Getting a LCSW, then a PsyD/PhD?

[PsychPhDone]

I can't speak nearly as much to social work as I can to psychology (and even within psychology, my answers as based in being in a PhD program), however, with that said...

I want to live in Texas my whole life, so it made sense to come a year early.

For a PsyD or PhD, even if you do manage to get into a program in Texas, eventually you'll have to match for internship. I'm not sure what the licensing requirements are in Texas, but then you might have to find a postdoc. The good news is that there are both these opportunities in Texas. The bad news is you're not guaranteed to get either an internship or postdoc there. Even if you manage to swing both in state, it's a big state, and there's a good chance you'll have to uproot yourself and/or your family at some point for these training opportunities.

3. Social work school is intense. Psychologists do their 1 yr internship after they finish classes. Social workers do it WHILE taking classes. At NYU we had a 21 hour internship per week, each year, while also taking 4 classes per semester. That totaled 6,000 hours of internship WHILE going to school full time. It's intense. But worth it! You learn SO much!

I have the utmost respect for well-trained LCSWs, just as I have the utmost respect for well-trained PhD-level psychologists, PsyD-level psychologists, and psychiatrists. They all can offer something useful and important, and there can be significant overlap in their skill sets. There are also differences they offer, and I think that's a strength. With that said, I just wanted to point out that all good graduate programs are basically intense. In my PhD program, I am completing my 1-year internship. Prior to this, in my 5 years at the university on-site, I completed clinical practica while taking classes, doing research, and teaching. I also walked uphill both ways in the snow.

It is certainly wise to consider potential incomes before jumping into any degree, but in the end, you can make a respectable salary with hard work with either degree (yes, even the MSW). What you should strongly consider now is what you want to do, and what training/education resonates with you.

Yup. Look into the salaries of those in localities you'd consider, and look into the costs, training, and outcomes of programs in localities you'd consider.

Also, I think it's great that you are considering (a) your career interests and (b) your future family goals and the finances that might entail. I sincerely hope you do find a wife who loves you, whom you love, and who is interested in your being the sole breadwinner and her staying home with 5+ kids. However, since you don't know how or when this might happen, I gently urge you to pursue a career about which you feel passionate and would hopefully give you satisfaction even without that.

Best of luck to you!

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[smalltownpsych]

Oh, not you! You've been very respectful. I meant the poster called "small town psych" who posted a picture of a disheveled man and called him a social worker and then the pic of the professional man and called him a psychologist. How you dress is about the person, not about their career choice. His post was rude and disrespectful and not helpful for this conversation.

I'll continue to say that neither profession is better or more sophisticated. It's all about which path you take. There's a lot of misconception about social workers. Clinical social workers aren't caseworkers. We're clinical psychotherapists, administrators, policy makers and, occasionally have joint JD or MPH degrees. I personally have also a MSEd and MA in Biopsych. I'm an educator, researcher, chairman of a non-profit and a clinical psychotherapist. You make your own path in life. Psychologists have a different focus than social workers. Different degrees with some overlap. They aren't the same degree and one isn't better than the other. They are just different.

Remember the Dr. Seuss book about the Snitches with stars on their bellies and those without stars? Neither was better than the other. They were just different. In the end they learned to get along and respect either other's differences.

The post was meant to be humorous. After all, the disheveled man is a pretty funny actor. I was just playing up a stereotype. Psychiatrists dress even better. I still think psychologists are the best, but maybe I'm biased.

Psychiatrist^
Of course when I saw this guy on celebrity rehab, he had the $500 suit and no socks. Only in LA.

 

[Goobernut]

Recent MSW grads are required to have 6,000 hours of clinical practice but they don't get an advanced (clinical) license until they get an additional 3,000 hours of clinical practice. For a total of 9,000 hours over 4-5 years. That's pretty extensive.

I'm a recent MSW graduate (not in NYC) and I had two practicums. The first was about 800 hours. I had over the required hours by nearly 300 hours. The second Practicum was a required 560 hours, and I had over the required hours then too. I don't see how 6000 is even possible before graduation given the fact there are 2080 work hours in a year and the MSW is a 60 hour program resigned to be completed in two years. My state requires 4000 post degree for clinical licensure. So yes, I'll have over 5000 hours for clinical licensure, but I don't really feel like they compare directly to hours earned pre-graduation in a PhD program. Nor do they compare directly to other masters programs -- their hours are typically counted via face-to face. Typically you are NOT doing therapy for that first practicum and the 4000 hours post grad are not all client face-to-face hours.

I still think I made the right decision for me, and I enjoy my profession, but I don't really think it's fair to state the hours are equal in scope.

 

[wesleysmith]

Agreed. That's the norm around here as well (1000 minimum pre- 4000 post-grad). Not sure how those hours add up or when, but that's considerably higher than what I'm going to do, and from what I understood, my state was on the higher end of required hours.

 

[smalltownpsych]

I'm a recent MSW graduate (not in NYC) and I had two practicums. The first was about 800 hours. I had over the required hours by nearly 300 hours. The second Practicum was a required 560 hours, and I had over the required hours then too. I don't see how 6000 is even possible before graduation given the fact there are 2080 work hours in a year and the MSW is a 60 hour program resigned to be completed in two years. My state requires 4000 post degree for clinical licensure. So yes, I'll have over 5000 hours for clinical licensure, but I don't really feel like they compare directly to hours earned pre-graduation in a PhD program. Nor do they compare directly to other masters programs -- their hours are typically counted via face-to face. Typically you are NOT doing therapy for that first practicum and the 4000 hours post grad are not all client face-to-face hours.

I still think I made the right decision for me, and I enjoy my profession, but I don't really think it's fair to state the hours are equal in scope.

Yeah. I think the problem is when people compare where our professions overlap. It's more important when making a decision to look at the areas where we differ. Emphasis on public policy and systems and effective case management (usually in charge of case managers in my experience) for social work and research and testing for psychologists. Obviously, each psychologist and social worker is going to emphasize different aspects so a private practice LCSW providing therapy and a private practice psychologist providing therapy are going to look about the same and who is better or more successful will depend more on the individual themselves more than the degree. My biggest competition for business in this town are an old school PhD psychologist and an LCSW. There are at least three other LCSWs, two PsyDs and maybe ten LPCs. As a clinical director in my last job in another part of the state I hired an LPC, an MSW, an MFT, and a PsyD. Each individual had their own approach that came from both personal skills and from training. When I wanted a family systems perspective, the MFT was the goto guy, when I needed some research on cutting edge treatments, I went with the PsyD, and when I wanted to make fun of someone's cheap suit that was the MSW. Not true, she was actually very attractive and never wore corduroy blazers, I just can't stay serious for a whole post!

 

[Lurking Oracle]

Agreed. The overlap is really quite minimal (maybe 10%, but honestly likely less than that).

 

[BX1959]

This has been a great thread so far--thanks everyone! (I rediscovered it by googling "lcsw to psyd," since I'm still thinking about all the different possibilities.) Oh, and I'm an awful dresser, so I think I'm a lock for an LCSW

There's been a lot of great discussion about the merits of the LCSW versus a PhD or PsyD, but not as much analysis of the idea of getting an LCSW first, and then pursuing a PsyD or PhD. First, is this a rare path to go down? There must be at least a few others who try it, based on this CSWE article:

http://www.cswe.org/File.aspx?id=59954
"“There is anecdotal evidence that many social workers are pursing practice doctorates in other professions (particularly the PsyD) precisely because of the lack of such an option in social work education.”
I wish this evidence were a little less anecdotal though
So far, I think the LCSW --> PsyD/PhD path could make sense, IF:
1. I really enjoy work in counseling/therapy, and would want to further develop my skills and qualifications in the mental health field.
2. The LCSW alone proves to be insufficient for meeting my personal and career goals. It may end up being 'all I need.'

As far as salary comparisons go (and when we're talking about supporting a family, this is relevant), I recognize that LCSW vs. PsyD/PhD insurance reimbursement rates are pretty similar. And yet, based at least on the (potentially very inaccurate) salary data on the internet, the median salary for psychologists is considerably higher than the median for LCSWs. So would it be wrong for me to expect a salary increase if I get a PsyD from a good school?

As far as what I'm looking for in a PsyD program, I would want to go to a school connected to a university, like Baylor or Rutgers, and ideally one where I would pay little/no cost. I know these are extremely competitive programs, but it wouldn't make sense to pay $100,000 or more to enroll in a program with a poor reputation.

Should I also be considering PhD programs in clinical psychology? The reason why I haven't so far is that these require extensive research experience as a pre-requisite for enrolling, to the best of my knowledge. I wouldn't want to spend years gaining that experience, only to not get in anyway since many of the programs are very competitive. (I decided not to do a thesis my senior year, since at the time I was planning to go to seminary . . . that was before I decided I wanted to get married instead!) I also feel that a LCSW would give me more than enough clinical experience to get into a good PsyD program, especially if I can do well on the GREs again. If I'm being irrational in closing the door to the PhD route, though, just let me know.

As far as staying within Texas goes, of course I would be willing to relocate for a good program or an internship opportunity. I just meant that I would prefer to settle in Texas once I have an established career.

Finally, I'm also thinking of pursuing an MBA after the MSW, as opposed to a psychology doctorate. I think a combined MSW/MBA education would open up lots of doors in the nonprofit and for-profit fields.

Thanks as always for your input.

 

[deleted343839]

Finally, I'm also thinking of pursuing an MBA after the MSW, as opposed to a psychology doctorate. I think a combined MSW/MBA education would open up lots of doors in the nonprofit and for-profit fields.

It sounds like you need to spend some more time figuring out where you want your education to take you. I think the LCSW to PsyD/PhD path can happen but is one of those things that people don't plan for. They change their minds about social work once they're in the field, and they decide that psychology offers the training and skills they need for the kind of career they envision. This happens in other fields too. As a rather flawed analogy (so please don't flame me for this), if you look at those folks who move from a nursing career to a career in medicine, you will find zero who planned it that way from the start. Since you're already expressing some doubts about social work, I think it's in your best interest to learn more about career options within the field and then decide if those seem like "enough" for you. It makes no sense to put in the time and effort and expense to enter a field when your mindset about it is "maybe it won't work out."

If what you really want is to be a psychologist, then apply to PsyD and PhD programs (yes, I said "and" deliberately - it's premature to rule out the PhD option). If you need to take some more time to make yourself competitive, then do that. A social work degree is not ideal preparation for doctoral work in psychology. The vast majority of incoming psychology graduate students have no professional clinical experience - that should tell you something about what is valued. Don't make the decision based on salary as the primary factor; I know social workers in private practice who are doing quite well for themselves and psychologists who are underpaid.

 

[jheda]

If you decide to take insurance, you will make considerably more money as a psychologist. You just have to weigh the increased income against the years of opportunity cost and possible student loan debt. I would recommend looking into the reimbursement rates for the major insurers where you live and then running the numbers.

I am an LCSW with Post Graduate Training in Child Psychotherapy. I am now 78 years old and my income is quite substantial. The key to success in private psychotherapy regardless of the degree is to demonstrate competence in a niche that is needed and wanted by persons with the ability to pay.
Since 1976, my practice has been located in Westwood or Brentwood. Both communities are affluent. For twelve years, my office rent in Brentwood was $7,500 per month. I now provide coaching for disruptive physicians from my home in Brentwood. I currently receive in advance $5,500 for each physician client.
If you practice in a middle class area, your income at best will be middle class. If I had chosed to practice in Watts, I sure I would have retired long ago on Social Security.

 

[MysteryDiagnosis]

Often I saw insurance reimbursement rates (lets say per hour of generic psychotherapy) at ~$130/hour for MD/DO, ~$80/hour for PhD/PsyD, and ~$75/hour for LCSW/LPC/MFT/etc. - If PP is your ultimate goal, I don't think you *need* to become a doctoral level provider.

If I was not interested in the flexibility offered by a clinical psych PhD (training in stats, methods, practice, and teaching), I wouldn't have pursued a PhD/PsyD - I would have either pursued an MPH, so I could stay involved in research/stats, or an MSW, so I could pursue licensure as an LCSW.

I know this thread is old I came across it and started reading... Why does an MD get paid so much more than a Psychologist for psychotherapy, they have less training in it and rarely do much of it.

 

[psych.meout]

I know this thread is old I came across it and started reading... Why does an MD get paid so much more than a Psychologist for psychotherapy, they have less training in it and rarely do much of it.

MDs (you mean psychiatrists, right?) don't get paid more for psychotherapy. Psychiatrists are making more, because they are likely focusing on medication management, not psychotherapy. The medication management takes far less time than psychotherapy, 15 to 20 minutes per patient vs. 45 to 60 minutes, meaning that they can fit more patients in per work day. They also face less competition for medication management, because this work is far less often completed by mid-level practitioners (maybe with psychiatric nurse practitioners at times) compared to psychotherapy (e.g. various master's-level counselors and social workers).

 

[deleted760483]

But everything isn't equal, is it?

It kind of is. The OP is the same person in both hypothetical degree scenarios. I don't know why his work ethic would change depending on his degree.