private practive. what degree

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Okay, I know this question has been asked a number of times on these forums as I am a long time lurker. However, I would like to ask it in my own words.

My plan was always to become a psychologist. I have a bachelors in psychology, above average GRE scores and a couple years of research experience. and some very solid clinical work experience. I believe that I would get into a couple of solid funded clinical psych PhD programs.

As I begin to take the next step to applying to grad school, I am wondering if becoming a psychologist is really worth it. My plan is to open a private practice and I know that LCSW's can do so as well. However, salary is very important to me. I am in the field to help but I also want to make as much money as possible.

Am I limiting myself by getting an LCSW instead of a PhD in

1) My education and development of practice skills.
2) My salary

Or is once I know the goal is PP, if I'm good my name will get out there regardless of the degree and therefore be able to charge what I want.


Thank you all for whatever advice you could give..I really appreciate it.

 

[BuckeyeLove]

What type of service are you hoping to deliver in PP? Your earning potential in Psych will largely be contingent upon your work product and it's value in a market. Food for thought; If all you desire is to hang out your shingle and do therapy, you might not be happy with your bottom line.

 

[redroller]

What type of service are you hoping to deliver in PP? Your earning potential in Psych will largely be contingent upon your work product and it's value in a market. Food for thought; If all you desire is to hang out your shingle and do therapy, you might not be happy with your bottom line.

I would like to do therapy...I understand the value of a niche and I'm sure I'll work one out eventually but that's a different discussion...I'm asking about the two different degrees.

Can you elaborate on your "food for thought" I'm not sure I understand that.

Thanks for your reply!

 

[AcronymAllergy]

I'm not in PP, so those who've worked in that arena can likely add a lot more information than can I. However, I'd imagine there are a number of variables that are going to affect your income; if "all" you do is accept insurance and provide psychotherapy, then honestly, I don't know that you'd see a huge income difference between the degrees. However, a doctorate is going to provide you with a good bit of in-depth training, and will prepare you to do much more than "just" therapy. If you can leverage that into various other endeavors and income streams (which most successful private practice psychologists I know have done), then the doctorate is likely going to end up being a more versatile degree.

Also, attending a funded program is a big selling point, considering you can complete your training with little or no debt. The main downsides, of course, are the added time requirements and the likelihood that you'll need to relocate a handful of times before finishing.

If I had the option of choosing between the two, I'd go with a doctorate, as I enjoy "all the other stuff" beyond therapy that grad school helped train me to do (caveat: this does not equate to me saying that "all" an LCSW can do is therapy, either).

 

[PsychPsyance]

I work as a professor in a clinical psych program (PhD) and in a private practice. While I think there are a lot of valuable things to be learned from getting a doctorate in psychology, I don't think it's a wise investment if your sole purpose is to do therapy in PP. At the private practice where I work, the one LCSW makes the same amount as the psychologists for individual therapy (she's also an exceptional therapist who knows CBT as well as any psychologist I know). The best (i.e., most knowledgeable and adept) CBT therapist I've ever met was actually an occupational therapist (MS degree). You don't need a doctorate to be a good therapist, you just need to be set on learning and using solid empirically supported interventions.

As for your scope of practice, there are things that you can't do, but LCSWs can diagnose and treat a wide range of disorders. There is of course a caveat, in that diagnosis often requires solid assessment abilities which you may or may not have. There's nothing wrong with referring a pt out for a good diagnostic clarification (I get Dx clarification referrals on a weekly basis from LCSWs and Masters level Counselors). Most other types of psych assessment will be outside your purview.

When it comes to the bottom line, the LCSW at the PP where I work makes as much as the psychologists (~$120k/year). She is reimbursed at the same rate for intakes and therapy as a psychologist. And for what it's worth, she loves her job.

 

[bostongal109]

I am biased here, but I don't understand why people believe that for a private practice to do therapy you must or should go the social work route, that actually seems a bit counter intuitive to me. If you want to do counseling, then why not do a masters in counseling, or clinical psychology or counseling psychology and become an LPC/LMHC/Whatever your state calls it? The almost entire point of those programs is to train you to do counseling.

 

[AcronymAllergy]

I am biased here, but I don't understand why people believe that for a private practice to do therapy you must or should go the social work route, that actually seems a bit counter intuitive to me. If you want to do counseling, then why not do a masters in counseling, or clinical psychology or counseling psychology and become an LPC/LMHC/Whatever your state calls it? The almost entire point of those programs is to train you to do counseling.

I could be wrong, but the LPC/LMHC may have a more restricted scope of practice in most states than the LCSW. Folks should probably check on that in their individual jurisdiction, though.

 

[WisNeuro]

I'm with AA here, I'd go with something that gives you more flexibility. These days it seems that many of those in the PP arena also have other things going on (e.g, side professorship in some capacity, some consulting, etc). With reimbursement rates from insurance and medicare/medicaid continuing to fall, I'd want to have as many options as possible in case I needed a different revenue stream.

 

[smalltownpsych]

The answer to both questions 1 and 2 is maybe. I think the better way to answer the question is to look at the areas where the degrees differ and see which one appeals to you more. Which ever path you choose that will inform your style of therapy and perspective so it would be bad if it wasn't a good fit. I have seen that happen more for social workers than psychologists, but that is my own biased sample, not exactly solid research. In any event, looking at the overlap in both providing therapy will lead to splitting hairs and ultimately private practice success will be dependent on much more than which degree that you have.

 

[Therapist4Chnge]

The good (but challenging) thing about doctoral training is that you are required to learn a great deal of information outside of traditional therapy skills. For some people this is desired because they also want to conduct research, provide psychological assessment, teach, etc…but for others those skills are just more hoops to jump through to eventually be able to provide psychotherapy. Admittedly I am biased towards doctoral training for therapy because there is much more in the training about the WHY and not just the HOW of therapy. The scientific underpinnings, the research that supports the various approaches, the statistics that help explain outcomes, etc.

In regard to degree (and associated licensure), that can be very state dependent. Social Work is often recommended because it has been around a long time, the state laws are generally favorable, and the training can offer some flexibility. However…and this is a big however, additional training is needed for ANY degree program, so the degree matters insomuch as it gets you the minimum requirements (once licensed), but much more is needed to do it adequately.

As for the money side…that's 80-90% business and 10-20% clinical skill. I know plenty of mediocre to poor clinicians who make great $ bc they know how to market themselves, while I also know amazing clinicians who couldn't run a lemonade stand.

 

[Doctor Eliza]

I've worked in PP for about 5.5 yrs at this point. I started my PhD with the intention to become a prof at a research institution. However, the profs at my school were miserable and I decided that the lifestyle of a professor was not for me. So, after graduation, I joined a group PP. I'd say for the first few yrs I was bitter that I went through all the pain and suffering of a PhD program to do work I could reasonably do with a master's (my program was truly awful to us, probably slightly more so than most). However, now the trauma of grad school has started to fade a little and I am getting into some endeavors that I could not do with a master's (psychoeducational assessment and some consultation work for the gov't that requires a PhD). It feels a little more worth it.

However, a few caveats. You think you want to do PP now, but that may not always be the case. People thing PP is the "dream job" but there are tons of downsides that people don't think about: no paid vacation/sick time/maternity leave, no medical benefits, no employer matching retirement, etc. Some of those things are much more stressful IRL than they sound. I know tons of people who have burned out on PP (at all points in their career). Additionally, at points when I wanted to leave PP, I found it astounding how few jobs existed in my (major) city for psychologists. Around here, MH jobs for therapists are largely dominated my master's folks. I have had a few doctoral friends take master's level positions (for master's level pay).

I don't really have an answer to your question. Just wanted to raise some points. Good luck to you!

 

[Doctor Eliza]

As for the money side…that's 80-90% business and 10-20% clinical skill. I know plenty of mediocre to poor clinicians who make great $ bc they know how to market themselves, while I also know amazing clinicians who couldn't run a lemonade stand.

Yes! This!

 

[PsyDr]

I am in full time private practice, with one day of clinical practice. IMO:

1) An MSW is woefully uneducated in psychotherapy. The education typically incorporates one year of education in clinical work. A doctorate would incorporate at least 3 years. Both require about a year afterward of training.

2) Income in the mental health field is dependent on subspeciality, education, geographic location, and productivity. First, psychotherapy reimburses at a similar rate for all if you are doing generic psychotherapy. If you specialize in something that no one else wants to do, then there will be increased demand. For example, I live in a medium size city and there is only one person who treats borderline patients. Next, if a patient is going to have to pay a $35 copay and one person is a doctor and the other is a Mr./Mrs., then the obvious choice is the former. Next: Geographic location determines demand. Move to LA, Chicago, or New York and the markets are saturated. Especially if you are trying to treat young, attractive, educated, intelligent, verbal, etc patients. Finally, income in private practice is mostly volume driven. If insurance is paying $95/hr for when you see patients, then how much work you do is going to determine how much you make, less overhead. If you work a relaxed schedule, then you make less. If you work a bunch, you make more.

 

[Therapist4Chnge]

1) An MSW is woefully uneducated in psychotherapy. The education typically incorporates one year of education in clinical work. A doctorate would incorporate at least 3 years. Both require about a year afterward of training.

This is what I was getting at, though I think PSYDR was more direct with the information. Generalist training is good to cover the bases, but most clinicians tend to develop a niche, which is advisable because you can better know the area. I'm 10+ years into the field and I'm constantly learning and trying to stay up on things (albeit not direct therapy services). Being a "jack of all trades" is definitely not recommended.

If insurance is paying $95/hr for when you see patients, then how much work you do is going to determine how much you make, less overhead. If you work a relaxed schedule, then you make less. If you work a bunch, you make more.

Overhead….cancellations (even if you charge a 'no show' fee), office space, admin assistance, billing, handling an audit, etc…all eats into your effective hourly rate. Being able to earn via other people you employee (therapists, psychometricians, etc) can help raise that rate, but it brings all sorts of fun 'business owner' issues.

 

[redroller]

Wow, tremendous information.. thanks to all of you.

While opinions did vary..it seems as if the overall consensus was go the MSW route.

The only downside I am seeing is that some of you feel that their training is inadequate. hmm...I definitely have what to think about. For what it's worth I would definitely pursue advanced training in different modalities after graduation; that is something I've heard would be a necessity if I went the MSW route over and over.

Thanks guys!

 

[WisNeuro]

I think I may have read a different thread without such a consensus. If anything, it was "depends", if not a strong recommendation to diversify your potential career avenues.

 

[PsyDr]

The confusion always centers around the terms "salary" and "private practice", when it should be "income and private practice".

If someone is trying to go to grad school to find a traditional job, then MSWs have many more hiring options. If someone is trying to go into private practice, then the answer is "it depends".

But anyone who says something about salary and private practice has set up their business wrong.

 

[redroller]

I think I may have read a different thread without such a consensus. If anything, it was "depends", if not a strong recommendation to diversify your potential career avenues.

I guess you did. I just re-read the thread because of your post and again, I feel as if the MSW is the degree being encouraged. The only "it depends" I saw was that it depends on whether or not I really only want to do therapy. Being as I said in my initial post that this is my goal...therapy in PP, it would appear as if most were agreeing that income alone would not be a good enough reason to pursue a PhD as those lcsw's in PP can make just as much (which was my question). I did note the advantages of going the PhD route i.e consultation, testing etc. but that is not my goal. Again, my question was if I want to do solely psychotherapy in PP will getting a PhD significantly effect my income. The question of whether or not I will always only want to do therapy and PP and if it is smart to bank on the fact that I will...is a different discussion all together.

The confusion always centers around the terms "salary" and "private practice", when it should be "income and private practice".

If someone is trying to go to grad school to find a traditional job, then MSWs have many more hiring options. If someone is trying to go into private practice, then the answer is "it depends".

But anyone who says something about salary and private practice has set up their business wrong.

Very good. This is true, good call.

 

[WisNeuro]

If 1.5 equals a consensus, I guess it's a consensus then.

 

[smalltownpsych]

If 1.5 equals a consensus, I guess it's a consensus then.

Must be reading with a confirmatory bias.

 

[redroller]

If 1.5 equals a consensus, I guess it's a consensus then.

Must be reading with a confirmatory bias.

LOL you guys are too funny...what are your motives to not want the answer to be MSW? I could tell you I have no idea which one I want to pursue and it's something I need to think long and hard about as well as ask some more people in the field. To be completely honest part of me wanted to hear that I needed a PhD because then I would feel better about all the extra research I did for the sake of a PhD. However, it is OBVIOUS that anyone reading these posts would infer from the responses that the OP would probably not benefit much from going the PhD route if his sole purpose was therapy in PP.

Are you guys trying to tell me that most of the responses didn't stand behind the idea that one's success in PP is not dependent on the degree if they are a business savvy and a competent therapist?

i.e Person A is competent and business savvy with a PhD

Person B is competent and Business savvy with an LCSW to the same extent...

Is person B likely to make less because of his degree?

Overall consensus of the posters on this forum....NO

does that mean the degrees are equal? absolutely not.

That was not my question. Does it mean there is no benefit to the PhD....No

That was not my question either.

 

[WisNeuro]

I don't think it's that we "want" the answer to be MSW. It merely wasn't. The MSW is a decent degree for some opportunities. I think the majority consensus here was that PP is not that simple and that many people in PP also do other things, for which the MSW is not the way to go most of the time.

 

[redroller]

I don't think it's that we "want" the answer to be MSW. It merely wasn't. The MSW is a decent degree for some opportunities. I think the majority consensus here was that PP is not that simple and that many people in PP also do other things, for which the MSW is not the way to go most of the time.

i.e Person A is competent and business savvy with a PhD only doing psychotherapy

Person B is competent and Business savvy with an LCSW to the same extent only doing psychotherapy...

Is person B likely to make less because of his degree?


Your opinion please.

 

[WisNeuro]

In a vacuum where reimbursement rates stay the same and burnout doesn't occur, those are likely equal. But these are unrelaistic hypothesticals.

This rarely occurs in the real world. Reimbursement rates have been going down, precipitously for medicare/medicaid. Being able to diversify is becoming more and more paramount, which is what most people have been getting at.

 

[AcronymAllergy]

I would agree with the general idea that the consensus has been that if all else remains equal and unchanged, and all one wanted to do was provide psychotherapy in private practice, then yep, and an LCSW will typically be reimbursed at the same rates by insurance as a psychologist. However, a psychologist may be able to get away with a larger proportion of private pay clients and/or charging said private pay clients more. Although I have a sneaking suspicion that as others mentioned earlier, this may have just as much or more to do with business savvy and marketing ability than training in mental health.

However, I also think it's important to give some attention to the idea that folks rarely end up doing post-grad school exactly what they'd planned on doing pre-grad school. In that sense, the doctorate may offer more flexibility. Although LCSWs can and certainly do carve out niches for themselves in various areas.

 

[Peacemaker36]

This has been posted on other threads, but in case you missed it, Medicare reimburses social workers at a rate of 75% of the fee for psychologists. Medicare rates don't correlate 1:1 with rates set by third party insurers, but there is a relationship. If you are going to have a private practice and plan to accept insurance, you will earn less money as a social worker. You have to weigh that against the opportunity cost of lost years of income during PhD/PsyD graduate school vs. a two year Master's program.

Generally speaking, the two training models (psychology vs. social work) are extremely different. It's apples and oranges. Yes, there are some social work programs with a strong clinical focus, and there are some psychology programs that emphasize social justice and macro issues. But I would be careful about choosing where to spend formative training years. Your professional identity may not be set in stone when you get the diploma, but the ink is drying.

 

[Goobernut]

All things being equal, you are going to get more AND detailed education at the PhD level. That really should be a no-brainer. I think the OP is pretty clear on this point. OP, please let me know if I am incorrect.

At the masters level, it's very important to consider what license is most employable in your state. Many people don't think to investigate it, kudos to you for doing so before you choose your degree. If you get a PhD and get licensed you will be able to things that a mid-level provider would not be able to do. I also see this as a no-brainer. There is no magical master's degree that will get you just as much education and experience as a PhD.

If all you want to do is talk therapy, then a master's level education may be a good fit for you. If all you want to be educated on is the "how of therapy" to use T4C's phrase, that's okay, and again, a master's level education may be a good fit for you. Mid-level providers exist for a reason. I lurked on these boards nearly my whole undergrad trying to decide what to do. The question of PhD vs masters vexed me. In the end, you have to decide what will fit your personality and lifestyle. The truth of the matter is that masters level clinicians can and often do practice therapy competently at their level of service. PhD's do often offer a fine-tuned and more expert version of therapy. Honestly, what is frustrating to me is these discussions devolve into "why masters therapists suck and aren't as good as we are." If you go read Physician forums, you'll see the same talk about how horrible PA and NPs are in comparison to physicians. They aren't horrible, in reality they have a different scope of practice. This is KEY to remember about the relationship between any clinician and their mid-level provider. You will have those that are respectful and value your contribution as a mid-level, and you will have those that feel like you don't add anything and would like to do away with your licensure.

I personally enjoy the role of mid-level provider. I will always further my education, certifications, trainings etc. Being a mid-level provider doesn't mean that continuing education ends. My program is heavy with admonishments to continue your education forever. After I graduate, I will have a highly interactive career, with many avenues for employment. I did have to pay for a masters vs an funded PhD program, but I am getting through it really cheaply because of scholarships and stipends that I received. I feel like MSW vs PhD is a very personal decision, rather than simply one of practicality.

One last note, OP, if you want to know career prospects for MSWs, I'd suggest asking MSW graduates and those currently in the field for that. I see so much mis-information handed out on this board about MSW training (and how they fare in the field after graduation), I have just given up on correcting it all. If you want to know about MSW training, please feel free to PM me and me and some of the other MSW students who read these boards will be happy to answer your questions. In the end, I would like the take-away to be that at the masters level, the individual program's curriculum matters more than the degree letters associated with it. There can be some generalizations made, as with everything, but you'll get more accurate information from the source rather than degrees (pun intended) removed.

 

[bcliff]

This has been posted on other threads, but in case you missed it, Medicare reimburses social workers at a rate of 75% of the fee for psychologists. Medicare rates don't correlate 1:1 with rates set by third party insurers, but there is a relationship. If you are going to have a private practice and plan to accept insurance, you will earn less money as a social worker. You have to weigh that against the opportunity cost of lost years of income during PhD/PsyD graduate school vs. a two year Master's program.

Generally speaking, the two training models (psychology vs. social work) are extremely different. It's apples and oranges. Yes, there are some social work programs with a strong clinical focus, and there are some psychology programs that emphasize social justice and macro issues. But I would be careful about choosing where to spend formative training years. Your professional identity may not be set in stone when you get the diploma, but the ink is drying.

^^ I agree with this, and would like to focus on the reimbursement component. Insurance companies often reimburse between 30-60% of a psychologists general rate. At the practice where I worked as a psychometrist/insurance coordinator, we saw a lot of patients with medicaid (We were a NHSC site and were obligated to see a certain % of medicaid patients). On the low end of reimbursement, Medicaid reimbursed us roughly $40/hour for services that we would have generally charged $150/hour for, and on the high end, some companies had rates around $100/hour. However, many of these companies with higher rates required explicit preauthorization for each service rendered.

Out of that reduced rate comes overhead expenses (our physical office building, utilities/security, etc.) staff (2 administrative assistants, 1 psychometrist/insurance coordinator, 1 practice manager), and salary for the provider actually administering these services. Don't forget (like I mentioned earlier) the hours of back office time that go into verifying insurance eligibility, seeking preauthorization for services rendered, filing claims, following up with billing, etc.

I've mentioned in previous threads that this specific psychologist had a very diverse caseload with a number of forensic/legal contracts and several psychoeducational evaluations each month, which definitely boosted our practice's cash flow. I mention the impact of reimbursement rates because (as previously mentioned) these rates are even lower for LCSWs & LPCs. We had several mid-level providers who worked in our practice (providing therapy exclusively), and while I have no idea what their annual take home salary was, I do know that reimbursement for their services usually ran from 50-75% of the reimbursement rate for services rendered by a psychologist. These mid level providers also had a much lower base rate for their services and were not able to provide psychological assessment/evaluation. Not to mention that some insurance providers require referral from an MD before a patient can see a mid level mental health provider (I think that the same is true for PhDs & PsyDs but is much less common).

If you are exclusively interested in pursuing a career in private practice, then definitely do not pursue a PhD/PsyD. I'm still in the middle of my applications, but still I only recommend pursuing a doctoral degree in psychology to people who are at least slightly interested in pursuing a career incorporating clinical, academic, and research work. Any solid psychology doctoral program is going to incorporate research into its training (most likely requiring you to complete a thesis and dissertation), and any doctoral program that doesn't incorporate research training into its curriculum will likely provide you with a sub-par education.

 

[smalltownpsych]

All things being equal, you are going to get more AND detailed education at the PhD level. That really should be a no-brainer. I think the OP is pretty clear on this point. OP, please let me know if I am incorrect.

At the masters level, it's very important to consider what license is most employable in your state. Many people don't think to investigate it, kudos to you for doing so before you choose your degree. If you get a PhD and get licensed you will be able to things that a mid-level provider would not be able to do. I also see this as a no-brainer. There is no magical master's degree that will get you just as much education and experience as a PhD.

If all you want to do is talk therapy, then a master's level education may be a good fit for you. If all you want to be educated on is the "how of therapy" to use T4C's phrase, that's okay, and again, a master's level education may be a good fit for you. Mid-level providers exist for a reason. I lurked on these boards nearly my whole undergrad trying to decide what to do. The question of PhD vs masters vexed me. In the end, you have to decide what will fit your personality and lifestyle. The truth of the matter is that masters level clinicians can and often do practice therapy competently at their level of service. PhD's do often offer a fine-tuned and more expert version of therapy. Honestly, what is frustrating to me is these discussions devolve into "why masters therapists suck and aren't as good as we are." If you go read Physician forums, you'll see the same talk about how horrible PA and NPs are in comparison to physicians. They aren't horrible, in reality they have a different scope of practice. This is KEY to remember about the relationship between any clinician and their mid-level provider. You will have those that are respectful and value your contribution as a mid-level, and you will have those that feel like you don't add anything and would like to do away with your licensure.

I personally enjoy the role of mid-level provider. I will always further my education, certifications, trainings etc. Being a mid-level provider doesn't mean that continuing education ends. My program is heavy with admonishments to continue your education forever. After I graduate, I will have a highly interactive career, with many avenues for employment. I did have to pay for a masters vs an funded PhD program, but I am getting through it really cheaply because of scholarships and stipends that I received. I feel like MSW vs PhD is a very personal decision, rather than simply one of practicality.

One last note, OP, if you want to know career prospects for MSWs, I'd suggest asking MSW graduates and those currently in the field for that. I see so much mis-information handed out on this board about MSW training (and how they fare in the field after graduation), I have just given up on correcting it all. If you want to know about MSW training, please feel free to PM me and me and some of the other MSW students who read these boards will be happy to answer your questions. In the end, I would like the take-away to be that at the masters level, the individual program's curriculum matters more than the degree letters associated with it. There can be some generalizations made, as with everything, but you'll get more accurate information from the source rather than degrees (pun intended) removed.

I had to smile when I read through this great post. Especially the part about asking a social worker or counselor how they feel about their job. Why do they ask us this question? This is a board for people who want to become a psychologist. I am happy that I chose to be a psychologist and my obvious bias is to recommend it over other related professions. Like most people in the world, I also tend to root for my local teams. On the other hand, some days I wish that I had become a professional bass fisherman, but that's kind of the way it goes in this line of work.

 

[Goobernut]

^^ I agree with this, and would like to focus on the reimbursement component. On the low end of reimbursement, Medicaid reimbursed us roughly $40/hour for services that we would have generally charged $150/hour for, and on the high end, some companies had rates around $100/hour. However, many of these companies with higher rates required explicit preauthorization for each service rendered.

... Not to mention that some insurance providers require referral from an MD before a patient can see a mid level mental health provider (I think that the same is true for PhDs & PsyDs but is much less common).

Just a quick addition on Medicaid reimbursements... reimbursement varies by state. Some states have insanely horrible reimbursement rates (think as low as 30% for some services), some pay at 100% the rate that Medicare pays for the locale. Medicare also has adjusted rates depending on cost of living in your area (just in case some of you weren't aware of that). In my state for example, Medicaid typically pays 95% the rate that Medicare pays for a service. There are more restrictions and hoops to jump through for Medicaid, but my state does have one of the higher Medicaid reimbursement rates. At one time we were at 100% of Medicare, but there were budget cuts.

Requiring a pre-auth or referral for behavioral health visits varies by commercial carrier. In my experience, there was no consumer difference to seeing a mid-level or PhD or PsyD. However, with as varied as commercial carriers are, I can believe that there are some companies that require referrals from an MD for only mid-levels and not to see a PhD's. Most insurance companies that I dealt with only required a general referral for any type of behavioral health visit. My personal insurance company doesn't require your MD to refer you, but you have to call the referral line and "self-refer."

LPCs and LMHCs are not recognized providers for Medicare, though Medicaid will often approve therapy charges for these providers.

 

[Goobernut]

Why do they ask us this question? This is a board for people who want to become a psychologist. I am happy that I chose to be a psychologist and my obvious bias is to recommend it over other related professions. Like most people in the world, I also tend to root for my local teams. On the other hand, some days I wish that I had become a professional bass fisherman, but that's kind of the way it goes in this line of work.

I think the bolded happens because there is a lack of traditional forums like this one for MSW students and young social work professionals. Especially for ones pursuing therapy specifically. There is GradCafe (geared for entrance assistance) and Reddit (which is its own unique beast). It could also be that if you google "MSW vs PhD" this is the first forum that pops up. You see MSW vs Phd in City-Data quite often. I have NOOO clue why that might be...

I think you hit the nail on the head when you compared it to rooting for your local team. I agree.

And I hear you, at one time I seriously considered becoming a nail tech instead of going back to college 😉 It's a nice portable career!!!! Haha.

 

[Fan_of_Meehl]

Okay, I know this question has been asked a number of times on these forums as I am a long time lurker. However, I would like to ask it in my own words.

My plan was always to become a psychologist. I have a bachelors in psychology, above average GRE scores and a couple years of research experience. and some very solid clinical work experience. I believe that I would get into a couple of solid funded clinical psych PhD programs.

As I begin to take the next step to applying to grad school, I am wondering if becoming a psychologist is really worth it. My plan is to open a private practice and I know that LCSW's can do so as well. However, salary is very important to me. I am in the field to help but I also want to make as much money as possible.

Am I limiting myself by getting an LCSW instead of a PhD in

1) My education and development of practice skills.
2) My salary

Or is once I know the goal is PP, if I'm good my name will get out there regardless of the degree and therefore be able to charge what I want.


Thank you all for whatever advice you could give..I really appreciate it.

I think that it was the late Richard McFall (in his 'manifesto' for the scientific practice of clinical psychology) who said something like the following (comparing the scientific practice of medicine and the scientific practice of psychology/therapy):

I don't know very many people who would (seriously) consider it immaterial whether or not the physician who is treating them for a general medical problem is familiar with the basic sciences and their application to understanding and treating their medical illnesses (e.g., pathophysiology, biochemistry, blood tests, etc.)

Why would this (fundamentally) be different if they were seeking mental health treatment?

 

[rotarman]

I'm not a psychologist or therapist but have a parent who is and I'm familiar w/ their practice's financials so take this FWIW. At parent's location, therapists tend to make quite a bit less than psychologists. Big reason for this are lower reimbursement (maybe not the case in other states). Another thing I think helps is no-shows are common, and psychologists can work on psych testing during them in addition to no-show fee so never really wasting time. Finally at least in our geography there aren't enough psychologists but plenty of therapists so the former can keep full schedules and get plenty of gravy stuff like narcotics evals that pay >$100/hr.
Of course can't speak to educational differences, but N=1 psychologists seem to do better pay-wise.