Important: Is obtaining a PhD in Clinical Psychology the best option for my career goals?

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BBH_Researcher

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Like many undergraduate students who have majored in psychology, I was single minded in my thought process: I wanted to become a Clinical Psychologist because it appeared to be the most prestigious and flexible option. Although I had relatively little experience as it relates to clinical work, it seemed interesting and fit well with my research interests. As a result, I applied to many programs and thankfully received an offer to join a PhD program that included a tuition waver and stipend. During my training as a graduate student and postdoctoral researcher, I gained clinical and research experience in a variety of settings (i.e., university sponsored psychology clinic, private practice, research hospital, large public school, small private school) before becoming a tenure-track faculty member. Because of the breadth and depth of my experiences, I believe that I am well positioned to answer the question: Is obtaining a PhD in Clinical Psychology the best option for my career goals? As with many questions in life, the answer is that it depends.

If one’s goal is to work with patients and limit the amount of research that is required, there are a variety of other options that could be better (e.g., Masters in Social Work [MSW] or Marriage and Family Therapy, Counseling Psychology PhD, Clinical Psychology PsyD). Of course, “better” is subjective, but there are important considerations if you plan to borrow money for your degree:

1. The number of years required in order to obtain the degree: One can obtain an MSW in 2 years, while earning a PsyD or PhD in Clinical Psychology takes 7-8 years on average.

2. Student loan debt associated with each degree: Graduate students receiving an MSW average approximately $45k in student loans; Clinical Psychology PsyD/PhD graduates average $80-120k in student loan debt. Keep in mind that interest accumulates while earning a degree, so the actual difference will be even higher (e.g., I borrowed $110k during the 6 years it took to earn my PhD in Clinical Psychology and the loans had accrued an additional $26k in interest by the time I started paying them back).

3. Salary potential: MSW graduates earn an average of ~$50k, Clinical Psychology PsyD graduates earn an average of ~$77k, and Clinical Psychology PhD graduates earn an average of ~$89k. The debt/income ratio is hugely important to consider.

Other students state that they would like to obtain a Clinical Psychology PhD because their career goal is to have a “mix” of clinical and research focused time. I’d like to be as clear as I possibly can about this…Such positions are extremely rare. Think about it this way: If you spend your time focusing on research, your earning potential as it relates to clinical work is reduced and you may not be able to afford (or justify using) the space dedicated to seeing patients. In hospital or private practice settings, the space would quickly be allocated to someone who could maximize profits. On the other hand, if you spend more time focusing on clinical work vs research, you will not be competitive for the funds that are required to run research studies and/or justify lab space. The real-world is simply not setup for positions that equally distribute clinical and research work. Of course, some folks are able to be engaged in both clinical and research work to some degree (e.g., a researcher who supervises the use of psychological interventions in their studies); however, the vast majority of their time is spent within category or the other.

Another common goal for students is to obtain a career in academia. As it relates to obtaining a Clinical Psychology PhD, there are two important considerations here:

1. The amount of time devoted to clinical work during your training. In comparison to other types of programs that are solely research focused, graduate students earning a Clinical Psychology PhD are required to take additional courses in order to meet APA requirements for clinical training, have additional meetings as it relates to their clinical work (e.g., supervision), accumulate patient contact hours, write session notes and assessment reports, as well as spend the final year of their graduate training completing an internship. All of this significantly reduces the amount of time that you can devote to research in comparison to graduate students from other programs; those students are often competing for the same postdoc and faculty positions.

2. Your own mental health. If you do not want to engage in clinical work for the rest of your career, the thousands of hours devoted to the tasks mentioned directly above may not be enjoyable.

If a career in academia is your main goal, I strongly encourage you to be open to other options. Many of these alternatives have just as much, if not more, flexibility as it relates to where you can land in your career. Take, for example, the PhD program in Biobehavioral Health (BBH) at Penn State (Biobehavioral Health Graduate Program | Penn State College of Health and Human Development). The faculty is comprised of individuals who have received training in various departments within psychology, public and global health, neuroscience, biology, genetics, among others. As a result, the training is highly interdisciplinary and graduate students are able to engage in a wide range of research topics, including the role of psychological interventions as they relate to mental and physical health. As a result, students are able to fit well within a number of departments upon graduation, including psychology departments. Like most graduate programs at highly ranked institutions, the program includes a tuition waver and stipend for all students. Importantly, it is also much easier to obtain an offer (acceptance rates are near ~25%). Although I am satisfied and grateful with my career choices, I wish that I would have been more open to programs like the BBH program in hindsight. It would have saved me time, money, and stress during my training. Most notably, without the assistance of a National Institutes of Health Loan Repayment Program grant, I do not believe that I would have been able to pay back my student loans after graduating despite earning an excellent salary for someone at my career stage (i.e., tenure-track faculty member). At the very least, I would have lived an extremely restricted lifestyle until being in my early 50’s.

This begs the question: When is a PhD in Clinical Psychology the best option? In my opinion, it is if you’d like to be in a supervisory/managerial role within a clinical setting. Those with a Clinical Psychology PhD are much more likely to obtain such positions than clinicians from a different academic background. This inevitably reduces the amount of time that one is focused on seeing patients themselves; however, a number of professionals find satisfaction as a supervisor/manager. They also tend to obtain a salary increase in such positions as well. Therefore, if working towards a supervisory/managerial role within a clinical setting is a goal for you, the Clinical Psychology PhD is the best option.

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This begs the question: When is a PhD in Clinical Psychology the best option? In my opinion, it is if you’d like to be in a supervisory/managerial role within a clinical setting. Those with a Clinical Psychology PhD are much more likely to obtain such positions than clinicians from a different academic background. This inevitably reduces the amount of time that one is focused on seeing patients themselves; however, a number of professionals find satisfaction as a supervisor/manager. They also tend to obtain a salary increase in such positions as well. Therefore, if working towards a supervisory/managerial role within a clinical setting is a goal for you, the Clinical Psychology PhD is the best option.

Outside of the VA, this is not really the norm in healthcare organizations. Managerial and supervisory roles are usually filled by people with business backgrounds. In the psychology divisions of the largest healthcare system in my state, there is not a single psychologist in a leadership role. Mostly SWs with MBA/MHAs. Closest someone comes is a Lead Assessment/Therapy person. But this is usually a 25% admin/75% clinical role with no increase in salary.
 
Other students state that they would like to obtain a Clinical Psychology PhD because their career goal is to have a “mix” of clinical and research focused time. I’d like to be as clear as I possibly can about this…Such positions are extremely rare.

I disagree with this. While it is definitely hard to balance a career w/ a mix of clinical and research responsibilities, I do not believe that these positions are all that rare. AMCs often thrive on this model (backfilling the time not covered by grants with clinical work). It's present at some R1s as well. The vast majority of my colleagues at AMCs across the country have a mix of clinical and research responsibilities. I have a 40 (research), 40 (clinical), 20 (admin) split, with the research vs. clinical depending on grants etc. There are some points where I have been 100% research (by choice), others where I have been 80 (research), 20 (clinical) and others where I have been 60 (clinical), 20 (research), 20 (admin).

Of course if someone has no interest in ever doing clinical work, then a clinical psych degree is generally a poor choice. However, for many the flexibility and ability to pivot is a major selling point of a clinical psych PhD.

As an aside, I advise against getting a PhD (clinical or otherwise) if it requires taking out a lot of loans. For most the RoI is not worth it. I will say that another one of the perks of a clinical degree is that it can increase earning potential. Compared to non-clinical departments at AMCs, clinical ones tend to have much higher base salaries.
 
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Those with a Clinical Psychology PhD are much more likely to obtain such positions than clinicians from a different academic background ...Therefore, if working towards a supervisory/managerial role within a clinical setting is a goal for you, the Clinical Psychology PhD is the best option.
Also going to chime in here. I've work in many clinical settings - several residential treatment centers, a psychiatric hospital, some PHP/IOP programs. In all of them, the Clinical Director (which is what I think you mean by "supervisory role") was a masters-level therapist or a nurse practitioner. I think one of them was a PsyD. For those types of roles, it's not the degree that matters, it's the experience. They worked 5-6 years as a clinician/lead clinician and then got bumped up. No one is going to hire an entry level PhD to fill a CD role lmao.

WisNeuro mentioned another kind of role, that of an administrator. Chief Officers, hospital administrators, Director of XYZ, and the like. THOSE folks tend to be businesspeople... actually, a lot of the time they're former psychiatrists who stopped practicing so they could get a slice of the business investment pie. Agreed that the MBA/MHA is the stepping stone there, in combination with another clinical degree of any variety (RN, NP, MD, DO, LICSW, whatever).
 
I disagree with this. While it is definitely hard to balance a career w/ a mix of clinical and research responsibilities, I do not believe that these positions are all that rare. AMCs often thrive on this model (backfilling the time not covered by grants with clinical work). It's present at some R1s as well. The vast majority of my colleagues at AMCs across the country have a mix of clinical and research responsibilities. I have a 40 (research), 40 (clinical), 20 (admin) split, with the research vs. clinical depending on grants etc. There are some points where I have been 100% research (by choice), others where I have been 80 (research), 20 (clinical) and others where I have been 60 (clinical), 20 (research), 20 (admin).

Of course if someone has no interest in ever doing clinical work, then a clinical psych degree is generally a poor choice. However, for many the flexibility and ability to pivot is a major selling point of a clinical psych PhD.

As an aside, I advise against getting a PhD (clinical or otherwise) if it requires taking out a lot of loans. For most the RoI is not worth it. I will say that another one of the perks of a clinical degree is that it can increase earning potential. Compared to non-clinical departments at AMCs, clinical ones tend to have much higher base salaries.

Great points...perhaps the better wording is that it is difficult to balance like you mentioned, particularly as it relates to maintaining grant funding (kudos to you there!). Also, I agree about the return on investment being an important consideration, in addition to debt/income ratio. I speak to many grad students who believe that they will be making a lot more money after internship than they actually end up getting. This is not unique to clinical psych, of course, and is something that we should educate students on much earlier.
 
Also going to chime in here. I've work in many clinical settings - several residential treatment centers, a psychiatric hospital, some PHP/IOP programs. In all of them, the Clinical Director (which is what I think you mean by "supervisory role") was a masters-level therapist or a nurse practitioner. I think one of them was a PsyD. For those types of roles, it's not the degree that matters, it's the experience. They worked 5-6 years as a clinician/lead clinician and then got bumped up. No one is going to hire an entry level PhD to fill a CD role lmao.

WisNeuro mentioned another kind of role, that of an administrator. Chief Officers, hospital administrators, Director of XYZ, and the like. THOSE folks tend to be businesspeople... actually, a lot of the time they're former psychiatrists who stopped practicing so they could get a slice of the business investment pie. Agreed that the MBA/MHA is the stepping stone there, in combination with another clinical degree of any variety (RN, NP, MD, DO, LICSW, whatever).

Thank you for commenting and I agree with your response to WisNeuro...those are different positions. Also, I did not state that clinical PhD's will get supervisory positions straight out of internship. That is obviously not the case...but they are more competitive for them as experience grows in comparison to a masters level therapist.
 
I would say the biggest advantage of a clinical/counseling psychology degree is “flexibility” in roles over the other options (MSW, MFT, MA in counseling). Career trajectories can include research, statistics, clinical practice, academia, assessment, teaching adjunct courses, program development, and administration (in limited settings). The huge caveat is that you can’t do some of these in tandem when gaining experience, and the bigger caveat is that some of these paths take a lot of preplanning and/or networking to achieve, otherwise some of these doors may be shut to you without the right experiences or connections.

Having been through the education process and on the other side, I’ve found that it’s much harder to get into certain roles than expected—-I think I wrongly assumed that my training breadth and doctoral education spoke for itself in terms of the flexibility to perform different roles in the eyes of employers. For example, I am well-equipped to analyze crime data from a city, summarize it, and present it to the community (I applied for this job) but because my paid experiences have been clinical/teaching (despite years of stats and research training/experience), I wasn’t considered for the position—in fact, I was told that I fit the base requirements but my app was tossed when they saw my body of work experiences. This is the challenge that many will navigate if they try to step into a new role that they are qualified for training-wise, but your paid experiences are not in that role (especially if it isn’t a clinical role). I was also surprised at how difficult it was to get into adjunct teaching in my area (many apps with no returned calls before landing one finally—and this with a PhD from an APA-accredited program seeking a teaching gig with very low pay!).

I think that flexibility is good, but keep in mind that in the job world, from what I’ve experienced, things aren’t quite as flexible in practice because employers out there don't necessarily see or understand that you have the competence to perform different roles with your training. It’s important to consider if you think you may shift to a different role, particularly if it isn’t as close to your current path and it is non-clinical. You still need the right connections to shift over if your recent paid experiences don’t match up, or you may need to preplan to have the right experiences that cover multiple roles if you think you might get burned out in one area.

Things I wish I’d known in grad school!
 
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Oh look, another new poster that is touting the merits of a program that doesn't lead to licensure.


Since the opinion is directly contradicted by the EdD literature, I tend to think this is fluff.
 
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2. Student loan debt associated with each degree: Graduate students receiving an MSW average approximately $45k in student loans; Clinical Psychology PsyD/PhD graduates average $80-120k in student loan debt. Keep in mind that interest accumulates while earning a degree, so the actual difference will be even higher (e.g., I borrowed $110k during the 6 years it took to earn my PhD in Clinical Psychology and the loans had accrued an additional $26k in interest by the time I started paying them back).

The student debt distribution for clinical, counseling, and schools psychologists is actually binomial so reporting an average is a misleading statistic. Nearly a quarter of applied psychologists graduate without any debt whatsoever and that doesn't account for psychologists interested in purely academic positions who typically receive funding for their Ph.D.
 
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Oh look, another new poster that is touting the merits of a program that doesn't lead to licensure.


Since the opinion is directly contradicted by the EdD literature, I tend to think this is fluff.


If you're speaking about the Penn State program in the OP, I agree that it does not lead to licensure and will stop you from having a clinical career. However, I do think the point stands that if you insist on chasing the academic dragon, then might be better off in fully funded program in a non-clinical area than taking on huge debt for a third rate Clinical PhD/PsyD.
 
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ut they are more competitive for them as experience grows in comparison to a masters level therapist.
But this is where I'm saying you're wrong. All else equal (same # of years in practice, etc.) they both have equal chance to get supervisory positions, assuming that there are no requirements on who they can/cannot supervise. (e.g. if it's a UCC and there are a bunch of APA interns working there, then obviously yes the psychologist will be the clinical director).

There is also selection bias: folks who did the PhD may also be more interested in supervisory roles vs. masters level therapists who really do make patient contact their bread and butter.
 
If one’s goal is to work with patients and limit the amount of research that is required, there are a variety of other options that could be better (e.g., Masters in Social Work [MSW] or Marriage and Family Therapy, Counseling Psychology PhD, Clinical Psychology PsyD). Of course, “better” is subjective, but there are important considerations if you plan to borrow money for your degree:
This is incorrect.
 
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