Increasing emphasis on interprofessionalism and teamwork in healthcare renders psychologists' collaborations critical and invites reexamination of psychologists' roles related to medications. The Collaboration Level outlined by the APA's Ad Hoc Task Force is more achievable and in synch with health reform than prescription privileges (RxP). RxP remains controversial due to training and safety concerns, lacking support from health professionals, psychologists, and consumers. Differences in educational preparation of psychologists relative to prescribing professionals are discussed. Enactment of only three of 170 RxP initiatives reveals RxP to be a costly, ineffectual agenda. Alternatives (e.g., integrated care, collaboration, telehealth) increase access without risks associated with lesser medical knowledge. Concerns about RxP and the movement toward team-based care warrant reconsideration of the profession's objectives regarding psychopharmacology. Collaboration and Prescribing 3Psychologists and Medications in the Era of Interprofessional Care: Collaboration is Less Problematic and Costly Than PrescribingThe premise that doctoral-level psychologists should prescribe psychoactive medications to meet mental health needs that are unmet by current prescribers, while theoretically helpful if done well, warrants reassessment as we enter an era emphasizing team-based healthcare. Concerns about the background, breadth and comprehensiveness of training for prescribing that the American Psychological Association (APA) currently advocates to complement psychologists' doctoral training (i.e., most of which is not oriented toward preparing to prescribe) have been raised; many psychologists believing that if psychologists are to prescribe their knowledge and training should be equivalent with that of other prescribers (Baird, 2007). Compromised training for prescribing raises questions about quality and safety that pose both regulatory and public health concerns, and uneasiness for numerous stakeholders. Consideration of whether or not organized psychology should pursue prescriptive authority also should be assessed within the context of existing alternatives-e.g., interdisciplinary care, in which psychologists collaborate with other professionals whose medical training allows more comprehensive management of medications compelling healthcare trends that provide psychologists opportunities to contribute substantively to patient care, but that lack the controversy of the agenda promoting prescription privileges for psychologists (RxP). We also review some of the history and concerns about psychologist prescribing, the relative limitations of the APA training model, and the impact of the pursuit of prescription privileges on the field, including the limited success and substantial costs of its legislative record. Medication TrendsMedications serve important roles in the arsenal of mental health treatments.According to the Substance Abuse and Mental Health Services Administration (SAMHSA; 2012), use of psychoactive medi...
This study examined the relationship between psychological adjustment and illness-related, demographic, intrapersonal, family and socio-ecological variables. A total of 132 men and women receiving active cancer treatment completed a battery of instruments designed to measure global psychological functioning, depression, anxiety, coping strategies, domestic and extended family relations, social support quantity and perceived quality, and satisfaction with the health care system. Results revealed that the majority of subjects were experiencing little or no psychological distress; however, 30-35% reported experiencing clinically significant levels of depression, anxiety or global adjustment difficulties. Results further revealed that coping strategies characterized by avoidance or acceptance-resignation, family disturbance and quantity and perceived quality of social support distinguished good versus poor adjustment and were most predictive of psychological distress in this sample.
The clinical art of applying scientific knowledge to a patient's circumstances of suffering is especially challenging when practicing psychotherapy with people who are experiencing chronic pain. Health psychology has made substantial contributions by showing that psychosocial factors are essential in explaining the phenomenon of pain and, particularly, its chronic progression to debilitating degrees. In addition, clinical health psychology has developed empirically supported treatments that improve the lives of chronic pain sufferers across many dimensions. This article is not concerned with reviewing that evidence or the treatment programs, but with noting some issues pain management psychotherapists may face in using this knowledge effectively to improve the lives of their patients.
This article provides an overview of the breadth of issues a therapist may face in treating a person with chronic pain. Questions such as the relative contributions of biological and psychosocial influences on the patient's reported condition must be addressed. In addition, the counselor often must help the patient deal with psychopathology that occurs in reaction to the pain, which is likely to be contributing to it. Other financial, medical, and legal circumstances also may impinge on the therapeutic framework to limit or influence the course of treatment. Two examples of treatment lessons are offered, and a case example illustrates the lengthy and multidimensional course some treatments can take.
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