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Weighting decision factors

Discussion in 'Nontraditional Students' started by sockit, May 15, 2014.

  1. sockit

    sockit 2+ Year Member

    Feb 13, 2012
    I'm finishing up a 2nd undergrad in psych, and have been trying to decide (for ages!) between allied health fields. I've been weighing out 1) a PhD in clinical or counselling psychology, 2) OT and 3) PT. I'm now doubting each for different reasons, and wondering if some of you might be able to help me make sense of my hopes and concerns, or have thoughts on alternatives I haven't considered.

    To that end, I'll try to quickly describe my motivations and constraints, rather than the end-goal, since I'm basically taking a poll. I set myself on a career change for the warm fuzzies, intellectual engagement, and financial security. Not shooting for big dreams or six digits here, just a reliable income in a field that will survive changing economic weather and keep me engaged. (Of course I do have a [now, it seems, unfortunate] passion, for psychology, but lots about the reality of that path has me worried.)

    "Engaged", to me, means providing at least some direct service to individuals with a reasonably founded hope of good outcomes. I've taught ESL to adults and seen them improve. That kind of satisfaction is what I'm after. I enjoyed and was especially good at the 'diagnostic' aspect of teaching - identifying the point at which individuals struggled, based on observation, and making a tailored plan to address areas needing improvement.

    Working with motivated students (most of them) was fantastic. Some had complicated relationships with the systems they were in; I did what I could to advocate on their behalf when I had the chance, and this was also rewarding. (Why aren't I teaching ESL now? Average pay is $20/hr where I am; it depends on government funding and is axed whenever possible, in my area; the subject matter itself holds my interest only a medium amount; management is the only progression route, and no thanks to that. I've done related admin as well, and it bores me to tears. Process, bureaucracy, politics, go-nowhere meetings - the less of that the better. There's a glut of elementary and secondary school teachers where I am - I do not want to be unemployed.)

    Must-haves: variety, challenge, and at least some autonomy.
    Would like to have: the potential to work in research, in some capacity, would be wonderful. The option to hang a shingle would also be nice.

    Constraints: no children, but yes to family obligations. Some recently developed health conditions that mean the option to work part-time might be relevant in future. Single woman in late 30s with traditional personal goals.

    1) Psych PhD
    Pros: Genuine and lifelong love for the subject - that's worth quite a lot. Particular interests are health psych, neuro and cognitive psychology. Part-time work is possible (not so much in my preferred areas, but in some). Not as physically demanding as other fields. I have a strong intuition I'd be good at it, which is supported by feedback (not my mom's ;) ).

    Cons: the hoops, the years, the hierarchy. Probably having to move to a city I don't love, due to competition. Dropouts. Outcomes aren't as clear as in some other allied health fields. Burnout. All of these are major cons and approach cancelling out the pros. Letting this dream die is hard.

    2) PT
    Pros: Everything. Some diagnostic functions; tangible outcomes; motivated patients; largely positive work atmosphere. People get better, and you can see it happen. Autonomy, including the option to work in private practice; steady work projected. Part-time work possible. Masters-level profession in my area - could work and continue on in research (possibly through an MPH, later. I'm interested enough in fascia to do the clinical work, but enough to do straight up PT research).

    Cons: My own health; occupational risks. It's a physical job that it's unlikely I'll be able to do until age 60+, or probably even 50. (I'm doing rehab myself right now for a few fairly impairing issues. Rehab will get me to a reasonable level of functionality, but new problems are extremely likely to come along, in my case.) This one con is so huge I've had to cross PT off. Which sucked, massively.

    3) OT
    Pros: Similar to PT in many ways, though outcomes aren't as clear (depending on population). Some overlap with psychology. Ability to work after the masters (earn $) as well as continue on, where there's a chance to contribute to research.

    Cons: Populations often deal with more persistent problems. Clinical work exclusively tied to hospitals. I do not think I would enjoy the work as much as I would psych (greater diagnostic responsibility/challenge) or PT (clearer outcomes). I'm kind of meh about it. (Though, it would still be more interesting than the kind of work I can do with my existing background and education, and I'd be financially better off.)

    4) Other
    Social work does not appeal to me, because I'll just say no to the idea of working in a setting in which resources flat out don't meet people's needs. I'd be burned out within two months, if I could drag myself through the training.

    Just the MPH, no direct service profession: it's all research, big-picture thinking, great. Policy side - 100% bureaucracy. Completely deskbound. Completely lacking in the reward department with no face to face contact anywhere. With no profession or PhD, it'd be mostly number crunching. I like spending time with people.

    Is there something I'm omitting in my decision-making (or a profession I've missed, ha)? What factors would you be thinking about in my shoes?
    Last edited: May 15, 2014
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  3. sockit

    sockit 2+ Year Member

    Feb 13, 2012
    PA - too much responsibility for life or death situations.
    Nursing - too hard on the body, or I'd do it. Risk is distributed. I'm good in emergencies.
    SLP: I would be bored with just dealing with swallowing (hospitals) and would be the first on the block in any funding cuts in the educational system. Same for school psychology < - all contracts,in my area, no staff positions.
  4. Angelatron


    Mar 23, 2014
    Charlotte, NC
    I can only give you information about my own experiences and those of several of my friends and colleagues, for whatever that may mean to you. I've worked in mental health for the past ten years, from the bottom of the pile to the professional.

    1) PhD in Psychology - First, doctoral programs in Clinical Psychology are INCREDIBLY competitive, and you're chances of getting into one is usually lower than getting into a med school. Counseling Psychology, Psych ED, and a PsyD are all a little more open, especially a PsyD program which is more likely to work with you in a part-time setting. Most Clinical Programs, and some Counseling and ED programs offer tuition assistance and living stipends, thus one of the reasons they are more competitive. The PsyD programs in general don't usually offer as much or any financial assistance, so you are talking about easily going 60-80,000 in debt over a five year commitment, possibly more now since I haven't researched these programs in a few years. The problem with going into that much debt for a PsyD or even the ED, is that for most practitioners of psychology the salaries won't really make up for the debt or the licensing and other obligations any time soon.

    Just like in your Option 4, you will likely start working for companies that "working in a setting in which resources flat out don't meet people's needs" and there is still a high burn out rate, especially if you are working in a high need area to try to get some loan forgiveness. If you really just love counseling, look into licenses at the Master's level, like LPCC, LPA, and LCSW and see what kinds of positions and salaries are offered in your area. Many states won't license LPA's, which is really a shame. If you're interested in the sciences and counseling, you could also explore a Master's in Genetic Counseling. Again, there's rarely much in the way of financial support for most master's programs except student loans, although sometimes you can get a GA position. side note: You will have to take responsibility for some life or death situations because you will be required to assess risk of suicide, self-harming, and homicidal behaviors in your clients.

    I'm not trying to dissuade you from psyche or counseling, but there is a high burnout rate. You have to be good a paperwork, able to deal with clients that you dislike and still give them fair treatment, able to do lots of case management, and be able to be "present" with the person, one after another, for the entire day. It's emotionally draining work, and it often takes a long time to see the rewards or improvements in your clients. But I have several colleagues that absolute love their jobs, and some that are considering going into retail.

    2/3: I know less about PT and OT, except the pay tends to be higher in both fields than an equivalent MS in one of the counseling fields. I have a friend in OT that was offered a very nice singing bonus at her first job out of her two year program, and she will now make close to 50% more than I do after being licensed for five years. I think I hate her a little bit.
    sockit likes this.
  5. sockit

    sockit 2+ Year Member

    Feb 13, 2012
    Angelatron (love your name and pic - is that Maude?? Excellent :) ) - Yes of course your input is valuable, thank you for sharing it!

    Your first point is well taken. Many here on the psych forum have outlined exactly those concerns, over and over again, and our undergrad program director and advisors echo that warning, taking pains to tell us exactly how rough it is out there. (I know from my own digging that one local PhD program - not even the best one - has a 0.6 acceptance rate.) My performance in this degree has been strong enough for my advisors to cautiously encourage me to take my chances, if I want to. (Most students are dissuaded from trying, and invited to look at other options.) But given the mediocre results of my old degree, I'd likely still have to do an MA before applying to funded PhDs, or else shoot for Counselling programs. There's no way I'd sign up for debt - or accept or even apply to a program that couldn't guarantee a good amount of funding.

    I am interested in counselling, yes. As far as academic interests, though, I'm mainly drawn to cognition and cognitive neuropsych (I've taken all the cog and npsych courses available at the undergrad level). But it's more the research that I like - I am not sure I have what's required to do rehab with people suffering from progressive diseases like PD or AD on a long-term basis (as an OT does). I know from personal experience (friends and family) the heartbreak of dealing with those kinds of illnesses day to day. The puzzle/problem-solving involved in assessment/diagnosis is a different kettle of fish, from what I can understand, and that definitely appeals to me. But it's a moot point; I honestly can't see myself committing to another 7-8 years to get the required training, which is certainly not a part-time endeavour. I'm also put off by the hoop jumping and competitive atmosphere. But maybe it feels different once you're properly in it and have cleared the hoops? Hard to say from the outside.

    As far as bearing the burden of monitoring life/death risks - not that I'm unconcerned with the notion of assessing risk of self-harm or suicide, obviously that's a huge responsibility, but I think if I did wind up going the psych route, I'd be well supported in terms of training to identify and manage those risks to an acceptable standard. (I would be less confident in PA training to equip me to catch those out-of-nowhere things that can kill people. It might well be enough to deal with most of the mundane issues people have, clearly it is since PAs exist, but I'd be bothered by the notion that I might be missing some crucial piece of knowledge that would make a difference for even one person.) Paperwork isn't a problem, so long as it's not the sole function of the job :)

    Emotional drain and burnout are the main things I'm worried about. I appreciate you speaking to this.

    (I really do just wish PT made sense for me.)

    Thanks again for your thoughts :)
    Last edited: May 17, 2014
  6. sockit

    sockit 2+ Year Member

    Feb 13, 2012
    Thank you for the suggestion! I have asked my PT about other options, and she did say women's health and neuro were physically easier options (and yup I am a woman). Both tend to be hospital-based, and neuro would be not unlike OT in terms of populations and outcomes - but I need to look into these possibilities more deeply.
    Last edited: May 18, 2014

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