Psyd/PhD/Clinical PA

[wants2help]

I am entering my third year of my BA in a psych program. Ultimately I want to do some form of private practice (basically, clinical work). I have been doing the necessary research assistantships for the psyd/phd programs. But what if I want to be a PA?

I am most concerned about 1. Enjoyment of future job 2. Salary 3.Cost and Completion of program. I want to be a therapist. If I can prescribe med's that's fine too.

1. a PhD seems to be the most difficult to obtain (most commitment, longest time, most research intensive...and research is not my calling). I have heard they don't earn that well for the amount of commitment. However, if you get in, they are the least expensive.

2. I think I would most enjoy a psyd program, as I enjoy the practical aspect of psychology. I heard they don't earn that well either. I'm also worried about not being able to find work because I have a psyd and not a phd. However, they seem to have less credit, and are the most expensive.

3. Clinical PA work, I have heard, can be very independent. I understand that you are always under a physician, but can you have your own clients? And then you prescribe medication? And what does the psychiatrist do after that? Give you an A? I just don't get this job description. Is it really that good? And only a 2-3 year PA program, right? Seem to be only 1 or 2 yrs less than a psyd, so works out to less expensive overall but proportionately equal tuition per year.
Also, worried about not getting into PA school with a BA in psych. I have taken bio but no chem or microbiology, etc., and not too entranced with the sciences. I could do them, but I'd rather not. However, if the job is as I described I very well may suck it up.

Some legit straightforward numbers as to what each profession ultimately earns (initially, and then a ten year projection) would be _greatly_ appreciated. I have heard too many varied answers. I get the impression that PA's are in demand, but I don't want to be a person who does check ups and adjusts meds - I want _clients_.

As mentioned, I am going into my third year. If I need to change and add some microbio the time to do so is _now_.

I have gone back and forth many, many times, and will be relieved when it is all sorted out and I am on a clear track.

Thanks for your help - any is appreciated!

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[erg923]

A Psy.D. will not earn less than a Ph.D on average. You will likely just have alot more loan debt to pay off for the Psy. D...so there is a trade off in that respect. The "average" salary for a clinical Ph.D or Psy.D is not very representative, because the range and standard deviation is so large. Also varies greatly by geographic location and what type of job you have. Some people make 50k, some are making 150K if they have a lucrative practice. I do not know about the PA degree. Most importantly however, is figuring out what kind of career you want. A PA degree and doctorate in clinical psych are very different kinds of training, and will prepare you for different career paths.

If you want to do therpay, and therpay only, clinical psych really is not the field for that. Yes, you can do it, and many do, but there is alot more to the Ph.D or Psy.D than therapy, and private pracrtice is becoming increasingly difficult due to reimbursement rates for mental health care, as well as market saturation in many areas. If therpay is all you want to do, spending 5 years on a doctorate is likely overkill. You will learn alot more than therapy including research methodology, statistics, psychometrics, assessment, and psychodiagnosis. Many jobs in the clinical service world will utilize these skills sets more than therpay actually. Several other professions can prepare you for a therpay only practice (MHC, LCSW, etc). Getting a PA is also not all that therapy friendly either. As with clinical psych, you can do it, but that is not the primary training model or goal of that degree. A psychiatric nurse practitioner is very psychiatrist like, and although some do therpay, they are not trained in it nearly as extensively as in a clinical program. They mainly do medication management and management of medical compilations in psychiatric patients. Additionally, if you are not interested in general medical science and pharm, I'm not sure you would be happy in that type of program. It would be like going to med school if you weren't that crazy about medicine.

 

[shock-me-sane]

if you are actually interested in psychology and the medical profession I would look into BA to MSN programs with an option to be a psych nurse practitioner. You are able to prescribe and do therapy.

I am almost an RN, but decided to go the PhD route since I love research and the schooling for NP isn't what I want to spend my time doing.

Medical related stuff and psych are very related, but also very different monsters. Do you want to learn about all types of physical illness or deal with more psych issues? It is a personal preference and I would recommend looking into programs and see what the coursework entails.

good luck!

 

[zenman]

If you want to do therpay, and therpay only, clinical psych really is not the field for that.

I don't think anyone does therpay..

 

[Therapist4Chnge]

I agree with erg923.

 

[erg923]

I don't think anyone does therpay..

What a joker...... I once wrote an assessment report and to my dismay (after it was already sent to the referring doc), I had the spell check had turned the work "therapist" into "the rapist." I had to explain that the patient currently had a therapist, not a rapist, following up with them.

 

[WannaBeDrMe]

I looked into PA programs and I think depending upon your geographic region, PA would be MUCH MUCH MUCH more financially lucrative than PsyD/PhD... at least from a starting out point... and with less effort on your part since PA's are most often paid a salary and do not have to file their own insurance, etc

Many states have a severe shortage of psychiatric practitioners... that includes behavioral health PA's, psychiatric NP's, and psychdocs. In my state, PA's with experience in psychiatric med management are far more in demand than doctoral level psychologists.

Additionally, PA's have a lot of flexibility in their scope of practice. If you wanted to work particularly in a position where you could rx and do therapy as well... I'd recommend going straight to PA school and taking a year-two-three part-time after you are working as a PA to take classes in a clinical field such as clinical social work, clinical counseling, etc... you wouldn't need the degree, but you would need to be competent in theory and practice before it would be ethical to try and therapize anyone...

If you are seriously considering PA school, there are a lot of requirements and you are right, you will NOT get in without taking the pre-reqs, like 1000 patient contact hours (I think, I might be making that up...) and all of your science classes.

To specialize after your initial program, the PA residency in psychiatric care/behavioral health that I researched was in West Virginia and I've heard of one other fellowship in Indiana...

Depending on where you live, the PA would allow you to go ahead and walk into a well established practice... my area ALWAYS has ads for PA's in all fields (physician extenders) ...

something to consider if you are interested in the rx aspect since there's no guarantee that psychologists will earn that privilege nationwide

however, if you only want to be a therapist, don't forget to look @ counseling, SA, and social work programs... lots of masters psych programs have SA concentrations meant for masters level practice and licensing as an LPA, counseling programs are broad from pastoral to educational to clinical, and social work can either be macro-micro... so you have a lot more options than just PA/PsyD/PhD if leading therapeutic interventions is your goal...

good luck!

 

[Therapist4Chnge]

... I'd recommend going straight to PA school and taking a year-two-three part-time after you are working as a PA to take classes in a clinical field such as clinical social work, clinical counseling, etc... you wouldn't need the degree, but you would need to be competent in theory and practice before it would be ethical to try and therapize anyone...

This is a *very* slippery slope. I wouldn't think it'd be ethical for most/all PA's to conduct therapy without extensive training. From my understanding of the average PA curriculum, it has nothing to do with therapy, so taking a handful of classes doesn't touch on supervision, etc.

 

[erg923]

The "therpay" they practice is much more equivalent to what many psychiatrists do. Supportive therapy, maybe a behavioral intervention or homework assignment here or there. I am ok with that for the most part. However, I've never known any of my patients to have a PA as a primary therapist. If PAs are doing anything more than this, I would wonder where they got the supervision, and the formal training necessary to practice "psychotherapay" competently. I don't think theories of personality and experimental learning theory are high priorities in their training programs.

 

[WannaBeDrMe]

Agreed, I should have been more specific. I was thinking that the therapy provided would be more along the lines of psych-ed stuff... groups, etc. I don't see a person working primarily as a PA having time to do any sort of ongoing therapy. I guess I was imagining them as a PA with enough knowledge of the field to connect the two worlds and better share his primary area of knowledge with the client...

A similar situation popped up in my internship, psych techs were running groups on my floor and most had barely a high school diploma. I had serious issues with the way they handled some situations. It was hard to get used to for the several months...

and thanks for moving the other thread, i didn't even know the sociopoli forum existed!

This is a *very* slippery slope. I wouldn't think it'd be ethical for most/all PA's to conduct therapy without extensive training. From my understanding of the average PA curriculum, it has nothing to do with therapy, so taking a handful of classes doesn't touch on supervision, etc.