Life, Work

Goodbye to all that: Letting go of the dream

Life update time!

Patient friends and family may have heard me talk about maybe becoming a therapist. I’ve spent more than a year thinking about it, and now that it’s the beginning of application season, it’s my self imposed time to do or die.

I’ve put in a good faith effort at really exploring this option by being honest with myself about my interests and capabilities, talking to people with the degree that I was considering, volunteering at places with similar work, and by doing the cold hard numbers. Still I waffled. Debt and an uncertain future were not exactly deterrents. Nuts, right? It wasn’t until I found this incredibly insightful, incredibly loooooong thread for the occupation that I really knew.

Nup, not happening.

I’m not going to become a therapist. I don’t want to do what it takes to get there, and I don’t think I would like the lifestyle. I figured it out last week. While this is all for the best, it’s really hard to give up on a dream.

Reasons I wanted to become a therapist:

  • I used to watch Frasier and think “that sounds awesome.” Yes, this is embarrassing. However once I started learning more about psychiatry, I realized that I wasn’t in line with drug therapy as the primary way to approach mental health issues. I ‘m more interested in talk therapy, and cognitive behavioral therapy (CBT), so counseling seemed like a better fit. Plus, no med school. Seriously.
  • I read a lot of self help for fun. My conversations with friends turns naturally to these topics.
  • I have a psych background. It’s destiny.
  • I like working one on one with people.
  • I am extremely comfortable with difficult topics such as grief, death and existential freakouts.
  • I’ve lived a little bit. Some bad things happened to me. I did some bad things. That seems like an essential therapist trait.
  • I wanted to own my own business and set my own hours.
  • I didn’t want to age out of my field. I wanted a job where my age is considered to be an asset.
  • There is a clear career path and a ladder for me to climb.

What Factors Changed My Mind?(Get comfortable this will take a while…):

Getting there:

  • $50,000- 84,000 in debt, not including living expenses for 2-3 years of schooling, and 2+ years of post school practice
  • 3,000 hours (about 2 years) of barely paid post graduate practice before sitting for the licensure exam.
  • Difficult to get experience without licensure, can’t get licensure without experience
  • Different licensure requirements across states will make my future life static. It also means that if a client moves, I can’t continue to help them. If I move, I may have to work for peanuts for another few years just to sit for licensure in the new state.
  • The wisest degree to get as far as reimbursements and employability would be a masters in social work, and while a very kind MSW helped me with grief counseling when my dad died ages ago, I’m not very interested in the coursework of the MSW degree.

Being a therapist:

  • Many insurance companies will only pay for a certain number of sessions, which means that you have to keep new patients coming in the door constantly. From reading over the forums, it is not that uncommon for a therapist to have 1-2 new patients starting each week, just to keep things going because others fall out due to insurance, cancel that week due to life events, or they just disappear completely.
  • The isolation of private practice.
  • The emotional heaviness of seeing people make the same mistakes over and over.
  • The intense marketing that is required to establish yourself and to keep your patient roster full (from creating relationships with doctors and employee assistance programs to create a referral funnel, to running free workshops, to managing the crazies on your Yelp page.)
  • The insanity that is doing insurance paperwork (which can be outsourced, but still).
  • While the listed rates may be high (100-150/hr) after negotiating with insurance companies, it seems that established therapists end up with an average rate of about 60$/hr of work, which they have to use to pay for malpractice insurance, office space, marketing, billing/admin, health insurance, taxes (especially high since they are self employed) etc.
  • If I want to be a good therapist, I am going to be on call. This would make it somewhat difficult to go on vacations, and would add an edge of uncertainty to everyday life.

After thinking it through, this is not the lifestyle that I want. If things were different with the American healthcare system, well… things would be different 🙂

So… now what?

I’m not sure. Mental health will always be a topic that I pursue on the side, like art. I’m really more upset at saying goodbye to a clear career path. I have so many interests that it can be hard to find something that feels right on most levels. At any rate, bullet dodged, my friends. You can all come out now and tell me that you told me so.