Psychotherapy Careers

If the human mind interests you and you’re fulfilled by working with people one-on-one, you may be well-suited to a career in psychotherapy. While this umbrella term encompasses a wide range of careers, which we will discuss below, the main thrust of a psychotherapist’s job is to work with individuals (and sometimes families or groups) to help them become better adjusted, face fears or traumas, handle emotional problems, and live a more effective and fulfilling life.

Psychotherapists have the opportunity to work with a huge range of different people, experiencing different life challenges, so chances are good you’ll be able to settle on a target population that meshes with your interests well. If you prefer research and the study of the human brain, you may also excel in a psychotherapy career.

Before you decide whether or not this career is for you, it’s helpful to learn a little more about the industry, the job description, the different roles you might play, and whether the salary and job outlook are right for you. Whip out that notepad and let’s dive in.

What Is Psychotherapy?

At its most basic level, psychotherapy is the practice of helping people deal with mental, social and emotional conditions by speaking with them and suggesting methods by which they may increase their chances of overcoming challenges and living a normal life. Psychotherapists observe and record words and behaviors to help assess their clients; determine how they respond to stimulus, people and the world around them; and recommend courses of action, which are usually behavioral but may include pharmaceutical help.

Psychotherapy is, as pointed out above, an umbrella term that encapsulates a number of careers beneath it. The field includes psychologists, psychiatrists, psychoanalysts and social workers. The roles are broken down as follows:

• Psychologists: Typically, in order to practice as a psychologist, you will need a Doctor of Philosophy (PhD) degree in psychology, or at least a master’s degree. You must be able to diagnose conditions using various tests – think the Rorschach test, which uses random shapes to draw out people’s beliefs and feelings. You may be trained to do either clinical or research work, a decision you must make while still in school in order to direct your training appropriately.
• Psychiatrists: Psychiatry is the only branch of psychotherapy that permits the practitioner to write prescriptions for medication. Because of this, psychiatrists cannot work without a Doctor of Medicine (MD). However, they still use many of the same techniques other psychotherapists use, including speaking with patients, performing assessments and recommending courses of behavioral therapy.
• Psychoanalysts: Psychotherapists in this focus use a specific type of psychology in working with their patients. Psychotherapy is based on the teachings of Sigmund Freud, who believed the subconscious was responsible for much of human behavior, and that only by accessing it can we make social, emotional and mental headway. The basic idea is that because our social and emotional motivations are outside conscious thought, we have a harder time breaking out of bad patterns unless we learn to access them on the subconscious level. Typically psychoanalysts also need a doctoral degree, though they don’t require medical training.
• Social Workers: While many social workers work with hospitals, educational institutions or non-governmental agencies, some are also in private practice as psychotherapists, using the tools of the trade to assess clients and encourage positive growth. Social workers may practice with only a master’s degree, and perform a smaller range of tests and assessments than other psychotherapists.

The career may be further refined by the setting in which you work, the organization that employs you, the populations you work with and your specific interest areas. Because of the differences in these careers, not all psychotherapists do the same thing. However, all psychotherapists have some duties in common.

What Does a Psychotherapist Do?

Psychotherapists may work with children, adolescents, adults or the elderly to help them face emotional problems, deal with negative aspects of the past and face the future in as healthy a manner as possible. The main role of a psychotherapist is to help the client view themselves and situations differently. For instance, they may help clients to:

• Think differently about past traumas and the likelihood of future traumas
• Respond to negative stimulants differently
• Calm obsessive or destructive thoughts
• Recognize the difference between feelings and facts, and learn to avoid acting on impulse
• Heal from trauma or abuse, handle socioeconomic challenges and become more tight-knit as families
• Deal with aging and the breakdown of the body, in the case of the elderly
• Cope with grief or betrayal
• Manage stress and insecurity more effectively
• Deal with addiction issues such as gambling, alcohol, drugs or sex
• Create plans to address common emotions, social situations or negative thought patterns
• Identify triggers and work to create new, healthier responses to them
• Define wellness goals and work toward them

Psychotherapy can fulfill important roles in the treatment of many different conditions, from manic-depressive disorder to anxiety to suicidal tendencies. A combination of assessment, communication and reflection back to the client can help people work through distressing thoughts or experiences, and end unhealthy behaviors, often for good.

Psychotherapists do not simply speak to people while they’re in the office, however. They also have a range of other duties, including assigning homework, tracking patient improvement, maintaining case files and meeting continuing education requirements. In the case of private practice, keeping your books and marketing your business will also be necessary, or you can hire others to do it for you.

Typical Work Environment & Occupational Challenges

While many psychotherapists practice alone, in offices they rent themselves, others work for organizations. Those who work on their own spend the majority of their time speaking with clients and providing counseling services. Other psychotherapists collaborate with medical providers or social workers, with schools and teachers, or with parents and community organizations.

Autonomy to practice how you will (as long as it meets regulations) is much wider in the former situation; in the latter, you may need to adhere to rules of the hospital, nursing home, educational facility, government organization or whatever other institution is employing you. Some practitioners find this too restrictive, and end up switching into private practice. While this is common enough, keep in mind that organizations may have different rules of practice than do the regulatory bodies that govern psychotherapists that work alone, so you’ll need to ensure you meet them.

Some psychotherapists are on call with their clients, especially in cases of suicidal tendencies or extreme medical conditions. While many find this aspect of the job very rewarding, because successful outcomes in these cases are so meaningful, it can also be stressful to go to sleep and not know whether or not you’ll be waking up in a few minutes or a few hours.

When working in institutional settings, you often don’t have the freedom to set your own hours. Depending on the population you’re serving, you may need to work nights and weekends, or long shifts to provide continuity of care. Again, many psychotherapists find this rewarding, but you need to make sure you’re prepared for the rigors of such a life before beginning, otherwise you may face burnout.

Psychotherapist Salary & Job Outlook

Psychotherapist salaries range with their specific role. Psychologists, for instance, make a median salary of $81,040 per year according to the Bureau of Labor Statistics. Social workers, on the other hand, can expect to make considerably less – $50,390 per year – while psychiatrists are at the high end of the salary spectrum when it comes to psychotherapy: $138,890 per year.

At first blush, it may seem like psychiatry is an obviously better role, but be sure to take into account the attendant duties that come with practicing psychiatry. The medical career path is very demanding, and requires you learn about a range of bodily systems beyond the brain, which may not interest some. Plus, you must meet federal regulations regarding the prescription of medication, which some find dull or onerous.

Demand for all these roles is growing a little faster than the 5% growth rate the BLS predicts for most industries through 2031. Psychiatry careers are rising at a rate of about 9%, while the rate is 6% for psychology and 9% for social work. If you complete your schooling and build a good resume, you could very well enter any one of these steadily-growing fields.

Psychotherapist Jobs & Job Description

Essentially, a psychotherapist is trained to treat people for emotional problems. Depending on your degree, you may work with different groups or people. For instance, social workers often work with families, children and the needy, while psychoanalysts typically work with individual children, adolescents or adults. Psychiatrists work with people of all ages to address problems with brain chemistry, using pharmaceutical means (in addition to talk therapy) to help them address their issues.

All types of psychotherapists may work with their clients for months or even years, and long-term relationships between psychotherapist and patient are often the most effective. In any psychotherapy role, your job is to help people heal themselves and cultivate positive thought patterns and behaviors, especially as it comes to dealing with stressors and challenges.

Important skills include:

• A thorough understanding of modern psychotherapeutic thought and approaches
• Working with people in a calm and nonjudgmental manner
• Identifying the underlying causes of negative thoughts and behaviors
• Communicating clearly and effectively with both patients and peers
• Providing thorough reports and maintaining excellent records
• Perform experiments, collect data or examine multiple studies to form meta-conclusions, if you are in a research role

Of course, those aren’t the only skills you’ll need, but they form the basic foundation for a long and successful career.

Psychotherapy Degrees & Education

Almost all psychotherapists have a tertiary degree, which means a degree at the doctoral level – either a PhD or, in the case of psychiatrists, an MD. The exception is for social workers, who need only a master’s degree to practice – and, in rare situations, can get away with a bachelor’s degree. However, individuals working at that level are not typically practicing psychotherapy, but rather work in supporting roles or managing cases without performing a lot of one-on-one talk or behavioral therapy.

If you have your sights set on psychotherapy as a career, therefore, you should plan on quite a bit of schooling. Once your master’s degree or doctorate is completed, you will need supervised training. This may include up to 3 to 4 years of training with oversight from a practicing psychotherapist, as well as 2 or more years of attending psychotherapy sessions yourself. Psychiatrists will need to undergo clinical training at hospitals or a private practice.

You will also need a license to practice in nearly all psychotherapy jobs. With rare exceptions when you work for organizations, you may be able to avoid this step, but it is absolutely necessary if you want to practice for yourself.

At the end of the day, your success as a psychotherapist depends largely on your willingness to complete a good deal of schooling and training, your ability to withstand the rigors of helping others deal with emotional problems, and your own interest in the area. If you have all three, you’re likely to find psychotherapy a prosperous and rewarding field.

Psychotherapy Organizations & Associations

• American Academy of Psychotherapists
• American Group Psychotherapy Association
• American Psychotherapy Association
• International Association for Cognitive Psychotherapy

2022 US Bureau of Labor Statistics job market trends and salary figures for psychologists, social workers, and psychiatrists are based on national data, not school-specific information. Conditions in your area may vary. Data accessed July 2023.