NP or Clinical Psychologist?!?! HELP!!

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I' know this is long, but I REALLY need some help.

Oh my, I have never gone back and forth on any decision in my life like I am on this one. I just cannot make a decision. I'd really appreciate any advice as I present my pros and cons of each field. I am currently a junior in a psychology major. My plan is to either apply to clinical psychology programs or to do a one year accelerated BSN and in a few years, become a nurse practitioner.

I am not particularly resilent to stress- but, psychology and nursing both have stress, the stress is just a different type. In nursing, the stress is physical stress and mental stress from being overworked in an intense, busy situation. In psychology, I feel the stress is more quiet and lonely, the stress of having to listen to people's issues day in and day out, sometimes not being able to solve their problems or bounce issues off other clinicians. In psychology there is the opportunity to do research and to write books and journal articles and to teach, all of which I like- but there are also opportunities to teach and probably some for research and writing in nursing too. In addition, my dream has always been to have a low cost clinic in an underserved area and providing medical care for those who really need it, especially women and childrens health, because I believe medicine is a right and not a privilige (sp?). I am passionate about helping people, extremely so. I am interested in mental health, partially because of my own mental health problems and those of my family and partially because I am a psych major with a lot of background in that field. Still, I am not sure if the mental health field is a good fit for me, and I feel like in nursing I could go through rotations and see what areas I click with. I also worry about being able to fund a PhD and not have a steady income, as I don't have parents who are putting me through school. I like the fact that I can take some time to be a nurse and learn about the field and make some money, and then go back and probably even work part time while I become an NP. I would also like to go back and get a DNP or PhD so that I can do some teaching, too. I am interested a great deal in both fields, and just SO torn...I really need some help with your experiences, ideas, and opinions about my situation.

Thank you!

Lindsay

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I know the feeling of indecision. Do you have to make the decision now? Maybe you can work for a year or two while you continue to research your options. And maybe you can get a job that helps to clarify the direction you'd like to head. With your current background, you should be qualified for a variety of positions where you might be able to interact with psychologists and/or nurses and be able to find out more while earning a paycheck and building your resume. Maybe neither one of these stands out to you as preferable because maybe neither really feel right. It's hard to know what direction to go when one has never been there before!!

About nursing school rotations - generally, there are rotations working with nurses in a variety of hospital units. You'd work with inpatients dealing with liver disease, kidney disease, heart disease, diabetes, knee or hip replacements, different kinds of cancer, traumatic injuries and more. You would learn about their conditions and treatments and do physical assessments, administer and educate about their medications, monitor for and respond to changes in status, and document. While nurses should always consider the psychological needs of their patients, they have many competing demands and the immediate physical health of their patients (patients who are essentially competing for the nurse's time and attention) take priority.

If you trained to become a psychologist, you'd also have rotations of sorts as well, wouldn't you? That is, opportunities to work with different populations and issues.

Take a step back and know that whatever you choose will teach you more about yourself and make the next step clearer.

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I have a good friend who is now in a PhD clinical psychology program. You really need to research these programs - she doesn't have to pay for hers. Instead they give her a $14,000 stipend a year - but she has to TA some courses. She has told me that for a PhD in clinical psych you shouldn't have to pay for the program. She has also been in the program for 5 years now and has 2 years or so left - she's exhausted all the time, and sometimes she regrets it, but other times she loves it. You really need to do some soul searching and research both avenues. Perhaps you should shadow both NP and a Clinical Psychologist. There's nothing wrong with taking a year off after college to think it through too - my friend did that. She worked in a psychiatry research department in a hospital and that clinched it for her that she wanted to pursue clinical psych. Good luck with your decision - I completely understand where you are coming from.

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Specializes in cardiology, oncology, telephone triage.

you definitely don't want to ignore the fact that nurses can find a job just about anywhere they want. my boyfriend is finishing up his PhD in counseling psychology and has to move to where the jobs are.... I, on the other hand, can find a job anywhere I want. From what he says.... our salaries are pretty close and I'm an RN, not a NP!

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It's true about more nursing opportunities. However, that's generally in regard to hospital work and LTC. Other nursing roles aren't as widely available and have low turnover. I thought nursing would be practical given all the opportunities, but it turns out I HATE acute care nursing. Volunteering and being a part-time CNA didn't make that clear to me. Now, I'd rather take a pay cut (and I do) because in addition to simply preferring non-clinical work, the current stresses in many acute care settings (understaffing!) is just too much for me. I'm glad that nursing does offer so much to so many, though and I admire those who thrive in acute care!

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Thank you all for your replies.

Last week I met with an advisor from the nursing department I would plan to go to and from the psychology department. I also discussed my career options with friends and family, and it seemed that they gave me a unanimous decision that I should go into counseling because I am a "talker" and not a "doer" (to some extent, quite true about me). Although I do realize that in nursing, I would make as much if not more money in far less time, I must say that for me it is about happiness in my job and aptitude as well. I am still not ruling out nursing- psychiatric NP is a growing field and something I could look into- but so far it seems that I am better suited for behavioral health, despite my reservations about it. I am actually bipolar, mildy so, and it took many years for me to find the resources in the mental health community to get on my feet. Sometimes this makes me feel as though I do not want to be in the psychology field. I am also disappointed in the lack of science/neurology that is studied in PhD programs. However, nursing is also stressful, and for me, it would involve learning a whole new set of constructs- because I'm already very far in a psychology major. I am still actively debating, but I am learning towards psychology. I've also thought about getting an MSW from a good university, rather than a PhD in psychology, but I am not sure of the breadth of those programs.

Thanks for all the advice!

Lindsay

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Lindsay- the MSW might not be a bad route at all for you. This is only two years at the max post bachelors. Frankly the MSW and Ph.D/Psy.D. in Clinical Psychology are very close in terms of duties and scope of practice.

There really is an oversupply of Ph.D.s in Psych. I do believe there will be more and more openings for psych NPs especially in the geriatric area.

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First off, I wanted to say that this is a *great* board, and I'm glad I stumbled across it (it came highly recommended from a member of a board i frequent). I've learned a good deal about the different specialties and areas, and hope more people who are looking to learn about the field stumble upon it.

Lindsay- the MSW might not be a bad route at all for you. This is only two years at the max post bachelors. Frankly the MSW and Ph.D/Psy.D. in Clinical Psychology are very close in terms of duties and scope of practice.

I just wanted to correct this statement. I liken the difference between an MSW and a clinical doc to be apples and a fruit salad. Both contain fruit, but there is little else that is the same after that. It is correct that both do some form of therapy, but the models/opportunities/scope are very different. MSW's are a great asset in the MHC, and they can do great work. They tend to do more 'applied' work, deal with pt life changes, etc. They can work in both public and private sectors, whether it be direct client contact or more administratively. There are numerous job opportunities....albeit not in the salary range of an RN/NP, etc.

A doctorally trained clinician has therapy as one part of what they can do, but their primary distinction are in the areas of clinical psych/neuro /behavioral/etc assessment, research, and they typically deal with more severe pathologies. They also can be professors, do private consulting (forensic, nuero, hospital, etc), and so on.

There really is an oversupply of Ph.D.s in Psych. I do believe there will be more and more openings for psych NPs especially in the geriatric area.

Last year Money Magazine wrote an article about the 50 Best Jobs In America, and psychologist came in at #10 (with professor being #2, another option for a doctorally trained clinician) The money range they gave was a bit low, though a good/bad thing about clinical psychology is the range of salary. There has also been a shift in job opportunities. For instance, clinicians tend to be in supervisory roles at community mental health centers, and not primary therapists. Academia/Research may or may not pay as well...but it can offer great security and allow you to mentor the future generations. Private practice can hit $100k+ (especially in met. areas...where it can be $150k+), though this is very dependent on the individual and their abilities to build a strong private practice. People who don't want to put in the time can still make a nice living, but it will be for less $.

Clinical psychology allows people to diversity and work in a number of different areas. There are many jobs geared towards 30-35hr/wk, which allows for a private practice, side assessments, consulting, etc. Much like nursing, specialty areas pay they best. Nueropsychologists, forensic consultants, and prescribing psychologists can all easily make $150k+....though post docs are typically required for these opportunities (usually 2 or more additional years).

The bottom line is clinical psychologists have greater flexibility and financial gain, but the training is significantly longer, and is typically much harder to get into.

-t

ps. I am admittedly biased towards clinical psych bc that is my training.

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Perhaps I should have noted that the MSW with the "R" designation is,in my opinion, more akin to the role of clinical psychologist. The MSW-R has many years of supervised clinical experience and certainly provides psychotherapy.

The nice thing,I think, about the psychiatric nurse practitioner role is that the NPP can prescribe as well as do therapy.

Indeed, as Therapist4change indicated, the doctorate in clinical psychology is a long route. It took me a good seven years! I had considered pursuing the psych NP as well since I am also an RN.

Frankly, I liked the depth of the doctorate in clinical psychology. But just look at the want-ads in the American Psychological Association to see how few are listed... also in your newspaper,etc. I am gainfully employed as I am an old gal with years and years of experience. But I do know that newer grads are having difficulty . So I guess this is where the prior poster and I might disagree.

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The MSW-R has many years of supervised clinical experience and certainly provides psychotherapy.

I've never heard of that degree, do you have any more info on it?

But just look at the want-ads in the American Psychological Association to see how few are listed... also in your newspaper,etc. I am gainfully employed as I am an old gal with years and years of experience. But I do know that newer grads are having difficulty . So I guess this is where the prior poster and I might disagree.

I think this is where people can get in trouble if they don't specialize. I think there are plenty of opportunities for people who gain proper training. For people who just want to hang a shingle as a generalist.....that will be harder, because you'll be competing against MSWs (who will charge less), insurance companies who will try to squeeze you on reimbursements (though cash only can be very $), etc.

-t

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The MSW gets the "R" designation after years of clinical supervision. It is not a separate degree per se. For example, it is typically the MSW-R who gets third party reimbursement for services. For example, just go to your own state's online license verification. Then look up someone you know who does therapy as an MSW and gets third party reimbursement. Then, you will see by the designation that there is an R at the end of the MSW licensure.

Interestingly re specialization-I specialize in treatment of patients with Parkinsons and Multiple Sclerosis but I get a zillion calls for adolescents with severe issues and I do not even advertise as such. I do not feel qualified to see adolescents, so I refer them elsewhere.

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The MSW gets the "R" designation after years of clinical supervision. It is not a separate degree per se. For example, it is typically the MSW-R who gets third party reimbursement for services. For example, just go to your own state's online license verification. Then look up someone you know who does therapy as an MSW and gets third party reimbursement. Then, you will see by the designation that there is an R at the end of the MSW licensure.

Interestingly re specialization-I specialize in treatment of patients with Parkinsons and Multiple Sclerosis but I get a zillion calls for adolescents with severe issues and I do not even advertise as such. I do not feel qualified to see adolescents, so I refer them elsewhere.

Is this specific to a state, or is this across the US (I'm assuming you are state-side)?

That is an odd referral to get, considering your background. Is there a shortage of providers for adolescents? Many people avoid certain populations, and I know adolescents aren't the easiest to work with (I happen to enjoy working with them).

-t

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