CAREERS IN COUNSELING AND PSYCHOTHERAPY
If you think you are interested in clinical or counseling psychology, you first should ask yourself a few questions. For how may years am I willing to go to graduate school? Do I want to work in a hospital, clinic, or program somewhere? Do I want to have a private practice? Is there any particular type of client or problem I would like to work with? Am I interested in doing research?
It's not easy answering these questions now, but trying to form a clear vision of what you would like to be doing someday will help you make decisions about graduate school.
The mental health field is complex. There are several types of professionals with different types of training. There are many different paths you can take to get to a career in which you "counsel" people. What follows is a description of the various doctorate and masters level programs. But remember this: You do not necessarily have to get a Ph.D. in order to be a counselor or psychotherapist.
MASTERS PROGRAMS (may be full or part time)
There are a variety of masters levels programs in fields related to clinical and counseling psychology. Usually these programs train people in basic counseling skills. Some programs may have specialized areas of training such as marriage and family counseling, drug addiction counseling, group counseling, vocational counseling, family therapy, child therapy, divorce mediation, prison counseling, etc. When it comes time to apply for jobs, it's very advantageous to have an area of specialization.
People with masters degrees usually work in group counseling practices, clinics, program for specific populations (drug abusers, battered wives, chronic psychiatric patients, etc.), and employee assistance programs. In many states people with masters degrees CANNOT have their own private practice. However, in California MFCCs can practice independently.
A Ph.D. may enable you to make more money and may open up different doors for you, but it is not absolutely necessary to have one. In many cases a masters degree may be ideal! In fact, with the current rise of managed care systems in the field of mental health, insurance companies may only pay for psychotherapy provided by clinicians who are part of a group practice. While Ph.D.'s may be in charge of the group, they may very well hire clinicians with masters degrees to do therapy with the clients who are referred to the group. It is very possible that psychotherapists with masters degrees will be in greater demand in the future than they have been in the past.
If you are determined to get a Ph.D., you can sometimes get a masters degree from one school and then transfer to Ph.D. program at another school. But you might lose credits. Some Ph.D. programs also prefer to train students right from the start.
COUNSELING PSYCHOLOGY (Ed.D. or Ph.D.), usually 4 -5 years full time, longer if part time; sometimes less difficult to get into than clinical psychology programs)
Counseling psychology programs usually emphasize training in counseling/psychotherapy methods. These programs also include some training in research methods (stat and experimental courses), but usually are not as rigorous as in clinical psychology programs. However, counseling programs that offer a Ph.D. rather than the traditional Ed.D. often have intensified their research training. Similar to clinical psychology programs, counseling programs require internship experiences and a dissertation. In many cases, the distinction between counseling and clinical psychology programs is disappearing. A counseling program often is completely separate from the psychology department at the university.
Some counseling programs are part time and tend to attract people who are older, working, and/or have families. Counseling psychology programs tend to be perceived as less prestigious than Ph.D. and Psy.D. clinical psychology programs, although these perceptions are based on bias rather than fact.
Counseling psychologists tend to work in group counseling practices, private practice, and programs for special populations (mental retardation, drug addicted, prison settings, battered wives, etc.). Some counseling psychologists may teach at universities - usually in graduate counseling psychology programs and less often at the undergraduate level or in psychology departments.
Ph.D. CLINICAL PSYCHOLOGY (5 years minimum, usually longer; full time; difficult to get into)
These programs educate students about issues related to mental health and mental health treatment. Many programs emphasize research and will require you to take courses in statistics and experimental design. You will be expected to conduct experimental research, which will culminate in your dissertation. A dissertation is a year long research project that you design and conduct on your own (with help from a committee of faculty members).
Most programs are either behavioral, cognitive, biological, or psychoanalytic in their approach. Some programs mix all of the above. A few are humanistic\existential. During the first few years in a clinical program you will get some training in psychotherapy and psychological testing, but the most intense clinical training usually comes later during an internship. A few Ph.D. clinical psychology programs underplay the research component and spend more time on training you to do psychotherapy. But most programs weigh heavily on the research.
All clinical programs require you to do an internship, usually in your fifth or sixth year. During that year you work full time in a hospital, clinic, or mental health center. The internship usually is separate from your graduate program. It may be in a different part of the country. Usually it is up to you to apply for an internship. Yes, it's another application and interviewing process all over again!
Clinical psychologists usually end up teaching at universities, working in hospitals and clinics, or in private practice.
PSY.D. CLINICAL PSYCHOLOGY (4-5 years; full or part time; difficult to get into)
These programs lead to the degree "Doctor of Psychology" rather than the traditional Ph.D. ("Doctor of Philosophy"). They were created as an alternative to Ph.D. clinical psychology programs. They are designed for people who specifically want to practice psychology and are not interested in quantitative research. There is some research training, but much more time is spent on learning the various aspects of clinical work (individual and group psychotherapy, testing, marriage and family counseling, etc.). Usually more internship type experiences in a wider variety of settings are required than in Ph.D. programs.
Psy.D. clinical psychologists usually work in hospitals, clinics, and private practice.
Psy.D. programs tend to have more students per class than Ph.D. programs as many as 30 or 40, as compared to 5 or 10 in the Ph.D. programs. The Psy.D. degree tends to be perceived as less prestigious than the Ph.D., although this perception is based more on bias than fact. California has an extensive Psy.D. system.
CLINICAL SOCIAL WORK (MSW, 2-3 years full time, longer if part time)
Social work programs are an alternative to psychology training. "Clinical" social work programs teach students about working in the mental health and social welfare systems. Training in counseling and psychotherapy sometimes is not as extensive as in psychology programs, especially PsyD programs. Research usually is not emphasized. Many clinical social workers do individual and group psychotherapy. Social work programs may be easy or difficult to get into depending on the reputation of the university.
Clinical social workers work in hospitals, clinics, specialized programs, and private practice. An MSW degree tends to be perceived as less prestigious than a doctorate degree in psychology.
SCHOOL PSYCHOLOGY (approx. 4-5 years for Ph.D. or Ed.D., 2-3 years for masters degree)
School psychologists are training to do counseling and psychological testing in a school setting. Their strength, therefore, is their understanding of school systems and education. They may work with the children in the school or the staff. Some school psychologists may also have a private practice. Some school psychology programs offer the Ed.D. Others, which may place more emphasis on research training, will offer the Ph.D.
APA APPROVAL
Some counseling, school, and clinical psychology programs (Ph.D. or Psy.D.) have been approved by the American Psychological Association. This means that the program meets the APA guidelines for "good" training. The APA book Graduate Study in Psychology will tell you if a program is approved or not. It is much more difficult to get into these programs. Graduating from them may open more doors for you later on. But people from non APA approved programs can still have productive, fulfilling careers.
If a program is not approved, it could mean several things. The program may have lost its approval or has been unable to attain it - which is a bad sign. Or the program may be in the process of applying for approval - which is a good sign since it may be an up and coming program. Or the program may not care about applying for APA approval - which usually is a bad sign, although there are a few excellent training facilities which aren't concerned about APA approval.
Internships in clinical and counseling psychology also will be APA approved or not. Usually APA approved internships prefer students from APA approved graduate programs. Jobs in the mental health field sometimes require that a person had an APA approved internship.
PSYCHIATRY (M.D., approx. 3-4 years of training after med school; full time, very difficult to get into)
After completing medical school, a student can specialize in psychiatry during his/her residency. Training is usually biological in its approach (e.g., drug treatment) although some programs endorse psychodynamic or behavioral therapy. Compared to psychology programs, there is little training in research and psychological testing.
Psychiatrists tend to work in hospitals, clinics, and private practice. They usually work with more severely disturbed patients (e.g., schizophrenia, major depression) although some psychiatrists prefer working with neurotic patients. In hospital settings, psychiatrists tend to be perceived as the most prestigious of the mental health professionals.
WORKING IN BUSINESS AND INDUSTRY (Industrial/Organizational Psychology)
Some psychologists work in the business world doing psychological assessments, testing, interpersonal mediation, group dynamic assessments, and workshops (on stress, depression, communication skills, etc.). These psychologists may be employed by a specific company or may offer their services "free lance." Many of these psychologists graduate from clinical and counseling psychological programs. Others have masters degrees. Some graduate programs specialize in Industrial/Organizational Psychology, although there are not many of them.
WORKING WITH A BACHELORS DEGREE
Believe it or not, people do get jobs in the mental health field with a bachelors degree. Usually they work in specialized programs - e.g., programs for chronic psychiatric patients, prison settings, drug addictions, etc. This is often difficult work and does not pay very well. People often use such jobs to get experience and as stepping stones to other jobs. Some employee assistance programs hire people with a B.A.
LICENSING TO PRACTICE PSYCHOLOGY (and having a "private" practice)
In order to practice psychology (and have your own practice) you must be licensed by the state. Most states require approximately two years of supervised experience AFTER you get your Ph.D., Psy.D., or Ed.D. You must also pass a national multiple choice exam and, in many states, present a case study to a board of psychologists. You cannot advertise yourself as a "psychologist" or say that you offer "psychological" services unless you are licensed. These terms are protected by law. Being licensed also enables you to receive payment from your clients' insurance companies.
The A.P.A. recognizes four major specialties in applied psychology: clinical, counseling, school, and industrial/organizational. All professionals, regardless of their specialty, take the same state licensing exam. If they pass the exam, all carry the same legal title in the eyes of the state: "Psychologist"
Clinical social workers also are permitted to have private practices as long as they have been licensed by the state.
In many states (but not all) people with masters degrees are not permitted to have their own private practice.
WHAT COURSES TO TAKE
What undergraduate courses should you take if you are interested in someday becoming a counselor or psychotherapist? Courses that constitute a psychology major are essential - especially those pertaining to abnormal, social, and developmental psychlogy. If you are considering applying to a Ph.D. program in Clinical Psychology you will also want to take research and statistics courses. But, in a way there is NO course that is irrelevant! As a therapist you will be working with people from all walks of life. It is very helpful to know something about their particular work, interests, and lifestyle. If you are working with an accountant, it helps to know something about accounting. If you are working someone who is Irish, it helps to know something about Irish history and culture. A good psychotherapist is someone who is well rounded in his or her knowledge! People are psychological, biological, historical beings, so courses in literature, philosophy, history, sociology, communications, art, biology, chemistry may all be relevant. Think about what ultimately you want to be doing in your career, and choose courses that fulfill and round out those interests.
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