Tag Archives: Clinical Psychology

January 24, 2012 · 5:25 pm

Financial questions about becoming a Christian psychologist


Recently, I received a  blog comment to an post I wrote a year ago about the decision process for those thinking about pursuing doctoral programs in psychology. You can read that old post here. In response, Emily asked,

I’m really wondering what you’re thoughts are on places like Rosemead and Fuller. They appear to be wonderful institutions but I have heard that students come out with $100,000+ worth of debt. Is that really worth it, or would it be just as well to get two separate degrees – one in psychology and one in theology. Doing my own research, I’ve discovered that to get a PsyD at Rosemead would cost me over $200,000 for 5 years. That includes tuition, miscellaneous fees, books, and the cost of housing in SoCal. I just can’t decide whether it’s worth it or not and I would love to know the thoughts of a Christian Psychologist on this.

Emily’s question is very important. Much of the time, we answer questions about doctoral training by discussing career goals, philosophy of education, and theological training. However, it is a huge oversight to ignore the high cost of a doctorate in clinical psychology. So, I want to respond to the issue of economics by raising a few questions for the person considering doctoral education.

What is your desired career outcome? Is it necessary to have a doctorate?

Wait, this doesn’t sound like an economics question, right? Well, if you are thinking about taking on a sizable debt then you ought to consider whether or not you absolutely need to do it. If you want to be a professor in a University, then you’d better be looking for a PhD (probably over a PsyD which tends to cost more). If you want to counsel people, you might not need a PhD or PsyD. You might be fine with a Masters’ degree and really good supervision by a doctoral level psychologist. If you really want the extra years of training and the possiblity of supervising others, then maybe the doctorate is right for you. If you don’t know if you need a doctorate for what you want to do, then find out first before you take on the debt load.

Can I find a cheaper PhD/PsyD program?

Some of the Christian programs tend to be longer and therefore more costly. The reason is that these programs believe (rightly so) that theological training is essential. While I am a proponent of an integrated (theological and psychological training), you may be able to find cheaper theological training and mentoring in another format while completing a secular (and shorter) degree program in clinical psychology. It is possible that a seminary degree or certificate in theological or biblical studies will provide you want you need. Or, you may be able to befriend a well-trained pastor or counselor who will mentor you for free or for a meal and and coffee. The question you need to evaluate is whether you want theological competency or a degree to show up on your vita? Do you need to get the official “blessing” of a degree to get a job?  Are you prepared to complete a secular based psychology degree and confident that your value system will remain intact? If not, you could undertake some graduate training in theology first and then complete your doctoral training elsewhere.

What is the likelihood you can pay off your school debt quickly?

Will you be able to secure a job that pays well enough to pay off your debt, pay your living expenses and/or purchase a house at the same time? Are you wanting to be a missionary psychologist with a 200K debt? Do you know what the going salary is for individuals working in the field you want to enter? You should check out www.apa.org for some very helpful data (search their site for “salary” and check out the information) such as this link or this one on the current debt load and salaries of the field.  Some psychology grads have been able to land jobs that enable them to pay off federal loans in an abbreviated fashion in return for their years of service in an underserved population.

One way that students reduce their debt is by (a) marrying someone rich (just kidding…though I was married to someone able to command a great salary), (b) working full-time while going to school full-time, (c) reducing expenses by living in a communal setting, or (d) getting work study for tuition reduction. Options A and D may be limited. Option B is possible but may drive you insane as you do it.

Finally, do you have family/friends who want to give to your educational needs?

I know of a student who held a dinner for important friends/family/church members in the church basement. After the meal, he made a presentation to all about his educational dreams and desire for training. He asked them to give…and they did. I imagine there might be some creative ways for people to give and get a tax credit for it. If what you want to do is important and will fill a void…someone might be willing to help fund you. Friends? Family? Church? Employer?

I was blessed by being able to get through a 5 year (4 years of coursework and 1 year postdoc year) program with no debt at all. We lived very frugally. My wife had a great job. We received some inheritance. I worked a couple of different part-time jobs. Somehow, we survived for a year of postdoc life with a newborn (adopted even! Thank goodness for adoption tax credits) on about 11,000 dollars of salary. The Lord provided. The degree was absolutely essential for what I wanted to do.

If you are thinking about this kind of major decision. Pray. Ask for those you trust to offer their advice and to pray with you for an open door.

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March 25, 2010 · 5:02 am

Considering a doctoral program?


In recent weeks I have had several students ask me about the pros/cons of doctoral programs in psychology. I would point those who know they want to attend a traditional clinical psych program to this book by the APA. It offers lots of helpful data on programs and what they require.

For those not sure what they want to do or if they should pursue doctoral studies, consider the following. If readers have additional questions we should consider, post them in a response and we’ll expand on these. This is my first pass:

What career doors do I want to open that are not available to me now? Do I want to teach? Do I see myself in private practice? In a research job? in the business world?

The PhD in Clinical Psych from an APA accredited program (and with an APA approved predoctoral internship) probably opens the most doors of all. This degree allows you to teach in both undergrad and grad depts., work in research settings, government settings, private practice, etc. There are specific kinds of jobs that it might not help: such as an area focusing entirely on social psychology or developmental psychology.

One caveat. If you want to teach in a MA Counseling program that is either seeking or already obtained CACREP accreditation (counseling accreditation sponsored by the ACA), you will need a PhD in Counselor Education (which entitles you to work towards an LPC credential). This is a recent and troubling change (turf warfare with psychology).

Part of your work dream should answer whether or not you are looking to work in either a secular or faith environment. Now, you can change your mind but there will be some doors that are easier to open with secular degree and other doors that a Wheaton/Fuller/Regent degree will open more easily.

What areas of counseling/psychology most excite you?

Try to be creative here. Think more than just private practice, 50 minute hour. Who do you know who is doing what you would like to do? Find out where they got their education? Be bold, ask them (even if you do so by email) what they would recommend as an educational route to do the kind of work they do now.

Programs tend to have both a model of psychology (some are CBT others are more analytic) and a focus (specialties). Further programs tend to either be scientist focused or practitioner focused.

Many programs are generalist, but it is helpful to have a specialty. Child? Forensic? Neuropsych? Geropsych? Marriage & Family?

Look at what the professors are publishing at the schools you are thinking about attending. Anything there excite you? FYI, professors love those who are excited to help them with their research

PhD or PsyD?

There are some differences. Typically, the PhD student completes a very rigorous dissertation (has more coursework in research and stats) but has fewer practice hours (maybe 800 total) leading up to their yearlong pre-doctoral internship year.

PsyD students tend to have a less rigorous dissertation (though my PsyD program acted more like a PhD) but have far more practice hours under their belts (maybe 2000!).

PsyDs do get teaching jobs but less likely in undergrad programs because of old assumptions (i.e., PsyDs are practitioners and PhDs are scientists).

Secular vs. Christian programs?

The first question: what is your current theological/biblical literacy level? How well do you understand the depths and complexities of your faith? How well versed are you in the controversies surrounding Christianity, Psychology, biblical counseling, integration, etc.? Your answer will dictate how ready you are to jump into a PhD or PsyD in clinical psychology. If your faith is weak, then you may want to strengthen it in an MA program at a Seminary. Or do some reading on your own. Psychology is not just an art and science, but a philosophy. You want to know what philosophy, even religion, you are imbibing. Sometimes the glittering images of psychology cause students to neglect the source of the power of change.

Practical matter: Christian doctoral programs in Psychology tend to be a year longer (because of extra bible/theology courses). Being a graduate of these programs will not harm you in secular settings (usually) if the program is accredited by the APA.

Obviously, programs and schools have identity. You graduate from Harvard, you get an identity. You graduate from Fuller, you get an identity—fair or not.

In my experience, secular programs tend to have less issues about a student’s Christian faith than do quasi-Christian programs or those housed in catholic institutions. These programs have had more fundamentalist-liberal wars and so you find faculty more sensitive.

If a student has a strong theological base, I would probably go for a secular institution unless you want the Wheaton/Fuller credential to open Christian doors.

Counseling Psychology vs. Clinical Psychology programs?

Not much of a distinction here anymore. I think the clinical one is more valuable (my bias) but once you have the degree, no one explores your transcript.

Would you rank the Christian doctoral program?

No. Each one has their own strengths and liabilities. I would look at the professors at each and what they are writing/doing. Try to go learn from some professors you’ve come to respect. For example (and this is a limited sample. Some schools I haven’t really known much about)

Regent University (VA Beach): Mark Yarhouse, Jen Ripley and Bill Hathaway are topnotch Christian psychologists. With Mark you get the sexual ethics research as well as someone well-versed in Puritan writings. With Jen, you might get access to her and Ev Worthington’s work (forgiveness, couples, etc.). Of course Ev is at VA Commonwealth and so you might want to go right for him.

Wheaton: There are a number of great faculty there. But let me mention just three. Sally Schwer Canning is doing child and urban stuff. Bob Gregory is doing neuropsych stuff and William Struthers just published on porn and the male brain.

George Fox: At Wheaton I came to really respect Mark McMinn. He is now at George Fox (Oregon). He’s great to study under for psych testing and his integrative model. Plus, if you get in on his research team, he’ll teach you how to be a survey king or queen. He is a publishing machine!

Biola: Todd Hall and Jon Coe just published a key work called Psychology in the Spirit. It is going to be a significant work.

On-line vs. residential programs

Online programs only if they are APA accredited (psychology programs that is). You have to be a self-starter. These still get negative reactions from some of those in the position to hire you. In the PhD in counselor ed, both Regent and Liberty have programs with good quality eworlds.

Residential provides lots of time to interact with profs on a daily basis. There isn’t a way to really do this in the on-line programs (which tend to have lots of students in them!). You can get good peer relationships in on-line programs, sometimes even better than in person.

I’m sure I’ve left something out. What else should we consider? Of course, you should get your MA from Biblical Seminary. That way, you will be prepared to think Christianly, biblically, and yet able to think psychologically about the world. 😉

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March 10, 2008 · 10:06 am

Science Monday: Child PTSD


Today’s psychopathology class focuses on child related problems. Given the societal focus on ADHD and Asperger’s, our class will hang out there. However, I want to bring to your attention some work in the area of family violence and childhood trauma reactions. Gayla Margolin and Katrina Vickerman (of USC) published 2 articles in a 2007 (38:6) issue of Professional Psychology: Research and Practiceon the topic of PTSD in children exposed to family violence.

Article one (pp 613-619) provides an overview. First, they recognize that some kids have PTSD without a single discrete precipitating and/or life-threatening event. It appears that prolonged exposure to violence (e.g., domestic violence, physical abuse, sexual abuse, community violence) likely has a deleterious impact on children. Some 30% of kids living with both parents experience domestic violence. Some 5-10% of kids experience severe physical abuse. One article summarizing a number of studies suggested that somewhere between 13 and 50% of kids exposed to family violence qualify for a PTSD diagnosis. In foster home and clinic studies, the number with PTSD seems higher, especially in girls. Not every child who experiences violence shows signs of PTSD. Severity and frequency of exposure to violence probably matters most. What makes family violence so troubling is that the child is faced with the constant threat of additional episodes.

What are the common domains of impairment related to complex trauma exposure? Affect regulation (inability to modulate anger, chronic flooding of negative affect), information processing (concentration, learning difficulties, missing subtle environmental nuances, overestimation of danger, preoccupied with worry about safety), self-concept (shame, guilt), behavioral control (aggression, proactive defenses, and substance abuse), interpersonal relationships (trust), and biological processes(delayed sensorimotor development (p. 615).

The authors repeat a previous suggestion of a new diagnosis: Developmental Trauma Disorder(DTD) to adequately capture the picture of youth trauma reactions to family violence. Criteria include: repeated exposure to adverse interpersonal trauma, triggered pattern of repeated dysregulation of affect, persistently altered attributions and expectancies about self and other, and evidence of functional impairment.

In their second article (pp. 620-628), the authors summarize typical treatments for children: reexposure interventions(to help the child understand and gain mastery over their past experiences that intrude. This is done primarily by a trauma interview where therapists work directively to bring fragments of the story together into a coherent whole and meaning and safety are explored), cognitive restructuring and education about violence exposure (goal to undo lessons learned, practice thought stopping, and to normalize reactions), emotional recognition and expression (to attend to and understand connections between emotions, thoughts, and behaviors), social problems solving, safety planning for those not able to be out of potentially violent environments, and parenting interventions.

Do any of these treatments work? It appears several do. I’ll mention just one here:Trauma-focused CBT for child abuse victims (by Cohen, Mannarino, and Deblinger. That intervention is published in their 2006 Guilford Press book, Treating trauma and traumatic grief in child and adolescents.   

We should not underestimate the impact of family and community violence on children. There are many kids labeled bi-polar, ADHD, personality disordered, oppositional (and worse) who carry within their body the impact of violence. They might look like a gang-banger or a thug who’d kill you because you scuffed his shoes, but they likely are hypervigilant and only read part of the environmental cues to determine if they are in danger.

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