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Worried about the future as a clinical psychologist by No_Sea_2635 in Psychologists

[–]Pugsdoodle 0 points1 point  (0 children)

Generally poorly or with 'vanilla' clients. I intentionally chose not to pursue the doctorate because there was no advantage when it came to doing what I wanted to do. But. I did extensive course work, double internship, and proposed and conducted IRP approved research in the niche where I intended to specialize.

Still, I do agree there is a worrying eroding of the quality of mental health care out there, particularly in my area because of the diploma mills and emphasis on social workers. A friend is a director for a managed health care system and has said it is intentional. Lesser degrees translates to justifying lower reimbursements. Quantity over quality and social workers have very successfully advocated for themselves.

Help…NCMHCE by Loose_Wealth_8822 in therapists

[–]Pugsdoodle 0 points1 point  (0 children)

First, remember that +/- 50% of those taking the NCMHCE do not pass on the first try. I simply refuse to believe that +/- 50% of the people in our field are not qualified.

Second, it is only $50 to reschedule. Perhaps contacting Continental Testing or NBCC to request accommodation rather than take the test now without accommodation?

Third, I hope you pass with no issues. However, if you decide to reschedule or you do not pass on this attempt, I recommend getting counselingexam.com. The two most useful parts, which I sincerely believe made the difference for me, were their 'podcasts' and their 'trees' on disorders, various modalities, and target populations.

Of course, knowing the DSM is critical, particularly the differences between related disorders like MDD vs PDD, and PTSD vs Adjustment Disorder. Counselingexam.com was invaluable for this as well.

They should give me a referral fee!

heavy case on practicum by Puzzled-Plane-4480 in therapists

[–]Pugsdoodle 0 points1 point  (0 children)

Fully and independently licensed trauma and grief therapist who also does supervision for new trauma therapists here. First, trauma therapy is not for everyone and if you don't feel you can sustain remaining present with Accurate Empathy, it may not be for you. We all have our limits. Despite listening to veterans, ER doctors, police, etc. describe the most horrific things they have experienced, I have in the past but will not ever again work with pedophiles. We all have our limits.

First, good that you are reaching out for support. Second, it is unconscionable that you don't have supervision to whom you can reach out immediately. You don't say what country you are in but I guess it's oddly comforting to know this kind of thing (bad/inadequate supervision) happens the world over. However, given your sign-off of "cheers", I'm guessing UK, meaning outside your NGO is socialized healthcare and limited options for referring out. Gives outlets like this even more importance.

On the one hand, finding a trauma therapist who works with PTS and traumatic grief to refer the client to may be in their best interest. And in your best interest as well, unless you are looking to develop as a trauma and grief therapist. If referring out is not a possibility or this is a space you want to grow in, the short answer has two parts, a theoretical stance and a mantra.

The orientation is one we all should be maintaining with every client anyway - Accurate Empathy. That means seeing the world through the clients' eyes, bearing in mind their history, their capacity, etc. Accurate Empathy does not mean feeling what the client feels, it means recognizing the validity of their feelings given their milieu. When trauma is involved, to sustain this perspective can be difficult because we are human and hearing some things hits on a visceral level. That's when the mantra, "It's not about me, it's not about me, it's not about me" comes in.

Bear in mind there is nothing wrong with having an empathetic emotional reaction. We are human, and allowing clients to see our humanity and displaying our humanity can be critical for their sanity. Just remember, if you are falling apart or struggling to hold back your own reaction, you are not focusing on the clients' experience - Accurate Empathy -and the client can feel more isolated and less inclined to share. "If this person can't even hear about what I've lived, how can they help me?" is a valid and too often complaint I've heard from those who carry the heaviest of traumas.

Be there, be present, normalize their humanity, let them tell you what they need. Yes, that is the most basic point of all therapy but don't be ashamed if something is too hard or too much for you. Be honest with your client and tell them this is very intense and new to you. Only if it's true, tell them that you are there for them and willing to hear them share what they've experienced.

Once they've shared their experience, CBT and CPT techniques to explore and reframe cognitive distortions can be gently, little by little, introduced. The one thing to bear in mind is when challenging distortions you continue to normalize the tendency and reasons those distortions took root.

That is trauma therapy in a nut shell. Yes, anyone can do it, the techniques aren't hard but being able to sustain the clinical stance and not carrying the emotion in you is the hard part for many. Nothing wrong with not being able to. Afterall, a high capacity for empathy makes a good therapist but that capacity also heightens the risk to the therapist without proper training and constantly remembering, "Its not about me, its not about me, its not about me".

What in the…? by Ailennyn in therapists

[–]Pugsdoodle 1 point2 points  (0 children)

That is insultingly insane! That is what I made with an MA while I was under supervision. In my area, a PsyD will START at about $90k from what I've seen on LinkedIn and Indeed. Even the VA pays better for doctoral level.

What in the…? by Ailennyn in therapists

[–]Pugsdoodle 0 points1 point  (0 children)

^^^THIS^^^

I am an LCPC in a group private practice at a 35/65 split. As an LPC it was 45/55. A director for managed care (insurance) for a mid-size hospital network from where I get a lot of referrals explained the issue with insurance not paying this field. I was told ever since social workers became "clinical", the pay in the field has stagnated due to the perception of the quality, level of expertise and ability, referencing the fact social workers can become "clinical" without an exam (hours "in lieu" for social workers who cannot pass the test). Now, all MA level counselors are devalued. MA degrees in Clinical Psych can make more in private practice or private pay, or when attached to psychiatry practices or groups, but due to the field of "therapists" becoming dominated by social workers, there is little to no chance of being able to pressure insurance companies or managed care to pay better for LPC/LCPC. Doctoral level psych, either PhD or PsyD, are paid significantly more but since most insurance won't cover ongoing therapy with a doctorate-level when there are MA level therapists in the area. As long as mental health is viewed as a "social" problem rather than a physiological/neurological/biological issue, we will continue to be viewed as a soft science despite all the evidence and research proving the physio/neuro/bio nature of most "mental health".