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Choosing the Right Career Path as a Psychologist

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Mental health services are becoming increasingly necessary on college campuses -- could this be the right career path for you?

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Mental health services are becoming increasingly necessary on college campuses -- could this be the right career path for you?

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News By Profession

Mental Health

Mental health services are becoming increasingly necessary on college campuses -- could this be the right career path for you?

By Sarah Sutherland

A recent increase in awareness of mental health issues has created new career paths for psychologists -- particularly in a college setting. In fact, it was estimated in 2015 that of approximately 106,000 licensed psychologists in the United States,1 20.9% worked in a university setting, and this percentage is bound to grow.2 Between 2009 and 2015, college counseling centers saw a 29.6% increase in students seeking services -- five times the rate of institutional enrollment. The number of counseling center appointments increased by 38.4%.3

There's no way to determine exactly what caused the sudden increase in usage of mental health services on college campuses. Although an estimated 26% of American adults live with a diagnosable mental health disorder, that doesn't mean they'll pursue the help that they need. Due to the stigma surrounding mental illness, those who struggle with mental health issues face pressure to keep their difficulties hidden, and that pressure could be strongest on college campuses: Individuals between 18 and 24 years of age show the lowest rate of seeking help from mental health professionals.4

To encourage college students to pursue the assistance they require, the sudden increase in usage of college counseling centers calls for substantial expansion of the services offered on campuses: 76.6% of college counseling directors have reported needing to decrease the number of visits for students to handle the increase in clients.5

PsychiatristTalkingwithPatient_300xOf course, college campuses do not house the only mental health services. Private practices are still well in demand: As of 2015, 33.1% of licensed psychologists in the United States worked in independent practices, making up the largest percentage of employed licensed psychologists.2

There are clear differences between working in a private practice compared to a college counseling center. How can mental health professionals decide what setting is the best fit for them? ADVANCE recommends carefully considering the differences between the two settings before determining which location would best benefit each professional and her patients.

Private Practice
In movies and television shows, psychotherapy is often depicted solely in private practices, and the depictions of these practices are rarely varied. On the screen, viewers see a psychologist with a notebook, looking over her glasses at a patient who speaks while lying on the couch. Of course, fictional portrayals cannot represent all private practices, but are these depictions generally accurate?

According to Natalie Petyk, PsyD, they can be -- but not always. Petyk, who has experience both in a private practice and in a college counseling center, spoke about the differences between the two settings. However, she noted that there is no universal experience of psychotherapy, particularly in a private practice setting. The beauty of private practices is that psychologists can design them to best fit themselves and their patients. They can choose to exclusively work one-on-one with patients, or to offer group therapy sessions. Similarly, psychologists can choose to work independently in a more isolated environment, or to work among peers while still operating a private practice. "They can get themselves in a peer-to-peer consultative group, or rent space with other professionals," offered Petyk. "They can create that culture for themselves."

However, the technicalities of operating a business unavoidably accompany working in a private practice. "You need malpractice insurance, you need record-keeping and billing systems, you need a national provider identifier (NPI)," said Petyk. "You also need to make all of the decisions having to do with establishing your fee, and it takes a lot of sensitivity when making those decisions. What's your personal threshold based on your caseload? Can you do your own billing? Will you hire an admin to do your billing?" These sorts of decisions may fall outside of what psychologists initially anticipate being part of their workday, but a private practice cannot operate without these technicalities.

College Counseling Centers
In Petyk's experience, the responsibilities that come with working in a college counseling center vary greatly. "You're wearing a lot of hats. You might do a workshop, you might run a 10-week psychotherapy group, you might do individual psychotherapy," she said. These variations in responsibilities can come about in different ways. Some can arise from a psychologist's own interests while others are assigned based on an identified need in the community, according to Petyk.

Just as responsibilities vary, so do roles played by the psychologist. "I was an adviser to Active Minds, a mental health advocacy group that's on hundreds of college campuses," shared Petyk. "Sometimes you're in a consultative role, where you're having faculty call you to run a scenario by you. I don?t think you'll see those kinds of roles as much in a private practice."

In college counseling centers, where patients all come from the same community and generally fall within the same age range, unique issues can arise. "Having a multiple relationship is a greater possibility than it is in a private practice," said Petyk. According to the American Psychological Association, these relationships occur "when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person."6 In college counseling centers, the second scenario is the most likely. If the psychologist realizes the presence of a multiple relationship within the initial sessions, she will likely refer the patient to a colleague -- but it's not always that simple.

"It can take you, or the clients, months to realize how worlds can overlap," explained Petyk. "At that point, you're already in the treatment relationship, so you don't want to refer the client out at the risk of losing the working alliance that's been built. You just have to do your best to hold onto those complexities and remember where you learned what information from, and all the while not revealing to the clients that there's a dual relationship. Most of all, though, you have to be aware of whether or not you can remain objective."

While some difficulties can potentially arise, Petyk sees them as being a crucial aspect of what makes college counseling centers such rich settings for psychologists. She has valued her time in a college counseling center due to both the variety in roles and responsibilities, and the abundant opportunities to interact with her colleagues. "There are things like staff meetings, professional development hours and case shares that are built into our schedule, but there are also the informal things, like knocking on someone's door to run something by them, or just talking during a break," Petyk said. "I really value the collegial atmosphere."

The Best of Both Worlds
"It doesn't have to be an either/or proposition," said Petyk. "You can do both. There are ways to have your foot in both doors." Indeed, many college counseling centers have begun to offer four-day workweeks to enable their staff to maintain private practices, creating the perfect opportunity for psychologists to pursue both paths.

There is no "right" career path for psychologists in general -- but there is a right career path for individuals. "You need to know how you thrive off of sharing or relating, or how much you thrive off of your own privacy and separateness," explained Petyk. Only in first determining what setting best fits their own needs can psychologists fully serve the people who depend on them.

Sarah Sutherland is a staff writer for ADVANCE. Contact: ssutherland@advanceweb.com

References
1. Lin, L., et al. 2015 County-level analysis of U.S. licensed psychologists and health indicatorsAmerican Psychological Association. 2016: 1-30.
2. Center for Workforce Studies. 2015 APA member profilesAmerican Psychological Association. 2016: 1-10.
3. Center for Collegiate Mental Health. 2015 annual reportPenn State. 2015.
4. Active Minds. The issue: student mental health.
5. American Psychological Association. The state of mental health on college campuses: a growing crisis. 2011.
6. American Psychological Association. Multiple relationships and APA's new ethics code: values and applicationsMonitor on Psychology. 2004;35(1).


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