It was in high school when I first started thinking that I might want to become a therapist. At that point the reality of me sitting in my own office and listening to my own clients seemed like a lifetime away, a far and distant journey. Well, about a decade later, here I am: sitting in my own office with a master’s degree on the wall wondering how that same high school kid got here. What did the past decade look like? What did it take to get here?
Well, there’s two versions of the story. There’s the logistical story, the list of requirements and hoops you have to jump through. That story’s more or less universal to all therapists. And then there’s my story, unique to me, just as yours will be to you.
We’ll focus on the logistical story here.
A forewarning: this is going to be a lot of information and might feel overwhelming, so I highly recommend you read this article afterwards. It will give you some helpful perspective to balance the weight of this one.
And a disclaimer: the specific requirements for different countries, states, and licensures may vary quite a bit, so take this as a general overview and then you can look into your specific situation more in depth.
Alright – take a deep breath – and let’s dive in.
Steps and Stages
Undergrad
From what I can tell, most if not all masters programs for therapy require an undergrad degree. My undergrad degree was in psychology but that is not a requirement. Many other students in my master’s program came from diverse backgrounds – teaching, accounting, finance etc.
Grad school
There are several questions you might want to consider when looking for grad programs. These might include:
- How much does it cost?
- How close is it to where I live?
- Do they use a cohort or traditional model? (In a cohort model you stick with the same core group of students through the entirety of the program. In a traditional model you have different classmates in each course.)
- Do they offer the track toward the license I want? (see this article for more details: How to choose which path to becoming a therapist is best for you)
- Does the school have specific accreditation for the license I want to attain?
- Is there an accelerated track? (An accelerated track may take 1.5-2 years to complete where a traditional track may take 2.5-3 years to complete.)
- Where do you plan to practice after you graduate?
- Is the GRE required?
Some masters programs will require you to take a national test called the GRE (similar in concept to the SATs and ACTs for undergrad applications) to apply. Not all though. I chose to apply to a school that did not require this and for me was a big time and stress saver.
I chose to go to St. Mary’s University in Minnesota for their marriage and family therapy master’s program. It was fairly close to where I lived, cost effective, they used a cohort model, and were COAMFTE accredited (which means there is a guarantee my credits will count toward my license).
Practicum
Again, most therapy programs require a practicum to graduate. A practicum is like riding the bike of being a therapist with training wheels on. There is often a competitive search process for finding a practicum site. Most programs want to support you and see you graduate, so they may help with this process as well. There are many different types of sites such as group practice, in home therapy, group therapy, outpatient programs and more. There are also many different supervisors attached to those sites. Supervision is one of the most important components of practicum as your supervisor is your lifeline for support and learning. Having a good supervisor is crucial to your practicum experience. This means that when you begin interviewing at practicum sites, you also want to interview the site and supervisor to make sure it is a good fit. Some helpful questions might be:
- What should I expect in terms of your availability towards me?
- What is your approach toward supervision?
- When I have questions or concerns, how should I bring those up to you?
- Do you expect me to see a certain number of clients a week?
- Will I be scheduled to see clients on specific days or is there flexibility in my schedule?
A good supervisor is patient and understanding, has clear expectations and communication, and creates an open and safe environment for learning and growth.
Unfortunately, you cannot always get a site and supervisor that is a perfect fit, especially with competition to secure a site. However, if you feel that you are not getting the support you need or find yourself getting burned out during your practicum, always advocate for yourself: ask other students how their practicum experience is going, talk with your professors and program directors, consult with your own therapist, and be direct with your supervisor.
Once you have secured a practicum there is often a requirement for how many client, administration, and supervision hours you accrue in order to graduate. Some practicum sites will have you observe another therapist or be a co-therapist with your supervisor before seeing clients on your own. Others will throw you in the thick of it. There are pros and cons to both. I was thrown into the thick of it which was scary at first, but it also helped me gain confidence from the get-go.
A final note: some practicum sites may pay you for your work, but most do not. Some people can flex their work schedule to accommodate their practicum. I couldn’t do this and had to cut back at work. I was typically at my practicum for two and half days seeing 7-12 clients a week while working my other job the other two and a half days. Financially, it is something to think about and plan for so you’re not adding additional stress to an already stressful time.
Licensure
Once you graduate and secure a job you will finally start getting paid for your work, but you are not quite finished. Getting licensed is not technically required to offer therapy (anyone can offer help for pay) but in order to avoid any ethical and legal trouble it is best practice to work toward licensure. Also, many mental health institutions will not hire you unless you are either licensed or working toward your license. The requirements for licensure typically entail more client contact and supervision hours as well as passing a national and state board exam. Depending on your case load, the road to licensure can take an additional 2+ years.
To attain my marriage and family therapy license here in Minnesota I need a total of 4000 hours (500 relational, 500 individual, 200 supervision, and the rest is administration – case notes, diagnostic assessments, research, travel etc.).
Maintaining licensure
Once you have completed all these steps you are now fully licensed and a free therapist! Well, sort of. You still must maintain your license by completing a certain number of CEUs (Continuing Education Units) each year. This is to make sure you are staying up to date on the latest research and best practices within the field. This is often less strenuous and exciting because you get to decide what you want to learn about, and it typically benefits your clients.
ok. Take a deep breath.
So that’s the process. Again, I know this is a lot to digest, so please read this to help calm the nerves and gain some perspective. Just know you are never alone in the process and where you are right now is just where you are supposed to be. Also, please let me know any questions you have about the steps or details below in the comments or reach out to me on Twitter.