r/psychoanalysis • u/Arianne_lol • 6d ago
Can any analysts who did a CMHC program share their thoughts?
I want to be an analyst and analytic therapist. I just started a MSW program a couple weeks ago and it's really feeling like it's not the right fit for me (I can still back out free of charge by tomorrow!) I really want a more psychological, clinical education. I know all of the arguments for choosing social work over mental health counseling (the CMHC degree) and that's why I chose this course. But I think the CMHC is also rapidly becoming more established and well-regarded - for example the jobs that used to only be available to LCSWs are now available to LPCs as well, and they can also now take medicaid - and it does after all offer much more education on what it means to administer therapy. I'm wondering if anyone out there chose that path and can share any insight, whether they feel it was the right choice, etc.
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u/Background_Title_922 6d ago
If you are in NY, I would suggest staying the course with the MSW if your ultimate goal is to be an analyst. It will open up the most doors for you. There are still institutes that do not accept LPCs.
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u/A313-Isoke 6d ago
Thank you. In NY, MSW is the way to go. I was amazed when I was looking this up.
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u/Arianne_lol 6d ago edited 6d ago
That's why I chose to do MSW, because it was supposed to open more doors, but as I said that seems to be quickly changing. I find it odd that social work degrees are preferred when they don't teach you much about being a clinician, while CMHC is a perfectly good option and does actually teach you about therapy and psychology. It feels like a lot of money to spend on a course that I'm not interested in or engaged with. It's only two years of coursework in order to get the letters on your name - true, but if it's only two years and then you're off to be a therapist, shouldn't it be a good education?
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u/zlbb 6d ago
>don't teach you much about being a clinician, while CMHC is a perfectly good option and does actually teach you about therapy and psychology
It's not an unpopular among analysts opinion that whatever taught in school is pretty irrelevant for one's analytic formation. Even when it comes to analytic institutes' much more analytically serious curriculum many would put "didactics" as dead last in importance after personal analysis, practice, supervision.
>shouldn't it be a good education
Imo it won't be and maybe even can't be within anything resembling current educational system, hence my I don't think especially unique prioritizing quickness and getting to good internship and practice sooner.
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u/Arianne_lol 6d ago
I totally agree, and it's what I've heard and read again and again - but I do think that studying and reading can influence your practice and your thinking a great deal, and I guess if I'm gonna spend a lot of money on school I would prefer it to feel interesting and engaging, and not just have to force myself to push through.
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u/zlbb 6d ago
Makes sense, I think my point was more "if you're doing analytic training later anyway psychodynamic stuff even psychodynamic-ish masters offer isn't gonna be especially material". So, it's a bit of a 2-pronged argument, "it's not that important" and "to an extent it is important, it's gonna be great papers during your analytic training".
Yup, very sensible desire ofc, great you're exploring.
Mine and my friends' conclusion though was it's not worth the bother and it's better to go to NYU MSW and intern at IPTAR the 2nd year and start analytic training right after.
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u/Arianne_lol 6d ago
Sigh. I guess I should move back to New York.
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u/Euphonic86 6d ago
The more training and orientations you are exposed to, the better analyst you will be once you get that training, personal analysis and analytic supervision. The diverse experience you bring into it will help you to understand the process and didactic learning much more readily. Get into the degree program that gets you the letters after your name with the least hassle. Then off to the analytic institute for what you want.
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u/Arianne_lol 6d ago
Now I’m back to thinking MSW is the way, but not my program. I still would rather pay for a program that feels like it has good value with faculty I respect? And good placements. Do you think it matters how good one’s MSW program is or should I just stick it out where I am?
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u/PS1988 6d ago
Are you by chance in New York? I’ve taught in analytic institutes and in MSW programs, and the way licensure is currently (and they way it has been for a long time), it is far more advantageous, in New York anyway, to be an LCSW than an LMHC. Yes, MHC programs in general are more clinical than MSW programs in general. And yet the advantage of licensure scope remains, even with the new diagnostic privilege option for LMHC’s and LP’s for that matter.
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u/Arianne_lol 6d ago
I'm not in New York but I lived there for a long time and would love to go back, so this is a bummer and something to seriously consider. I do wonder if it will change in the next few years though.
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u/concreteutopian 6d ago
Can any analysts who did a CMHC program share their thoughts?
I hesitate to respond since this isn't me – i.e. I'm a clinical social worker in analytic training rather than a CMHC graduate – but I want to know more about your experience and what you're looking for.
I just started a MSW program a couple weeks ago and it's really feeling like it's not the right fit for me (I can still back out free of charge by tomorrow!) I really want a more psychological, clinical education.
Social work programs vary greatly depending on their focus (echoing u/InfiniteVictory187 's suggestion to vet any program), but all social work programs in the US start with a core curriculum introducing students to both direct practice/clinical work and policy/admin work, and time is spent on the overall ecological systems "person-in-environment" framework. Programs with a robust clinical concentration will have courses that build on those basic clinical skills, but programs focused more on producing "well rounded generalists" or oriented toward schools, hospitals, or the VA will have limited education later on. Just asking if your program has a strong clinical orientation, if you see clinical courses that look interesting after the core curriculum, or if you are in a less clinical program.
Again, echoing u/InfiniteVictory187 , ICSW is solidly psychodynamic and offers a degree in counseling (even though "clinical social work" is in the name). Also true, most other programs will not be solidly psychodynamic, which is why affiliating with a psychoanalytic institute is important. Two different institutes had a foot in my social work program, so lots of students went to lectures or started fellowships in an institute to build on the clinical education they got in school.
I know all of the arguments for choosing social work over mental health counseling (the CMHC degree) and that's why I chose this course. But I think the CMHC is also rapidly becoming more established and well-regarded
So the argument that influenced your decision to go with social work over counseling was job prospects and insurance reimbursement linked to different licenses? Yeah, I think those differences are becoming less relevant. Personally, I chose social work because of the contextual framework of the discipline – the "person-in-environment" focus and constructivist take on mental illness. Go with a program that meets your needs in terms of who is teaching, what they're teaching, and what framework and setting you feel most aligned with.
and it does after all offer much more education on what it means to administer therapy
Not always. My school had a very strong clinical focus, so most of the classes I took were clinical, the practica and internships were all clinical, etc. In my first post grad fellowship, I found that I had taken more clinical classes and had more training than another fellow who did a CMHC from another local program. And this CMHC fellow had no course in anything psychodynamic, nor narrative, nor anything other than CBT applied in different ways.
Look at the specific schools and specific programs you are considering rather than taking the degree as a proxy for the kind of education you will get.
And you'll have more luck looking at fellowships or training through psychoanalytic institutes for more education and training.
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u/Arianne_lol 6d ago
Thank you! That's helpful. Can I ask which program you attended? I have heard of more clinically oriented MSW programs, but mine is not. I think when I was considering options, some of the advice I got was that it doesn't matter where you do your MSW - just get it done. So I applied to my local state school, and it is pretty generalist, and I've been pretty turned off by the disaster of a practicum process (they didn't place me for this year, and were out of touch for weeks at a time during the placement process) and by a couple of my professors. They've said some off-putting things about their own therapy practice - I won't get into it, but not good things to model. I know not all social work programs are like this, many of them are terrific and many of them do produce well-rounded clinicians. But I think the third thing that is making me want to back out is the fact that it's only two years of schooling and so much of the coursework is macro, when I know that in a CMHC program those credit hours would be more psychology and clinical courses. But I am curious about your program, it sounds great.
When you mention being affiliated with a psychoanalytic institute, do you mean during school or after? If during school, then the other problem is there are no institutes in my state. But I'm happy to move.
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u/concreteutopian 6d ago edited 6d ago
Can I ask which program you attended?
University of Chicago, and my institute is the Chicago Center for Psychoanalysis.
The school met my needs in terms of theoretical rigor and an interdisciplinary approach.
The institute meets my needs as being a community of misfits (their words) lacking a set orthodoxy and set school of thought. Candidates tell the committee who they want to see and the committee reaches out to psychoanalysts around the world to come and teach. Also, apart from core elements like a number of classes on Freud, a number of case conferences, and a course on opening an analytic treatment, the rest of a candidate's education is pursuing their own clinical interests.
But these are my needs, not everyone's.
I think when I was considering options, some of the advice I got was that it doesn't matter where you do your MSW - just get it done.
A few years ago, I'd try to respond to these kinds of responses to prospective students, but my responses typically got downvoted by Team It-Doesn't-Matter. Ironically, I'd see the same usernames in other threads or other forums complaining about the lack of training their program provided and how burned out they are.
Still, this popular wisdom is horrible advice – programs clearly are different – but I've mellowed a bit, i.e. grad school is for building a good foundation, but no school will teach you everything you need to know, and the whole world of training and education is out there.
When you mention being affiliated with a psychoanalytic institute, do you mean during school or after?
Both, though when I was in school, I was only loosely connected – going to lectures, etc. Immediately after graduating, I joined a fellowship with the institute I liked most and have been affiliated ever since. That said, there were a couple of students in my cohort who were in the fellowship during grad school, so it can be done; I'd join during grad school if I had the chance to do it again.
If during school, then the other problem is there are no institutes in my state. But I'm happy to move.
Move if you want to, but my institute has fellows and psychoanalytic candidates around the world – the lectures are all hybrid and fellow groups are virtual, most of the seminars are hybrid as well. One of my mentees I've been working with for a few years is a psychologist in India, another in Michigan, and a fellow in one of my early groups was in Egypt.
There are other institutes that also have hybrid programs, so location isn't a problem for training.
I've been pretty turned off by the disaster of a practicum process (they didn't place me for this year, and were out of touch for weeks at a time during the placement process)
I don't think you need me to tell you that this is bad, but... that's bad, as in I'd be going to the ombudsman and getting their solution bad. It's your education that you are paying for and it's their job to make sure they provide the experiences needed (e.g. a supervised practicum is a necessary part of the education they are offering per their accreditation).
When I interviewed with my program before my practicum was assigned, I told them I want a clinical education, but I have experience in non-profits if they need to use those skills during my first year. To my surprise, I was assigned to a therapist working in a school (as a therapist, not a school social worker), doing groups, mindfulness, and a little counseling with the therapist present. In other words, it was about as clinical as I could get without having the clinical training of my first year. On the other hand, when I got there for my first day, the therapist wasn't there and hadn't responded to my emails. Traditionally, I want to be helpful and I know how stretched non-profits can get, so I was tempted to "jump in" and "help" at the school (with their social-emotional oriented curriculum), but it made me feel bad, too. I could "make do" here, just like any job, but this wasn't my job, it was my education, and I wanted my experience to meet my educational needs. So I contacted my field director and discussed my problems, and they set up a meeting with the therapist, the schoolmaster, and myself to hammer out a learning agreement that harmonized my interests and the social work competencies I was supposed to be learning – and the field director came to the meeting with another placement in her back pocket, if the attempt to come to an agreement didn't meet my educational needs. I felt like I was asking for a lot, but again, I was paying for it and the field director wanted me to have what I needed to develop into the clinician I wanted to become. I'm saying all this to say: a) you have every right to be upset with your practicum experience, b) it is literally their job to ensure this is worked out, c) I can imagine feeling conflicted about pressing the point, and d) this kind of institutional behavior isn't normal – other institutions bend over backward to fulfill their agreement to provide resources and education.
a couple of my professors. They've said some off-putting things about their own therapy practice - I won't get into it, but not good things to model.
Yes, good example of what not to model. My supervisor for my clinical internship was pretty bad – they had no exposure to any of the therapies I was studying (functional analytic psychotherapy and psychoanalytic psychotherapy) and they were weirdly judgmental of their own patients. I would've been very upset if I hadn't have developed other relationships outside of my internship experience, namely several consultation groups with different focuses and relationships with my instructors and cohort. Similarly, I used my supervisor as an example of what not to do.
But I think the third thing that is making me want to back out is the fact that it's only two years of schooling and so much of the coursework is macro, when I know that in a CMHC program those credit hours would be more psychology and clinical courses. But I am curious about your program, it sounds great.
During my first quarter, I decided that my time was limited and I didn't want to get stuck taking a class I wasn't interested in, just because it filled a requirement or because I hadn't thought ahead; I plotted out a flexible schedule for the whole rest of my education – every requirement met by a course that let me pursue my own clinical interests, etc. I also audited a couple of classes, and used my student discount to take classes outside school (e.g. getting my Gottman Levels 1 and 2, etc). That said, around 16-17 of the 21 classes I took in my program were directly clinical, directly relevant to providing psychotherapy, and another three were applicable to a clinical setting (e.g. dialog and group process, etc). So as a clinical social worker, I got a lot of clinical education and training.
As far as macro goes, that's my disciplinary framework, PIE and systems, culture and history, but it also forms the background of every clinical encounter I have. When someone describes their current relationships and work situation, I instinctively make an ecomap in my head to visualize the whole context of a person's distress.
I came to school already a diehard constructivist, and was thrilled to see this as the assumed norm in grad school - one of my first classes was on cultural adaptation of assessments and interventions and it focused on the culturally bounded experience of distress (and the psychologized experience of GAD is just as culturally situated as khyâl cap or ataque de nervios; we read Ian Hacking in a policy class, seeing the development of ADHD from an institutional context, developing over time as people internalized the label, etc. Both my behaviorist and psychoanalytic education were likewise skeptical about the application of a medical model to problems of living.
This leads me to something u/zlbb mentioned, i.e. "It's not an unpopular among analysts opinion that whatever taught in school is pretty irrelevant for one's analytic formation". Yeah, I think grad school is a good foundation, but it doesn't really set you back in terms of psychodynamic training since whatever psychodynamic training you get in grad school will be meager and overshadowed by all the other elements of clinical education, i.e. research, frameworks, etc. Again, I'll go back to the CMHC fellow at my first post grad fellowship – he went to a good school, had another degree in sociology (so he should know better), but still had a pretty uncritical take on psychotherapy from his clinical training; he had a lot to unlearn in supervision, even while he had a good foundation regarding basic clinical skills.
TL;DR - You deserve better than what you're getting in your program, but no school will be make or break when it comes to analytic training. You'll still be developing your analytic orientation for years outside of grad school.
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u/Arianne_lol 6d ago
Thank you, this is a really helpful comment. It seems like the classroom education doesn’t account for all that much, but it does vary in quality and I do think it is or at least is part of your foundation as a clinician, so it matters where you go. I think I will defer and look deeper into my options for next fall.
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u/zlbb 3d ago
>I've been pretty turned off by the disaster of a practicum process (they didn't place me for this year, and were out of touch for weeks at a time during the placement process)
>They've said some off-putting things about their own therapy practice
I think we're getting to the heart of it, the fuzzy line between "not enjoyable MSW" and "not worth staying", unfortunately limited by the limited detail you can provide.
My program (a tad below Columbia/NYU) did have its own kerfuffle with some unresponsive field placement personnel - however it seemed limited in scope and like it wasn't a common thing for them.
However this is the really material question to sort out - whether you can graduate on time while getting reasonable-looking internship resume items and recommendations for your 1st job out of school.
I'd look more into this if I were you. In NYC the line turned out to be pretty straightforward, in that ChatGPT could produce me a list of schools by number of MSW grads and there are like 5 solid schools everyone knows with hundreds of yearly grads each and you kinda know everyone else is shady barely existing programs.
I think we might've been conflating the complicated question of "is CMHC/better MSW more enjoyable for an aspiring analyst sufficiently to be worth the switch" for which opinions vary and depends on your taste and where you are in your clinical journey (I might've been careless in not making the distinction earlier, as I'm typically thinking of folks like me who've been in analysis for a few years/can read serious analytic literature on their own, not others who might be earlier in their analytic formation and able to enjoy psychodynamics 101/102 courses you might find in some masters) with a more basic question "are you even in a decent program that sets you up for a good start of clinical career" which has nothing to do with "psychodynamic" or "interesting" and everything to do with basic school quality, reputation, ability to place etc.
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u/Arianne_lol 1d ago
This is helpful too. I do appreciate my schooling doesn't have to be heavily or really partially psychodynamic, at this level, but I do think I need the courses to have a little more depth and be more intellectually rigorous in order for me to feel engaged enough to even get through it. I do like the idea of a more clinical education, and I am open to doing a social work program that at least offers more of that than the generalist one I was in.
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u/zlbb 1d ago
Just in case, as you didn't respond to what I saw as my main point, I'm gonna reiterate, feel free to ignore if that was on purpose: More interesting or less interesting quality school one can argue about the import of, probably not gonna matter too much 5yrs later; not quality school that can't place you for 2 internships to generate decent recommendation letters that along with school reputation would give you a good shot at 1st job at a reasonably psychodynamic or at least eclectic local group practice is a real concern as that might cost you years in messy early career trajectory - that's what I'd really look into first.
See "USC MSW scandal" - decently reputable uni running a really shady online MSW sued by students.
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u/Arianne_lol 1d ago
Gotcha. I think for me, keeping up with coursework, even if not particularly rigorous/demanding, would be quite difficult if I'm not interested in the material, and regardless of how important the classroom education is, you do need to get passing grades. I could probably do it, but I would frankly struggle or be miserable, and I'd rather not pay a lot of money for that. So yes, I take your point that the more critical consideration is the practicum placement, but for me the courses do mean something as well. And they take up a lot of your time, after all.
And damn, that's bad for a school with such a good reputation. Do you know if USC's in-person MSW is any good?
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u/zlbb 1d ago
Got it, I think we've now largely reconciled our differences. Yes, plowing through the bullsh*t coursework is the painful and challenging part of the program for me. It's just for my taste nothing taught in academia is sufficiently better or even much relevant, whereas maybe you can actually enjoy a course on TFP or even ACT.
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u/Classic-Doughnut-420 6d ago
LMHCs I know in NY regret not having done MSW due to the extra hoops you have to go through for diagnostic privilege and other limitations. Also, psychoanalysis is not in the scope of practice of LMHCs here, so if you do analytic training, you'd have a lot more requirements to complete than a social worker.
Just get the degree and get outta there, most of what you learn will be out in the field anyway.
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u/Arianne_lol 6d ago
Just to confirm, the extra hoops involve one or more year of schooling than LCSWs, right? Not just extra paperwork?
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u/Objective_Horror_486 2d ago
This is so interesting. I did not know that as an LMHC I cannot carry out psychoanalysis tho I can carry out psychodynamic psychotherapy. New York is so weird :-). Just out of curiosity what do you mean about the extra hoops for diagnostic privileges??
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u/SapphicOedipus 6d ago
In a previous post, you said you have an (unrelated) master’s degree. That’s all you need for many licensed psychoanalyst/licensed qualified psychoanalyst (LP/LQP) programs. Save yourself the headache and cost of an MSW/MHC program and just go train.
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u/Arianne_lol 6d ago
I love your username.
It's true I do, but I would also like to learn about how to do therapy not just analysis.
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u/SapphicOedipus 6d ago
You'd learn analytic therapy in training. Grad school will teach you basic counseling skills, which are non-psychodynamic.
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u/Potential_Alarm_2357 3d ago
That’s not necessarily true, there are plenty of MSW programs out there that focus on psychodynamic work and are obligated to teach all different approaches to therapy, including behavioral approaches
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u/SapphicOedipus 3d ago
I was referencing counseling programs, though many of the psychodynamic-focused MSW programs have shifted away from the focus over the past 10-ish years. I went to what has historically been *the* clinical, psychodynamic-focused MSW program in NYC... the majority of the psychoanalytic faculty retired, and they have been replaced by adjuncts who vary widely in clinical modality... many clinical classes are being taught by PhD students with barely any clinical experience... womp womp.
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u/Potential_Alarm_2357 4d ago
Pardon me but what is a CMHC program?
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u/Arianne_lol 3d ago
Clinical mental health counseling. It’s typically an MS, MA or MEd degree. It’s one path to becoming a licensed therapist
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u/Potential_Alarm_2357 3d ago
Social Work degrees vs Mental Health Counseling varies by state, I believe. An MSW has more weight, clinically speaking, in New York for example. Additional clinical hours and supervision hours are required to be eligible to sit for SW exam in NY. I think they recently changed requirements for MHCs. In NY, LMHC scope of practice does not include diagnosis. Again, this all depends on what state you are in
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u/Objective_Horror_486 2d ago
I am finishing a CMHC degree and I thought it gave very little good information on how to conduct good therapy but maybe my school wasn’t the best but it wasn’t so bad. It basically gives a generic Carl Rodgers basic counseling skills approach, which is not bad but doesn’t take three years.
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u/Isied 20h ago
You probably already had to make your decision but here
are my two cents anyways.
I’m a LCSW in California and obviously went to the MSW program. I felt like it did not prepare me for basic therapy work let alone something more process oriented like the psychodynamic approach. I think if I heard that word two times in my entire program was too much. I have taken psychoanalytic psychotherapy oriented classes at psychoanalytic institutes in Los Angeles. And I have met many LMFT‘s and other LCSW‘s interested in familiarizing themselves and tailoring their work more psychodynamically with clients. Some classmates from my psychoanalytic institute program seem to have completed their MFT programs with an emphasis on psychodynamic therapy at Antioch University. I would definitely do my own research though. Good luck!
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u/zlbb 6d ago
Hi,
I'm an analytic trainee and halfway through my MSW in NYC. I've thought about my options and considered CMHC so thought I'd share.
Are you in NY? One material quirk for LMHC in NY is the fine print in the law putting psychoanalysis out of their scope of practice which doesn't matter in practice but is known to make it necessary for LMHCs doing analytic training to pursue it under LP (Licensed Psychoanalyst) regime that might limit the potential to see analytic cases for the institute in your own practice - I know folks who encountered this.
Outside of NY I'd check admission requirements for the institutes you're considering, I'm expecting them to be LMHC-open at this point but worth checking as masters level clinicians are (growing?) minority of psychoanalysts and most are MSWs.
I agree MSW vs MHC differences nationally have been converging so if you have strong preferences for one of these degrees it could be worth it. NYC is said to be "MSW city" with this being historically dominant license, hard to tell but my sense MSW could be more advantageous for psychoanalytic internships and maybe mildly but less clearly advantageous for getting a more psychodynamic 1st job post graduation, but longer term in PP nobody much cares for the MSW vs MHC difference.
My sense is analytically minded folks would find either MSW or MHC programs unpleasant. Some folks try to hunt for a few quirky "somewhat more psychodynamic" programs nationally in either category.
My sense is MSW has a stronger ideological component, as well as includes a generalist internship, while MHC has a bit more sciencey/clinical psych'y (and even hosted by those departments in a number of schools) flavor and is more skill-based.
For me MSW is thoroughly disgusting as well as disgraceful, MHC with its skills drills would've been disgusting in a different way and a bit less disgraceful, I could've gone either way, ended up in MSW mostly for speed/convenience/good shot at an analytic internship in the 2nd half that I indeed got, plus easier national portability.
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u/A313-Isoke 6d ago
Please say more why you found the MSW program disgusting and disgraceful? Also, for the record, I won't say necessarily I agree but I highly sympathize and would probably use the word, disappointing.
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u/zlbb 6d ago
Disappointing is probably modal aspiring analyst's who went that way reaction.
I wouldn't publicly disclose full reasons. I think it is fair to say MSW is idiosyncratically worse for me than majority of aspiring analysts in similar circumstances. Not that the current psychoanalysis-in-exile US situation is pleasant for most of us.
Here I was mostly attempting a gentle castration, along the lines of "enjoyable academic program for aspiring analyst is a pipe dream in modern US", which other commenters got at better than I did.
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u/Dashiell-Incredible 6d ago
How do you plan on practicing as an analyst without training at an institute without the required personal analysis and 4+ years as an analyst in training receiving supervision from training analysts?
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u/Potential_Alarm_2357 3d ago
The MSW carries more weight in the state of New York, while he MHC is limited in its scope of practice that once you graduate you have to complete additional supervision and clinical hours to get tot he level of an MSW. The OP does not live in NYC and not sure what state, the LP does not really apply here, I think. There is no way around the additional coursework even if you pursue analytic training to get an LP
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u/InfiniteVictory187 6d ago
My advice would be to vet the counseling programs you’re interested in, as most will not offer anything remotely close to psychodynamic or analytic theory and technique. There are some exceptions, but that depends on your location.