What does a successful career look like that features no therapy caseload work?

[psychconsultant]

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After about 12 years in academia and then private practice, I realized that I hated hearing people talk about their lives. Most people are so boring. I decided to become a consultant, where I tell other people and organizations how to run their programs, rather than actually having to deal directly with people. It was the best decision in my career and life. I've defined success on my own terms: I earn in the low 100s; own an apartment in NYC; I work on average about 2-4 hours per week; I don't work at all between mid-June through August; I work from home; I have no office overhead; I don't carry liability insurance because my work is so low risk; I'm totally self-employed, with no co-workers or office politics to deal with. I decided that I'd rather make a decent baseline income than actually work hard and have to deal with people every day. Hard work is over-rated.

 

[Sanman]

After about 12 years in academia and then private practice, I realized that I hated hearing people talk about their lives. Most people are so boring. I decided to become a consultant, where I tell other people and organizations how to run their programs, rather than actually having to deal directly with people. It was the best decision in my career and life. I've defined success on my own terms: I earn in the low 100s; own an apartment in NYC; I work on average about 2-4 hours per week; I don't work at all between mid-June through August; I work from home; I have no office overhead; I don't carry liability insurance because my work is so low risk; I'm totally self-employed, with no co-workers or office politics to deal with. I decided that I'd rather make a decent baseline income than actually work hard and have to deal with people every day. Hard work is over-rated.

Interesting take for someone with a doctorate. One would think there are easier educational paths.

 

[therow]

After about 12 years in academia and then private practice, I realized that I hated hearing people talk about their lives. Most people are so boring. I decided to become a consultant, where I tell other people and organizations how to run their programs, rather than actually having to deal directly with people. It was the best decision in my career and life. I've defined success on my own terms: I earn in the low 100s; own an apartment in NYC; I work on average about 2-4 hours per week; I don't work at all between mid-June through August; I work from home; I have no office overhead; I don't carry liability insurance because my work is so low risk; I'm totally self-employed, with no co-workers or office politics to deal with. I decided that I'd rather make a decent baseline income than actually work hard and have to deal with people every day. Hard work is over-rated.

Really interesting perspective, thank you. Do you have any tips for how to pivot into such a role? You say self employed so i imagine its not job listings in this area but rather being reached out to by varying organizations?

 

[AcronymAllergy]

Wonderful perspective, thank you. Lastly, can I ask if the majority of the evaluations you do or the evaluations you would do for ADHD/autism would be private pay or bill under insurance, I’ve heard mixed things on the field about what is most common in assessment private practice

In my case, it'd be all or almost all through insurance. I imagine the private pay market would be there, it might just take a little longer to build up. Probably easier for kids, where psychoed evals are more commonly out-of-pocket anyway, and because parents are often more willing to spend money on their children (especially RE: education) than themselves.

The downside of private pay ADHD/ASD/psychoed evals are the expectations that come from patients about the results of said evals. If I were doing them, I'd want to focus on providing some proactive education about that during the informed consent process (i.e., before starting the eval or charging anything). It wasn't super common, but I had more than one irked parent call me way back when I was in grad school if the heavily-discounted psychoed evals we were doing for their college-aged children didn't support a diagnosis of ADHD. I suspect they would've been even more irritated had they paid the market rate for the evals.

Mind you, I think we all know that who the payor is should never influence the results of your eval. Just putting out there that there are very real pressures you could face.

 

[cara susanna]

It's also probably easier in a bigger metropolitan area like NYC, I imagine.

 

[R. Matey]

If you do stats consulting, you can make pretty decent money.

 

[therow]

Find a state hospital job. Doing it 10 years now and you won’t find much chiller work with solid compensation and pretty amazing benefits (some better than others depending on the state). Youll likely have time to do other work as well.

I’ve had my eye on this, and am interested in internships down this route? What is your work in a hospital typically like? Brief inpatient evals? The scope of any therapy?

 

[Therapist4Chnge]

It depends. ADHD evals tend to get grouped w psycho education, so commercial insurances likely will push back. Autism evals for school-aged can get covered, but it takes some effort. Low cost/free autism evals can have a year+ wait in most communities, but cash pay can be a few weeks.

Both of these diagnoses more recently have become popular to self-diagnose as adults, but they are trickier to get covered bc commercial insurances will argue they are not medically necessary,

ADHD requests are common, but neuropsych eval of ADHD aren’t really diagnostic per the research, but they can be helpful to help w compensatory strategies. That said, some clinicians can carve out lucrative practices if they get in w private schools and/or work in affluent areas bc parents will pay out of pocket to get their child every advantage possible.

 

[ClinicalABA]

... Hard work is over-rated.

Depends. Look at the equation in my profile. Though it's the simplified version of the matching law, if we assume B1=easy work and B2=hard work, and r1 and r2, respectfully equal the quantity/quality of reinforcement for B1 and B2, you could imagine some values of r2 that might lead one to allocate more time to B2 than to B1. However, as the difference between r1 and r2 lessens, the allocation of resources to B2 also lesson (and if they don't other bad things start to happen!)

 

[BuckeyeLove]

I’ve had my eye on this, and am interested in internships down this route? What is your work in a hospital typically like? Brief inpatient evals? The scope of any therapy?

It really varies day to day (which is why I am still here I think). We have a staff of about 12-15 psychologists, about half who are forensically-trained, the other half more clinical-focused, and one neuro. I used to work on an acute unit and I miss it - think every movie or book you've seen with inpatient psych and multiply that by 1000 and that's what it was like - so many stories, and did some good work. That work was mostly solution-focused, brief, which is why we tended to see better outcomes. The unit I am on now is solely for competency restoration, so it's a bit slower paced. The work on that unit is dedicated to getting the patients opined competent, or getting them seen early if they're not going to get there. I also do psycho-legal work, so around 2 evals a month (usually competency to proceed or sanity) as well as violence risk. Our hospital system doesn't have any billing, rvus, productivity requirements, which is another reason i don't really see myself leaving. You're also never in a silo...if you need help or consultation, you've got great colleagues right down the hall (figuratively speaking). There's also dedicated time for scholarship, research, other stuff (when i was going through the boarding process they allowed me to have dedicated days for board prep). . Along with all the other benefits that come with working in a system. I also have a private practice as well (most of us at my hospital do some sort of side work) If you can't handle bureaucracy, it's probably not a good fit.

 

[quickpsych]

2) Go look up psychology jobs on indeed or psychcareer or wherever. Look at the preferences for “trained in”. Near zero jobs say psychodynamic.

True. Back when I was in grad school which was primarily psychodynamic focused on the therapy side of things (and not too far back) they were already phasing out the word "eclectic" and encouraged students to avoid that language in CVs, applications, interviews. The push was to describe it as "integrative" (i.e. drawing from other modalities and recognizing it's not one size fits all). IMO psychodynamic therapy is fine,, has it's uses, and is probably helpful to more patients than insurers and bean counters like to admit; I believe a shift away was based on time limited formats and modalities that save insurers money.

 

[Sanman]

Depends. Look at the equation in my profile. Though it's the simplified version of the matching law, if we assume B1=easy work and B2=hard work, and r1 and r2, respectfully equal the quantity/quality of reinforcement for B1 and B2, you could imagine some values of r2 that might lead one to allocate more time to B2 than to B1. However, as the difference between r1 and r2 lessens, the allocation of resources to B2 also lesson (and if they don't other bad things start to happen!)

Agree to an extent. However, the delta between B1 and B2 also declines. Most generalist folks have no idea how to do what I do. At this point for me, it is so practiced as to be relatively easy. It's the bureaucracy that will make me quit.

 

[Sanman]

True. Back when I was in grad school which was primarily psychodynamic focused on the therapy side of things (and not too far back) they were already phasing out the word "eclectic" and encouraged students to avoid that language in CVs, applications, interviews. The push was to describe it as "integrative" (i.e. drawing from other modalities and recognizing it's not one size fits all). IMO psychodynamic therapy is fine,, has it's uses, and is probably helpful to more patients than insurers and bean counters like to admit; I believe a shift away was based on time limited formats and modalities that save insurers money.

At the end of the day, IMO, psychodynamic therapy is just the attempt to adapt psychoanalysis to something besides a small group of rich people. No one says it is bad. However, no one else is going to foot the bill for it. A personal trainer and a weekly massage are good for you too, insurance is not paying for that either.

 

[psychconsultant]

Depends. Look at the equation in my profile. Though it's the simplified version of the matching law, if we assume B1=easy work and B2=hard work, and r1 and r2, respectfully equal the quantity/quality of reinforcement for B1 and B2, you could imagine some values of r2 that might lead one to allocate more time to B2 than to B1. However, as the difference between r1 and r2 lessens, the allocation of resources to B2 also lesson (and if they don't other bad things start to happen!)

Like I said, so boring. (I'm not trying to be a jerk, just stating the fact that this type of talk would bore most people).

 

[docloufan]

Really interesting perspective, thank you. Do you have any tips for how to pivot into such a role? You say self employed so i imagine its not job listings in this area but rather being reached out to by varying organizations?

I would be skeptical of anyone who talks about working 4 hours/week, taking a full summer vaca, and earning over 100k/annum with a Psychology Ph.D. with almost no effort or marketing. I mean, maybe, yes. But probably, no. If it were that easy....you fill in the rest.

Chances are very high that most people who try to do this just using their Psychology Ph.D. will fail. Meaning they have to work work at least close to 5 days a week like the rest of us slubs. Right?

And I don't know how the "just over 100k/annum" buys you a "Manhattan Apartment?" Thrice that to buys...yea?

 

[R. Matey]

I would be skeptical of anyone who talks about working 4 hours/week, taking a full summer vaca, and earning over 100k/annum with a Psychology Ph.D. I mean, maybe, yes. But probably no. If it were that easy....you fill in the rest.

I know someone who got a five figure consulting gig with a psych-adjacent PhD, but it was very much a one time thing. Also, My doctoral advisor is pretty well known in their area of psych and frequently had some consulting contracts so not entirely unheard of. Still, on-going high yield, low hours contracted consulting work does sound pretty fishy. Seeing the best in the intent in the post (something I'm actively trying to get better at), the poster could be obfuscating details due the public nature of the board, but I know that I want more details.

Like I said, so boring. (I'm not trying to be a jerk, just stating the fact that this type of talk would bore most people).

Idk man, it just sounds to me like you never should've been a psychologist in the first place. I'm glad you found your happiness though.

 

[chicandtoughness]

Hello, might I interest you in the wonderful world of utilization management? 😁 (it is expected I will bring this up in every “what non therapy job can I get” thread, my apologies to those who have seen it many times)

A doctorate would be overkill, but if you really don’t want to do therapy, it’s a very chill way to pass the time. I started at 80k and for a time was double-jobbing for a total of 150k while working a total of 6 hours a day. My single job atm is 3 hours a day at WORST and makes me 75k (I’m also in med school so, you know, this is fine).

 

[ClinicalABA]

Like I said, so boring. (I'm not trying to be a jerk, just stating the fact that this type of talk would bore most people).

The truth is often not as exciting as we would wish it to be...

 

[docloufan]

Hello, might I interest you in the wonderful world of utilization management? 😁 (it is expected I will bring this up in every “what non therapy job can I get” thread, my apologies to those who have seen it many times)

A doctorate would be overkill, but if you really don’t want to do therapy, it’s a very chill way to pass the time. I started at 80k and for a time was double-jobbing for a total of 150k while working a total of 6 hours a day. My single job atm is 3 hours a day at WORST and makes me 75k (I’m also in med school so, you know, this is fine).

Never met a full-time working UM who thought ..."It was chill."

Writing quality clinical summaries, MNC summaries, calling out to providers to clarify requests all day long, and then sending on to a MD or Ph.D. for a whopping 80 grand/year. Then calling the providers back with the news. And, then documentation of that before the day is over. I don't believe a word you said beyond that for one second unless you are a **** UM.

 

[PsyDr]

After about 12 years in academia and then private practice, I realized that I hated hearing people talk about their lives. Most people are so boring. I decided to become a consultant, where I tell other people and organizations how to run their programs, rather than actually having to deal directly with people. It was the best decision in my career and life. I've defined success on my own terms: I earn in the low 100s; own an apartment in NYC; I work on average about 2-4 hours per week; I don't work at all between mid-June through August; I work from home; I have no office overhead; I don't carry liability insurance because my work is so low risk; I'm totally self-employed, with no co-workers or office politics to deal with. I decided that I'd rather make a decent baseline income than actually work hard and have to deal with people every day. Hard work is over-rated.

So you charge a minimum of $694/hr, and that covers state tax, city taxes, plus health insurance?

 

[docloufan]

I know someone who got a five figure consulting gig with a psych-adjacent PhD, but it was very much a one time thing. Also, My doctoral advisor is pretty well known in their area of psych and frequently had some consulting contracts so not entirely unheard of. Still, on-going high yield, low hours contracted consulting work does sound pretty fishy. Seeing the best in the intent in the post (something I'm actively trying to get better at), the poster could be obfuscating details due the public nature of the board, but I know that I want more details.

I think the other poster is telling a fib.

 

[chicandtoughness]

Never met a full-time working UM who thought "It was chill."
Writing clinical summaries, MNC summaries, calling providers to clarify requests day long, and then sending on to a MD or Ph.D. for a whopping 80 grand/year. Then calling the providers back with the news. I don't believe a word you said beyond that for one second unless you are a **** UM. Aim higher, folks.

If you’re fast and good at what you do (and your clinicians have semi-good documentation), it is absolutely chill. I had one case sent to peer last year. One. I’d show you receipts but don’t want to dox myself any further than I already have.

I’m on facility side UM and not insurance side. That side is absolutely a labor farm and they will work you to the bone while recording all your calls for “quality assurance”.

 

[docloufan]

If you’re fast and good at what you do (and your clinicians have semi-good documentation), it is absolutely chill. I had one case sent to peer last year. One. I’d show you receipts but don’t want to dox myself any further than I already have.

I’m on facility side UM and not insurance side. That side is absolutely a labor farm and they will work you to the bone while recording all your calls for “quality assurance”.

"Fast and good?" Is that a joke? Is that really what you think this is happening here?

 

[chicandtoughness]

"Fast and good?" Is that really what you think this is happening here?

Is there a point you’re trying to make? If you’re interested in ad hominem attacks I’m not going to engage further. I get atrociously good LOS for my patients, rarely have cases sent to peer, rarely have denials, and can crank through 30+ cases a day if I need to. It is absolutely possible to be efficient and good at your job.

 

[docloufan]

Son, these are human beings. Not something you "crank" thru.

The job of everyone here is to allow fair access to services that also adhere to best-practice treatment standards...not just services requested for or by your employed agency. "Getting services" is not a "win" or some kind of brag.

 

[chicandtoughness]

Son, these are human beings. Not something you "crank" thru.

The job of everyone here is to allow fair access to services that also adhere to best-practice treatment standards...not just services requested for or by your employed agency.

I'm a little confused at what your point is. I literally spend my entire workday advocating for patients to get access to the treatment that they need, and I do a damn good job of it. Please take your negativity elsewhere.

 

[docloufan]

I'm a little confused at what your point is. I literally spend my entire workday advocating for patients to get access to the treatment that they need, and I do a damn good job of it. Please take your negativity elsewhere.

I see now. Advocate? Is that right?

 

[chicandtoughness]

I see now. Advocate? Is that right?

Oh... I should have checked your post history before engaging. This is not a conversation where logic or being open to other perspectives is going to happen, so I'm out. Cheers.

 

[R. Matey]

I think the other poster is telling a fib.

Eh, this person has said similar in other threads and then deleted their posts. If they're lying, at least they're consistent.

 

[cara susanna]

Utilization management sounds soul crushing to me, as someone who hates the concept of RVUs and how we measure productivity

 

[Sanman]

Eh, this person has said similar in other threads and then deleted their posts. If they're lying, at least they're consistent.

My question is whether this is a realistic goal for someone fresh out of grad school vs someone that spent years in academia developing a reputation. I know a few folks with cushy gigs like this. They are mostly older folks cashing in on years as an expert or really good talkers selling a trend (looking at you Six sigma and Lean folks).

 

[docloufan]

Eh, this person has said similar in other threads and then deleted their posts. If they're lying, at least they're consistent.

Yea. Im gonna put it at about a 100% right now.

 

[R. Matey]

My question is whether this is a realistic goal for someone fresh out of grad school vs someone that spent years in academia developing a reputation. I know a few folks with cushy gigs like this. They are mostly older folks cashing in on years as as expert or really good talkers selling a trend (looking at you Six sigma and Lean folks).

That's mostly how I've seen it play out too. Not great advice to a student absolutely, but theoretically possible. I've actually worked with consultants before who seem to have pretty cushy gigs. I very distinctly remember a call I joined at about 10 in the morning and the consultant was outside in some very sunny place under a cabana drinking espresso while we all talked stats. However, this person is well-known name in their particularly area and would like be recognizable to most in academia who use statistics for their research. So, possible? Yes. Probable? No.

 

[docloufan]

That's mostly how I've seen it play out too. Not great advice to a student absolutely, but theoretically possible. I've actually worked with consultants before who seem to have pretty cushy gigs. I very distinctly remember a call I joined at about 10 in the morning and the consultant was outside in some very sunny place under a cabana drinking espresso while we all talked stats. However, this person is well-known name in their particularly area and would like be recognizable to most in academia who use statistics for their research. So, possible? Yes. Probable? No.

That was 100% purposeful behavior for the call.

 

[Therapist4Chnge]

My question is whether this is a realistic goal for someone fresh out of grad school vs someone that spent years in academia developing a reputation. I know a few folks with cushy gigs like this. They are mostly older folks cashing in on years as as expert or really good talkers selling a trend (looking at you Six sigma and Lean folks).

Agreed. I also did Six Sigma in my Corp Consulting days (prior to clinical training) and being fresh out w either background likely won’t have options w/o some years experience. It’s great work once you can get it though.

 

[psychconsultant]

Eh, this person has said similar in other threads and then deleted their posts. If they're lying, at least they're consistent.

I like to stir the pot a bit. Honestly, I charge a pretty standard $200,000 annually for my consultant services with a large behavioral health agency. I mostly focus on program development, training, and data management, much of it automated and so easy after doing it for 10 years, and then net $120-150K after taxes and overhead. I literally have one Zoom call per week for 60 minutes with lower-level program managers, and one monthly meeting with executive-level types. I also read a lot of scientific articles in the areas of psychology, integrated care, health technologies, and then synthesize emerging issues in so-called issue briefs that I write for the executives. During COVID, I stopped doing in-person private practice and decided to not do remote therapy.

 

[psychconsultant]

Really interesting perspective, thank you. Do you have any tips for how to pivot into such a role? You say self employed so i imagine its not job listings in this area but rather being reached out to by varying organizations?

Most consultants are so-called experts in a field and/or have highly-valued skill sets. I had about 7 solid years of supervisory and management experience in mental health settings, and about 6 years in academia (Asst Professor level), when I realized that I didn't want to do direct-care and clinical supervision. In academia, I didn't have any teaching load; I just had to write, publish, get grants, like a meat-grinder. Not fun.

 

[PsyDr]

I like to stir the pot a bit. Honestly, I charge a pretty standard $200,000 annually for my consultant services with a large behavioral health agency. I mostly focus on program development, training, and data management, much of it automated and so easy after doing it for 10 years, and then net $120-150K after taxes and overhead. I literally have one Zoom call per week for 60 minutes with lower-level program managers, and one monthly meeting with executive-level types. I also read a lot of scientific articles in the areas of psychology, integrated care, health technologies, and then synthesize emerging issues in so-called issue briefs that I write for the executives. During COVID, I stopped doing in-person private practice and decided to not do remote therapy.

So you have 2-4hrs of face to face work, and additional non-clinical work.

 

[Sanman]

So you have 2-4hrs of face to face work, and additional non-clinical work.

By this logic, I know a guy that makes 3.3 million/yr currently working 5-10/hrs week. All he had to do was spend a build and sell his software company for the past 10 years to make it happen.

 

[PsyDr]

By this logic, I know a guy that makes 3.3 million/yr currently working 5-10/hrs week. All he had to do was spend a build and sell his software company for the past 10 years to make it happen.

By his/her logic, I make more, work the same number of hours, and travel more.

@psychconsultant While I am happy for your success, I think it is important to project realistic work expectations to students on here.

 

[failureisnotfatal]

On the topic of your question, there is definitely a possibility of having a career that is all assessment and no counseling. I actually did one of my practicums in a hospital and all the psychologists I worked with did was assessments and it was set up to where they did 2 a day usually, mostly focused on autism and other developmental conditions. The work in that type of setting is pretty stable and pays fine. And I believe psychologists in that type of setting are usually salaried employees.

 

[psychconsultant]

So you have 2-4hrs of face to face work, and additional non-clinical work.

Yes, about 2-4 hrs per week of work, not counting the 4-5 publications I read each week in my "free time" to keep myself updated on various topics. One of the benefits of being a PhD-level psychologist is defining yourself, and success, on your own terms. I'm glad I made a pivot away from direct clinical work into consulting work, where I could use my training and background in an indirect manner. I highly value my personal time, and realized that was more important than making more money. I'm not materialistic in any way and live a modest lifestyle, where travel, doing cultural stuff in NYC, and being with friends and family is most important to me. In this forum, I see lots of comments from two types of people: those who work government/VA- jobs that provide a decent, modest standard of living with stability (until recently); and those who are in private practice with cash-only practices serving upper-middle class people of privilege. These are worthy paths to pursue, but my path is an option, too, and something you can decide to do if you find yourself seeking non-clinical options.

 

[Sanman]

Yes, about 2-4 hrs per week of work, not counting the 4-5 publications I read each week in my "free time" to keep myself updated on various topics. One of the benefits of being a PhD-level psychologist is defining yourself, and success, on your own terms. I'm glad I made a pivot away from direct clinical work into consulting work, where I could use my training and background in an indirect manner. I highly value my personal time, and realized that was more important than making more money. I'm not materialistic in any way and live a modest lifestyle, where travel, doing cultural stuff in NYC, and being with friends and family is most important to me. In this forum, I see lots of comments from two types of people: those who work government/VA- jobs that provide a decent, modest standard of living with stability (until recently); and those who are in private practice with cash-only practices serving upper-middle class people of privilege. These are worthy paths to pursue, but my path is an option, too, and something you can decide to do if you find yourself seeking non-clinical options.

I'll disagree here. This is more the function of being mid-career with time and money than it is simply having a PhD. Students today graduating with mountains of debt need to do what pays reliably and quickly. Those of us that have amassed some level of financial stability over time have choices.

 

[Therapist4Chnge]

Yes, about 2-4 hrs per week of work, not counting the 4-5 publications I read each week in my "free time" to keep myself updated on various topics. One of the benefits of being a PhD-level psychologist is defining yourself, and success, on your own terms. I'm glad I made a pivot away from direct clinical work into consulting work, where I could use my training and background in an indirect manner. I highly value my personal time, and realized that was more important than making more money. I'm not materialistic in any way and live a modest lifestyle, where travel, doing cultural stuff in NYC, and being with friends and family is most important to me. In this forum, I see lots of comments from two types of people: those who work government/VA- jobs that provide a decent, modest standard of living with stability (until recently); and those who are in private practice with cash-only practices serving upper-middle class people of privilege. These are worthy paths to pursue, but my path is an option, too, and something you can decide to do if you find yourself seeking non-clinical options.

I'm not sure they are quite that silo'd, but I think institutional employment (e.g. VA, hospital-based, AMC, academia) are a big chunk and yes, private practice are a large chunk...both reflective of employment surveys. I'm most familiar with the neuropsych ones, but general surveys about the field as a whole tend to cluster in these two main areas. There are small % who do consulting and other work too, though the general surveys do a poor job of splitting them out and highlighting the differences.

I think it is too simplistic to say those in PP only cater to upper-middle class, as I don't think that is true. Many "generalists" take insurance and see a wide range of people, though some have found that untenable for economic and sanity reasons. There is a lot of downward pressure on the field, so it'd behoove us to pursue more jobs that are in line with our training. I recommend against generalist work for the vast majority of psychologists because it's too easy to get lumped in with "therapists", which devalues our work.

It's also worth noting that even the cash pay practices (like my own) still often do pro-bono work, we just don't talk about those parts as much because most clinicians these days are just trying to survive (psychologists included). I personally try to put in caveats about my path and choices bc they are often non-traditional and not a fit for most, but I think the basics of most clinicians are in PP or institutional and not doing much non-clinical work. I wish non-clinical options were plentiful, but they definitely take more work and effort to secure.

 

[markovnikoving]

I'm so curious where you're training that's got you thinking that full-time therapy is more lucrative than full-time assessment. What was told to me in grad school (and shown via bar graphs made from surveys of recent alumni) and my direct experience joining the job market is the opposite: Full-time assessment pays better. That's not the only metric of success, but that's what you're talking a lot about (and it is really important). I should add that I'm thinking of neuropsych assessment, can't speak to full-time psychoed evals or the like.

 

[markovnikoving]

I should also add, just in case this needs to be said out loud, it doesn't make anyone a bad person to realize that they don't like the field they got into. You're allowed to learn that it's not a good fit but choose to stay anyway (for many reasons, not least of which is sunk cost).

 

[AcronymAllergy]

I'm so curious where you're training that's got you thinking that full-time therapy is more lucrative than full-time assessment. What was told to me in grad school (and shown via bar graphs made from surveys of recent alumni) and my direct experience joining the job market is the opposite: Full-time assessment pays better. That's not the only metric of success, but that's what you're talking a lot about (and it is really important). I should add that I'm thinking of neuropsych assessment, can't speak to full-time psychoed evals or the like.

For insurance-based practices, an hour of psychotherapy may pay more than an hour of testing, especially once considering the costs of materials. Although you can't multiply your billables by having a tech administer psychotherapy like you can testing; but then you have to see enough people to cover the tech's pay. And recently, the psychotherapy codes have taken less of a reimbursement hit than the testing/assessment codes.

Partly also depends on how legitimately a person is billing. If they're submitting for 7-8+ hours of 96132/96133 for a standard outpatient adult dementia eval, I probably have some questions.

For self-pay, all bets are off. If someone's charging $3k out-of-pocket for an outpatient neuropsych eval (that may take them a half-day to do), it's going to be tough to catch that with just therapy.

 

[smalltownpsych]

Assessment, psychotherapy, research, teaching, consulting, overseeing or developing programs, forensic work. We have a broad set of skills and we tend to mix and match these in our careers. Much of the time we are too busy to post here as we do all of the work other than just talk therapy which I personally like to limit to about half my time and also prefer briefer interventions and supervising/teaching newer clinicians. That being said, I believe that successful psychologists have all the skills. Grad school and our clinical training is the time to get that broad exposure. Once one gets out into the real world, they will see how the skills contribute to their success and sets us apart from the midlevels who lack in some of those areas. My advice to students is to not pigeonhole yourself too early. Also, a big part of psychotherapy skills are interpersonal communication skills so even if one doesn’t want to do just that for a living which many psychologists don’t, experience in psychotherapy translates easily into success.