Social Work vs. Psychology: Choosing

[tobia_e]

Hi all,
I hope you don't mind me posting here--you parents seem to give great advice, so I figured it was worth it to ask. I'm a college sophomore and double major (actually, a double degree) in Psychology (BA) and Social Work (BSW) with an anticipated minor in Biology. I had different career plans coming into college, but they didn't pan out for a variety of reasons. I know it's a tad early in the process to begin looking ahead to graduate school, but I like to plan, so...

I'm involved in a biomedical lab (actually vaguely psychology-related as we work with serotonin receptors) and a psychology lab ([almost] all qualitative, so totally different) as well as some other on-campus origanizations. I applied for government internships for the summer but won't know if I get any "bites" until late spring until early summer. I'm also doing volunteer work at an agency for people with brian injuries and worked at a physical therapy clinic last semester but don't have any any real clinical experience (I'll apply to work at the school's sexual assault hotline next year, but there are no gurantees). I did an internship in high school working at the local branch of United Way and decided that that type of micro work isn't for me. I want to work with people or groups.

I'm currently deciding between pursuing an MSW or a clinical psychology PhD/PsyD after graduation. I want to work in rural-ish areas in the West/NW--I live in a pretty rural state (~60,000 people qualifies our university city as the second biggest one in the state!), and the psychology research I'm doing deals a lot with Native Americans. I'm pretty sure I don't want to do the academia thing, though I do enjoy research greatly (in both my labs).

Things I find applying about the MSW option includes the smaller time commitment (1 year if entertaining with a BSW), the verasitility of the degree in terms of how you can use it, and the likely wider range of program options (more programs and generally much less competitive than clinical psych!). The concerns I have about this option are finances (generally, MSWs are unfunded, but seeing as I am scholarship here, I should, Gd-willing, have enough money saved up to cover most of the most costs), the general trend out of burn out in many social workers (one wonders why this does not seem to be a problem in clinical psych...?), the fear of being typecast into policy/macro work (just not for me), lack of research, the lack of assessment training/ability, and the fact my general conceptualization of cases tends to fall more to the "medical model" side of things, though I'm starting to see that that isn't necessarily at odds with social work per se.

Things I find appealing about clinical psych include the extensive training in clinical work, therapy, AND research, the fact that most programs are fully funded, the use of more of a medical model perspective, and the burgening possibility of limited perscription rights. Things that worry me include the huge time commitment (I have a friend at the tail end of her program, and seeing the sheer amount of work she has had to complete [masters thesis, coursework, field placement, internship apps, internship, dissertation approval, dissertation process, dissertation writing, dissertation defense, teaching, etc, etc.] concerns me... not because I mind work but...), the EXTREME competitiveness of these programs (generally ranging from 3%-10% or 15%), the cost if one is not funded (in most cases, these wouldn't be good schools to go to anyway, though), the relative lack ofversatility, worry about the degree's usefulness in rural markets, etc.

So, as you can see, I've thought a lot about the relative pros and cons, but I'm still stuck. The PhD/PsyD appeals to me with the sheer depth of clinical, assesment, and research training, the funding, and the psychopathology focus, but unnerves me with the time commitment, possible money commitment, and narrow scope of practice. I love the MSW's versatility, relatively low time commitment, and broad scope of practice (I'm the strange person that doesn't mind filling out paperwork! ) but am heistrant about being forced into a policy/macro position instead of a clinical/micro/mezzo one, lack of assesssment training, and lack of research training.

Thoughts? Advice? Any info on burnout or lackthereof in clinical psychology?

Thanks!

[dufay]

Just one to make one comment, as I see my stepD go through this decision making- BIG difference between $ with PhD vs PsyD programs. PhD programs generally have funding/stipends- PsyD programs are $$$. Of course, there are other differences in research, dissertation planning etc. too, but financial constraints are a big one.

[rap_mom]

I'm replying as a middle-aged PhD psychologist. Note that I work in academia, so I have a somewhat biased perspective. I don't see tremendous "burnout" among psychologists, but many are in private practice. Similarly, the social workers who have private practices don't seem to burn-out too much either. As a private therapist, you can ramp up or ramp down your volume, and ensure that you maintain peer supervision for support. It is my impression that social worker burnout is less related to burnout due to working with patients than with frustration in dealing with unresponsive social service systems, but perhaps social workers reading this thread have a different view.

You note that you are more "medical model" oriented. It strikes me that, whether you choose to go the MSW or PHD route, it's important to find the specific program that meets your career goals and conceptualization of mental illness/health. Some PhD programs are likely to be a poor fit for you. Similarly, you should steer clear of MSW programs that are policy oriented.

[wedgedrive]

I am a MSW in private practice. I agree with rap_mom that burn-out is not so much an issue for social workers and psychologists in private practice. It occurs more frequently among practitioners in social service agencies, welfare departments, etc. I have loved my career (30 years). It has afforded me a great deal of opportunities and freedom. I have had the opportunity to ramp up or down depending on family/life circumstances. I have taught on a college level on occasion while maintaining my private practice, and have loved that. My specialties have gradually evolved, according to what I found interesting. While initially anxious about the responsibility, I have grown to love the freedom of being an independant practitioner. I have been surprised to discover that I now enjoy the business aspects of my career, and mentor other social workers in this.

That said, if I had to do it again, I would go for a doctorate in psychology, probably the Psy D. That program was not available when I was applying to graduate schools, and gaining admission to a clinical psych program was impossible at the height of the baby boom. Doctorate level psychologists receive better insurance reimbursement. Also, if you have any desire to teach at a college level in other than an adjunct capacity, a doctorate is a must. Having a college connection would aolow you to do research. Another option would be getting a doctorate in social work. I do not happen to know if there are DSW programs that specialize in clinical work.

Best wishes to you. The field needs good people whether MSW's, PsyD's, PhD's or DSW's!

[dudedad]

Have you considered an MPH? My wife has both an MSW and an MPH and the MPH has been more useful in her career.

[northeastmom]

dudedad, What can you do with a masters in public health?

[Runners2]

Either choice may be a good one - depending on what you most want to do. I wanted to point out though that I think you're mistaken to think that a Ph.D. or Psy.D. is not as versatile as a MSW. In fact one of the aspects of my career that I've enjoyed the most has been its diversity. I have a Ph.D. in psychology and have recreated my career over the years as my interests and family requirements shifted. I've worked in nonprofit agencies, in a medical hospital, on the faculty of a medical school, and now teach in a Psy.D. program. In the course of those positions my responsibilities have ranged from providing psychotherapy, psychological assessment, research, teaching medical students and graduate students to administration. There's not a bad choice here, but it might be worth taking some time out to work and really assess what you most want to do before taking the leap into graduate school.

[rap_mom]

Dudedad, An MPH is NOT useful for someone who is interested in doing clinical/therapy work. (I have both a PhD in Psychology and a masters in epidemiology, so I know quite a bit about an MPH). Depending on the subspecialization (epidemiology, environmental science, health administration, etc.), it allows one to work in a variety of public health settings. It is NOT mental health oriented. The combination of an MPH and MSW is a nice one for someone interested in mental health administration and/or policy, but this doesn't sound like it's what the OP was interested in.

[tobia_e]

Wow. Thank you for all the responses!

A few followup question/comments, if you don't mind:
Yes, I am interested in being mainly a clinician. I don't intend to work in private practice, at least not as a sole source of income simply for insurance reasons--I'm uninsurable by private insurance companies, so if not covered by a group policy, I would have to pay very high premiums for high deductable state "high risk pool" coverage, provided I live in a state that even has it (some do not). So, private practice is not really a a realistic outcome for me. Ideally, I would work to work in a community mental health center, college counseling center, psychiatric hospital, or possibly in a general hospital after graduation/post-degree licensure. I would also seriously consider working for the government (mainly VA) or through the IHS. I would even consider, though somewhat heistantly, working in a therapy position in a prison (A good friend of mine did a substantial amount of pre-internship coursework in our state prison and actually seemed to have a really good experience). So, generally, I'd like a study, salaried clinical job.

I've done some TAing as an undergraduate and liked it (did very well acoding to my supervising professor ), but I'm not as geographically flexible as one would probably need to be to be an academic (I'm not particularly tied down to a city or state, though I do have one strong preference, but I would like to stay in a general area of the country). From brief glances, there seems to be a decent number of social work adjunct positions, so I guess that could be a possibility if I wanted to do that part-time.

wedgemom,
If you don't mind me asking, why would you go for a PsyD and not an MSW if you had to "do it all over again"?

rap_mom,
Thank for you responding. If you don't mind me asking, why would some clinical programs not meet my views? I thought clinical psychology almost always orientated itself toward a psychopathology view of disiorders and treatment. Is this not the case?

Runners2,
What are your thoughts on your various positions? Any that you particularly liked or did not like?

Dudedad,
What kind of work does your wife do?

Again, thank you all for your responses; I really appreciate them! Feel free to ask any questions you may have if something I said isn't clear or to PM me if you'd prefer.

[Runners2]

tobia_e, I've really enjoyed all the positions I've had for a variety of reasons. As I suggested before, I have particularly enjoyed the flexibility I've had to arrange my professional life around my personal one. When my children were very little, I was engaged in a lot of clinical work which required some late afternoon/evening hours. That was fine when my kids were babies and preschoolers as my husband was available to handle childcare in the evening and I handled other times of day. Once they started to school, I didn't want to be at home during the day when they were at school and then have to see clients at night when they were home. Then an academic schedule worked better for me and I switched to teaching. The positions I've enjoyed the most have been those that allowed me to pursue multiple areas of interest within one job, e.g. clinical work, teaching, and research.

[rap_mom]

re my comment that some clinical programs might not meet your views: Perhaps I misspoke. It's probably true that all programs will present you with standard psychiatric nosology a la the DSM-IV (or whatever the latest classification bible for psychiatric disorders is numbered in its next incarnation). There may be variation among programs in the way these conditions are "explained" and in what treatment approaches are emphasized in training.

There seems to be a divide between programs that are oriented toward a classical, psychoanalytic or psychodynamic view and those that are more cognitive behavioral in approach. I don't know whether you have enough exposure yet to therapeutic schools to decide on what you prefer. If not, you might want to do a little homework (about both these approaches and about the schools to which you are considering applying).

[bookworm]

Have you looked into Masters programs that are geared towards school settings? Being a guidance counselor has always been available, but there are now programs aimed towards colleges, in preparation for becoming deans. You would be insured thru the school/college, be able to combine management skills with counseling, and have regular work hours. In addition, you would be able to relocate.

Relocation is a major drawback of psych/social work. You build up a local reputation and then have to begin anew. If you cross state lines, you often to need to take a state ethics exam to be licensed to work in that state.

[laris]

I have a PsyD in Clinical psychology and have worked in the field for 22 years. I am so grateful I completed my doctorate and it has provided me with a great career in hospital work, supervision, and private practice. Rather than looking at graduate school as long, you really need substantial training to feel confidence in your skills. I think the big disadvantage of the shorter MSW degree is that you feel thrown to the wolves after school, my colleagues who are MSW have supplemented their training post masters and function at a high level. I think the doctoral program provides a better apprenticeship period through 4-5years of supervision, coursework, externship and internships. Trust me, you need this time and training (and it's really fun).