Least stressful psychologist setting

[taylortaylor164]

Hi, I was wondering what is the least stressful of a setting a psychologist can work in. My guess is private practice but want to get the input of others.

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[PsyDr]

Private practice combines the stress of running a small business with the added responsibility of your clinical work.

Someone has to pay office rent. And if you have a period of time with low patient volume, or insurance decides to delay your payments for 2 months, or your rent goes way up... your bills don’t care.

 

[WisNeuro]

If you just want to clock in at a certain time and clock out a certain time with stability, the VA. Of course, this is if you don't mind not having any control over your work life. As @PsyDr mentioned, private practice can be very stressful if you do not like the business side of things. But, I like that part, and I hate stupid, arbitrary rules, so private practice is much less stressful for me. Really depends on what causes you stress in a work setting.

 

[Ollie123]

You need to operationalize stressful for us. One person's stress is another's ideal. If the most stressful thing you can imagine is a fixed schedule and a boss telling you what to do, PP might be the dream. If you prefer the routine and don't mind bureaucracy as long as you have a steady job, the VA might be good, etc.

I work in academia. Many would consider it hell, but I would go crazy in most other psychology settings because the things I find fun (research) aren't really an option in most other settings...at least not the type and caliber of work I want to do.

 

[erg923]

Hi, I was wondering what is the least stressful of a setting a psychologist can work in. My guess is private practice but want to get the input of others.

Managed care, psychologist peer reviewer. WFH and no liability. Get up at 9 (or 10), work till done. Sometimes just 3pm. Ahhh.....

 

[taylortaylor164]

I mean stressful as in unpredictable setting, sudden emergencies, high client load, low flexibility. Inpatient would be pretty stressful it sounds like

 

[PsyDr]

I mean stressful as in unpredictable setting, sudden emergencies, high client load, low flexibility. Inpatient would be pretty stressful it sounds like

Inpatient? You mean the place where they bring the patients to you? And there are people on staff to handle stuff when things get wild? Not so stressful.

 

[DynamicDidactic]

You need to operationalize stressful for us. One person's stress is another's ideal. If the most stressful thing you can imagine is a fixed schedule and a boss telling you what to do, PP might be the dream.

I mean stressful as in unpredictable setting, sudden emergencies, high client load, low flexibility. Inpatient would be pretty stressful it sounds like

Most settings are predictable, meaning once you are in that setting and know how things work they don't tend to be unpredictable (whether that is inpatient, outpatient hospital, or private practice).
Sudden emergencies. That will most likely depend on who you are working with rather than where. So, if you work with people that are not going to be likely to abuse others or think about homicide or suicide then emergencies will be few.
High client load is relative but there are 8 working hours in a day and if you work for someone they will try to fill your day as much as possible. The VAs and Kaiser tend to have a lot of clients that you may see less often. Other places have less clients that you see more often. But no one is looking to pay you to sit around and conceptualize your cases for an hour a day in between lunches and late afternoon drinks.
Flexibility in what? Again, usually working for others will mean you have less power. Usually admin responsibilities come later in your career if working in a VA or AMC. Some teaching available in med school settings.

It sounds like you want to have a part time private practice with folks that fall into the worried-well category but make enough steady income not to worry about it. That would be least stressful but that is not a common situation.

I think it is more important to figure out what you like and don't like to do. For example, I learned early that an AMC was not for me. This is what practicum, internship, and post-doc are for. It allows you to learn what type of position you most want to seek out. Then after a few years you may change your mind. Plenty of people on this board have changed their mind.

 

[cara susanna]

I always envy inpatient because the patients at some point will be discharged. Lol.

I think that there are certain VA positions that seem pretty stress-free, but it depends on the facility as well.

 

[Sanman]

On the emergencies front, I will add it also depends on the stress tolerance of the staff you work with if you are catering to any sort of medical unit. I had plenty of "emergencies" that were patients who stated they wanted to shoot themselves in the middle of a painful PT session. Of all of those I got, none were hospitalized for SI. The only true SI I had in thousands of cases was a routine follow-up that was paranoid and demented.

 

[Indiana_Jane]

I always envy inpatient because the patients at some point will be discharged. Lol.

I think that there are certain VA positions that seem pretty stress-free, but it depends on the facility as well.

This is exactly why I love inpatient lol.

 

[BuckeyeLove]

I mean stressful as in unpredictable setting, sudden emergencies, high client load, low flexibility. Inpatient would be pretty stressful it sounds like

The reason I love inpatient is because it is kind of the opposite of what you're saying here.

 

[ClinicalABA]

My current gig is one of the least stressful jobs (of any type- not just psychology) that I've ever had. I'm part of a large group assessment practice, but we are all spread out in different offices across the state. I set my own schedule, and have limited my practice to an age range (12-48 months)that I find the most fun to work with (and easiest from a clinical perspective). If I get bored, I can see older kiddos if I want. Highly predictable and very flexible. As long as I meet my minimum hours/billable requirements (which are very reasonable), I'm left alone to do my own thing as I see fit (of course, I need to be in line with the mission and values of the agency, including using empirically supported practices).

I have had some pretty stressful jobs- mainly in administration/sr. management. Things like being on-call, staff discipline (including firings and lay-offs, as well as deciding who gets promoted and who doesn't), worrying about meeting payroll, etc. Also have worked with some relatively volatile, 24 hours-a-day clinical populations where I had to worry about physical aggression, elopement, and criminal behaviors, as well as negative community interactions. When I think about those positions, I feel guilty that now, in essence, get paid to play with 2 year-olds!

 

[Doctor Eliza]

Private practice combines the stress of running a small business with the added responsibility of your clinical work.

Someone has to pay office rent. And if you have a period of time with low patient volume, or insurance decides to delay your payments for 2 months, or your rent goes way up... your bills don’t care.

Well said. Also, sometimes there is a pandemic and you are paying office rent for an office you don't use for months and months because you are doing telehealth.

PP is definitely not without its stresses. In addition to what PsyDr said, I also find it stressful not to have benefits (sick time, vacation time, 401K, health insurance). I think sometimes grad students and grad school applicants romanticize PP and don't immediately think about the impact of these things.

That said, I love making my own decisions and using my creativity. I don't have to worry about meeting productivity standards or following arbitrary agency policies that I don't believe in. I like that essentially the more I work, the more I make. In general I'm a happy camper and would be hesitant to switch to an employed position.

 

[Sanman]

The more I think about this question, the more I feel it has parallels to questions such as "who is happiest" and "what is the best job"

I am not sure that I have one static answer to the question:

When I was first licensed, being an employed psychologist on the private side with a steady referral stream was great because I enjoy things like being able to keep a roof over my head, paying my bills, and eating three meals a day regularly. This enabled me to make more money working more hours.

Now that I am a few years into my career, I enjoy my VA practice as I don't put in as many hours, am well compensated, and have lots of paid leave. This allows me more time with my family.

In the future, once I own my home (pay it off) and I have plenty of money in the bank, I imagine that private practice may be the best fit since I can command higher rates and would be able to set my own hours and have more freedom to enjoy my life since I will not need to concern myself about finances as much.

To which version of me are you asking that question? Because all three versions picked the least stressful practice for their circumstances.

 

[Spydra]

I'm still training, but am curious is working for an EAP relatively stress free? From the limited knowledge I have the referrals come to you, you choose your own hours/case load limits, the pay is determined by what the employer will pay but is generally competitive, the population skews high functioning, and treatment is brief. It may not be suitable as a sole income stream depending on lifestyle preferences or financial needs, but could be a worthwhile supplement.

 

[WisNeuro]

Well said. Also, sometimes there is a pandemic and you are paying office rent for an office you don't use for months and months because you are doing telehealth.

PP is definitely not without its stresses. In addition to what PsyDr said, I also find it stressful not to have benefits (sick time, vacation time, 401K, health insurance). I think sometimes grad students and grad school applicants romanticize PP and don't immediately think about the impact of these things.

That said, I love making my own decisions and using my creativity. I don't have to worry about meeting productivity standards or following arbitrary agency policies that I don't believe in. I like that essentially the more I work, the more I make. In general I'm a happy camper and would be hesitant to switch to an employed position.

If you structure it the right way, your ability to shield income into retirement accounts is much better in PP than most options working form someone else. I do agree that PP can be stressful if you do not know what you're doing, but if you do your research, consult with colleagues who have been doing it a while, and have adequate support (i.e., tax professional, identified legal consult, etc) it can ultimately be much more lucrative and much less stressful.

 

[BuckeyeLove]

I'm still training, but am curious is working for an EAP relatively stress free? From the limited knowledge I have the referrals come to you, you choose your own hours/case load limits, the pay is determined by what the employer will pay but is generally competitive, the population skews high functioning, and treatment is brief. It may not be suitable as a sole income stream depending on lifestyle preferences or financial needs, but could be a worthwhile supplement.

I can only speak from what I've seen in my city, but where I live there is essentially one psychologist who over the course of 30 plus years has acquired the contracts for almost all EAP work. He is a multi-millionaire (honestly I would call him a businessman over a psychologist, hasn't done actual clinical work himself since the 80s I bet), and he pays absolutely nothing to the clinicians providing those services. Like....45 to 50 bucks an hour, contract rate.

 

[PsyDr]

@Doctor Eliza based upon your previously referenced income in a post where you indicated I was wrong about the business of PP: at a bare minimum you should have a SEP IRA, an HSA, own occupation disability insurance, and a corporate leased car.

There, I just got you those benefits and a car using pre-tax dollars.

 

[DynamicDidactic]

@PsyDr is a car for any business acceptable. Or does one need to have a specific reason why a non-travel job like PP psychologist needs a car?

 

[PsyDr]

@PsyDr is a car for any business acceptable. Or does one need to have a specific reason why a non-travel job like PP psychologist needs a car?

All depends on the corporate structure of your PP, what type of car, etc. individual, LLC, LLC functioning as an S Corp, S Corp, etc all have different rules. Hint: there is a reason that Cars are treated differently than an 18 wheeler.

If you have an LLC that is treated as a disregarded entity, then you’d need a personal car in addition to your business lease. Of course, some smart person would recognize that you could leverage the fact that classic car insurance is super low, that such cars are defined by being 20 years old, some make/models have a reputation for running forever, and that one can purchase such cars for under $5k off Craigslist.

 

[taylortaylor164]

Thank you for these answers. What about college counseling centers?

 

[BuckeyeLove]

What about college counseling centers?

This legit to me sounds horrifying from a stress perspective. But I have colleagues who love it. I'm a big process group proponent, and I always was jealous of my graduate student colleagues at my school because of the great experience they had with group and this population. But it would still terrify me today to do it from a risk and stress perspective.

 

[Sanman]

All depends on the corporate structure of your PP, what type of car, etc. individual, LLC, LLC functioning as an S Corp, S Corp, etc all have different rules. Hint: there is a reason that Cars are treated differently than an 18 wheeler.

If you have an LLC that is treated as a disregarded entity, then you’d need a personal car in addition to your business lease. Of course, some smart person would recognize that you could leverage the fact that classic car insurance is super low, that such cars are defined by being 20 years old, some make/models have a reputation for running forever, and that one can purchase such cars for under $5k off Craigslist.

Other smart people who enjoy playing with low cost classic cars in their free time could be mad at such a smart person for blowing up their spot.

 

[Doctor Eliza]

@Doctor Eliza based upon your previously referenced income in a post where you indicated I was wrong about the business of PP: at a bare minimum you should have a SEP IRA, an HSA, own occupation disability insurance, and a corporate leased car.

There, I just got you those benefits and a car using pre-tax dollars.

As a point of reference, previously referenced income no longer applies, as I am no longer working for someone else.

 

[Sanman]

As a point of reference, previously referenced income no longer applies, as I am no longer working for someone else.

I think this is a big point to make in the real world. Working as a contractor in another person's PP is a very different world than having your own practice.

 

[PsyDr]

Other smart people who enjoy playing with low cost classic cars in their free time could be mad at such a smart person for blowing up their spot.

Rest assured, your hobby is safe. Classic car insurance rates apply for cars older than 20 years. The IRS is not going to believe that your personal car is a classic sports car. However, they might believe that your personal car is a 1989 diesel Volvo station wagon.

I have some ambitions with a car hobby, after my dreams of getting a blimp pilot's license were dashed.

 

[Sanman]

Rest assured, your hobby is safe. Classic car insurance rates apply for cars older than 20 years. The IRS is not going to believe that your personal car is a classic sports car. However, they might believe that your personal car is a 1989 diesel Volvo station wagon.

I have some ambitions with a car hobby, after my dreams of getting a blimp pilot's license were dashed.

Damn it, Now I want to be a blimp pilot. Anyone have a Duff Beer blimp for sale? Eh, my wife probably won't let me anyway.

If you are going diesel wagon, Mercedes W123 is the way to go. Better parts support.

 

[summerbabe]

What about college counseling centers?

I've never worked or trained in this setting but you're likely to spend some time each month being on call after hours and may need to respond to crises in the middle of the night or weekends. And staffing levels can definitely vary based on how well-funded the school is.

 

[DynamicDidactic]

I've never worked or trained in this setting but you're likely to spend some time each month being on call after hours and may need to respond to crises in the middle of the night or weekends. And staffing levels can definitely vary based on how well-funded the school is.

Also, the case loads will vary depending on school size and feeling efficacious is tough due to poor attendance and high attrition. Also, remember Tarasoff, it can be a sticky wicket at UCCs. UCCs tend to also be on the lower end of salaries. But, if you like being part of a campus community then it can be rewarding.

As numerous people have said earlier, that's the thing about "stress," it depends on your personal experience. I'd hate to try to deal with college-aged problems for low pay and consistent no-shows. But, I'd love to be part of a campus community, depending on the campus.

 

[PsychPhDone]

Thank you for these answers. What about college counseling centers?

I did a practicum at one and really enjoyed many aspects of it, but there were many aspects that would have made it extremely stressful for me if I had been on staff (e.g., high caseload, evening/weekend on call hours, some of the most frequent/severe SI I've seen in an outpatient setting).

Like others said, highly variable.

 

[taylortaylor164]

Also, the case loads will vary depending on school size and feeling efficacious is tough due to poor attendance and high attrition. Also, remember Tarasoff, it can be a sticky wicket at UCCs. UCCs tend to also be on the lower end of salaries. But, if you like being part of a campus community then it can be rewarding.

As numerous people have said earlier, that's the thing about "stress," it depends on your personal experience. I'd hate to try to deal with college-aged problems for low pay and consistent no-shows. But, I'd love to be part of a campus community, depending on the campus.

I have the same sentiment. I have not had the opportunity to have a practicum at one and not sure I will have the chance to. Meaning I cannot go down that path

 

[chicandtoughness]

Managed care, psychologist peer reviewer. WFH and no liability. Get up at 9 (or 10), work till done. Sometimes just 3pm. Ahhh.....

This is my dream job. Or being a WFH intake specialist. "Let me ask you some questions from a predetermined list. Yep, you need RTC. Off you go."

I mean stressful as in unpredictable setting, sudden emergencies, high client load, low flexibility. Inpatient would be pretty stressful it sounds like

Have you worked inpatient before?! It is SO chill. Shift work, short sessions, barebones tx plans (I mean, how much psychotherapeutic deep digging are you going to do in 3-5 days? your goal should be "stabilization" on all your patients and that's that), low client loads. I love inpatient and would go back in a heartbeat.

Now if you're talking about residential, that's a totally different beast.

 

[R. Matey]

Thank you for these answers. What about college counseling centers?

UCCs are far from chill. They were like 10-15 years ago, but have run more like community mental health centers in the last few years with no real corresponding increase in pay. That said, the summer session at my internship was SUPER chill partly due to a decrease in demand for services because of COVID.

 

[foreverbull]

I have the same sentiment. I have not had the opportunity to have a practicum at one and not sure I will have the chance to. Meaning I cannot go down that path

I think it is a good experience for anyone to have, but if you don’t end up doing a practicum in one it would be harder to get to or that path, although not impossible.

Counseling centers can vary widely from site to site. Overall trends and research suggests that UCCs are being utilized at higher and higher rates each year (but without additional staff support), leading to staff being overwhelmed overall. I did a few counseling centers at small private colleges that weren’t heavily utilized and had bare bones staff (loved it then), then did my internship at large state school with several staff (although in a rural area) but that was slammed with students and crisis walk-ins. Our service usage went up 15% from one year to the next. Staff psychologists said things like “I miss the days when we could actually stop and chat.” A colleague of mine did a postdoc in a college counseling center and basically had a crisis “day” per week every week that she took walk-ins in the day and was on-call for 24 hours. She pretty much stopped sleeping much on those nights because she’d get a call almost every other week late at night.

Lots of SI and having to assess safety, and sometimes CPS reports or having to assess threat toward others. Depending on how adequately staffed the site is, it can feel extremely stressful all the way down to okay or enjoyable. Some sites slow way down in summer so staff hold on until then and get a “break” during the slower months.

Overall, it’s trending toward increasing usage in most sites but without added funding for more staff. It was looking bleak when I left that area of practice some years ago. I know a few colleagues who are still working at UCC’s and seem to have better staffing situations—but most of my UCC-trained colleagues have gotten out of college counseling altogether, if that’s any indication. The egregiously low pay at the majority of sites is also not helpful.

 

[cara susanna]

Yup, I had a friend who wanted to work in a UCC and pretty much targeted their career towards working in a UCC (UCC prac, internship, and post doc). They work at a VA now.

 

[Ollie123]

Did practicum at a UCC one semester. I just checked and they're still paying ~ 65k for licensed positions. I'll make more than the director next year, ~4 years out of post-doc. If it was low-stress I could understand the appeal, but they seem to put in fairly long hours these days.

Then again, I have also never seen a setting that went further out of their way to "create" work for themselves than that one. Hours of meetings for psychobabble, over-processing straightforward low-acuity cases and extensive consultation despite the fact that it was unquestionably the least evidence-based place I have worked (i.e. I was strongly discouraged from doing exposure therapy out of fears I might "re-traumatize" people...by having them touch doorknobs or chat with the front desk staff for a few minutes...we weren't even talking about PE/CPT).

Some of this is certainly specific to that one setting. Wasn't topping my list to begin with, but I refused to go within a mile of it after that experience. Strangest people I have met in the field.

 

[WisNeuro]

Did practicum at a UCC one semester. I just checked and they're still paying ~ 65k for licensed positions. I'll make more than the director next year, ~4 years out of post-doc. If it was low-stress I could understand the appeal, but they seem to put in fairly long hours these days.

Then again, I have also never seen a setting that went further out of their way to "create" work for themselves than that one. Hours of meetings for psychobabble, over-processing straightforward low-acuity cases and extensive consultation despite the fact that it was unquestionably the least evidence-based place I have worked (i.e. I was strongly discouraged from doing exposure therapy out of fears I might "re-traumatize" people...by having them touch doorknobs or chat with the front desk staff for a few minutes...we weren't even talking about PE/CPT).

Some of this is certainly specific to that one setting. Wasn't topping my list to begin with, but I refused to go within a mile of it after that experience. Strangest people I have met in the field.

Yuck, that's just a touch higher than my old postdoc salary.

 

[R. Matey]

Did practicum at a UCC one semester. I just checked and they're still paying ~ 65k for licensed positions. I'll make more than the director next year, ~4 years out of post-doc. If it was low-stress I could understand the appeal, but they seem to put in fairly long hours these days.

Then again, I have also never seen a setting that went further out of their way to "create" work for themselves than that one. Hours of meetings for psychobabble, over-processing straightforward low-acuity cases and extensive consultation despite the fact that it was unquestionably the least evidence-based place I have worked (i.e. I was strongly discouraged from doing exposure therapy out of fears I might "re-traumatize" people...by having them touch doorknobs or chat with the front desk staff for a few minutes...we weren't even talking about PE/CPT).

Some of this is certainly specific to that one setting. Wasn't topping my list to begin with, but I refused to go within a mile of it after that experience. Strangest people I have met in the field.

This checks out for my internship exp as well. I was the "weird one" for doing EBPs with students. There was a strong preference for humanistic/interpersonal/existential theoretical orientations at my former site.

 

[cara susanna]

The UCC where I did a prac embraced CBT but they also loooooved EMDR.

 

[Ollie123]

This checks out for my internship exp as well. I was the "weird one" for doing EBPs with students. There was a strong preference for humanistic/interpersonal/existential theoretical orientations at my former site.

It was a little surreal. Other places people might not use them but at least "got" it. There I felt like they didn't even understand the concept.

 

[Sanman]

This checks out for my internship exp as well. I was the "weird one" for doing EBPs with students. There was a strong preference for humanistic/interpersonal/existential theoretical orientations at my former site.

I feel like the draw at these places was always that people wanted to work with "YAVIS" type patients with low acuity concerns (this was my first therapy externship describes most of the patients I saw) and have a cushy schedule, However, with the low pay and recent push on the UCCs for managing suicidality and some significant mental health concerns of the student population, I don't get it anymore.

 

[taylortaylor164]

Thank you for this insight. It is really helpful.

 

[Mercury in Taurus]

I mean stressful as in unpredictable setting, sudden emergencies, high client load, low flexibility. Inpatient would be pretty stressful it sounds like

I personally found inpatient least stressful. It is fast-paced with short lengths of stay, but everyone is working and supporting each other. The nursing staffs are on their feet doing 15-min rounds to check every patient. High-risks are provided with one-on-one, the rest if not meeting with psychiatrists then would be in groups. If a patient becomes combative, there is an isolation room that can be used per doctor's order. My last place never used it while I was there, we were able to find other ways to distract the patient or calm them down. We had an art therapist who ran an art group. The nurses helped out too and offered psychoeducation groups. You run groups, offer milieu therapy, do intakes, and write group notes and therapy notes. The social workers are doing all the discharge planning and follow-ups. If we are talking about outside of VA, I personally find the electronic medical record softwares used in private sectors are usually more user-friendly than CPRS.

 

[Fan_of_Meehl]

Hi, I was wondering what is the least stressful of a setting a psychologist can work in. My guess is private practice but want to get the input of others.

In clinical psychology, you get to choose your source of stress...but you don't get to avoid it.

 

[modestmousktr]

This checks out for my internship exp as well. I was the "weird one" for doing EBPs with students. There was a strong preference for humanistic/interpersonal/existential theoretical orientations at my former site.

Hey! Interpersonal psychotherapy is an EBP for depression. Just throwin that out there.

 

[R. Matey]

Hey! Interpersonal psychotherapy is an EBP for depression. Just throwin that out there.

Lol, true. I did appreciate learning that modality while on internship. Super useful for college students.

 

[Sanman]

Lol, true. I did appreciate learning that modality while on internship. Super useful for college students.

Have you explored bong therapy? Popular among college students and in Colorado and California as well from what I hear.

 

[R. Matey]

We mainly stuck with MDMA-assisted psychotherapy at the beginning until we received too many complaints from neighboring faculty to turn the d*** music down.

 

[BuckeyeLove]

I'm a big IPT guy. And also interpersonal process alone (however the evidence there isn't quite as substantive). If I ever needed therapy, that would likely be what I need.