PMHNP, FNP, or Psy D/LPC?

Psychcns · Jul 16, 2016

For a PMHNP and a FNP you will have two certifications to keep up. For a psychology degree you will learn more about how to do therapy I would think. If you get your PMHNP you would be qualified to do therapy and you could pursue programs to learn to treat trauma etc. Psychotherapy is less valued in our culture than it should be. It is much more all-encompassing and interesting than meds but meds are where the jobs are for PMHNPs.

Jules A, MSN · Jul 16, 2016

If you get your PMHNP you would be qualified to do therapy and you could pursue programs to learn to treat trauma etc. Psychotherapy is less valued in our culture than it should be. It is much more all-encompassing and interesting than meds but meds are where the jobs are for PMHNPs.

I agree 100% about the value of therapy but what many don't realize is that unless you are going to open your own practice a PMHNP almost never does psychotherapy, it doesn't pay. Its med management only not that you can't slip a little therapy in there and there but not much in a typical 20 minute med check.

OP you will need to decide if you med management or therapy as the two are rarely compatible unless you open your own practice in which case do PMHNP and you can do whatever you want. If you want to do medication management only do NP, if you want to delve into therapy my recommendation is LCSW-C. This designation has better billing capability than a LCPC. The independent cash only therapists in my area bill $125 an hour, a bit more than I get paid at my jobs as an employee. The more certifications they get in trauma etc the more valuable they are for side contract jobs also. Psychologists although they think they are the bomb diggity in my area seem to mostly do testing rather than individual therapy because again the reimbursement is better. I'm not a fan of many of the psychologists I have encountered because there seems to be some angst in that they can't prescribe. They need to stay in their lane because the minute they start attempting to offer up med suggestions to me the conversation is concluded. Good luck with whatever you decide.

allnurses Guide · Jul 16, 2016

I agree with Jules. In my area, most therapists are LICSWs. It's a fairly long process, but you will be able to have your own practice and bill accordingly.

smilealot · Jul 16, 2016

For a PMHNP and a FNP you will have two certifications to keep up. For a psychology degree you will learn more about how to do therapy I would think. If you get your PMHNP you would be qualified to do therapy and you could pursue programs to learn to treat trauma etc. Psychotherapy is less valued in our culture than it should be. It is much more all-encompassing and interesting than meds but meds are where the jobs are for PMHNPs.

Good point about maintaining the two certifications. I had not thought about that. Im thinking maybe Im going to be in school for awhile (-: I like idea of FNP because I love doing medical mission and I want to still be able to provide that. I know a Psy D who is also a PA. Works as a PA in an ER but also has his own clients. I guess that is where I got the idea from.

smilealot · Jul 16, 2016

Thanks! Im not really fond of the the med management side plus I don't really want to run my own practice..... way to much work. I have noticed the same thing with PMHNP is that its mostly med management. I have worked with a few that did intakes for the psych ER but ultimately I think I imagine having my own clients in the future.

Jules A, MSN · Jul 16, 2016

I have noticed the same thing with PMHNP is that its mostly med management.

Its all med management but so is FNP, right?

smilealot · Jul 16, 2016

Its all med management but so is FNP, right?

I guess depending on the setting. I mostly work with FNPs in ER and urgent care settings and they seem to to more procedures in addition to prescribing.

Psychcns · Jul 17, 2016

A PMHNP friend, just out of school, worked 4 years in a community outpatient rural clinic with good MD supervision. She also negotiated for 4 hours of therapy per week. She just left that clinic to join a private practice where she will be doing meds and therapy with supervision for therapy by a psychologist. There are ways you can incorporate therapy but your market value is meds.

Jules A, MSN · Jul 17, 2016

A PMHNP friend, just out of school, worked 4 years in a community outpatient rural clinic with good MD supervision. She also negotiated for 4 hours of therapy per week. She just left that clinic to join a private practice where she will be doing meds and therapy with supervision for therapy by a psychologist. There are ways you can incorporate therapy but your market value is meds.

Interesting, I haven't heard of that option around here. Any idea how much she's making? It doesn't make financial sense to me. I know there is no way my clinic would pay me over $100 an hour when a very competent therapist could do it for $35.

Psychcns · Jul 17, 2016

At the clinic after 4 years was making 100k per year. Her hourly rate didn't change because she was doing therapy. They were very glad to hire her and she wanted therapy experience. Private practice is a 60-40 split. (She gets 60 percent-the practice gets 40 percent). You are only paid when people show up so you have to have a good business head. ( I like hourly myself).

Jules A, MSN · Jul 17, 2016

Yikes thats low. The % of billing folks here are getting 80% now from what I hear, physicians 85%. I agree with you and prefer hourly for OP but will do productivity on an inpatient basis.