I want to be a therapist
September 14, 2020 2:02 PM   Subscribe

I want to be a therapist/counsellor, and I've started reading, and planning. If you are a therapist/counsellor can you give me any advice or tips on starting out?

I'm feeling overwhelmed, but mainly in a good way. There is so much to learn, and I am kind of out of practice with learning, so I am trying to read as much as I can whilst getting ready (practically and financially) to enroll on an actual course.

But I have so many questions! Do you have to specialise in a particular method, and if so, how soon? Are there any pitfalls that baby therapists often fall into? How long should one study for before one can competently practice? How soon, once you are able to practice, can you make a living from doing so?

If you can answer any of the above, or anything I'm not thinking of, I would be grateful for any advice at all. I'm old enough, and have spent enough time in careers that weren't really right for me, that I want to take my time and get this right.

[Edited to add: OP is located in the UK]
posted by anonymous to Work & Money (12 answers total) 5 users marked this as a favorite
Where are you located or where would you be practicing? That would help us answer helpfully. Requirements change between countries, states and provinces so wildly that without that information we can't really answer what kind of education would be required, what kind of credentials or or what kind of money you could make being a therapist. (Note, not a therapist, but someone who interacts with them as a patient, and a family member of a minor patient, and who has done research on what would be required to practice where I live.)
posted by chesty_a_arthur at 2:15 PM on September 14

You should probably start by speaking to a local college or university regarding what the qualification and licensing requirements are wherever it is you live. (I know that in some countries or areas, you can call yourself a "therapist" or "counselor" without any qualifications or a license, but you don't want to be one of those charlatans!) Becoming licensed will probably take a couple of years in and of itself, and you might need a graduate degree in a relevant field before you become eligible for licensure.
posted by MiraK at 2:16 PM on September 14

Your country, and possibly state or local municipality are incredibly important to answer this question. I would contacts the mods to add it.

Each state in the US has requirements on becoming a licensed therapist (almost all of which requires a masters degree, followed by x hours of direct supervision before you can practice completely solo), and a certain number of hours of continuing study per year. Per but your spelling of counsellor may mean you're not in the US? This would change things.
posted by furnace.heart at 2:36 PM on September 14

How long should one study for before one can competently practice? How soon, once you are able to practice, can you make a living from doing so?

If you're in the US, this is a licensed thing that requires a master's degree and further things to become certified. It's state based.

Practically, what you should do is look at schools that would work that have programs (there are many options, I was considering a licensed clinical social worker masters).

This isn't a quick thing. It would take you years to go through school then do your hours under supervision. That isn't to discourage you, but you need to be looking at programs and talking to the people there. It's not a quick process, there are no shortcuts to becoming a licensed therapist (there are no unlicensed therapists in the US).
posted by OnTheLastCastle at 2:43 PM on September 14

Also, if you are in the US, planning on where you want to live (for a long long time) can dictate much of how you go about your education and subsequent licensure; sometimes states have transfer agreements for licensure, they often do not, and it is very patchwork and complicated. You can study anywhere, but often, if you want to live in a state, you are best to at least get your license and supervision in that state (and then live there, again, for a long long time).
posted by furnace.heart at 2:46 PM on September 14 [1 favorite]

Assuming from your post that you're in a Commonwealth country or a non-Anglophone country; as noted above, check with local universities about what is needed. Here in the US, an MSW (master of social work) grad program takes two years, although with an undergrad Social Work major you can do some limited things. After the MSW, there's an exam to receive your LMSW (licensed medical social worker) license and then you can practice under supervision. After a few years worth of supervised hours and a year or two that doesn't have to be supervised, you can write the LCSW (licensed clinical social worker) exam and practice independently.

(side note: please don't try to practice without a license; not only do you run the risk of harming your clients, you also open yourself up to legal liability.)

In terms of what you can work on now: learn about the major schools (Freud / psychoanalysis, humanism (Carl Rogers, the concept of unconditional positive regard), life cycle and human development (Erik Erikson), group therapy (Yalom), cognitive-behavioral therapy, dialectical behavioral therapy (Marsha Linehan), trauma-informed care (The Body Keeps the Score by Bessel van der Kolk)...

Start practicing mindfulness and meditation and self-awareness. There are lots of apps and books and YouTube videos. Therapists, we don't have stethoscopes or hammers; our professional tools are our selves and the therapeutic relationship we establish. That's something you can start developing now.
posted by tivalasvegas at 2:48 PM on September 14 [6 favorites]

If you are a therapist/counsellor can you give me any advice or tips on starting out?
Volunteer at something like a suicide crisis line or any other paraprofessional role to find out if this is something that you actually enjoy doing.
Make friends at school and continue to consult with them afterwards. My student practicum was with several folks I really respected, and we all did our internship together the next year. We meet monthly now to consult on difficult cases.

Do you have to specialise in a particular method, and if so, how soon?
No, but you can if you want to. If you want to go into private practice, it helps to have a niche, but when you start school many people will declare themselves strict whatever-whatevers, and that will either stay the same or their approach becomes more eclectic if they realize one approach doesn't work for everything.

Are there any pitfalls that baby therapists often fall into?
Impatience. The academic content of grad school was frightfully easy and simplistic for me. I learned most about the importance of patience.
Once graduated, the other pitfall is believing that you're not good enough yet. It makes me sad when I see intern (not yet independently licensed) counselors with websites that say things like "my rates are so low because I'm not yet adequate in the eyes of the licensing board." Yeesh. Yes, self-awareness is important, but clients do benefit from believing that you might actually have some training and expertise.

How long should one study for before one can competently practice?
This depends on your jurisdiction and licensing bodies. In Oregon, USA, for Licensed Professional counselors it's 3 years of school and 300-ish supervised student intern client contact hours before you can operate semi-independently. We have to be supervised until we reach 2400 client contact hours, which, if you're in private practice requires paying a supervisor for 2-3 hours per month of supervision. This takes most of us about 3 years.

How soon, once you are able to practice, can you make a living from doing so?
My practice was full in about 12 months. At 18 months I stopped drawing anything from savings and haven't since. I make good money. Some folks I know who needed to make more money sooner started out charging less than I did and thus made more money sooner but earn less now.
posted by MonsieurBon at 8:42 PM on September 14 [1 favorite]

If you are a therapist/counsellor can you give me any advice or tips on starting out?
It's faster to become an LMFT (licensed marriage and family therapist) in the United States or an MSW anywhere else than it is to become an R. Psych. In Canada, Master's in Counselling Psychology programs have recently flourished, including a couple of dodgy online ones. Personally if I were looking for a therapist I would screen out anyone who had less than two years of training as a reasonable source of therapy and avoid RCCs like the plague. LMFT programs seem common in institutions with Christian influences. Social work education has more of a social justice flavour and you will learn about people within systems and how people are impacted by policy. There are lots of other things you can do with an MSW besides therapy, including community development, policy analysis, research, or child welfare or hospital social work. In Canada it is less important to become an LCSW (licensed clinical social worker) in order to have a private practice because that designation is just gaining ground here. Not sure about the UK/elsewhere though. It is enough to have an MSW and be an RSW (registered social worker).

Do you have to specialise in a particular method, and if so, how soon?

The funny thing about the particular methods is that most of them don't have their own certification structures. So when you feel competent in say, CBT, you can call yourself a therapist who does CBT, assuming you have some other credential like an R. Psych or MSW. These will mostly be learned outside of school. There are more and less reputable places to learn these things, that range from checking some books out of the library, to doing an online course, to going to a reputable school to do an online course (the Beck Institute for CBT is where I did mine) to in-person classes for some modalities. You university degrees may include some as well. In some cases you do not need a graduate degree or licensure to take these courses, so it is useful to do them before or during graduate school. It gave me a real boost when I graduated to have them done already. You can charge more and will have an easier time building a practice if you are very good at something in particular.

Are there any pitfalls that baby therapists often fall into?
Contrary to what a previous poster said, I would suggest not going right into private practice after an MSW. Hospital social work, in particular is a good training ground for learning about the practical sides of mental health, grief, life, death, and families - things that a good therapist is comfortable with. Hospital social work will teach you to work with these things in such a diversity of permutations and circumstances that even if you have had colourful life experience, one person's life experience could never really come near what you might see in a hospital. Alternately, working in community mental health is similar. I supervise new social workers, and I think it's important for them to have had a year or two of hands on experience in these sort of human condition type issues before they can sit with anyone and go particularly deep.

How long should one study for before one can competently practice?
Just please don't get a one year, online master's degree in counselling psych with an undergrad in something unrelated.
posted by unstrungharp at 9:25 PM on September 14 [1 favorite]

there are no unlicensed therapists in the US

Not true. I am one, because I am in the process of getting my license, which requires 1500 hours of supervised counseling, which I am getting currently.(plus a Master's Degree in Counseling Psychology and internship, which I have already completed.) I work for a community mental health agency with several other unlicensed therapists. This is not an internship- I already completed my internship in grad school, and am now an employee of the agency.

In PA, MSWs have a licensing exam after grad school, so they can call themselves licensed (LSW). I have a Masters in Counseling Psychology, and can only become licensed as an LPC after completing the Master's Degree plus 3,000 hours of work, and an exam. This is analogous to the LCSW license. However, both Master's Degrees are similar. This might be part of the confusion on the licensing question.

In PA where I am, and in most states, you are required to work as a therapist under supervision before obtaining your license. Therefore, yes, there are many people working as therapists who do not have their license, in the U.S. In fact, you are required to.

Directly to OP- I think your best bet to find out about requirements is to look into graduate programs in Counseling Psychology or Social Work in your area and get a lot of your questions answered there because they vary state-to-state.

I have been working as a therapist at an agency for about a year. As an pre-licensed therapist, the jobs open to you are mostly in community mental health, which are the most difficult and lowest paid. I am working as a fee-for-service therapist. It's very interesting and can be rewarding, pay right now is not sustainable and the job can be very stressful. Most other fee-for-service therapists I work with have other sources of income and are not relying totally on the income from the job. I am struggling financially. Once I get my license, more opportunities will open up, but I wish I had been more prepared for this period right now.
posted by bearette at 6:52 AM on September 15

I have thoughts on the other questions too, but no time right now. I will try to return later to answer, and also, feel free to PM me, OP.
posted by bearette at 7:01 AM on September 15

[Note: OP contacted us to update that they are in located in the UK.]
posted by taz (staff) at 4:02 AM on September 16

Given your update on the location you can pretty much disregard advice as to specific degrees etc. as this does not apply here (source - I am at beginning stages of counselling training) but there is some excellent advice on process and approach which will apply regardless of location.

In terms of training in the UK - and please forgive my assumption that you mean you are based in England, the other nations will have different training routes, your options are as follows:

- vocational route via a college/local training provider, will take about 3 years. You start with an intro Level 2 course (GSCE I think equivalent), Level 3 (A-level equivalent) - you can do Level 2 and 3 in about a year. Then Level 4 which will take 2 years and will involve 100 hours practice with actual clients in a placement setting, under supervision. By the end of Level 4 you can register with a professional body and get indemnity insurance etc. to allow you to practice either privately or within agency setting. Actual jobs are very few and far between and there is a massive issue of oversupply. Also, it's possible that in the next couple of years this vocational route will become redundant if there are changes to how counselling is regulated in the UK (which it is not at the moment)

- degree route - can be a foundation degree, can be a masters degree - you have to be extremely careful to read the small print and make sure that if you go down the degree route you will get the required placement hours that will be approved by the relevant membership body - BACP for counselling, UKCP for psychotherapy. The psychotherapy route will usually be a 4 year part time masters degree and 450 placement hours.

- doctoral level route to become a counselling psychologist - requires an undergraduate degree in psychology or a conversion masters, followed by 3-4 year doctorate. This route will open doors to NHS posts that are open to clinical psychologists as well

Feel free to memail me - as I said, I am at the early stages of career change myself. But in a nutshell, you are looking at 3+ years of training.
posted by coffee_monster at 6:36 AM on September 16

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