I have been frequently asked about what it takes to become a psychologist, psychiatrist, therapist or a clinical social worker. Many people are interested in becoming a therapist, or mental health professional. Ironically, there are not many places to find the answers. My goal is to shed some light on this and answer some of your questions.

In general, you must go to four years of college to get a B.A. or B.S. (Bachelor’s) degree. This is the general preparation for entry into professional graduate education which starts AFTER you have completed college. Many students will major in psychology or social work during their undergraduate four years of college. However, having a B.S. degree is not enough to work in the helping professions.One must go on to graduate school and obtain a graduate degree before one can be licensed to practice a profession. There are four basic graduate degree mental health professions.

Psychiatry

The first option is a career in psychiatry, which requires, after four years of college, four more years of medical school after which you will get the M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathic Medicine) degree. Then there is one year of general internship in general medicine. At this point the physician can now be a general practitioner. To be a psychiatrist the MD or DO must then go on for three more years of working in hospitals studying Psychiatry. If they want to be a child psychiatrist, they must study an additional fourth year (one more year) to specialize in child psychiatry. MD/DO’s are physicians and they can prescribe medications and hospitalize patients and tend to work more in hospitals and with more seriously disturbed patients. Their 8 years of college is mostly in science courses such as biology and chemistry. Only the last three years are in psychiatry.

Psychology

The next one is psychology. In addition to the four years of college one must take four to five more years of graduate study leading to the Ph.D. (Doctor of Philosophy) in psychology or the Psy.D. (Doctor of Psychology) degree. After the doctoral degree is obtained a one year internship and one year of Residency Post-Doctoral speciality training working with patients before they can be licensed must be completed. To be licensed as a Psychologist, one must have the doctors degree. All of college, and graduate school, education and training is spent in studying psychology and human behavior; courses also include classes in human physiology and pharmacology (medications) as it relates to behavior. You cannot get licensed with any other degree than the Ph.D. or Psy.D. Many people feel that they can practice with a B.S. college degree or a Master’s Degree. This will not work since psychologists must have a Doctor’s degree. Check out Careers in Psychology for more information.

Psychologists specialize in psychological diagnostic testing and assessment in addition to counseling and psychotherapy. They are the experts in psychological tests. Many specialize also in family therapy or Behavioral Medicine (the practice of working with patients who present with physical problems). The two main specializations are Clinical and Counseling Psychology. Clinical psychologists tend to focus more on scientific research as it relates to clinical issues. Counseling Psychologists tend to do most of the counseling and therapy with patients. They are known as the practitioners who provide the services.

To be a child psychologist, one must have the Ph.D. or Psy.D. degree and have advanced practical training after the doctorate in working with children. This training usually takes place in hospitals or clinics that provide speciality services to children. All of the mental health professionals have training in dealing with children and families as part of their regular training. Many specialize in Family Therapy feeling that one cannot help children apart from their families and the family environment. Child Psychologists generally just work with the child and refer the family to another professional.

Psychiatric Nursing

The next profession is the psychiatric nurse. This training is four years of college studying for the Bachelor of Science in Nursing (BSN) Degree and becoming an R.N., or Registered Nurse. After this is graduate school where the nurse completes a Master of Mental Health Nursing degree. Psychiatric nurse practitioners (PNP) can prescribe medicines. Like most types of Nurse Practitioners, they can work independently in their own offices. If a person has a Bachelor’s (four year) degree in another field, some NP programs will admit such an applicant to their 3 year NP Master’s degree program. The first year is in general clinical nursing after which they take the exam to become an RN. The next two years are devoted to the NP program of one’s choice–like a “Psychiatric Mental Health Nurse Practitioner” or a Family Nurse Practitioner, etc. Nurse practitoners do not have to do post Master’s degree supervision. Once they pass their licensing examinations to be an NP they can go directly into practice and see patients.

Clinical Social Work

Another mental health profession that not too many people know about is Clinical Social Work. It has in the past been known as Psychiatric Social Work. After the four years of college you must take two to three more years of graduate school to obtain the M.S.W. (Master of Social Work) degree. You then have to work under supervision of a Licensed Clinical Social Worker for two years (just like the psychologist), before being licensed as a Clinical Social Worker. You can go into private practice in counseling as a psychiatric or clinical social worker and insurance companies will reimburse you for your work just as if you are a psychologist. Many clinical social workers do specialize in working with children.

Clinical social work is different than regular (non-clinical) social work. It is not well understood that clinical social work is a graduate profession. They think it is related to welfare. It is not related to welfare, or caseworkers. Clinical Social Workers have excellent training as family and marital therapists, do psychotherapy, and are the major providers of mental health services in the country. The profession of professional social workers started in the early 1900’s and now are licensed in all 50 States. Some psychologists were first clinical social workers. Most clinical social workers do not get the doctors (D.S.W.) degree since all you need to practice is the Masters (M.S.W.) degree. The focus can be to combat the high divorce, child abuse, drug abuse, family problems.

Recommendations

If you want to become a therapist, my recommendation is to obtain the M.S.W. degree in clinical social work. Once you get this degree you can become licensed as a Licensed Clinical Social Worker (LCSW). The LCSW professional is able to bill insurance and to be in private practice of counseling and psychotherapy. If you want to ultimately get a Ph.D. in psychology, you can then later take part-time courses in counseling psychology (the practitioner’s degree program. Then when you get your Ph.D., you can still be in private practice as an LCSW, while having to serve the two years as a psychology intern and resident prior to taking your written and oral exams to be licensed as a psychology. Only clinical social workers can do this. However, the M.S.W. is a terminal degree. You do not have to have a doctoral degree to be in private practice. The M.S.W. degree is all you need to have a private practice, to get insurance coverage, and to offer therapy services. That is why I recommend the M.S.W. degree. The other degrees may sound better, but a degree in clinical social work is the only career that allows the professional to work independently at the Master’s degree level.

For a full list of schools offering degrees in clinical social work, check out the Council on Social Work Education.

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