PhD worth it?

[lily_pad]

Hi everyone. I'm new to SDN so please be nice 🙂 A little background: I'm a first year MSW student focusing on psychodynamic clinical social work. During the pandemic I realized that I wanted to go back to school to become a psychotherapist and began the process of looking into gradate school options. Truthfully, I really wanted to do my doctorate in clinical psychology but as this was a slightly later in life realization (I'm in my late 20s) and wasn't a psych undergrad with any research/clinical experience I realized that getting into a PhD program would be next to impossible. I did apply to two PsyD programs and got rejected from one, waitlisted at the other. Honestly, I'm glad I didn't end up going the PsyD route because I know the student debt would be just crippling for me.

Most people told me that based on what I want to do (private practice) that getting a PhD would be superfluous. I'm not interested in the scientist or researcher route--I really just want to be doing intensive clinical work with individuals. I'm really interested in working with eating disorder and personality disorder populations. I also am really interested in eventually doing psychoanalytic training. The problem is, as I continue my studies, I'm realizing that a lot of the work that I want to be doing in inpatient or institution settings gets prioritized for psychologists while the social workers get relegated to doing mostly group work or case management style support which is not what I'm interested in. I feel like at my program I'm a clinical psychologist in social worker's clothing. My question is: if I want to be doing mostly private practice but also have some clinic/inpatient experiences, is it worth going back to school to get my PhD in clinical psychology or should I just focus on doing advanced trainings after I graduate with my MSW? I do think that social workers can make exceptional clinicians, it just feels like we don't always get the opportunity to do that complex psychological work in certain settings. My last question is: if I did decide to go back to get my PhD eventually, what programs would you recommend that are aimed for people who want to be focusing on clinical work. Will an LCSW and relevant clinical experiences be enticing to a PhD program?

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[summerbabe]

My question is: if I want to be doing mostly private practice but also have some clinic/inpatient experiences, is it worth going back to school to get my PhD in clinical psychology or should I just focus on doing advanced trainings after I graduate with my MSW?

You're right in that some inpatient settings are more likely to have social workers do case management and groups but this will vary facility by facility.

However, your goals of being a clinician in private practice and outpatient clinic/hospital roles are absolutely attainable with a LCSW and given your lack of interest in the scientist portion of a PhD, this seems like the best fit for you. And advanced training once you determine your specific areas for focus is very much recommended!

Will an LCSW and relevant clinical experiences be enticing to a PhD program?

Potentially but not enough to bypass lack of research experience and program for.

 

[R. Matey]

My question is: if I want to be doing mostly private practice but also have some clinic/inpatient experiences, is it worth going back to school to get my PhD in clinical psychology or should I just focus on doing advanced trainings after I graduate with my MSW?

The latter. You don't need a Ph.D. to attend a psychoanalytic institute if that is what you want. Please also consider getting some training in EBPs for eating disorders and PDs (e.g.: CBT, IPT, DBT etc).

My last question is: if I did decide to go back to get my PhD eventually, what programs would you recommend that are aimed for people who want to be focusing on clinical work. Will an LCSW and relevant clinical experiences be enticing to a PhD program?

Probably not because the helping professions are becoming increasingly siloed. It will probably count for something, but not as much as research experience would.

 

[lily_pad]

Probably not because the helping professions are becoming increasingly siloed. It will probably count for something, but not as much as research experience would.

Thanks for the feedback! So you think even in a clinically focused program it would really hurt my chances of not having research experience? If I did decide to go back for my PhD it would probably be after I become an LCSW so I can give myself the chance of seeing what opportunities I have as a licensed social worker. Do you think it would be feasible to get some research experience while also getting my clinical hours towards my LCSW?

 

[futureapppsy2]

The latter. You don't need a Ph.D. to attend a psychoanalytic institute if that is what you want. Please also consider getting some training in EBPs for eating disorders and PDs (e.g.: CBT, IPT, DBT etc).

FBT, too, especially if you are working with adolescents at all.

 

[R. Matey]

Thanks for the feedback! So you think even in a clinically focused program it would really hurt my chances of not having research experience? If I did decide to go back for my PhD it would probably be after I become an LCSW so I can give myself the chance of seeing what opportunities I have as a licensed social worker. Do you think it would be feasible to get some research experience while also getting my clinical hours towards my LCSW?

Well, a Ph.D. worth its salt (e.g.: funded) will demand some kind of research experience in order to show your commitment to and competence in research. Remember that a Ph.D. is typically a scientific degree so you need to show some kind of interest in that area even if the program is more clinically balanced. If you'd like more information about clinically balanced programs, you can check out the insider's guide. If you want free advice, there's a sticky thread here with some, but that advice is getting a bit dated.

 

[futureapppsy2]

it just feels like we don't always get the opportunity to do that complex psychological work in certain settings.

Tbh, this is true for psychologists (and psychiatrists) in a lot of settings, too. Most in-patient settings really focus on getting patients stabilized enough to be discharged, because of the way payment structures work. IOP/PHP are better bets for that type of thing, though some of the less-good ones can have a lot of fluff/bordering on psuedoscience in them.

 

[PsycIntern2021]

I would definitely check out some of the older threads here. As others have alluded to, a PhD isn't simply about taking more classes or getting more clinical experience (though they are parts). You are actively doing research the entire time you are there (and need to complete at least one research project for your dissertation, if not another for a Master's) - it doesn't matter whether it's clinically focused or not, that is the degree that you are getting. So in order to be qualified when you apply, PIs want to see a base level of research so that they know you have a solid foundation and can make it through the program. I think if you don't like research, you would really, really struggle in a PhD.

If you truly want an advanced degree that is more clinically focused, then that's a PsyD (which as you already mentioned, includes a boatload of debt and many programs to be wary of). I think you can do all of what you want with an LCSW, it's just about figuring out how to get the key training experiences that you need. For instance, is there an eating disorders clinic locally that you could do a practicum at? Or it might mean getting your degree, working at the entry level for an LCSW in a setting where you can get experiences in the things you are interested in (even if your role is not appealing to you) to be able to then go for something else later down the line. Also, I would encourage you to seek out other professional development experiences that could be helpful, like attending conferences (International Conference of Eating Disorders is a good one for clinically-minded folks - there are plenty of LCSWs there) - or reach out to folks that are doing what you want to be doing and do an informational interview with them. It will take a lot of hustle, but honestly, you are wanting to work with speciality populations that require specialty training, regardless of the degree.

 

[WisNeuro]

I would definitely check out some of the older threads here. As others have alluded to, a PhD isn't simply about taking more classes or getting more clinical experience (though they are parts). You are actively doing research the entire time you are there (and need to complete at least one research project for your dissertation, if not another for a Master's) - it doesn't matter whether it's clinically focused or not, that is the degree that you are getting. So in order to be qualified when you apply, PIs want to see a base level of research so that they know you have a solid foundation and can make it through the program. I think if you don't like research, you would really, really struggle in a PhD.

If you truly want an advanced degree that is more clinically focused, then that's a PsyD (which as you already mentioned, includes a boatload of debt and many programs to be wary of). I think you can do all of what you want with an LCSW, it's just about figuring out how to get the key training experiences that you need. For instance, is there an eating disorders clinic locally that you could do a practicum at? Or it might mean getting your degree, working at the entry level for an LCSW in a setting where you can get experiences in the things you are interested in (even if your role is not appealing to you) to be able to then go for something else later down the line. Also, I would encourage you to seek out other professional development experiences that could be helpful, like attending conferences (International Conference of Eating Disorders is a good one for clinically-minded folks - there are plenty of LCSWs there) - or reach out to folks that are doing what you want to be doing and do an informational interview with them. It will take a lot of hustle, but honestly, you are wanting to work with speciality populations that require specialty training, regardless of the degree.

This portion is simply not true. Legitimate PsyDs look and function similarly to clinically focused and balanced PhDs with regards to research involvement. Also, PhDs tend to edge out PsyDs in reported clinical hours on internship applications.

 

[lily_pad]

Tbh, this is true for psychologists (and psychiatrists) in a lot of settings, too. Most in-patient settings really focus on getting patients stabilized enough to be discharged, because of the way payment structures work. IOP/PHP are better bets for that type of thing, though some of the less-good ones can have a lot of fluff/bordering on psuedoscience in them.

Ok that's good to know! My dream place to work would be somewhere like Austen Riggs on the east coast which is a psychoanalytically oriented residential psychiatric facility. I know the social workers there get to do a decent amount of psychotherapy but I think the psychologists probably get prioritized for doing some of the more complex clinical work with patients. And the internship opportunities for social workers there is all case management which is what makes me think that at more prestigious places where there's an attention paid to hierarchy that I might not be able to do what I want.

 

[lily_pad]

I would definitely check out some of the older threads here. As others have alluded to, a PhD isn't simply about taking more classes or getting more clinical experience (though they are parts). You are actively doing research the entire time you are there (and need to complete at least one research project for your dissertation, if not another for a Master's) - it doesn't matter whether it's clinically focused or not, that is the degree that you are getting. So in order to be qualified when you apply, PIs want to see a base level of research so that they know you have a solid foundation and can make it through the program. I think if you don't like research, you would really, really struggle in a PhD.

If you truly want an advanced degree that is more clinically focused, then that's a PsyD (which as you already mentioned, includes a boatload of debt and many programs to be wary of). I think you can do all of what you want with an LCSW, it's just about figuring out how to get the key training experiences that you need. For instance, is there an eating disorders clinic locally that you could do a practicum at? Or it might mean getting your degree, working at the entry level for an LCSW in a setting where you can get experiences in the things you are interested in (even if your role is not appealing to you) to be able to then go for something else later down the line. Also, I would encourage you to seek out other professional development experiences that could be helpful, like attending conferences (International Conference of Eating Disorders is a good one for clinically-minded folks - there are plenty of LCSWs there) - or reach out to folks that are doing what you want to be doing and do an informational interview with them. It will take a lot of hustle, but honestly, you are wanting to work with speciality populations that require specialty training, regardless of the degree.

Thanks, this is very helpful. I guess I do have the misconception that with clinical PhD programs you aren't doing a lot of research so I appreciate you dispelling that for me. Maybe the right path will be eventually looking for a funded PsYD program. They're few and far between but I do know they exist!

 

[WisNeuro]

Thanks, this is very helpful. I guess I do have the misconception that with clinical PhD programs you aren't doing a lot of research so I appreciate you dispelling that for me. Maybe the right path will be eventually looking for a funded PsYD program. They're few and far between but I do know they exist!

Funded PsyDs will have similar research expectations and requirements as balanced and clinically based PhD programs.

 

[R. Matey]

Funded PsyDs will have similar research expectations and requirements as balanced and clinically based PhD programs.

This can't be understated: OP, Please do not consider a doctoral program if you have no interest in doing research.

 

[lily_pad]

This can't be understated: OP, Please do not consider a doctoral program if you have no interest in doing research.

Yeah, I'm really not interested...I feel like I'm in a bind then because the clinical work I'm interested in doing is not as accessible to LCSWs or at least is prioritized for PhD/PsyDs. My dream fellowship does not accept LCSWs and it's purely clinical. It's also confusing to me because all of the PhD/PsyD clinicians I know do almost exclusively clinical work.

 

[R. Matey]

Yeah, I'm really not interested...I feel like I'm in a bind then because the clinical work I'm interested in doing is not as accessible to LCSWs or at least is prioritized for PhD/PsyDs. My dream fellowship does not accept LCSWs and it's purely clinical. It's also confusing to me because all of the PhD/PsyD clinicians I know do almost exclusively clinical work.

I'm sorry to hear that. Generally speaking though, LCSWs have quite a few training opportunities available to them, more so than LPCs/LMFTs. While your dream fellowship may be off-limits to you, you might find one you like just as much. I was once turned down from a fellowship because the TD said it was only available to clinical psychologists even though I had everything they were looking for (I'm a counseling psychologist). While it was discouraging, I was able to find one that I really like and fits me well.

 

[Therapist4Chnge]

Yeah, I'm really not interested...I feel like I'm in a bind then because the clinical work I'm interested in doing is not as accessible to LCSWs or at least is prioritized for PhD/PsyDs. My dream fellowship does not accept LCSWs and it's purely clinical. It's also confusing to me because all of the PhD/PsyD clinicians I know do almost exclusively clinical work.

Unlike 50+ years ago, the vast majority of doctorally-trained clinicians spend the majority of their time providing clinical services. Only a small minority are primarily researchers. Research is a cornerstone of doctoral training, so if you aren't interested in learning and conducting research during your training...it likely is not the path for you.

 

[bluecolourskies]

Hi everyone. I'm new to SDN so please be nice 🙂 A little background: I'm a first year MSW student focusing on psychodynamic clinical social work. During the pandemic I realized that I wanted to go back to school to become a psychotherapist and began the process of looking into gradate school options. Truthfully, I really wanted to do my doctorate in clinical psychology but as this was a slightly later in life realization (I'm in my late 20s) and wasn't a psych undergrad with any research/clinical experience I realized that getting into a PhD program would be next to impossible. I did apply to two PsyD programs and got rejected from one, waitlisted at the other. Honestly, I'm glad I didn't end up going the PsyD route because I know the student debt would be just crippling for me.

Most people told me that based on what I want to do (private practice) that getting a PhD would be superfluous. I'm not interested in the scientist or researcher route--I really just want to be doing intensive clinical work with individuals. I'm really interested in working with eating disorder and personality disorder populations. I also am really interested in eventually doing psychoanalytic training. The problem is, as I continue my studies, I'm realizing that a lot of the work that I want to be doing in inpatient or institution settings gets prioritized for psychologists while the social workers get relegated to doing mostly group work or case management style support which is not what I'm interested in. I feel like at my program I'm a clinical psychologist in social worker's clothing. My question is: if I want to be doing mostly private practice but also have some clinic/inpatient experiences, is it worth going back to school to get my PhD in clinical psychology or should I just focus on doing advanced trainings after I graduate with my MSW? I do think that social workers can make exceptional clinicians, it just feels like we don't always get the opportunity to do that complex psychological work in certain settings. My last question is: if I did decide to go back to get my PhD eventually, what programs would you recommend that are aimed for people who want to be focusing on clinical work. Will an LCSW and relevant clinical experiences be enticing to a PhD program?

"I'm realizing that a lot of the work that I want to be doing in inpatient or institution settings gets prioritized for psychologists while the social workers get relegated to doing mostly group work or case management style support which is not what I'm interested in."

When you say this, what work are you exactly interested in? You mentioned earlier you want to do "intensive clinical work." Per my experience, psychologists in state hospitals also do not do intensive clinical work, individual therapy, or psychoanalytic focused individual therapy. As a whole, state hospitals are more about groups/med management, and not "lets explore your past, family, and traumas". You may be doing more of that as a social worker in a state hospital, because the ones where I was at did 30 minute sessions with their clients to work on skills or do motivational interviewing to get them to take their meds. Maybe psychologists at IOP/PHP's do more of the intensive clinical work?

 

[niceman]

Ok that's good to know! My dream place to work would be somewhere like Austen Riggs on the east coast which is a psychoanalytically oriented residential psychiatric facility. I know the social workers there get to do a decent amount of psychotherapy but I think the psychologists probably get prioritized for doing some of the more complex clinical work with patients. And the internship opportunities for social workers there is all case management which is what makes me think that at more prestigious places where there's an attention paid to hierarchy that I might not be able to do what I want.

Austen Riggs is one of a kind so it is probably hard to find somewhere else like it. Many psychoanalytically oriented clinicians are in private practice or scatter in hospitals trying to fight for providing longer/more intensive treatment. As you said you want to go into private practice, it is more about getting the training you want and marketing yourself than the degree you get. Even within the same geographical area (since you mentioned Austen Riggs), MGH, McLean, and Tufts run their inpatient very differently (and change from time to time) so it'll be easier for you to create your own "brand" and scope of services than trying to look for a unicorn.

 

[lily_pad]

Austen Riggs is one of a kind so it is probably hard to find somewhere else like it. Many psychoanalytically oriented clinicians are in private practice or scatter in hospitals trying to fight for providing longer/more intensive treatment. As you said you want to go into private practice, it is more about getting the training you want and marketing yourself than the degree you get. Even within the same geographical area (since you mentioned Austen Riggs), MGH, McLean, and Tufts run their inpatient very differently (and change from time to time) so it'll be easier for you to create your own "brand" and scope of services than trying to look for a unicorn.

Thanks niceman. Your insight regarding just focusing on the postgrad trainings I want to do instead of on a single place is particularly appreciated.

 

[lily_pad]

"I'm realizing that a lot of the work that I want to be doing in inpatient or institution settings gets prioritized for psychologists while the social workers get relegated to doing mostly group work or case management style support which is not what I'm interested in."

When you say this, what work are you exactly interested in? You mentioned earlier you want to do "intensive clinical work." Per my experience, psychologists in state hospitals also do not do intensive clinical work, individual therapy, or psychoanalytic focused individual therapy. As a whole, state hospitals are more about groups/med management, and not "lets explore your past, family, and traumas". You may be doing more of that as a social worker in a state hospital, because the ones where I was at did 30 minute sessions with their clients to work on skills or do motivational interviewing to get them to take their meds. Maybe psychologists at IOP/PHP's do more of the intensive clinical work?

I want to be trusted to do psychological evaluations with patients who have complex mental illness or pathology, help develop treatment plans, and track for progress. I probably wouldn't want to be at a hospital but instead do inpatient or IOP work (places like Austen Riggs, McLean's personality disorder clinics or other similar prestigious institutes are pipe dream places in terms of the types of clinicians working there as well as the populations being treated, and modalities being used. Personality pathology, mood disorders, eating disorders are my primary clinical interests.

 

[summerbabe]

I want to be trusted to do psychological evaluations

So this can only be done by a psychologist. Social workers can diagnose and bill for 90791 (think intake interview with self-report) but use of objective testing to guide assessment is protected.

I probably wouldn't want to be at a hospital but instead do inpatient or IOP work (places like Austen Riggs, McLean's personality disorder clinics or other similar prestigious institutes are pipe dream places

A great piece of advice I got a long time ago was to figure out what type of education, experience, and networking is needed to land ‘dream’ positions. Look up these clinicians and network.

Lastly, when I was younger and still in grad school, I was much more open to moving anywhere for the ‘right’ position. But now as an early career licensed professional, there’s pretty much nothing that I would uproot my life for so these types of priorities may change. Your horizons expand, you set down roots, and you start to figure out what you can actually do with this degree that’s meaningful which could potentially be in your backyard.

 

[WisNeuro]

So this can only be done by a psychologist. Social workers can diagnose and bill for 90791 (think intake interview with self-report) but use of objective testing to guide assessment is protected.

Physicians can actually use these codes as well, not sure they'd want to given the time to RVU breakdown, but they can.

 

[ClinicalABA]

Yeah, I'm really not interested...I feel like I'm in a bind then because the clinical work I'm interested in doing is not as accessible to LCSWs or at least is prioritized for PhD/PsyDs. My dream fellowship does not accept LCSWs and it's purely clinical. It's also confusing to me because all of the PhD/PsyD clinicians I know do almost exclusively clinical work.

Unfortunately, it just doesn't seem like you are going to be able to do what you want to do without a doctoral degree (or where you want to do it without going to a pretty good Ph.D. program). Should it be that way? It's debatable. Is it that way? Most definitely.

I think it's a false belief that all ph.d. grad students love research and science. While it's probably best that you at least have an appreciation for it, it doesn't have to be something you enjoy to be successful at it. I went to graduate school with a few classmates who did internships and later worked at some of the places you identified (e.g. McClean). If you asked them at the same point of their professional development as you, they would've said that they are interested in primarily in the clinical piece, with minimal interest in doing research or other academic pursuits. However, they ended up doing some things that they weren't interested in for a relatively short period of time (4-6 years) so that they could spend a lot more time (i.e., the rest of their careers!) doing what they wanted to do. Some would now say that they like the science/research stuff more than they thought they would. Others would now say that they hated it even more than they thought they would. These are the people you will be up against in trying to achieve your professional goals. To get there, you have to do some things that will be challenging and unpleasant- there aren't any shortcuts (or at least none that are even close to being worth the time and financial risk). Others have done it, and you can too. It ain't always easy, but it really is worth it to bear down and do things you don't want to do early in your career trajectory. That way you can be old like me and have a lot more options to do the things you like doing.

 

[Sanman]

Yeah, I'm really not interested...I feel like I'm in a bind then because the clinical work I'm interested in doing is not as accessible to LCSWs or at least is prioritized for PhD/PsyDs. My dream fellowship does not accept LCSWs and it's purely clinical. It's also confusing to me because all of the PhD/PsyD clinicians I know do almost exclusively clinical work.

Austen Riggs charges $70k cash for treatment, hardly something the average person has the means to pay for (or really most people with significant MH problems). As others have mentioned, that is not something easily replicated. McClean and the other facilities you mentioned are quite elite. You are unlikely to get accepted to many of these places with a run of the mill PsyD either. You need to be the best of the best. That takes time, intelligence, networking, and luck. Not to mention that not all of these places offer the best salaries. I have friends that left nationally regarding places for no name jobs for a pay raise. Either way, this a far cry from the original post regarding private practice. Is your goal to be a psychotherapist or one of the best psychotherapists in the country? You can do the former and continue on your current path. Doing the latter will mean dropping out, spending years getting more research and clinical exposure, applying to a PhD, outpublishing your competition, lading the right internships and fellowships, and maybe landing a job at one of these places. That is 10 years of hard work. Which path is the one you really want? What level of sacrifice are you willing to undergo to get there?

 

[lily_pad]

Austen Riggs charges $70k cash for treatment, hardly something the average person has the means to pay for (or really most people with significant MH problems). As others have mentioned, that is not something easily replicated. McClean and the other facilities you mentioned are quite elite. You are unlikely to get accepted to many of these places with a run of the mill PsyD either. You need to be the best of the best. That takes time, intelligence, networking, and luck. Not to mention that not all of these places offer the best salaries. I have friends that left nationally regarding places for no name jobs for a pay raise. Either way, this a far cry from the original post regarding private practice. Is your goal to be a psychotherapist or one of the best psychotherapists in the country? You can do the former and continue on your current path. Doing the latter will mean dropping out, spending years getting more research and clinical exposure, applying to a PhD, outpublishing your competition, lading the right internships and fellowships, and maybe landing a job at one of these places. That is 10 years of hard work. Which path is the one you really want? What level of sacrifice are you willing to undergo to get there?

I definitely know how elite these places are. And I do know social workers who do psychotherapy at Riggs who have been able to get in the door without having a heavy research background but they're not psychologists obviously.

 

[lily_pad]

To get there, you have to do some things that will be challenging and unpleasant- there aren't any shortcuts (or at least none that are even close to being worth the time and financial risk). Others have done it, and you can too. It ain't always easy, but it really is worth it to bear down and do things you don't want to do early in your career trajectory. That way you can be old like me and have a lot more options to do the things you like doing.

Thanks, I really appreciate this advice. I'm 28 at this point, will graduate with my MSW by 30 and be a licensed social worker by around 32. That would mean if I did decide to go back to get my PhD I'd probably be 37 or 38ish. I guess that's not too bad and absolutely worth the investment if I plan to spend the rest of my life doing this work.

 

[foreverbull]

Hi everyone. I'm new to SDN so please be nice 🙂 A little background: I'm a first year MSW student focusing on psychodynamic clinical social work. During the pandemic I realized that I wanted to go back to school to become a psychotherapist and began the process of looking into gradate school options. Truthfully, I really wanted to do my doctorate in clinical psychology but as this was a slightly later in life realization (I'm in my late 20s) and wasn't a psych undergrad with any research/clinical experience I realized that getting into a PhD program would be next to impossible. I did apply to two PsyD programs and got rejected from one, waitlisted at the other. Honestly, I'm glad I didn't end up going the PsyD route because I know the student debt would be just crippling for me.

Most people told me that based on what I want to do (private practice) that getting a PhD would be superfluous. I'm not interested in the scientist or researcher route--I really just want to be doing intensive clinical work with individuals. I'm really interested in working with eating disorder and personality disorder populations. I also am really interested in eventually doing psychoanalytic training. The problem is, as I continue my studies, I'm realizing that a lot of the work that I want to be doing in inpatient or institution settings gets prioritized for psychologists while the social workers get relegated to doing mostly group work or case management style support which is not what I'm interested in. I feel like at my program I'm a clinical psychologist in social worker's clothing. My question is: if I want to be doing mostly private practice but also have some clinic/inpatient experiences, is it worth going back to school to get my PhD in clinical psychology or should I just focus on doing advanced trainings after I graduate with my MSW? I do think that social workers can make exceptional clinicians, it just feels like we don't always get the opportunity to do that complex psychological work in certain settings. My last question is: if I did decide to go back to get my PhD eventually, what programs would you recommend that are aimed for people who want to be focusing on clinical work. Will an LCSW and relevant clinical experiences be enticing to a PhD program?

Good questions, and a lot of good advice in this thread.

Ultimately, you're right that psychologists will have more opportunities to work with eating disorders and personality disorders in inpatient settings, but private practice is another area where you may find that you can work with folks with these concerns. One of my past supervisors specialized in eating disorders but saw private clients, not in hospital settings. Although she does have a doctorate, you could potentially see personality disorders and ED in private practice at the master's level if you have the right training experiences/supervision along the way in your master's program--that will be key. PhD programs would probably offer more opportunities to practice in these types of settings, but since you seem to be drawing a line in the sand about really not wanting to do a dissertation/dissertation research at all, a doctorate may not be the best fit, as others have said.

If you ARE set on working within ED programs/facilities/inpatient, it would be much harder as an MSW to not get funneled into the case management/group work role. But I am less familiar with MSW programs, so it would be great to hear from some MSWs about the types of training experiences offered in clinical track MSW programs and whether it is realistic to try to pursue this route via the MSW path.

 

[lily_pad]

Good questions, and a lot of good advice in this thread.

Ultimately, you're right that psychologists will have more opportunities to work with eating disorders and personality disorders in inpatient settings, but private practice is another area where you may find that you can work with folks with these concerns. One of my past supervisors specialized in eating disorders but saw private clients, not in hospital settings. Although she does have a doctorate, you could potentially see personality disorders and ED in private practice at the master's level if you have the right training experiences/supervision along the way in your master's program--that will be key. PhD programs would probably offer more opportunities to practice in these types of settings, but since you seem to be drawing a line in the sand about really not wanting to do a dissertation/dissertation research at all, a doctorate may not be the best fit, as others have said.

If you ARE set on working within ED programs/facilities/inpatient, it would be much harder as an MSW to not get funneled into the case management/group work role. But I am less familiar with MSW programs, so it would be great to hear from some MSWs about the types of training experiences offered in clinical track MSW programs and whether it is realistic to try to pursue this route via the MSW path.

Hey, thanks for this. I appreciate your non-condescension and honesty here. There is a really great training program on Transference Focused Psychotherapy for licensed clinicians that is geared towards therapists who want to do analytically focused work with personality disorders. They accept LCSWs. And I'm applying to a well-known psychoanalytic institute for my second year MSW internship which, if I get it, will hopefully provide some useful connections. Anyway, I appreciate the feedback and am going to at least try the route of doing as much specialized training as I can before deciding if a PhD is right for me.

 

[summerbabe]

There is a really great training program on Transference Focused Psychotherapy for licensed clinicians that is geared towards therapists who want to do analytically focused work with personality disorders. They accept LCSWs. And I'm applying to a well-known psychoanalytic institute for my second year MSW internship which, if I get it, will hopefully provide some useful connections. Anyway, I appreciate the feedback and am going to at least try the route of doing as much specialized training as I can before deciding if a PhD is right for me.

This sounds like a really good fit for you; I hope it works out. I’ll just caution that the overwhelming majority of PhD and PsyD programs are not psychodynamically oriented/friendly so you might be limiting yourself to a handful of programs that are Northeast concentrated.

 

[WisNeuro]

This sounds like a really good fit for you; I hope it works out. I’ll just caution that the overwhelming majority of PhD and PsyD programs are not psychodynamically oriented/friendly so you might be limiting yourself to a handful of programs that are Northeast concentrated.

Though I'd agree that CBT is definitely the modal main area, I do think that there are more programs with strong psychodynamic training than people think. I know of a handful in the Midwest just within programs that I know very well. And I doubt that they are the only ones in the region. Now, if we're talking about psychoanalysis, that's a different story in terms of PhD/PsyD programs, but I know of 5 institutes in the Midwest that do training in the area.

 

[lily_pad]

Though I'd agree that CBT is definitely the modal main area, I do think that there are more programs with strong psychodynamic training than people think. I know of a handful in the Midwest just within programs that I know very well. And I doubt that they are the only ones in the region. Now, if we're talking about psychoanalysis, that's a different story in terms of PhD/PsyD programs, but I know of 5 institutes in the Midwest that do training in the area.

What are your thoughts on the general phasing out of psychodynamic training in PhD programs?

 

[WisNeuro]

What are your thoughts on the general phasing out of psychodynamic training in PhD programs?

I have not seen evidence of this phasing out at the programs that I am familiar with.

 

[Sanman]

I have not seen evidence of this phasing out at the programs that I am familiar with.

I don't think that there is a phasing out of modern psychodynamic treatment, though fewer new faculty may utilize this method. There is most certainly a phase out of more classic psychoanalytic and longer term treatment because no one pays for it.

 

[WisNeuro]

I don't think that there is a phasing out of modern psychodynamic treatment, though fewer new faculty may utilize this method. There is most certainly a phase out of more classic psychoanalytic and longer term treatment because no one pays for it.

Psychoanalytic, I definitely agree that it's been phasing out for decades, thankfully. Better served in the training institutes and niche markets. Still plenty of training opportunities in terms of programs and prac sites for psychodynamic. It obviously depends on the setting, as some settings are better suited for it than others.

 

[R. Matey]

I don't think that there is a phasing out of modern psychodynamic treatment, though fewer new faculty may utilize this method. There is most certainly a phase out of more classic psychoanalytic and longer term treatment because no one pays for it.

I've had three psychodynamic supervisors in training. Ballparking, I'd say the average age between them was around 65.

 

[ds1]

@lily_pad

So I had a similar journey to yours. I graduated from an MSW program when I was 29 and was licensed at 32. I have found that an LCSW can open a lot of doors for you. I started in a residential facility and now I work private practice and while there were case management aspects both places (there will be case management regardless where you work) I spent a lot of time doing therapy. I like private practice a little better as I generally have more autonomy in clinical decision making. Shoot, with an LCSW you could open your own practice and advertise that you specialize in working with people with personality disorders and eating disorders if you wanted.

On that note, personality disorders are tough. Start practicing setting very firm boundaries if you haven't already. Feel free to PM me if you have any questions.

 

[NatInternationalMD]

I second what ds1 just said! As a recovering eating disorder patient, one of my best psychotherapists was a MSW with some additional trainings/certifications. (I moved later so sadly I couldn’t stay with her). She had her own private practice for MFT, but I was referred to her by the psychiatrist who was treating me with medication and thought I should also have concurrent psychotherapy sessions. My psychotherapist (the MSW) also recommended group sessions, so we crafted my own three pronged outpatient program which I was diligent with for the first year to jumpstart my recovery. This was the perfect combo for me and I was happy to not have to put my life on hold, I could work full time, attend necessary sessions a few times a week and was supported through beginning a career with an eating disorder bc of these sessions.
Mental health professionals are sorely needed especially for young people, you will definitely be able to work in psychotherapy as a MSW. I’m a high school teacher and I know many teens have long waiting lists just to get in to see a therapist (depending on type of insurance).
Congrats on going for that degree, get it done and get out there, we need you! Through your clinical experiences you will learn which specific additional certs you need for your patients. Good luck!

 

[quickpsych]

I would definitely check out some of the older threads here. As others have alluded to, a PhD isn't simply about taking more classes or getting more clinical experience (though they are parts). You are actively doing research the entire time you are there (and need to complete at least one research project for your dissertation, if not another for a Master's) - it doesn't matter whether it's clinically focused or not, that is the degree that you are getting. So in order to be qualified when you apply, PIs want to see a base level of research so that they know you have a solid foundation and can make it through the program. I think if you don't like research, you would really, really struggle in a PhD.

If you truly want an advanced degree that is more clinically focused, then that's a PsyD (which as you already mentioned, includes a boatload of debt and many programs to be wary of). I think you can do all of what you want with an LCSW, it's just about figuring out how to get the key training experiences that you need. For instance, is there an eating disorders clinic locally that you could do a practicum at? Or it might mean getting your degree, working at the entry level for an LCSW in a setting where you can get experiences in the things you are interested in (even if your role is not appealing to you) to be able to then go for something else later down the line. Also, I would encourage you to seek out other professional development experiences that could be helpful, like attending conferences (International Conference of Eating Disorders is a good one for clinically-minded folks - there are plenty of LCSWs there) - or reach out to folks that are doing what you want to be doing and do an informational interview with them. It will take a lot of hustle, but honestly, you are wanting to work with speciality populations that require specialty training, regardless of the degree.

Came here to say exactly this. Spot on.

I have my PsyD but also knew I wanted to do specific things in the field and also have a greater level of freedom and flexibility to do so. I also didn’t start my doctoral studies until I was 30 (and had a masters before that).

A caveat : there is also research in PsyD programs although mostly focused around a dissertation.

I’ve worked with plenty of wonderful LCSWs and masters level therapists. If you want to work in certain settings as above post said, a masters level degree in social work or clinical/counseling psych is sufficient. Especially if you just want to do things like groups and individual therapy. Both in inpatient and outpatient settings.

If you want to work more with highly specialized populations (intellectual disabilities , brain injury, forensic, neuropsychology) and/or be able to do assessments and evaluations a doctoral degree would be necessary.

As for PsyD programs , look for ones that are APA accredited (and have APA internships or consortium), offer smaller cohort sizes, and offer either grant , work study , or other opportunities to reduce the expense a bit.

 

[lily_pad]

Came here to say exactly this. Spot on.

I have my PsyD but also knew I wanted to do specific things in the field and also have a greater level of freedom and flexibility to do so. I also didn’t start my doctoral studies until I was 30 (and had a masters before that).

A caveat : there is also research in PsyD programs although mostly focused around a dissertation.

I’ve worked with plenty of wonderful LCSWs and masters level therapists. If you want to work in certain settings as above post said, a masters level degree in social work or clinical/counseling psych is sufficient. Especially if you just want to do things like groups and individual therapy. Both in inpatient and outpatient settings.

If you want to work more with highly specialized populations (intellectual disabilities , brain injury, forensic, neuropsychology) and/or be able to do assessments and evaluations a doctoral degree would be necessary.

As for PsyD programs , look for ones that are APA accredited (and have APA internships or consortium), offer smaller cohort sizes, and offer either grant , work study , or other opportunities to reduce the expense a bit.

Thanks so much for this! So it sounds like in terms of clinical skills, the only thing a licensed psychologist can do that an LCSW cannot do is certain types of psychological evaluations and tests, is that right? Would you be able to be more specific about what types of testing an LCSW would not be able to perform? This is something I'm not as clear on. And thanks for your great answer!

 

[lily_pad]

I second what ds1 just said! As a recovering eating disorder patient, one of my best psychotherapists was a MSW with some additional trainings/certifications. (I moved later so sadly I couldn’t stay with her). She had her own private practice for MFT, but I was referred to her by the psychiatrist who was treating me with medication and thought I should also have concurrent psychotherapy sessions. My psychotherapist (the MSW) also recommended group sessions, so we crafted my own three pronged outpatient program which I was diligent with for the first year to jumpstart my recovery. This was the perfect combo for me and I was happy to not have to put my life on hold, I could work full time, attend necessary sessions a few times a week and was supported through beginning a career with an eating disorder bc of these sessions.
Mental health professionals are sorely needed especially for young people, you will definitely be able to work in psychotherapy as a MSW. I’m a high school teacher and I know many teens have long waiting lists just to get in to see a therapist (depending on type of insurance).
Congrats on going for that degree, get it done and get out there, we need you! Through your clinical experiences you will learn which specific additional certs you need for your patients. Good luck!

Hey, I really appreciate your reply here. Thanks so much! I'm working as a high school therapist this year for my internship practicum and can also attest to the long waiting lists at the school I'm working at. And thank you for the work you do as a teacher, it is not easy work--especially right now!

 

[quickpsych]

I would say that ethically and training wise, only doctoral level clinicians should be doing most assessments and evaluations. That's not to say that some without these degrees and training aren't administrating/scoring some (after all psychometricians sometimes only have a Bachelors in psych and do the administration). And of course many masters level clinicians administer basic questionnaires, screeners, and such like the Beck Inventories.

Also there are school psychologists who administer brief academic/educational focused assessments but I believe the way they assess is different from that of a clinical psychologist. Their scope of knowledge and training tends, by function of shorter more specific degree programs and likely work setting, to be much narrower.

It's not the administering and scoring that's the tricky part, it's the interpretation, understanding what the test measures, and being able to integrate those findings into a cohesive report and diagnosis that considers the other tests, patient history, etc. Even deciding which tests to use in a test battery can be nuanced and if you don't know why you're using a particular test or how it can be correctly assessed alongside other tests...well then the results and findings can be inaccurate.

Not to mention that some tests are meant to be utilized for specific diagnostic questions (i.e. autism, neuropsychology related, etc) and thus require both an understanding of psychometrics as well as specialized training.

The short answer: It's easy to learn how to administer and score most test measures; it's the ability to understand the results and interpret them in light of many different variables of the case that the psychologist has the training and knowledge for.

 

[iheartbacon]

This doesn't answer your question about whether or not a doctoral degree would be worth it, but have considered getting training at a psychoanalytic institute? There are some programs for standalone training for licensed mental health professionals and some programs offer training that can transfer to different doctoral programs. The cost and time commitment would likely be much lower than a doctoral program, should that be an option.

To enter a doctoral program in psychology, you would generally need to have taken certain foundational undergrad psychology courses. If you are interested in having doctoral training but do not have these courses, would a DSW program be another option to achieving your goal? I have known multiple DSWs who have careers similar to clinical psychologists (academic, clinical, research, leadership, etc.).

 

[discolemonade]

Hi everyone. I'm new to SDN so please be nice 🙂 A little background: I'm a first year MSW student focusing on psychodynamic clinical social work. During the pandemic I realized that I wanted to go back to school to become a psychotherapist and began the process of looking into gradate school options. Truthfully, I really wanted to do my doctorate in clinical psychology but as this was a slightly later in life realization (I'm in my late 20s) and wasn't a psych undergrad with any research/clinical experience I realized that getting into a PhD program would be next to impossible. I did apply to two PsyD programs and got rejected from one, waitlisted at the other. Honestly, I'm glad I didn't end up going the PsyD route because I know the student debt would be just crippling for me.

Most people told me that based on what I want to do (private practice) that getting a PhD would be superfluous. I'm not interested in the scientist or researcher route--I really just want to be doing intensive clinical work with individuals. I'm really interested in working with eating disorder and personality disorder populations. I also am really interested in eventually doing psychoanalytic training. The problem is, as I continue my studies, I'm realizing that a lot of the work that I want to be doing in inpatient or institution settings gets prioritized for psychologists while the social workers get relegated to doing mostly group work or case management style support which is not what I'm interested in. I feel like at my program I'm a clinical psychologist in social worker's clothing. My question is: if I want to be doing mostly private practice but also have some clinic/inpatient experiences, is it worth going back to school to get my PhD in clinical psychology or should I just focus on doing advanced trainings after I graduate with my MSW? I do think that social workers can make exceptional clinicians, it just feels like we don't always get the opportunity to do that complex psychological work in certain settings. My last question is: if I did decide to go back to get my PhD eventually, what programs would you recommend that are aimed for people who want to be focusing on clinical work. Will an LCSW and relevant clinical experiences be enticing to a PhD program?

Hi! I’m on internship, about to finish my PhD coming from a very psychodynamic program and having done all primarily psychodynamic training in hospital settings. I hear your points/concerns about not having the same opportunities in hospitals as social workers, but I also think the opportunities/roles of psychologists on inpatient settings (at least in my experiences) is super varied as well and can sometimes be disappointing. Reading about your interest in psychoanalysis/psychoanalytic training makes me think that maybe investing the time/money into this would be a better fit than doing the PhD. Honestly sometimes I wish I had gone the masters route and done additional training which now I won’t be able to afford for many years. Happy to talk more over messages if that would be helpful!

 

[msc545]

At least in California, you will be locked out of many job opportunities if you don't have a Ph.D. or PsyD from an APA accredited program, an APA accredited Post doc internship, and a Psychologists license. People underestimate the importance of these things until an opportunity slips away...

 

[lily_pad]

Hi! I’m on internship, about to finish my PhD coming from a very psychodynamic program and having done all primarily psychodynamic training in hospital settings. I hear your points/concerns about not having the same opportunities in hospitals as social workers, but I also think the opportunities/roles of psychologists on inpatient settings (at least in my experiences) is super varied as well and can sometimes be disappointing. Reading about your interest in psychoanalysis/psychoanalytic training makes me think that maybe investing the time/money into this would be a better fit than doing the PhD. Honestly sometimes I wish I had gone the masters route and done additional training which now I won’t be able to afford for many years. Happy to talk more over messages if that would be helpful!

Hi! I somehow had my notifications turned off so I'm just seeing your reply now! Would love to chat more over private message if the offer still stands 🙂