Practicing in VIRGINIA, LPC vs. MFT vs. LCSW and grad program questions

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MettaKaruna

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Hello friends,

Thank you for taking the time to consider my questions. First a little background on me. I am interested in focusing on clinical mental health counseling in my career, helping people learn to face the ups and downs of life with inner peace and happiness. I would like to do as little case management as possible.

In Virginia, how does employability compare between LPC, MFT, and LCSW?

Which clinically focused programs (LPC, MFT or LCSW) are best respected in Virginia and would make me most competitive for employment? I have considered counseling masters programs at George Mason and William And Marry. How competitive would these program make me?

How important is it for working in Virginia to attend a counseling program with CACREP accreditation?

Thank you again for your kindness and generosity in helping me begin my career!

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I'm in a bit of a rush, but I would just like to address one of your concerns. The LCSW most certainly will not have you pigeon holed as a case manager; that is generally filled by BSW or other bachelor level folks. Of course your job may include a certain amount of work that could be considered case management, and this will vary greatly depending on your work environment (non-profic, private, state, federal etc.), it will not be your focal point should you chose to concentrate on mental health. I am not quite sure about the compensation in Virginia for all of those professions, but I would imagine glassdoor, indeed, or payscale could give you an okay idea (from what I understand, most clinical positions are not posted online so it would be somewhat inaccurate). Search for the NASW salary survey, it gives you a much better idea of the average income for masters level social workers (and is a relief for all those who though $40,000.00 was close to the norm.). I have heard from others, through this site (with some searching around), that in general, the LCSWs will be more employable (I've heard exceptions, LPC at certain VA and so on so maybe someone will chime in that knows Virginia's deal) and due to the fact that they are usually promoted to administrative positions before their LPC/LMHC/LMFT counterparts, they are compensated better. Hopefully this was somewhat helpful (albeit not a specific to Virginia as you'd hoped), I'm sure someone else will pitch in soon!
 
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I'm also an MSW student, but as part of my decision I researched licensing pretty exhaustively. I had to keep in mind that I might have to move frequently. Wesley gave some great advice, and I only have one thing to add. I think if you are looking into LPC and counseling programs, keep in mind CACREP accreditation. It makes transferring your license to another state much easier, and Tricare has moved to only accepting providers that attended a CACREP accredited school. If you do not plan to move, or you don't wish to participate in the Tricare system, then it may not be as important to you.

LCSWs are currently the only master's level therapist that can bill Medicare as well. What I have found is that most unlicensed MSWs do perform case management. There is this whole inbetween world for MSWs. I found that quite a few hospital social workers were all unlicensed and they all performed case-management duties. This is also the level that a lot of the DHS employees function at.

There are MSW programs with a clinical focus, and if you decide to go with an MSW, make sure you will get clinical training. Otherwise, the standard "generalist" type program will not give you enough therapy training, and you can find yourself struggling to get that training and get licensed. My advice to everyone is to research the atmosphere in your state, because getting the wrong license, or getting the wrong degree from the wrong school can seriously hinder you. I talked to several people that worked at agencies in my city and didn't get a definite "this is what you should do" but more of a "Please avoid 'x' place because their training is sub-par."

I hope some of my ramblings make sense! Well wishes with your search.
 
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Thank you Goobernut. Best of luck with your program and career.
 
I second all that WesleySmith and Goobernut have said. The regular MSWstudent contributors on this forum are likely engrossed in school and practicums as our semesters just got underway, but I (and I am sure others) will be happy to answer any questions about the MSW route. There are also MFT, LPC, and licensed SW'rs on this particular forum who may be able to speak to your concerns of practicing in Virginia
 
I agree with all that was said above...I was in a similar situation until I started getting in contact with people in my state who were doing exactly what I saw myself doing and found out the best route for me was the msw/lcsw-c....even some mft's, lcpc's and psyd's told me the best route to take if my only interest is counseling is the lcsw. I am in a very clinical-heavy program and love it so far. let me know too if you have any more specific questions about the MSW.
 
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double post by mistake (why can we not delete!)
 
Just out of curiosity Goobernut, are these unlicensed MSWs you're speaking of (mainly performing case management) medical social workers or psychiatric social workers (so many labels, just for the sake clarity I'm breaking down the clinical)? Because that sounds par for the course for medical social workers, but unless you land an unfortunate gig after graduation, I was told my unlicensed time should be spent doing assessments, crisis intervention work, and referrals at the very least, and if not, I'm not getting good supervised experience. I'm only in my first semester so I'm just a stem, but if an MSW just ends up doing all case management during their supervised hours, I have no idea how one becomes a competent therapist, so I hope that's not the case. In any event, sorry for the misinformation MettaKaruna, these others that chimed in are the more experienced SWs, so take what I said keeping that in mind I guess.
 
I am sure that Goobernut will chime in... I am going to quickly add my two cents. I have colleagues that graduated this past May who are doing psychotherapy in outpatient settings. They don't spend the entire day doing psyhco-therapy but they are getting experience. I think that the regular posters and lurkers know that I am interested in working with the military/veteran population (and their families) , so I will also add that unlicensed folks who are hired on at the VA also perform in therapist capacities. I'm doing that this year during my practicum. I too am a student WesleySmith, however, it give me pause to think that we should spend the time between graduating and getting our independent doing assessments, crisis intervention, and referrals. I would venture to say that's not the case. I wonder if the unlicensed folks that Goobernut mentioned were unlicensed by choice?
 
I am sure that Goobernut will chime in... I am going to quickly add my two cents. I have colleagues that graduated this past May who are doing psychotherapy in outpatient settings. They don't spend the entire day doing psyhco-therapy but they are getting experience. I think that the regular posters and lurkers know that I am interested in working with the military/veteran population (and their families) , so I will also add that unlicensed folks who are hired on at the VA also perform in therapist capacities. I'm doing that this year during my practicum. I too am a student WesleySmith, however, it give me pause to think that we should spend the time between graduating and getting our independent doing assessments, crisis intervention, and referrals. I would venture to say that's not the case. I wonder if the unlicensed folks that Goobernut mentioned were unlicensed by choice?

Agreed, that's why added "at the very least", if I get accepted into my TF-CBT program next semester, I'll be required to treat at least two clients before I even graduate, if I land a job in the clinic afterwards I'll be operating as an lcsw would, but with the added supervision and everything that comes with it of course. I was just pointing out that the jobs should be therapy oriented, if not at a very elementary level. My mind is all over the place after finishing my second week, not being as careful while posting as I should be.
 
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WesleySmith, I can relate. I had to read your post over again because I wanted to make sure I didn't offend you. The good thing is that as the semester goes on, we will find our groove. Then before we know it, it will be winter break. Have a great week!
 
Sorry MettaKaruna for semi derailing your thread :) Just to reiterate, I think picking a route is a very personal thing and at the master's level very important to research the licensing in the state you want to practice. So I'm not recommending one route over the other, because it's important to see what license is a big deal in your state. Also, from what I've experienced programs and degrees are so variable at the master's level, it's more about the specific program you attend than even the school. Some schools have both a poor program and an excellent program that both offer a route to licensure in your state, housed in different departments within the same university. So really all I'm saying is buyer beware. I, like some of the others talked to professionals in my state and many of them said, "having an LCSW makes things easier" so yeah, I took their advice...That doesn't mean the same advice will be what's best for you.

Just out of curiosity Goobernut, are these unlicensed MSWs you're speaking of (mainly performing case management) medical social workers or psychiatric social workers (so many labels, just for the sake clarity I'm breaking down the clinical)? Because that sounds par for the course for medical social workers, but unless you land an unfortunate gig after graduation, I was told my unlicensed time should be spent doing assessments, crisis intervention work, and referrals at the very least, and if not, I'm not getting good supervised experience. I'm only in my first semester so I'm just a stem, but if an MSW just ends up doing all case management during their supervised hours, I have no idea how one becomes a competent therapist, so I hope that's not the case. In any event, sorry for the misinformation MettaKaruna, these others that chimed in are the more experienced SWs, so take what I said keeping that in mind I guess.

I don't think you gave misinformation, I think we're just talking about different parts in the process of getting an MSW and getting licensed. The unlicensed social workers are medical social workers and social workers at DHS. They are unlicensed because they don't need a license to perform their basic job duties. However those basic job duties are crisis intervention, referrals, resource management, coordination, discharge planning (inpatient and psych hospitals also use MSWs for this). In my understanding, that is all a part of case management at the master's level. These things, in my opinion are not therapy. Therapy is learning to be one on one with a patient/client for approx 50 minutes, applying actual therapy techniques such as CBT, narrative, etc. If you have at least 2 patients that you will have to sit with and actually listen to for more than one standard session, and then apply an evidenced based theory of therapy in your sessions (yes multiple), then yes I'd say that qualifies as therapy training. I'm kinda just covering all bases in this paragraph because I think we're in agreement, I just want to make sure I'm being clear haha. You have to be very careful when getting an MSW (not likely a problem in programs with a clinical focus) that you get a good practicum that understands you want therapy training rather than generalist MSW training.

My program is very broad, because it's the only MSW in the state. I have had to be very careful and choose my experiences carefully. I mention therapy often to my mentors/advisors so that everyone understands I want a license to do actual therapy. For whatever reason, the LCSW in this state has become a qualification for someone who wants to be a supervisor, which makes no sense at all. I am going to a practicum that will provide me an opportunity to practice therapy skills I've learned with clients/patients, to add to some of the experiences I had last year. Once I graduate with my degree, instead of looking for a job that only requires the MSW qualifications, I'll be looking for an agency that can provide supervision and provide a work experience that has me doing therapy, rather than just case management. Some MSW graduates are unable to find work doing strictly therapy, or do not want to take the salary/pay associated with working for a community mental health center. They go to work at a hospital, then to discover they do no actual therapy, and will have to work part time somewhere else, or will have to work in a "manufactured" environment, borrowing their supervisors clients (which I think is hideous and unethical, but is allowed by the state) to earn therapy experience for their license. In my state, the LCSW requires 4000 hours of client time, but the qualification on the hours are such that almost everything qualifies. For example, case management qualifies as client time. For LPCs and LMFTs in my state, they are required to perform a certain number of client face-to-face hours instead of a huge number of general hours. My LMFT friend took over two years to get her 1000 hours of client face-to-face time with the board frequently "turning down" many of her hours. Personally, I think being strict on the kind of hours makes for better training. My state social work board is now moving to all social workers being licensed. I will have to take a test as soon as I graduate to become an LMSW. BSW will take the LSW test etc.. (there are like 6 or 7 of these with different emphasis). I think the state board did this to reverse the trend of everyone trying to get the clinical license as a stamp of legitimacy. Which ties back to that supervisors trying to get the LCSW to better put them in position for a job/raise. I will take the test for LMSW (Licensed Master's social worker) as soon as I graduate, then immediately go under supervision for my LCSW. I will accrue hours and be allowed by the state to diagnose etc...

I apologize for the book. I have lost my ability to summarize succinctly with all the papers I've been writing. Unless you want a power point, I could do one of those for you hahaha. There is a TL: DR at the bottom.

I am sure that Goobernut will chime in... I am going to quickly add my two cents. I have colleagues that graduated this past May who are doing psychotherapy in outpatient settings. They don't spend the entire day doing psyhco-therapy but they are getting experience. I think that the regular posters and lurkers know that I am interested in working with the military/veteran population (and their families) , so I will also add that unlicensed folks who are hired on at the VA also perform in therapist capacities. I'm doing that this year during my practicum. I too am a student WesleySmith, however, it give me pause to think that we should spend the time between graduating and getting our independent doing assessments, crisis intervention, and referrals. I would venture to say that's not the case. I wonder if the unlicensed folks that Goobernut mentioned were unlicensed by choice?

Well if you are hired as a recent grad, with the knowledge that you are under supervision and you want to learn to do therapy, you should (I say should) get therapy training. Like submarine said, no one is going to spend 8 hours a day in therapy, so take that into consideration. I guess I'm saying to be aware some sites think they are "clinical" in nature, will represent themselves as such, and then not actually train you in therapy. The problem is that some MSW grads don't realize the difference between being a "generalist" and being a "therapist" so they are surprised when then get out into the world, work at a hospital and realize the work they do doesn't qualify them to go under supervision to be an LCSW. Does that make sense? Or that the work they do for DHS or the job at the psych inpatient ward as a discharge planner isn't going to qualify them for the LCSW. They think crisis intervention is a form of therapy...

TL: DR
MSW is a broad degree and some people don't know what they are getting into. They get a crap job and then are all mad when their dreams of becoming a therapist are dashed and blame everyone else. If you get a job with the specific understanding that you are under supervision for LCSW licensure and they are providing therapy experiences, you should be fine. There are actually MORE jobs for an MSW that do not require any therapy training, and do not implement therapy as part of the job. Many people are disappointed when they realize they ended up with one of those jobs rather than a job as a therapist. The really confusing thing is that some of these jobs will give preference to, and ask for LCSWs in the job description. To add to the confusion, anyone who does work with transplant patients needs to be an LCSW for billing purposes, but they don't usually end up doing therapy (they are referred to the psychologist for a full eval). Same with dialysis social workers. There did I confuse everyone enough? LOL.
 
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