Prescribing privileges: Grail for some practitioners, potential calamity for interprofessional collaboration in mental health

Abstract

The focus of this article is the probable consequences, in the event psychologists aggressively pursue prescription privileges (RxP), upon collaboration between psychologists and physicians. The case for RxP is briefly and critically summarized and the current state of collaboration between psychologists and medical professionals is reviewed. Data are presented from a recent small survey of clinical psychologists that support the following hypotheses: (1) psychiatrists and other medical professional receive a consequential volume of referrals from psychologists which would be diminished by RxP; (2) psychologists receive referrals for psychosocial services from medical professionals which would be diminished by RxP; (3) psychologists anticipate an adverse effect upon collaboration from RxP; and (4) contrary to some claims, psychologists are at best divided over RxP. Implications of these findings upon interprofessional collaboration are discussed.

Concluding remarks on the debate about prescription privileges for psychologists

“…The article by Weene (2002), "The Psychologist's Role In The Collaborative Process Of Psychopharmacology," provided a number of positive aspects of collaboration and noted the assets psychologists bring to a collaborative model would also apply to prescribing psychologists. The article by Bush (2002), " Prescribing privileges: Grail for some practitioners; potential calamity for interprofessional collaboration in mental health" suggested collaboration may be what psychologists prefer. Weene (2002) noted that psychologists function in a multidisciplinary environment and make contributions that complement those of physicians, nurses, teachers, parents, employers, and lawyers.…”

“…While Weene (2002) and Bush (2002) agreed on the assets of collaboration, Bush also reported the results of a small web-based survey to back up his arguments that collaboration is common and that psychologists are already an integrated part of the health care field. His survey also leads one to question the degree of interest in PPP outside of the officials at the APA, a point addressed in more detail by Hayes et al (2002).…”

“…Indeed, McFall (2002) indicates that whether psychologists are smart enough to learn psychopharmacology is not what this debate is about. Furthermore, Bush (2002) indicates that collaboration between psychologists and physicians is common and desirable, which requires some understanding of behavioral neuroscience. The testimony of AAAPP (Heiby, 2002) explicitly supports the alternative of obtaining a degree in medicine or nursing for psychologists who wish to prescribe.…”

“…As indicated in the introductory article (Heiby, 2002), this special series was organized around six topics that have been disputed in testimony submitted at state legislatures by the American Psychological Association (APA) and the American Association of Applied and Preventive Psychology (AAAPP). These topics and articles addressing them are as follows: (1) whether there is a societal need for psychologists to practice medicine (Albee, 2002;Norfleet, 2002); (2) whether are precedents indicating psychology as a discipline has evolved in this direction (Sechrest & Coan, 2002); (3) how train-ing would change the discipline (Levant & Shapiro, 2002;McFall, 2002);(4) what the addition of medical training would cost financially (Wagner, 2002); (5) if the current collaborative model is adequate (Bush, 2002;Weene, 2002); and (6) how the policy of APA and AAAPP can be better understood (Caccavale, 2002;Hayes, Walser, & Bach, 2002). Articles reflecting the APA position on the evolution of the field and the financial cost of training were solicited but not submitted for this special series.…”

Concerns about substandard training for prescription privileges for psychologists

“…The RÂP proposal remains controversial within psychology and objections involve anticipated negative effects of the amount of training (Albee, 2002;Bush, 2002;Hayes & Heiby, 1996, 1998Hayes, Walser, & Bach, 2002;Heiby, 2002;Heiby et al, 2004;McFall, 2002;Pollitt, 2003;Sechrest & Coan, 2002;Wagner, 2002). Proponents of RÂP have observed that the major reason for the failure of most enabling legislation is concern over the quality of the APA model training (Fox et al, 2009), and the consumer protection reasons given in one governor's veto of an enabling bill supports this impression (Lingle, 2007).…”