What are we doing to the field of Professional Psychology?

[psychology24]

I am wondering if someone can help explain to me why we (SDN forum) are constantly encouraging people to go into Master level programs? It seems almost like a double-edged sword. If more and more people are going into Master level programs and becoming a practicing therapist, then it makes more and more sense for psychologists (who are practicing) to take a pay cut. Why pay a psychologist $150/hr when you can pay a Master's level therapist $60/hr to "do the exact same thing" (as many have said on this forum).

I remember for instance reading outrage on this fourm about a job description (this esp. goes for Counseling Center positions) where it lists eligible applicants include 'Counseling or Clinical PhD, PsyD, or MSW' and the salary is roughly $45k.

If we continute to argue that a Master's level therapist is the same as a Professional practicing psychologist, we are digging a deeper hole in de-valuing professional doctoral education.

I understand the other sides most notably related to: These students who do not get into a funded PhD/PsyD program (1) saturate the market going into a an unfunded, "one of those" PsyD programs, and consequently the (2) APPIC Match imbalance.

I also understand that a doctoral psychology program is not ONLY psychotherapy and there is an (3) importance on critical analysis and research (even for PsyDs). However, where are most professional psychologists these days employed? (Last I heard the VA was #1 employer for psychologists- so if the govt wants to cut back, why not cut back psychologists and hire master-level therapists if we continue this type of discourse).

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[psychology24]

Just came across this article which helps summarize this issue:

The silent conversation: Talking about the master's degree.
Hays-Thomas, Rosemary Lowe
Professional Psychology: Research and Practice, Vol 31(3), Jun 2000, 339-345. doi: 10.1037/0735-7028.31.3.339
http://psycnet.apa.org/journals/pro/31/3/339/

 

[Therapist4Chnge]

Why pay a psychologist $150/hr when you can pay a Master's level therapist $60/hr to "do the exact same thing" (as many have said on this forum).

I think the vast majority of people who direct potential students towards master's-level programs aren't saying they "do the exact same thing", they are saying that those people want to do therapy...and they are not interested in the rest of what doctoral training requires/offers. Unfortunately most MA/MS programs (particularly online) are cash cows for universities, and they help prop up less lucrative but more prestigious programs. I have been banging the "watch out for mid-level" drum for years, but most psychologists are too caught up in circling the wagons....and aiming in.

 

[psychstudent5]

I think the reason people steer some folk towards the masters is because those people are primarily interested in therapy. Also, it would be waste of that person's time, money, and energy to get a doctorate just to do therapy. It's not practical. If you're worried about master's level usurping jobs and reducing the salary of people with a doctorate, well, too late - we've been there for some time. however, that is not the only reason as to why a doctorate in psychology is paid poorly.

 

[Chase3557]

During one of my Psy.D. interviews (I won't say where), my interviewer drilled me over my decision to seek out a Psy.D. instead of a M.A. in counseling. I told him that I wanted to do psychotherapy; he said I didn't need a doctorate. I said I was interested in private practice; he replied, "You could do this with a M.A. (in some states)." Then I said teaching had always interested me too, so he asked why I wasn't doing a Ph.D. Rough interview huh? I know he was probably testing me -- seeing how I respond under pressure. But what should I have answered instead? Talked about assessment?

 

[O Gurl]

You raise many valid points, however there is very little that we can (or should) do to combat/reduce the number of master's level therapists entering the field. The truth is that there are plenty of people who are interested in providing clinical services and have no interest in or lack the skill set for all the other aspects involved in doctoral training (research, assessment, program development, teaching). I for one, would much prefer that we have a growing number of competent and skilled mid-level therapists than continue to see a lowered standard of what "psychologist" means. Sadly, that is what is occurring due to the large number of uninformed or down-right stubborn psychology undergraduates who "just want to help people " but do not have the stats to get into real programs. Instead of re-evaluating their goals and options to get there, they are falling prey to FSPSs and pushing through into the field.

I think the challenge for our profession is to capitalize (and protect) our other skill areas. For ex. doing something to ward off the inappropriate use of neuropsych batteries by speech and language therapists. To do that, we have to become more rigorous about who is entering our ranks. We need to be sure that all who seek doctoral training in psychology are skilled in various areas and securing positions that capitalize on many of these domains.

In my microcosm of VA life, I have seen increasing numbers of dual listed job posts. The most recent for our hospital was a telemental health job that consisted entirely of offering ESTs for PTSD to veterans in community outpatient clinics. IMO, that job is perfectly suited for a mid-level professional (it was listed for psychologist or social worker). While there are a larger raw number of social workers in our hospital they do not do "the exact same thing" as psychologists by any stretch of the imagination. For example, all of our mental health program directors are psychologists (natural fit given our strengths for program development; training dissemination; broader understanding of what other disciplines do etc); the vast majority of PIs for active research are psychologists; and of course, testing is referred directly to psychologists. In my job search, I am careful to only apply to jobs that draw on these strengths in addition to therapy. Realistically, that is the only way to save and protect our field.

 

[O Gurl]

During one of my Psy.D. interviews (I won't say where), my interviewer drilled me over my decision to seek out a Psy.D. instead of a M.A. in counseling. I told him that I wanted to do psychotherapy; he said I didn't need a doctorate. I said I was interested in private practice; he replied, "You could do this with a M.A. (in some states)." Then I said teaching had always interested me too, so he asked why I wasn't doing a Ph.D. Rough interview huh? I know he was probably testing me -- seeing how I respond under pressure. But what should I have answered instead? Talked about assessment?

As rough as his approach might have been, he was kinda right. Master's level clinicians will have the edge in therapy-heavy settings, particularly private practice. PhD's will have the edge in academia. If you are not interested in specialized training that involves an assessment component (neuropsych or forensics) then there really is no need for the PsyD.

 

[AcronymAllergy]

You raise many valid points, however there is very little that we can (or should) do to combat/reduce the number of master's level therapists entering the field. The truth is that there are plenty of people who are interested in providing clinical services and have no interest in or lack the skill set for all the other aspects involved in doctoral training (research, assessment, program development, teaching). I for one, would much prefer that we have a growing number of competent and skilled mid-level therapists than continue to see a lowered standard of what "psychologist" means. Sadly, that is what is occurring due to the large number of uninformed or down-right stubborn psychology undergraduates who "just want to help people " but do not have the stats to get into real programs. Instead of re-evaluating their goals and options to get there, they are falling prey to FSPSs and pushing through into the field.

I think the challenge for our profession is to capitalize (and protect) our other skill areas. For ex. doing something to ward off the inappropriate use of neuropsych batteries by speech and language therapists. To do that, we have to become more rigorous about who is entering our ranks. We need to be sure that all who seek doctoral training in psychology are skilled in various areas and securing positions that capitalize on many of these domains.

In my microcosm of VA life, I have seen increasing numbers of dual listed job posts. The most recent for our hospital was a telemental health job that consisted entirely of offering ESTs for PTSD to veterans in community outpatient clinics. IMO, that job is perfectly suited for a mid-level professional (it was listed for psychologist or social worker). While there are a larger raw number of social workers in our hospital they do not do "the exact same thing" as psychologists by any stretch of the imagination. For example, all of our mental health program directors are psychologists (natural fit given our strengths for program development; training dissemination; broader understanding of what other disciplines do etc); the vast majority of PIs for active research are psychologists; and of course, testing is referred directly to psychologists. In my job search, I am careful to only apply to jobs that draw on these strengths in addition to therapy. Realistically, that is the only way to save and protect our field.

Agreed on essentially all points. Mid-levels providing therapy are here to stay; rather than attempting to "take back" what we did a horrible job of protecting in the first place, we should be ensuring that the services these individuals provide are adequate via the many unique skills we, as doctoral-level practitioners, possess (e.g., program development and monitoring, supervision, consultation in both the educational/training and professional settings). We can also aid in clinical care on the front end via our advanced training in assessment, which can inform case conceptualizations that are then used to inform the treatment recommendations we make to mid-levels.

I'm definitely not saying psychologists should no longer provide therapy services themselves. But I really do believe that if psychologists focus ONLY on assessment, they're short-changing themselves.

 

[Therapist4Chnge]

As rough as his approach might have been, he was kinda right. Master's level clinicians will have the edge in therapy-heavy settings, particularly private practice. PhD's will have the edge in academia. If you are not interested in specialized training that involves an assessment component (neuropsych or forensics) then there really is no need for the PsyD.

To most competently practice, a doctorate should be sought. Understanding the research that informs clinical practice is vital. However, a much lower bar was set so putting in enough effort (e.g. taking the licensing exam enough times to finslly pass) and jumping through administrative hoops can get you independent practice. There are many great mid-level providers, but most/all sought significant additional training and mentorship.

 

[Ollie123]

I'm perfectly comfortable allowing "therapist" to become a mid-level profession (as others have pointed out, it largely already is). No doubt, we get extensive training in it and this isn't meant to discount the value of that. However...any psychologist worth his/her salt should be FAR more than a "therapist" (or even therapist/assessor). To me, it seems at best unproductive to fight a losing battle against mid-levels doing therapy, particularly given we're struggling to show substantial differentiation in outcomes - though admittedly, the research on this is extremely tough to do. At worst, it borders on unethical since we're fighting against increased access and less expensive alternatives for our patients because its bad for "us". I think the problem is that we're not continuing to evolve in new directions (and I'm not referring to RxP since I think that movement has been equally or more backwards) ourselves. We have a lot to offer..rather than trying to halt professional evolution, let's be the ones pushing it forward.

In sum, the problem isn't mid-levels learning therapy. The problem is the growing number of psychologists (and psychology training programs) who seem to have forgotten that we're supposed to be learning more than just therapy.

 

[psychology24]

I'm perfectly comfortable allowing "therapist" to become a mid-level profession (as others have pointed out, it largely already is). No doubt, we get extensive training in it and this isn't meant to discount the value of that. However...any psychologist worth his/her salt should be FAR more than a "therapist" (or even therapist/assessor). To me, it seems at best unproductive to fight a losing battle against mid-levels doing therapy, particularly given we're struggling to show substantial differentiation in outcomes - though admittedly, the research on this is extremely tough to do. At worst, it borders on unethical since we're fighting against increased access and less expensive alternatives for our patients because its bad for "us". I think the problem is that we're not continuing to evolve in new directions (and I'm not referring to RxP since I think that movement has been equally or more backwards) ourselves. We have a lot to offer..rather than trying to halt professional evolution, let's be the ones pushing it forward.

In sum, the problem isn't mid-levels learning therapy. The problem is the growing number of psychologists (and psychology training programs) who seem to have forgotten that we're supposed to be learning more than just therapy.

These all have been really good points. I think at the core of my initial post was just hearing (or at least my interpretation) that a psychologist practicing therapy= a master's level clinician practicing therapy. I think all the components suggested are extremely important for psychologists and that is what make unique practitioners in the field. In addition to research components, I just feel that a doctoral level education provides so much more depth in psychotherapy components as well where MA-level educations are taught micro counseling and interviewing skills. Is this wrong thinking that?

 

[Ollie123]

I certainly feel that my therapy training has been more in-depth than master's level programs (and I'm at a program that emphasizes research training over clinical training). However, I also recognize that from a practical standpoint, I can't claim that this "In depth knowledge" justifies paying me more unless I can show it translates to better patient outcomes or some other tangible benefit to a potential employer. In an ideal world, knowledge alone would be valued but I recognize that's a completely unrealistic pipe dream.

Wanting to be the best therapist possible is admirable, but if someone is ONLY interested in being a therapist (how often do we get the "I want a PsyD because I don't care about research" posters here?), I would definitely push them towards masters programs. Even if not equivalent, they can probably come at least reasonably close with appropriate training and experiences. From a professional standpoint, I'd argue far less harm is done by these folks going on to be excellent mid-levels rather than piss-poor psychologists. If we could show practical differences, my opinion might change, but so far we haven't been able to accomplish that. Given that, I actually feel its better for the profession if we aren't welcoming in people who are really only interested or willing to learn one aspect of being a psychologist just so they can call themselves doctor and/or have a (potentially unnecessary) in-depth understanding of one area for the sorts of jobs they will likely be entering.

 

[cara susanna]

I think we'd all like psychologist to be the gold standard for therapy, but it just isn't realistic anymore. Like people have been saying, I'd rather someone go for a Masters than enter a PhD or PsyD program when they don't like research or see it as useful in practice.

 

[Duck Duck Goose]

Wanting to be the best therapist possible is admirable, but if someone is ONLY interested in being a therapist (how often do we get the "I want a PsyD because I don't care about research" posters here?), I would definitely push them towards masters programs.

Having seen how those posters' threads usually go and being someone who really just wanted to be a therapist, not a doctor or a research doer or professor, I'd recommend the gentle approach of explaining that therapist does not mean psychologist and pointing out that there are more efficient and cost-effective routes to become a therapist than to go to grad school for psychology, "such as pursuing an MSW or MFT or another Masters level degree." That's on my personal, "I wish someone had told me..." list.

 

[PavlovWolf]

I think we'd all like psychologist to be the gold standard for therapy, but it just isn't realistic anymore. Like people have been saying, I'd rather someone go for a Masters than enter a PhD or PsyD program when they don't like research or see it as useful in practice.

Agreed, but - as educated psychologists who use research to inform practice, I feel like the same should be expected of master's level clinicians (at least to some extent). Unfortunately, I know that is not always the case. I really hate the "I don't like research" stuff This is truly a "downer" topic...back to my job search...

 

[O Gurl]

To most competently practice, a doctorate should be sought. Understanding the research that informs clinical practice is vital. However, a much lower bar was set so putting in enough effort (e.g. taking the licensing exam enough times to finslly pass) and jumping through administrative hoops can get you independent practice. There are many great mid-level providers, but most/all sought significant additional training and mentorship.

I agree. Ideally therapists would be skilled scientists or at least understand how to integrate scientific findings into practice. The reality, however, is that a doctoral level therapist will have a hard time using this argument to compete against master's level providers simply due to economics. Like the OP mentioned, why pay 3x more for what others perceive to be the same service? Like AA pointed out, it is impossible to try to take back what we did not protect to begin with. So moving forward, what can we do? I think we do ourselves a much larger disservice by allowing the title of "psychologist" to become increasingly muddled by those entering the field (often, but not always through psyd professional programs) who are only interested in therapy only to find themselves competing for jobs with master's level folks. It is time to streamline, implement quality control, and protect what still distinguishes us.

 

[AnnoyedByFreud]

One thought that may be of concern is that when the midlevels aren't under your control, they might not want to stay at that mid-level for long. It makes me think about physicians and how they let nurses get away but have PAs under their thumbs (PAs are controlled by the board of medicine, can never practice independently, etc.). Because nurses don't answer to the BOM they've been able to use lobbying and politics to dramatically expand their scope of practice and to basically start practicing medicine. (full disclosure: I'm starting a psych NP program this summer).

I think midlevel therapists are here to stay, but it's a shame for the psychologists that they don't have some formal control, like MDs do with PAs. I think we'll see more and more LCSWs, masters level therapists, etc. lobbying their state for more power … after all, who is there to stop them?

 

[3rdWave]

I think we'll see more and more LCSWs, masters level therapists, etc. lobbying their state for more power … after all, who is there to stop them?

FYI- West Virginia is the only state that allows master's level psychologists to practice independently, and call themselves psychologists (after X years of supervision). However, there is a new president of the state psychological assoc. and she is insisting that this is going to change ASAP and you will need to have a doctoral degree to practice indpendently and call yourself a psychologist in WV.

 

[Therapist4Chnge]

FYI- West Virginia is the only state that allows master's level psychologists to practice independently, and call themselves psychologists (after X years of supervision). However, there is a new president of the state psychological assoc. and she is insisting that this is going to change ASAP and you will need to have a doctoral degree to practice indpendently and call yourself a psychologist in WV.

It's sad that I'd be excited if we got all of the states to do this (and include prosecution for misrepresentation). I wish they did the same thing for neuropsych, but that is even less likely.

 

[PsychPhDone]

I care more about the dissemination of ESTs and people getting treated for mental health concerns than preserving some special status for myself. I plan on doing research and influencing how therapy is delivered.

 

[PavlovWolf]

I care more about the dissemination of ESTs and people getting treated for mental health concerns than preserving some special status for myself. I plan on doing research and influencing how therapy is delivered.

I think the point many here are trying to make is not necessarily about a special status, but about the quality of treatment and the knowledge, experience, and training discrepancies there are between the master's level and the doctorate level. We have invested a lot in the field, and all the work, training, supervision, and time it takes to be a doctoral level psychologist is seemingly invalidated when we're lumped in with those in other fields for job openings. Not to mention, many master's level clinicians aren't qualified to do a lot that psychologists are (i.e. assessment) and some agencies are unethically allowing this sort of thing to happen.

 

[psychology24]

I think the point many here are trying to make is not necessarily about a special status, but about the quality of treatment and the knowledge, experience, and training discrepancies there are between the master's level and the doctorate level. We have invested a lot in the field, and all the work, training, supervision, and time it takes to be a doctoral level psychologist is seemingly invalidated when we're lumped in with those in other fields for job openings. Not to mention, many master's level clinicians aren't qualified to do a lot that psychologists are (i.e. assessment) and some agencies are unethically allowing this sort of thing to happen.

Yes. That is exactly what I was trying to say starting this thread. Thank you for summarizing in more of a concise way!

 

[PsychPhDone]

Anyone have any citations for studies showing that PhD level therapists have better outcomes than masters levels? And moderators of this effect?

 

[PsychPhDone]

Yes. That is exactly what I was trying to say starting this thread. Thank you for summarizing in more of a concise way!

I think I made the comment I did is that is why, if someone "only" wants to be a therapist, I suggest a masters or perhaps PsyD. I do think that these programs should step up their research consumer perspectives, but I don't think the research supports therapists needing to have PhDs to perform well.

 

[Wrightus Reign]

Dear PsychPhDStudent,

There is no research to show that doctoral level anything provides better psychotherapy than masters level psychologists, meaning, that research shows that they do not. Lambert edits the 5th edition of the seminal "Bergin & Garfield's Handbook of Psychotherapy and Behavior Change." There, they summarize the studies and meta-analyses of therapist variables in psychotherapy. That is a good place to start if you want to know more. It is pretty astounding what you may find.

 

[MBellows]

We should be looking toward different metrics in evaluating this. I'd suggest directly assessing practitioners, not outcomes, specifically. What do you know, what do you do, and how do you do it?

Jon, you're being silly today, that would make too much sense.

One of the bigger problems in mental health is the proliferation of nonscientific therapy techniques. Do a search for msw and see what comes up. Last time I did this, I found idiots practicing shakra therapy and primal scream therapy. Might as well go to a priest.

This is one of those things that makes me ashamed to call myself a counselor at times. I got online and looked at some of my area colleagues and found that most of them practice EMDR, a far larger chunk than I would expect practice "energy manipulation" (after all shouldn't only 2% of the general population have an IQ under 70?). I only really wanted to comment for two reasons. One, to tell you that there are some of us non Ph.D. folk out there who agree with you, but then again I'm just serving my time before I start applying to them.

The second reason was this. http://www.schoolofmysticalawakening.com/about/index.html

 

[Lisa44201]

Jon, you're being silly today, that would make too much sense.


The second reason was this. http://www.schoolofmysticalawakening.com/about/index.html

Oh, my.

 

[Pragma]

Oh, my.

Only $2000 down for divine intervention training. Sounds like a bargain!

 

[Sanman]

The second reason was this. http://www.schoolofmysticalawakening.com/about/index.html

She offers reiki has a history in japanese culture, the divine intervention/spontaneous healing (according to her) is from mayan culture, and, yet, she has an Indian Om symbol and a picture of the Hindu goddess of wealth (cause she is hoping this makes her $$$$?). If you are going to rob ideas from old and revered cultures, can you at least keep them straight?

I do like that she calls it an investment instead of a fee. I need to adopt that idea.

 

[xerxesc]

http://www.schoolofmysticalawakening.com/about/index.html

Wow, the cognitive dissonance is great in this one: an MD with all this nonsense....

 

[MBellows]

Wow, the cognitive dissonance is great in this one: an MD with all this nonsense....

What really blows my mind, this isn't California, it's Texas. Not even Austin.

 

[LivingOffLoans]

During one of my Psy.D. interviews (I won't say where), my interviewer drilled me over my decision to seek out a Psy.D. instead of a M.A. in counseling. I told him that I wanted to do psychotherapy; he said I didn't need a doctorate. I said I was interested in private practice; he replied, "You could do this with a M.A. (in some states)." Then I said teaching had always interested me too, so he asked why I wasn't doing a Ph.D. Rough interview huh? I know he was probably testing me -- seeing how I respond under pressure. But what should I have answered instead? Talked about assessment?

An academic acquaintance of mine once experienced this same exact interview dialogue (but I've looked at your others posts, so I know you're not them).

A majority of the Psy.D.'s I know go into private practice, no doubt. I've seen some go into assessment, and a few less than that will get involved in adjunct lecturing positions. I don't know if Psy.D. programs are trying to lessen their effect on market saturation, and maybe that's why they want to admit candidates with stronger (or at least feigned) interests in assessment.

One thing that really gets me about your interviewer's response though - yes, you can do psychotherapy (including private practice) without a doctorate. But, the employment options available to M.A. graduates along the continuum between community mental health outreach and private practice are very few (at least in my area). Many of the most desirable clinical positions through an employer are asking for doctorates, and so most of the M.A.'s are working in community mental health. So, while some on this forum might disagree with me here, I think a Psy.D. is desirable for those who want to practice [*ducks and hides from flying debris*]. Even if you look at Ph.D. program websites, there is almost always a page that says something like "if your career goal is more geared toward clinical practice, and not research or academia, consider a Psy.D. program".

Sorry to hear about your interview experience. Perhaps next time you'll have better luck now.

 

[Doctor Eliza]

I absolutely disagree on your point about the job market for master's vs PhD. I have had more than 1 PhD friend get a job by convincing the agency to hire them for a MA position (with the MA salary). Perhaps you live in a unique area, but around here there are jobs for MA's (although also not plentiful or great) but very few for PhD's. PhD jobs tend to be very specialized (e,g. Autism). Which, guess is fine if that happens to be your specialty. Of course in PP you don't need the doctorate either.

Dr. E

 

[Sanman]

I absolutely disagree on your point about the job market for master's vs PhD. I have had more than 1 PhD friend get a job by convincing the agency to hire them for a MA position (with the MA salary). Perhaps you live in a unique area, but around here there are jobs for MA's (although also not plentiful or great) but very few for PhD's. PhD jobs tend to be very specialized (e,g. Autism). Which, guess is fine if that happens to be your specialty. Of course in PP you don't need the doctorate either.

Dr. E

The ironic thing is that the ubiquity of doctoral level clinicians wanting jobs makes it more difficult for the masters level person as doctoral people are willing to take their jobs. I know plenty of places that prefer doctoral level people and clients who do as well. So, while you may not get the position you want, you will get a position with the doctorate.

 

[neuroal]

Just completed several job and schooling options myself with state boards, universities and professionals in my state. Some of the items that became apparent:

1. Most jobs in our state in psychology are Master's level (be it right or wrong) unless you are looking into PP which still hires master's level.
2. LPCs and School Psych's can complete and interpret most if not all assessments a PhD can. In fact, this is protected under individual state licensing boards and the ordinances. They cannot do neuropsych testing unless they can prove "competence" via special training (not board certification) (again, very scary but right or wrong that's how it is)
3. Most private inpatient facilities have not one single PhD on staff and only hire LICDCs, LISWs, LPCs and LSWs. They do not complete a lot of assessments or seem to have the desire to do so. If they need an assessment, they have a master's level clinician "trained" in them do so.
4. PhD jobs are very few and far between

As I'm new to the field, I'm unsure what happened with the profession of psychology in our state. When I look at the other state boards it seems as if they are very cohesive as far as what goals to pursue, how to prioritize them, and how to protect their fields. The nursing board has done an amazing job, for example, in protecting their "turf" and still expanding into others (CNP etc).

It seems that our field does not have a clear definition of what we do anymore. It also seems as if there are other fields that have "taken over" our function(s) and they allow students to license after 2 years of (much cheaper) schooling, function in the same capacity, and do so for a cheaper price. I have no idea if the services are comparable to PhD's services as I've seen no outcome studies on which to base that conclusion. So if it's not for therapy or assessment that a student would pursue the PhD, that leaves research it seems. But if that's the case, where would that leave the future of PP?

It seems that the APA needs to lead the state chapters to ensure that the profession is preserved for whatever purposes make sense. That means the state boards need to be hearing from those with PhDs and the message should be unified across the country (speaking for USA of course - not sure how these things work in other countries). Otherwise, we've allowed scope creep in a major way by other professionals and it can't be corrected it seems.

 

[bmedclinic]

Jon, you're being silly today, that would make too much sense.
The second reason was this. http://www.schoolofmysticalawakening.com/about/index.html

Ya know, I went to the national sleep conference a few years ago (i've been multiple times) and a person who was kinda like this was talking to me and trying to recruit me to join her practice after I was out of school.

Who knew that had I gone that route, I could be a level 2 priest in a cult by now....

 

[bmedclinic]

Just completed several job and schooling options myself with state boards, universities and professionals in my state. Some of the items that became apparent:

1. Most jobs in our state in psychology are Master's level (be it right or wrong) unless you are looking into PP which still hires master's level.
2. LPCs and School Psych's can complete and interpret most if not all assessments a PhD can. In fact, this is protected under individual state licensing boards and the ordinances. They cannot do neuropsych testing unless they can prove "competence" via special training (not board certification) (again, very scary but right or wrong that's how it is)
3. Most private inpatient facilities have not one single PhD on staff and only hire LICDCs, LISWs, LPCs and LSWs. They do not complete a lot of assessments or seem to have the desire to do so. If they need an assessment, they have a master's level clinician "trained" in them do so.
4. PhD jobs are very few and far between

As I'm new to the field, I'm unsure what happened with the profession of psychology in our state. When I look at the other state boards it seems as if they are very cohesive as far as what goals to pursue, how to prioritize them, and how to protect their fields. The nursing board has done an amazing job, for example, in protecting their "turf" and still expanding into others (CNP etc).

It seems that our field does not have a clear definition of what we do anymore. It also seems as if there are other fields that have "taken over" our function(s) and they allow students to license after 2 years of (much cheaper) schooling, function in the same capacity, and do so for a cheaper price. I have no idea if the services are comparable to PhD's services as I've seen no outcome studies on which to base that conclusion. So if it's not for therapy or assessment that a student would pursue the PhD, that leaves research it seems. But if that's the case, where would that leave the future of PP?

It seems that the APA needs to lead the state chapters to ensure that the profession is preserved for whatever purposes make sense. That means the state boards need to be hearing from those with PhDs and the message should be unified across the country (speaking for USA of course - not sure how these things work in other countries). Otherwise, we've allowed scope creep in a major way by other professionals and it can't be corrected it seems.

You very well represented what I've been thinking.

 

[Therapist4Chnge]

PhD jobs tend to be very specialized (e,g. Autism). Which, guess is fine if that happens to be your specialty.

Specializing seems to be one of the few ways to help differentiate from non-doctoral therapists and doctoral generalists.

 

[PHD12]

Specializing seems to be one of the few ways to help differentiate from non-doctoral therapists and doctoral generalists.

+1

I wanted to point out that the most common job for doctoral-level PhD and PsyD graduates is still private practice or group practice. For many doctoral level providers, it's "private practice or perish."

 

[edieb]

Specializing seems to be one of the few ways to help differentiate from non-doctoral therapists and doctoral generalists.

The sad thing is this is the kind of thinking that got us to the point where we are today. Almost no states protect what we do as our own. Thus, there is nothing to stop a social worker from moving into your area

 

[PHD12]

The sad thing is this is the kind of thinking that got us to the point where we are today. Almost no states protect what we do as our own. Thus, there is nothing to stop a social worker from moving into your area

In my location, marriage and family therapists frequently advertise themselves as experts in CBT and exposure treatments for OCD, PTSD, Social Anxiety Disorder etc. in both adults and children.

 

[neuroal]

The sad thing is this is the kind of thinking that got us to the point where we are today. Almost no states protect what we do as our own. Thus, there is nothing to stop a social worker from moving into your area

This is exactly what I found as well. Any of the master's levels can say they are specialists in Autism, DBT, TBI rehab just to name a few I've seen in our area and there is nothing at the state level that either polices the claims or provides standards for them. In fact, master's level professionals are creating programming that makes these claims in all venues (inpatient, PP, community mental health etc). If the state says it's ok, insurance companies pay the claims, and the consumers go there, what would propel a student to continue to a PhD degree knowing they can do the work at an alternate level?

If PhDs truly believe it is necessary to have a PhD to do such work, then the PhDs need to do something to preserve it at the state levels at the very least.

 

[bmedclinic]

What really blows my mind, this isn't California, it's Texas. Not even Austin.

No joke.. when I saw that I thought 1. It's in Austin.. 2. "Keep Austin Weird", indeed.

But in Sherman? Surprised they havent lynched her or found out a way to "defend" themselves from her.

Just sayin'- Texans think differently.

 

[Therapist4Chnge]

The sad thing is this is the kind of thinking that got us to the point where we are today. Almost no states protect what we do as our own. Thus, there is nothing to stop a social worker from moving into your area

Psychology is a Hot Mess when it comes to protecting our turf. At the state and national level we are outspent and out-manuevered, so it should be no surprise that we are in this mess.

 

[edieb]

This is exactly what I found as well. Any of the master's levels can say they are specialists in Autism, DBT, TBI rehab just to name a few I've seen in our area and there is nothing at the state level that either polices the claims or provides standards for them. In fact, master's level professionals are creating programming that makes these claims in all venues (inpatient, PP, community mental health etc). If the state says it's ok, insurance companies pay the claims, and the consumers go there, what would propel a student to continue to a PhD degree knowing they can do the work at an alternate level?

If PhDs truly believe it is necessary to have a PhD to do such work, then the PhDs need to do something to preserve it at the state levels at the very least.

Hi, neuroal, are you looking for a job right now, are you in school or are you looking at applying to PhD programs? If you're still in school, you are very astute to catch onto all of this. Most people don't learn this till after they obtain their degree!

 

[neuroal]

Hi, neuroal, are you looking for a job right now, are you in school or are you looking at applying to PhD programs? If you're still in school, you are very astute to catch onto all of this. Most people don't learn this till after they obtain their degree!

Kinda of all of them. Thank you for saying that!

I first was hired a year ago as a PHP counselor in community mental health for low SES, disabled clients w/schizophrenia and BP while in a master's program which I am finishing in a couple of weeks. Also, I was doing a prac in an inpatient facility and they hired me after 4 months as a therapist doing adult and adolescent work. I left that job for ethical reasons (PhD supervision issues). I then was offered a position as a therapist at a PP doing assessment, individual therapy, and group DBT. I also was accepted to a PhD program but have deferred for a year due to personal reasons (my sister was dxed w/terminal cancer and I am helping care for her) as well as the issues mentioned in this thread.

While deciding what to do, I called all the state boards and talked to people at all levels of training - LISWs, LPCs, LICDCs, PhDs in every venue I could come across. So any astuteness on my part is a self-preservation tactic. I think the biggest shock for me was the state licensing and scope of practice by license(s). I had no idea that there literally is no difference between a PhD and a master-level clinician in my state according to the boards and in PP. Strange but glad I know this now.

I have to be honest on my skepticism on where things are going for the field as well.

 

[Sanman]

Specializing seems to be one of the few ways to help differentiate from non-doctoral therapists and doctoral generalists.

I have to agree with this and really think that large groups with more masters level clinicians is in the future. If I don't end up in a VA career (I am really hoping my recent interview pans out), I have been making plans and I think that a specialized clinician with a number of years of experience will certainly earn a clinical director or administrative position above a masters level clinician and that is what I am most interested in. The clinical director I work for seems to have an easier life than lowly therapists. Ironically, my fear is being stuck as a therapist in the private practice arena. It is fine for now, but I have little interest in grinding out more and more pts for less and less money.

As an aside, I found this article on psychiatrists and thought it was relevant to the thread:

http://www.nytimes.com/2011/03/06/health/policy/06doctors.html?_r=2&adxnnl=1&pagewanted=1&adxnnlx=1366696929-N1gO66HWPoT9KsWqWI0uRg

http://www.huffingtonpost.com/dr-ronald-ricker-and-dr-venus-nicolino/psychiatry-how-low-can-we_b_852893.html