Should Psychologists Have Prescription Privileges?
Moyer, Diane M., USA TODAY
A number of articles have been published by psychologists in favor of their profession being permitted to prescribe psychotropic medications. A review of studies surveying practitioners, though, reveals that the majority of psychologists are opposed to the gaining of prescription privileges. For example, Donald Boswell of Oklahoma State University and Walter Litwin of Goodins Psychiatrists, Alexandria, La., surveyed 582 hospital-affiliated licensed psychologists. The results indicated that 49% disagreed, 27% agreed, and 24% were unsure whether psychologists should have prescription privileges. Garland DeNelsky of The Cleveland (Ohio) Clinic found that 30% were in favor of prescription privileges for psychologists, 61% were opposed, and nine percent were undecided. Unless a major shift occurs in the attitudes of most psychologists on this issue, prescription privileges could cause divisions within the field, as well as a greater division between psychologists and other professions.
There has been a growing interest in psychopharmacology among a variety of subspecialties in psychology. Therefore, before psychologists become involved in prescribing psychopharmacological agents, it is critical that licensure provisions be developed. According to psychologist Tom Kubiszyn, school psychologists, because of their training and setting, may be in a unique position to expand their competencies in the areas of pediatric medication and evaluation procedures, particularly with schoolchildren diagnosed as having attention deficit hyperactivity disorder. However, Stephen DeMers of the University of Kentucky points out possible complications with school psychologists seeking greater involvement in psychopharmacology. School psychology programs provide much less training and experience in psychopathology and therapeutic interventions than clinical psychology programs do.
Within the field of psychology, there are varying degrees of credentials, making it difficult for clients to identify competent practitioners. For instance, in psychology, the public may have difficulty understanding the difference between a Psy.D., a Ph.D., and an Ed.D. Some psychologists have a master's degree, while others have earned certificates of advancement in areas such as drug and alcohol or family therapy. Currently, psychology licensing acts allow for the credentialing of all psychologists with a doctoral degree, regardless of whether the individual was trained as a practitioner. Perhaps the Psy.D. and Ph.D. need to be two distinct degrees, whereby the Psy.D. is for practitioners and the Ph.D. is for researchers and academicians. The result would be different training in psychology for the two degrees. The absence of criteria identifying the practitioner is a serious impediment for professional psychology and must be resolved before granting psychologists the right to prescribe psychotropic medication.
Giving psychologists the option to become trained prescribers may create a division among psychologists whereby some will be able to prescribe and others will not. As a result, major discord could emerge. It is possible that psychologists with the right to prescribe may consider themselves superior to those without the right. If gaining prescription privileges would lead to broader third-party payments or full hospital privileges for those qualified to prescribe, psychologists unable to do so may feel that they have been accorded second-class status in their profession.
The debate, thus far, has focused on the training necessary to grant psychologists prescription privileges. Although this matter is important, of more basic concern are treatment implications and the future role of psychologists. Prescription privileges could move psychologists closer to a medical model and further away from their historical goal. Psychology began in the late 19th century as an application for psychological techniques. Its focus has been on assessment, behavioral interventions, consultation, and applied research. …