I posted about wanting to be a psychologist several months ago and was basically walked into pursuing a master’s degree in social work instead, as it is less work and would allow me to be a therapist, which is what I want to do.
Just a couple of days ago I had dinner with some friends, and one of them (the new one we were meeting for the first time) HAS a master’s in social work, and says it’s a useless degree that you can’t do anything with without lots of extra schooling. So now I’m confused.
My wife is the expert, but from what I have learned it will vary by state. Generally you have to be licensed by the state as a mental health specialist, chemical dependency counselor and so on. There is also a ‘clinical social worker’ license that requires more training.
Key to all of the licenses seems to be a several thousand hours with clients, several hundred of which must be supervised by a licensed clinical social worker. You can work as a therapist for an organization that provides the clinical supervision by another licensed therapist. Many of my wife’s team members work for several years before getting enough time for a license.
She says you can open a private practice without a license, but you must pay for a certain amount of supervision. Many insurance companies will not pay for a therapist who is not licensed.
My wife says to check on your state dept of health web site for the details.
There is a requirement in most states for ‘continuing education’ - a couple of seminars a year seems to do it for my wife. Usually her employer pays for that.
Every state is going to be different, but actually providing therapy (and almost certainly in a private practice) is generally going to require a license of some sort, not just a degree. Check with your state’s licensing authority - which can be anything from the education department to the health department to the department of consumer affairs. This will also let you know about other possible options- my daughter started out interested in a PsyD , but is instead beginning a master’s program which will qualify her for a license in mental health counseling .The "extra schooling " your friend is talking about is possibly a supervised practice requirement.
Licensed social workers can see patients in Massachusetts. In fact, most of the ones around that just do regular counsellings are licensed social workers rather than clinical psychologists or psychiatrists in Massachusetts. Licensed social workers can have a private practice or work in other settings like hospitals and do things like substance abuse counseling or marital counseling. Medical insurance companies cover their services in these roles as required by law. The laws are different in other states and some of them use psychologists rather than licensed social workers for most of those roles.
FWIW my MSW wife has a very busy private practice providing counseling. Yes she is a licensed clinical social worker (LCSW). And she both does a wide variety of continuing ed and even as a very experienced professional has regular sessions with other therapists in “group supervision.”
That said I also appreciate that it is not easy to develop such a practice. Jobs with organizations are generally low paying and not for profits have been dealing with significant cutbacks. And you do need to do your time in such a job in order to get your LCSW. as supervised work experience, continuing ed, and passing the state exam, are all required.
Within most MSW programs you can specialize - some specialize in becoming trained to become therapists, some as school social workers, some as case mangers in health care settings … and so on. You will get some very specific therapy training.
What everyone is telling you here is that there is no degree – not even an M.D. – that will let you walk out and do therapy. You need to be licensed, which for different degrees and different states has different requirements. They universally require supervised patient exposure, and the less education and patient exposure the degree involved, the more the license requires. An MSW is an excellent start, as are the MFCC and MFT (Master of Family and Child Counseling and Master of Family Therapy, respectively).
My mom is a registered nurse in Illinois, with over a dozen years of clinical work; she now works as a workers compensation drug review nurse for a large insurance company. When I was looking at local therapists, she explicitly told me to avoid anyone who listed ***LSW ***after their name. I asked why, and she said (I’m paraphrasing) because they’re “only” social workers, they have less schooling, and no ability to prescribe medication.
So I don’t know whether this is just a professional bias on her part, or whether there’s some truth to it, but my mom doesn’t think LSWs are qualified mental health professionals.
Well given that one of her items is the ability to prescribe medication, then she is specifically directing you to a psychiatrist (psychologists cannot prescribe medication in Illinois). I speak as an MD here - very few psychiatrists (MDs) are trained to do or have any interest in doing therapy. You go to a psychiatrist to get evaluated for medication or to have your meds re-evaluated, not for therapy.
The therapy part of psychiatry is being done in some places by licensed nurse practitioners. They must work under clinical supervision of a psychiatrist and can prescribe medication. The supervision seems to be consultive for the most part. So maybe that’s what rachellelogram’s mother recommends?
(I have some opinions about this too, but this is the fact board)
Well we’d need to ask her, but I doubt it. Truth be told I know of very few psychiatric NP doing therapy, and fewer still who would be on a list of local therapists list to select from. For kicks, go to The Psychology Today “Find a Therapist” page and type in your own zip. You’ll likely see no NP’s come up. PsyD’s, LCSWs, PhD, a variety of other counseling degrees , and of course the occasional MD, but very few NPs. I see them more marketed as physician extenders. The patient comes to see the MD and after the initial diagnosis and basic treatment plan visit is shunted for follow up visits to the NP. Nor is providing therapy a significant part of an NP’s training.
Most likely, as is the law in most states, not even a psychologist with a master’s degree (whatever initials appear after the name) can write a report on a patient without its being countersigned by a psychologist with a Ph.D. In fact, not even a Ph.D. psychologist can prescribe medication. Medication can be prescribed by only a medical doctor (M.D., D.O.), which means in the case of therapy a psychiatrist. [A doctor of optometry in SC can prescribe certain limited eyecare medications, and a dentist can also prescribe medication.)
SSA will accept as medical opinions evaluations by a psychologist, but the psychologist must have a doctorate degree to be so accepted. This is probably true for insurance companies, also, as they usually follow SSA’s practice on disability.
My experience actually using mental health services is that for ordinary counselling, there may be a limit on the number of sessions but aside from that the insurance company does not care if you see a MSW, MD, PhD or your cousin Bob, as long as they are licensed to provide counselling services in your state.
Much therapy/counselling does not involve medications, and many talk and behavioral therapists refer to psychiatrists if such is needed.
Most people who see a therapist on a short-term basis do not have any medically diagnosable pathology, nor do they have a disability, they just need a little help sorting out their shit. Think marriage counselling, “why do I always date assholes,” fear of flying, grief counselling, etc. (not to discount those that do have a medical condition – at all – just that it is not the only type of situation that benefits from counselling).