The so-called “gig economy” — best exemplified by ride-sharing companies like Uber and Lyft — has brought political attention to the plight of workers who are hired as independent contractors rather than employees. As independent contractors, these workers typically have no ability to engage in collective bargaining, often receive little or no benefits, and have limited workplace protections. The attention they are receiving might end up helping therapists and counselors who take insurance — or who would, if the pay and benefits were better. It could also help clients by improving accessibility of care.
At its November 2015 meeting, the California Board of Behavioral Sciences (BBS) voted to pursue legislation in 2016 that would change the titles of post-degree, pre-license professional clinical counselors (PCCs) and marriage and family therapists (MFTs) from “interns” to “associates.”
There are a lot of “ifs” here, but if they are able to find an author, and if the bill gets through the Legislature and if it is then signed by the Governor, it would not take effect until 2018. This would give individuals and employers ample time during 2017 to plan changes to their marketing materials.
My new book, Saving Psychotherapy, will be officially released September 22 [Update: Here it is!]. An edited excerpt about licensing exams is available here. Another excerpt focused on student debt appeared in the January/February 2015 issue of AAMFT’s Family Therapy Magazine (it starts on page 26).
I could spend a lot of time convincing you why you should read the book, but I think these two charts will be sufficient.
I’ll be presenting to the California Board of Behavioral Sciences tomorrow on the possibility of changing the title for a post-degree, pre-license MFT from “intern” to “associate.” [Update: That change is going to happen. It takes effect in 2018.] The current intern title is confusing for interns and employers alike, and is likely one reason (albeit certainly not the only one) why so many prelicensed MFTs in California work in unpaid internship settings.
The licensing board meeting will be webcast, and you can get to the webcast through the BBS meeting calendar. But for those who have been through a post-degree unpaid internship in mental health, there are ways of seeking — and sometimes getting — back pay that don’t require a change in professional title.
California law — with apologies to folks in other states, this post is pretty California-specific — says that any master’s level therapist who is not fully licensed cannot “lease or rent space, pay for furnishings, equipment, or supplies, or in any other way pay for the obligations of their employers.”
Fair enough. But what reasonably is an “obligation of their employer?” What should you expect to see as supervisor expenses, and what should you expect to pay for yourself as an intern? I surveyed MFT interns in the state to find out.
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.
Originally posted June 2009; updated August 2014.
The most common question I hear these days from marriage and family therapists (MFTs) is simple: “Where can I find a job as an MFT?”
The more pessimistic ones ask the same question, they just leave out the word “Where.”
If you’re considering a career in mental health, there’s some good news on the economic front. After stagnation associated with the larger economy’s downturn, salaries in mental health professions appear to be back on the rise.According to the federal Bureau of Labor Statistics, salaries are improving for all of the mental health professions except Psychology, which has been effectively flat since 2009. There are several cautionary notes that go with this data (more on those below), but if you’re considering a master’s degree in counseling, clinical social work, or family therapy, overall it’s promising:
Source data: Bureau of Labor Statistics Note that the y-axis there starts at $40k, so it’s a little misleading as to proportionality but shows year-over-year changes more clearly. The news seems to be especially good for MFTs in California (I’m one of them, so I’m incredibly biased on this): From 2012 to 2013, the mean annual wage for MFTs here went from $47,230 to $54,470. That’s an increase of more than 15% in just a year. As I said, some pesky cautionary notes: First, the BLS data assumes full-time work, calculating the average annual wage by multiplying the mean hourly wage by 2,080. There are benefits and drawbacks to that approach; it keeps the mean from being dragged down by part-time workers, but also arguably overestimates what the average worker actually makes, since many do work part-time. Second, there is significant state-by-state variability in the numbers. Even if the national means are improving, it can be worth checking to see what the trend is within your state. Third, especially in states with smaller populations of mental health professionals, it isn’t unusual to see big gains or drops in a year simply due to small sample sizes. Data for larger states is more reliable. Finally, the BLS data isn’t perfectly broken down by license; the data shown here uses the BLS categories of Mental Health Counselors (21-1014); Clinical, Counseling, and School Psychologists (19-3031); Marriage and Family Therapists (21-1013); and Mental Health and Substance Abuse Social Workers (21-1023). These are the categories most focused on mental health services and thus the closest parallels to licensure. There should be a new data set for 2014 out within a couple of months; I’ll update this post once that data is available. # # # 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.
There’s an interesting alternative to the student loan model of financing education floating around: In essence, sell stock in yourself.On Wednesday, Senator Marco Rubio and Representative Tom Petri introduced legislation defining “income share agreements” (ISAs), which are basically contracts where investors could fund your education in exchange for a percentage of your future earnings. Under such agreements, which are expressly not loans, an investor could lay claim to a limit of 15 percent of your future income under a contract that could last no more than 30 years. (Those are just upper limits. Presumably most contracts would be shorter and have lower percentages of income involved.) The idea is interesting, and worthy of consideration insofar as it transfers the risk associated with education funding away from the student and their family. One of the worst possible outcomes of taking out tens of thousands of dollars in student loans is then not being able to pay it back, either because you failed to finish your degree or, once you did, there simply weren’t enough well-paying jobs in your field. Changes in bankruptcy law have made it much more difficult to get out of student loan debt even in difficult circumstances. Under the proposed ISA rules, on the other hand, it would be the investor who would be out of luck, not the student. Unfortunately, that doesn’t mean that selling stock in yourself is a good idea for a prospective student in the mental health professions of psychology, counseling, clinical social work, and family therapy. For one thing, private investors may simply not be willing to fund education that is long and expensive when they look at salary data in mental health. It seems much more likely that such investors would flock to students in more lucrative fields like business, engineering, technology, and medicine. And even if some enterprising therapy students could attract investors willing to fund their education, the kind of system envisioned with ISAs holds the potential to be rather exploitive. Let’s say, for example, that you are unable to secure enough in student loans, so you turn to a private investor to fund your education. And — lucky you! — you find one willing to take on the risk. In exchange for $50,000 to fund your education, they ask for 10% of your income per year for the next 25 years. To a hopeful student with no other options to fund schooling, that may be an attractive offer. From the outside, though, it just looks like a classier form of indentured servitude. It’s true that if you don’t complete your degree, you would not need to pay the money back. However, because these agreements define the investment as being in the individual, and not the specific career for which you received education funding, you would still owe a portion of what you make for the term of the agreement no matter what kind of work you wind up doing. Worse, if you do complete your degree, and you do find a well-paying job after graduation, you could easily wind up paying back four or five times the amount of the initial investment. Investors, after all, would understandably want their good investments to pay off bigger if they are taking all the risk for the bad investments. If nothing else, I admire the creative thinking on Rubio’s and Petri’s part. (In fairness, it isn’t their original idea; startups like Upstart and Pave have been working on this model for some time.) There is certainly some merit in having the most successful students end up paying the most for their education, rather than further financially punishing those who struggle the most to find work or finish their degrees. However, as it applies in mental health, this kind of a funding vehicle seems like a band-aid at best. It would keep a supply of students coming in to overly long and expensive training programs, with primarily investors and universities profiting. We still need a viable long-term solution that makes graduate training in mental health accessible and affordable for those who prove they are capable of doing the work. # # # Your comments here are welcome. You can post them in the comments below, or email me at ben[at]bencaldwell[dot]com.