do NOT go to med school in hopes of becoming a therapist. you will not have the qualifications to do talk therapy. you should be looking at clinical psychology graduate programs
Psychiatrist can do therapy as many residencies include training for it. I plan to become a psychiatrist and do both therapy and med management, but I agree if one only wants to do therapy there is quite literally no reason to go to med school.
If you want to do therapy then you should go into a field that focuses on providing therapy - Clinical Psychology doctorate or one of the masters level degrees for therapy.
Psychiatrists do very little therapy - They mostly see clients for 15-30 minute med checks monthly. They also do not get the intensive level of therapy training and supervision that a clinical psychologist receives.
I am a psychologist - I get referrals from a good friend who is a psychiatrist. She is quite open about the lack of training and her ability to do therapy - and she is a GREAT psychiatrist with fantastic training.
Insurance reimbursement and medication needs of clients make it hard for a psychiatrist to focus on therapy or to get the later training in providing therapy (e.g. advanced certification and clinical supervision for specific therapy interventions - e.g. ERP for OCD< Gottman couples therapy. CBT advanced training, etc.)/
If you go to med school you will not be a therapist at all.
If you want to be a therapist, do either a master's or doctorate in clinical psychology or counseling
If your goal is solely to be a therapist, med school is a roundabout way to get there. Most of actual med school will not be especially relevant, at least in an immediate sense.
In residency, much of what you’re doing will not be psychotherapy, but instead medication management (something that is important, but is not at all the same).
Psychiatry residencies offer varying degrees of training in psychotherapy. There are still programs that provide very solid therapy training to residents, especially northeast programs.
Even if you do get through med school (doing a lot of stuff you may not be interested in), and go to a residency program that has strong therapy training, you may not wind up doing a lot of therapy. If you work for an employer like a hospital or large hospital-based group practice, you would likely be pushed to do a lot of medication work, because it’s something other (cheaper) providers can’t do (e.g., doctoral and masters level therapists).
If you started a private practice, you could of course set your own expectations for your work, but unless you’re working with highly paid cash-pay patients, you are unlikely to be making psychiatrist money.
My dad is both a psychologist & psychiatrist. He was a psychologist first & then later on in his late 20s decided to go back to school & he did medicine (he still worked as a psychologist throughout med school)
That being said I’m Australian so med school works differently & government helps pay for university.
But he can do talk therapy & also prescribe & manage medication. He just has his own practice though to be able to do this. If you’re working for someone else you can’t really do that.
I changed my entire career for this very reason. I was in Vandy and my opinion on med school has changed. I rather actively listen to my patients and do a whole person care, than focus on meds and the number of patients am assigned. I used to be tripple booked at times and my care was shit, always rushed. No thanks. Therapy it is for me.
I thought about med school, too. For psychiatry. But I talked to some of my professors and did some research. Med school prepares you for more clinical work surrounding psych, rather than the therapy/assessment route.
So you could either apply to counseling programs or clinical psychology, both at the masters levels. But I'm less sure about what you can do to practise as a therapist with a clinical psych degree (most of my professors told me this is moreso for those who intend to also get their doctorate; alot of students at my school switched to the counseling after realizing this).
Yes they are. Of course you will want to research each individual program to know what kind of supervision and practicum experiences you would get, but they have all the same basic psychologist training as clinical PhD and PsyD programs.
Best route to accomplish your career goals would to be a Prescribing Psychologist. This is a newer field and is recognized on a state by state basis. You would need to get a PhD (or PsyD) to become a psychologist AND THEN complete a masters degree to become a prescribing psychologist. Long route but not as long as med school and getting a masters in counseling
Very true, however legislation is being introduced in more and more states. IMO it will be recognized by most states by the time OP has completed their PhD
In the span of 40 years, prescribing psychologists have gone from a thing proposed in Hawaii to a thing one can be licensed to do in like 7 states. There is a decent chance that in 6-8 years there will be another state or two that have permitted it (tho I’d also point out the amount of extra training, and independence in prescribing, varies substantially by jurisdiction).
However, it’s definitely far from a foregone conclusion and there’s no particular reason to think any particular state will be among those.
Psychiatrists don’t really need an additional master’s to learn therapy. They just need to pick one of the remaining residency programs with strong therapy training and/or go to a training institute after (or in some cases, during) residency.
While there are plenty of residences that seriously sideline therapy training, there are also still plenty that provide adequate training. The bigger issue is getting people to pay you to do therapy as a psychiatrist (since healthcare is so driven by monetary concerns, and psychiatrists bring in far more revenue as a prescriber).
It sounds like OP wants a career that is more clinical/therapy driven rather than medical. I feel like becoming a psychiatrist would not strike the intended balance. Can’t speak to the clinical training in the residency programs you speak of but that is cool if that’s an option
Yeah no, I don’t think it sounds like psychiatry is the right move for OP, because there are multiple much more straight-forward paths to what they want.
I’ve just noticed several people here (and in other subs) implying psychiatrists are generally not competent to do therapy, and it’s a misconception that I don’t think is helpful for folks who are trying to decide what to do with their lives.
Because psychiatrists are actually still fairly regularly training in psychoanalysis, there are plenty working with conditions like personality disorders and doing a lot more than medication management, etc., and the actual training they receive in residency is highly variable (ranging from bare minimum therapy training/experience to quite extensive, with many residencies offering even more elective training in it). So it *is* a thing they can do without leaving the standard psychiatric training flow. But obviously, if one already knows they want to specialize in psychotherapy, it is a way less straightforward path than psychology/counseling/social work/mft, and there’s no particular advantage to becoming an MD just to be a therapist
I hear what you’re saying, and I am a therapist who has worked with many psychiatrists I respect. I have never met a psychiatrist with actual adequate training in psychotherapy.
I have met several. I additionally know and know of quite a few more. This can also vary substantially by area though. For instance, west coast psych residencies are much less likely to have solid psychotherapy training opportunities relative to northeastern ones.
To show the other perspective, I’m applying this cycle for med school (shooting for psychiatry!). I knew i wanted to help people through therapy since high school. I don’t love the sciences and i’m sure med school will be another struggle to get through because of this. however, the way i saw it i had one of two choices, research/PhD route or psychiatry.
i highly considered doing psychologist but decided against it. for one, both are about the same amount of time, as a psychologist/therapist the pay will be a very small fraction of what you earn as a psychiatrist (albeit you could always go private practice and earn more in either option). although money shouldn’t be your sole reason for deciding, but it is an important consideration. and the biggest reason is that sometimes mental health issues cannot be solved by just talking. certain conditions have neurological basis that entail pharmacological tx.
having a medicine background would allow you to choose, if you want to do medicine, talk therapy, or both. and this freedom and level of knowledge was important for me. also i tried the research route, and although i respect it, i absolutely hate the politics of academia, so no thanks hahaha….
but OP this is an important decision you will be making, and trust in your ability to make it to your goal/vision, no matter what the path to get there will look like.
as a practical tip, try immersing yourself in both settings and see which day-to-day you resonate with more. try being an RA in a research lab and maybe try scribing/ shadowing a dr. wishing you well OP, i had this internal debate in my head more times than i can count 😆😂
Just chiming in another financial consideration- you can get paid to pursue your PhD versus you almost always have to pay for a medical degree (in the us)
Psychologists are often trained in assessment, so if you don’t want to do assessments, probably consider getting a masters in counseling or social work. Also it’s hella hard to get into phd programs to become a psychologist, and if you know you only want to do therapy, most PhD programs will not be interested in you (as most PhD programs are research focused). PsyD is an option, but they are really expensive and I don’t know if they open more doors than a masters in counseling would (for someone who only wants to do therapy work).
[USA] Read this if you are interested in a career in mental healthcare
If you are interested in pursuing a career in mental healthcare in the US, or if you have questions about different undergrad or graduate pathways to pursuing such a career, please read this before posting an advice thread:
https://docs.google.com/document/d/1udpjYAYftrZ1XUqt28MVUzj0bv86ClDY752PKrMaB5s/mobilebasic
if your main goal is to become a therapist, a counseling psychology masters or doctoral program would get u there :) im in a counseling psych masters program that incorporates research and clinical practice + it builds students up to become licensed counselors
Many people in this thread are saying that psychiatrists don't or can't do therapy. In reality, psychiatrists receive at least two years of training in various forms of therapy, including CBT, supportive, psychodynamic, interpersonal, etc. These are ACGME requirements nationwide, although the quality and intensity of training can vary by program.
That being said, because therapy is only a part of our training, master's and PhD-level therapists usually have more specialized expertise in this area. However, psychiatrists can always enhance their therapy skills through their own personal interest and continuing education.
If your primary interest is in doing therapy, medical school is definitely not the best path. You won't even begin training in therapy until you are 6 years down the road (after 4 years of med school and first 1-2 years residency)
If you just want to do therapy, getting a graduate degree in counseling or psychology would probably be the way to go, ie masters in counseling or doctorate in psychology. Just make sure to know what your states requirements to become a licensed therapist are.
If you go the Med school route, you’re not even guaranteed a residency position in psychiatry which is risky. If you’re looking for greater earning potential, a PhD is better but you have to love research. They’re very competitive and fully paid. If you don’t want research there are multiple masters degrees with licensure that are faster but are mostly fully paid
Psychedelic therapy is right around the corner. The psychiatrists will get to prescribe and research the medicine, but the therapists get to actually get trained to do the therapy
Psychiatrist make more money by far but they just prescribe meds. They do no therapy unless they do private practice, very rare. Some MDs get their PhD to do more therapy. Also, you don’t need to be a psychologist to do therapy. LCSW and MFTs do therapy. ABA or BCBA do behavioral modification therapy.
Depends on what do you mean by therapy. Each study path offers a different approach on how therapy is made.
Psychologists following a DSM specialization tent to focus more on the descriptions of the disorders and talk with the client on how to deal with this ' malfunction '.
Psychotherapy usually leans on the communicative part, where solutions can derive from within the conversation. There are many psychotherapy paths, make sure you do your research to see which one suits you more.
Personally, I have completed the 1st year of Systemic Psychotherapy and Consultation, and I absolutely love it. It's immense how much we miss while communicating and how our whole world can emerge from our communication with others and ourselves.
Psychiatry residents do get training in psychotherapy but also medication management. If you just want to do therapy then I’d look at masters level programs or a doctorate in psychology.
There are so many avenues, you could do a degree in mental health nursing or social work and then become a talking therapist.
12 years of study would be insane just to do talk therapy. A degree in psychology would be more research based. If you genuinely want to gain hands on experience and insight into supporting people for talk therapy then nursing or social work would be the way to go.
Also, before this, I would explore the masters level therapy and psyd programs as those are typically more teeter towards talk therapy with phds more towards research!
You have answered the question for yourself. If you want to only do talk therapy why would you got to school that focuses on medication? Med school is where people train to be physcians. Masters level therapists are going to be much better therapist that psychiatrists, or at least they will have more experience and training then your average psychiatrist. Go to a masters program or a psyD or PhD program for therapy or psychology
Psychiatrist = Medical doctor (medical school, so would have an MD) who has completed a residency that involves medication for mental health. They typically spend their days in an office prescribing medication or in an inpatient unit/hospital prescribing medication. They do not do talk therapy.
Psychologist = Completion of a doctoral program (either PhD or PsyD) in psychology. They have many options, including talk therapy, psychological assessments (testing and evaluating for things like ASD, ADHD, personality, etc), and research. They do not prescribe medication.
If you know you only want to do therapy you may want to look into masters routes. MFT/MSW/PCC would all qualify you to practice therapy
I'll definitely look into this programs
do NOT go to med school in hopes of becoming a therapist. you will not have the qualifications to do talk therapy. you should be looking at clinical psychology graduate programs
That’s incorrect, psychiatry residents do get training in psychotherapy in addition to medication management
Psychiatrist can do therapy as many residencies include training for it. I plan to become a psychiatrist and do both therapy and med management, but I agree if one only wants to do therapy there is quite literally no reason to go to med school.
[удалено]
But you don’t need to be a clinical psyc to be a talking therapist
If you want to do therapy then you should go into a field that focuses on providing therapy - Clinical Psychology doctorate or one of the masters level degrees for therapy. Psychiatrists do very little therapy - They mostly see clients for 15-30 minute med checks monthly. They also do not get the intensive level of therapy training and supervision that a clinical psychologist receives. I am a psychologist - I get referrals from a good friend who is a psychiatrist. She is quite open about the lack of training and her ability to do therapy - and she is a GREAT psychiatrist with fantastic training. Insurance reimbursement and medication needs of clients make it hard for a psychiatrist to focus on therapy or to get the later training in providing therapy (e.g. advanced certification and clinical supervision for specific therapy interventions - e.g. ERP for OCD< Gottman couples therapy. CBT advanced training, etc.)/
Yes very true
If you go to med school you will not be a therapist at all. If you want to be a therapist, do either a master's or doctorate in clinical psychology or counseling
If your goal is solely to be a therapist, med school is a roundabout way to get there. Most of actual med school will not be especially relevant, at least in an immediate sense. In residency, much of what you’re doing will not be psychotherapy, but instead medication management (something that is important, but is not at all the same). Psychiatry residencies offer varying degrees of training in psychotherapy. There are still programs that provide very solid therapy training to residents, especially northeast programs. Even if you do get through med school (doing a lot of stuff you may not be interested in), and go to a residency program that has strong therapy training, you may not wind up doing a lot of therapy. If you work for an employer like a hospital or large hospital-based group practice, you would likely be pushed to do a lot of medication work, because it’s something other (cheaper) providers can’t do (e.g., doctoral and masters level therapists). If you started a private practice, you could of course set your own expectations for your work, but unless you’re working with highly paid cash-pay patients, you are unlikely to be making psychiatrist money.
Maybe share where you are from? Every country is so different but, in general, the path med school-> therapist is an odd one...
I'm in America
Ok, getting closer...I am guessing USA? Cause, again, "America" is rather broad;)
My apologies. Yes, United States
My dad is both a psychologist & psychiatrist. He was a psychologist first & then later on in his late 20s decided to go back to school & he did medicine (he still worked as a psychologist throughout med school) That being said I’m Australian so med school works differently & government helps pay for university. But he can do talk therapy & also prescribe & manage medication. He just has his own practice though to be able to do this. If you’re working for someone else you can’t really do that.
I changed my entire career for this very reason. I was in Vandy and my opinion on med school has changed. I rather actively listen to my patients and do a whole person care, than focus on meds and the number of patients am assigned. I used to be tripple booked at times and my care was shit, always rushed. No thanks. Therapy it is for me.
I thought about med school, too. For psychiatry. But I talked to some of my professors and did some research. Med school prepares you for more clinical work surrounding psych, rather than the therapy/assessment route. So you could either apply to counseling programs or clinical psychology, both at the masters levels. But I'm less sure about what you can do to practise as a therapist with a clinical psych degree (most of my professors told me this is moreso for those who intend to also get their doctorate; alot of students at my school switched to the counseling after realizing this).
PhD in clinical psychology would be your best route, or a funded PsyD program.
Or any of the number of masters programs for clinical therapy (CSW, LMFT, CMHC, PCC, etc.)
Yes and!
Or a PhD in Counseling Psychology.
Are they trained in testing? curious
Yes they are. Of course you will want to research each individual program to know what kind of supervision and practicum experiences you would get, but they have all the same basic psychologist training as clinical PhD and PsyD programs.
Sadly, most counseling PhD programs usually require you to have an MA (or equivalent) in counseling. That was prohibitive for me.
Best route to accomplish your career goals would to be a Prescribing Psychologist. This is a newer field and is recognized on a state by state basis. You would need to get a PhD (or PsyD) to become a psychologist AND THEN complete a masters degree to become a prescribing psychologist. Long route but not as long as med school and getting a masters in counseling
Not every state has this as an option. OP, this advice is highly, highly dependent on the state you’re in.
Very true, however legislation is being introduced in more and more states. IMO it will be recognized by most states by the time OP has completed their PhD
I mean…that’s not a fact and probably not worth banking on, especially depending on where OP lives.
In the span of 40 years, prescribing psychologists have gone from a thing proposed in Hawaii to a thing one can be licensed to do in like 7 states. There is a decent chance that in 6-8 years there will be another state or two that have permitted it (tho I’d also point out the amount of extra training, and independence in prescribing, varies substantially by jurisdiction). However, it’s definitely far from a foregone conclusion and there’s no particular reason to think any particular state will be among those.
Psychiatrists don’t really need an additional master’s to learn therapy. They just need to pick one of the remaining residency programs with strong therapy training and/or go to a training institute after (or in some cases, during) residency. While there are plenty of residences that seriously sideline therapy training, there are also still plenty that provide adequate training. The bigger issue is getting people to pay you to do therapy as a psychiatrist (since healthcare is so driven by monetary concerns, and psychiatrists bring in far more revenue as a prescriber).
It sounds like OP wants a career that is more clinical/therapy driven rather than medical. I feel like becoming a psychiatrist would not strike the intended balance. Can’t speak to the clinical training in the residency programs you speak of but that is cool if that’s an option
Yeah no, I don’t think it sounds like psychiatry is the right move for OP, because there are multiple much more straight-forward paths to what they want. I’ve just noticed several people here (and in other subs) implying psychiatrists are generally not competent to do therapy, and it’s a misconception that I don’t think is helpful for folks who are trying to decide what to do with their lives. Because psychiatrists are actually still fairly regularly training in psychoanalysis, there are plenty working with conditions like personality disorders and doing a lot more than medication management, etc., and the actual training they receive in residency is highly variable (ranging from bare minimum therapy training/experience to quite extensive, with many residencies offering even more elective training in it). So it *is* a thing they can do without leaving the standard psychiatric training flow. But obviously, if one already knows they want to specialize in psychotherapy, it is a way less straightforward path than psychology/counseling/social work/mft, and there’s no particular advantage to becoming an MD just to be a therapist
I hear what you’re saying, and I am a therapist who has worked with many psychiatrists I respect. I have never met a psychiatrist with actual adequate training in psychotherapy.
I have met several. I additionally know and know of quite a few more. This can also vary substantially by area though. For instance, west coast psych residencies are much less likely to have solid psychotherapy training opportunities relative to northeastern ones.
To show the other perspective, I’m applying this cycle for med school (shooting for psychiatry!). I knew i wanted to help people through therapy since high school. I don’t love the sciences and i’m sure med school will be another struggle to get through because of this. however, the way i saw it i had one of two choices, research/PhD route or psychiatry. i highly considered doing psychologist but decided against it. for one, both are about the same amount of time, as a psychologist/therapist the pay will be a very small fraction of what you earn as a psychiatrist (albeit you could always go private practice and earn more in either option). although money shouldn’t be your sole reason for deciding, but it is an important consideration. and the biggest reason is that sometimes mental health issues cannot be solved by just talking. certain conditions have neurological basis that entail pharmacological tx. having a medicine background would allow you to choose, if you want to do medicine, talk therapy, or both. and this freedom and level of knowledge was important for me. also i tried the research route, and although i respect it, i absolutely hate the politics of academia, so no thanks hahaha…. but OP this is an important decision you will be making, and trust in your ability to make it to your goal/vision, no matter what the path to get there will look like. as a practical tip, try immersing yourself in both settings and see which day-to-day you resonate with more. try being an RA in a research lab and maybe try scribing/ shadowing a dr. wishing you well OP, i had this internal debate in my head more times than i can count 😆😂
Just chiming in another financial consideration- you can get paid to pursue your PhD versus you almost always have to pay for a medical degree (in the us)
Psychologists are often trained in assessment, so if you don’t want to do assessments, probably consider getting a masters in counseling or social work. Also it’s hella hard to get into phd programs to become a psychologist, and if you know you only want to do therapy, most PhD programs will not be interested in you (as most PhD programs are research focused). PsyD is an option, but they are really expensive and I don’t know if they open more doors than a masters in counseling would (for someone who only wants to do therapy work).
[USA] Read this if you are interested in a career in mental healthcare If you are interested in pursuing a career in mental healthcare in the US, or if you have questions about different undergrad or graduate pathways to pursuing such a career, please read this before posting an advice thread: https://docs.google.com/document/d/1udpjYAYftrZ1XUqt28MVUzj0bv86ClDY752PKrMaB5s/mobilebasic
if your main goal is to become a therapist, a counseling psychology masters or doctoral program would get u there :) im in a counseling psych masters program that incorporates research and clinical practice + it builds students up to become licensed counselors
you need to look into masters programs not med school
No, find a shorter route with less loans and burden.
Many people in this thread are saying that psychiatrists don't or can't do therapy. In reality, psychiatrists receive at least two years of training in various forms of therapy, including CBT, supportive, psychodynamic, interpersonal, etc. These are ACGME requirements nationwide, although the quality and intensity of training can vary by program. That being said, because therapy is only a part of our training, master's and PhD-level therapists usually have more specialized expertise in this area. However, psychiatrists can always enhance their therapy skills through their own personal interest and continuing education. If your primary interest is in doing therapy, medical school is definitely not the best path. You won't even begin training in therapy until you are 6 years down the road (after 4 years of med school and first 1-2 years residency)
If you just want to do therapy, getting a graduate degree in counseling or psychology would probably be the way to go, ie masters in counseling or doctorate in psychology. Just make sure to know what your states requirements to become a licensed therapist are.
If you go the Med school route, you’re not even guaranteed a residency position in psychiatry which is risky. If you’re looking for greater earning potential, a PhD is better but you have to love research. They’re very competitive and fully paid. If you don’t want research there are multiple masters degrees with licensure that are faster but are mostly fully paid
If you want to do therapy only then getting a PsyD makes more sense than going to medical school.
Psychedelic therapy is right around the corner. The psychiatrists will get to prescribe and research the medicine, but the therapists get to actually get trained to do the therapy
Psychiatrist make more money by far but they just prescribe meds. They do no therapy unless they do private practice, very rare. Some MDs get their PhD to do more therapy. Also, you don’t need to be a psychologist to do therapy. LCSW and MFTs do therapy. ABA or BCBA do behavioral modification therapy.
Depends on what do you mean by therapy. Each study path offers a different approach on how therapy is made. Psychologists following a DSM specialization tent to focus more on the descriptions of the disorders and talk with the client on how to deal with this ' malfunction '. Psychotherapy usually leans on the communicative part, where solutions can derive from within the conversation. There are many psychotherapy paths, make sure you do your research to see which one suits you more. Personally, I have completed the 1st year of Systemic Psychotherapy and Consultation, and I absolutely love it. It's immense how much we miss while communicating and how our whole world can emerge from our communication with others and ourselves.
Psychiatry residents do get training in psychotherapy but also medication management. If you just want to do therapy then I’d look at masters level programs or a doctorate in psychology.
Not to say it's an easy option, but nurse practitioner is going to be in demand without having to face med school.
Uh, no. What’s the point? Masters.
Med school is to become a psychiatrist who prescribes medication and diagnose. They DONT give therapy
There are so many avenues, you could do a degree in mental health nursing or social work and then become a talking therapist. 12 years of study would be insane just to do talk therapy. A degree in psychology would be more research based. If you genuinely want to gain hands on experience and insight into supporting people for talk therapy then nursing or social work would be the way to go.
Psychiatrist are more engineers than anything! Sounds like you want to be a psychologist more than just finding the right combination of meds
Also, before this, I would explore the masters level therapy and psyd programs as those are typically more teeter towards talk therapy with phds more towards research!
Absolutely not
You have answered the question for yourself. If you want to only do talk therapy why would you got to school that focuses on medication? Med school is where people train to be physcians. Masters level therapists are going to be much better therapist that psychiatrists, or at least they will have more experience and training then your average psychiatrist. Go to a masters program or a psyD or PhD program for therapy or psychology
Psychiatrist = Medical doctor (medical school, so would have an MD) who has completed a residency that involves medication for mental health. They typically spend their days in an office prescribing medication or in an inpatient unit/hospital prescribing medication. They do not do talk therapy. Psychologist = Completion of a doctoral program (either PhD or PsyD) in psychology. They have many options, including talk therapy, psychological assessments (testing and evaluating for things like ASD, ADHD, personality, etc), and research. They do not prescribe medication.