MSW/Clinical Psychology with biological stuff...my situation

[brightness]

I am not exactly sure how I want to phrase all of this. I am in my junior year of an undergrad psych program with good grades and I'm trying to figure out what I want to do in terms of graduate programs. I have thought about doing an MSW because I like the fact that the degree is short and also very flexible in terms of work environments. I also want to work with people who are underpriviliged, particularly mothers and children.
The problem is that I really enjoy biological psychology and I want to employ this knowledge in my clinical work as a psychologist. I am not particularly interested in being a doctor- as in, a psychiatrist- and its not even necessary for me to prescribe. What I really want is a degree program or perhaps (?) a clinical specialty where I can learn about the biological basis for mental problems. Do psychology programs usually teach this way? I also want to learn about medications and how they work so that I can be the best therapist possible and be as useful to my clients as I can be.
Does anyone know of a way to blend these interests all together, or at least some of them?

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[50960]

If you want bio-at all go clinical psych route with a an emphasis on medical/health psych. You will not learn any bio in a masters level program, and even if you did you would not be able to use it. Psychologists have a much broader scope of practice, are on medical staff at hospitals, and can colloborate on medications or prescribe with proper training in certain states. If I were you, and I was... I would get a PsyD/PhD in clinical psych, do a good health psych postdoc, and get out there doing behavioral medicine work in primary care. Here you can work with adults, kids, families, and people who are in the most need for what you have to offer. Once you are licensed a few years and decide what environment(s) you want to work in you can choose if you want to spend the extra 2.5 yrs to get the medical/science training you will need to really understand meds.

I almost moved this to the MA/Undergrad area, but I think doctoral level folks have the most to offer you......

 

[snyder_phd]

Clinical psychology will give you the information about meds and how they are used. Let's face it, a doctorate gives you lots of flexibility. The world is at your finger tips once those letters follow your name. Please feel free to join us at the Psychology forum, I will be glad to answer any questions that you have in more detail. -Jon Snyder, Ph.D.

 

[Therapist4Chnge]

I'll echo what psisci said. PhD or PsyD + health concentration (and/or post-doc). The additional pharma training he alluded to would really meet what you are looking for. It is a long road, but for what you want, an MS won't get you there. I have similar interests as yourself, and I chose between med school and clinical programs (my career goals matched up better with clinical).

-t

 

[Logic Prevails]

Clinical psychology will give you the information about meds and how they are used.

I wholeheartedly disagree. Although there will be a few programs that will provide a basic course in psychopharm, most will only pay lip-service, and some programs/supervisors will discourage you from interpreting anything from the medication a patient may be on, saying: "we're psychologists, not doctors." As for "the world is at your fingertips with the PhD title..." although I applaud your enthousiasm, I think that this comment is a huge overstatement.

 

[Therapist4Chnge]

I believe clinical programs do not do enough in the areas of biological training (for the generalist). A clinical program will probably have psychobio and psychopharm courses, but the 'heavier lifting' is left up to the concentrations and post-doc work. Additional training (above and beyond what you learn in a doctoral program) is necessary to really understand medications, drug interactions, etc. I chose to get extra training in these areas, and it really has broadend my ability to provide service to my patients. I didn't realize how much there was left to learn until I started working with the information. To really understand medications, you need to understand all of the underlying biology, chemistry, neuroanatomy, neurophysiology....etc. Psychobio and psychopharm are merely scratching the surface. If you plan on working in a medical setting, i STRONGLY suggest you consider not only a health focus, but also plan on a health specific post-doc, and further training in pharma.

-t

 

[brightness]

I have a couple questions.
1) How much chemistry do you need for pharmacology? I have no problem with taking some Chem, but the undergraduate psychology program doesn't require any. Do you take Chem in your PHD program?
2) Where can you do pharmacology programs?
3) You do postdoctoral programs at select universities that offer them, right?
4) The general consensus is that a PHD in Psychology is still better than an MSW, even though there may be "holes" in the degree in terms of the biological training?
Good good good advice so far.

 

[Pterion]

...

 

[Therapist4Chnge]

Better? How about much different than. . . You're talking 2 years versus 5+ an additional 1-2 years of postdoc. It's not the same game.

Apples and Oranges.

LSW has a much different focus (think life planning type stuff, ajustment stuff, etc) vs a clinician who deals with everything from assessment to severe pathology. From my understanding, LSw stuff is much more 'practical', and less about theory.

-t

 

[Logic Prevails]

Here is my advice,

If you haven't already done so, take undergraduate coursework in biopsychology, drugs & behavior & neuroanatomy (if it is offered). You will get a rough idea of how you take to the material and how it might be useful. It doesn't matter what your program "requires" - you have to go above the minimum if you plan on getting into any program. Unless you plan on prescribing, you don't need to take any courses in organic chemistry.

If you do end up going with the SW program, for the love of god, stay away from anything to do with the "brain" unless you at least have these basic foundational courses. Too many people are seduced by the idea of changing peoples brains and then use therapy approaches like "Neuro-Linguistic Programming (NLP)" and "Eye Movement Desensitization and Reprocessing (EMDR)" - they don't have the foundational courses to know that these approaches are absolute garbage and don't map on to anything we know about how the brain works (these approaches seem favored by masters level counselors).

Going into graduate school, I had the above courses under my belt and had some experience working in a hospital & reading patient charts (you pick up a lot). At the graduate level, I took courses in neuroanatomy and neurology, hung out in the ERP lab from time to time, and attended weekly psychiatry rounds at a nearby hospital. I don't plan on prescribing or anything, but I have found my neuro knowledge to come in handy in my case conceptualizations.

Hope this helps you some

FYI: There are psychopharm books written specifically for social workers - this might help you insofar as getting a grasp on common drugs and potential side-effects/interactions.

 

[Therapist4Chnge]

Great advice Logic P.

He is right about Organic Chem....if you don't want to get really into it, you can probably skip that and take the other stuff, but it is useful information if you want to get into the nitty gritty. I found it to be very annoying at times, but it helped me with my later classes.

-t

 

[doctorpsych]

ok, now that I've worked in the field for quite a while and have interfaced with various mental health professionals... here's what I would do if I were you and had the same interest. MSW programs won't give you enough tools to effectively treat someone with mental illness, adjustment issues and other case management issues is fine, but if your interest lies in psychopharm and bio, that falls in the realms of mental illness, the "more severe" conditions... get a ph.d. in clinical psych or a reputable psy.d. You'll get better groundwork in clinical skills/theory than any master's level program. Look into specific programs that may have subspecialties with an emphasis in bio/psychopharm... I believe there are some out there... some doctorate programs allows you to get subspecialties (e.g. I believe UCLA does, UI Urbana, Widener... not sure if they have sub in bio/psychopharm though, you gotta do the research here...), when you get out, continue training, whether be getting additional post doc education in psychopharm or more intense and specialized clinical training (e.g. CBT institutes, psychoanalytic institutes)... by then, you should have a lot of knowledge and little money in your pockets... BUT after all that training, you should be able to start filling up your piggy bank...

Good luck.

 

[doctorpsych]

ps. community psychology within clinical programs is another avenue if you are interested in working with underserved/minority populations... there are a number of clinical psych programs with that emphasis

 

[doctorpsych]

ps. community psychology within clinical programs is another avenue if you are interested in working with underserved/minority populations... there are a number of clinical psych programs with that emphasis

see link

http://www.psych.uiuc.edu/divisions/clinicalcommunity.php

http://gsappweb.rutgers.edu/pdf/Community_Psych_Brochure.PDF

 

[brightness]

Better? How about much different than. . . You're talking 2 years versus 5+ an additional 1-2 years of postdoc. It's not the same game.

I understand that. What I meant, and perhaps I should have been more clear, is that a PHD would be better for what I want to do and for the areas I am interested in. I guess that for me, you can't fully treat mental illness without an understanding of the biological foundations and the medications that are used to treat mental illnesses.

 

[brightness]

I am currently in an introductory nueroscience course and I do plan on taking at least another course before graduation. I really enjoy learning about it, which I never expected.
The thing is, I don't want to "half ass" biological, brain oriented stuff, as you were talking about with SW/masters level counselors. If I am going to work in the biological basis for mental illness I need to have a correct understanding of whats going on. So, if I did go into social work I wouldn't do anything biological.
How did you get a job working in a hospital? I would really like that. And how did you do psychiatry rounds? I don't care about prescribing persay, but I want to understand how medications work so that I can help people with their medication situation and understand cases, too.
Your post was very helpful! I appreciate it.

 

[brightness]

I will look into specializations, including community psyche. Silly me, I didn't even know that there were specializations in clinical psyche, I thought clinical psyche was a specialization.

ok, now that I've worked in the field for quite a while and have interfaced with various mental health professionals... here's what I would do if I were you and had the same interest. MSW programs won't give you enough tools to effectively treat someone with mental illness, adjustment issues and other case management issues is fine, but if your interest lies in psychopharm and bio, that falls in the realms of mental illness, the "more severe" conditions... get a ph.d. in clinical psych or a reputable psy.d. You'll get better groundwork in clinical skills/theory than any master's level program. Look into specific programs that may have subspecialties with an emphasis in bio/psychopharm... I believe there are some out there... some doctorate programs allows you to get subspecialties (e.g. I believe UCLA does, UI Urbana, Widener... not sure if they have sub in bio/psychopharm though, you gotta do the research here...), when you get out, continue training, whether be getting additional post doc education in psychopharm or more intense and specialized clinical training (e.g. CBT institutes, psychoanalytic institutes)... by then, you should have a lot of knowledge and little money in your pockets... BUT after all that training, you should be able to start filling up your piggy bank...

Good luck.

 

[vhermann]

I am also interested in the biological and psychopharm aspects of things (I am currently an MSW and work on an inpatient psych unit). I also just started a PhD program in clinical psych so that I could expand in these and other areas. BUT, now that I am in the program and doing it, I realize you don't get that much info on psychopharm and the bio aspects unless you do a post-doc, as other people have mentioned. THE PhD IS A VERY LONG ROAD. you are looking at 7 years of study, with a 2 year post doc afterwards. I am 35 years old at this point, and am feeling terribly discouraged by the length of study in the PhD program, so I have looked at alternate ways of getting what I want.

Given that I already have an MSW and can do private practice, another way to get psychopharm and info ont he bio aspects of mental health, and ALSO have a shorter length of study is to do a nurse practitioner (MS) program that specializes in psychiatry and mental health. After only 3 years in this program, you also can have private practice and prescribe. I can't even believe I am saying this, but I am think of quiting the PhD program, and pursing this instead. Paired with me MSW, I will be in high demand, and I can do almost everything I could do with the PhD except neuropsych testing.

 

[50960]

Very true, but keep in mind psych NP's are probably amongst the least qualified to do what they do in healthcare today.

 

[PsiKo]

I am also interested in the biological and psychopharm aspects of things (I am currently an MSW and work on an inpatient psych unit). I also just started a PhD program in clinical psych so that I could expand in these and other areas. BUT, now that I am in the program and doing it, I realize you don't get that much info on psychopharm and the bio aspects unless you do a post-doc, as other people have mentioned.

Your observation that PhD programs offer very little in the biological bases of psychology, it's inevitable -- and I imagine it has already begun somewhere -- that MSWs will also seek RxP. After all, in terms of prerequisite coursework for their respective degree programs, both professions are equally deficient in anatomy and physiology classes, so why should psychologists be more entitled? And then, of course, mental health counselors will make similar formulary privilege demands, and the saga will continue. You don't have to be Nostradamus to envision this.

Given the increasingly crowded number of players vying for the same dollar, I just can't foresee the profession of psychology ever really carving out a unique niche that the public will identify as uniquely its own. Mental health service providers of all stripes will continue to receive increasingly skimpier pieces of the mental health dollar pie. Yes, there will always be some exceptions to the rule, but 7+ years of graduate school is not an inconsiderable gamble of debt and groveling to become a pill-dispensing psychotherapist. It's a sign of something perverse -- I'm not quite exactly of what -- that the competition to get into doctoral psych programs is as fierce as it is. The number$ just don't add up.

 

[Therapist4Chnge]

Your observation that PhD programs offer very little in the biological bases of psychology, it's inevitable -- and I imagine it has already begun somewhere -- that MSWs will also seek RxP. After all, in terms of prerequisite coursework for their respective degree programs, both professions are equally deficient in anatomy and physiology classes, so why should psychologists be more entitled? And then, of course, mental health counselors will make similar formulary privilege demands, and the saga will continue. You don't have to be Nostradamus to envision this.

I have been saying for awhile that psychologists need a stronger basis in the hard sciences (something that at least a health or neuro psych would have). Not everyone wants RxP or is willing to put in the work, but we need something more than the rather meager training in current doctoral (generalist) programs. There are just too many classes needed for a doctorate...and cutting really isn't a viable option, because the research aspect is very important, as is the applied clinical aspect.

As for MSWs trying for RxP.....I'm not sure how real that would be, but I understand your point. The general clinical skills of most MSWs already give me pause (for treatment of severe pathologies), not even considering the RxP piece. Pharma solutions are already tricky, and this just adds more variability to it. The training is already 2 years + 2 year residency (1-2 for NM?)....and that is at the doctoral level, so i'm not sure what else you'd need to add.

I'm still working on the answer....but I *really* hope it doesn't slide down the slope to MS level people trying to prescribe.

-t

 

[Dr.JT]

I have been saying for awhile that psychologists need a stronger basis in the hard sciences (something that at least a health or neuro psych would have). Not everyone wants RxP or is willing to put in the work, but we need something more than the rather meager training in current doctoral (generalist) programs. There are just too many classes needed for a doctorate...and cutting really isn't a viable option, because the research aspect is very important, as is the applied clinical aspect.

As for MSWs trying for RxP.....I'm not sure how real that would be, but I understand your point. The general clinical skills of most MSWs already give me pause (for treatment of severe pathologies), not even considering the RxP piece. Pharma solutions are already tricky, and this just adds more variability to it. The training is already 2 years + 2 year residency (1-2 for NM?)....and that is at the doctoral level, so i'm not sure what else you'd need to add.

I'm still working on the answer....but I *really* hope it doesn't slide down the slope to MS level people trying to prescribe.

-t

I have generally stayed of the RxP discussions on this message board since I feel I am somewhat biased. As a neuropsych I have no interest in pursuing RxP. My bias dates back to grad school. My program had a strong neuro and health emphasis so there was the option to take lots of biopsych classes and many students had strong backgrounds in biology. Out of the students who followed these specializations, I cannot think of one who is interested in pursuing RxP. On the other hand, there was a large group of students in a general track who were mainly interested in becoming therapists. Many in this group at least supported if not were interested in pursuing RxP. What struck me was these individuals, generally speaking, had no interest in biology or taking courses that would build a knowledge base of psychopharmacology. So my very biased perception based on this early experience is that those with the biopsychological background don't have much of an interest, and those without that background, and mainly interested in straight psychotherapy, are the ones who would pursue RxP.

Please tell me I am wrong so I can put this bias to rest.

 

[PsiKo]

I have generally stayed of the RxP discussions on this message board since I feel I am somewhat biased. As a neuropsych I have no interest in pursuing RxP. My bias dates back to grad school. My program had a strong neuro and health emphasis so there was the option to take lots of biopsych classes and many students had strong backgrounds in biology. Out of the students who followed these specializations, I cannot think of one who is interested in pursuing RxP. On the other hand, there was a large group of students in a general track who were mainly interested in becoming therapists. Many in this group at least supported if not were interested in pursuing RxP. What struck me was these individuals, generally speaking, had no interest in biology or taking courses that would build a knowledge base of psychopharmacology. So my very biased perception based on this early experience is that those with the biopsychological background don't have much of an interest, and those without that background, and mainly interested in straight psychotherapy, are the ones who would pursue RxP.

Please tell me I am wrong so I can put this bias to rest.

You're talking sense, brother JT.

Psychologists such as yourself who've already secured a somewhat rarefied specialty like neuropsych don't need additional specialization to sustain their economic viability (though surely some may desire it for clinical or academic purposes).

RxP is perceived by many in the field as an essential lifeline to the preservation of private practice. According to one former APA president I heard promoting RxP, this campaign is economics driven, and don't let anyone try to convince you otherwise (e.g. providing a needed service to underserved populations -- pure poppycock!).

 

[Therapist4Chnge]

RxP is partly about money....though it isn't the sole reason. It will also help underserved communities, offer a higher standard of care for private clinicians, solidify the profession (and not get lumped in with MSWs, LPCs, etc).

-t

 

[PsiKo]

RxP is partly about money....though it isn't the sole reason. It will also help underserved communities, offer a higher standard of care for private clinicians, solidify the profession (and not get lumped in with MSWs, LPCs, etc).

-t

I respectfully disagree. The push for RxP is only partly (and rarely) about helping underserved communities. I've read too many compelling counterarguments to buy into that. The main underserved community that stands to benefit the most is psychologists whose sources of income continue to get decimated by managed care and an influxing glut of master's-level providers who are bottoming psychology's bottom line.

I'm not arguing against professional psychology's lobbying for RxP -- I'm fence-sitting on this one -- but it's naive not to recognize the primary motivation behind it: income, income, income.

 

[Therapist4Chnge]

MS's are definitely undercutting psychologists, and HMOs are screwing us all. Our areas of practice are shrinking, and assessment isn't far behind.

-t

 

[50960]

The reason I did it, and most of the others I have known is because we felt we did not have enough bio to practice in bio-psycho-social model, and we did not know enough about the meds most of our patients were on. I could write a book on just on stories of patients who have been treated with therapy only for depression/anxiety who later discovered quite randomly that they had a thyroid condition etc... I did not want to be one of those clinicians. The other major groups of people I have seen go for the RxP training are well off people who can afford it, and brand new grads. Personally i do not care if I ever prescribe, as I manage medications in primary care every day, and have done for a few years. I have all the control and very little liability because all Rx's are done by a PCP.

 

[Therapist4Chnge]

I agree with psisci @ the reasoning aspect of RxP....though I am in the boat that would like to prescribe. The knowledge you acquire really enhances the clinical side; I think clinicians, therapists, etc....really limit themselves when they skirt away from neuro and biological aspects of psych.

-t