An Academic's Guide to Becoming a Therapist

I used to work primarily as an academic philosopher: I did research and taught, mostly contentedly, at several research universities in the United States and abroad. I still do some speaking and thinking about philosophy, but my primary work is as a therapist. I am on the staff of an outpatient psychiatric clinic where I see patients, most of them with a diagnosis of serious mental illness, for long-term psychotherapy.

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Occasionally, people wonder how I made this change, either because they are contemplating such a change themselves or because they are simply curious. This post is an attempt to answer them.

There are probably many ways to become a therapist, and I will be focusing mostly on how I did it, partly because it’s the one I know best. I will also generally be speaking to other folks of my general background – a humanities Ph.D. and some post-Ph.D. experience – but what I say should have fairly broad applicability to people from different backgrounds as well.

Finally, I will focus on how things are in the United States. This whole process is quite licensing-dependent, so questions of jurisdiction matter far more than they might in academia. I don’t know what a similar guide might look like for Australia or China, though I’d be interested to read one.

Step One: Gaining Experience

I got a start in doing this kind of work on the side, while working a full-time job, in two ways that I would strongly recommend to anyone.

First, I had the opportunity to volunteer at a Boston-based suicide helpline, Samaritans. Samaritans provided remarkably good training and experience, but there are many similar helplines in other cities seeking volunteers. (The Trevor Project is another one that has been recommended to me). This is a vital way to gain experience in attentive listening while being of genuine use to people in crisis.

Second, I did a year-long postgraduate fellowship at a psychoanalytic institute, the Massachusetts Institute for Psychoanalysis. We read articles in the history of analysis and discussed cases. This was a remarkable opportunity to train alongside working clinicians, and it was open to anyone with an advanced degree. Similar programs are available at many psychoanalytic institutes.

Step Two: Returning to School

These were great experiences, but ultimately retraining as a therapist requires an additional degree. This was the most daunting part of the process for me – I had spent a long time in school, had worked as a professor, didn’t want to be a student again – and I suspect for many potential academic would-be therapists as well.

For me, at least, this was a real but manageable hurdle. I considered and decided against the degrees that would require a long return to school – the Ph.D. in Clinical Psychology, which is another full research Ph.D., or the Psy.D., which is slightly quicker but also generally unfunded. I narrowed my search to two-year degrees: the Masters in Social Work (MSW) and then other Masters degrees in Counseling or Psychology. This is an important choice point, and worth researching. I myself ended up deciding to pursue an MSW, and have been happy with that choice.

There is then the question of which school to attend. I probably spent more time worrying about this than I needed to, and this is the kind of question that tends to loom large in the minds of academics. I would suggest the following strategy: find a list of reputable programs (this one seems fairly accurate), apply to the programs on that list in the geographic area where one wants to practice (MSW training is state-independent, so this is not essential, but it cuts down on relocations), and then go to the program that gives one the best financial aid package. This is roughly the strategy that I ended up following.

The question of financial packages raises the financial impact of this whole enterprise. These degrees are generally not funded, though in my experience several offered grants that significantly offset the “sticker price” of the program. Furthermore, I found many people (myself included) worked part-time during our studies to offset costs. I had several friends from all sorts of personal and professional backgrounds, who managed to make the financial side of things work out. But this is a highly personal decision and it's hard to generalize.

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Then there is the school itself. I had some brilliant introductions to critical material (CBT, suicidality, group therapy) taught by dedicated instructors. I found, however, that I learned the most in my clinical placements, especially my second-year placement, which I was honored to spend providing individual psychotherapy to patients with HIV at a major Boston hospital.

Step Three: Finding Work

Having completed the degree, the next step is to find a job. For the MSW and similar degrees, one is required to have 2 years of supervised post-graduate work before acquiring licensure, somewhat analogous to residency for an MD. There are several fellowships for this stage that may be appealing for folks coming from academia. I personally knew that I specifically wanted to work with patients with serious mental illness (schizophrenia and bipolar disorder) and was fortunate to find a position in a clinic focusing on such patients, with supervision while I prepare towards independent licensure.

That is what I do now. I see patients in my office in downtown Boston for individual long-term therapy. I set my own schedule, have a manageable caseload, and work with dedicated and brilliant colleagues. I am fortunate to be doing precisely what I set out to do when I set out on this path a few years ago. The purpose of this guide is to help some other folks from an academic background to see the way towards doing the same.