Unfunded PhD / PsyD - Worth it?

[R. Matey]

Absolutely agree with this. As a (mostly) reformed finance bro, I’ve actually found grad school to be easier on the whole than my prior post -college life because of my comparative control over my time and goals. I don’t begrudge the hoops I had to jump through to get here or the aspects of the degree that are less interesting to me. Mostly trying to spitball, from a place of limited knowledge, how to potentially increase the number of providers of doctoral level clinical competency (if this is actually necessary) without while still maintaining a path to academia for those who want it.

IMO, a path could be to improve master's level training by providing post-degree, pre-license residency programs that specifically train in EPBs and increase exposure to research. It's a considerably cheaper degree than an unfunded doctoral degree with a licensure structure already in place. The issues there is that master's level training over-emphasizes humanistic approaches to treatment in a short amount of time leaving clinicians with exposure to EBPs, but competency in humanistic skills. I know APA has a workgroup exploring accreditation for master's level programs, which ultimately may end up accomplishing the same goal as a post-licensure program. I would just hope that they wouldn't make the same mistakes as CACREP.

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[smalltownpsych]

IMO, a path could be to improve master's level training by providing post-degree, pre-license residency programs that specifically train in EPBs and increase exposure to research. It's a considerably cheaper degree than an unfunded doctoral degree with a licensure structure already in place. The issues there is that master's level training over-emphasizes humanistic approaches to treatment in a short amount of time leaving clinicians with exposure to EBPs, but competency in humanistic skills. I know APA has a workgroup exploring accreditation for master's level programs, which ultimately may end up accomplishing the same goal as a post-licensure program. I would just hope that they wouldn't make the same mistakes as CACREP.

If this workgroup ends up with individuals with masters degrees being able to refer to themselves as psychologists that wouldn’t be good for the field. That would be my fear.

 

[WisNeuro]

If this workgroup ends up with individuals with masters degrees being able to refer to themselves as psychologists that wouldn’t be good for the field. That would be my fear.

This would be one of my hard stops for supporting APA. I'd be done with any advocacy efforts or monetary support of they actively pursued that option.

 

[AcronymAllergy]

If this workgroup ends up with individuals with masters degrees being able to refer to themselves as psychologists that wouldn’t be good for the field. That would be my fear.

You certainly aren't alone in that fear, and I've seen that mentioned in direct pushback in response to APA's efforts. I don't think that's APA's plan at the moment, but I agree, it would be horrible for the field if it comes to pass. I believe the original idea, IIRC and from what little I've pieced together, was that APA felt that because master's-level providers are here to stay, they (APA) should ideally have more control over setting a training standard via accreditation/offering a different accreditation option. Or something like that.

 

[R. Matey]

If this workgroup ends up with individuals with masters degrees being able to refer to themselves as psychologists that wouldn’t be good for the field. That would be my fear.

I've been out of the loop for a few years now, but I recall exactly zero people were advocating for that. More likely that they will support MPCAC, which already accredits a handful of master's level counseling programs (they are called counselors). Psychologists teach in MPCAC accredited programs.

 

[Sanman]

You certainly aren't alone in that fear, and I've seen that mentioned in direct pushback in response to APA's efforts. I don't think that's APA's plan at the moment, but I agree, it would be horrible for the field if it comes to pass. I believe the original idea, IIRC and from what little I've pieced together, was that APA felt that because master's-level providers are here to stay, they (APA) should ideally have more control over setting a training standard via accreditation/offering a different accreditation option. Or something like that.

I've been out of the loop for a few years now, but I recall exactly zero people were advocating for that. More likely that they will support MPCAC, which already accredits a handful of master's level counseling programs (they are called counselors). Psychologists teach in MPCAC accredited programs.

It is a good idea, but several decades behind the ball.

 

[R. Matey]

It is a good idea, but several decades behind the ball.

I won't defend APA since they got us into this position in the first place, but it's certainly better than the status quo, IMHO. You might also be overestimating CACREP's influence, which is quite a small organization with a comparably sized operating budget. My suspicion is that if APA threw their weight at, say, an M.A. in counseling psychology with the professional title of counselor (as it was prior to 2009), few state boards would have issues.

 

[Sanman]

I won't defend APA since they got us into this position in the first place, but it's certainly better than the status quo, IMHO. You might also be overestimating CACREP's influence, which is quite a small organization with a comparably sized operating budget. My suspicion is that if APA threw their weight at, say, an M.A. in counseling psychology with the professional title of counselor (as it was prior to 2009), few state boards would have issues.

Could care less about CRACREP. Social work is the bigger problem. Same issue physicians had with NPs when they were late out the gate with PA degrees. Now, many states with independent practice for NPs.

 

[R. Matey]

Social work is the bigger problem. Same issue physicians had with NPs when they were late out the gate with PA degrees. Now, many states with independent practice for NPs.

Between social work and unfunded Ph.Ds/Psy.Ds, social work is the better choice. You're right in the sense that they are not going away.

 

[BuckeyeLove]

It's still weird to me that you can go to school for like 2 years post undergrad and then get a license of sorts where you can call yourself a "therapist." It's not quite in the same ballpark as the trend of "coaches" we've seen boom in recent years (who appear to run the gamut for like...everything), but it's close. Saw a website of an LPCC the other day who literally treats EVERYTHING. The list of claimed expertise in treating was never ending. Then I think about myself who went to school forever with so much supervision and I'm like...kind of good at providing CBT for a few things, decent at group, decent at forensic psycho legal evaluation, and that's about it. Makes me think maybe I should have gone the LPCC route hahah.

 

[WisNeuro]

It's still weird to me that you can go to school for like 2 years post undergrad and then get a license of sorts where you can call yourself a "therapist." It's not quite in the same ballpark as the trend of "coaches" we've seen boom in recent years (who appear to run the gamut for like...everything), but it's close. Saw a website of an LPCC the other day who literally treats EVERYTHING. The list of claimed expertise in treating was never ending. Then I think about myself who went to school forever with so much supervision and I'm like...kind of good at providing CBT for a few things, decent at group, decent at forensic psycho legal evaluation, and that's about it. Makes me think maybe I should have gone the LPCC route hahah.

It's been this way for a while, even in the doctoral careers. Look at psychiatry. Sure, there are a small percentage who get adequate training, but i've talked to far more who had like a handful of supervised cases and were like "yeah, I'm good." We're all probably slightly biased as we get a LOT of training, both didactically and supervised in therapy. Heck, even most neuropsych people who do the bare minimum have more training in therapy than most other therapy professions. And, as it's an ambiguous field, there is no real regulation out there restricting this.

 

[R. Matey]

Heck, even most neuropsych people who do the bare minimum have more training in therapy than most other therapy professions. And, as it's an ambiguous field, there is no real regulation out there restricting this.

Probably higher quality hour-for-hour, but I doubt it's more. My impression is that you can do one therapy prac mainly just to check a box. Maybe not at the better residency programs though. I think that's one of the big issues in master's level training: They do a lot of poor quality hours and people just assume they're competent as a result. They could be, but often are not.

 

[counselor2b]

It's still weird to me that you can go to school for like 2 years post undergrad and then get a license of sorts where you can call yourself a "therapist." It's not quite in the same ballpark as the trend of "coaches" we've seen boom in recent years (who appear to run the gamut for like...everything), but it's close. Saw a website of an LPCC the other day who literally treats EVERYTHING. The list of claimed expertise in treating was never ending. Then I think about myself who went to school forever with so much supervision and I'm like...kind of good at providing CBT for a few things, decent at group, decent at forensic psycho legal evaluation, and that's about it. Makes me think maybe I should have gone the LPCC route hahah.

I agree with this. I think there is way too much variability between programs as far as training and focus. My practicum experience was 150 hours and my internship was roughly 700 hours. However, I was fortunate in that I received the bulk of my supervision both in school and postgrad from two different psychologists, that helped me conceptualize versus check boxes. I was also employed at an inpatient psychiatric facility for 3 years before I went back to grad school which provided me exposure to severe and persistent mental health conditions, psychopharmacology, and the roles of each mental health provider. Most of my cohort were fresh out of undergrad, many of which did not even have an undergrad degree in psychology or real exposure to the field. It really helped me understand my limitations, and what to refer on. I cannot imagine working in my capacity without that background.

 

[chicandtoughness]

APA felt that because master's-level providers are here to stay, they (APA) should ideally have more control over setting a training standard via accreditation/offering a different accreditation option. Or something like that.

About time. They really should have been supervising masters programs from the get-go instead of letting CACREP run rampant and dilute the quality of training. I would have no issue with "psychological associates" being made a proper thing in all states with a requirement of completing an APA-accredited masters program.

 

[WPMO]

About time. They really should have been supervising masters programs from the get-go instead of letting CACREP run rampant and dilute the quality of training. I would have no issue with "psychological associates" being made a proper thing in all states with a requirement of completing an APA-accredited masters program.

Absolutely. There are ongoing efforts in many states to allow LPCs to do every assessment that Psychologists can (making an identical scope of practice). Few LPCs want to do this, but some boards do, and I know in states like Virginia their only requirement is "appropriate training and education", which is not further defined. I believe in California there was a bill to define appropriate training in order to avoid this sort of issue.

CACREP has nearly 1000 programs now, and a ton of influence. They managed to kill off a lot of Psychology master's programs, so the APA's delay now puts us in a worse position. In Virginia the Board of Counseling just decided one day that any psychology program no longer qualifies for licensure. This led three programs to shut down, and others to become Counseling programs instead of Counseling Psychology programs. Fortunately, at least attempts to mandate CACREP were defeated (for now). I do think the MPCAC is doing great work, since they reversed a CACREP mandate in Florida, and they are now trying to reverse the one in North Carolina. Hopefully the fact that there are numerous high quality MPCAC programs will carry the day over CACREP's lobbying. We need to keep Psych master's programs alive, as well as other programs that at least let Psychologists teach in them.

This is the bill in North Carolina that is seeking to add MPCAC and other equivalent programs to qualify for licensure there Senate Bill 337 (2023-2024 Session) - North Carolina General Assembly (Click on "filed" on the left hand side to read it - it's less than a page). I would encourage people to reach out to state representatives in NC to support this bill.

 

[WisNeuro]

Absolutely. There are ongoing efforts in many states to allow LPCs to do every assessment that Psychologists can (making an identical scope of practice). Few LPCs want to do this, but some boards do, and I know in states like Virginia their only requirement is "appropriate training and education", which is not further defined. I believe in California there was a bill to define appropriate training in order to avoid this sort of issue.

CACREP has nearly 1000 programs now, and a ton of influence. They managed to kill off a lot of Psychology master's programs, so the APA's delay now puts us in a worse position. In Virginia the Board of Counseling just decided one day that any psychology program no longer qualifies for licensure. This led three programs to shut down, and others to become Counseling programs instead of Counseling Psychology programs. Fortunately, at least attempts to mandate CACREP were defeated (for now). I do think the MPCAC is doing great work, since they reversed a CACREP mandate in Florida, and they are now trying to reverse the one in North Carolina. Hopefully the fact that there are numerous high quality MPCAC programs will carry the day over CACREP's lobbying. We need to keep Psych master's programs alive, as well as other programs that at least let Psychologists teach in them.

This is the bill in North Carolina that is seeking to add MPCAC and other equivalent programs to qualify for licensure there Senate Bill 337 (2023-2024 Session) - North Carolina General Assembly (Click on "filed" on the left hand side to read it - it's less than a page). I would encourage people to reach out to state representatives in NC to support this bill.

Which states? Aside from TX, I haven't seen anything close to this for the most part.

 

[WPMO]

Which states? Aside from TX, I haven't seen anything close to this for the most part.

Virginia, for one, asserts that this has been the case since the 90s. I know Pearson will give you access to their Level C assessments automatically if you have a *doctorate* in Counselor Education and Supervision. Also, if you really want to tear your hair out, read this article, which is essentially lobbying material for a group affiliated with the AMHCA that is advocating for counselors with "appropriate training" to be able to do any type of assessment, especially forensic assessment: https://www.nbfe.net/resources/Documents/Can Counselors Test.pdf

Here's a gem: "Counselors should meet criteria for Level C qualification with Pearson regardless of whether they possess a master’s or doctorate degree".

That document contains some of the most wildly inaccurate statements I have ever seen, and I say that as a graduate of a CACREP master's program before I began my psychology doctorate. Our Assessments class was a great foundational overview of the ideas behind assessments, but did not include anything about administering or interpreting assessments like IQ tests, MMPI, etc. I don't want to make it seem like this is the position most LPCs take, or that they even know/are aware of this issue, but this is the result of the APA being so complacent for so long.