LCSW in California

[Danagirl]

I have been learning a lot and considering going back to school for LCSW since lots of research consensus seems to say LCSW is more hirable than MFT in psychology.

Ideally I would eventually get into PhD for a licensable Psychology track if I can go with tuition paid for.

But in the meantime, I’m interested in private practice for psychotherapy and case management in the future. I know after the MSW degree I will need to work 3000 hours for my license.

****After the 3000 hours and getting licensed would I be able to bill insurance on my own for private practice or do I have to have even more post license experience to be accepted for insurance reimbursement. ***

Is it realistic to be be able to work say 3-4 days a week on my own schedule and make atleast 50k-60k as a Californian LCSW in private practice or for a company?

I’m so sick of being worked to death as a wage slave so I am willing to deal with a small amount of financial fluctuation to have more control over my schedule but I don’t want to starve. Am I able to still charge people or their insurance if they schedule but don’t show up and don’t cancel in an agreed amount of time?

I have honestly only up to this week heard nothing but horror stories about agencies and community health organizations. So though I know they may be necessary evil I don’t want to make a career out of them.


***Also how hard is it to get supervision without ending up in some nightmare low paying organization? Do they even pay? ***

I’m in Los Angeles now but am willing to move to other areas of the state that are at least an hour away from a major city so I am interested in all people with experience in California. Is the Social worker scene getting Too saturated to find work or clients? I don’t want to have to pay for a master’s and then end up screwed due to poor research. So any and all pointers to where to further research LCSW as a business accepting insurance is highly appreciated!

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[Danagirl]

To answer one of my own questions I found out that some insurances require counselors to be licensed for 2 years before being able to be excepted assuming they don’t have a full panel once you qualify.

 

[foreverbull]

But in the meantime, I’m interested in private practice for psychotherapy and case management in the future. I know after the MSW degree I will need to work 3000 hours for my license.

****After the 3000 hours and getting licensed would I be able to bill insurance on my own for private practice or do I have to have even more post license experience to be accepted for insurance reimbursement. ***

Is it realistic to be be able to work say 3-4 days a week on my own schedule and make atleast 50k-60k as a Californian LCSW in private practice or for a company?

I’m so sick of being worked to death as a wage slave so I am willing to deal with a small amount of financial fluctuation to have more control over my schedule but I don’t want to starve. Am I able to still charge people or their insurance if they schedule but don’t show up and don’t cancel in an agreed amount of time?

***Also how hard is it to get supervision without ending up in some nightmare low paying organization? Do they even pay? ***

I’m in Los Angeles now but am willing to move to other areas of the state that are at least an hour away from a major city so I am interested in all people with experience in California. Is the Social worker scene getting Too saturated to find work or clients? I don’t want to have to pay for a master’s and then end up screwed due to poor research. So any and all pointers to where to further research LCSW as a business accepting insurance is highly appreciated!

A few thoughts here as a fellow CA resident:

1. if you plan to get your doctorate, this is going to be a VERY long educational path with generally poor pay. It will take 2+ years to get your master's, an extra 1-2+ to get licensed, and then you will be starting out fresh and with no referrals or leads in private practice. Private practice takes several years to build up to full-time if you don't have a HIGHLY sought-after specialty or have a steady referral stream. My old supervisor said a good rule of thumb is 1 year of buildup = 1 day of clients, so about 3-4 years AFTER licensure to make the income you're hoping for in private practice, assuming you have plenty of cash pay clients to offset the low pay of insurance and business fees. Then you're going to go into a grad program full-time after doing this? I just don't see the point if it takes 6-8 years to go from education to building up your business.

2. A colleague of mine has an LCSW degree and is in private practice. She was full, last time we talked, but she takes insurance and sees a majority of insurance-based clients who aren't paying full fee (full fee in CA can be anywhere from $100-$150+). Insurance reimbursement can be as low as ~$75 in California, and don't forget you have to pay business fees like billing and/or billing software, rent, licensing, insurances, marketing/website, etc. that will offset your gross income. For example, I know some folks who have business expenses in the range of anywhere from ~ $12,000-$25,000+ per year. This also means you don't have health insurance, sick pay, PTO, retirement, dental, etc., so that ALSO comes out of pocket if you do this full-time.

3. Insurance:

No shows: I don't take insurance, but from what I've heard, insurance will not reimburse for no service rendered. I do this in private practice, but it's a different ballgame with insurance, so I can't answer that one definitively. I can't speak to insurance rules for master's level practitioners, either, unfortunately.

4. I'm not familiar with the specifics of supervision after graduation and pre-licensure for LCSWs, but I was GROSSLY underpaid as a postdoc, so much so my paycheck for the month didn't even pay rent. I'm not sure if there are cushy jobs for LCSWs pre-licensure, but I tend to doubt it.

 

[psychtnt]

A few thoughts here as a fellow CA resident:

1. if you plan to get your doctorate, this is going to be a VERY long educational path with generally poor pay. It will take 2+ years to get your master's, an extra 1-2+ to get licensed, and then you will be starting out fresh and with no referrals or leads in private practice. Private practice takes several years to build up to full-time if you don't have a HIGHLY sought-after specialty or have a steady referral stream. My old supervisor said a good rule of thumb is 1 year of buildup = 1 day of clients, so about 3-4 years AFTER licensure to make the income you're hoping for in private practice, assuming you have plenty of cash pay clients to offset the low pay of insurance and business fees. Then you're going to go into a grad program full-time after doing this? I just don't see the point if it takes 6-8 years to go from education to building up your business.

2. A colleague of mine has an LCSW degree and is in private practice. She was full, last time we talked, but she takes insurance and sees a majority of insurance-based clients who aren't paying full fee (full fee in CA can be anywhere from $100-$150+). Insurance reimbursement can be as low as ~$75 in California, and don't forget you have to pay business fees like billing and/or billing software, rent, licensing, insurances, marketing/website, etc. that will offset your gross income. For example, I know some folks who have business expenses in the range of anywhere from ~ $12,000-$25,000+ per year. This also means you don't have health insurance, sick pay, PTO, retirement, dental, etc., so that ALSO comes out of pocket if you do this full-time.

3. Insurance:

No shows: I don't take insurance, but from what I've heard, insurance will not reimburse for no service rendered. I do this in private practice, but it's a different ballgame with insurance, so I can't answer that one definitively. I can't speak to insurance rules for master's level practitioners, either, unfortunately.

4. I'm not familiar with the specifics of supervision after graduation and pre-licensure for LCSWs, but I was GROSSLY underpaid as a postdoc, so much so my paycheck for the month didn't even pay rent. I'm not sure if there are cushy jobs for LCSWs pre-licensure, but I tend to doubt it.

Thank you for making these points. I also live in CA and I have been considering the same path as the OP. I don't want to waste years in pursuit of a MSW then LCSW then PhD/PsyD just to be met with the uphill battle of building a private practice in order to be financially stable. I am interested in working or completing my postdoc at a University Counseling and Psychological services center then maybe building a part time practice on the side. Is this a feasible path in CA? Ideally I would go straight into a doctoral program then work at the university while I build a private practice in my spare time.

 

[foreverbull]

Thank you for making these points. I also live in CA and I have been considering the same path as the OP. I don't want to waste years in pursuit of a MSW then LCSW then PhD/PsyD just to be met with the uphill battle of building a private practice in order to be financially stable. I am interested in working or completing my postdoc at a University Counseling and Psychological services center then maybe building a part time practice on the side. Is this a feasible path in CA? Ideally I would go straight into a doctoral program then work at the university while I build a private practice in my spare time.

Yes, this is possible. I know some folks who did this, in fact, but here’s the caveat: UCC work is exhausting, and early career folks usually have to deal with the crisis calls/on-call stuff, or the outreach programs, etc. (meaning sometimes extra hours for no extra pay). UCC jobs are definitely less appealing and much busier than they were 15 years ago, and pay is egregiously low (at Northridge and other nearby LA schools, staff psychologists were paid in the $50s/year, mid-thirties for postdocs—this was about 5 years ago). Thus, it’s done here and there, especially if private practice is the ultimate goal, but fair warning: it’s exhausting. People usually start out with one evening seeing clients if they go that route.

 

[Danagirl]

Yes, this is possible. I know some folks who did this, in fact, but here’s the caveat: UCC work is exhausting, and early career folks usually have to deal with the crisis calls/on-call stuff, or the outreach programs, etc. (meaning sometimes extra hours for no extra pay). UCC jobs are definitely less appealing and much busier than they were 15 years ago, and pay is egregiously low (at Northridge and other nearby LA schools, staff psychologists were paid in the $50s/year, mid-thirties for postdocs—this was about 5 years ago). Thus, it’s done here and there, especially if private practice is the ultimate goal, but fair warning: it’s exhausting. People usually start out with one evening seeing clients if they go that route.

thank you for your thorough replies. I thought about it since starting this thread and MSW just makes more sense.
***In regards to practicing while in a PHD another member here said you most likely can’t practice for a LCSW while in the PhD for psychology. I couldn’t find info on that. Is that true in California? It seems none of the work counts if it needs to be post-the degree.

 

[foreverbull]

thank you for your thorough replies. I thought about it since starting this thread and MSW just makes more sense.
***In regards to practicing while in a PHD another member here said you most likely can’t practice for a LCSW while in the PhD for psychology. I couldn’t find info on that. Is that true in California? It seems none of the work counts if it needs to be post-the degree.

None of the practice hours you do in MSW training or private practice or a social worker job to earn money as a licensed clinical social worker will count towards your doctoral training, this is absolutely true. Having time to have a private practice just for money may or may not be feasible while in a doctoral program (for folks with master’s degrees in my program including me, it wasn’t feasible at all so none of us tried it due to time limitations and logistics). You will be starting over completely in terms of obtaining “direct hours” and will have to do several unpaid practica along the way for training hours, culminating in a year-long, full-time internship that is usually in another state and offers extremely low pay despite how competitive it is because internship is required (it’s a competitive national match process that you apply for the year before internship). During internship, you’d be applying for postdocs, as well.

 

[R. Matey]

In regards to practicing while in a PHD another member here said you most likely can’t practice for a LCSW while in the PhD for psychology.

Can verify. I hold an LPC and did not use it on my internship, which is a full time clinical role.

 

[Danagirl]

Can verify. I hold an LPC and did not use it on my internship, which is a full time clinical role.

Did they pay you something livable for the clinical role? Did you have to start paying loans during this time?

 

[R. Matey]

Did they pay you something livable for the clinical role? Did you have to start paying loans during this time?

My internship pay was actually a little more above what's typical for internship pay so I found it to be pretty affordable given the COL of my area (small college town). My only loans were from my master's program and I've already paid them off. But, you are still registered as a student while you're attending internship so I imagine the same rules apply re: student loan payback.

 

[foreverbull]

Did they pay you something livable for the clinical role? Did you have to start paying loans during this time?

I barely made enough money for rent, bills and food on internship. Really depends on where the internship is and living situation.

My program had us pay for a certain number of credit hours of internship so as not to enter repayment (interest will accrue during this time as always, but you’re still considered a student taking classes). Internship didn’t pay enough to cover the cost of the tuition, however. This is typical of doctoral programs.

 

[R. Matey]

Internship didn’t pay enough to cover the cost of the tuition, however. This is typical of doctoral programs.

Oh, right. I should've mentioned that I used a scholarship to cover my tuition for internship year.

 

[AcronymAllergy]

Essentially, if you have another MH license while going through doctoral training, you can't practice under that license for any activity that is considered part of your doctoral training (including while on internship). Programs and states will likely vary in terms of whether you're allowed to practice under that license outside of your doctoral training activities. Even if a program allows it, I'd want to double-check with the state I'm working in, and the state(s) I plan to be licensed in, to see if that would somehow interfere with my training or licensure. You would also, of course, need your own malpractice coverage, as your program's wouldn't cover you for those activities.

And yes, it's common for programs to enroll you in some number of hours for your clinical internship so that you remain a student of the program. I think mine was a 1 credit hour course, but I honestly can't remember. Tuition for it was covered by my funding I believe, but (as is usually the case), I was responsible for fees. My internship salary was tight but livable in the city in which I trained (low COL).