd have had to learn pretty much entirely on my own if I went to med school. The pay sucks, but like I said, it should be plenty given I have relatively simple tastes and will have zero debt.
 

Jon Snow

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Like PhD programs, not all MDs are alike.

I've had the opportunity to work with several very interesting MD researchers. I've been in labs that have both PhD and MD students working together. One of my labs was comprised of the following in various levels of training:

Neurosurgeon/Bioengineering PhD student
Bioengineering PhD Student
Electrical engineer/mathmetician/PhD neuroscience student
MD/PhD student
2 MD students
3 PhD psych sciences fellow (1 comparative)
1 neuropsychology fellow (me, at the time)
4 PhD clinical students

We all pretty much did the same thing. . . granted catered to our level of training and expertise.
 
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Psychology as a profession has been gradually, but methodically losing out to other mental health professions. While the APA was busy competing with the AMA for prestige, it missed the real threats to our livlihood (of course ther are other factors involved as well).

The bottom line is, that to an alarming degree, we are becoming highly-trained but somewhat unemployable experts. In terms of status, power and income, the MD's have sustained their dominance, while at the same time, master's level practitioners such as LCSW's and MFT's have maneuvered within the mental health service system so well, that psychologists are losing not only their traditional status and levels of income, they are increasingly being replaced.

This is a real tragedy for psychology as a viable profession. :(

My own solution after getting my Ph.D. was to not even to look for regular employment, but to begin a private practice as soon as I could. Luckily, I had already begun practicing in California under the licencse of a clinical suprvisor, which enabled me to get my feet wet and begin generating a modest practice, which I gradually developed to full time. This included diversifying my practice, continually developing new areas of expertise and lots of networking. This strategy, which was tough at the beginning, has paid off for me extremely well over the years. :)

Therefore I find it interesting that nobody on this thread even mentioned private practice as an option. While it may not be for those interested primarily in research or academia, private practice for clinical psychologists in particular can be both challenging and very rewarding, as long as they are willing to face the risks and invest in themselves rather than in a job.

Perhaps one reason the private practice option was not even raised here is that there is a certain self-selection in psychology, such that we tend to be more introverted than extroverted. This tendency is further strengthened by years of academic socialization and graduate training. To the extent that this is true, it might make the networking/marketing aspects of private practice more uncomfortabale for us than for other professions, both on the individual and profession-wise (APA) level.

What do you think?
 

Therapist4Chnge

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I find it interesting that nobody on this thread even mentioned private practice as an option. While it may not be for those interested primarily in research or academia, private practice for clinical psychologists in particular can be both challenging and very rewarding, as long as they are willing to face the risks and invest in themselves rather than in a job.
I plan on opening up a multi-disc. office and having a small private practice out of it. I'm looking outside of the profession for more financial stability, though I think if done correctly a private practice can still be sustainable.
 

psychmama

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My own solution after getting my Ph.D. was to not even to look for regular employment, but to begin a private practice as soon as I could. ... This strategy, which was tough at the beginning, has paid off for me extremely well over the years. :)

Therefore I find it interesting that nobody on this thread even mentioned private practice as an option. While it may not be for those interested primarily in research or academia, private practice for clinical psychologists in particular can be both challenging and very rewarding, as long as they are willing to face the risks and invest in themselves rather than in a job.

What do you think?
Although I'm not an entrepreneur by nature, I tend to think I'll end up in private practice. My goal is to get a job after internship in order to pay the bills and get the benefits. In a few years when my kids are off the college, I hope to have built up a part-time practice that I can parlay into full-time private practice. For the fist few years after licensure, I'd like something in a hospital, clinic, counseling center with decent hours -- that way I can hopefully see a few patients one or two nights a week. I've started doing a little networking with therapists in my area in preparation for all of this. They've given me some good tips and strategies.:)

While the idea of private practice is sort of scary, I think it could be very rewarding over the long-haul.
 

psychmama

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3. Neuropsyc and forensic work still remains strong
No joke. The job openings I see most frequently are neuropsych, anything related to children, and forensic work. There are an especially large number of jobs working in corrections, both as an employee and doing per diem work. Pay's not bad either.;)
 

medium rare

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I would encourage any of you willing to put in 2 more years of training to pursue training as a psychiatric NP and/or push hard for Rx authority in your state. Whether you are for, against, or undecided about RxP, the impact it makes on practice (from my experience) is undeniable.

I decided to go back and train as a psych NP 5 years ago because I could not get any of my own patients (mostly child/adolescent) into a psychiatrist for 2-3 months. (Psych NPs in my state have independent authority and essentially practice in the same capacity as a psychiatrist.) What I have learned through this process has solidified my original thinking that we as psychologists are optimally and uniquely trained to provide mental health services from a bio/psycho/social perspective. What was somewhat (although not entirely) surprising to me was how the 'flood gates' would open once I got a prescription pad. My practice has been bursting at the seams for over 2 years now, and hardly a week goes by that I don't get a job offer from someone or some agency. My income is exceptional and I only work with insurance on an out-of-network basis. I wish I had other psychologist/NPs to whom I could send some of these referrals.

My point is that no one cares that I am a psychologist/NP and not a psychiatrist (except maybe some psychiatrists). This is supply-demand economics up close and personal. As psychologists, we are fighting a losing battle if we don't have a seat at 'the table.' Right, wrong, or indifferent, in today's market, having a seat at the table means having medical (Rx) authority. Case mangers, child protective services, physicians, therapists, attorneys, etc. are now suddenly interested in my "expert opinion" and seemingly cling to my every recommendation whereas before it was like pulling teeth to get the attention of some of these parties. Nothing has changed expect my ability to prescribe and, by default, 'direct' treatment.

From a theoretical perspective, this can be infuriating. But on a macro-systemic level it makes more sense. Psychologists don't really have a full seat at the table, and, thus, we are largely ignored. We can whine and complain about how we are not valued and not being utilized to the full extent of our training or about how lesser-trained professionals are supplanting us. But until there is a systemic shift that allows us to be valued, nothing will change.

In mental health today, that shift for us is largely prescriptive authority. Don't get me wrong, RxP is in no way a panacea and comes with its own accouterment of problems. But, it will get psychology to the table and empower us to dictate treatment as we see fit. What I have found most ironic about this process is how I have been able to implement the skills and training I learned and honed as a psychologist (various aspects of psychotherapy, behavioral modification, family and couples therapy, etc) while I have been in the role of a prescriber. I am less likely to prescribe than my physician/NP counterparts and am also able to not prescribe or un-prescribe when I believe it is appropriate.

The demand is clearly there. Psychology needs to do a better job enabling itself to meet the demand.
 
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psychmama

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Great post, medium rare. This really is thought provoking. Other than prescription authority, what does training as a NP entail?
 

Therapist4Chnge

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Great post, medium rare. This really is thought provoking. Other than prescription authority, what does training as a NP entail?
I briefly looked into NP training, though it seemed like a long road to get an RN, then NP. There was a program in the northeast that seemed pretty good, but I couldn't realistically do it until I'm at least a couple years out. For the interim I did thepsych RxP training, though that was more for the education and it was much easier to fit into my schedule. I did find it lacking in a few areas, though I found some weak areas in a number of NP programs....so I guess a person has to choose what they are willing to accept.

I like the idea, though I'm not sure how feasible it will be for most.
 

medium rare

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Great post, medium rare. This really is thought provoking. Other than prescription authority, what does training as a NP entail?
I went back solely for prescriptive authority, but you have to become a RN in order to be a NP. I did an accelerated BSN (Bachelor of Science in Nursing) program that was 14 months in length then went directly into a NP program which took 12 months. I had to pass the NCLEX (nurse licensing exam) and be licensed as a RN in my state prior to starting NP clinical training, but I found the process to be manageable.

This won't be feasible for everyone; the accelerated BSN requires full-time study and it is very difficult to work during that year (although still possible in some instances). RN training is the hard part with all the (fun?) stuff associated with nursing training and long hours (12-hour shifts) at the hospital. With my background as a psychologist, I found the psych NP program very manageable and almost easy to complete.

This whole process represented a little over two years of time for me and the results have been more than worth it. Nursing and NP training have their own issues and being a member of both professions can be somewhat confusing and trying at times, but nothing substantially overwhelming. Combining both professions has been a great fit clinically and has made the demand for my services go through the roof. I would encourage anyone even remotely interested in this to look into it further.
 

Therapist4Chnge

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This won't be feasible for everyone; the accelerated BSN requires full-time study and it is very difficult to work during that year (although still possible in some instances). RN training is the hard part with all the (fun?) stuff associated with nursing training and long hours (12-hour shifts) at the hospital.
I tutored some nursing students in 1st year (science/pharma) courses, so I'm not too concerned with the work, it is the hours doing the dredge work that I would not enjoy.

If you don't mind me asking, were you able to work and pay out of pocket for the courses, as I'd rather not take on any more loans. I'd imagine a state school would be cheaper than a private one, but is that financially manageable?
 

alansda

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medium rare, has something specific to RN or NP training made you more in demand, or is it just because of your prescription rights?
What do you think of going the PA route instead?
 
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