MSW Its only been 2 weeks and I'm considering dropping out of my MSW program

[PGM_777]

I want to be a therapist and work doing individual therapy in private practice (and perhaps in residential SUD treatment). Full stop.

I am very disillusioned with my MSW program. They told me I will learn many clinical skills, etc etc. They said I will be able to practice therapy. But it turns out that the "advanced" clinical classes don't teach therapy. In addition, the coursework so far is easier than undergraduate. Its weird.

I don't want to be a "social worker" or do case management - ever. I have done it before and I hate it. Most of my professors are LCSWs and they say I can be a therapist.

But they arent going to train me, as far as i can tell. The internship placements have been chaotic. They told me I could do PP first year, then I got stuck with a CMH spot which would be totally fine or preferred if it had anything to do with therapy. But it doesn't. They can't guarantee me a therapy placement second year but i will probably get one.

I'm thinking of dropping out and seeing if i can defer my Counseling masters application i turned in last year to next year. Or reapply.

This is nuts... they say I can be a therapist but can't guarantee me training. Why am I doing this??

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[R. Matey]

First, considering dropping out of graduate school while in graduate school is a completely normal experience. During my tenure, I was able to count on my annual existential crisis where I considered leaving and opening a taco stand/coffee bar on the north shore of Oahu *sighs dreamily*

More importantly, psychotherapy is an acquired skill that takes years to learn and practice and it is not the only goal of your MSW program. Your faculty's job is to train you to be a competent social worker in all facets of social work. This is important because the degree is flexible, which will allow you to work in a variety of settings. In contrast, LPC/LMFTs receive training almost exclusively in psychotherapy and their lobbies have a difficult time convincing people that they are qualified to do much past working in high volume settings doing exclusively the things they are trained to do.

I'm not a social worker, but I know many of them. I know many have received the bulk of their psychotherapy training past their MSW program and pre-licensure. The good therapists I've encountered did their licensing hours at the VA or in some kind of postgraduate training program. The mediocre or bad ones I've encountered did their licensing hours in a CMHC or something similar and never pursued any additional training outside of the minimum necessary for licensure or pursued some kind of pseudoscientific credential based on their own personal pet theories about change rather than what science says works in psychotherapy. The nice thing about being a social worker is that those opportunities are more open to you than they would be if you were an LPC/LMFT.

It's also worth mentioning that being a full time therapist requires some degree of case management. I was not prepared for this reality when I was training to be an LPC. My first job out of graduate school post-masters, pre-licensure was a mental health case manager at a program that worked directly with the state hospital. I was the only non-MSW on the team and learned a lot from my social work colleagues that I carried forward into nearly every setting I've worked in since.

 

[PGM_777]

Thanks for the reply. Helpful.

One thing that happened between applying and starting is that my focus shifted towards only therapy as i became more sure of myself. Now, these "options" SW has seem like negatives because I don't care to exercise any of them. I feel like an 18 year old freshman dead set on Sports Management walking into his first day of college algebra: What does this have to do with anything? I like social justice but doing assignments about systemic racism has literally nothing to do with my goals.

I'm not trying to connect people to services. I'm trying to save their lives.

I also have come to realize it may be that I am in a program teaching me stuff I don't want to learn or have a philosophical issue with - ex. systems theory, working with community organizations. I'm not enjoying the learning at all. The only thing i look forward to is getting this certificate in Animal Assisted Therapy through an elective across-programs in the counseling dept. They offer it to SW. I have no interest in working with animal therapy, but its literally the only way to get any training in therapy.

I do find it suspicious that only SWers have ever tried to convince me to do Social Work while all the LPC/LMHCs and counseling PhDs I have asked have been cool to let me figure it out and even sometimes suggest social work. Funnily enough, that makes me respect the approach of the LMHC/LPC more.

More importantly, psychotherapy is an acquired skill that takes years to learn and practice and it is not the only goal of your MSW program.

This seems like more reason to leave, as either way I'm wasting my time. I am trying to learn therapy now.

pseudoscientific credential

What like reiki?

The nice thing about being a social worker is that those opportunities are more open to you than they would be if you were an LPC/LMFT.

Would you be willing to clarify which opportunities?

It's also worth mentioning that being a full time therapist requires some degree of case management

It seems sensible to learn case management on the job after being schooled in therapy. It seems wild to me that the converse is true in social work.

Anyway, the only reason I haven't dropped out yet is due to the better licensing ease across states and the SW lobby. It just seems dishonest of both me (and the LCSWs in my program pushing the stuff) to have no interest in doing social work to continue learning/teaching this stuff out of duty. In my heart I'm a therapist, talker, listener, counselor, psychologist, etc but I am not a social worker. I could identify as a LCSW psychotherapist though, but it seems untrue to the profession of SW what i am doing and what i want.

 

[R. Matey]

I also have come to realize it may be that I am in a program teaching me stuff I don't want to learn or have a philosophical issue with - ex. systems theory, working with community organizations. I'm not enjoying the learning at all. The only thing i look forward to is getting this certificate in Animal Assisted Therapy through an elective across-programs in the counseling dept. They offer it to SW. I have no interest in working with animal therapy, but its literally the only way to get any training in therapy.

Animal Assisted Therapy is a good example of pseudoscientific treatment. While it's true that counseling coursework is focused on psychotherapy, if you peruse the threads here, you'll find a few testimonials from LPCs (myself included) stating that their coursework did not adequately prepare them to be good therapists. Counseling coursework is sufficient to teach you supportive listening and a few basics techniques from MI/CBT/ACT/DBT, but usually don't provide enough supervision in running full protocol treatments. Basically, you wind up a dilettante. When I realized this, I left the field.

Also important to say that you're not going to avoid SJ coursework in counseling and psychology. It's a prevalent aspect of all of the helping professions.

I'm not trying to connect people to services. I'm trying to save their lives.

Social workers do save lives. Getting people housing, food, and treatment is pretty important to human survival.

This seems like more reason to leave, as either way I'm wasting my time. I am trying to learn therapy now.

Do what you want with your own life, but I think being a counselor terrible career choice. I still have the license in one state, but I don't use it. Not only are LPCs paid less than social workers for doing similar types of work, but are also often kept out of positions that are desirable in terms of pay, benefits, and opportunities. In terms of pay, you honestly better off as a teacher.

Would you be willing to clarify which opportunities?

Sure, hospital and VAs usually favor social workers to counselors for psychotherapy positions. It's also easier for social workers to move into management than it is for counselors because social workers have policy coursework. My guess is that this will probably change in the future, but I can't say for sure.

Anyway, the only reason I haven't dropped out yet is due to the better licensing ease across states and the SW lobby. It just seems dishonest of both me (and the LCSWs in my program pushing the stuff) to have no interest in doing social work to continue learning/teaching this stuff out of duty. In my heart I'm a therapist, talker, listener, counselor, psychologist, etc but I am not a social worker. I could identify as a LCSW psychotherapist though, but it seems untrue to the profession of SW what i am doing and what i want.

Not really. You're just choosing to focus on one aspect of social work for your career. If you'd prefer to be a psychologist, you could always check out the psychology forums to find info about applying to or getting to clinically balanced Ph.D. programs or funded Psy.D. programs. It's a long time in school to just be a therapist, but you will get good training in therapy though you will also have to tolerate coursework that has nothing to do with therapy.

 

[PGM_777]

Animal Assisted Therapy is a good example of pseudoscientific treatment.

What qualifies it as pseudoscience. I have no skin in the game but it does seem like theres some meta-analyses with good results.

their coursework did not adequately prepare them to be good therapists

I am thinking providing therapy would prepare to be a good therapist. Counseling programs can guarantee 1000 hours of that, plus the coursework. MSW programs say maybe you'll get 500, maybe not if there's not a PP or therapy place that can supervise. Its luck based. If you don't get that, you struggle to get a therapist position for experience.

What would prep them to be good therapists? You're saying do SW over counseling, but neither will allow me to be a good therapist?

Basically, you wind up a dilettante. When I realized this, I left the field.

What do you do now?

Social workers do save lives. Getting people housing, food, and treatment is pretty important to human survival.

I can accept your view on that, but I don't want to do just case management even if it pays better than therapy. Which, if its PP it surely doesn't.

but I think being a counselor terrible career choice

I am appreciating your help however it is sort of seeming like you're trying to argue against counseling due to some sort of resentment against the field.

but are also often kept out of positions that are desirable in terms of pay, benefits, and opportunities. In terms of pay, you honestly better off as a teacher.

I have heard the same thing in reverse as well. I have heard clinical dirs and program dirs getting the job because they have more psychotherapy experience vs LCSW. I also have not found a significant difference in pay between LCSW and LMHC/LPC for the same job description. A therapist position for a Liscensed MH Clinician accepting all master's level clinicians pays what it pays more or less, no?

And if it doesn't the difference in FL is 1.9% according to onetonline.com. The national difference is 2.8%. Even the national difference of the highest end according to that data is exactly 10%, which isn't chump change but is it worth 7k to do a job you dislike?

According to onetonline.com, the average pay for a MHC in FL is about 39k and a SW is 40k. A teacher makes 60k. I could go teach middle school but I, as with case management social work, don't have an interest in that. Compared to the teacher, neither seem to pay that good. However, if one does PP individual therapy one can easily make about 100k/year. But my point is that everyone says SWers make more which is only true from a certain point of view. A therapist role pays what it pays and seems to be more about experience, client base, and going rate.

LMHC Salaries, FL, 2020
SW Salaries, Florida, 2020
Middle School Teacher, FL, 2020

 

[R. Matey]

What qualifies it as pseudoscience. I have no skin in the game but it does seem like theres some meta-analyses with good results.

Let's see them.

I am thinking providing therapy would prepare to be a good therapist. Counseling programs can guarantee 1000 hours of that, plus the coursework. MSW programs say maybe you'll get 500, maybe not if there's not a PP or therapy place that can supervise. Its luck based. If you don't get that, you struggle to get a therapist position for experience.

What would prep them to be good therapists? You're saying do SW over counseling, but neither will allow me to be a good therapist?

Again, you can choose to do whatever you want with your own life. I really couldn't care less if you choose counseling over social work. I do feel a responsibility to you and anyone else reading to provide informed consent for the decisions they make. While it might be true that counseling programs offer a number of supervised hours, the quality of those supervised hours is highly variable. I suspect that many of those hours are case review where you simply report to a supervisor what happened in therapy. This is generally viewed as a lower quality form of supervision because your report is vulnerable to your bias. It has generally been my experience as someone who has taught and practiced counseling in a few states that case review is the primary form of supervision in counseling programs.

Honestly, it sounds like your mind's already made up and you're just looking for verification. But, regardless of whatever decision you make, be sure to seek out quality supervision experiences in your training. These include live supervision experiences. We had video supervision for both my master's degree and Ph.D., but I've only had live experiences as a part of my doctoral training. Hopefully, it's different for you.

I am appreciating your help however it is sort of seeming like you're trying to argue against counseling due to some sort of resentment against the field.

This is the ad hominem fallacy. It's fallacious in this situation because people who don't have my experiences share my view.

I have heard the same thing in reverse as well. I have heard clinical dirs and program dirs getting the job because they have more psychotherapy experience vs LCSW. I also have not found a significant difference in pay between LCSW and LMHC/LPC for the same job description. A therapist position for a Liscensed MH Clinician accepting all master's level clinicians pays what it pays more or less, no?

And if it doesn't the difference in FL is 1.9% according to onetonline.com. The national difference is 2.8%. Even the national difference of the highest end according to that data is exactly 10%, which isn't chump change but is it worth 7k to do a job you dislike?

According to onetonline.com, the average pay for a MHC in FL is about 39k and a SW is 40k. A teacher makes 60k. I could go teach middle school but I, as with case management social work, don't have an interest in that. Compared to the teacher, neither seem to pay that good. However, if one does PP individual therapy one can easily make about 100k/year. But my point is that everyone says SWers make more which is only true from a certain point of view. A therapist role pays what it pays and seems to be more about experience, client base, and going rate.

Like I said, this might be changing as more LPCs flood the master's level market. As far as PP, this is something the counseling folks like to throw around, but that figure is dependent on a number of factors such as market saturation, reimbursement rates of the insurance companies you are paneled with, etc. Based on the figures you have shared, an LMHC in FL can expect to make $39/yr after two additional years in graduate school and another two years to become licensed yet you believe that somehow you will be an outlier.

 

[PGM_777]

Again, you can choose to do whatever you want with your own life. I really couldn't care less if you choose counseling over social work. I do feel a responsibility to you and anyone else reading to provide informed consent for the decisions they make. While it might be true that counseling programs offer a number of supervised hours, the quality of those supervised hours is highly variable. I suspect that many of those hours are case review where you simply report to a supervisor what happened in therapy. This is generally viewed as a lower quality form of supervision because your report is vulnerable to your bias. It has generally been my experience as someone who has taught and practiced counseling in a few states that case review is the primary form of supervision in counseling programs.

Honestly, it sounds like your mind's already made up and you're just looking for verification. But, regardless of whatever decision you make, be sure to seek out quality supervision experiences in your training. These include live supervision experiences. We had video supervision for both my master's degree and Ph.D., but I've only had live experiences as a part of my doctoral training. Hopefully, it's different for you.

My mind is all but made up. Regardless of that in the course of the discussion we have established that at the master's level, it is more likely to get supervised experience and coursework going the counselor route over social work. But social work pays more - maybe. However, if i come at it based on my initial concern stating that I want to do therapy, it is pretty easy to look at the information presented (regardless of what you're expressing as the point you're trying to make) and see the information leading to a conclusion that both kinds master's level therapists aren't well trained at therapy. And no I am not trying to strawman you. You don't think it can come off that way?

I say I want to do therapy, might do counseling > you say do SW, not counseling > I mention that it may be hard or impossible to get hours in SW > you say yeah but the guaranteed hours in counseling might be garbage. Well, then the hours I might get in SW could also be garbage and there will be half of them.

It seems like an argument against counseling or even therapy at all at the master's level.

This is the ad hominem fallacy. It's fallacious in this situation because people who don't have my experiences share my view.

Well, I don't know your experiences and your profile is private. I would be happy to learn more about you, though. I know that you thought the training was inadequate as a master's level LPC and wen't for the PhD. As an aside, going for the counseling PhD is an upside of the counselor route versus the social work options. I'm generally inspired by people who get higher degrees because maybe I will be doing it one day. Its admirable to have to will to do such a thing.

Anyway, ad hominem on a bias isn't always fallacious. Where we aren't seeing eye to eye though I believe I never used ad hominem/bias to refute an argument, either way. And if it came off like that I apologize. Honestly I do think you have a bias, but I don't have reason to believe we have evidence to conclude any ad hominem:bias to be sound.

 

[R. Matey]

I say I want to do therapy, might do counseling > you say do SW, not counseling > I mention that it may be hard or impossible to get hours in SW > you say yeah but the guaranteed hours in counseling might be garbage. Well, then the hours I might get in SW could also be garbage and there will be half of them.

SWs have, in my experience, better access to training opportunities because of their better lobby and these have, in my experience, occurred during postmaster's supervision, which is what I wrote to you before. SWs have better access to jobs because of their better access to training experiences that can lead to jobs. In contrast, counselors, in my experience, rely on their master's training, which can be of good quality, but is usually variable because of the lack of quality control. This is because counseling is the newest player in the helping professions and has had some difficulty establishing a national standard. It was only 12 years ago that counseling didn't even exist as a license in every state. Up until maybe five years ago, the credit load of what was necessary for a master's degree in counseling was variable depending on where you lived. CACREP is trying to be that standard, but there is really no great outcome research that suggests CACREP graduates fair better than non-CACREP graduates in any sort of meaningful outcome. You are inserting the argument that your SW hours will be garbage, I didn't say that. In that way, you are committing a straw man.

Anyway, ad hominem on a bias isn't always fallacious. Where we aren't seeing eye to eye though I believe I never used ad hominem/bias to refute an argument, either way. And if it came off like that I apologize. Honestly I do think you have a bias, but I don't have reason to believe we have evidence to conclude any ad hominem:bias to be sound.

I don't even know what this means. You're simultaneously doubling down on your ad hominem argument while also apologizing for it. Suppose I had my same experiences and I agreed with you, would I be biased? You calling me biased is a way to dismiss my argument because you can't refute it and you've already made up your mind. That is the ad hominem fallacy. Saying that you aren't committing a fallacy when you are is simply denying the antecedent. You also don't have to take my word for it, peruse this forum, Reddit, and anywhere else you like. I think if you'll find other folks in my camp. Are all of them biased also? Maybe only people who agree with you are unbiased.

 

[Sanman]

A few quick points:

1. If you want to be a therapist, there is no good path. Pick between all the imperfect ones because it is the system we have.

2. SWs are the only therapy mid levels that can bill medicare and the only ones qualified for the vast majority of federal VA jobs. This may be important in the future, especially in FL. I hear they have old people.

3. Many counseling folks have a hard time getting licensed as they are required to complete a certain number of therapy hours after they graduate and not many people want to hire/supervise unlicensed mid-level folks, so there is the danger of no jobs. SWs can do a case management gig while getting therapy hours.

4. Most SWs are not therapists so the salary numbers are likely low.

 

[PGM_777]

A few quick points:

1. If you want to be a therapist, there is no good path. Pick between all the imperfect ones because it is the system we have.

2. SWs are the only therapy mid levels that can bill medicare and the only ones qualified for the vast majority of federal VA jobs. This may be important in the future, especially in FL. I hear they have old people.

3. Many counseling folks have a hard time getting licensed as they are required to complete a certain number of therapy hours after they graduate and not many people want to hire/supervise unlicensed mid-level folks, so there is the danger of no jobs. SWs can do a case management gig while getting therapy hours.

I may have wrongly assumed I would enjoy graduate school. 🤯🙂 Its a hard pill to swallow...

4. Most SWs are not therapists so the salary numbers are likely low.

Haha but anyway could you elaborate? They're actually lower or actually higher?

 

[Sanman]

I may have wrongly assumed I would enjoy graduate school. 🤯🙂 Its a hard pill to swallow...


Haha but anyway could you elaborate? They're actually lower or actually higher?

You won't get good psychotherapy training without a doctoral program from what I hear (counseling program grads seem to report a lot of supportive therapy training only) and you don't want to be stuck with that kind of debt if all you want to do is therapy. It's all a means to an end.

Case management, while not something you enjoy, opens up a lot of jobs for you at many larger institutions. This is good if you need benefits. I work with a number of social workers that have a SW job and private practice on the side. Something to think about.

My old company hired LCSW therapists (and only them as we billed medicare) starting at $55-60k. Dept of Veterans Affairs starts LCSWs in the 70k range going up. I know several LCSW therapist in the $100k range.

 

[deleted462159]

You won't get good psychotherapy training without a doctoral program from what I hear (counseling program grads seem to report a lot of supportive therapy training only) and you don't want to be stuck with that kind of debt if all you want to do is therapy. It's all a means to an end.

Case management, while not something you enjoy, opens up a lot of jobs for you at many larger institutions. This is good if you need benefits. I work with a number of social workers that have a SW job and private practice on the side. Something to think about.

My old company hired LCSW therapists (and only them as we billed medicare) starting at $55-60k. Dept of Veterans Affairs starts LCSWs in the 70k range going up. I know several LCSW therapist in the $100k range.

Those ranges sound like what I've seen as well. $55k seems kind of low for an LCSW but I guess there's wide variation.

Average I've seen for newer LCSWs is in the 70k range.

 

[summerbabe]

However, if i come at it based on my initial concern stating that I want to do therapy, it is pretty easy to look at the information presented (regardless of what you're expressing as the point you're trying to make) and see the information leading to a conclusion that both kinds master's level therapists aren't well trained at therapy.

2 years of training as a baker will probably have you baking pretty good loaves of bread because that process is very technical and scientific. If I were to look at my own growth as a therapist in 2 year increments, the difference is pretty major at each increment.

In many ways, a degree program is providing you the basics such as understanding the scope of your field/license and how to practice ethically while also providing some foundational hands-on training to get you started. I have a PhD and the single biggest improvements to my therapy skills were gained by attending very specific professional trainings and with follow-up consultation after I was already licensed. Of course, I had a foundation that was developed during grad school and some programs/degrees will provide better or worse foundations but every program is going to have limitations. If you want to become a kickass therapist, get a licensable degree, begin to practice and figure out your interests within the field of therapy, and then really focus on getting quality continuing education in those areas.

I may have wrongly assumed I would enjoy graduate school. 🤯🙂 Its a hard pill to swallow...

Sorry grad school isn't what you thought it would be. I majored in something with literally zero pathway to a career (philosophy) because that was my academic passion and while some parts of grad school were interesting, it was generally something that I trudged through/tolerated in order to receive the credential.

They told me I could do PP first year, then I got stuck with a CMH spot which would be totally fine or preferred if it had anything to do with therapy. But it doesn't. They can't guarantee me a therapy placement second year but i will probably get one.

That's a bummer and if you stay in the program, I hope that you can find an effective avenue for advocating for your needs next year.

I don't want to be a "social worker" or do case management - ever. I have done it before and I hate it.

You might be a poor fit for the SW field, which is fine. But if you're willing to make it work, you can definitely still use it to become a full-time therapist and as others have pointed out, there are some major career benefits to having a LCSW versus LPC or MFT degrees. Good luck and hope things work out for ya.

 

[singasongofjoy]

As others have noted there are clear benefits to social work over counseling when first out of the gate- at least in some states. In my state and others i have lived in, counseling folks have extremely specific requirements about what counts as licensure towards therapy, whereas social work allows a much wider variety of work to count, which makes the licensing process much faster (and the cost of supervision if you have to pay for it, lower salary before licensed, etc are considerable costs). The versatility is also much more limited with billing in many cases- to the point that my organization has, after hiring a few pre-licensed folks in both social work and counseling in the past few years, is now reluctant to hire counseling folks at the master's level. it's too much of a headache to stick with them to licensure given the billing limitations, supervision needs, etc. that is a burden on others on the team- and in an admin and supervisory position, I'm completely on board with that. It has been particularly hard during COVID to adequately support my counseling staff pre-licensure. So that is one thing to take into consideration among all the other variables.

 

[Dahresto]

LCSW in CA here.
Just do what you want to do, but know that there is no clear path to do "therapy", you still have to go to graduate school for 2 years, accrue hours, study for clinical exam, pass exam, and then, well, do what you want to do.

 

[PGM_777]

LCSW in CA here.
Just do what you want to do, but know that there is no clear path to do "therapy", you still have to go to graduate school for 2 years, accrue hours, study for clinical exam, pass exam, and then, well, do what you want to do.

Thanks for the reply. I decided to stay in the program. If i wanna do something more therapy heavy, maybe I will get another degree or something.

That being said I still get a little bummed about the coursework sometimes. I am trying to balance it out with electives from the Counseling program, the coursework of which I am so jealous of. That being said, I do see a lot of positives in the MSW coursework, but it is not at all academically rigorous.

I spend a lot of my free time supplementing with youtube videos, therapy manuals, and CE trainings. I'm interning as a therapist in a private practice. Yep. First year. I would be really silly to complain about that, huh?

 

[chicandtoughness]

If it helps, there are a LOT of LPCs/LMHCs out there who wish they would have done the MSW instead. Myself being one of them. I'm also disillusioned with the counseling field and am choosing to leave. Yes, some of me and Matey's statements may come from a place of bitterness, but I think it's valid to consider why we're bitter in the first place- because this field of study failed to show us that it was a worthwhile career to stay in if you value high quality work, being paid properly for your time, and not being a shill. Oops, did I say that out loud?

I'm glad you decided to stay. There is a lot of "grass is greener" in your posts. There's not a lot of therapy training in counseling programs either. If I had done the bare minimum in my counseling program, no WAY would I have been prepared to actually do therapy upon graduation. It genuinely TERRIFIES me how little gatekeeping there is in the counseling world. I cannot wrap my head around the fact that some of my classmates are out there now, charging upwards of $100/hour for bargain bin low quality of services.

The only reason I felt mildly confident to do therapy after graduating is because I chose to do 3 internships (the requirement was 1) and also worked throughout all 2.5 years of grad school as a counselor/group therapist (not a clinician, just leading groups and milieu management) at a PHP/IOP program. I literally came out with probably 5-6x as many hours as my classmates, and there are some days where even I look back and think wow, it's straight up unethical that I was allowed to see patients by myself after graduating.

Get the MSW, because the degree and the license (not necessarily the training) will open up the doors for you. I know you're not interested in this, but as an example, there's a prominent psychoanalytic institute that I want to attend. They do not accept LMHCs/LPCs. They DO accept LICSWs. There's no reasoning, just good old nepotism and history.

As for programs not being academically rigorous... that's just what human services masters programs are like. I cruised through my program (and had the time to work 2 jobs along with internships). It's simply not an area of study that is didactically difficult.

I'm not trying to connect people to services. I'm trying to save their lives.

I hate to beat a dead horse, but this statement really stood out to me. As a therapist who has worked in all levels of care (inpatient, RTC, PHP, IOP, CMHC OP, and private practice), the most lives I have saved were from "connecting people to services." By helping coordinate a transfer of care to a HLOC. From giving them hope when there's too much month at the end of the bills. From helping connect a patient to sober living. From finding nonprofit scholarships for treatment. From providing psychoeducation on their conditions. From negotiating 504s and LOAs from work and disability benefits. From linking them up to support groups so they're not alone. Case management has saved MANY more of my patients' lives than 1:1 therapy in private practice. Take that as you will.

As another point: consider that your desires may change as you get older. Now, you could very well still be doing pp 20 years down the line and will be happy in that field. Great! But neither you nor I have crystal balls. I went into my program ADAMANT that I would never touch 1) children/adolescents, 2) substance use, 3) inpatient, 4) SMI. I wanted my cash pay private practice where I would make $150k a year and get to recline on a couch all day. I almost quit my program when the only practicum site that took me was a substance use PHP.

7 years later, guess where I work now? At an inpatient psychiatric hospital. I work the child/adolescent floor. My other job is intake/assessments for a substance use RTC/PHP/IOP.

I love my jobs. I say this 100% unironically.

Leave room for those opportunities. The MSW will give you that space to pivot and grow if your interests change.

 

[PGM_777]

If it helps, there are a LOT of LPCs/LMHCs out there who wish they would have done the MSW instead. Myself being one of them. I'm also disillusioned with the counseling field and am choosing to leave. Yes, some of me and Matey's statements may come from a place of bitterness, but I think it's valid to consider why we're bitter in the first place- because this field of study failed to show us that it was a worthwhile career to stay in if you value high quality work, being paid properly for your time, and not being a shill. Oops, did I say that out loud?

What do you plan to do next? What advice do you have for people who want to stay master's level and do HQ work?

(I've thought about a future PsyD or counseling or clinical PHD because I don't want a social work PHD... but not sure I want to engage in hardcore research or pay 200k)

I'm glad you decided to stay. There is a lot of "grass is greener" in your posts. There's not a lot of therapy training in counseling programs either. If I had done the bare minimum in my counseling program, no WAY would I have been prepared to actually do therapy upon graduation. It genuinely TERRIFIES me how little gatekeeping there is in the counseling world. I cannot wrap my head around the fact that some of my classmates are out there now, charging upwards of $100/hour for bargain bin low quality of services.

I can't speak to counseling specifically, ofcourse. But yeah - I'm concerned about the same things. Anyway, I have noticed the "grass is greener" BS about myself. ::

I know you're not interested in this, but as an example, there's a prominent psychoanalytic institute that I want to attend. They do not accept LMHCs/LPCs. They DO accept LICSWs. There's no reasoning, just good old nepotism and history.

What makes you think I wouldn't be interested in that? Actually, a significant reason I went for the MSW is that basically every master's level psychoanalytic or jungian oriented practitioner I could find is an MSW. Also the profession has been involved with psychodynamic theory from the beginning Freud was the only game in town...as you noted. Yeah, I did factor in the lobby and general nepotism into my degree decision. Slick, i guess.

The MSW will give you that space to pivot and grow if your interests change.

Yeah exactly. I think I know what I want. But let me tell you, that hasn't always been the case historically. The best things In my life I sort of just fell into. Also, I have been over he last few months been having the tendency to get frustrated with things because I have been tapering an SSRI.

 

[chicandtoughness]

What do you plan to do next? What advice do you have for people who want to stay master's level and do HQ work?

I'm pre-med now, applying for med school this upcoming cycle. And no, I do not plan on doing psychiatry haha. For master's folks who want to continue doing therapy, do LOTS of continuing education. Go above and beyond to seek out high quality trainings (read: not EMDR lol). I thought I had read somewhere above about your theoretical orientation, but I realize I got you confused with another post. If you're interested in psychoanalytic studies, then go for it! Find a program approved by the IPA or APsyA (if you're in the Freudian camp), or a CG Jung Institute (self explanatory). I'm part of a program now so I'm happy to share insights.

(I've thought about a future PsyD or counseling or clinical PHD because I don't want a social work PHD... but not sure I want to engage in hardcore research or pay 200k)

There are PhD programs that are more practice oriented, which you might find interesting! They have just enough research requirements that will feel "rigorous" to you (unlike the MSW) but not too much. Check out the Insider's Guide to Clinical and Counseling Psychology Programs, which rates all the APA accredited programs on a scale from 1 (practice oriented) to 7 (clinical science).

Yeah exactly. I think I know what I want. But let me tell you, that hasn't always been the case historically. The best things In my life I sort of just fell into. Also, I have been over he last few months been having the tendency to get frustrated with things because I have been tapering an SSRI.

Oh dude I feel you. I was a major grouchypants getting off my antideps earlier this year. I feel so apologetic for every customer service rep I interacted with during that time lol.

 

[MrFahrenheit]

You've worked so hard to get into the program! Give it a little more time before making such a rash decision. Pro and Con lists always help me out!