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

Abstract

Following a veto of a prescriptive authority (RxP) bill in Oregon, 397 of 743 randomly selected psychologists were surveyed online regarding their attitudes and knowledge. Participants were randomly assigned to a control (n = 203) or education (n = 194) condition. After being exposed to information regarding access, training, and legislation, education participants completed post‐test measures. Evidence supporting proponents’ argument of improved access was not forthcoming. There was a division about scope expansion (43% support, 32% opposed, 25% undecided). Respondents’ knowledge of RxP was minimal, but education increased knowledge. Views were more stable, with attitudes shifting only in targeted areas. Using a “cultural cognition” framework, the discussion centers on exploring the need to evaluate RxP and use this information to educate psychologists about this issue.

Prescriptive authority: Psychologists’ abridged training relative to other professions’ training.

“…Despite these milestones and other initiatives, stakeholders, including psychologists, question the appropriateness and ponder the benefits, challenges, impact, and necessity of RxP (e.g., Robiner, Tumlin, & Tompkins, ; Stuart & Heiby, ). McKay () noted a generation of psychologists has been exposed to a preponderance of messages about the virtues of, and relatively little about, the downsides of RxP (Baird, ; Fagan, Ax, Liss, Resnick, & Moody, ; Robiner et al, , ; Sammons, Gorny, Zinner, & Allen, ; St. Pierre & Melnyk, ; Tompkins & Johnson, ; Walters, ). There remains division within the profession and a paucity of data regarding competencies, prescribing practices, and outcomes.…”

Prescriptive authority for psychologists: The next step.

“…An RxP program focused on helping those most in need could produce prescribing psychologists interested in providing services in underserved areas. One topic in RxP training could be to figure out how to best provide prescribing psychology services in rural areas, where it is currently severely lacking (Kaplin & Dacunto, 2014; Tompkins, 2018; Tompkins & Johnson, 2016).…”

“…Not disputing that there are populations lacking access to quality psychiatric care, Tompkins and Johnson (2016) are correct in that there is little data on whether prescribing psychologists improve access to care and that most psychiatrists and psychologists live in the urban areas. In the testimony in opposition to the Ohio RxP bill HB 326 in 2018, Tompkins (2018) called on more health care professionals to serve rural areas, which the current authors fully support.…”

“…The first is to provide a summary of RxP for psychologists who are unfamiliar with it. According to Tompkins and Johnson’s (2016) survey of psychologists in Oregon, most psychologists know very little about RxP. The second purpose is to detail recent events that have moved RxP forward, such as RxP’s legalization in several states.…”

Toward a new predoctoral model: Education and training in clinical psychopharmacology.

“…Whereas providing patient access to quality mental health care has been at the forefront of the prescriptive authority movement, we must not ignore the economic viability of HSP practice. Some researchers opine that psychologists should abandon clinical psychopharmacology education and instead focus on collaboration with physicians (Robiner et al, 2013; Tompkins & Johnson, 2016). Competency in interdisciplinary collaboration is a primary aim of MSCP programs: however, as a profession, we must demand fair and equitable compensation.…”