Careers in Counseling and Psychotherapy
Prepared by Steve Davis for the Psychology Department at North Central
College[1]
Congratulations on your decision to explore a career
in the helping professions! However, as you are probably beginning to realize, many
types of professionals (including psychiatrists, psychologists, and social
workers) may practice psychotherapy, each type having its own unique
educational requirements and areas of specialization. This document will allow you to compare the different types of
helping professionals with one another.
While the information provided below may begin to answer some of your
questions, we strongly encourage you to discuss this information further with a
faculty member in the Psychology Department.
Where's the
Money Coming From?
You may be surprised to discover
that anyone can charge another person for advice or helping! You require no special education or
certification to hang out a sign calling yourself a "professional advice
giver" or "personal consultant." However, if you want to call yourself a "Psychologist"
or "Clinical Social Worker" or any of several other state-regulated
titles, you need to meet the requirements for the appropriate certification in
your state.
Why then, would you ever want to bother with getting
this certification? Well, aside from
the obvious answer (so that you know what you're doing!), the other reason is
money. Most clients in therapy do not
pay their therapists directly, but instead pay through third parties (such as insurance companies, Medicare, HMO's,
etc.). Such third parties have strict
regulations about whom they will be willing to pay for psychotherapy
services. These regulations vary
somewhat, depending on which third party you are trying to get to reimburse you. However, only providers who conform to these
regulations will be reimbursed. This
means that if you do not conform to these regulations in your background and
licensure, you will need to be under the direct supervision of a professional
who does, to whom the third party will make payments. Thus, your earning potential and your professional freedom are
less restricted if you have a state-certified credential that is recognized by
third party payers. Otherwise, you can
accept only self-paying clients, or must work under the supervision of others
(for example, as a psychiatric technician in a psychiatric hospital). Some people without such state credentialing
may also work in institutions that are government funded and do not depend on
third party payments (for example, as a caseworker in a social service agency).
Types of
Mental Health Professionals
Different types of mental health professionals vary in terms of background and training, the types of clients they work with, the kind of work they do, and the level of reimbursement that they receive. The following list of mental health professionals is roughly organized from the professions that provide the most flexibility (and generally require the most training) to the professions that provide the least flexibility. Note that licensing requirements for different professions are generally state-mandated. The information provided below applies to Illinois requirements; requirements in other states may differ somewhat. Although median incomes are reported, remember that incomes may have a huge range depending on type of employment and geographic location (for example, the average rate for private practice clinical psychologists in Naperville may be as much as $120,000).
Psychiatrists. Psychiatrists are medical doctors, and as such, are the only
mental health professionals able to prescribe medications (although there is
currently some discussion about training psychologists to have limited
prescription privileges). Psychiatrists
may also perform psychotherapy, although they often focus more on medication
due to their more extensive training in this area. Earning potential is high (although less than doctors in most
other medical specialties); Median annual income of psychiatrists was $97,700
in 1997 (Psychotherapy Finances, 1997) although the AMA estimated the mean
annual income of psychiatrists at $120,000 in 1992 (Mariani, 1995).
Training. After obtaining a bachelors degree,
psychiatry trainees spend four years in medical school earning a general
MD. They then complete a four-year
residency in psychiatry (residencies on child psychiatry generally require an
extra year of training). Undergraduates
interested in pursuing a career in psychiatry should consider joining the NCC
Pre-health Organization, and should speak with Jeff Bjorklund, the pre-health
advisor. While undergraduates may major
in any field, certain science courses are recommended to help them prepare for
the MCAT (medical school admission test).
These include at least 8 hours of general, inorganic chemistry, 8 hours
of general biology, 8 hours of organic chemistry, and 8 hours of physics. Many medical schools are also requiring one
year of composition and courses in calculus and behavioral science.
Clinical and Counseling Psychologists. Clinical and counseling psychologists have
doctoral level training. This training
prepares these psychologists to do psychotherapy and psychological assessment
(along with school psychologists, clinical and counseling psychologists
generally do the bulk of psychological assessments). Historically, clinical psychologists were trained to work with
people with more severe psychopathology and counseling psychologists were
trained to work with people with more “normal” problems (including adjustment
problems, career counseling, etc.).
However, the distinction between clinical and counseling psychology is
not as clear as it once was, and today both clinical and counseling
psychologists work with clients with a variety of problems (Halgin, 1986). A 1999 APA (APA, 1999) survey found the
median salary for doctoral level clinical psychologists to be $65,000, and
$60,000 for doctoral level counseling psychologists, although they were quite a
bit higher for psychologists in individual private practice ($80,000 and
$72,000 respectively, with 15-19 years of experience). A 1997 study (Psychotherapy Finances, 1997)
estimated median salaries for psychologists at $80,500.
Training. After obtaining a bachelors degree, it
generally takes about six years to complete a Ph.D. in clinical or counseling
psychology. Five of these years are
spent in school taking courses, doing research (including a dissertation), and
working part-time with clients at various practicum sites. The last year of the program is spent in a
predoctoral internship, which may be at any of a variety of APA approved sites
across the country. This year is spent
doing clinical work full time. To be
licensed as a psychologist in the state of Illinois, a student must also do a
year of supervised postdoctoral practice before sitting for the licensure exam.
Ph.D. programs are designed to train
psychologists as “scientist-practitioners” – that is, to be experts both in
helping skills and in understanding research.
While some Ph.D. programs focus more on the “scientist” part and others
focus more on the “practitioner” part, all such programs require a minimum
competence in both areas. An
alternative doctoral degree, the Psy.D., is designed to train psychologists
primarily as practitioners (although some Psy.D. psychologists are involved
with research as well). Because of the
de-emphasis on research skills, these programs generally take about a year less
time to complete than a Ph.D. program.
Some of these Psy.D. programs are situated within a university setting;
however, many of then are based in freestanding “institutes of
psychology.” While these Psy.D.
programs often can provide excellent training, there is a great deal of
variability in the quality and reputation of these programs, more so than for
Ph.D. programs. Some Psy.D. programs in
institutes of psychology have been criticized as being “diploma mills,”
processing a large number of graduate students while providing substandard
training.
Social Workers. Practicing social workers generally have
master’s level training. Licensed
social workers can practice psychotherapy in a variety of settings; however
they are not trained to do assessment or research. In 1995, the median social work salary was between $30,000 and
$35,000, although the median for private practice social workers was between
$42,000 and $45,000 (Linsley, 1996).
Training. While there are bachelors degree programs in
social work, in order to be licensed as a clinical social worker in Illinois
one needs a master’s degree (MSW). MSW
programs generally require two years that include both class work and practicum
experiences. Different MSW programs
often have different tracks, including clinical social work, school social
work, and administrative social work.
While administrative social workers are trained primarily in managing
social service programs, clinical and school social workers get more extensive
training in providing psychotherapy.
After graduating from an MSW program, a student may immediately apply
for an LSW (Licensed Social Worker) license.
This license allows you to practice social work, but not in an
independent practice. LSW’s are also
available to graduates of Bachelors Social Work degree programs after they have
completed three years of supervised professional experience. To practice independently, one needs a LCSW
(Licensed Clinical Social Worker) license.
MSW’s may apply for the LCSW after receiving 3000 hours of supervised
clinical work following the master’s degree (NASW Illinois Chapter, n.d.). School social workers must complete two
school years (2160 hours) full time supervised work (post-MSW) as a school
social worker to meet the specialty certification in school social work.
School Psychologists. School psychologists are trained to do a
variety of clinical activities, but assessment is usually a key part of the
school psychologist’s job. School
psychologists can also consult with teachers and provide direct counseling
services to students. Most school
psychologists work in public or private school systems. The median salary for licensed
doctoral-level school psychologists was $71,000 in 1999 (APA, 1999). School psychologists also have the benefit
of being on a school schedule (with summer vacations, holidays, etc.)!
Training. While most graduate programs in school
psychology are housed in education departments, some are housed in psychology
departments. While training
requirements vary from state to state, Illinois requires at least master’s
level training and one year of supervised experience (Illinois State Board of
Education, n.d.). Beyond the master’s
level, some school psychologists earn a Ph.D. or may earn a specialization
certificate (midway between master’s and doctoral level).
Marriage and Family Therapist. Although psychiatrists, psychologists, and
social workers can all do family therapy, marriage and family therapists choose
to specialize in this particular type of psychotherapy. Median MFT salaries were $57,100 in 1997 (Psychotherapy
Finances, 1997).
Training. To be licensed as an MFT in Illinois, one
must complete at least a master’s degree from an accredited MFT program,
followed by at least two years of supervised experience in marriage and family
therapy, including at least 200 hours of supervision.
Professional Counselor. Illinois licenses professional counselors,
who are eligible to perform psychotherapy.
Median salary for professional counselors in 1997 was $48,000
(Psychotherapy Finances, 1997).
Training. There are two levels of licensure, the LPC
(Licensed Professional Counselor) and the LCPC (Licensed Clinical Professional
Counselor). An LPC license requires
either a masters degree in psychology or counseling OR a bachelors degree in an
approved human services department and the equivalent of 5 years of supervised
experience. An LCPC requires a master’s
degree in counseling or psychology, and the equivalent of two years supervised
experience subsequent to the degree.
School Guidance Counselor. Guidance counselors work with school-aged children,
helping them to better understand themselves and to plan for their
futures. They do different things at
different grade levels, but are generally concerned with student developmental
needs, emotional adjustment, and career planning and preparation. Median annual income for school counselors
in 2000 was $42,100 (Occupational Outlook Handbook, 2002).
Training. Guidance counselors hold both a standard
teaching certificate and a Guidance Specialist endorsement. They must hold a master’s degree from a
recognized teacher education institution, and complete a graduate program of 39
semester hours in coursework. This
includes a variety of supervised experience, including a 600-hour internship
for students with no previous teaching experience (300 hours for students with
two or more years of teaching experience).
Other Related Professionals. The above list is by no means complete. A variety of other professionals work with
people facing psychological problems, including psychiatric nurses, substance
abuse counselors, occupational therapists, art therapists, forensic
psychologists, and others. Other
professionals, such as community psychologists and organizational psychologists
may work to prevent psychological problems, often by consulting to workplace or
community settings to create more mentally healthy environments.
1. Spend your first few college years
wisely. Take courses that will help you
to explore different areas in which you might be interested (courses that might
help you think about these issues include Personality, Psychopathology of the
Child, Tests and Measurement, Abnormal Psychology and Counseling
Psychology). Do well in your courses; a
high GPA is required for many graduate programs in the helping
professions. Get to know several
faculty members well enough that they can write you meaningful letters of
recommendation. Get involved in
research, internships, and other applied experiences.
2. Decide which graduate schools most interest
you.
a.
To
avoid potential problems with licensing, apply only to graduate schools that
are accredited by the appropriate governing body (e.g., the American
Psychological Association or the Counsel on Social Work Education). A list of APA accredited programs in
clinical, counseling, and school psychology is available at http://www.apa.org/ed/doctoral.html
and also in the book Graduate Study in Psychology (APA 2001). The Counsel on Social Work Education has a
searchable directory of accredited social work programs at http://www.cswe.org/ .
b.
Write
postcards to schools to request information on the programs and applications.
c.
Find
programs that fit with your interests.
Look for faculty that share interests with you or for affiliated
practicum sites that will give you the experiences that you want.
d.
Remember
that the reputation of a university does not necessarily tell you much about the
reputation of a particular program at that university. Some excellent programs exist at otherwise
mediocre schools. Look more to the
reputation of the faculty in your field than at the name of the school.
e.
Weigh
the professional and personal costs and benefits of each program. For example, particular geographic locations
may give you better access to friends and family. However, limiting yourself geographically will also limit the
available number of programs that fit your needs.
3. Apply to a sufficient number of graduate
programs. For more competitive
programs, such as clinical psychology, you may want to apply to 6-8 schools in
order to increase you chances of acceptance (the same is true if your credentials
are not stellar).
4. Look to see what the requirements are for
the particular programs that interest you (see the book Graduate Study in
Psychology for information on specific psychology programs). In particular, many will require you to take
exams, such as the GRE-General test or the GRE-Psychology test. If such exams are required, be sure that you
study thoroughly for those exams before taking them. Buy one of many available preparation books for the General test,
and work through the problems.
Discipline yourself and spend some time on this (15-20 hours / week for
a month is not too much); you can greatly improve your scores by
preparing. For the GRE-Psychology test,
you may buy a preparation book, or alternatively, review the chapters in a recent
good introductory psychology textbook.
More information on GRE preparation along with free preparation software
is available at the GRE web site at http://www.gre.org/
.
5. Other important criteria may vary. Most graduate schools heavily weigh your GPA
and letters of recommendation from faculty.
Again, make sure that you get to know a few of your teachers well enough
that they can write meaningful letters for you. Undergraduate clinical and research experiences are also valued,
particularly if you can refer to them in your personal statement and explain
how they have influenced your interest in graduate school. Your personal statement itself will be read
carefully, and should thoughtfully explain why you are a good fit with the
program to which you are applying.
Study up on the program before writing this statement, and describe
specific faculty that you would like to work with and specific opportunities
that appeal to you. Tailor each letter
to the program to which you are applying.
We hope that this document has been helpful in
describing some of the main differences among mental health professionals. We strongly encourage you to get more
information by talking to faculty members in psychology and by exploring some
of the references listed below. You are
choosing a career that can be very rewarding, but you have some important
decisions to make about how to tailor that career to your personal
interests. Good luck!
APA (2001). Accredited Doctoral Programs in Professional Psychology. Retrieved from http://www.apa.org/ed/doctoral.html .
* APA (2001). Graduate Study in Psychology. Washington, DC: American Psychological Association.
* APA (1994). Getting In: A Step-By-Step Plan for Gaining Admission to Graduate Schools in Psychology. Washington, DC: APA.
APA Research Office. (1999). Salaries in Psychology: 1999. Retrieved from http://research.apa.org/99salaries.html
Counsel on Social Work Education. (n.d.). Member Program Directory. Retrieved from http://www.cswe.org/
Educational Testing Service (2001). Graduate Record Examinations. Retrieved from http://www.gre.org/
Halgin, R. (1986). Advising undergraduates who wish to become clinicians. Teaching of Psychology, 13(1), 7-12.
Mariani, M. (Spring, 1995). Beyond psychobabble: Careers in psychotherapy. Occupational Outlook Quarterly,
12-25.
Illinois Department of Professional Regulation (n.d.). Profession Selection. Retrieved from http://www.dpr.state.il.us/proflist.asp
Illinois State Board of Education (n.d.). Minimum Requirements for State Certificates. Retrieved from http://www.isbe.state.il.us/teachers/Documents/tocminreq.htm
Linsley, J. (1996). Salaries for New Social Workers. In The New Social Worker, 3, [On-Line]. Retrieved from http://www.socialworker.com/salaries.htm .
NASW (n.d.). Specialty Certification for the Experienced MSW School Social Worker. Retrieved from http://www.naswdc.org/credentials/school.htm
NASW Illinois Chapter. (n.d.). Social Work Licensing in Illinois. Retrieved from http://www.naswil.org/FactLicensing.htm
Occupational Outlook Handbook. (2002). Counselors. Retrieved from http://www.bls.gov/oco/ocos067.htm
Psychotherapy Finances (1997). As cited in Studies on Fees and Salaries of Marriage and Family Therapists. Retrieved from http://www.aamft.org/resources/Career_PracticeInformation/salaries.htm
* Sternberg, R.J. (1997). Career Paths in Psychology: Where Your Degree Can Take You. Washington, DC: APA.
(* indicates book on reserve at Oesterle Library under PSY 099)