How much should it cost to become a psychologist, family therapist, social worker, or counselor? Student debt is piling up for thousands of current students in the mental health professions, many of whom will struggle to pay it off after graduation.
Education
Kill the teaching evaluation
It’s time to put an end to them.
The best MFT programs
How to choose the best MFT programs (master’s and doctoral) for your needs. Originally published August 2009; updated January 2013 and September 2014.
Aspiring MFTs have lots of options — there are more than 100 COAMFTE-accredited programs around the US, and about 80 license-eligible MFT programs (accredited and not) in California — for graduate school. How should you go about choosing the school that is right for you?
MFT licensure: California
Ah, the Golden State. Home to me and half the licensed Marriage and Family Therapists in the country. And, in the eyes of the rest of the country, some pretty weird practices within the profession.
MFT licensure in California looks a lot different here than it does everywhere else. And it shouldn’t have to, seeing as the profession itself — that is, our scope of practice and competence — is pretty much the same here as it is everywhere else.
What the heck is so different here, and why?
Would anyone buy stock in a future therapist?
There’s an interesting alternative to the student loan model of financing education floating around: In essence, sell stock in yourself.
Nazareth College was probably smart, not sexist, in rescinding tenure-track job offer
The interwebs are in their typical fits of consternation this week over an accusation that Nazareth College, a small liberal-arts school in New York, rescinded an offer of a tenure-track professorship in philosophy to a woman who had attempted to negotiate the terms of the hire.
As you know, I am very enthusiastic about the possibility of coming to Nazareth. Granting some of the following provisions would make my decision easier.
1) An increase of my starting salary to $65,000, which is more in line with what assistant professors in philosophy have been getting in the last few years.
2) An official semester of maternity leave.
3) A pre-tenure sabbatical at some point during the bottom half of my tenure clock.
4) No more than three new class preps per year for the first three years.
5) A start date of academic year 2015 so I can complete my postdoc. I know that some of these might be easier to grant than others. Let me know what you think.
It is fully appropriate to negotiate salary in such a situation, and W has since said that her request was less than 20% above what was originally offered. The request for capping new class preps may or may not be reasonable; depending on her prior teaching experience, this might limit her to teaching no more than three classes total in her first year (which would be highly unusual), or it might not have much practical impact at all (if most of the classes the university wanted her to teach were ones she had taught elsewhere before, and thus would not need to create from scratch).
The maternity leave request seems silly — the university already would have to accommodate maternity leave in accordance with the law, and it is hard to tell what she meant by an “official semester” of such leave. But W said it was simply an effort to put in writing what she had already been informally offered, so let’s take her at her word there. W’s mistakes are in the rest of the requests. (By the way, I am using that term “requests” purposefully — those who have been casting her requests as “demands” are themselves failing to understand how negotiation works. They also are apparently failing to actually read W’s letter.) The pre-tenure sabbatical and moved-start-date requests are would give any university pause, not because the requester is a woman, but because accommodating such requests just doesn’t happen at this type of school. A research university might honor such requests, though even there it would be extremely rare. In a response rescinding the job offer entirely, Nazareth suggests that W should have been aware of that:Thank you for your email. The search committee discussed your provisions. They were also reviewed by the Dean and the VPAA. It was determined that on the whole these provisions indicate an interest in teaching at a research university and not at a college, like ours, that is both teaching and student centered. Thus, the institution has decided to withdraw its offer of employment to you.
Thank you very much for your interest in Nazareth College. We wish you the best in finding a suitable position.
Liberal arts schools hire faculty to teach. (“Student-centered” is obtuse language, but it generally indicates that the school is focused more heavily on teaching and mentorship than on research.) If they hired for a position to start in fall 2014, they knew they would need someone who could start teaching then. If they would have been fine waiting a year to add a faculty member, they would have waited a year to do the hiring process.
You might argue that pushing her start date would not be a tremendous burden on the university — they could always hire more adjuncts — but this ignores the very real needs a university has for program administration, student advising and mentorship, and faculty governance, tasks that simply are not accomplished by part-timers. Depending on the school’s accreditors and their own internal targets, they might also have been hiring full-time faculty to meet specific requirements for the ratio of full-time faculty to full-time students. And pre-tenure sabbatical — a (typically paid) break from teaching of a semester or more so that one can focus on research projects — is virtually unheard of. Would you go into an entry-level position in any company asking for a four-month break in your first few years? The problem isn’t that W is a woman making these requests. It’s that the requests go far beyond what is reasonable in this context. Any good negotiator will be willing to walk away from a potential deal if the other side seems to be asking for too much. Perhaps the university unfairly blamed W for her naivete in making the requests, but regardless of whether those requests were viewed as troubling behavior in and of themselves or as a larger statement about the candidate’s preparedness, they would be enough to turn many universities away from her. It is an employer’s market in academia. I would be the first to say that too many universities use that obtuse language of being “student-centered” to chill faculty into shutting up and making do with what the university is willing to offer them. It gets used to imply that faculty members should repress their own needs and desires in salary, benefits, and work-life balance in order for students to have lower tuition, greater access to faculty, shiny new sports facilities, or even guns on campus. And I agree with David Perry that questions of “fit” in an academic culture should be viewed skeptically, since they can be smokescreens for various forms of bias. Faculty absolutely should be critical of the use such terms, and absolutely should call out sexism where it exists in the negotiation process surrounding faculty hiring. But there is no truly convincing evidence that sexism is present in Nazareth’s response to W. If anything, this simply seems to be an example of the importance of what one commenter on the original post noted:# # # The Philosophy Smoker has a nice run-down of various commentaries since their original post was published, and takes a refreshingly positive and level-headed view of the whole debate. Your comments here are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.This indicates how important it is to do your best to understand the culture and needs of the hiring institution, both before and during negotiations. […] “Will so-and-so be a good colleague and carry their fair share of the burden?” is often one of (if not *the*) most important considerations during the hiring process at small institutions.
Training in mental health is unreasonably long
Just as a quick thought experiment, go over to this piece at Slate discussing medical training, and every time it references “medicine” change that to “mental health.” (Accordingly, change “physicians” and “doctors” to “therapists.”) You’ll find most of it applies perfectly. To wit:
Over the past century, there have been additions to, but few subtractions from, the training process. Residency and fellowship programs became longer and longer … and longer.
and
The long process doesn’t just weed out the incompetent and the lazy from the potential pool of physicians—it deters students who can’t pay for so many years of education or who need to make money quickly to support their families. That introduces a significant class bias into the physician population, depriving a large proportion of the population of doctors who understand their background, values, and challenges.
and
The fundamental problem here is that the argument between traditionalists and reformers [debating the appropriate length of training] is essentially theoretical — we are in an evidence vacuum.
In the time I’ve been in academia, I’ve watched as the requirements for training in mental health have increased dramatically. Family therapist training in California increased from 48 to 60 units based not on science but on workplace competitiveness. (MFTs were fighting clinical social workers for some of the same jobs, and since LCSWs need 60 units of training, MFTs couldn’t really argue that their training at 48 units was equivalent.) I’ve also watched as education in general has gotten much more expensive, and loans harder to come by. And I’ve been enlightened by learning that our 3,000-hour supervised training requirement is based entirely on tradition, and is in virtually no way linked to the science that we now have available (though admittedly, it isn’t much) on how therapist skill develops over time.
Our old apprenticeship model is broken. It’s as true in therapy as it is in medicine. It will be interesting to see how experimentation with medical training goes, as it can blaze the trail for similar efforts in other health care professions like ours. I’m just not sure we should be waiting for doctors to do it first. # # # Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.No, counseling psychology is not a terrible major in college
Of course salary numbers in mental health look bad when you leave out people with the graduate degrees necessary to practice.
NPR ran a story last month punctuated by a graph of the highest- and lowest-earning college majors. The worst on the list, by far, was Counseling Psychology. Those who majored in Counseling Psych brought in a median income of under $30,000 per year.
No one gets into mental health care for the money, but the numbers were a black eye for the Counseling field — the American Counseling Association has even responded by commissioning its own study of salaries among its members.
But there was a big problem with that original chart, one that the researchers themselves had noted but which was often ignored in discussions of their findings: It didn’t include people with graduate degrees.
In just about any mental health field, you need at least a master’s degree to practice. Those who don’t take that extra step are often limited to very basic, entry-level jobs with little hope for advancement.
So NPR is back this week with another chart, one that includes graduate-degree earners. And Counseling Psychology no longer shows up on the list of the 10 lowest-earning undergraduate majors. Counseling Psych majors get a big bump in median incomes when you include those who go on to advanced degrees, as should be expected.
Notably, social work stayed in the bottom 10, even when those who get their graduate degrees are included. Their median incomes went from just under $40,000 a year (with graduate degree earners excluded) to about $45,000 a year (with graduate degree earners included).
It’s hard to place family therapy here, since MFTs come from a wide variety of undergraduate majors, most commonly (but by no means exclusively) psychology or family studies. For MFT salary data, the best place to start is this Bureau of Labor Statistics page.
# # #
Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.
Proposed new MFT accreditation standards eliminate vague religious exemption
If adopted, the draft COAMFTE standards would require all programs to teach LGBTQ-affirmative practices.
The public comment period closes Wednesday on the draft version of new accreditation standards for graduate programs in marriage and family therapy. The Commission on Accreditation for Marriage and Family Therapy Education (COAMFTE) is proposing some major changes from current standards:
- The draft standards would restore the 500-client-contact-hour requirement for practicum. Under the current, version 11.0 standards, programs can require fewer hours as long as they have evidence to show that their practicum results in students being competent to practice at the master’s level. This vague standard has left different accredited programs using different experience requirements, which can be confusing to state licensing boards who want to know how much practical experience they can reasonably expect to be included in graduate degrees.
- The draft standards separate accreditation requirements into “eligibility standards” and “accreditation standards.” As it is now, the Commission makes its decisions based on the full scope of information presented to them. Programs that meet most but not all standards may still be granted accreditation, with stipulations — requirements that the program comes into full compliance with the standards within a year. This proposed split into eligibility and accreditation standards arguably makes the accreditation bar a bit higher: Programs that fail to meet even one of the eligibility standards would not be eligible for accreditation, regardless of their performance on the other standards.
- The draft standards would go back to a singular, mandatory core curriculum for all accredited programs. Of course, programs would remain free to add on to this core curriculum as they see fit, but all accredited programs would be required to have the same core set of coursework.
- Perhaps what is most notable in the draft standards is what is missing: The draft standards remove COAMFTE’s current vague, blanket exemption for religious programs. The exemption, present in the current COAMFTE standards (p. 3), says
Religiously affiliated institutions that have core beliefs directed toward conduct within their communities are entitled to protect those beliefs.
It has never been clear to me what that is supposed to mean in practice, but the way I read it, any religious-based program that wants COAMFTE accreditation but isn’t in tune with any part of the standards was free to ignore that part of the standards, as long as they could tie their objection to their religious beliefs. Under the proposed new standards, not only would that clause go away, but the required curriculum would include at least three semester units on
diversity, power, privilege and oppression as they relate to race, age, gender, ethnicity, sexual orientation, gender identity, socioeconomic status, disability, health status, religious and spiritual practices, nation of origin or other relevant social categories throughout the curriculum. It includes practice with diverse, international, multicultural, marginalized, and/or underserved communities, including LGTBQ affirmative practices. [emphasis in original]
It is much clearer what the new standards would mean: Every COAMFTE-accredited program would need to teach its students how to work with LGBTQ clients in a positive, affirming way, and an appreciation for the harm such clients suffer from living in a heterosexist society.
To me, these are all good and necessary changes. First, as to the hours and curriculum changes: I hear chatter among MFTs around the country that licensing boards haven’t known what to do with the current COAMFTE standards. Those current standards are so flexible that licensing boards don’t necessarily know what they’re getting when someone comes to them with a COAMFTE-accredited degree. The draft standards, if adopted, would bring back greater consistency in content across programs and could restore state boards’ confidence in maintaining COAMFTE accreditation as the standard educational requirement for licensure.
Second, as to the removal of the religious exception: I’ve written previously about the struggles some religious therapists face when trying to work with LGBT clients, and the debate there is far from settled. But accredited programs can and should teach affirmative practices. The debate here should be restricted to how a therapist balances their values with client needs in the therapy room, not about whether the therapist can be exempted from exposure to affirmative techniques or to the suffering LGBTQ clients genuinely experience. There’s only one thing COAMFTE didn’t included that I wish they would: Require MFT programs to be more transparent about cost. COAMFTE will be reviewing comments on the proposed changes this fall. If adopted, the new standards would likely take effect in 2014 for new accreditations and be phased in for those programs already accredited.Eastern Michigan settles Julea Ward case
The university settled in December and will pay Ward $75,000, according to AnnArbor.com.
Julea Ward’s lawsuit against her graduate program in counseling at Eastern Michigan University took several interesting turns last year. The case started when Ward refused to counsel a gay client as part of her training; the university determined this was discrimination, and expelled Ward from the program. She sued, claiming she was being singled out for her religious beliefs. I’ve previously discussed the case here and here.
Ward’s case is often discussed in the same breath as Jennifer Keeton’s. Keeton sued Augusta State University, where she had been a graduate student in counseling, after the university expelled her for clearly stating her refusal to counsel gay and lesbian clients and her unwillingness to complete a university-mandated remediation plan.
While Keeton lost her case, Ward appeared to at least have some chance of winning hers. In a footnote within his ruling in favor of Augusta State University in the Keeton case, United States District Judge J. Randal Hall made it clear that the two cases had similar themes but very different specifics (citations removed, and paragraph breaks and emphasis added, for clarity):
This case is distinguishable. In Ward, the plaintiff, a student enrolled in Eastern Michigan University’s graduate counseling program, asked to refer a gay client during her practicum course because she claimed that her faith prevented her from affirming a client’s same-sex relationships. No remediation plan was issued; instead, the plaintiff was promptly dismissed from the program following a formal review. […] The plaintiff in Ward was disciplined after she asked to refer a client, but evidence showed that the university may not have had a policy prohibiting such referrals; indeed, there was evidence that referrals had been permitted for others in the past. […] The Sixth Circuit held that a juror could find that the plaintiff was dismissed because of her religious views.
This case presents a stark contrast: Keeton was cited by faculty for statements which evinced an intent to clearly violate program policies, i.e., according to the remediation plan, faculty believed that Keeton had expressed an interest in conversion therapy. Moreover, Keeton later stated definitively, and without mention of referral, that she would not withhold open judgment of a client’s sexual choices in a counseling session, action also in violation of program policies. One final set of facts serves to
distinguish the two cases – Keeton was not, like the plaintiff in Ward, summarily dismissed. Instead, she was subjected to a remediation plan, the details and import of which was painstakingly explained by faculty members through meetings, written plans, emails, and face-to-face discussions. […] In sum, the patience and measure exhibited by faculty members during the course of Keeton’s protracted remediation proceedings, coupled with the nature and content of their efforts to ensure that Keeton understood how her actions violated professional ethics and could harm future clients, mark this case as different from Ward.
Eastern Michigan, apparently seeing the writing on the wall, chose to settle with Ward and has agreed to pay her $75,000. Notably, the university is neither admitting any wrongdoing nor changing any of its policies as a result of the ruling, according to AnnArbor.com. In the meantime, Michigan’s legislature debated the “Julea Ward Freedom of Conscience Act” — which would have allowed graduate students in mental health to refuse to treat gay and lesbian clients if providing treatment would conflict with the student’s religious beliefs.
I’ve written about that and a similar “conscience clause” bill that did become law in Arizona. A similar bill has now been proposed in Tennessee, which I’ll tackle in a separate post. # # # Your comments are welcomed in the comments section below, by email at ben[at]bencaldwell[dot]com, or in the conversation on my Twitter feed.