Job Outlook in Clinical Psychology (not private practice)... questionable?

[carlyhylton]

I have a question/discussion topic that I have wanted to post here for a long time but have held off on posting it because I know that we are in the middle of application season and that everyone's time is probably completely dedicated to applications and everyones posts here are seeming to revolve around that... 

(I can't imagine how stressful it must be...)

 

However I've decided to post it anyways.

 

I was talking to a friend of my boyfriend who is just finishing her PhD in Clinical Psychology. 

The discussion I had with her quite frankly summed up to this.... in her words "clinical psychology is dying".

What she meant by this was that- in her experience, and in the experiences relayed to her by colleagues, current clinicians and people in the field in general- the role of clinical psychologists is increasingly being filled by 1) psychiatrists doing increasing diagnosis and psychotherapy and 2) counsellors typically with masters level training who aren't necessarily psychologists (e.g. social workers, even occupational therapists, etc) doing psychotherapy. We were specifically discussing clinical psychologists who aren't in private practice. She indicated that she and a lot of her colleagues would end up having to go into private practice, which is obviously quite a bit different than working in a hospital setting, for example. I have been hearing about this shift toward private practice though out my undergraduate degree but, again, she said that the role of the clinical psychologist was dying outside of private practice, whereas I thought that it would still be at least possible to pursue a career as a clinical psychologist in a psychiatric hospital (I'm personally not as interested in working in private practice and want to help people within the context of a public, psychiatric hospital).

 

I recently started an RAship at a psychiatric hospital in Toronto (CAMH) and have noticed the same trend within the programs that I have been able to be involved in.

 

Another interesting point that she brought up was the ability to pursue the career path she would eventually be forced upon with only a masters degree (of course this varies by regional regulations... the situation in Ontario is quite interesting... licensing only differs in educational requirements but different levels of licensure (i.e. psychological associate or registered psychologist) do not differ in what they are allowed to do and their scope of practice... but I will not go into a discussion of this)

 

A couple of important things to note before I move onto my questions... 

Again, I am referring to the role of clinical psychologists outside of private practice.

I live in Toronto, Canada. The friend of my boyfriend is from Toronto, Canada and is finishing her PhD in Toronto, Canada. I know that this anecdotal trend may vary by region. For example, in Alberta (my home province), you can be registered as a psychologist at the masters level. A clinical psychologist who I am working with in my RAship who also happens to have lived in Alberta for a while said that more psychologists were employed in their traditional roles in Alberta than in Ontario, were we both are now.

Less anecdotal data show that there is relatively a good outlook in clinical psychology (e.g. http://www.bls.gov/ooh/Life-Physical-and-Social-Science/Psychologists.htm, http://www.workingincanada.gc.ca/report-eng.do;jsessionid=04323DD3216845FF51BF5FCA8A824B94.imnav5?area=9219&lang=eng&noc=4151&action=final&s=2&source=6)

However the APA seems to acknowledge the stiff competition presented my masters level counsellors to PhDs in Clinical Psychology (or even other areas) (http://www.apa.org/gradpsych/2011/03/cover-sunny.aspx)

 

So... clinical psychology graduate students, applicants, future applicants, and anyone else who cares to reply...

My questions are as follows...

 

• What is your experience with the job outlook in your region? All answers would be helpful but Canadian answers would be great (and Ontario answers would be better and Toronto answers would be wonderful!)
• How do you go about gathering job outlook information that will shape your decisions before you are on the job market or perhaps even apply? Is information from the government sufficient or too generalized?
• If we assume the outlook is poor, and you know you want to serve what I am calling the 'traditional (non private practice) clinical psychologists role', what would you do? Look for a region where you can fulfil this role with clinical psychology training? Get training in another field to fill this role (e.g. psychiatry, social work, etc)?...

Sorry for the long winded post (as you might imagine I'm quite invested in this... to say the least...)

 

Thank you so much for any responses!!!!!

 

(Sorry in advance for any typos or phrasing errors!)

Edited November 26, 2013 by carlyhylton

[nugget]

Spoken by a friend who recently graduated from such a program and now lives in Ontario.... The full time, permanent, well-paying job with benefits for recently graduated clinical psychologists at hospitals is rare. Most of that kind of work for new people in the field is contractual now (often renewable once a year, pending availability of funding).

 

Get into the field if you love it. But when you consider the number of years of schooling required (at least 7 years of grad school), plus an extra year of post doc training in Ontario, the fact that you may possibly need to take a few extra courses after the PhD (it's important to choose courses wisely as a PhD student to avoid this - I know someone who needs to take 5 extra courses for licencing), followed by three comprehensive exams for licencing.... you need to consider the time, money and effort involved to complete the process and if it is still worth it to you. Do you have a back up plan in case you aren't able to find your dream job right away after graduation, such as private practice or something else?

 

Those are a lot of things to consider when you make this big decision. I wish you the best of luck! 

[PsychGirl1]

Honestly, I wouldn't do a PhD program unless you're at least somewhat interested in pursuing research as a career (whether that's part-time or full-time). Also, within my field specifically, there are still these hospital-type positions- but within our psych specialty, not as a general practitioner position. I'd start with what sort of job specifically you want to get, and then work backwards to figure out what degree/experiences you need, whether that's a master's, an MD, or a PhD.

[carlyhylton]

jenste thank you so much for your response! That is very helpful.

The fact that the rare positions in clinical psychology at hospitals are contractual scares me.

I think what I would want to do is work in a psychiatric hospital and do diagnosis, psychotherapy, and some research. As such, I think my back up plan would be research but I am told that these positions are also rare.

I don't think I would like going into private practice for a couple of reasons. First, I imagine that the patients or clientele would be quite different. I would assume that it would be more costly to be a patient at a private practice even if you have great health insurance. I truly believe that the services rendered my mental health professionals should be available to everyone in need. I don't like the idea of being in the 'business' of mental health. Also, I imagine private practice being less specialized whereas in a psychiatric hospital you might be able to work with more specific populations (e.g. mood, schizophrenia, etc).

Having said that these notions aren't really based in anyone's experience that has been relayed or any other more objective sources, so if anyone could comment on what the difference between private practice and working in a public setting would be that would be great!

I love the field but I am afraid that my aversion to private practice means that I should 'give up the dream' based on job outlook.

[carlyhylton]

PsychGirl1, as per my response above I am interested in doing research.

Based on my research experiences so far I think I would be more interested in doing research in a clinical setting than an academic one, along with clinical practice.

However I think that research positions, whether clinical or academic, are also rare, so I don't think I can really consider that as a backup.

 

PsychGirl1, can you clarify what you mean by clinical practice within your specialty? By this do you mean that you would be working with a specific population (i.e. mood, schizophrenia, etc)? Can you also comment on your location (you don't have to be too specific if you don't want to)?

 

I suppose this career path might be more feasible if I was open to moving around for perhaps another 5-10 years after graduation from PhD but I don't know if I really am open to that...

Perhaps this implies a lack of 'passion'... I don't know..

Edited November 26, 2013 by carlyhylton

[PsychGirl1]

I'm having trouble following your replies. Ignore what you think the outlook/situation/rarity/etc., and figure out what you want to do exactly- that's the first step. You can try asking people for informational interviews, shadowing people in different job positions, etc. In my opinion, you're better off taking a harder path that is what you want to do, than an easier path that is NOT what you want to do.

 

If you are interested more in research, there are AMC (academic medical center) psychologists, but I don't think that they do clinical work (people, feel free to correct me if I'm wrong), but I think they can do clinical research. I think there are also still a good number of positions where you do general diagnosis/psychotherapy/etc. in the VA system.

 

"I think what I would want to do is work in a psychiatric hospital and do diagnosis, psychotherapy, and some research."- to me, this sounds like you want to go the psychiatry route (yes, they can do psychotherapy, in fact they originally were the ones doing psychotherapy, but very few do based on insurance reimbursements- they make significantly more money handing out prescriptions than they do with psychotherapy). Since I'm research-focused, I know little about other clinical options, but you might want to look into the job descriptions of people with a master's of counseling, MSW, or even advanced psychiatric NPs.

 

"However I think that research positions, whether clinical or academic, are also rare, so I don't think I can really consider that as a backup."- Research positions are competitive, but not rare.

 

"PsychGirl1, can you clarify what you mean by clinical practice within your specialty? By this do you mean that you would be working with a specific population (i.e. mood, schizophrenia, etc)? Can you also comment on your location (you don't have to be too specific if you don't want to)?"- my field is eating disorders and obesity- I have seen a good number of people take on clinical/hospital positions within obesity clinics, clinics that perform gastric bypass surgeries, inpatient/outpatient ED clinics, etc.

 

Basically, you need to figure out: 1) what setting you're interested in doing, 2) what specific type of work you're interested in doing and % breakdown of your time; 3) what you're willing to sacrifice (or not) to get there. Then we can help you more.

[carlyhylton]

@PsychGirl1... 

Firstly, please specify where you are having trouble following my replies and I will clarify and avoid a similar lack of clarity when replying in future.

 

Secondly, I can't help but feel that I need to 'defend' myself here. 

I think that I have a pretty good idea about what I want to do, and have taken the right steps to evaluate this (e.g. informational interviewing, research assistantships, clinical experiences etc... having said that I will continue to do so in future). I have not elaborated on it here... my posts have already been quite lengthy and I think that elaborating about what I "want to do" in a response might be quite lengthy. Moreover, I think elaborating on my point of what I want to do might be tangential. I think that you are implying that I don't know what I want to do and have come misconceptions about what I want to do, and perhaps you are right. However, for the sake of this discussion please assume that I know what I want to do, unless you feel compelled to play career counsellor. 

 

My question was about the job outlook of clinical psychology and if these positions were becoming fewer in number (hence the "dying out" comment).

If positions are becoming fewer in number than I think it is very important to consider this and not to ignore the "job outlook/situation/rarity/etc". I think if this is the case this would have direct implications for "what I want to do". What I am definitely not willing to sacrifice is "what I want to do" if there are no positions.

 

Please again understand that I am talking about Toronto, Ontario and asking if this is similar in other regions. Consider that there might be regional differences.

 

A few clarifications/corrections on my earlier comments...

 

 

Based on my research experiences so far I think I would be more interested in doing research in a clinical setting than an academic one, along with clinical practice.

 

What I meant by doing research in a clinical setting rather than an academic one, along with clinical practice was that I am interested in a career as a clinician-scientist at a hospital. There are a lot of clinician-scientists in lots of areas in a lot of university-affiliated hospitals in Toronto and other cities in Canada. I'm not going to go into the concept because I think it is fairly straight forward but if you need further clarification and evidence I can provide it.

Im not sure if by academic medical centre you mean university-affiliated hospital, if it these are similar concepts. Obviously the terminology and practice surrounding this concept, like other things, differ between regions. 

 

 

 

However I think that research positions, whether clinical or academic, are also rare, so I don't think I can really consider that as a backup.

 

Thank you for making the distinction that research positions are not necessarily rare, but competitive. You are right.

Edited November 26, 2013 by carlyhylton

[carlyhylton]

To anyone who might be interested I posted this on SDN and received lots of helpful responses...

 

http://forums.studentdoctor.net/threads/job-outlook-in-clinical-psychology-not-private-practice-questionable.1043273/

 

Moreover, a poster there directed me to some threads on the same topic with literally pages and pages of helpful responses from clinicians, researchers, post docs, graduate students etc. Very helpful for anyone who is interested.

 

http://forums.studentdoctor.net/threads/accurate-sources-of-information-about-the-future-of-the-field.1040264/page-2

http://forums.studentdoctor.net/threads/where-do-we-fit.1029415/

http://forums.studentdoctor.net/threads/would-you-do-it-over-again.1021698/

 

Finally, although they are old, here are two articles on the topic for anyone who might be interested, one from the Journal of Clinical Psychology and one from Professional Psychology (not sure how good these journals are but nonetheless these are published articles)...

 

https://www.zotero.org/jeanbaptiste.combes/items/itemKey/UJ45N25X

http://link.springer.com/article/10.1023%2FA%3A1020782817079

Edited November 27, 2013 by carlyhylton

[nugget]

Are you interested in assessment? There are long wait lists for certain kinds of assessments and some people are willing to pay to get them done privately to get a quicker diagnosis. You can charge about $1,500 for an assessment that takes about 1.5 days of work to conduct an interview, calculate scores and write up a report (time will vary a bit depending on the type of assessment you do, of course).

 

This sort of work could tide you over after you complete your studies, until you get your first big break in the job market, if it's of interest to you. Even if you do one assessment a week, you'd still have a liveable salary.

 

I'd also consider whether or not you are willing to move after completing your studies, as this could change your situation and job prospects substantially. Perhaps there is more work available in rural areas, as is the case with MD's. This might be something worth looking into. 

 

jenste thank you so much for your response! That is very helpful.

The fact that the rare positions in clinical psychology at hospitals are contractual scares me.

I think what I would want to do is work in a psychiatric hospital and do diagnosis, psychotherapy, and some research. As such, I think my back up plan would be research but I am told that these positions are also rare.

I don't think I would like going into private practice for a couple of reasons. First, I imagine that the patients or clientele would be quite different. I would assume that it would be more costly to be a patient at a private practice even if you have great health insurance. I truly believe that the services rendered my mental health professionals should be available to everyone in need. I don't like the idea of being in the 'business' of mental health. Also, I imagine private practice being less specialized whereas in a psychiatric hospital you might be able to work with more specific populations (e.g. mood, schizophrenia, etc).

Having said that these notions aren't really based in anyone's experience that has been relayed or any other more objective sources, so if anyone could comment on what the difference between private practice and working in a public setting would be that would be great!

I love the field but I am afraid that my aversion to private practice means that I should 'give up the dream' based on job outlook.

Edited November 27, 2013 by jenste

[PsychGirl1]

@PsychGirl1... 

Firstly, please specify where you are having trouble following my replies and I will clarify and avoid a similar lack of clarity when replying in future.

 

Secondly, I can't help but feel that I need to 'defend' myself here. 

I think that I have a pretty good idea about what I want to do, and have taken the right steps to evaluate this (e.g. informational interviewing, research assistantships, clinical experiences etc... having said that I will continue to do so in future). I have not elaborated on it here... my posts have already been quite lengthy and I think that elaborating about what I "want to do" in a response might be quite lengthy. Moreover, I think elaborating on my point of what I want to do might be tangential. I think that you are implying that I don't know what I want to do and have come misconceptions about what I want to do, and perhaps you are right. However, for the sake of this discussion please assume that I know what I want to do, unless you feel compelled to play career counsellor. 

 

My question was about the job outlook of clinical psychology and if these positions were becoming fewer in number (hence the "dying out" comment).

If positions are becoming fewer in number than I think it is very important to consider this and not to ignore the "job outlook/situation/rarity/etc". I think if this is the case this would have direct implications for "what I want to do". What I am definitely not willing to sacrifice is "what I want to do" if there are no positions.

 

Please again understand that I am talking about Toronto, Ontario and asking if this is similar in other regions. Consider that there might be regional differences.

 

A few clarifications/corrections on my earlier comments...

 

 

What I meant by doing research in a clinical setting rather than an academic one, along with clinical practice was that I am interested in a career as a clinician-scientist at a hospital. There are a lot of clinician-scientists in lots of areas in a lot of university-affiliated hospitals in Toronto and other cities in Canada. I'm not going to go into the concept because I think it is fairly straight forward but if you need further clarification and evidence I can provide it.

Im not sure if by academic medical centre you mean university-affiliated hospital, if it these are similar concepts. Obviously the terminology and practice surrounding this concept, like other things, differ between regions. 

 

 

Thank you for making the distinction that research positions are not necessarily rare, but competitive. You are right.

 

Yeah... I was trying to be helpful, no idea why you felt you had to respond that way.

 

My point was that "clinical psychology" is a very large and broad field, that encompasses many different jobs that varies by setting, roles, funding sources, specialties, day-to-day tasks, etc. To ask about the job outlook in Clinical Psychology is a very broad question, and my response would be that certain areas/settings (and also in certain subfields) are expanding, others are looking poorly, and others are a mix depending on what you are willing to sacrifice or how you want to construct your time (for example, I know many people who work part-time in specialty clinics and then part-time in separate but related research settings, and this has seemed to be a very successful approach for those who do not want to go into academia). I was trying to get a sense of what exactly you are looking for so that we could help you out with your question. Especially since other related areas (such as social workers and psychiatrists) increasingly cover various aspects of the world of "clinical psychology" and depending on what you want to do and where, may have better "job outlooks" for the future than a "clinical psychology" degree, yet with a similar/identical job description.

 

Won't be checking this thread again. I'm glad you found your answers.

[carlyhylton]

jeneste thank you for your response.

I would be interested in assessment, but can you be more clear about "the certain types of assessments" that people chose to have done privately?

 

Again I'm kind of iffy on the notion of private practice but this is all good to know.

 

Also, I think you are right that I need to consider how flexible I am geographically and if there might be more jobs in rural areas (which I could theoretically even commute to).

Thank you again!

[PsychGirl1]

Also, thanks for the SDN shout-out for my "particularly unhelpful responses".

[carlyhylton]

PsychGirl1 or anyone else who reads this, as PsychGirl1 apparently will not be.

 

I am sorry if I offended you in my response.

I realize that that does not make for good discussions on forums like these. I do sincerely apologize.

 

I simply felt that you were implying that I was more naive than you could possibly know, and so I did certainly get defensive.

More importantly I felt that the conversation would be better off if directed back to the subject of my original post (job outlook in clinical psychology in hospital settings). My intention was to (firmly) direct the topic back to that topic.

 

While I knew that my response was defensive I did not intend it to offend you to the point of your reply to my post. Please know that was not by intention.

 

Thank you for your response. It is helpful to note that clinical psychology is broad. I thought that I got to this point in my posts but I obviously did not make this clear enough.

 

Sorry to any others who might have found my reply offensive.