Is there a point in my PhD if i'm only doing therapy

[FreudianSlippers]

Hi all!

I went to a funded program, got some solid research experience with a handful of publications, conducted numerous psych evals....basically did the whole 9 yards. I got licensed with my state a few months ago and currently I work at a university counseling center doing therapy and I am opening up a private practice doing.....you guessed it...therapy! I love doing therapy and i'm starting to make a pretty penny with this fee-for-service private practice. However, I can't help but feel as though i'm wasting my degree somewhat. What separates me from a masters level clinician now? I just wanted to make this thread to see if other psychologists here have had similar experiences. I'd also love any thoughts on how I might be able to utilize my experience more effectively.

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[erg923]

Hi all!

I went to a funded program, got some solid research experience with a handful of publications, conducted numerous psych evals....basically did the whole 9 yards. I got licensed with my state a few months ago and currently I work at a university counseling center doing therapy and I am opening up a private practice doing.....you guessed it...therapy! I love doing therapy and i'm starting to make a pretty penny with this fee-for-service private practice. However, I can't help but feel as though i'm wasting my degree somewhat. What separates me from a masters level clinician now? I just wanted to make this thread to see if other psychologists here have had similar experiences. I'd also love any thoughts on how I might be able to utilize my experience more effectively.

Although I did not ONLY do therapy in my former clinical role (see other recent posts), LCSWs has my same (full-time) job description when I was working in a the VA. This, and the job in general, did not settle well, with me...so I did something else. Yes, I make more money now. Yes, I am happier. I do not see patients as part of my job.

 

[Sanman]

What are your goals? Does it matter of you are wasting your degree if you are making good money and happy?

 

[Spydra]

Well maybe its better to say you're not maximizing your degree, because the fact that you are employed in your field is a good thing. I don't think its terrible to focus more on therapy if you enjoy it, maybe you'll branch out into supervision (if you aren't already) and there is always a need for more opportunities for students to receive good training.

 

[cara susanna]

Is there any way to include assessment in your current role, either in PP or the UCC?

 

[ClinicalABA]

Hi all!

I went to a funded program, got some solid research experience with a handful of publications, conducted numerous psych evals....basically did the whole 9 yards. I got licensed with my state a few months ago and currently I work at a university counseling center doing therapy and I am opening up a private practice doing.....you guessed it...therapy! I love doing therapy and i'm starting to make a pretty penny with this fee-for-service private practice. However, I can't help but feel as though i'm wasting my degree somewhat. What separates me from a masters level clinician now? I just wanted to make this thread to see if other psychologists here have had similar experiences. I'd also love any thoughts on how I might be able to utilize my experience more effectively.

I'd offer that if, as a result of your degree, you find yourself with a successful therapy practice where you "make a pretty penny," combined with a UCC gig where you presumably are adequately reinforced, then the degree was certainly not a "waste." If you are only doing (and continue do) things that a MA level clinician could also do AND are being reimbursed at the same rate as a MA level clinician, you could say that it may not have been the most efficient degree, but it certainly wasn't a waste. Based on your statement that you went to a fully funded program, I'm guessing the overall financial costs of your degree vs. a MA clinical degree were much less (MA clinical degrees tend not to come with funding and ain't necessarily cheap) . If you account for opportunity costs, lost wages where you could have been generating income, etc., it may be an even draw financially. However, your Ph.D. training, research, pubs, and evaluation experience likely give you more options and a higher earning potential than a MA level clinician. Sounds like you are early career. What you are doing now isn't likely to be what you are doing forever . Your career will likely evolve and include an increasing amount of responsibilities that are unique to someone with a doctorate in psychology. If it doesn't, that's ok too. A good therapist who is able to (and does) use the evolving scientific literature to change their approach to more effectively serve their clients is a very good thing.

 

[FreudianSlippers]

Is there any way to include assessment in your current role, either in PP or the UCC?

Not at the current UCC, but it's definitely a possibility in PP...it will just be a big investment buying all the materials. Plus, I don't currently take insurance and have to figure out how I would charge for them and where I will get my referrals from. I think once I have a solid PP therapy case load it will be more realistic.

 

[FreudianSlippers]

+/

I'd offer that if, as a result of your degree, you find yourself with a successful therapy practice where you "make a pretty penny," combined with a UCC gig where you presumably are adequately reinforced, then the degree was certainly not a "waste." If you are only doing (and continue do) things that a MA level clinician could also do AND are being reimbursed at the same rate as a MA level clinician, you could say that it may not have been the most efficient degree, but it certainly wasn't a waste. Based on your statement that you went to a fully funded program, I'm guessing the overall financial costs of your degree vs. a MA clinical degree were much less (MA clinical degrees tend not to come with funding and ain't necessarily cheap) . If you account for opportunity costs, lost wages where you could have been generating income, etc., it may be an even draw financially. However, your Ph.D. training, research, pubs, and evaluation experience likely give you more options and a higher earning potential than a MA level clinician. Sounds like you are early career. What you are doing now isn't likely to be what you are doing forever . Your career will likely evolve and include an increasing amount of responsibilities that are unique to someone with a doctorate in psychology. If it doesn't, that's ok too. A good therapist who is able to (and does) use the evolving scientific literature to change their approach to more effectively serve their clients is a very good thing.

I love this...Thank you so much for the insights @ClinicalABA . Excellent points all around....each of which highly resonated with me. And yes, I am quite early career....I have only been licensed for about 3 months and I can definitely see things continue to evolve. It's very helpful to put things into perspective in terms of having no debt, having a solid understanding of the scientific literature, and having a higher potential ceiling in terms of pay and job opportunities.

 

[DynamicDidactic]

However, I can't help but feel as though i'm wasting my degree somewhat. What separates me from a masters level clinician now? I just wanted to make this thread to see if other psychologists here have had similar experiences.

I have spoken to grad students before I went to grad school that felt this way. Really bright people that went to very good programs. Those thoughts were around the end of their training, so maybe they feel differently now.

This is what I telll undergrads all the time. Weigh the costs/benefits of your decision.

 

[tr]

I have a bit of a different perspective as a psychiatrist who often does med management for people who are getting their therapy elsewhere. (I do some targeted CBT myself also for people who want that.). I have repeatedly seen patients who made little progress with master's level therapists really turn things around quickly once they started seeing a psychologist.

I'm sure master's level clinicians can do focused training to gain the skills they didn't learn in their programs, but in practice most of them probably don't. And I have also heard a lot of jaw-dropping therapist quotes from patients, pretty much all of them seeing master's level clinicians.

I know the published data indicate that therapeutic efficacy is about the individual and the relationship, not the degree, but years of experiences like this lead me to believe that you all have definitely learned something useful in 6 years of grad school. I would absolutely not consider a psychologist who has a psychotherapy practice to be wasting his training.

 

[tr]

PS I have a PhD in developmental neurobiology (basic science, I grew little neurons in dishes) and it absolutely informs everything about the way I practice.

 

[PsySeeker]

^ X
I do mostly forensic therapy. You don’t have to have a doctorate to do it, but many of the cases involve severe MI/PD/paraphilias, difficult criminal Hx, poly-trauma (often lifelong), and severe SES issues. We have mid-levels at my agency, but I’m funneled the more difficult cases, I supervise some students, and I do a few diagnostic evals a week. I make more for the same services then a masters level person, and I find I’m frequently consulted by and respected by my peers.

Finally, without the assessment and supervision component added in, I earn low six figures via a reasonable split of mostly in network large insurer reimbursements.

In a nutshell, I do probably 90% therapy because I like it, having my doctorate helps me with that in both tangible and intangible ways, and yes, ultimately, the degree was worth obtaining, financially and otherwise IMO.

 

[Meteora]

^ X
I do mostly forensic therapy. You don’t have to have a doctorate to do it, but many of the cases involve severe MI/PD/paraphilias, difficult criminal Hx, poly-trauma (often lifelong), and severe SES issues. We have mid-levels at my agency, but I’m funneled the more difficult cases, I supervise some students, and I do a few diagnostic evals a week. I make more for the same services then a masters level person, and I find I’m frequently consulted by and respected by my peers.

Finally, without the assessment and supervision component added in, I earn low six figures via a reasonable split of mostly in network large insurer reimbursements.

In a nutshell, I do probably 90% therapy because I like it, having my doctorate helps me with that in both tangible and intangible ways, and yes, ultimately, the degree was worth obtaining, financially and otherwise IMO.

Your career sounds very similar to what I'm aspiring towards. I'd like to do mostly therapy, but I love assessment and would enjoy doing some form of evaluation/testing on the side. The one extra thing is that I also really like teaching so ideally I'd have the opportunity to adjunct lecture and supervise graduate students. Any tips for that kind of trajectory?

 

[PsyDaVinci]

I know the published data indicate that therapeutic efficacy is about the individual and the relationship, not the degree, but years of experiences like this lead me to believe that you all have definitely learned something useful in 6 years of grad school.

Someone anecdotally described it to me as Master's therapists being bimodal, many good and many poor. When I first started out I got my MA and went straight to work. What I like to do doesn't necessarily require licensing (prison work) and was happy working under someone else's license. After several years though I felt like I hit a ceiling as I was doing therapy, research, professional training... I squeezed every last bit of that MA out that I could. So I went back and got my PhD. I did learn some new things and got a deeper understanding of some theoretical issues, however I think the bigger issue is that doctoral programs have a sorting out function more so than masters programs.

I always find it a bit brow-furrowing that LCSWs can do as much as they can with their degree compared to people with psych MAs, but there is a social benefit to having a doctoral degree in terms of marketability. If therapy is your thing, particularly private practice, having that Dr. title does get the door open faster. Plus the options are open if you want to branch out at some point, say for occasional testing where needed.

If you are doing what you love, then you are the only one who can determine if degree had a meaningful point. Screw everyone else.

 

[DynamicDidactic]

If therapy is your thing, particularly private practice, having that Dr. title does get the door open faster.

I don't think anyone would argue against this. The caveat we often try to tell students is that this needs to be considered in terms of trade off. High debt from poor schools that limit your marketability may not be worth it. Similarly, lifestyle, stress, and delay in adult milestones need to be added to the calculus.

 

[PikminOC]

I have a bit of a different perspective as a psychiatrist who often does med management for people who are getting their therapy elsewhere. (I do some targeted CBT myself also for people who want that.). I have repeatedly seen patients who made little progress with master's level therapists really turn things around quickly once they started seeing a psychologist.

I'm sure master's level clinicians can do focused training to gain the skills they didn't learn in their programs, but in practice most of them probably don't. And I have also heard a lot of jaw-dropping therapist quotes from patients, pretty much all of them seeing master's level clinicians.

I know the published data indicate that therapeutic efficacy is about the individual and the relationship, not the degree, but years of experiences like this lead me to believe that you all have definitely learned something useful in 6 years of grad school. I would absolutely not consider a psychologist who has a psychotherapy practice to be wasting his training.

Agreed. Also in terms of liability, in a complex case, I'd much rather have sent the patient to a psychologist than LCSW, lcpc

 

[mkberry85]

I have a bit of a different perspective as a psychiatrist who often does med management for people who are getting their therapy elsewhere. (I do some targeted CBT myself also for people who want that.). I have repeatedly seen patients who made little progress with master's level therapists really turn things around quickly once they started seeing a psychologist.

I'm sure master's level clinicians can do focused training to gain the skills they didn't learn in their programs, but in practice most of them probably don't. And I have also heard a lot of jaw-dropping therapist quotes from patients, pretty much all of them seeing master's level clinicians.

I know the published data indicate that therapeutic efficacy is about the individual and the relationship, not the degree, but years of experiences like this lead me to believe that you all have definitely learned something useful in 6 years of grad school. I would absolutely not consider a psychologist who has a psychotherapy practice to be wasting his training.

You are clumping all master's clinicians as the same; the training is vastly different among the different fields. And, I would not say your quoted experience is the norm; I rarely see a doctoral-level psychologist that is any more trained or skilled at psychotherapy than a master's trained LPC. If you think about it, yes, a doctoral psychologist has 5-6 years of training, though, their clinical hours are not necessarily greater than that of a LPC (in fact, typically less), and the actual training in psychotherapy and interventions is much greater in a MHC program, compared to a doctoral psychology program.

I probably shouldn't, but I do find it worthy to note that I do come from a background in both MHC and clinical psychology.

 

[psych.meout]

You are clumping all master's clinicians as the same; the training is vastly different among the different fields. And, I would not say your quoted experience is the norm; I rarely see a doctoral-level psychologist that is any more trained or skilled at psychotherapy than a master's trained LPC. If you think about it, yes, a doctoral psychologist has 5-6 years of training, though, their clinical hours are not necessarily greater than that of a LPC (in fact, typically less), and the actual training in psychotherapy and interventions is much greater in a MHC program, compared to a doctoral psychology program.

I probably shouldn't, but I do find it worthy to note that I do come from a background in both MHC and clinical psychology.

LPCs typically have more hours than an ECP including practicum, internship, and post doc? Can you provide a source for this?

 

[Sanman]

You are clumping all master's clinicians as the same; the training is vastly different among the different fields. And, I would not say your quoted experience is the norm; I rarely see a doctoral-level psychologist that is any more trained or skilled at psychotherapy than a master's trained LPC. If you think about it, yes, a doctoral psychologist has 5-6 years of training, though, their clinical hours are not necessarily greater than that of a LPC (in fact, typically less), and the actual training in psychotherapy and interventions is much greater in a MHC program, compared to a doctoral psychology program.

I probably shouldn't, but I do find it worthy to note that I do come from a background in both MHC and clinical psychology.

 

[R. Matey]

You are clumping all master's clinicians as the same; the training is vastly different among the different fields. And, I would not say your quoted experience is the norm; I rarely see a doctoral-level psychologist that is any more trained or skilled at psychotherapy than a master's trained LPC. If you think about it, yes, a doctoral psychologist has 5-6 years of training, though, their clinical hours are not necessarily greater than that of a LPC (in fact, typically less), and the actual training in psychotherapy and interventions is much greater in a MHC program, compared to a doctoral psychology program.

I probably shouldn't, but I do find it worthy to note that I do come from a background in both MHC and clinical psychology.

Also an LPC and a psychologist (well, almost). As an LPC, I felt completely unqualified to do my job, which is why I went back to graduate school. As a predoctoral intern currently with several more years of my tapes being reviewed by supervisors in addition to specific training in EBPs, I have a much stronger sense of what I'm doing. LPC training is highly variable. My experience of it is that most people have a vague understanding of psych theory and basically just do humanistic counseling because they are taught that those are the "basic skills." I sought out extra training in CBT when I was getting licensed at that level, but found that being unable to read the literature, I was not in a position to judge the quality of my own work. That's not an intellectually honest place to live, IMO.

Moral of the story being that just because the hours are the same on paper doesn't mean that they impart the same training. It's misrepresenting the fact to imply that they do.

 

[Fan_of_Meehl]

Hi all!

I went to a funded program, got some solid research experience with a handful of publications, conducted numerous psych evals....basically did the whole 9 yards. I got licensed with my state a few months ago and currently I work at a university counseling center doing therapy and I am opening up a private practice doing.....you guessed it...therapy! I love doing therapy and i'm starting to make a pretty penny with this fee-for-service private practice. However, I can't help but feel as though i'm wasting my degree somewhat. What separates me from a masters level clinician now? I just wanted to make this thread to see if other psychologists here have had similar experiences. I'd also love any thoughts on how I might be able to utilize my experience more effectively.

The advantages are these (and they're pretty key):

1) You not only get training in the current (at the time of your training) BODY of scientific knowledge about assessment, psychotherapy, and applied psychology; importantly, you get training in the very philosophy of science underpinning the process via which all of this content was generated; you now have the ability not only to properly digest (and, as needed, refute) claims being made (by colleagues, by lecturers, by patients, by administrators, by your patient, by yourself) but you also have a conceptual framework to properly frame the right questions and seek out meaningful answers to those questions; this is absolutely invaluable
2) You (should) get some intellectual humility beaten into you (and that's a good thing); this should prevent you from being too smug/secure in your own hypothesizing about cases and cause you to (appropriately) doubt your initial diagnostic impressions (and be open to having them questioned), your case formulation, and your approach to treatment
3) You are able to create unique and customized clinical case formulations that usefully explain how your patient's symptoms are generated via application of the important concepts from clinical science (e.g., theories pertaining to emotion regulation, drug tolerance/withdrawal, operant/classical conditioning, cognitive science, neuroscience) that will allow you to go beyond 'folk explanations' (e.g., 'he just doesn't want to get better; he's a 'spoiled brat'); this allows you to properly leverage THEORY in service of active HYPOTHESIS GENERATION and HYPOTHESIS TESTING ongoingly with your client and to gather (and listen to) data to help you and your client judge the 'fit' of your explanations (and, therefore, what treatment decisions to make)

 

[msc545]

Hi all!

I went to a funded program, got some solid research experience with a handful of publications, conducted numerous psych evals....basically did the whole 9 yards. I got licensed with my state a few months ago and currently I work at a university counseling center doing therapy and I am opening up a private practice doing.....you guessed it...therapy! I love doing therapy and i'm starting to make a pretty penny with this fee-for-service private practice. However, I can't help but feel as though i'm wasting my degree somewhat. What separates me from a masters level clinician now? I just wanted to make this thread to see if other psychologists here have had similar experiences. I'd also love any thoughts on how I might be able to utilize my experience more effectively.

Something that others did not say, but I will. You will get more respect from other healthcare professionals. In particular, I have found that some Psychiatrists are prone to verbally abusing Psychologists and denigrating our profession, and I have also noticed that they do this to people with masters degrees a lot more than to doctoral level people, although they do it to us too. It is probably due to the fact that in residency they are at the absolute bottom of the heirarchy, and get abused a quite a bit themselves. It is, of course, unprofessional as hell, but it happens a lot.

 

[BuckeyeLove]

and get abused a quite a bit themselves.

This is essentially the entire medical model of training right?

 

[WisNeuro]

This is essentially the entire medical model of training right?

At least according to my spouse and our physician friends, seems to be the case, across disciplines in these specific cases (FM, IM, ID, EM).

 

[Sanman]

At least according to my spouse and our physician friends, seems to be the case, across disciplines in these specific cases (FM, IM, ID, EM).

They love their hierarchies in medicine. Much more of a fraternity mentality, but it seems to be changing from the stories I hear recently as compared to those that graduated years ago.

 

[deleted343839]

You will get more respect from other healthcare professionals. In particular, I have found that some Psychiatrists are prone to verbally abusing Psychologists and denigrating our profession, and I have also noticed that they do this to people with masters degrees a lot more than to doctoral level people, although they do it to us too.

It's a learned behavior. My experience is that family medicine, internal medicine, and most other specialties are generally easier to work with and haven't been socialized to do this.

 

[msc545]

Less than it used to be, but don't forget that in addition to this, Psychology has the longest educational track of any profession, and the lowest pay.

 

[WisNeuro]

Less than it used to be, but don't forget that in addition to this, Psychology has the longest educational track of any profession, and the lowest pay.

We're similar to physicians, within a year or two and, depending on specialty, they definitely win out. Neurosurg is something like a 7 year residency.

 

[psych.meout]

We're similar to physicians, within a year or two and, depending on specialty, they definitely win out. Neurosurg is something like a 7 year residency.

Yeah, but FM, IM, & Peds are the lowest paid specialties, especially compared to Neurosurg, and there are a hell of a lot more of the former than the latter.

 

[WisNeuro]

Yeah, but FM, IM, & Peds are the lowest paid specialties, especially compared to Neurosurg, and there are a hell of a lot more of the former than the latter.

I don't dispute that at all. I was only disputing the assertion that we have the longest educational track.

 

[psych.meout]

I don't dispute that at all. I was only disputing the assertion that we have the longest educational track.

Sorry, I was agreeing with you by pointing out that it's a bit obtuse to complain that psychology has a long educational track and low pay. The physician specialties with substantially higher pay require much more education and training and are highly competitive and relatively rare.

 

[WisNeuro]

Ah, ok, makes sense

 

[AcronymAllergy]

IM & FM

Sorry, I was agreeing with you by pointing out that it's a bit obtuse to complain that psychology has a long educational track and low pay. The physician specialties with substantially higher pay require much more education and training and are highly competitive and relatively rare.

True. Although even IM, FM, and Peds (all 3-year residences if I'm remembering correctly, for 7 years total; comparable to a Psychology doctorate) make twice what the average psychologist does. But I'll also concede the potential substantial difference in student loans.

Then again, I wouldn't want to do what the average IM, FM, or Peds physician does. Kudos to them.

To get back to the OP a bit, I still say a person can find value in pursuing a Ph.D. even if they're "only" providing therapy. In large part because many people who start out in therapy eventually branch into different areas made accessible by their training.

 

[Sanman]

Sorry, I was agreeing with you by pointing out that it's a bit obtuse to complain that psychology has a long educational track and low pay. The physician specialties with substantially higher pay require much more education and training and are highly competitive and relatively rare.

That depends how you define higher pay. Average physician pay easily doubles a well paid psychologist. Education is comparable

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