PsyD and PhD Degree Programs in Mental Health Counseling

Mental health counselors see it all. You get the funny stories, the clients with a little neurosis and a fear of streetlamps, and you get the really tragic stuff… traumatized kids, couples growing apart after decades of marriage. There are addicts and people with phobias, and plenty of folks who are perfectly normal but are absolutely convinced they aren’t. You get the clients who try hard and the ones who have already checked out.

All of them have a real need for professional psychological counseling. And there are a lot of them out there. According to the National Alliance on Mental Health, more than 20 percent of Americans experienced some form of mental illness in 2019. The numbers aren’t in for 2020 yet, but, woo, boy… you can bet they didn’t go down.

Slightly less than half of those folks received the treatment they needed. There is a stigma against seeking out mental healthcare that you never see around medical treatment. The role of a professional psychologist in mental health counseling is to overcome that stigma and deliver the kind of services to every person who needs it.



You don’t have to earn a doctorate to become a perfectly good counselor. According to an in-depth, 10-year survey by the American Psychological Society, only about 43 percent of active psychologists hold a doctoral degree. There are many types of counselors where a master’s or even a bachelor’s degree is the norm.

But going on to pick up a PsyD puts you among the elite in mental health counseling services. Of course you’ll see the toughest cases and make the hardest treatment calls, but you will also be recognized as an authority in your field, among the relative few the rest of the profession turns to for guidance and a sense of how the field is progressing and evolving.

What is Counseling and Mental Health Psychology?

Mental health really is psychology, in that every aspect of mental wellness is covered in the field of psychology, even if the causes are physical or neurological.

Counseling is a primary tool for dealing with certain kinds of mental illness or psychological challenges. It’s used as a method for focusing in on a specific issue and is designed to offer solutions to that particular problem. For drug addicts, for example, counselors can lay out well-proven programs in cognitive behavioral therapy, motivational interviewing, and implement contingency management strategies designed to reinforce positive behavior as a way to get patients through the challenge. The analysis of the problem and the application of the therapy are based on the counselor’s training and education.

This can be a much less intensive and less expensive course of action for many mental health issues. In fact, a 2016 study published in the Journal of Affective Disorders found that interpersonal counseling was equally effective for patients with depression compared to in-depth psychotherapeutic treatment.

COVID-19 put the American mental health and counseling industry to the ultimate test. For a field that relies on extensive, empathic interpersonal contact, social distancing could have been a disaster.

But instead, mental health counselors adapted. With expanded authorizations from major insurers and state regulators, telehealth services were brought into the fold to allow patients and psychologists to do counseling sessions by phone. And as the mental health crisis worsened as a result of the pandemic itself, so did the adaptability and technology counselors used. Soon, Zoom meetings were putting people face-to-face in virtual sessions with their psychologists.

And revolutionary services like Talkspace and BetterHelp exploded into multi-billion dollar businesses almost overnight, offering new ways for patients in need and mental health counselors to connect.

Pandemic trauma isn’t going away, and it’s something that counseling and mental health psychologists will be addressing for years to come.

Because it is focused on specific issues, counseling can often be a relatively short-term approach to mental healthcare. It’s well-suited to such specific problems with clearly defined outcomes as these:

  • Marital and family issues
  • Substance abuse treatment
  • Grief counseling
  • Stress management
  • Career difficulties or specific performance issues, such as with athletes

The Role of Doctors of Psychology in Counseling and Mental Health

Because there are so many opportunities in mental health counseling at every educational level, there is a good chance that by the time you start thinking about picking up a doctorate, you’ve already spent plenty of time actively working in the field. So you already know what the job involves: working directly with patients who have mental health issues severe enough to interfere with their ability to lead a healthy, happy, productive life.

Unlike clinical psychologists, you do not typically work with the most aggravated or serious psychopathologies. Counselors deal with patients who are at a point in their lives where the right perspective, the right advice, and the right insights can nudge them back onto a better path. On the other hand, you will deal with clients who may have psychological issues that are more advanced than a basic social worker or therapist could handle.

That makes empathy and understanding the key virtues for counseling psychologists. In a lot of cases, your ability to listen will be the crucial skill that determines your ability to successfully treat a patient.

You might specialize in any of the areas that counseling is commonly offered for. Or you can work as a generalist, handling whatever kind of challenge walks in the door. You’ll have the full toolset of an accomplished doctorate in your pocket to handle anything.

While master’s-prepared counselors working with families, married couples and others suffering from relationship issues and psychological distress can find work in more informal settings, doctorate-prepared counseling psychologists tend to find jobs at the level more serious issues escalate to. That means dedicated mental health facilities or in regular healthcare settings like hospitals and nursing homes.

Apart from licensing, there are no bright lines in the business between counselors, counseling psychologists, or clinical psychologists. In practice, you may end up taking patients that could also be handled higher or lower on that spectrum of treatment. It’s all about whether or not you think you can help… and with a doctorate, you’ll be able to do that more effectively.

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Everything You Need to Know About a PhD or PsyD for Counseling and Mental Health Services

Before you get that doctorate, though, you have to pick the right school for it. The APA accredits more than 400 doctoral programs in the United States, but you’re only going to attend one of them! It had better be the right fit, considering how much money and effort you will put into it.

First, though, you’ll have to pick just which type of doctorate you are interested in: a PsyD (Doctor of Psychology), or a PhD (Doctor of Philosophy in Psychology). You’ll find both degrees with specializations in counseling and mental health.

What’s the Differences Between a PsyD and a PhD in Counseling and Mental Health?

A PsyD is a doctorate program that focuses mostly on practical clinical practices in the field. These programs have become more and more popular in recent years among practitioners more interested in understanding how to implement solutions than the theory behind it all. In a PsyD program, your training will almost exclusively revolve around the treatment of patients, so the skills you develop will revolve around assessing, diagnosing and helping people in need.

A PhD will cover many of the same subjects, but from a different angle. You’ll learn just as much about psychological conditions and treatments, but you will do it from a theoretical perspective. PhD graduates are prepared for academic and research roles. Their coursework is grounded in experimental design, statistical analysis, and the ethics of investigation.

In practice, either a PhD or PsyD can prepare you perfectly well for a career in counseling. State licensing boards are just as happy to accept an APA-accredited PhD program as a PsyD. Once you get into professional practice, the kind of roles you’ll qualify for and the work you do won’t be limited by having earned one or the other. A PsyD student can forge a great career as a teacher or a researcher in counseling and mental health, and PhD graduates very often go on to work exclusively with patients without doing any formal research after graduation.

Admission Requirements for Doctoral Programs in Counseling and Mental Health Psychology

There can be quite a bit of competition for spots in a doctorate program in counseling and mental health. Not everyone gets in. So it’s wise to get started in preparing while you’re still an undergraduate if you want to have the best shot at being accepted. You will have to hold a bachelor’s degree at a minimum before applying, but you don’t necessarily need to go the traditional route by earning a master’s degree first.

And your bachelor’s doesn’t even need to be in psychology, but you will need to have at least some psychology-related coursework on your transcript. Most doctoral programs look for a certain minimum number of classes in areas such as:

  • Psychological statistics
  • Experimental psychology
  • Theories of personality
  • Abnormal psychology

A strong GPA at the undergrad level is also required. Most schools want to see at least a 3.0.

Some schools also require that you submit standardized test scores from the GRE exam, although there isn’t usually a clear minimum score to achieve since they evaluate the results together with your application as a whole.

That’s going to include a CV, your full college transcripts, several letters of recommendation, and usually a personal essay that describes your career goals and aspirations. You’ll have to sell your potential and your achievements to stand out from the crowd.

APA Accreditation is the Stamp of Rigor for Counseling and Mental Health Psychology Doctorates

As we noted above, the American Psychological Association is the organization that handles specialty accreditation for PsyD programs in the United States. Their dedicated Commission on Accreditation brings a diverse perspective to evaluating potential programs. They have members of the general public, accomplished academics, and other healthcare professionals, as well as currently practicing clinical psychologists from a variety of specialties on tap.

Those members and the CoA staff go through exhaustive document and policy reviews as well as undertaking on-site visits to check things out for themselves. They look at aspects of the program including:

  • Instructor qualifications and hiring standards
  • Academic policies and organization
  • Grading and appeals processes
  • Internship opportunities
  • Recruiting and admissions processes

It all adds up to a thorough look at each program, and in the end, an assurance that students have every opportunity to get the latest and most effective education available in the field today. That’s why every state requires that you hold a degree from an APA-accredited program in order to be eligible for licensure as a psychologist.

Should You Pick an Online PsyD in Counseling and Mental Health?

The COVID-19 pandemic pushed life online in ways that people found hard to imagine before. That included both the study and practice of psychology. But some PsyD programs were way ahead of that curve, offering online options well before the pandemic forced their hand.

Of course, in a field that relies on interpersonal interaction as much as counseling, not every part of the program can be online. You’ll still find that most practicum courses are in person, even if your academic classes can be taken through live or asynchronous options over the net. But even just having your regular classes available in that format can offer a lot of flexibility in your daily life.

Whether you are shifting your study time to your lunch break or tackle your coursework at night when the house quiets down, online programs make a PsyD or PhD accessible to many students who simply couldn’t make the time for a traditional on-campus program. The quality of instruction has long been proven equally effective, so your choice will be mostly about what works best for you.

Curriculum and Electives in Counseling and Mental Health Psychology Doctoral Programs

A PsyD program can take anywhere from four to six years to complete, and a PhD is often one or two years longer than that. What do you spend all that time studying?

Developmental Psychology – Like all PsyD students, you’ll probably start off your program by learning a bit about the stages of human development through the lifespan. This will cover both theories of neuropsychology and the applied aspects of developmental changes.

History of Counseling Psychology – Some courses will cover the history of psychology as a field, including the major branches of theory and practice, from behaviorism to psychoanalysis, that have emerged along the way. In a counseling and mental health specialization, you’ll focus in on the specific uses that psychology has found in the field of counseling and how it has influenced health and wellness practices in healthcare today.

Theoretical Psychotherapy and Counseling – The current major perspectives on counseling and psychotherapies will be covered with critical and differential perspectives to give you a solid grounding in the types of practice you may perform in the field.

Psychopathology – In order to correctly treat patients in counseling, you have to be able to assess them properly. You’ll take courses that offer in-depth studies of mental and behavioral disorders, including possible physical, social, and neurological origins. You’ll learn how to spot the characteristics of mental disorders, diagnose them and develop treatment plans.

Counseling Processes – These courses are where the meat and potatoes of the degree are. You’ll learn about the actual practices to use in therapy sessions. That includes developing the kind of listening skills required of counselors and maintaining the right presence and perspective during counseling sessions. You’ll see how to put treatment plans into practice through a variety of theoretical and actual case studies.

Legal and Ethical Issues in Counseling – Psychology is a field that has to develop unbreakable trust between the counselor and the patient. That means learning and sticking to a strong set of ethical standards as outlined by the APA’s Ethics Code. You’ll also learn about state laws and regulations governing psychologist conduct and responsibilities.

Research and Experimental Design – While a PsyD will not include as much research focus as a PhD program, you will still spend time learning about statistics and experimental design. Building a foundation of knowledge takes an inquisitive mind and the ability to apply logic to any situation, both of which you’ll learn about in these courses.

The format and structure of these courses will vary from program to program. In some cases, you’ll find yourself following a fixed schedule, with the same exact courses as every other student in the program. In other cases, you’ll find a variety of electives that offer different angles on those general subjects where you can pick and choose the best course to fit your interests.

The Dissertation Process That Cements Your Education

The next to last year of your program is generally dedicated to completing the capstone of your studies: a dissertation or doctoral project.

In most cases, this involves carrying out an original research project in a subject you select in coordination with your advisors and dissertation committee. For some programs, a doctoral project that involves a more practical expression of your studies is accepted or encouraged instead.

In both cases, you’ll spend at least a year putting together a project that brings together and demonstrates the sum of your learning. A dissertation can run to 50 pages or more, and you’re likely to go through multiple revisions over the course of months in the process of defending it before it’s finally accepted by the doctoral committee.

At the end, you’ll have a publication-worthy piece of writing that contributes something new to the psychology field. They’ll be looking hard at how you conducted your research, how you have applied your knowledge, and what kind of original conclusions you have developed in the process. It’s an extremely tough process, but it’s part of what makes a doctoral graduate the best in the business of counseling.

What You Will Spend on a Doctorates in Counseling and Mental Health Psychology

Since you probably have already earned or are on your way to earning a bachelor’s degree, we don’t really have to tell you how expensive college is in America today. But if you thought your undergraduate tuition was costly, buckle up! Graduate tuition is even more expensive, and often runs even longer than your bachelor’s degree program.

The National Center for Education Statistics publishes data on the costs of college education in the United States. For 2018, they found that the current annual cost of attending a doctoral program can differ quite a bit between public and private universities:

  • Public in-state university – $12,171
  • Private university – $25,929

The APA has done its own investigation of psychology doctoral program costs. The data from 2016 on PhD and PsyD programs tells a similar story:

  • Public in-state university – $11,000 per year
  • Public out-of-state university – $24,000 per year
  • Private university – $34,000 per year

Although it’s somewhat less than the NCES data, keep the dates in mind. Today’s cost of a PsyD is probably somewhat higher than that of other doctoral programs. In fact, the APA documented a nearly 50 percent increase in costs between 2009 and 2015. It’s safe to say that trend hasn’t reversed.

As you can see, private schools are generally more expensive. But they can also be more valuable. A degree from a highly respected psychology program will open doors to positions that a run-of-the-mill state school might not.

There’s nothing remarkable about counseling and mental health PsyD programs as far as costs, so you should be fine estimating off of general PsyD tuition rates.

Becoming Licensed as a Doctor of Psychology in Counseling and Mental Health

All states require that psychologists be licensed. In counseling and mental health practices, the standards required for those licenses can vary a lot from state to state.

To become a full-fledged licensed clinical psychologist, you’ll have to pass the EPPP, or Examination for Professional Practice in Psychology. A two-part exam that covers both essential knowledge and practical skills, it has a variety of different question formats and requires extensive preparation in order to pass. You must apply for and receive approval from your state board of psychology before you are allowed to take it.

As a fully licensed psychologist, you can take on roles that would otherwise be restricted to specialty license holders since your license supersedes master’s-level credentials like Licensed Professional Counselor, Licensed Mental Health Counselor, or Licensed Mental Health Practitioner. But you are also free to pursue those credentials directly in lieu of becoming a full-authority licensed psychologist. Most require only a master’s degree, so you’ll be more than qualified in the education department.

They have their own array of tests, which may be mandated by the respective state boards:

You’ll also often have to take a state-specific exam on local laws and regulations, as well as pass background checks and take some ethical training.

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Job and Salary Expectations for Graduates with a PsyD in Counseling and Mental Health

Jobs in counseling are widely viewed as offering more compensation in terms of job satisfaction than in terms of high salaries. Yet with a PsyD hanging on your wall, you can get both.

The APA conducted a study in 2016 that found that members working in counseling psychology made an average of $89,108 per year That was the fourth highest category of specialization in the salary tables.

The Bureau of Labor Statistics (BLS) groups clinical, counseling, and school psychologists together in a single salary category and shows figures that are current as of 2019. According to the BLS, the median pay for that group was $78,200, while those in the top ten percent earned more than $132,000. A salary somewhere between those two is what you can expect that doctoral degree to be worth in terms of annual income.

The BLS also shows the employment settings where mental health counselors are most likely to work:

  • Offices of Healthcare Practitioners – $100,300
  • Outpatient Care Centers – $99,870
  • Psychiatric and Substance Abuse Hospitals – $86,350
  • Elementary and Secondary Schools – $80,180
  • Education Support Services – $78,610

Whatever the take home pay comes to for you, it’s hard to compare any job in the world with counseling in terms of satisfaction. Any time a client comes into your office with the weight of the world on their shoulders and after a few sessions leaves with a smile and a bounce in their step, it’s like cashing a check for a million bucks. You don’t find that in too many professions, and not even in every psychology job. Working in mental health gives you that most precious of bonuses: knowing you are making a difference.

(Salary data reported by the U.S. Bureau of Labor Statistics in May 2019 for psychologists. Figures represent national data, not school-specific information. Conditions in your area may vary. Information accessed Feb 2021.)