The “Just Get A Masters Degree” Argument

[HesitantPsyD]

There have been an increasing number of posts here where people with doctorates in psychology advise people considering clinical work to pursue Masters Degrees instead of obtaining doctoral level training. I’m not here to debate the relative merits of masters level vs doctoral training and outcomes. I do, however, want to argue another side to the “just get a Masters degree” refrain that is repeated ad naseum from people with doctorates on this board. I have had a Masters degree in counseling for over 6 years now, and am provisionally licensed in two states (ie I am continuing to try and get enough direct client hours to work independently). It sucks, because with my degree I can’t realistically get a job doing therapy, and am instead relegated to jobs with the amorphous job description of “case management”, which in my experience entails many things... little to none of which involves doing therapy. At best, I’m a social worker and at worst I’m a glorified taxi driver being used for my vehicle. I would love to do therapy with my Masters degree, but although I’ve tried in two states to do so, I have been constantly thwarted and lied to about the possibility of getting therapy jobs at my level of licensure. I also know of numerous people who, after they grin and bear the case management grind, can’t get a therapy job post independent licensure because they “don’t have therapy experience”. Each case management job I’ve had coworkers in this type of predicament, and I for one view it as an occupational trap. Therefore, regardless of the relative merits of doctoral vs masters level training, one thing that sticks out is the fact that many doctoral level people don’t know what the actual facts of the masters level job market entail. In my experience, and in the experience of several people I know in two states, Masters level counselors don’t seem to have the automatic ability to do therapy that doctoral level practitioners often assume.

---

Members don't see this ad.

 

[futureapppsy2]

There have been an increasing number of posts here where people with doctorates in psychology advise people considering clinical work to pursue Masters Degrees instead of obtaining doctoral level training. I’m not here to debate the relative merits of masters level vs doctoral training and outcomes. I do, however, want to argue another side to the “just get a Masters degree” refrain that is repeated ad naseum from people with doctorates on this board. I have had a Masters degree in counseling for over 6 years now, and am provisionally licensed in two states (ie I am continuing to try and get enough direct client hours to work independently). It sucks, because with my degree I can’t realistically get a job doing therapy, and am instead relegated to jobs with the amorphous job description of “case management”, which in my experience entails many things... little to none of which involves doing therapy. At best, I’m a social worker and at worst I’m a glorified taxi driver being used for my vehicle. I would love to do therapy with my Masters degree, but although I’ve tried in two states to do so, I have been constantly thwarted and lied to about the possibility of getting therapy jobs at my level of licensure. I also know of numerous people who, after they grin and bear the case management grind, can’t get a therapy job post independent licensure because they “don’t have therapy experience”. Each case management job I’ve had coworkers in this type of predicament, and I for one view it as an occupational trap. Therefore, regardless of the relative merits of doctoral vs masters level training, one thing that sticks out is the fact that many doctoral level people don’t know what the actual facts of the masters level job market entail. In my experience, and in the experience of several people I know in two states, Masters level counselors don’t seem to have the automatic ability to do therapy that doctoral level practitioners often assume.

What field is your masters degree in? I taught masters students in counseling, and everyone who wanted one got a job doing therapy.

 

[WisNeuro]

What field is your masters degree in? I taught masters students in counseling, and everyone who wanted one got a job doing therapy.

Equally, the only therapists that my system is really hiring are SW/Masters. And we account for most of the healthcare in the state.

 

[Sanman]

Why haven't you been able to get enough clinical hours to get licensed?

 

[HesitantPsyD]

I have an M.A. in Counseling. It’s not as if there are no jobs, it’s more like I can’t get the jobs that require full licensure because the hours leading up to full licensure don’t entail doing therapy for the most part.

Equally, the only therapists that my system is really hiring are SW/Masters. And we account for most of the healthcare in the state.

 

[LadyHalcyon]

I was just approached by a masters level clinician who is the director of a group home. She needs a doctoral level clinician to sign off on treatment plans for Medicaid. Masters level clinicians definitely face some challenges and don't have as many available opportunities. That being said, there are many masters level clinicians in the group practice where I work who do nothing but therapy and make a decent living.

 

[HesitantPsyD]

Why haven't you been able to get enough clinical hours to get licensed?

I don’t want to do case management, especially after seeing friends and coworkers getting the shaft post full licensure (eg not being able to get therapy jobs with little to no therapy experience). Why put myself in often dangerous and difficult circumstances when there is no light at the end of the tunnel?

 

[MAClinician]

I have an M.A. in Counseling. It’s not as if there are no jobs, it’s more like I can’t get the jobs that require full licensure because the hours leading up to full licensure don’t entail doing therapy for the most part.

What states are you provisionally licensed in?

What types of jobs are you applying for?

 

[Sanman]

I don’t want to do case management, especially after seeing friends and coworkers getting the shaft post full licensure (eg not being able to get therapy jobs with little to no therapy experience). Why put myself in often dangerous and difficult circumstances when there is no light at the end of the tunnel?

Wait, so you are choosing not to complete clinical hours and get licensed because you don't think you will get a job? What dangerous circumstances are you speaking of?

 

[GradStudent2020]

I have my Masters in Counseling Psych and did not have trouble finding a job as a provisionally licensed clinician while completing my supervision requirements. In one state (where I obtained my degree), I had a position immediately post-degree where I was provided supervision. I moved states about 100 hours short of my full license. I was not employed as a therapist for about 9 months in the new state, but until I found the “right” job I did ABA therapy as an entry level technician. In the 2nd state I had to pay for my supervision for hours.

If I wanted to continue doing therapy I would not have pursued a doctorate. However, I live in a state that has a Master’s level license to do psychological testing. I like therapy, I LOVE assessment. Love the testing, scoring, interpretation, writing, and giving feedback. I knew that with my Master’s only I’d be restricted to only a few states if I wanted to continue doing testing.

I’m sorry you have had such difficulty getting your hours completed.

 

[GradStudent2020]

I have an M.A. in Counseling. It’s not as if there are no jobs, it’s more like I can’t get the jobs that require full licensure because the hours leading up to full licensure don’t entail doing therapy for the most part.

Wait, are you saying that your case management work is counting towards required licensure but that employers don’t consider them to be therapy and therefore won’t hire you after you are licensed?

That was a very long sentence, sorry.

 

[HesitantPsyD]

Wait, so you are choosing not to complete clinical hours and get licensed because you don't think you will get a job? What dangerous circumstances are you speaking of?

Yes, I’m debating not completing my clinical hours due to discouragement. Dangerous circumstances include being trapped alone with an actively psychotic client brandishing a box cutter in my face, being forced by my then supervisor to drive another actively psychotic client in my personal car to the hospital (where once there the police stated “why didn’t you call us”). That was my idea, which my supervisor overruled. I’ve had to transport people in danger of jumping out of moving cars on the expressway. None of this I initially signed up for when wanting to sit in room do psychotherapy.

 

[GradStudent2020]

Yes, I’m debating not completing my clinical hours due to discouragement. Dangerous circumstances include being trapped alone with an actively psychotic client brandishing a box cutter in my face, being forced by my then supervisor to drive another actively psychotic client in my personal car to the hospital (where once there the police stated “why didn’t you call us”). That was my idea, which my supervisor overruled. I’ve had to transport people in danger of jumping out of moving cars on the expressway. None of this I initially signed up for when wanting to sit in room do psychotherapy.

Well, that sounds unsettling but there are definitely settings and populations that aren’t so potentially dangerous.

 

[HesitantPsyD]

Yes, at every case management job I’ve had I’ve had co workers who are already fully licensed counselors who were actively seeking therapy jobs not get offers due to their lack of therapy experience.

Wait, are you saying that your case management work is counting towards required licensure but that employers don’t consider them to be therapy and therefore won’t hire you after you are licensed?

That was a very long sentence, sorry.

t is what

 

[GradStudent2020]

Yes, at every case management job I’ve had I’ve had co workers who are already fully licensed counselors who were actively seeking therapy jobs not get offers due to their lack of therapy experience.

t is what

Are there any therapy job postings for provisionally licensed therapists? I would try to get one of those (vs. case management) as soon as possible. How much actual therapy experience did you get while working on your degree? Do any of your past practicum supervisors have ideas?

 

[HesitantPsyD]

I’m licensed in Texas and Illinois. There is the occasional private practice offering therapy hours, but from what I understand they are usually innundated with applications and it’s extremely hard to secure these positions. They are needles in haystacks.

Are there any therapy job postings for provisionally licensed therapists? I would try to get one of those (vs. case management) as soon as possible. How much actual therapy experience did you get while working on your degree? Do any of your past practicum supervisors have ideas?

 

[GradStudent2020]

I’m licensed in Texas and Illinois. There is the occasional private practice offering therapy hours, but from what I understand they are usually innundated with applications and it’s extremely hard to secure these positions. They are needles in haystacks.

I cold called (emailed my CV and a very nice letter) a ton in both states. None of my positions have come from job postings. Have you tried reaching out to every practice (community, pp, inpatient, etc) that offers therapy and employs at least one clinician eligible to supervise you?

 

[MAClinician]

In my state, unlicensed masters folks (we don’t have provisional license for counseling but SW can get LCSW before LICSW) Work in community mental health centers, residential programs, and hospitals that accept Medicaid. Are there options like that available for you?

I will also say, that even psychologists at times end up doing case management/social work. Sometimes you need to refer/connect clients to a service or resource in the community.

 

[deleted343839]

I appreciate your post and your willingness to share what sounds like a terribly disappointing experience. While it's true that master's level clinicians can provide psychotherapy, and I know many who do, the "fine print" is important.

Psychologists receive many more hours of supervised clinical training and have a fairly structured and predictable path toward licensure as long as they do the work and stay within the bounds of APA accredited programs. This is an advantage right out of the gate, though it comes at the cost of a longer delay to start one's career.

Even within psychology, though, there are programs there are programs that offer weak training and burden their students with the responsibilities for arranging practica and other things necessary for their professional development. In these programs it is less likely that graduates will go on to become licensed to practice psychology (though some already have master's level licensure and may be less inclined to do so as long as they can call themselves "doctor").

I wonder if we are talking about an analogous situation here. In other words, what is your program's reputation in the community? What proportion of your cohort are now providing counseling and psychotherapy services? Is your experience typical for your training program, or are you an outlier?

 

[Chalupacabra]

I think one fair pushback against this argument is that there are a number of opportunities for training that one might not get exposure to outside of a PhD program, and it's also hard to predict how experiences will change/shape your interests. I know my clinical interests from when I began training at the graduate level to now are vastly different and they probably changed the most while I was enrolled in my doctoral program (after completing an M.S.). I've published and presented on topics I knew little to nothing about before starting my doc program and became intensely interested in due to the variety of clinical and academic experiences I've had as a doctoral student.

Though I think that argument alone doesn't really justify taking on 4+ years more of training, it is something worth considering.

 

[HesitantPsyD]

I went to a university based M.A. program in the Midwest, which also happens to have a respected PsyD program in the same department. I always got the impression that my program was the cash cow that helped the much more successful PsyD program flourish (close to 100 percent APA match rates etc.). I should also mention that my program was in a terribly saturated mental health market, making finding good practicums more difficult than it should have been. Nevertheless, my program had a good local reputation.

I appreciate your post and your willingness to share what sounds like a terribly disappointing experience. While it's true that master's level clinicians can provide psychotherapy, and I know many who do, the "fine print" is important.

Psychologists receive many more hours of supervised clinical training and have a fairly structured and predictable path toward licensure as long as they do the work and stay within the bounds of APA accredited programs. This is an advantage right out of the gate, though it comes at the cost of a longer delay to start one's career.



I wonder if we are talking about an analogous situation here. In other words, what is your program's reputation in the community? What proportion of your cohort are now providing counseling and psychotherapy services? Is your experience typical for your training program, or are you an outlier?

 

[Sanman]

Yes, I’m debating not completing my clinical hours due to discouragement. Dangerous circumstances include being trapped alone with an actively psychotic client brandishing a box cutter in my face, being forced by my then supervisor to drive another actively psychotic client in my personal car to the hospital (where once there the police stated “why didn’t you call us”). That was my idea, which my supervisor overruled. I’ve had to transport people in danger of jumping out of moving cars on the expressway. None of this I initially signed up for when wanting to sit in room do psychotherapy.

You are correct that this does not seem like a safe environment or a clinically useful one to you. Your predicament seems similar to that of psychologists in their post-doctoral year before getting licensed in some states. Have you thought about reaching out to your school to see if there are any positions in your area that may be amenable to having you complete your hours? Also, have you considered moving to another state/area that is not so saturated even temporarily. I know I had considered moving for a year to a state where I could be licensed straight out of grad school for the income bump. Then, I would have paid for supervision so that I could move back to other states later as a licensed provider. I've actually made a fairly successful career by taking jobs others are not interested in or are unwilling to do. I'm sorry that this road has been so tough for you.

 

[Seven_Costanza]

I don’t recall too many posts where people recommended getting a masters in counseling, which I agree is very limiting. The majority recommend pursuing either a clinically-oriented MSW, which provides tons of different job opportunities when you’re done (including private practice), or a master’s in general/clinical psych if you’re trying to improve your GPA and/or gain more research experience to become more competitive for doctoral programs.

 

[WisNeuro]

I don’t recall too many posts where people recommended getting a masters in counseling, which I agree is very limiting. The majority recommend pursuing either a clinically-oriented MSW, which provides tons of different job opportunities when you’re done (including private practice), or a master’s in general/clinical psych if you’re trying to improve your GPA and/or gain more research experience to become more competitive for doctoral programs.

This is generally my recommendation, much more versatile job-wise.

 

[Sanman]

This is generally my recommendation, much more versatile job-wise.

Agreed, they also have the ability to bill Medicare, which opens up a lot more clients.

 

[WisNeuro]

Agreed, they also have the ability to bill Medicare, which opens up a lot more clients.

I'm sure there is some regional variation, but LCSWs hold most of the therapy positions in hospital systems here. Also a decent number of split therapy/case management positions.

 

[Sanman]

I'm sure there is some regional variation, but LCSWs hold most of the therapy positions in hospital systems here. Also a decent number of split therapy/case management positions.

I think the medicare thing is a big issue with hospitals and larger health system jobs. PP, schools, and other systems seem more open to counselors. There was a new proposed bill last year to allow counselors and MFTs the right to bill medicare. Not sure how far it is though, but it will balance the playing field a bit more.