Working as a Nurse Psychotherapist

Pursuing jobs in the field of psychotherapy isn’t just for doctors; nurses can do it too. Benjamin Evans, DD, DNP, RN, APN, past president of the New Jersey State Nurses Association, has his own practice as a nurse psychotherapist in addition to consulting. He made the change in the 1980’s after he had completed his nurse practitioner training. Based on his work with people living with chronic and catastrophic illnesses, he decided to earn a master’s degree in counseling because it would be a good fit.

Evans talked with us about what a nurse psychotherapist does and what nurses who are thinking of entering this area of the field should keep in mind.

What exactly does a nurse psychotherapist do?

A nurse psychotherapist does the same work as any other educated psychotherapist — using psychological and counseling methods to assist in behavior and mental health changes. Usually the state board of nursing incorporates some form of health counseling within the definition of nursing practice. Psychotherapy can be done with individuals, families, and groups.

What should nurses keep in mind if they are thinking of becoming a nurse psychotherapist?

Nurses need to understand their reasons for wanting to become psychotherapists. Psychotherapy is not about “fixing” others who have similar issues to the therapist.

It is not solely health counseling for issues like nutrition, stress, or weight control.  It is not nurse coaching. Psychotherapy is undergirded with theoretical frameworks that are used by the psychotherapist to help in the change.

Nurses who wish to become psychotherapists will be integrating nursing theories with theoretical frameworks from psychology, psychiatry, social work, and other disciplines.

Psychotherapy education is usually done at the graduate level. For this reason, the nurse wishing to do psychotherapy needs to determine if she or he will pursue psychotherapy education through a graduate nursing program like a psychiatric mental health nurse practitioner/clinical nurse specialist role or through another discipline like psychology, educational counseling, or social work.

What kind of certification or other education would they need?

Certification can be obtained by credentialing organizations like the American Nurses Credentialing Center or through various certifying bodies outside of nursing. Some types of psychotherapy have non-degree supplemental experiential training and then “certify” the practitioner in a particular modality — for example, training in cognitive behavioral therapy.

What else should they do?

A nurse wishing to become a psychotherapist should meet with and shadow a nurse psychotherapist to really learn all that the specialty initials. She or he should become familiar with modalities of psychotherapy and vet programs for training. 

What are the greatest challenges to being a nurse psychotherapist?

Challenges include training (time and cost), building a practice, obtaining referrals, and ongoing maintenance of competency. 

Additionally, reimbursement issues play into the challenges of practice as many insurers do not cover nurses for psychotherapy.

What are the greatest rewards?

There are many rewards to being a nurse psychotherapist, including watching as behavior changes and mental health improvements are accomplished by the patients. 

Is there anything else important for our nurse readers to know?

The practice of psychotherapy as a nurse is quite rewarding. The nurse who chooses to go into psychotherapy practice must want to help others to make behavioral or mental health changes. The nurse must have clear boundaries — being able to be empathic and not take on the issues of the client. Nurse psychotherapists must be mindful of self-care and to develop a sound network for referrals when the issues presented are outside of the psychotherapist’s area of expertise.