Location, location, location: what it’s like to be a licensed clinical psychologist in different parts of the United States

Have you ever wondered what the distribution of licensed psychologists looks like in the United States?

A recent report from the American Psychological Association’s Center for Workforce Studies examined data from state licensing boards of 50 states and Washington, D.C., from 2012-2015. This report presents a county-level look at the distribution of licensed psychologists in the United States.

Hot Spot Analysis Licensed Psychologists


In addition to the distribution, this report also looks at the relationship between distribution of psychologists compared to population health outcomes such as mental health and others.

The report found that there were higher concentrations of psychologists in the northeast and along the pacific coast areas while the South and Midwest areas of the United States had lower concentrations of licensed psychologists. Areas that were more urban had higher concentrations of licensed psychologists and more rural areas had lower concentrations.

Here is the breakdown, state by state:

With all this data, I wanted to put it all in context. This led me to the question:

“What is it like to actually be a licensed psychologist in a low or high concentration area of the United States?”

So I decided to ask that question to 4 licensed psychologists throughout the United States. Here are their thoughts:

Heather AustinName:
Heather Austin

Years practicing: 13

State you practice in: Alabama

School you attended: Auburn University

What brought you to practice in Alabama?
 I attended graduate school and then internship and postdoctoral fellowship in Alabama.

Why did you choose to practice here?
Alabama is a beautiful state with a warm climate and plenty of outdoor activities. Also, the University of Alabama at Birmingham (UAB) and Children’s Hospital of Alabama have several opportunities available for psychologists and after a national search, I decided to continue to live in Birmingham, Alabama.

What does a typical day look like for you?
There really is not a “typical” day for me. I am currently employed in private practice. I generally provide 20 to 25 face to face hours of service to patients within my private practice.

I see patients on Mondays, Tuesdays, and half days on Thursday and Fridays. I also consult and provide supervision to master’s level counselors for a nonprofit organization within the community (usually 10 to 15 hours per month).

In addition, I am employed part time as an Assistant Professor at UAB where I am the supervising psychologist for the Leadership Education in Adolescent Health (LEAH) program (typically my Wednesday job).

What are some of the challenges you face?
I worry about access to mental health care for our community. Many providers, including myself, have long waits for first appointments and often find it challenging balancing patient needs for services, having appropriate, timely access to affordable care and being able to make a reasonable income to support their own families. In addition, many of the punitive auditing measures of major insurance companies cause many providers in our state to discontinue accepting insurance for services, also reducing access to care.

What’s your advice to young psychologists / psychology doctorate students finishing their degrees?
I believe involvement in advocacy for our profession is a primary concern. I would suggest considering ways that you can be involved in your state psychological association and promote psychology as a profession and a valuable resources to our communities. Without this type of advocacy, it is very easy for legislators and large insurance companies to overlook the value and importance of our services.

I also think it is important to continue to explore career options, diversify and be creative about how our expertise and knowledge as psychologists can be used successfully on the job in a variety of ways.


PalmiterName: David Palmiter

Years practicing: 27

State you practice in: Pennsylvania

School you attended: George Washington University; Ph.D., Clinical Psychology

Why did you choose to practice here?
I grew up in Northeastern PA. My professional reasons for returning here were (1) to be the founding director of this region’s first outpatient mental health training clinic (i.e., at Marywood University) and (2) to partner in launching this region’s first doctoral clinical psychology program (i.e., a Psy.D. degree, also at Marywood University). So, establishing a private practice was a natural next step for synergizing my teaching, scholarship and training missions.

What does a typical day look like for you?
My work days vary a lot, which is what I prefer. I teach, write, supervise, do public education, offer workshops, perform various kinds of volunteer service and see clients.

What are some of the challenges you face?
There isn’t much I’d change about my life if I hit the PowerBall, which is a major blessing. But, I’d probably write and travel more…and I’d stop worrying about paying for my kids’ college tuition (I have two at Cornell University and one behind them in the pipeline). Otherwise, finding a way to process all the meaning that comes my way is a challenge some days.

In terms of my professional work, I have two primary struggles. First, it is still sometimes too difficult to find referral sources for therapy. Having multiple graduates of our Psy.D. program now practicing in Northeastern PA has definitely helped. But, I still sometimes struggle to find practitioners who use evidence-based approaches to treat certain conditions (e.g., marital dysfunction), who also have openings. Second, I find promoting a positive multicultural perspective within the circles I travel to be an uphill battle; this may be the case everywhere, but if feels like it is harder in a part of the world that is overwhelmingly Caucasian, heterosexual and Christian.

What’s your advice to young psychologists / psychology doctorate students finishing their degrees?
In my humble opinion, prioritizing mission over money increases doses of meaning while not ultimately compromising a standard of living. Ask yourself, “how can I use my top strengths as a psychologist to take on those human problems that bother me the most?” That’s the script for feeling like you have electricity in your veins as you work. Try also to think big and to avoid WAIT, or “who am I to…?” The latter kind of self-doubt is a mission and meaning crusher and, I find, is imbued within all corners of our profession. Finally, try to be creative and wise about brand formation, be active within communities of psychologists (e.g., your SPTPA and relevant APA divisions), seek out peer review from time-to-time (e.g., applying for the ABPP designation, writing for peer-reviewed publications) and practice loving-kindness as much as you can, especially with yourself.


apojeName: Albert B Poje

Years practicing: 8 (years licensed); 13 (by combined training experiences and license-eligibility)

State you practice in: Kansas


School you attended:
University of Missouri at Kansas City (BA, MA Psychology; PhD Clinical Psychology)
University of Kansas Medical Center at Kansas City (Practicum, Internship, Post-Doctoral Fellowship)

What brought you to practice in your Kansas? Why did you choose to practice here?
This is my hometown community. I was exceptionally fortunate to be able to join the staff of my clinical training site once I completed my training. This gave me the chance to give back to my mentors, training program and our community of learners and patients. Also, this work/practice location is a well-known academic medical center which provides a great number of learning opportunities on a day-to-day basis. Joining the staff was an easy decision for me.

What does a typical day look like for you?
I am a clinical psychologist and associate professor of psychology at an academic medical center in a psychiatry department. A typical day involves direct patient contact in multiple settings, including inpatient and outpatient psychotherapy, group counseling, psychological assessment, consultation, and work with a multidisciplinary medical team. I get exposed to patients with a myriad of clinical complaints, diagnoses, psychosocial circumstances and medical considerations. As such, a person in this situation benefits from being a general psychology practitioner. I routinely rely on my background knowledge in abnormal psychology, biological psychology, cognitive psychology, ethics and professionalism.

In addition, education by way of lecture, direct/collaborative clinical supervision, or curriculum development for psychology interns, psychiatry residents, and medical students is very common along with research activities. It is great to have so many different ways to function as a professional psychologist on a day to day basis! I often think my professional experience is what was envisioned by the Boulder Model of training and practice.

What are some of the challenges you face?
Balance of activities, time, and inter-professional education. However, I prefer to see these more as “opportunities.”

What’s your advice to young psychologists / psychology doctorate students finishing their degrees?
My advice is to remember that you will be an ambassador to the field of inquiry and practice that you love and that your work will be highly valued in a variety of locales and contexts. Think about how wonderful that will be. Also, remember that your training gives you a broad professional spectrum of expertise with many possible career paths, so always be an advocate for yourself and associated stakeholders in shaping the career that you want to have!


Regina MendozaName: Regina Mendoza

Years practicing: 14

State you practice in: Florida

School you attended: Nova Southeastern University

Why did you choose to practice here?
I chose to practice near where my family lived.

What does a typical day look like for you?
I work in private practice and a small amount of hospital practice. I see mostly psychotherapy patients at my office from 10am to 7pm. I also do psychological testing an average of once or twice per month. In addition to my outpatient practice, I see pediatric patients in a hospital setting 4 days per month. At the hospital I do consultations for a variety of pediatric conditions such as cancer, diabetes, anxiety, depression, and drug ingestions. I also see the pediatric cancer patients for therapy throughout their treatment.

What are some of the challenges you face?
Low insurance reimbursement and the potential for burn-out from long hours.

What’s your advice to young psychologists / psychology doctorate students finishing their degrees? If you are interested in private practice, educate yourself on how to run a business. Explore various income sources and stay open-minded to different work opportunities.

Okay, Psych Learning Curve-ers: are you a practicing licensed psychologists in the United States? Are you in a state this is considered to have a low- or high-concentration of psychologists? Why did you choose to practice in that state? What are some of your challenges? Share in the comment section below!

About the Author

Amanda Macchi, MPH
Amanda comes to the APA as a recent graduate of the George Washington University’s Milken Institute School of Public Health. During her time at GW, Amanda studied global health, focusing on the challenges facing mental health in low-and middle-income countries. She received her undergraduate degree in marketing from Emerson College in Boston, Mass. In her free time Amanda loves pyrography, furniture making and spending time with her dog, Becky.