Behavioral Mental Health Care Career Guide – P199, Dr. Patton Part 3. Decisions about License & Degree Program All licensed mental health care professionals – no matter whether they are generalists or specialists - have to earn a graduate academic degree and complete supervised clinical work experience in order to be licensed. A license is a "quality control" credential awarded by the state - it gives you legal authority to work. Some licenses allow you to work with supervision, others allow you to engage in independent diagnosis and treatment of mental and behavioral disorders. We encourage you to think about the career you want and how you can prepare for it by following these steps: 1. Learn about the types of licenses you could hold. LCSW, LMHC, LMFT, LP or HSPP 2. Explore how various licensed mental health care careers are similar to and different from each other. What are the similarities and differences in the careers of professionals who hold LCSW, LMFT, LMHC, and LP/HSPP licenses? 3. Learn about the types of graduate degrees you could complete to earn each license. MA? MS? MSW? PhD? PsyD? 4. Investigate which licenses and graduate degree programs will be a good fit for your specific career interests. You can read about career fields and subfields and talk with professionals who hold various licenses. If you want to provide therapy to children, it’s useful to know that practitioners with all 4 licenses listed above can work with any age group. If you’re specifically interested in Health Psychology or Neuropsychology, it helps to know that these are subfields of Clinical Psychology. You have to become a Licensed Psychologist (LP, HSPP) to practice Neuropsychology or Health Psychology. Over the next few months or years - so you can become really confident about your career & graduate school plans – you’re encouraged to explore the following questions: • Where do professionals with each type of license work and what roles do they play within their organization? Do they do research? Work one-on-one with clients? Teach? • Are professionals with some licenses in greater demand from organizations that employ them (such as behavioral health centers, hospitals, schools, and government agencies) than professionals who hold other licenses? • How diverse is the array of jobs you could hold with each license? If you wanted a change of pace after a few years in practice – could you work with different age groups, diagnoses, or therapies? • How long will it take you to earn your graduate academic degree? What types of classes would you take in graduate school? • How many hours of supervised clinical work experience are required during and/or after graduate school before you can sit for the licensing exam? • How “portable” is each license? You’ll take your licensing exam in a particular state and you’ll be licensed to practice in that state. Will you be simultaneously licensed in some other states? How easy/hard is it to get licensed in a second state? • What are the salary ranges for professionals holding different types of licenses? Are professionals with this license reimbursed by private insurance plans? Public insurance plans – like Medicare or Medicaid? • How do professionals with this license get training in the most effective evidence-based practices? Is it typically during or after graduate school? • What courses would I take in the graduate programs that lead to each type of license? Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 14 1. Licensed Clinical Social Worker (LCSW) License: The Licensed Clinical Social Worker typically has had 2-3 years of graduate training plus 2 years of clinical work experience and has completed a state-certified licensing examination. Career: Clinical Social Work is the application of social work theory and specialized clinical knowledge and methods to assess, diagnose, prevent and treat mental, emotional or behavioral disorders, conditions or addictions through the provision of individual, marital, couples, family or group counseling and psychotherapy of a non-medical nature for the purpose of improving, restoring or enhancing the social and/or psychosocial functioning of such individuals, couples, families or groups. Such services include, but are not necessarily limited to, the provision of individual, marital, couples, family or group counseling and psychotherapy services and the performance of related collateral contacts and record-keeping. Degree: MSW – MASTER OF SOCIAL WORK To be sure that you’ll be able to enroll in the courses necessary to sit for the LCSW license, you’ll need to look for MSW programs that provide concentrations in mental health assessment and treatment. For example, the IU School of Social Work MSW program does offer a concentration in mental health & addictions. 2. Licensed Mental Health Counselors (LMHC) License: The Licensed Mental Health Counselor typically has had 2-3 years of graduate training plus 2 years of clinical work experience and has completed a state-certified licensing examination. Career: Mental Health Counseling. The rendering of professional services to individuals, families or groups including: applying the principles, methods, and theories of counseling, human development, learning theory, group and family dynamics, the etiology of mental illness and dysfunctional behavior and psychotherapeutic techniques to define goals and develop a treatment plan of action aimed toward the prevention, treatment and resolution of mental and emotional dysfunction and intra or interpersonal disorders to all persons irrespective of diagnosis. The practice of mental health counseling includes, but is not limited to, assessment, diagnosis and treatment, counseling and psychotherapy, of a nonmedical nature of mental and emotional disorders, psycho-educational techniques aimed at prevention of such disorders, and consultation to individuals, couples, families, groups, organizations and communities. Associated Degrees: MA - MASTER OF ARTS IN COUNSELING PSYCHOLOGY MA - MASTER OF ARTS IN CLINICAL PSYCHOLOGY MS – MASTER OF SCIENCES IN PSYCHOLOGY ED.S. - EDUCATION SPECIALIST Master’s degree programs that can prepare you for LMHC licensure include a wide variety of specializations – counseling psychology, clinical psychology, substance use/addictions, rehabilitation psychology, art therapy, music therapy and more. While some Master’s degrees programs are sufficient to prepare for the LMHC license, some are not – you’ll have to read the descriptions of degree programs very carefully! For example: • The Master of Arts in Counseling Psychology at IUB can be followed by 4 additional courses from the Education Specialist – Mental Health degree program to prepare for LMHC licensure. • The Master of Arts in Mental Health Counseling at Valparaiso is a 60-credit program sufficient for licensing. • The Master of Science in Rehabilitation Psychology at IUPUI is not sufficient for licensure. Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 15 3. Licensed Marriage and Family Therapist (LMFT) License: The Licensed Marriage and Family Therapist typically has had 2-3 years of graduate training plus 2 years of clinical work experience and has completed a state-certified licensing examination. Career: Marriage and Family Therapists (MFTs) are mental health professionals trained in psychotherapy and family systems, and licensed to diagnose and treat mental and emotional disorders within the context of marriage, couples and family systems. They evaluate and treat mental and emotional disorders, other health and behavioral problems, and address a wide array of relationship issues within the context of the family system. Marriage and Family Therapists broaden the traditional emphasis on the individual to attend to the nature and role of individuals in primary relationship networks such as marriage and the family. MFTs take a holistic perspective to health care; they are concerned with the overall, long-term well-being of individuals and their families. A family's pattern of behavior influences the individual and therefore may need to be a part of the treatment plan. In marriage and family therapy, the unit of treatment isn't just the person - even if only a single person is interviewed - it is the set of relationships in which the person is embedded. Marriage and family therapists treat a wide range of serious clinical problems including: depression, marital problems, anxiety, individual psychological problems, and child-parent problems. Degree: MA OR PHD IN MARRIAGE & FAMILY THERAPY 4. Licensed Clinical, Counseling, or School Psychologist (LP / HSPP) Licenses: • LP or LCP. The Licensed Psychologist or Licensed Clinical Psychologist has had 4 years of graduate training plus 2 years of clinical work experience and has passed the Examination for Professional Practice of Psychology (EPPP). LPs practice under the supervision of an HSPP. • HSPP. The Health Service Provider in Psychology is an LP who has obtained an endorsement as HSPP and can engage in the independent diagnosis and treatment of mental and behavioral disorders. Careers: • Counseling psychologists help people recognize their strengths and resources to cope with their problems. Counseling psychologists do counseling/psychotherapy with individuals of all ages, families, and organizations (e.g., schools, hospitals, businesses) and sometimes teach. Counseling psychologists help promote psychological well-being and help people understand and take action on problems. • School psychologists help children and youth succeed academically, socially, behaviorally, and emotionally. They collaborate with educators, parents, and other professionals to create safe, healthy, and supportive learning environments that strengthen connections between home, school, and the community for all students. They conduct behavioral interventions when appropriate. • Clinical psychologists assess and treat mental, emotional, and behavioral disorders. These range from short-term crises, such as difficulties resulting from adolescent rebellion, to more severe, chronic conditions such as schizophrenia. Some clinical psychologists treat specific problems exclusively, such as phobias or clinical depression. Others focus on specific populations: youngsters, ethnic minority groups, gays and lesbians, and the elderly, for instance. They also consult with physicians on physical problems that have underlying psychological causes. o Health psychologists specialize in how biological, psychological, and social factors affect health and illness. o Clinical neuropsychology is a sub-field of psychology concerned with the applied science of brain-behavior relationships. Clinical neuropsychologists use this knowledge in the assessment, diagnosis, treatment, and or rehabilitation of patients across the lifespan with neurological, medical, neurodevelopmental and psychiatric conditions, as well as other cognitive and learning disorders. Assessment is primarily by way of neuropsychological tests, but also includes patient history, qualitative observation and may draw on findings from neuroimaging and other diagnostic medical procedures. Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 16 Compare Master’s Degree Programs – An Overview Compare Graduate Degree & Clinical Experience Requirements for LCSW, LMHC & LMFT Licenses “Becoming Licensed in Indiana” content retrieved on 10/27/2011 from Indiana Counseling Association ( http://www.indianacounseling.org/ ). Reformatted by Dr. Hoffman Licensed Clinical Social Worker (LCSW) Licensed Mental Health Counselor (LMHC) Licensed Marriage and Family Therapist (LMFT) General Requirements Has a master’s or doctor’s degree in social work from an approved institution…. General requirements Has a master’s or doctor’s degree in mental health counseling from an approved institution…. General requirements Has a master’s or doctor’s degree in marriage and family therapy or related area from an approved institution…. Educational Requirements Coursework Complete 24 semester hours of clinically oriented services courses containing: 1. Theory & research of human behavior 2. Theory & research of the social environment 3. Theory & research of practice methods Educational Requirements Coursework Complete graduate coursework including: 1. Human growth & development 2. Social & cultural foundations of counseling 3. Helping relationship, counseling theory & practice 4. Group dynamics, processes, counseling & consultation 5. Lifestyle & career development 6. Assessment & appraisal of individuals 7. Research & program evaluation 8. Professional orientation & ethics 9. Foundations of MHC 10. Contextual dimensions of MHC 11. Knowledge & skills for the practice of MHC & psychotherapy Educational Requirements Coursework Complete graduate coursework containing material in the following content areas: 1. Theoretical foundations of MFT 2. Major models of MFT 3. Individual development 4. Family development & family relationships 5. Clinical problems 6. Collaboration with other disciplines 7. Sexuality 8. Gender & sexual orientation 9. Issues of ethnicity, race, SES & culture 10. Therapy techniques 11. Behavioral research that focuses on the interpretation & application of research data as it applies to clinical practice Complete additional coursework in clinical social work and related areas, including: 1. Psychiatric social work 2. Medical social work 3. Social case work 4. Case management 5. Psychotherapy 6. Group therapy Clinical Experience Complete 1 year of clinical social work experience under the supervision of a LCSW Clinical Experience Not less than 1 supervised clinical practicum, internship or field experience in a counseling setting. It must include a minimum of 1000 clock hours consisting of 1. Practicum of 100 hours 2. Internship of 600 hours 3. Advanced internship of 300 hours 4. At least 100 hours of face to face supervision Post-Graduate Experience Complete 2 years of clinical social work experience under the supervision of a LCSW Post-Graduate Experience Complete over a 2-year period: 1. 3000 hours of clinical experience 2. 100 hours of face to face supervision from a LMHC Complete at least 2 semester hours in each of the following areas: 1. Legal, ethical & professional standards issues in MFT practice Clinical Experience At least 1 supervised clinical practicum, internship or field experience in a MFT counseling setting. It must include: 1. 500 face to face client contact hours 2. 100 hours of supervision from a LMFT 3. Direct service to unmarried couples, married couples, separating or divorcing couples & family groups Post-Graduate Experience At least 2 years clinical experience including: 1. 1000 hours of clinical experience 2. 200 hours of supervision from a LMFT (100 hours must be individual) Direct service to unmarried couples, married couples, separating or divorcing couples & family groups. Looking for licensing requirements to become a Licensed Psychologist (LP) or (HSPP) in Indiana? Check out the Indiana State Board of Psychology website: http://www.in.gov/pla/psych.htm Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 17 Compare Master’s Degree Programs – Compare the courses you’ll take… MA in Clinical Psychology Mental Health Counseling Track University of Indianapolis http://psych.uindy.edu/masters.php The MHC Track is suited for students who are interested in a career as a professional counselor and/or future study in a doctoral program. The curriculum includes foundational coursework in clinical psychology, the opportunity to apply knowledge and skills through a 1,000 hour practicum experience, and elective coursework. Completion of the MHC Track requires a minimum of 60 credit hours and results in students being eligible for state licensure in Indiana. A master's thesis is not required for degree completion. Students in the MHC Track may elect to enroll in the Child and Adolescent Concentration. Choosing this concentration requires completion of specific electives and three additional credit hours of coursework. Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 18 Masters in Counseling and Counselor Education Indiana University – Bloomington http://education.indiana.edu/graduate/programs/counseling/index.html You can help others live up to their full potential–personally, professionally, socially, and academically. The M.S. in Counseling and Counselor Education provides thorough preparation for a career as a professional counselor through a combination of course work, laboratory experiences, practica, and a two-semester internship in a relevant setting. School Track or Community Track coursework: Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 19 Indiana University -‐ Masters in Social Work Program Indianapolis http://socialwork.iu.edu/ Social work is a dynamic profession concerned with the changing needs of people and society. To respond to such needs, the faculty, students, members of the practice community, and others regularly review the curriculum of the School of Social Work. The MSW program consists of 60 credit hours of study and fieldwork. The first 15 credits are referred to as the Foundation curriculum. The second 15 credits serve as a bridge to concentrations and are called Intermediate courses. The third group of credits provides a Concentration of study in child welfare, school social work, mental health & addictions, health, families, and social work leadership. Although the school values knowledge gained from life experience, academic credit cannot be granted for non-academic activities. Advanced Course Sequence: Mental Health & Addictions Concentration Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 20 Pros and Cons of Various Types of Programs. Interview a variety of professionals for additional perspectives! Masters in Social Work - LCSW License • No matter what your career goal - social work (generalist), school social work, medical social work, or clinical social work you will have to take general social work classes (during your first year especially) and typically have to do a generalist social work practicum during the first of your 2 internships before graduation. • Someone with an LCSW license has the option of working in a wide variety of social work roles: mental health, school social work, medical social work, or generalist social work. • LCSWs can typically be reimbursed by private insurers, Medicare, and Medicaid. • If you want closely supervised training in EBP and EST to treat psychological disorders you will typically have to put significant effort into finding internship(s) with expert therapists who can train you in behavioral, cognitive-behavioral, and family systems therapies and/or seek additional training during or after graduate school and/or seek employment with an organization that will train you. (You might look at the MSW program @ Washington U in St. Louis as a positive example). M.S. Ed. & Ed.S. Counseling and Counselor Education - LMHC License • The program is focused on counseling from the start. Most counseling programs present a variety of theoretical approaches with about equal emphasis, but you can search for programs that give more time and attention to those approaches that have been demonstrated to be most effective by current research - behavioral, cognitive-behavioral, and family systems therapies. • Someone with an LMHC license is likely to work as a mental health counselor throughout their career – but can work in a variety of positions - in private practice, in mental health facilities, in schools, or medical facilities. • LMHCs can typically be reimbursed by private insurers and Medicare – but not (yet) Medicaid. • If you want closely supervised training in EBP and EST to treat psychological disorders you may have to put significant effort into finding internship(s) with expert therapists who can train you in behavioral, cognitive-behavioral, and family systems therapies and/or seek additional training during or after grad school and/or seek a job with an organization that will train you. Doctoral Programs in Counseling Psychology – PhD or PsyD • May be a best fit for people who want to teach counseling to graduate students or professionals or who want to do research. Some provide more in-depth training in counseling theories & practice than the masters in counseling. Is it worth getting a doctorate as compared to a masters? You’ll have to examine the list of additional courses & training opportunities offered. Masters in Clinical Psychology - LMHC License • The best programs are focused on training students to do clinical assessments and interventions throughout. They will provide a course to train you in foundational skills for psychotherapy; behavior therapies; cognitive-behavioral therapy; and offer electives in EST for special populations - such as CBT for children & adolescents. The best will teach evidence-based practice throughout and have at last one course in case conceptualization and treatment planning. Doctoral Programs in Clinical Psychology – PhD or PsyD • If you are intending to practice (assess and treat individuals) and you are considering PhD programs, then pay special attention to the 1-7 rating scale in the “Insider’s Guide to Clinical and Counseling Psychology”. A program that is “practice oriented” may be a better fit for you than a program that is strongly “research oriented”. Note, however, that if you do attend a program that is research oriented and the research is focused on developing better therapeutic interventions or on implementation research (how best to train therapists in EST) you may receive extensive, excellent clinical training so that you can deliver the intervention or train therapists. Also note: You can obtain significant funding for your education if you attend a research oriented graduate program and work as a research assistant or teaching assistant. • Will you be attending a research-oriented graduate program in preparation for a career as a psychological scientist or as a practitioner? READ: http://www.indiana.edu/~PSYUGRAD/gradschool.php • PsyD programs are all practice-oriented, they exist to train students to work with clients. • Investigate all doctoral programs thoroughly: • Carefully examine the curriculum of any/all doctoral program you’re considering. PhD programs are more likely to emphasize EBP than PsyD programs. PhD programs are more likely to give more time and attention to those approaches that have been demonstrated to be most effective by current research - behavioral, cognitive-behavioral, and family systems therapies. PsyD programs are more likely to have a primarily humanistic or psychodynamic theoretical orientation (and therefore offer courses on projective tests) and less likely to emphasize EST. PsyD programs vary widely – you might examine curricula and practica expectations for Loyola and Rutgers as good examples. • Look up the pass rate on the EPPP licensing exam for any type of doctoral program that you’re considering & ask for internship “match” rates. EPPP pass rates tend to be higher for PhD students than for “university-affiliated PsyD” graduates (Loyola, Rutgers, Baylor, University of Indianapolis…); which tend to be higher than for “free-standing PsyD” graduates (some schools of professional psychology.). The “Insider’s Guide…” recommends that you apply only to doctoral programs where 75% or more of the students pass the licensure exam. Prepared by Dr. Cynthia M. Patton, Last revised September 2, 2014 21
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