Would you advise someone to go into psych today?

[R. Matey]

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My Gen-Z niece has some interest in the field and has been asking me to speculate on the future of the field. What should I say? Is the end nigh? Or would you still advise college students to enter professional psych?

 

[Sanman]

This depends entirely on who the person is and what their other options are in life. That said, my general philosophy still stands:

1. Keep your educational debt as low as possible if entering the field.
2. Patients prefer medication because it is often easier.
3. You will require more time in training to acquire a decent salary, but you are unlikely to starve or be jobless once licensed.
4. If you actually possess the customer service and business skills to do well, you would likely make more in product sales.
5. If you want to be a parent, the field offers good flexibility in work hours and environment, unlike many other fields.

 

[The Cinnabon]

I'm Gen-Z

Honestly, after seeing my parents struggle for a few years or seeing my higher income friends put up with jobs they truly hate for the golden handcuffs, it breeds perspective ig. I'm sure this opinion will evolve but just having a job with decent security, a stable (and even decent) paycheck, and doing something I don't actively despise (and I'm a picky person, hence the psych route) is good enough for now.

Keep in mind I'm a lowly 1st year PhD student, so I'm barely into training let alone truly "in the field." I also view this for what it is - a job.

I fell into two axioms on this. I'd either do something I'm very interested in OR whatever would make me the most amount of money in the least amount of time, both paths were healthcare oriented so stability and the like was less of a concern. My "backup" to clinical psych was just going the CRNA/Anesthesia assistant route and doing locums for half the year while doing w/e else I wanted for the rest. I ended up getting admitted to the former which made the choice for me.

 

[AcronymAllergy]

I wouldn't outright advise against it, but I'd let them know there's no telling what things will look like in 10 or 20 years, and psychology is perhaps a bit more uncertain income-wise and with respect to scope of practice, responsibilities, etc., than some other healthcare professions. I'd probably find out what they're really interested in and wanting to do, and see if they're a good match with psych vs. an adjacent field.

 

[Fan_of_Meehl]

My Gen-Z niece has some interest in the field and has been asking me to speculate on the future of the field. What should I say? Is the end nigh? Or would you still advise college students to enter professional psych?

I think it's a pretty unique field that is uniquely hard on high achievers / perfectionists.

We're generally trained well enough in terms of clinical sophistication, critical thinking, and research acumen to experience the daily agony of swimming in a sea of substandard mental health practice and (hopefully) hold out against fully surrendering to 'lowest common denominator' in our own practices yet stop short of perfectionistic self-immolation.

There's also been the steady dystopian march of the mind-numbingly stupid 'corporate medicine' mindset which is soon to be married with 'AI' and machine learning related 'innovations' that will be pushed hard by administrators who can't be bothered to do 4th grade arithmetic to critically evaluate their own clinic operations (things like addiction/subtraction, percentages/ratios, averages...). If I hear the word 'metrics' blithely mouthed by another corporate drone type who couldn't do basic arithmetic to save their life...breathe...breathe...

But this is happening everywhere, not just our field.

 

[Sanman]

I think it's a pretty unique field that is uniquely hard on high achievers / perfectionists.

We're generally trained well enough in terms of clinical sophistication, critical thinking, and research acumen to experience the daily agony of swimming in a sea of substandard mental health practice and (hopefully) hold out against fully surrendering to 'lowest common denominator' in our own practices yet stop short of perfectionistic self-immolation.

There's also been the steady dystopian march of the mind-numbingly stupid 'corporate medicine' mindset which is soon to be married with 'AI' and machine learning related 'innovations' that will be pushed hard by administrators who can't be bothered to do 4th grade arithmetic to critically evaluate their own clinic operations (things like addiction/subtraction, percentages/ratios, averages...). If I hear the word 'metrics' blithely mouthed by another corporate drone type who couldn't do basic arithmetic to save their life...breathe...breathe...

But this is happening everywhere, not just our field.

I will say, I am much more hard pressed to recommend medical school to young folks as the ability to start a business has become much more difficult and I only see salaries decreasing as the field shifts into largely employed practitioners.

 

[PsyDr]

Using the APA's most recent salary data (which is old), and assuming CMS continues to decrease payments by 3% per year, and assuming CMS affects psychologists' income, and assuming the median individual income in the USA ONLY increases by 3% per year, and assuming that zero psychologists are in PP so there are no overhead covariates that impact net income, and assuming I'm not totally bad at excel:

The numbers intersect in 2039 (average psychologists= $87,493.52 vs average Joe=$88,214.82).

 

[WisNeuro]

Fort someone who wants to do general clinical or research work? No, I would not recommend current students to go into the field.

 

[Sanman]

Using the APA's most recent salary data (which is old), and assuming CMS continues to decrease payments by 3% per year, and assuming CMS affects psychologists' income, and assuming the median individual income in the USA ONLY increases by 3% per year, and assuming that zero psychologists are in PP so there are no overhead covariates that impact net income, and assuming I'm not totally bad at excel:

The numbers intersect in 2039 (average psychologists= $87,493.52 vs average Joe=$88,214.82).

I wholeheartedly believe that in 2039 this will still be the most recent APA salary survey.

EDIT: We'll still make more than Jeff Bezos. Maybe we can be billionaires too.

 

[R. Matey]

Fort someone who wants to do general clinical or research work? No, I would not recommend current students to go into the field.

So neuropsych, forensics, or bust?

 

[WisNeuro]

So neuropsych, forensics, or bust?

I'm not even sold om general neuropsych. I think forensic will hold out longer. If someone is passionate, sure, go ahead, but it will likely be a very poor return on investment as salaries will soon be pretty comparable to midlevels for most providers. A small percentage of PP will do ok for a longer period, but even that will start to wane as reimbursement pressures hit across the field.

 

[smalltownpsych]

There is plenty of work to be done in our field and a good living to be made. We do need to continue to combat the problems and work hard at maintaining our status as leaders in research and application of psychological science. If we allow the corporate types to make all the decisions then we are screwed and even to believe that we would make more money being them is a bit ludicrous since we are not good at what they do. That’s ok because if we stay good at what we can do, then we’ll be ok. My wife says I’m a Pollyanna though and if I was more realistic then I would see the doom and gloom more clearly. 😉

 

[WisNeuro]

There is plenty of work to be done in our field and a good living to be made. We do need to continue to combat the problems and work hard at maintaining our status as leaders in research and application of psychological science. If we allow the corporate types to make all the decisions then we are screwed and even to believe that we would make more money being them is a bit ludicrous since we are not good at what they do. That’s ok because if we stay good at what we can do, then we’ll be ok. My wife says I’m a Pollyanna though and if I was more realistic then I would see the doom and gloom more clearly. 😉

There will always be plenty of MH work available, it just won't pay well for a majority of providers, particularly those whop spent the time for a legitimate doctoral degree. We're more concerned with non-guild related issues and dumbing down the training and other requirements to adequately protect reimbursements. Ultimately, it's due to many factors, but this is mostly a self-inflicted wound that we continue to re-administer over the years.

 

[Sanman]

There will always be plenty of MH work available, it just won't pay well for a majority of providers, particularly those whop spent the time for a legitimate doctoral degree. We're more concerned with non-guild related issues and dumbing down the training and other requirements to adequately protect reimbursements. Ultimately, it's due to many factors, but this is mostly a self-inflicted wound that we continue to re-administer over the years.

I do think that is a key question separate from entering the field as a whole.

 

[WisNeuro]

I do think that is a key question separate from entering the field as a whole.

Well, it speaks to the watering down of competence when the mills pump out a relatively large number of people whose competence is at or below most midlevels.

 

[Sanman]

Well, it speaks to the watering down of competence when the mills pump out a relatively large number of people whose competence is at or below most midlevels.

It may speak to competence of the field. However, it is true of healthcare as a whole. I have a hard time finding a PCP that is not a PA or an NP that has an open panel. Part of the reason for this is where we are now. The push for "value-based care" and healthcare by algorithm without proper reimbursement for the same minimizes the value of individual expertise. CMS has put a number on this. An MSW is compensated 75% of a psychologist with a fraction of the educational costs. While APA has fallen down on the job system overall is trending in the same direction.

EDIT: Out of curiosity, NPs and PAs are reimbursed at 85 percent of a physician per CMS. So, we are not doing that bad there.

 

[Ollie123]

I think it will still be a solid move for someone sharp, motivated, isn't locked into a single career path and who can be content with a reasonable middle-class lifestyle. Mental health is definitely a worsening problem at the population. I think job opportunities are going to grow for well-trained psychologists with diverse skillsets who are open to unique and interesting paths. If you want to become an academic, its still one of the easier paths to doing so owing to the sheer number if different departments psychologists can work in and that a clinical degree pretty much guarantees your ability to get a faculty job at a medical center "somewhere." Opportunities outside the mainstream are only going to grow. I know a LOT of psychologists working in the tech industry right now. Which admittedly I think is long overdue for an epic and well-deserved collapse itself, but other opportunities will arise.

I would strongly discourage psychology for the classic "I did pretty good in undergrad but have limited vision/potential and really only want to do therapy" student. More and more I think "Just get a master's" is going to be the answer there.

If the goal is the most money for the least work....we've always been a bad choice and always will be. Doesn't mean it is impossible to do that, but there are unquestionably dozens upon dozens of better ways.

 

[oliversacks4thewin]

My running joke is that I am one of the worst spokespersons for our own field. I personally feel like the return of investment makes other options much more desirable, especially in the context of individuals who are only interested in the title or feel like "they are really good at listening and helping others with their problems." All of this is coming from an individual who has a high level of job satisfaction too. Despite this video being a bit old, and certainly a hyperbole, I still find the way of how it presents information about our career to be a good way to open discussion about our profession:

 

[Fan_of_Meehl]

My running joke is that I am one of the worst spokespersons for our own field. I personally feel like the return of investment makes other options much more desirable, especially in the context of individuals who are only interested in the title or feel like "they are really good at listening and helping others with their problems." All of this is coming from an individual who has a high level of job satisfaction too. Despite this video being a bit old, and certainly a hyperbole, I still find the way of how it presents information about our career to be a good way to open discussion about our profession:

The robotic prosody really adds to the effect, lol

 

[summerbabe]

There’s some inherent privilege in being afforded the option to choose a vocation that potentially provides both intrinsic satisfaction and financial stability.

These individuals are also likely to have other options besides psych/mental health and should fully explore other paths and accumulate well-rounded life experiences.

Regardless of likely/possible future negative trends in our field, I think it can and will remain a great option for the right person, even as things continue to change.

It also helps if that person will be satisfied driving a Toyota instead of a Rivian (which will definitely go bankrupt before any of us get put out to pasture).

 

[The Cinnabon]

There’s some inherent privilege in being afforded the option to choose a vocation that potentially provides both intrinsic satisfaction and financial stability.

These individuals are also likely to have other options besides psych/mental health and should fully explore other paths and accumulate well-rounded life experiences.

Regardless of likely/possible future negative trends in our field, I think it can and will remain a great option for the right person, even as things continue to change.

It also helps if that person will be satisfied driving a Toyota instead of a Rivian (which will definitely go bankrupt before any of us get put out to pasture).

Not wanting/having kids really helps.

If I wanted kids I probably wouldn't have jumped on this. No shade to those with kids that pull it off, which is most psychologists.

 

[Sanman]

Not wanting/having kids really helps.

If I wanted kids I probably wouldn't have jumped on this. No shade to those with kids that pull it off, which is most psychologists.

That's just a sad statement on society.

 

[BuckeyeLove]

That's just a sad statement on society.

And we wonder why we are below (and continue to get increasingly below) replacement level.

 

[RxPsych]

This is a difficult question that I believe is strongly influenced by someone's specialty upon graduation. My experiences in more niche areas (neuropsychology, inpatient consult-liaison, transplant) have shown me the growing recognition of the important roles we fill on treatment teams. In my experience, the demand for our services largely outweighs our availability. However, I think the structural issues (e.g., insurance reimbursement, salaries [particularly early career], stagnant graduate school stipends resulting in difficulty graduating with no loans) would be justification enough to consider not going into this field, which is a shame.

 

[ClinicalABA]

If it was (a) in line with their career goals (e.g., senior level clinician/clinical researcher; assessment practice); and (b) could be done with accruing unfathomable levels of debt or savings depletion, I'd have no problem advising someone to pursue a Ph.D. from a legit, non-diploma mill graduate school.

 

[AcronymAllergy]

Not wanting/having kids really helps.

If I wanted kids I probably wouldn't have jumped on this. No shade to those with kids that pull it off, which is most psychologists.

Maybe not the training part, but in terms of professional lifestyle, I actually think psychology may be one of the more kid-friendly doctoral-level healthcare professions. Especially in private practice.

But yes, daycare in the US is a minefield.

 

[WisNeuro]

Maybe not the training part, but in terms of professional lifestyle, I actually think psychology may be one of the more kid-friendly doctoral-level healthcare professions. Especially in private practice.

But yes, daycare in the US is a minefield.

Yeah, PP has definitely been good with small kids. Flexibility to manage drop-off/pickup times and appointments has been key. I'd be burning through PTO like crazy in a 9-5 job.

 

[The Cinnabon]

Maybe not the training part, but in terms of professional lifestyle, I actually think psychology may be one of the more kid-friendly doctoral-level healthcare professions. Especially in private practice.

But yes, daycare in the US is a minefield.

Very fair!

I was definitely projecting my own life wishes onto my original statement, and I think someone who doesn't want kids is going to view every field as being not ideal with children.

Speaking objectively, private practice and the ability to set your own schedule seems like a godsend for parents.

 

[BuckeyeLove]

The early career salaries for some places are not that different now than they were in 2013. Like maybe 10-15k more. Everything seems to have quadrupled in price since then though (when i was wrapping up graduate school). Tough to sell ANY potential career (medicine included) that stalls making money right out of college these days.

 

[Sanman]

Yeah, PP has definitely been good with small kids. Flexibility to manage drop-off/pickup times and appointments has been key. I'd be burning through PTO like crazy in a 9-5 job.

Ironically, that is exactly why I delayed PP. I have so much built up leave at the VA that burning through PTO is not a problem. I would have lost a lot of income in PP compared to paid sick and parental leave.

 

[quickpsych]

You have to enjoy the work and also I think to be worth it, have an interest in other aspects of the work and the field (i.e. if you just want to do traditional talk therapy, a masters degree with a license is going to be sufficient BUT I think midlevels have a less flexibility in the workforce unless they want to dive into PP therapy).

That said I don't think the sheer freedom, flexibility, and job security that comes with the professional license we have as psychologists can be understated. I used to think it wasn't going to be that big of a difference once licensed, but it's like day and night. I feel like I have options, I have leverage, I can work more or work less and still make a decent income, and I have the freedom and ability to change where I work or how I work much more easily than I think midlevels usually have. And there's no shortage of work for psychologists in a variety of settings and opportunities. How many unemployed licensed psychologists have any of you met?

 

[LM02]

I agree with so much that has been said here, but to add my 2 cents... I think it also really depends upon a person's ability to tolerate delayed reward. It's a lot of up front work and sacrifice to get to the finish line of training - I say this as someone who graduated from college during the internet boom of the late 90s and watched all of my friends take on very high paying jobs right out (or shortly after) college, while I was toiling away in a low paying postbac job, grad school, internship, and postdoc. It was demoralizing and difficult at times, and definitely a financial strain, but I stuck with it.

And now that I've been at it for nearly 20 years, I absolutely love my job and all of the opportunities it has afforded me. I find what I do enjoyable and intellectually stimulating, and often still cannot believe that "this is actually my job." I've been able to pivot into new areas and roles as they have come up (and we have the flexibility in our training to do this kind of pivoting!). My compensation is high and I live very comfortably, and also have a ton of flexibility in my day to day to be present for my children, who will soon enough launch into the world as adults. It means sometimes having to work on evenings and weekends, but I can set my own schedule to make sure that my life is more than just my work. I think it's a great career path with so many possibilities (still).

 

[WisNeuro]

Ironically, that is exactly why I delayed PP. I have so much built up leave at the VA that burning through PTO is not a problem. I would have lost a lot of income in PP compared to paid sick and parental leave.

That part can be good at the VA, and I did get a nice chunk of change when my AL was paid out. As for now, the increase in compensation/hour more than makes up for general PTO in my case.

 

[cara susanna]

I honestly would say no, i don't think it's worth the loss of income and spending pretty much all of your 20s in school/training. Not to mention the constant having to move around the country.

Like, I don't regret it doing it, but I'm not sure I'd do it again either.

 

[Ollie123]

One other benefit I forgot to note.

For better or worse, I do think a clinical PhD sets a floor for compensation and there is something to be said for that. Barring complete economic collapse of the entire country, I cannot possibly envision a scenario I make less than $80,000/yr long-term unless its by choice. Get fired from my academic job? Mediocre clinical jobs are a dime a dozen - I can get by and it buys me some time to reinvent myself. Insurance payments are dropping? I could work my way up to cash-only (or mostly cash-only).

Salaries are obviously much lower than medicine, but there is a security and peace that a clinical license brings knowing that you are basically always going to be in demand to some degree and barring a debilitating injury/illness could keep working as long as you want/need to keep working. Could I have made more as a computer scientist? Probably. But almost inevitably with a couple layoffs in the mix and concerns about age discrimination keeping me out of the top roles by the time I'm 45-50.

Long story short, I'm going to put my behavioral economics hat on and say "Should we advise someone to go into psych" is the wrong way to think about the issue. Career decisions are almost never a yes/no question (or at least shouldn't be). It should be a question of psych versus something else and until we know the parameter space of <something else> there isn't a good answer. It is one option that comes with pros and cons.

The thread makes it clear most of us don't believe this to be the objectively "best" career choice. I doubt anyone here would argue it is the "worst" career choice.

 

[R. Matey]

Long story short, I'm going to put my behavioral economics hat on and say "Should we advise someone to go into psych" is the wrong way to think about the issue. Career decisions are almost never a yes/no question (or at least shouldn't be). It should be a question of psych versus something else and until we know the parameter space of <something else> there isn't a good answer. It is one option that comes with pros and cons.

Absolutely, though the 'likelihood function' in your Bayes equation would in an interest in behavioral/mental health with some type of interventional focus, which narrows the playing field a bit from all career decisions and is very common for those majoring in psych (which she hasn't done yet, but is considering). She knows she doesn't want a master's degree due to low pay and lack of flexibility, for which I of all people can't blame her. But the risk-reward equation also seems to shifting away from psychologists to midlevel providers in terms of reimbursement at the very least, to the detriment of having expertise in the field.

 

[Sanman]

One other benefit I forgot to note.

For better or worse, I do think a clinical PhD sets a floor for compensation and there is something to be said for that. Barring complete economic collapse of the entire country, I cannot possibly envision a scenario I make less than $80,000/yr long-term unless its by choice. Get fired from my academic job? Mediocre clinical jobs are a dime a dozen - I can get by and it buys me some time to reinvent myself. Insurance payments are dropping? I could work my way up to cash-only (or mostly cash-only).

Salaries are obviously much lower than medicine, but there is a security and peace that a clinical license brings knowing that you are basically always going to be in demand to some degree and barring a debilitating injury/illness could keep working as long as you want/need to keep working. Could I have made more as a computer scientist? Probably. But almost inevitably with a couple layoffs in the mix and concerns about age discrimination keeping me out of the top roles by the time I'm 45-50.

Long story short, I'm going to put my behavioral economics hat on and say "Should we advise someone to go into psych" is the wrong way to think about the issue. Career decisions are almost never a yes/no question (or at least shouldn't be). It should be a question of psych versus something else and until we know the parameter space of <something else> there isn't a good answer. It is one option that comes with pros and cons.

The thread makes it clear most of us don't believe this to be the objectively "best" career choice. I doubt anyone here would argue it is the "worst" career choice.

I think the bolded is something that gets overlooked often. I have close friends in tech and a wife in corporate America. Now that we are mid-career, both my tech friends and my wife have been thinking about age discrimination at we edge closer to 50 and having backup plans. My plan has always been private practice in my later years with a gradual slowdown in work. There is something to be said about the ability to earn in a flexible manner on the back end of your career (barring a major stroke or other severely debilitating condition). I plan to eventually slow down but continue to see a few cash patients and maybe supervise in PP up to my 70s.

 

[Fan_of_Meehl]

I think the bolded is something that gets overlooked often. I have close friends in tech and a wife in corporate America. Now that we are mid-career, both my tech friends and my wife have been thinking about age discrimination at we edge closer to 50 and having backup plans. My plan has always been private practice in my later years with a gradual slowdown in work. There is something to be said about the ability to earn in a flexible manner on the back end of your career (barring a major stroke or other severely debilitating condition). I plan to eventually slow down but continue to see a few cash patients and maybe supervise in PP up to my 70s.

This is definitely an upside. Even with most physical disabilities, assistive technology would keep us able to earn a living nearly up to the grave. Wait a minute...considering my VA position...I just gave myself an early Halloween terror/panic attack.

#WEAREALLINTHISTOGETHER
#NOONEGETSOUTALIVE
#HAPPYHALLOWEEN

 

[Ollie123]

Absolutely, though the 'likelihood function' in your Bayes equation would in an interest in behavioral/mental health with some type of interventional focus, which narrows the playing field a bit from all career decisions and is very common for those majoring in psych (which she hasn't done yet, but is considering). She knows she doesn't want a master's degree due to low pay and lack of flexibility, for which I of all people can't blame her. But the risk-reward equation also seems to shifting away from psychologists to midlevel providers in terms of reimbursement at the very least, to the detriment of having expertise in the field.

Does a master's degree = low pay and lack of flexibility relative to a clinical psychologist with a purely "interventional" focus though? The LCSWs I know in PP don't seem to make markedly less than the psychologists. I think this is especially true once you "control" for motivation/drive - the psychologists I know doing extremely well as clinicians are generally the ones who set up a PP and have others working for them with passive income rolling in, but they could just as easily have done that with a master's.

 

[R. Matey]

Does a master's degree = low pay and lack of flexibility relative to a clinical psychologist with a purely "interventional" focus though? The LCSWs I know in PP don't seem to make markedly less than the psychologists. I think this is especially true once you "control" for motivation/drive - the psychologists I know doing extremely well as clinicians are generally the ones who set up a PP and have others working for them with passive income rolling in, but they could just as easily have done that with a master's.

Well, having done both, I'm lucky enough to have friends in both camps. My master's clinician friends who are there own practice owners with a number of underlings and my psychologist friends work in specialist interventionist spaces (peds, health, forensics, military, sports). The anecdata I have suggest to me that psychologist is still the better gig in terms of base pay and flexibility. And BLS salary data (which if anything is a downward estimate) in my state puts psychologist pay nearly twice that of counselors, social workers, etc.

ETA: I do wonder if psychiatry is still the better gig though for people who are seeking direct clinical work.

 

[WisNeuro]

Does a master's degree = low pay and lack of flexibility relative to a clinical psychologist with a purely "interventional" focus though? The LCSWs I know in PP don't seem to make markedly less than the psychologists. I think this is especially true once you "control" for motivation/drive - the psychologists I know doing extremely well as clinicians are generally the ones who set up a PP and have others working for them with passive income rolling in, but they could just as easily have done that with a master's.

I'd agree here. On average, the clinician doing purely therapy type services isn't all that much better off than midlevels in many settings. The key for our training is that we have many more niches available due to our training (e.g., assessment, forensics, data analysis, etc). But, these types of positions are not the modal. I love what I do and make very good money at it, but I am not the modal clinical psychologist in terms of what I do.

 

[Therapist4Chnge]

Would I recommend clinical psych, mostly…no. Hard Pass for generalists, but some speciality areas could work: neuro, rehab, transplant, and their forensically-related work.

Some people might think they want to specialize, but often the reality of the day to day job is very different than what trainees initially estimate would be a typical day.

I was trying to climb the academic ladder bc I thought I wanted to eventually be a Dept Chair or maybe transition into a hospital administrator gig. The more I worked w different mentors, the more I realized I would have hated either high-level leadership role bc it was mostly phone conferences, budgets, & a lot of politics.

 

[R. Matey]

I'd agree here. On average, the clinician doing purely therapy type services isn't all that much better off than midlevels in many settings. The key for our training is that we have many more niches available due to our training (e.g., assessment, forensics, data analysis, etc). But, these types of positions are not the modal. I love what I do and make very good money at it, but I am not the modal clinical psychologist in terms of what I do.

I don't fully disagree, but I think psychotherapeutic excellence at the "generalist" level is far more likely to come from a psychologist than a mid-level by virtue of our ability to integrate psychological knowledge for clinical problems and follow evidenced based care, which is something many mid-levels do not do. I grant the monetary benefit would more likely be seen in private practice.

 

[Sanman]

I don't fully disagree, but I think psychotherapeutic excellence at the "generalist" level is far more likely to come from a psychologist than a mid-level by virtue of our ability to integrate psychological knowledge for clinical problems and follow evidenced based care, which is something many mid-levels do not do. I grant the monetary benefit would more likely be seen in private practice.

Sure. However psychotherapeutic excellence pays exactly $0 more than psychotherapeutic mediocrity. It actually costs you money if it decreases volume.

 

[MCParent]

It’s hard to imagine generalist work being worth it, between BH-type agencies that are super accessible to patients but I hear pay around $40/hr and AI bots that can do fine jobs of making people feel better (but probably not get better, bc that would cut into subscription payments).

Knowing my career path, I’d do it again. If that were an unknown to me, though, that’d be tough.

 

[WisNeuro]

I don't fully disagree, but I think psychotherapeutic excellence at the "generalist" level is far more likely to come from a psychologist than a mid-level by virtue of our ability to integrate psychological knowledge for clinical problems and follow evidenced based care, which is something many mid-levels do not do. I grant the monetary benefit would more likely be seen in private practice.

I wholeheartedly agree that doctoral level therapists are usually leagues better than midlevels, but in general, that isn't worth much more in reimbursement, particularly for insurance based work. That gap will continue to close in both public and private work as time goes on.

 

[R. Matey]

I wholeheartedly agree that doctoral level therapists are usually leagues better than midlevels, but in general, that isn't worth much more in reimbursement, particularly for insurance based work. That gap will continue to close in both public and private work as time goes on.

I guess I'm just less cynical. Demand for quality work seems high from my perspective. Seems like the opportunity to make money is there, if you're able to run your business and market well.

 

[WisNeuro]

I guess I'm just less cynical. Demand for quality work seems high from my perspective. Seems like the opportunity to make money is there, if you're able to run your business and market well.

For some in PP, most definitely. But for many of those and those in most institutions, we'll likely see the stagnation or decrease in salary.

 

[Sanman]

I guess I'm just less cynical. Demand for quality work seems high from my perspective. Seems like the opportunity to make money is there, if you're able to run your business and market well.

Now, we are talking important skills. If your niece does decide to venture into the field, a marketing and business development class in college would go further to improve income than perfecting psychotherapy skills. At the end of the day, most consumers don't even know what really good psychotherapy is. Plenty of rich folks I know won't pay for better services despite shelling out more than that per month on the latest German SUV. A triumph of marketing right there.

 

[R. Matey]

Now, we are talking important skills. If your niece does decide to venture into the field, a marketing and business development class in college would go further to improve income than perfecting psychotherapy skills. At the end of the day, most consumers don't even know what really good psychotherapy is. Plenty of rich folks I know won't pay for better services despite shelling out more than that per month on the latest German SUV. A triumph of marketing right there.

Maybe not mutually exclusive? I can't tell you how many folks feel relief at the idea that there is an evidenced-based treatment for their problem.

ETA: I truly appreciate the feedback, folks.