Did you know that approximately 57% of therapists don’t get licensed after graduating with their Masters degree?!! That statistic blows my mind!
I found this survey statistic referenced in the November/December 2023 issue of Psychotherapy Networker. They had a whole section for new therapists.
The editor’s note at the beginning of the magazine was what first caught my eye.
It said, “Beginning clinicians are leaving the field in droves: a recent survey shows that fewer than half of people who graduate from therapy training programs ever make it to licensure” (Kent, 2023)
Fewer than half?! That’s a huge claim. I looked into that statistic and that’s when I read more about the survey they are referencing. Later on, I will dig into the details of this survey.
But, saying that over half of therapists don’t get licensed after graduating with their masters degree is a gigantic statement. Over half!
This statistic aside, I think the experience of being a new therapist or a therapist trainee is a really important one to talk about.
The data shows that not only is the demand for therapists increasing, but therapists are having a harder time entering the field. Let alone feeling like they can thrive once they’re licensed – if they make it that far!
We need to do something about this. There are only so many things I can do. But, I can certainly talk about it.
The New Therapist Experience
My favorite article that I read in this Psychotherapy Networker issue is an article by Ben Behnen.
He did a lovely job in his article, “The Long, Lonely Trek to Licensure” of sharing his lived experience of being a new therapist and all the layers of what makes it so challenging.
I appreciate Behnen’s vulnerability. I want to share an excerpt from the article in which Behnen recounts a hard work day. He had just logged off from a virtual appointment with a tough client and then he says, “I clamber into my car and start driving. Somehow, I make it to a nearby park. I put the car in park and collapse onto the steering wheel. Tears stream down my face, rainwater pours down my windshield, and my body convulses as I sob. I’m not okay.” (Behnen, 2023)
Oof. I know from my own experience, from folks in my circles, and from my audience, that Behnen is not alone in feeling this way. It is very common to find our therapy training incredibly overwhelming.
He goes on to share how he didn’t feel like he could talk about how much he was struggling. Behnen didn’t feel like he could tell his peers or his supervisor. It seemed as though everyone else was doing just fine, while he was falling apart.
The Survey
Behnen references a statistic from the survey that found that less than half of masters-level therapists are getting licensed.
I decided to dig a little deeper into this survey. As I did, I uncovered some really interesting information.
The survey comes from Motivo Health. It appears they work to connect supervisors and clinicians together.
I signed up for their email newsletter so I could access their white paper that breaks the survey down a bit more.
They begin with the claim: 57 percent of Master’s Level Graduates Don’t Achieve Licensure. The article specifies: “We looked at annual graduation rates for two degree types: Masters in Clinical Social Work and Masters in Mental Health Counseling and compared this data to annual licensure exam rates.”
So, they compared the numbers of two groups of people. They looked at how many people graduated from these programs and then how many people passed the licensure exam in that same year.
Later, in the white paper it is stated that they did try to include MFTs but they weren’t able to obtain the test data for this group.
The Data
The data that was collected was from 2019-2021. During those years the number of people graduating with a Masters in Social Work and Counseling stayed relatively stable.
Those graduating with a Masters in Social Work went from 32,257 to 33,871 over the three-year span. Of those graduates, only 14,359-18,597 got licensed each year.
There were approximately 15,000 folks graduating each year with a Masters in Counseling degree. The number that actually obtained licensure ranged from 4,549 and 7,275.
This data seems pretty compelling to me. Based on this data from folks they surveyed, a significant amount of people who obtain their masters are not getting licensed.
I absolutely believe these statistics. It’s really hard to get licensed as a therapist! Clearly, it’s not just because the licensure exam is tricky because there’s not a big difference between how many people sit for the exam and pass it.
Why are Graduates Not Getting Licensed?
My favorite part about this article is that they break down the reasons for not obtaining licensure.
Half of those surveyed pointed to things related to finances. 29.7 percent said that the inadequate pay kept them from licensure. Whereas 21.1 percent said that it was because of the cost associated with licensure.
The rest of the reasons listed in the white paper are important as well. But, I have a theory. *And it’s just a theory.* My theory is we would only need to change one thing to fully resolve many of the other issues.
I think the one change that is needed is: to improve the financial situation for those going through the entire training and licensure process.
For example, 11.7 percent of folks said that burnout was one of the reasons for not getting licensed. My understanding of burnout is that if you dial back how many hours you are working then there’s a decent chance you can nip burnout in the bud.
For most people working fewer hours doesn’t feel like an option because you need to see clients to make money. Or, you need to see clients to get the number of hours you need to get licensed and make more money. If the financial situation was improved for trainees, then the burnout issue would decrease.
The Time Limit
Another reason therapists gave for not getting licensed was the licensure time limit. Five point five percent of respondents said this was the hurdle keeping them from licensure.
From my experience, at the time I was getting licensed, I had six years to complete my hours as a trainee. The issue about the time limit is that you often have to get a full-time job to pay the bills while working on your licensing hours.
On the flipside, if you fill your schedule with client hours, you may not get paid enough to live.
Therefore, to my point: if we just paid our trainees enough to make a livable wage then maybe the time limit may not be such an issue.
Reasons For Not Getting Licensed
Once you account for these items, there is about 25 percent of the pie left. The other reasons for why therapists don’t get licensed included a complicated licensure process and difficulty getting licensed in a new state.
The final items preventing graduates from getting licensed make me sad. Three percent said they had a poor internship experience, and 1.6 percent said it was barriers specific to clinicians of color.
Then, out of all the people who were surveyed, only three percent said they were not licensed because they found passing the exam difficult.
Clearly, the problem of therapists not getting licensed is becoming a huge one. Across the board. For everybody. This survey data doesn’t even account for folks who never started grad school because of concerns around pay, or left their masters program partway through.
All of these responders have graduated with their masters degree – cap, gown, and the whole shebang. They also unfortunately accrued student debt. And they are still exiting the field.
And, I imagine a lot of folks who did get licensed are still feeling the same burdens of financial pressures, burnout, and the other variables that were mentioned in the survey.
Solutions
Motivo gives four proposed solutions to this issue.
1) The first: ease the financial burden.
I agree! But, easier said than done. It feels like a huge systemic issue. They are advocating for organizations to pay their entry-level trainees and clinicians more. But those organizations have to get that money from somewhere…
So, I think the system is set up to fail. I would argue, we need some systemic level change for there to be true change.
They go on to touch on student loan debt. A statistic they quote is, “The mean educational debt for Masters in Social Work graduates is $66,000. The mean salary for starting MSWs is $47,100.”
They go on to say, “But for clinicians of color, the burden is greater. After grad school, the mean total debt for Black clinicians is $92,000 and $79,000 for Hispanic clinicians.”
2) The second proposed solution: make the licensure process easier to navigate.
I’m absolutely in support of this! If there is any way to make this process easier, I’m all for it. I had a tough time. But, now looking back at what I had to navigate, I think I had it relatively easy. And I hated the whole thing. 🙃
3) The third solution: employers need to focus on helping associate therapists find balance.
I agree! I imagine this would need to look different from one workplace to another. They suggest making sure employers are keeping in mind what type of clients their early-career therapists are working with. For example, if there is a client with a higher level of need, they should be referred to a more seasoned clinician. I wholeheartedly agree!
Personally, I primarily worked with the highest-need clients earliest in my training years. That’s how our system is set up right now.
4) The last proposed idea: prioritize clinical supervision and make it less complicated.
I both agree with this statement and also realize that Motivo’s business is helping folks access clinical supervision. So, they have some skin in the game in offering this solution.
But that said, I’m all for more quality supervision in a way that’s affordable and sustainable.
Cultural Change
I agree with the four proposed solutions Motivo put forth. I would also advocate for culture change in how we think and talk about our profession. In particular, how we think and talk about people who are early in their therapist career.
We should be aware of student debt, racial bias, the challenge of finding supportive work environments and good pay. It’s also difficult to find good peers and quality supervision. The whole early-career process is really hard.
If we just came with the assumption that most trainees are having a tough go at it we could at least start to validate the experience. Though that doesn’t magically solve all the problems, it can combat the shame that sets in.
I know that I carried that shame early in my career. As I was struggling, I thought I was the only one having a difficult time. In retrospect, I’m sure that others were having a tough time too.
And if you work in a setting where there are trainees or early-career clinicians, it would be helpful to notice them and check in with them. Ask them how they are doing, or offer to take them out to coffee to hear how their time in the field has been so far. I would have loved that in my early-career days.
Burnt Out?
Often therapists who don’t get licensed get burned out along the way. And even those who do get licensed often experience burnout early in their career. Read my article about why burnout is so prevalent among therapists.
I also have a video that takes a deep dive into burnout in the therapy profession.
Wherever you are in your career journey as a therapist, I hope that you know that you are not alone in what you are experiencing.
And until next time, from one therapist to another: I wish you well!
-Marie
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