Community Mental Health
Many graduate students enter into mental health agency work after graduate school for many reasons. Some because they interned at the agency and were offered a job upon graduating, some because they feel invested in as an employee and others for the expansive learning they will continue to gain.
Team Based and Focused
Continuing to work for a mental health agency after graduate school will allow you to continue to learn among a team and have other clinicians to support you and educate you on areas that you may not have much knowledge on. When you work for a team, you start to see the areas of strengths team members have and you can access that knowledge by engaging with them. You are in the process of continuing to grow your clinical mind and you have a team of people to help you with that. You also get to work with all levels of therapists whether it be social workers, mental health counselors, marriage and family therapists and therapists who have been practicing for more than a few years. Having a team behind you as your begin your work is not something to take lightly. Being a therapist can sometimes feel lonely and isolating due to the HIPAA Laws we have and the confidentiality we serve our clients. The team helps fight this loneliness and is an automatic generated team of support.
As with any job that has coworkers and teams, there is always opportunity for conflict and not enjoying the people you work with. If you prefer to work solo and not having someone to have to turn to, then maybe agency work would not be the best fit for you. There are a lot of emotions and differing opinions in agency work. Sometimes that leads to conflict or a feeling that you are not understood and it is an opportunity to learn conflict resolution skills. We often think we are great with conflict resolution as therapists due to the knowledge we hold, but we are also human and have our own ingrained ways of reacting and dealing with conflict. You have the opportunity to build your conflict resolution skills in this type of environment.
Access to Benefits
You will also receive benefits which is a hot commodity with a job. Having access to healthcare and an organization that covers part of the cost is helpful as you get started. You will also be able to start a retirement account and have life insurance as well depending on what your specific agency offers. We live in a world now where health insurance can be hard to pay for out of pocket so this is something to really consider.
Most agencies also provide you with training funds to use to continue your education training. If you have looked into extra training while you have been in school, you have probably discovered it is not cheap to continue your ongoing education. Agencies that provide training funds help support you with the cost associated with training. Agencies also often have access to free training's due to the nature of their work. You can receive training's in evidence based practices without having to pay out of pocket and count those hours towards your licensure.
Free supervision is another benefit of working for an agency. As you may know already or will learn, once you graduate you need a set amount of direct service and supervision hours. Agencies provide you with weekly supervision at no cost to you. This can save you up to $10,000-plus to obtain the required hours you need for licensure. Many people seek outside supervision as well for other more focused treatments as the supervision in the agency may not be niche focused.
Diverse Clients and Learning Experience
Another beneficial area of working for an agency is the diverse clientele you will have the ability to work with. Being able to work with different mental health concerns and diagnoses allows you to continue to grow your clinical mind and discover different ways of dealing with the diagnoses we can encounter in our work. While this is a benefit, it can also be a con of agency work. You will start to learn more about the type of clients you enjoy working with and feel capable of working with. As you learn this, you may start to be frustrated with the inability to work with your ideal client or to take on clients that you feel are out of your realm of experience.
With the clients you begin to work with, you will also learn how to have a caseload of clients. Due to how most agencies are funded, it is common for therapists to have high caseloads. For a therapist who works full-time, an average caseload size is between 50-100 clients depending on what type of agency you are in. During my time as a child and family therapist full-time in agency work, I averaged a caseload of 50-60 clients with the majority of those clients actively engaged in treatment. This can be a huge shift as you transition from being an intern or from another field of work into agency work.
While managing a large caseload may not be ideal, it can assist with helping you become fully licensed quicker than other routes. Depending on the type of license you are pursuing, most therapists in agency work can achieve their hours for licensure within 2-3 years if not faster. I was able to obtain all the hours I needed within a year and a half of graduating. If it is important to you to be licensed in a quick manner, then working for an agency may be a great fit for you.
Not working with your ideal client and your caseload size can often lead to burnout. Burnout can happen in any field you work in. It tends to be more prevalent in the people-centered careers due to the amount of emotional, mental and physical support you provide for your clients. Agency work typically lasts 2-3 years for most clinicians due to numerous reasons, but one of the main reasons being burnout. It is important that you find a way to take care of yourself in this line of work whether it is agency, private practice or group practice. Your lifespan in this work is dependent on your self-care and being aware of when burnout is coming on and taking the action steps to prevent it.
Agency work is often associated with system work. You will learn about different systems such as schools, foster care, criminal care, and the political side of mental health care. While it is great to be knowledgeable in this area, it can also create a lot of frustration. There are many systems that have a say in how therapists should be providing mental health care and they can dictate documentation, length of sessions, and best care practices that you may not necessarily agree with. It can also feel like there are limitations that do not make sense or seem fair that impact your clients significantly.
Having experience working with crises is important as a therapist and you can have access to a lot of crisis work in the agency setting. For some this is a positive and for others this is a negative. A crisis can come up at any point at an agency and the protocol for dealing with it may not be in alignment of your ideal work. With the team though, you have support as you work through the crisis and even team members who will attend to the crisis when you cannot. It’s possible you may have had crisis experience in your internship which is great. If you have not, then moving into agency work may be ideal to help you work through these experiences and know how to support clients in crisis.
If you have talked to anyone about agency work, one of the biggest disadvantages people will say is the pay. Compared to private practice and group practice work, agency pay is the lowest. Most likely you will be paid hourly for 40 hours a week plus the benefits we discussed earlier. It’s important to consider the benefits added to your pay because in a private practice or group practice you are typically paying for all of that out of your own pocket. While having a masters degree is an amazing accomplishment, it can feel like that degree does not mean as much at an agency even though it is required to do the work. I would encourage you to run the numbers to discover how much you actually make in a year with benefits added before ruling out agency jobs. Another area to consider for agency income is that it is a steady paycheck. You will get paid every two weeks and it does not vary week to week.
So let's pause and practice that visualization exercise we began with. Close your eyes and envision yourself in this role at an agency. What makes your excited and what concerns you? What makes you attracted to this position and what would be hard to deal with? Take some time and jot down your thoughts and ideas of community mental health. I am happy to answer any questions you may have and here to encourage you!