Anyone know about PMHNP to Psy.d/Ph.d? - page 2

by 91W

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I have three questions about PHMNP 1) How many more classes are usually required for FNP to become eligible to take the PMHNP exam as well. (there are zero pmhnp programs around where i live) 2) If you decide to pursue a... Read More


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    Thanks for the in depth reply, and yes I (was) a medical specialist. Just got out of the Army in Feb.
    Thank you for your sevice. I joined out of high school but unfortunately I had a bad ankle that caused me to be unable to pass the run (short by 17 seconds) and I was discharged after basic training. Oh well. I have the greatest respect for military service.

    How long were you in?

    the bad thing is about nursing in my area is it is a 3 year program and would start next fall, bringing my total time invested to about 5 years to get a BSN when i already have 80 credits(school uses about 60). I know that if I were to go the Psychology route I could complete the education around the same time if not a year earlier than the PMHNP.
    How old are you? If you are my age (30s) or older you may simply want to go the fastest route. If you are in your 20s I suggest going the way that would make you the happiest regardless of time.

    Maybe I do not understand the flexibility of a Psy.d and am somewhat afraid of uncertainties with residency. Finacially the nurse to PMHNP seems more secure and with a life goal to include a Psy.d it just seemed to be long but benificial
    If your life goal includes the Psy.D. you may want to pursue it, if that is really what you want would you be happy with something else? (That's one of the reasons I decided against the alternatives I've considered, including RN then PMHNP).

    As for the PMHNP being more secure, that isn't necessarily so. There is a nursing shortage so most MSNs will never have a problem with jobs. Depending upon your psychological specialty that may or may not be the case with psychologists. While I've never heard of any having to spend time in the unemployment line, the job search for many clinical or counseling psychologists may be longer and more frustrating, especially since some jobs will also consider LCSWs or LCPCs often for lower pay (I'm using MD terminology for licensed social workers and counselors). However, some areas of psychology are every bit as secure as nursing. If you take coursework in the right areas and an internship in the schools and get certified as a school psychologist you will never be unemployed unless you want to spend time without a job. School psychologists are part of the special education team and with special ed services being federally mandated these programs tend not to get cut, and often have increased budgets, even during the leanest times. Also, there is a current school psych shortage in addition to an increasing need for their services. The employment picture is quite rosy for psychologists who are qualified (either primarily or secondarily) as school psychologists. Depending upon the school district, some are paid on the teacher scale (OK, but not great) but some are paid on their own scale or the administators scale (it isn't unheard of for even MA level school psychologists to be looking at starting salaries over $50K). You can also tailor your clinical specialty (either your specialty such as geriatrics or child psych, or your primary mode of therapy like family therapy or cognitive therapy types) to take into account current trends and needs in the field.

    Flexibility of a Psy.D. is every bit as good as with a Ph.D. in practice areas. With a doctorate (whether Ed.D., Ph.D. or Psy.D.) in clinical, counseling, or school psychology you will be what the profession considers a "professional psychologist" (meaning you will be prepared for all practice areas) and along with your state license you will be educationally, ethically, and legally qualified to work in any practice based psychology setting. With school psych you may have some trouble landing a job in a hospital since they are run by medical staff and medical administrators who may not understand the different psychology designations, but you would be fine in other areas. With a clinical or counseling psych Psy.D. you shouldn't have trouble landing a job in a psychiatric hospital, med hospital, mental health clinic, university counseling center, group mental health practice (be it psychology only or multi-disciplinary), group health practice that includes mental health services, state agency, school, or any other mental health setting. You can also set up a private practice after you receive your license and many psychologists do organizational or business consulting work. You might have trouble landing a job as a professor due to the limited research in a Psy.D. program but you could quite possibly get a position at a community college and a part-time college teaching position on the side shouldn't be much trouble to land. In addition to therapy and possibly teaching, many psychologists take on administrative or management roles in the same settings mentioned above.

    In research areas a Psy.D. is more limiting than a Ph.D. since the program involves far less independent research. However, if you go to a program with more stringent research requirements, take advantage of voluntary research opportunities, or take a post-doc research fellowship you can counter much of that disadvantage and be competitive with Ph.D.s for research and achedemic positions as well.

    this semester I am going to go to school and just feel it out. I am going to go with what seems to flow for me.
    Sounds to me like this is the best possible advice anyone could give you. Go back to school, take some psych and nursing related coursework, and decide what best "speaks" to you. If you decide on nursing, even if you don't go the PMHNP route, a psych background would be helpful. If you go the psych route, the science courses in the pre-nursing curriculum will be very useful, and psych programs do usually look favorably on science and nursing coursework.
    Last edit by 1911guy on Jun 30, '06
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    I have had plenty of PMHNP's who have said their experience and educational background have been of benefit to their admission to Psy.D. programs. In fact, on an application I have, it it listed as being preferable so I am a bit confused but perhaps I missed something.
    My post addressed both Ph.D. and Psy.D. programs so that may not have helped. Let me try to clarify and expand on psychology doctorate programs MA preferences.

    Ph.D. programs in clinical psych are extremely competitive. Many (about 20%) will even count an MA in psychology as a negative (as strange as that sounds) and strongly prefer BA/BS psychology students as the entry level. Almost all of the other programs will look at an MA or consider it neutral, but usually require a BA/BS in psychology as a minimum (with some taking an MA in psychology along with a bachelors in another area as a substitute). Almost all Ph.D. programs in clinical psych will make a person with an MA in psychology start from scratch so certainly a non-psych but related masters (education, nursing, social work, etc) will gain a person no advanced standing whether it is considered for admissions or not.

    Ph.D. programs in other psych areas (including counseling psych and school psych which are very closely related to clinical psych) and Psy. D. programs in clinical psychology are a lot more MA friendly (some Ph.D. programs in counseling psych require an MA first) and also will often look more favorably on an MA in a related area. Some of these programs look very favorably for admissions towards an MA in any related area (including nursing, and not always psych nursing). However, usually for advanced standing (if offered at all, which often isn't the case) an MA in psychology or counseling is required. Also, even these programs will always prefer a BA or MA in psychology or counseling (counseling sometimes limited as a preference to counseling psych programs) over a BA and MA in a related field (the exception being school psychology programs which will look almost as favorably on a degree in education as they will a degree in psychology).

    I am curious to know what state it is legal for psychologists to prescribe.
    The only state I knew of was New Mexico. Someone here said Louisiana also allows it, but I wasn't aware of this.

    Additionally, the military has successfully had psychologists with prescription privileges since 1994 (first as a trial program which I believe has been expanded), and South Africa has had it for some time with no problems.

    Over the past few years several states have introduced bills to allow it including: AK, CA, IL, FL, NH, OR, WY, HI, TX, GA.

    Indiana has passed a law allowing psychologists involved in a federal government sponsored training or treatment program to prescribe. I'm not sure if regulations have been written and the law implemented yet though.

    I am aware that this is a very hot issue which is one reason I went for the PMHNP post masters... I am not certain that prescriptive privileges will come to psychologists but we shall see. The AMA lobbies long and hard and are not too thrilled about PMHNP's prescribing.
    Yes, the AMA is strongly against it, as they were psychologists even being allowed to practice therapy. For decades the AMA fought long and hard to prevent the states from licensing psychologists for professional practice. Today, I think very few people would argue that psychologists as professional providers of mental health services has been anything but an asset to patients and clients. The AMA is opposed, but they don't always win (many other non-physician professionals can prescribe, and most came with the AMA's strong opposition and predictions of dire consequences) and the APA (the American Psychological Association) is fighting just as hard.

    Everyone thinks it's not a big deal to prescribe mental health medications but it really is.
    I don't hear anyone saying it is no big deal. Can I guess from this wording that your personal take is that psychologists aren't qualified to prescribe and that psychologists and psychology students pushing for it consider meds to be "not a big deal"?

    First, this certainly wouldn't be the first time a non-physician profession was given prescription privileges. Podiatrists and optometrists not only can prescribe within their specialties but they can perform surgery. Some chiropractors can prescribe and perform medical procedures like x-rays and in some states can prescribe some medication. NPs and PAs can prescribe, and in some states they don't require supervision or even consultation with a physician.

    Many psychologists already work in consultation with physicians and collaborate on medication issues. Nine states (CA, CT, DC, FL, IL, MA, OK, TX and UT) currently recognize such consultation to be within the official scope of practice for psychologists.

    Psychologists certainly already possess a high level of education on mental illness, physiological aspects of mental illness, and psychopharmacology. At minimum it requires 4 years of graduate level coursework plus a one year internship to get the doctorate (many programs due to the amount of coursework and research requirements take an average of 6-7 years to complete). Included in this coursework are classes on psychopharmacology and the physiology of mental illness. While in school, often after, psychologists do research, including research on psychopharmocology. To be licensed a psychologist has to have an understanding of the symptoms of common physical as well as mental illnesses, they need an understanding of psychophysiology and psychopharmacology and they need to know the behavioral and cognitive effects of common drugs (not just psychotropic medications but most commonly prescribed meds)- think about it, someone licensed to diagnose and treat mental illness and psychological issues needs to be able to determine if the symptoms may be a psych problem or a side effect of a med or symptom of a physical illness. Many psychologists already take additional coursework in these areas, fellowships in these areas, or post-doc masters degrees in psychopharmacology or physiology. The fact that over 3000 psychologists are currently teaching in medical schools, including courses on psychopharmacology, shows that even physicians recognize that psychologists have some competence in the field.

    Psychologists already prescribe in South Africa, the US territory of Guam, New Mexico and the US military (I'm not sure if the military program is still in the test phase or if all psychologists who meet certain criteria are qualified to do so) with no resulting problems.

    Psychology as a profession is pushing for prescription privileges, but only for psychologists who meet certain criteria. Specifically, the APA is pushing for legislation that requires 5 years experience as a professional psychologist, a current license as a psychologist, and advanced training in psychopharmocology including training in:
    Neuroscience, Clinical and Research Pharmacology and Psychopharmacology, Physiology and Pathophysiology, Physical and Laboratory Assessment, and Clinical Pharmacotherapeutics. Additionally, the legislation they are pushing would require a practicum for the psychologist seeking prescription privileges in which he/she would be required to see at least 100 patients before they could independently prescribe.

    So, a 5-7 year Psy.D. or Ph.D. which includes coursework and competency in psychopharmocology and psychophysiology, 5 years of professional psychological experience, and then an additional 1-3 years of psychopharmocology education with a practicum shouldn't be enough to qualify a professional to prescribe? If so, prescription privileges for NPs, PAs, podiatrists, and optometrists should be reconsidered.
    Last edit by 1911guy on Jun 30, '06
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    Thank you again for all of the information, I served as a army medic for almost seven years, after my year deployment with 1st brigade stryker combat team in the city of Mosul Iraq, I left the military, moved to California with my wife and three, soon to be four children.
    From my combat experiences as a Medic I began to lean toward nursing, possibly as a method to re-enter the service and finish my time. I especially feel the compulsion to relate to those who have been in harms way and suffer from PTSD, from my own experiences, I believe that i can truly help some in this area. My true interest is in Psychology/ Anthropology. Nursing provides a longer route to end up at the counseling table it seems but possibly it has more diverse methods of treatment including primarily the ability of prescribed drugs.
    I have decided not to actively pursue nursing simply for the sake of it being two steps forward and one step back for me in years of college spent getting the degree i need, especially when I am beging to feel as though I may want to have some degree of autonomy when I complete my education. For that reason I am going to complete an Anthropology/Psychology BA and then go from there. I think there are just too many interesting things to study! There are entry level masters in nursing around here, that do not require a BSN, just any BA with the right pre-reqs. Thanks again for your input and for allowing me to tell someof my story.
    Mark Smith
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    Mark,

    Serving as a combat medic with the infantry, especially during wartime? Any respect I already had for your service just jumped about 10 fold.

    I understand your thoughts of becoming a nurse and going back to "finish" your time (I guess I understand what you are saying as getting your 20 years). If I lose about 80lbs I may well give it another try (I am about to turn 36, the cut off for the Reserves and Army NG is now 39). I'd go as a mental health specialist or possibly wait until after grad school, but it is rather unlikely (my ankle wouldn't take it at 19 and in the best condition of my life so I doubt it would now, plus my soon to be fiancee was an Air Force brat and is 100% opposed to her husband being deployed like her dad was so it would be off if I joined). Still, there is a sense of duty that even the slightest exposure to the military seems to often instill.

    PTSD? Hmm, the current fighting and the likelihood of PTSD from this style of warfare is actually what had me considering trying again. If you choose not to go back in the Army would you consider the VA? Even privately there are plenty of opportunities for this specialty unfortunately. In addition to combat PTSD there is an awful lot from other causes (usually abuse). The psych hospital has a trauma unit with many people (mostly women) with PTSD and my unit (Eating Disorders) sees a lot of them too.

    If you are looking for the fastest route to becoming a therapist/counselor have you thought about social work? It pays a little less than most other options but there are a ton of jobs, you can do about 80-90% of what a psychologist does, and it is only a 2 year masters program.

    Have you considered medical school? If you want to prescribe it is the most sure-fire option (100% independence under all states' laws).

    If you really want the prescription option you probably should consider med school or NP (though like you said, the MSN programs that admit without an RN are a consideration). Who knows how far or fast the move for prescription privileges for psychologists will go. Some psychologists actually go on after their doctorate to get an MSN to be NPs so they can prescribe (they primarily work as psychologists, the NP is strictly for the prescription privileges).
    Last edit by sirI on Jun 30, '06 : Reason: TOS
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    Thanks again for the reply,
    I was referring earlier to finishing my twenty years for retirement yes, the retirement is pretty good. Half of your base pay + full med for the rest of your life. After treating traumatic injuries and being part of the medical team in an Infantry battalion I saw the potential to either use my experiences in the civilian sector or return to duty to train others and perform at a higher level. My wife is a LVN, and at times I am amazed at what a civilian nurse cannot do. She cannot give an IV for example, unless a Dr. orders it, she cannot even give cough syrup and so on. All of these things were second nature to us medics and in fact we usually had everything you need within our reach. Procedures are something I am fortunate to have taken part of. We were able to suture, use chest tubes, venus cut downs, and even were given several opportunities to perform emergency crichotomies. These are all way out of the scope of practice for a LVn I am guessing,I could be wrong but maybe RNs can do this too?
    I started to think that maybe an alternative to military nursing woul be corrections, since they seem to operate on a similarity with the aid station to clinic to hospital mentality. But the documentries with inmates smearing crap on the walls doesnt make me want to enter into mental health with the prison system. It is very good money ( around 6300+ a month which is more than a Psy.d/Ph.d or MSW) but I dont want to spend my life in that direction. I am kind of side tracking here and dont want to ramble on and on! I will take the 4 pre reqs they have for the BSN/MSN and finish my BA. If it happens great if not I think I will be quite happy with the other routes I have checked out. It was just real hard to let the 3 twelve hour shifts go and do the 5 days a week thing, but who's complaining! I am just cursed with a wide interest range.

    1911, I have considered VA, it does push up the retirement age and some benifits but it is an option, I have also considered the reserve and the National Guard but their deployments run as far as 18 months, for me twelve was pretty lengthy, 18 months is a big chunk of your time. I am not sure if my family or I am ready for that, plus all the pre-deployment training. There are no medical schools close by and I really am not sure that I have the scholastic aptitude required for that. I would give it a shot, but pre med course work is almost a double major within itself. I have checked ou MSW as a route too. Just going to see what happens, thank you for the questions and your ideas!
    If you are seeking a under or graduate degree, then I would wait and enter the military as a MSW or PSy.d/Ph.d. That is unless you need the money, I am sure they are offering bonuses for 91X as it used to be called. I went to that school and dropped out to some heavy personal problems. It really wasnt hard though. If I could get passed the difficult part anyone can. I really thought it was a let down though, the people didnt seem to really dig the psychology aspect of the course. There was a lot of jesting toward the mental health population ( by students). I think you would be dissappointed if you went in as enlisted. Better for you finacially and it would better suit your age. You gotta remember most privates are kids and San Antonio is a party city for sure. I would love to give you any info on that subject, it is something I know a bit about. One last thing just FYI, Army CNS's can prescribe meds you dont need to be a NP.
    Mark Smith
    Last edit by 91W on Jul 1, '06
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    the military psychologist program is not really active. the nine initial psychologists who started the program are no longer prescribing and never really worked in that role, even though reviews of the program showed the psychologists were highly trained and capable of prescribing. i don't think the program was ever expanded beyond the initial 9 people, even though they showed good results. specific states attempts to have psychologists be able to prescibe (including nm) are based on this program. the training the psychologists underwent in the military program was very similiar to pmhnp training, and about the same amount of time, same pre-reqs were required (eg: chemistry, physics, a and p etc.).
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    91 W, I'm prior service 91A/B 187th Med Det deployed twice shield and storm then did 91-C at Ft Sam as a "reward" for services rendered. I'm re-uping here shortly(reserve this time) going officer route as an NP and the local Med group officers I have spoken to state that the longest involuntary deployment for nurse/medical officers is 6-8 months. I haven't found any way to verify this as yet but it doesn't bother me anyways. I'm always ready to go. Just food for thought.
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    i worked at landstuhl in germany as a civilian nurse and i was there during the navy rotation-all reserves (2008-2009). most people in germany who were deployed were there for at least 1 yr. they could volunteer for longer and some people, i think, had to do a second deployment. have a great deployment, hope you go somewhere cool--germany was really cool. and you can travel all over europe on your days off! hint..hint..
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    Hey All,
    Its funny, "allnurses" comes up no matter where or what I type! Now, I love psych. I am a BS prepared RN. I have worked in psych for over 10 years. I am hopefully going to be getting my MSN PMHARNP through Vanderbilt (distance option.) However the problem remains, I need preceptors here in NH, and after months of looking- still nothing. I begged my preceptor at schNPol to help me, she is gonna look into it. Vanderbilt is my number one because I get an MSN w/ FPMNNP all in 11 months. But if I cant find a preceptor, I cant go to Vanderbilt. At the last minute when I noticed that things where not looking so great for me in terms of Vanderbilt, so I applied to two schools kinda locally. Both PMHNP, one MSN (2 yr) one DNP (3 yr) they are my backups (if I get in and I do not find a preceptor.)
    I came across PsyD and read about it, im hooked. I actually wish that I had applied for the PsyD Forensic Clinical program. So I was thinking... Originally... I was going to get my MSN in PMHRP then go to UT for my MSN-DNP with a focus on either forensics or public health. But, now Im wondering if I should consider after graduating with my MSN PMHNP.... applying/going to a psych program and apply for PsyD Forensic Clinical.
    Here is the Question??? What is better DNP or PsyD? Both Doctorate
    My life goals are:
    `I would like to author a book
    `I could like to teach at the collegiate level
    `Id like to see patients provide therapy and meds
    `Id like to market myself as someone who can provide legal consulting
    `I would like to open and run a surrogacy and international adoption program
    Help?
    R
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    Quote from t2krookie
    91 W, I'm prior service 91A/B 187th Med Det deployed twice shield and storm then did 91-C at Ft Sam as a "reward" for services rendered. I'm re-uping here shortly(reserve this time) going officer route as an NP and the local Med group officers I have spoken to state that the longest involuntary deployment for nurse/medical officers is 6-8 months. I haven't found any way to verify this as yet but it doesn't bother me anyways. I'm always ready to go. Just food for thought.
    I completed the 91C program at Ft. Sam in, cough, cough, 1972. I then challenged the CA RN state board and my career was on the way.


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