Prescriptive authority for psychologists: A consensus of support.

Abstract

Prescriptive authority for psychologists became a preeminent practice issue for the psychological community during the 1990s. Scope of practice, relationships with other health care providers, and perhaps even a change in identity of the profession are subsidiary issues bound up in the prescription privileges debate. The authors surveyed Maryland psychologists on this topic and examined 2 decades of opinion surveys regarding prescription privileges. A consistently high level of endorsement of prescription privileges for psychologists has been found over the past decade. At this point, the profession of psychology strongly favors the acquisition of prescription privileges by appropriately trained professional psychologists.In January 1999, psychologists in the American territory of Guam obtained the right to prescribe psychotropic medications under the supervision of a physician (Allied Health Practices Act, 1998, Title 10). Guam Bill 695 was passed by the legislature in December 1998 and then vetoed. The gubernatorial veto was subsequently overridden, however, and prescriptive authority for psychologists became law. This law represents the first time in almost a decade of legislative attempts that American psychologists have been successful in their endeavor to obtain prescriptive authority. 1 Since the mid-1990s, prescription privileges interest groups have been developed by at least 21 state psychological associations (Cullen & Newman, 1997), and several programs designed to train psychologists to this end have been established. Although momentum toward prescriptive authority is clearly growing, some opposition remains. Key arguments by opponents of prescription privileges are that a significant number of those in the profession do not desire to pursue this ability (Heiby, 1998) and that the issue is heavily promoted by leaders of organized psychology, who are at odds with the desires of psychologists at large (Chatel, Lamberty, & Bieliauskas, 1993).

What Oregon Psychologists Think and Know About Prescriptive Authority: Divided Views and Data‐Driven Change

“…In contrast to ardent supporters who argue that their “data should provide reassurance to psychologists spearheading legislative initiatives” because of high approval ratings (Sammons et al., , p. 608), our data suggest disagreement among a group of professionals who are not particularly well‐informed, nor willing to undergo training to become a prescriber. Our relatively high response rate in comparison with past surveys (e.g., 21% in Sammons et al.)…”

“…Of the psychologists contacted, 397 completed the survey, 242 declined to participate, and 104 did not return contact yielding a response rate of 53%. Although directly contacting psychologists by phone and email resulted in higher response rates relative to prior studies that recruited via mail (Baird, ; Fagan et al., ; Sammons, Gorny, Zinner, & Allen, ), future researchers should note that this population can be difficult to recruit, even with more direct phone and email contact methods.…”

“…For example, Sammons et al. () have suggested “that the usefulness of organized debates or other public forums devoted to dissecting the issue has become limited” and “that to wait until all have been converted serves no purpose but results in immobility” (p. 608). In point of fact, when considering the amount of time, money, and effort invested in the RxP movement, now is the time to carefully evaluate those who have been prescribing and to create open dialogue that will allow professionals to move away from the two camps who hold opposing cultural viewpoints and instead recognize that they need to evaluate existing evidence toward understanding how best to achieve the shared desired outcome: improve mental health outcomes for those most in need.…”

“…(); 4 = Sammons et al. (); 5 = Baird (); 6 = Kubiszyn & Carlson (); 7 = Luscher et al. (); 8 = Tatman et al.…”

Prescription privileges for psychologists: Scared to death?

“…Expanding scope of practices, such as telehealth and prescriptive authority, were carefully considered and found not to need separate standards or sections, as these activities would be covered in other sections (Celia Fisher, Chair, APA Ethics Revision Taskforce, personal communication, August 3, 2001). Robiner et al briefly and unsystematically review surveys of psychologists and psychologists‐in‐training regarding their views on prescription privileges. They state, “More recent surveys continue to suggest inconsistent attitudes among psychologists.” By contrast, Sammons, Gorny Zinner, and Allen (2000) systematically reviewed the results of 21 studies conducted between 1981 and 1998 on psychologists' attitudes toward prescribing. Their results “revealed a uniformity of opinion about prescriptive authority” (p. 605).…”