psych-mental health NP vs Psychologist

Smitty08 · Apr 30, 2009

the more i look into becoming a psych-mental heath NP, i'm wondering why not just become a pyschologist...i'm not interested in RX privileges. i am more interested in diagnosing & counselling...so thats what psychologists do right? so im wondering what the advantages are in become a PMH-NP vs just become a psychologist.....

I'm not a psychologist, so I am just answering this from my perspective. Psychologists do all kinds of therapy, psych. testing, in a few states I understand they can get additional education for Rx'ing. They have very rigorous training in therapy (usually if Clinical Psych.) and testing. Psych. NP's do not do psych. testing however do complete mental status exams, all kinds of therapy, RX'ing, among other roles, such as liason work, or ED triage for psych. I would think a major issue is what background you bring to the table. If you are an RN already you may want to go the NP route. I think the salaries of the two career tracks vary by state, role, what you do and etc...and I think the salary difference is shrinking. Just my :twocents:

inthesky · May 4, 2009

PMHNPs (at least in my state) do much more medication than therapy. I'm a pharmacology nerd so this is ok for me, but psychology might truly be a better fit for you.

al dente · May 4, 2009

I'm both a clinical psychologist and a psych NP. You will be in demand as a PMHNP because you can prescribe and, generally, you will be well paid for it. No one will pay you to do therapy - there are many other (and cheaper) personnel to fill that role.

Additionally, you will most likely not be very well trained in therapy coming out of a PMHNP program. In comparison to my training as a clinical psychologist, the non-medication mental health training I received in my program was minimal. If psychotherapy is your passion, you will probably not be happy in the role of a PMHNP. You can always do private practice, but again, if you don't have the training, it will be hard to sustain a psychotherapy-based outpatient practice.

However, training as a clinical psychologist takes a minimum of 5 years post-bachelor's and the programs are very competitive to gain admission. You could come out in 2 years or so as a NP.

crystal1 · May 6, 2009

I want to ask Al Dente if he/she likes being a PMHNP? I am a counseling psychologist by training( M.Ed) and am interested in both the FNP and PMHNP route . I got accepted into the FNP tract and will be starting a direct entry in the fall. But my heart is more with psychology. Your last entry was very informative for me. Do you feel you are in demand as a PMHNP? Can you give me an idea of the pay scale?? I am currently not an RN but with the direct entry I will be recieving that certification. As a Counselor currently the pay is very poor with a masters degree, as you probably know and that is why I do want to go back to school. ANy assistance, guidance you can offer will help me trememndously. THanks!!

al dente · May 6, 2009

If you want to be in mental health, you are going to need the PMHNP specialty. We had several FNPs doing a post-master's certification in psych because they were unable to practice in a mental health setting and get reimbursed for their services unless they had PMHNP certification. This is becoming more and more common.

PMHNPs are in great demand in most parts of the country, especially in states where NP practice is independent. Counselors, unfortunately, are a dime-a-dozen and have flooded the market in many places. In some areas, it is even difficult to find work if you are a psychologist.

westcoastgirl · May 10, 2009

I second the poster above, psych NP (and indeed any psych prescribers) are in great demand and paid well. I was accepted into a psych NP program but due to time and money did not go and work as a FNP instead and so have interviewed some people in field about it.

I have close friends and colleagues who are psychologists. they have put in years and years only to make as much as a RN and also jobs are hard to come by at least on the West Coast. Unless you hate med management and prescribing, I would choose the Psych NP route.

Therapist4Chnge · Jun 23, 2009

Money and time-wise.....NP makes more sense. Being a clinical psychologist requires training in research, assessment, therapy, etc....which is great, but if you aren't interested in those things, it can be a LOOOONG road. While some people can get out in ~6 years (4 + 1 yr internship + 1 yr post-doc), it often takes longer. I'm on an 8 year plan because neuropsych requires a 2 year post-doc fellowship, so obviously the time commitment isn't exactly ideal. The flexibility and autonomy is nice once you get out (or so I hear :/ ).

nursegirl2001 · Sep 23, 2010

You know, we as nurses are so well-rounded in our studies and are becoming increasingly more educated and independent, :redbeathe thank the Good Lord above!! The psychologist route is indeed a good one and provides the nurse with the therapy background which could only strengthen an NP degree as well. And as others have so well pointed out, time is everything when you have a family and everything. I frankly don't have the time to pursue both degrees or I might consider doing so. However, I love the idea of diagnosing and prescribing as I have practiced this secretly over the years a psyche RN. If you like the therapy, go that route but some schools are offering a psychotherapy component to the Psychiatric Mental Health Nurse Practitioner (PMHNP) tract. A master's in psychology with a PMHNP would possibly help strenthen this career path which is what I am currently doing. Actually, I am pursuing a Master's in Psychology: Mental Health Administration degree:yeah: and then I will also obtain my PMHNP as well. My aim is to show that I am competent in mental health and then I will also obtain my FNP certificate..... :lol2:

KimmbaFNP, MSN, APRN, NP · Jan 9, 2011

This is what I am doing and why....(all info specific to CA, other states may differ regarding licensure and scope of practice)

I am getting my doctorate in psychology (PhD) but will practice under a psych NP license.

1. In California you need 3000 hours of fieldwork (clinical internships) before you can sit for the psychologist license. HOWEVER, only 1500 of those hours can be obtained while in school, the other 1500 must be completed AFTER graduation. You must have a doctorate to sit the psychologists licensing exam, so either a PhD or PsyD. Either way, you will be in school for quite some time and then have to do additional FREE work after graduation, so there's quite some time before you will start bringing in money. There are a few paid positions and assistantships, but they are very few and far between and very competitive.

2. Psychologists cannot prescribe or even make recommendations on pharmaceuticals/med management.

3. A psych NP can prescribe and all clinical hours are obtained while in the program. An NP can also do nutritional and wellness counseling. If a psychologist does this w/o having additional, verifiable training, such as completing a nutrition program, they are in violation.

So essentially, an NP has a larger scope of practice than a psychologist. However, the psychology programs have a significantly stronger focus and training on therapy. By completing my psychology PhD I will obtain the in depth counseling/therapy skills that isn't in place in the NP program, yet have the larger scope of practice offered by NP licensure. The PhD in psychology gives me the degree and credibility that clients seek, yet with the added bonus ob being able to do med management, nutritional counseling, etc. - all within my scope of practice so no gray areas or risk of licensure issues.

I had already begun a FNP program, so I'm completing that and will do a post-grad certificate for the psych NP. And I've been in my PhD program concurrently. Depending on the doctorate program you CAN do them concurrently if you're not working FT also. Otherwise you'd need to arrange it differently. I'd suggest doing the NP first, so you could get out there and start working, and work on the PhD while working as a psych NP.

Just something to consider............

newtinmpls, BSN, RN · Jun 21, 2011

I'm in a PMHNP doctoral program. Because the dealing with medical issues is limited to those "related to the mental issues", I am going to follow it up with a certificate in family practice (can't think of how to phrase it - and it's 5 something in the morning, so I'm not even going to try that hard) which will be .... about 350 more clinical hours and a year and a half of schooling. Then another (probably similar, I haven't looked it up) bunch of time in for my geriatric cert. Then I go find myself a nice rural place to practice in an area where NP's have decent prescriptive permissions, and I settle down as the "local practicioner" and live happily ever after, getting help on my ungodly student loans and taking copayments in zuccini and puppies.