I got into multiple doctoral programs.. So why do I feel like giving up?

[flowerpsych]

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I got accepted to graduate school–3 PsyDs this cycle. I should be excited.. But honestly? I'm exhausted.

I have ADHD, and despite therapy, coaching, and medication... sometimes it feels like I'm just barely making it through. Yeah, I had a great GPA, solid experiences, strong letters of recommendation–but I still can't believe I got this far. I'm feeling this state of 'what does it matter anymore?' And some days, I just want to give up.

I keep having the internal battle: Am I questioning my career path because of ADHD exhaustion, or is this truly not the right path for me?

My mind is saying that the only reason I doubt myself is because of things tied to my ADHD. My life is perfect.. except for when I'm struggling to read, write, do ADL's, sleep, etc. People in my academic circle don't know–it's not something I could share with fear of people speaking about my work negatively, or having a bias against my abilities. I get my work done. Behind closed doors, it's hard. And there is impairment. I feel like I'm fighting an uphill battle, constantly trying to navigate a boat in choppy waters.

If my ADHD isn't going to get much better– and if I'm still going to be masking, exhausted, and drained despite utilizing all of my resources–then what?

Part of me believes that the people who achieve great things push past their feelings. That no matter how hard it gets, they keep going because feelings are temporary and change, but goals are forever. But I just keep asking myself: Why does this path have to be this hard? And if I'm already exhausted simply doing everything I was to get into these programs, should I make things even harder by committing to this?

My rational self knows I'd regret not pursuing a doctoral program. The flexibility of the degree, specialized training, ability to provide assessments and truly help people in the way I wanted to. It's the big awesome end goal. I can't just give that all up.. can I? It's everything I wanted. But.. I don't want to grind myself to the bone getting there.

Has anyone felt this way? How did you figure out if it was just burnout or a sign that you should change paths? Would appreciate a challenge if there is something I am not seeing about this situation because I'm kind of being a negative nancy rn.

 

[Neurocaterpillar]

Congrats on your acceptances!

It’s good that you are able to recognise how your body feels. A doctoral program is really tough and exhausting. I did not feel like this before it started but by second year, I was completely burnt out like I’ve never been in my life. Try to talk to some supportive friends or family, see if you’re able to develop some self care activities before the program starts.

 

[R. Matey]

I got into two or three Psy.D. programs my first year applying and the amount of prospective debt made me physically nauseous. I'm very glad that I ended up rejecting those offers only to get in a fully funded program a year later.

OP, it sounds like your career goals are vague. For example, you say you want to do assessment, but in what context? Every intake is an assessment of sorts and you don't need a doctorate to do those. My suggestion would be to do some work on yourself to figure out exactly what you want to do with this degree before pursuing it and then ask yourself if a master's degree or another career path might suit you better.

 

[The Cinnabon]

I got into two or three Psy.D. programs my first year applying and the amount of prospective debt made me physically nauseous. I'm very glad that I ended up rejecting those offers only to get in a fully funded program a year later.

OP, it sounds like your career goals are vague. For example, you say you want to do assessment, but in what context? Every intake is an assessment of sorts and you don't need a doctorate to do those. My suggestion would be to do some work on yourself to figure out exactly what you want to do with this degree before pursuing it and then ask yourself if a master's degree or another career path might suit you better.

I'm glad someone said this as I honestly do wonder how so many, particularly self-funded PsyD, students mention something vague about "Oh, I want to do assessment but don't like research."

I always have a weird gut reaction where I'm like "but assessment is so grounded in research, what?" that I just don't have when talking with students, usually from funded PhDs, who may be interested in say forensics or neuro. There's never any doubt that this path wasn't a clearly planned out path.

 

[Sanman]

Congrats on the acceptances. Here is the truth, this a job plain and simple. If you are like most people, you do it to support yourself. Only you can answer whether this is the correct fit for you. I am not sure of your experiences thus far. However, if you are unsure of if this is right for you. Maybe consider deferring acceptance and getting a job in the field for a year. If doing the work makes you miserable, reconsider. If it energizes you, it may change you perspectives on acceptance as this may simply be burnout. Good luck.

 

[PsyDr]

Yeah, you're putting forth all this effort because you don't want to do something. /s

 

[silverway]

My PhD program was pretty hard. But for me and my undiagnosed ADHD, it was also a surprisingly good fit. Being in a cohort of 6, with a kind and supportive advisor, and studying material I was mostly super passionate about, I did better academically in grad school than at any point in my life before. My apartment was usually a mess, though, and my self-care was just a step or two above passable. And I went into it feeling the opposite of burnt out— I was two years out of college, and itching to be a student again.

I don't want to give you an overly rosy view of things. But try to get a sense of what kind of supports you'd have or lack in your specific program and how that might impact you. And waiting to start might help you feel excited and better prepared to do grad school. A year or two probably won't make or break your future but it might help you feel more certainty and enthusiasm for clinical psychology or whatever else you pursue.

 

[flowerpsych]

Congrats on your acceptances!

It’s good that you are able to recognise how your body feels. A doctoral program is really tough and exhausting. I did not feel like this before it started but by second year, I was completely burnt out like I’ve never been in my life. Try to talk to some supportive friends or family, see if you’re able to develop some self care activities before the program starts.

Ty for sharing what it was like for you!

Are there systems that worked for the burnout?

 

[flowerpsych]

I got into two or three Psy.D. programs my first year applying and the amount of prospective debt made me physically nauseous. I'm very glad that I ended up rejecting those offers only to get in a fully funded program a year later.

OP, it sounds like your career goals are vague. For example, you say you want to do assessment, but in what context? Every intake is an assessment of sorts and you don't need a doctorate to do those. My suggestion would be to do some work on yourself to figure out exactly what you want to do with this degree before pursuing it and then ask yourself if a master's degree or another career path might suit you better.

I'm glad someone said this as I honestly do wonder how so many, particularly self-funded PsyD, students mention something vague about "Oh, I want to do assessment but don't like research."

I always have a weird gut reaction where I'm like "but assessment is so grounded in research, what?" that I just don't have when talking with students, usually from funded PhDs, who may be interested in say forensics or neuro. There's never any doubt that this path wasn't a clearly planned out path.

You guys bring up good points about the assessment comment I said. My long-term career goal was to specialize in assessments for ADHD, although I have enjoyed learning about different psychopathology and know I would be exposed to it all during grad school. And I know I can't be that narrow in my interest when I do go to school, as we learn about everything in the DSM.

Long term I really just want to be the one go-to ADHD specialist in my area, and even if I did a Master's in therapy I would be specializing in therapy for adults with ADHD and autism-- they are the population I gravitate towards the most since I have experience with those diagnoses both personally and professionally.

I wanted to be able to provide those diagnostic services, like test battery (although I hear that structured interview is more important for ADHD) and formal write up, as I just don't think that diagnosis for ADHD/autism is taken seriously if it's given from a Master's level clinician. Although I've seen LCSW and LMHC marketing themselves for "ADHD evaluations" on PsychologyToday.. Idk what those would look like though.. probably are not getting approved everywhere.

 

[flowerpsych]

Congrats on the acceptances. Here is the truth, this a job plain and simple. If you are like most people, you do it to support yourself. Only you can answer whether this is the correct fit for you. I am not sure of your experiences thus far. However, if you are unsure of if this is right for you. Maybe consider deferring acceptance and getting a job in the field for a year. If doing the work makes you miserable, reconsider. If it energizes you, it may change you perspectives on acceptance as this may simply be burnout. Good luck.

Do you have any suggestions for what a good next job would be in the field? I have worked as a psychometrist, RBT, and am currently at my uni lab doing research thingssss... not sure what else to throw myself into

 

[smalltownpsych]

There is an optimal level of stress and if we are in a chronically over stressed state, symptoms increase. If one already has an identified vulnerability and is taking on a big challenge, one should expect to be pushed past their limits and have symptoms. The only solution for any of us is to know our limits and work within them. I have accomplished what I have so far in my career despite significant obstacles mainly because I recognized this and forged a path that worked for me. Part of that was leaning on my wife and being very explicit with what I needed to assist me as the path was pushing me over the limits at different times. Having a therapist or other supports that understand how to facilitate this process instead of trying to make you into someone else is also very useful.

 

[R. Matey]

Long term I really just want to be the one go-to ADHD specialist in my area, and even if I did a Master's in therapy I would be specializing in therapy for adults with ADHD and autism-- they are the population I gravitate towards the most since I have experience with those diagnoses both personally and professionally.

Something to think about is psychotherapy does not treat either ADHD or autism by itself. In ADHD, the current thinking is that CBT-ADHD can be helpful for adults complaining of ADHD symptoms if they are already medication-treated. The effects are far more variable in non-medication treated adults. It might be fine in the most mild presentation of ADHD, but even then it's unclear. In autism, depending on the severity, psychotherapy may be of no benefit at all. If you are thinking about folks with more milder presentations with comorbid conditions (e.g., an anxiety disorder) than psychotherapy could be of some benefit, but it's typically to treat the comorbid condition rather than the autism itself.

Translating this into a business perspective (assuming you're doing this in private practice), you will be competing with ADHD skills coaches and other psychologists and psychiatrists who also market these services. Psychiatrists have an advantage on you because they can provide both the coaching and make medication adjustments (especially now with the psychotherapy add on for E/M), if they're confident in their own ability to diagnose ADHD. You may find that this is an insufficient specialty to fill a practice considering that many will just choose to seek out medication and be done with it.

I'm telling you this underscore my point to ensure that you have knowledge about the field you are entering before you commit yourself to over $100k in tuition and nearly a decade of your life in training. It may not be the outcome you're anticipating.

 

[borne_before]

I got accepted to graduate school–3 PsyDs this cycle. I should be excited.. But honestly? I'm exhausted.

I have ADHD, and despite therapy, coaching, and medication... sometimes it feels like I'm just barely making it through. Yeah, I had a great GPA, solid experiences, strong letters of recommendation–but I still can't believe I got this far. I'm feeling this state of 'what does it matter anymore?' And some days, I just want to give up.

I keep having the internal battle: Am I questioning my career path because of ADHD exhaustion, or is this truly not the right path for me?

My mind is saying that the only reason I doubt myself is because of things tied to my ADHD. My life is perfect.. except for when I'm struggling to read, write, do ADL's, sleep, etc. People in my academic circle don't know–it's not something I could share with fear of people speaking about my work negatively, or having a bias against my abilities. I get my work done. Behind closed doors, it's hard. And there is impairment. I feel like I'm fighting an uphill battle, constantly trying to navigate a boat in choppy waters.

If my ADHD isn't going to get much better– and if I'm still going to be masking, exhausted, and drained despite utilizing all of my resources–then what?

Part of me believes that the people who achieve great things push past their feelings. That no matter how hard it gets, they keep going because feelings are temporary and change, but goals are forever. But I just keep asking myself: Why does this path have to be this hard? And if I'm already exhausted simply doing everything I was to get into these programs, should I make things even harder by committing to this?

My rational self knows I'd regret not pursuing a doctoral program. The flexibility of the degree, specialized training, ability to provide assessments and truly help people in the way I wanted to. It's the big awesome end goal. I can't just give that all up.. can I? It's everything I wanted. But.. I don't want to grind myself to the bone getting there.

Has anyone felt this way? How did you figure out if it was just burnout or a sign that you should change paths? Would appreciate a challenge if there is something I am not seeing about this situation because I'm kind of being a negative nancy rn.

Dude, i've got ADHD. You kinda sound like me at times (even now).

Sounds like a mix of the imposter syndrome, stress of the unknown, and having to make a big commitment? You're exhausted and you're wondering if you can keep going.

I think you need to be in this field and you're kind of struggling with your ego a little bit. Lot's of "I"s in your statement. But, it's pretty clear you didn't get into this hustle and walk this path for "I". So let's get back to why you went into this. I think a lot of people like "us" need people like you in the field. You have the ability to do a lot for people like you.

The other thing is that graduate school is hard. But so is not going or trying. Regret is also hard.

Let's slow your roll a little bit. Maybe focus on what school you're going to go to?

You're also being pretty hard on yourself. Sometimes I struggle on vacations because it's like my mind doesn't know what to do when I'm not busy. I wonder if the battle for getting into grad school is over and your mind is kinda looking for the next fight.

 

[borne_before]

I got accepted to graduate school–3 PsyDs this cycle. I should be excited.. But honestly? I'm exhausted.

I have ADHD, and despite therapy, coaching, and medication... sometimes it feels like I'm just barely making it through. Yeah, I had a great GPA, solid experiences, strong letters of recommendation–but I still can't believe I got this far. I'm feeling this state of 'what does it matter anymore?' And some days, I just want to give up.

I keep having the internal battle: Am I questioning my career path because of ADHD exhaustion, or is this truly not the right path for me?

My mind is saying that the only reason I doubt myself is because of things tied to my ADHD. My life is perfect.. except for when I'm struggling to read, write, do ADL's, sleep, etc. People in my academic circle don't know–it's not something I could share with fear of people speaking about my work negatively, or having a bias against my abilities. I get my work done. Behind closed doors, it's hard. And there is impairment. I feel like I'm fighting an uphill battle, constantly trying to navigate a boat in choppy waters.

If my ADHD isn't going to get much better– and if I'm still going to be masking, exhausted, and drained despite utilizing all of my resources–then what?

Part of me believes that the people who achieve great things push past their feelings. That no matter how hard it gets, they keep going because feelings are temporary and change, but goals are forever. But I just keep asking myself: Why does this path have to be this hard? And if I'm already exhausted simply doing everything I was to get into these programs, should I make things even harder by committing to this?

My rational self knows I'd regret not pursuing a doctoral program. The flexibility of the degree, specialized training, ability to provide assessments and truly help people in the way I wanted to. It's the big awesome end goal. I can't just give that all up.. can I? It's everything I wanted. But.. I don't want to grind myself to the bone getting there.

Has anyone felt this way? How did you figure out if it was just burnout or a sign that you should change paths? Would appreciate a challenge if there is something I am not seeing about this situation because I'm kind of being a negative nancy rn.

You also sound like someone, and this totally common for people with disabilities, and even myself, that you're struggling with your disability identity. I get the vibe that you're viewing the world as if your disability defines you. Hell, getting the diagnosis could have been the first time you ever even had your struggles validated. But, you're also an individual.

I've got ADHD, but am so much more. I've got a name, some people call me dad, some people call me son. A kid in my kid's preschool called me Mr. Poo Poo yesterday. I felt the urge to correct them to "Dr. Poo Poo." I'm extroverted to a fault sometimes. But I also need time alone. I used to think my extroversion was because of the ADHD, but I teared up when I realized my tendency toward extroversion was just me. ADHD is part of me. But, it's not who I am.

When you apply to grad school, so much of it personal statements and marketing that you also might forget that you are individual, unique, aware, conscious.

Maybe go do something selfishly fun. Did you even hit the bars with homies to celebrate? These days I'd go find a ruin and go explore by myself while listening to some dumb audiobook or spend too much time on a bike. Three acceptances is no small feat. Your bucket sounds empty.

 

[quickpsych]

Ty for sharing what it was like for you!

Are there systems that worked for the burnout?

Congrats on multiple acceptences. In terms of systems or self care strategies to avoiding burnout, there's a few things to consider:

1.) Most programs are cohort based models which means you'll be spending a lot of time with a small group of fellow students for years. While you won't all necessarily become BFFs, good programs try to help new cohorts get some cohesiveness and encourage at least spending some time together outside the classroom and trainings. Our cohort had a tradition of going to one of 2-3 rotating restaurants/arcades after the last final each semester. We also had a few who hosted gatherings at their places a few times a year. A few of us are into video games so we'd play online together some evenings. We even went on one weekend trip renting a house in a resort area and hanging out. Results may vary but the point is everyone will be in the same boat of being under stress and it's nice to know you're not alone in the program or the process.

2.) That said above, it's also important to make time completely outside of the program and cohort for self care and activities not linked to the program. For me, I had a weekly tradition of going to the mall after a later class (well this was least 8 years ago by now lol) and also as someone who enjoyed gaming (which can be a relatively cheap and easy relaxing activity you can in the evenings after a long day). Also creating a reasonable and realistic exercise routine will be important alongside good study habits and routines.

3.) You should before the start of each semester review your upcoming semester course load, practicums, other obligations and develop a realistic routine and schedule...make sure you carve out time for relaxing/self care. So think of something you like to do that doesn't cost much, is fun for you, and can feasible be done regularly. Some semesters will be much harder and more packed than others, going into each semester with a plan of managing your time realistically will be a big help; and you will have to some semesters make sacrifices and set firm boundaries to make sure you feel you have time to do what you need.

As for your ADHD; I share a cautionary tale: one cohort member ended up getting dismissed from the program in about YII because their ADHD significantly impacted their ability to not only pass some courses but brought up concerns among the facility as to whether this student would be able to perform competently both in practicums/internships and also be able to pass Comps, EPPP, and practice. I recall they were offered an opportunity after being put on probation in the program to "take a 1-3 semesters off" and reassess after that if both her and the program felt it was in the best interest to continue. This student refused that and said give me one semester and I'll do better. Spoiler: They did not and ended up with at least two courses below the grade threshold for dismissal after probation. They now work in a rural area has a ranch hand caring for horses and as far as i know they're loving it. They just needed to find what they could enjoy doing and focus on doing as well, for them being outdoors and working with horses which they had grown up with was more manageable than sitting in classrooms for hours a day. '

My point with this story is to 1.) be aware of how your ADHD impacts your day to day, and also to reflect on what strategies helped you in undergrad to get to where you are with three acceptances...and strengthen those strategies and 2.) make sure you have a good idea of why you want to get your doctorate and consider first is there something else you'd rather be doing and if so see if you can defer acceptance and explore that something else.

 

[jdawg2017]

Something to think about is psychotherapy does not treat either ADHD or autism by itself. In ADHD, the current thinking is that CBT-ADHD can be helpful for adults complaining of ADHD symptoms if they are already medication-treated. The effects are far more variable in non-medication treated adults. It might be fine in the most mild presentation of ADHD, but even then it's unclear. In autism, depending on the severity, psychotherapy may be of no benefit at all. If you are thinking about folks with more milder presentations with comorbid conditions (e.g., an anxiety disorder) than psychotherapy could be of some benefit, but it's typically to treat the comorbid condition rather than the autism itself.

Translating this into a business perspective (assuming you're doing this in private practice), you will be competing with ADHD skills coaches and other psychologists and psychiatrists who also market these services. Psychiatrists have an advantage on you because they can provide both the coaching and make medication adjustments (especially now with the psychotherapy add on for E/M), if they're confident in their own ability to diagnose ADHD. You may find that this is an insufficient specialty to fill a practice considering that many will just choose to seek out medication and be done with it.

I'm telling you this underscore my point to ensure that you have knowledge about the field you are entering before you commit yourself to over $100k in tuition and nearly a decade of your life in training. It may not be the outcome you're anticipating.

As someone in neuropsych, I would strongly echo this point.

Evaluating and treating ADHD is not what I would recommend as a specialization. The vast majority of mental health providers can and do make this diagnosis based on a clinical interview. Psychiatrists dominate the market because of their ability to prescribe meds, which in my experience a vast majority of people with ADHD want to take because they do help. Neuropsychologists may also handle a lot of referrals, even though formal cognitive testing adds little to nothing in terms of diagnosis (in fact it often contradicts the diagnosis when someone does well on all tests, including attention/EF tests). Some people with ADHD who have comorbid anxiety and/or depression will pursue and can benefit from a course of CBT. Even fewer might pursue executive functioning coaching, but I’m not sure how popular this is anymore given the hundreds of self-help books on this topic that are out there.

If you go the ASD route I’d probably focus on evaluating and treating children, as the research most strongly supports early intervention.

Both of the above could be done with a master’s degree, FWIW.

 

[RxPsych]

How about becoming a spiritual healer/shroom addict and working on one of RFK Jr.'s wellness farms for the people with ADHD that are addicted to meds and need a nutritional balance? You'd save tons of money in loans, wouldn't need to worry about research, and would probably make more money.

/s (just in case)

 

[borne_before]

How about becoming a spiritual healer/shroom addict and working on one of RFK Jr.'s wellness farms for the people with ADHD that are addicted to meds and need a nutritional balance? You'd save tons of money in loans, wouldn't need to worry about research, and would probably make more money.

/s (just in case)

I've always wanted to try a microdose of psilocybin. But, not to get better at work or anything lame like that.

 

[AcronymAllergy]

As someone in neuropsych, I would strongly echo this point.

Evaluating and treating ADHD is not what I would recommend as a specialization. The vast majority of mental health providers can and do make this diagnosis based on a clinical interview. Psychiatrists dominate the market because of their ability to prescribe meds, which in my experience a vast majority of people with ADHD want to take because they do help. Neuropsychologists may also handle a lot of referrals, even though formal cognitive testing adds little to nothing in terms of diagnosis (in fact it often contradicts the diagnosis when someone does well on all tests, including attention/EF tests). Some people with ADHD who have comorbid anxiety and/or depression will pursue and can benefit from a course of CBT. Even fewer might pursue executive functioning coaching, but I’m not sure how popular this is anymore given the hundreds of self-help books on this topic that are out there.

If you go the ASD route I’d probably focus on evaluating and treating children, as the research most strongly supports early intervention.

Both of the above could be done with a master’s degree, FWIW.

I agree. I think at the moment, a person could easily fill an entire assessment practice with ADHD and adult autism evaluations (and nothing else). I commonly see folks in the community add cognitive testing to at least the ADHD evals for a variety of reasons, although I'm not sure how often insurance is willing to pay for that.

But I don't know how long that will be the case. There's been a decent demand for it for the entirety of my career (going back to early grad school), but it's definitely higher now than in the past. So it'll probably decline at some point.

 

[R. Matey]

I agree. I think at the moment, a person could easily fill an entire assessment practice with ADHD and adult autism evaluations (and nothing else). I commonly see folks in the community add cognitive testing to at least the ADHD evals for a variety of reasons, although I'm not sure how often insurance is willing to pay for that.

My experience is that if they add some kind of differential, some insurance companies will pay.

 

[Freud’sMommy]

If it’s not a clear “hell yeah!” then I’d advise anyone to consider options other than a doctoral program.

It’s a tough, grueling process that, even in supportive programs and labs, will chew you up. The fact that you already feel the way you do despite doing all the correct things and before year one begins does not bode well. If you choose to enroll, don’t forget to engage with your school’s disability office and get all the supports you’re eligible for.

Grad school isn’t for everyone, and that’s okay. Good luck.

 

[Doctor Eliza]

Are you disappointed in the 3 programs you got into? Like were you hoping for something funded and didn't get that?

 

[cara susanna]

I personally would not go the PsyD/PhD route unless the program offered funding.

 

[borne_before]

If it’s not a clear “hell yeah!” then I’d advise anyone to consider options other than a doctoral program.

It’s a tough, grueling process that, even in supportive programs and labs, will chew you up. The fact that you already feel the way you do despite doing all the correct things and before year one begins does not bode well. If you choose to enroll, don’t forget to engage with your school’s disability office and get all the supports you’re eligible for.

Grad school isn’t for everyone, and that’s okay. Good luck.

I dunno, I think it's a huge decision. I was always struck by the enormity of the task for that hell yeah.

 

[flowerpsych]

Dude, i've got ADHD. You kinda sound like me at times (even now).

Sounds like a mix of the imposter syndrome, stress of the unknown, and having to make a big commitment? You're exhausted and you're wondering if you can keep going.

I think you need to be in this field and you're kind of struggling with your ego a little bit. Lot's of "I"s in your statement. But, it's pretty clear you didn't get into this hustle and walk this path for "I". So let's get back to why you went into this. I think a lot of people like "us" need people like you in the field. You have the ability to do a lot for people like you.

The other thing is that graduate school is hard. But so is not going or trying. Regret is also hard.

Let's slow your roll a little bit. Maybe focus on what school you're going to go to?

You're also being pretty hard on yourself. Sometimes I struggle on vacations because it's like my mind doesn't know what to do when I'm not busy. I wonder if the battle for getting into grad school is over and your mind is kinda looking for the next fight.

Thanks so much for this, you spoke to my soul, like actually, in so so many ways! Wow. I'm going to do a few things you mentioned here.

 

[flowerpsych]

As someone in neuropsych, I would strongly echo this point.

Evaluating and treating ADHD is not what I would recommend as a specialization. The vast majority of mental health providers can and do make this diagnosis based on a clinical interview. Psychiatrists dominate the market because of their ability to prescribe meds, which in my experience a vast majority of people with ADHD want to take because they do help. Neuropsychologists may also handle a lot of referrals, even though formal cognitive testing adds little to nothing in terms of diagnosis (in fact it often contradicts the diagnosis when someone does well on all tests, including attention/EF tests). Some people with ADHD who have comorbid anxiety and/or depression will pursue and can benefit from a course of CBT. Even fewer might pursue executive functioning coaching, but I’m not sure how popular this is anymore given the hundreds of self-help books on this topic that are out there.

If you go the ASD route I’d probably focus on evaluating and treating children, as the research most strongly supports early intervention.

Both of the above could be done with a master’s degree, FWIW.

I had no idea I could do what I wanted to with a Master's degree! Whenever I have told people about my assessment interests they have continued to give me advice in the doctorate lens. I also didn't think either conditions could be diagnosed at the Master's level, especially if one needs the diagnosis for medication or disability services.

 

[ClinicalABA]

As you might imagine, this is a relatively common concern/feeling among people making graduate school decision. As others have pointed out, doctoral psych training can be (and to some extent should be) a big pain in the @ss.

Don't discount the extent to which this is also a typical phase of development and reaction to it. Assuming you're of typical undergrad senior age, you're at the part of life where things start to get more real. You are getting the privilege to make much bigger decisions, with the responsibilities of dealing with the consequences. It can be tough to finalize realized "what you want to be when you grow up" and commit significant time and resources to becoming that. It's not unique to psych graduate school. You obviously want to choose a psych graduate program wisely (and you have some good advice about doing that above and on other threads). However, deferring that decision now will just put it off until later. Just be certain of what your goal is in accepting an admission offer and-just as importantly- declining all admission offers.

 

[flowerpsych]

Are you disappointed in the 3 programs you got into? Like were you hoping for something funded and didn't get that?

No, not that. Funding has been at the back of my mind if I'm being honest, as there are competing motivations that are more important (for me).

 

[flowerpsych]

I agree. I think at the moment, a person could easily fill an entire assessment practice with ADHD and adult autism evaluations (and nothing else). I commonly see folks in the community add cognitive testing to at least the ADHD evals for a variety of reasons, although I'm not sure how often insurance is willing to pay for that.

But I don't know how long that will be the case. There's been a decent demand for it for the entirety of my career (going back to early grad school), but it's definitely higher now than in the past. So it'll probably decline at some point.

You say that a person could easily fill an entire assessment practice with ADHD and autism evals.. at the masters or doctorate level?

 

[ClinicalABA]

I had no idea I could do what I wanted to with a Master's degree! Whenever I have told people about my assessment interests they have continued to give me advice in the doctorate lens. I also didn't think either conditions could be diagnosed at the Master's level, especially if one needs the diagnosis for medication or disability services.

This all depends on a combination of local regulations/policies. A lot of it (especially in regards to ASD diagnosis) is dictated by state laws and insurance practices regarding who has to make the diagnosis in order for insurance to be mandated to pay for treatment. In my primary state of practice (MA) an autism diagnosis from Master's level mental health professional will not qualify you for insurance funded ABA treatment (it has to be a from a psychologist, MD/DO, of Clinical Nurse Practitioner). In the other state where I'm licensed (CT), and ASD diagnosis from and masters level social worker will qualify you for ABA services up until age three (through the state Birth-to-Three program), but no for post-3 insurance funded ABA. It's all pretty complicated.

That said, you can do a lot of assessment and diagnosis with a Master's level mental health degree/licensure. I'd guess the modal client in psychotherapy has never seen a doctoral level clinician. I actually taught psych diagnosis classes in a master counseling program. I still think that there's more you can do with a doctoral level psych degree/license, with more flexibility and the potential for higher pay, but there are a lot of relatively happy, professionally satisfied master's level clinicians out there who seem to be doing ok making their mortgage and car payments.

 

[ClinicalABA]

You say that a person could easily fill an entire assessment practice with ADHD and autism evals.. at the masters or doctorate level?

My practice is exclusively autism evals limited to kids under 3 (and I rarely see a kid over 2 years old. There are 3 other psychologists under the umbrella of the larger group practice (at other offices throughout the state) who do the same. We all have very full schedules. You have to have be a licensed psychologist (doctoral level) to do this here.

 

[ClinicalABA]

No, not that. Funding has been at the back of my mind if I'm being honest, as there are competing motivations that are more important (for me).

It really should be at the front of your mind. Taking on large amounts of debt to finance even a really good doctoral psych education is a risky thing and in most cases should be avoided. Taking on large amounts of debt to fund a poor-mediocre education at a large-cohort, for profit-professional school is even riskier. Yeah- many people take that route and make it work professionally and financially, but MANY do not! You can't rely on such programs to honestly evaluate your potential to be successful, in the same way that you can with funded, university-based doctoral programs.