Help me realize my counseling career dreams!
September 3, 2009 6:53 AM   Subscribe

I want to be a counselor in clinics and/or hospitals. What degree do I need to get?

I have a B.S. in psychology. My main interests lie in "behavioral medicine"- the clinical side, not the research side. I want to be a counselor for people with chronic illnesses like HIV, but I also want to live comfortably (and by that I mean never worrying about being able to cover basic needs- I don't need to drive an aston martin).

Originally I thought PhD, but I'm not sure whether hospitals or clinics even hire PhDs to do counseling outside of psych wards, and I'm not so excited about research OR 6 years of school. Then I thought social work, but I feel like I would be locked into a job with a very low salary cap for the rest of my life. I have also thought about a PsyD, or a masters in counseling, etc. etc., but I don't know very much about what kinds of opportunities those degrees will afford.

I have extensive internship and work experience in this area (mostly with MDs who unfortunately can't really answer my questions about psychology careers), and I have taken the GREs (regular and psych), so I feel like getting into a school won't be that terrible for me- it's just a question of picking what school to go to.

Any kind of advice would be greatly appreciated- after going back and forth over so many options, I am at a real loss here.
posted by GarotaDaCidade to Work & Money (9 answers total) 4 users marked this as a favorite
I have done what you want to do. I am a social worker.

These kinds of jobs usually fall to the Social Work department of major hospitals, although those departments are much more often used for case management services. In smaller clinics this is also a job usually done by social workers. PhDs are usually used in this context only when administering things like educational tests are necessary.

The truth is that social workers come more cheaply than do PhDs, while, in counseling, having basically the same skillset, and so these types of positions are usually written for social workers. Many social workers move into administration and/or private practice as their careers progress and their salary wants and needs change. The trade-off is in not getting to do direct work with the population you orginally went into the work for.

I will say, as someone who maintains a clinical practice, but has moved mostly into public health in my primary job, that there are a lot of positions I cannot apply for because I lack a PhD. This is true in hospitals as well, where the hierarchy of graduate degrees can matter a lot when jobs come open.

The specific jobs you describe, though, do not pay all that well, and are staffed by MSWs for the most part.
posted by OmieWise at 7:07 AM on September 3, 2009

Oh, feel free to email me if you have any other questions.
posted by OmieWise at 7:08 AM on September 3, 2009

Not sure if this helps exactly, but this is a current job posting on my hospital's website. It's not exactly the job you're looking for, but at least shows you can get something in the field with a BS. I really think experience required would vary from place to place. BTW, I do not work in the psych. dept....just know some people who do.

Experience Required:

One year related work experience in order to have gained practical knowledge of dealing with difficult clients, multiple agencies, psychiatric behaviors and interventions, psychological assessment, and appropriate mental health laws. Experience working in an acute Inpatient or Partial psychiatric setting is helpful.
Job Description:

Assesses mental status and makes appropriate recommendations for mental health treatment setting. Observes, assesses, intervenes into, and documents client behaviors in a therapeutic clinical manner. Provides independent or supervised therapeutic interaction in a group or individual setting. Provides direct physical care as needed to include vital signs and ADL assistance.

Professional knowledge at a level normally acquired through the attainment of a Bachelors degree in Psychology or closely related discipline.

Maybe calling a hospital with a psych. department could get you more answers.
posted by fresh-rn at 7:08 AM on September 3, 2009

My wife does that and she has a Masters in Social Work (MSW). As for pay, meh.
posted by JohnnyGunn at 7:17 AM on September 3, 2009

Consider an MS in Counseling (may also be called Community Counseling or, as a new standard is about to be adopted, Clinical Mental Health Counseling). Licensed professional counselors (LPCs) do this kind of work.
posted by catlet at 8:35 AM on September 3, 2009

Most of the people who I know who have jobs like you describe have MSWs.

Some are licensed clinical social workers, or otherwise licensed as a therapist (MFT, e.g.), which involves many hours of practice and an exam. Licensed positions will pay more than a straight MSW, even if there's not always a huge difference in function. I also know a handful of people who do that kind of work as a nurse practitioner, including a psych NP. That's a longer, different educational track, obviously, but opens up more opportunities and generally pays better than a MSW.
posted by gingerbeer at 8:45 AM on September 3, 2009

You could totally get a case manager job with an agency that serves HIV+ communities in NYC with a psychology bachelors degree, you should jump in and do some work in the field while you figure out the application process.
posted by The Straightener at 8:58 AM on September 3, 2009

Social work jobs might pay enough if you're not in NYC. Consider moving.

Most clinical psych PhD programs are research-oriented but some are much less so than others.
posted by kathrineg at 11:42 AM on September 3, 2009

I don't have advice about what degree you should get but I can tell you this... a PsyD will cost you. The program will be at least 4 years (if your school allows fast-tracking, but its not necessarily a good idea) and will probably cost at least $100,000 (they don't pay you to go to school). I'm in my sixth year of school, just started my internship, and owe approxmiately $200,000 in student loans. I don't expect to live comfortably for quite some time.
posted by Nolechick11 at 3:08 PM on September 3, 2009 [1 favorite]

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