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Prescription Privileges

Prescription Privileges. Should Psychologists have the right to prescribe?. Leanne Fraser November 8, 2005. Field of Psychology.

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Prescription Privileges

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  1. Prescription Privileges Should Psychologists have the right to prescribe? Leanne Fraser November 8, 2005

  2. Field of Psychology • Psychology can be defined as being directed toward psychological and behavioural interventions that result in more adaptive functioning (Fox, Barclay, & Rogers, 1982, as cited in DeNelsky, 1996). • The field of psychology is not a unitary entity, but a grouping of vastly differing models of study and practice (Klein, 1996)

  3. Psychoactive Drugs • A psychoactive drug or psychotropic substance is a chemical that alters brain function, resulting in temporary changes in perception, mood, consciousness, or behaviour

  4. The Privilege Debate Five key issues: • Heritage of Psychology • Effectiveness of Psychoactive Drugs • Education and Training • Effect on Psychology as a Profession • Public Interest

  5. Heritage of PsychologyAgainst • Psychology • Psychological intervention

  6. Heritage of PsychologyFor • As in every other field, psychology has to move with the times and should welcome the opportunity (Klein, 1996) • Results from current opinions should not direct the future (Naussbaum, 2001)

  7. Effectiveness of Psychoactive DrugsAgainst • Effectiveness is overstated (DeNelsky, 1996) • Psychoactive drugs are over-prescribed (Dobson & Dozois, 2001)

  8. Effectiveness of Psychoactive DrugsFor • When psychotherapy is effective, significant neurobiological alterations have occurred (Naussbaum, 2001) • There are times when psychotropic medications will be effective where psychotherapy will not (Naussbaum, 2001)

  9. Education and TrainingAgainst • More time learning about medications than about psychotherapies (DeNelsky, 1996) • Lengthy and Costly (Hayes, Walser, & Bach, 2002)

  10. Education and TrainingFor • Lesser trained medical specialists already prescribing psychotropic medication (Cullen & Newman, 1997, as cited in Walters, 2001) • Lengthy education not an issue (St-Pierre & Melnyk, 2004)

  11. Effect on Psychology as a ProfessionAgainst • Greed (DeNelsky, 1996) • Dilute the identity of psychologists (Dobson & Dozois, 2001)

  12. Effect on Psychology as a ProfessionFor • Propel therapeutics to new levels (Nussbaum, 2001) • Enhance income and status (Healy, 1995, as cited in Walters, 2001)

  13. Public InterestAgainst • Lack of demand (DeNelsky, 1996) • Privileges will not change attendance to certain populations (Dozois & Dobson, 1995)

  14. Public InterestFor • Psychotherapy patients use psychotropic drugs (Olfson & Pincus, 1994, as cited in Pagliaro, 1995) • Medication being prescribed without proper knowledge (Zimmerman & Wienckowski, 1991, as cited in Walters, 2001)

  15. New Mexico • Prescription privileges for psychologists • Law employs a two-step process • Still some controversy

  16. Possible Solutions from the Opposition • Doctorate in Mental Health (Hayes et al, 2002) • Collaboration between medical practitioners and psychologists (Dobson & Dozois, 2001)

  17. What Does the Majority Think? Study conducted by St-Pierre & Melnyk (2004) • Surveyed Canadian psychology students and clinical psychologists

  18. Questions Posed • 1. “Do you think it is possible for psychologists to attain the required training in order to properly prescribe psychotropic medication?” • 2. “Do you think the attainment of prescription privileges is theoretically or philosophically opposed to the field of psychology?” • 3. “Do you think that the attainment of prescription privileges would compromise psychological service delivery in any way?” • 4. “How probable do you think it is that Canadian psychologists will ever attain prescription privileges?”

  19. Results • Trained psychologists should have prescription privileges • CPA should advocate for prescription privileges • Graduate students would seek privileges • Do not believe rights will be granted

  20. Graduate Studies Keith Dobson PhD University of Calgary Can obtain a PhD in Clinical Psychology Edouard St-Pierre Lakehead University in 2004

  21. References DeNelsky, G. Y. (1996). The case against prescription privileges for psychologists. American Psychologist, 51(3), 207-212. Dobson, K. S., & Dozois, D. J. A. (2001). Professional psychology and the prescription debate: Still not ready to go to the alter. Canadian Psychology, 42(2), 131-135. Dozois, D. J. A., & Dobson, K. S. (1995). Should Canadian psychologists follow the APA trend and seek prescription privileges? A reexamination of the revolution. Canadian Psychology, 36(4), 288-304. Hayes, S. C., Walser, S. D., & Bach, P. (2002). Prescription privileges for psychologists: Constituencies and conflicts. Journal of Clinical Psychology, 58(6), 697-708. Klein, R. G. (1996). Comments on expanding the clinical role of psychologists. American Psychologist, 51(3), 216-218.

  22. References Nussbaum, D. (2001). Psychologists should be free to pursue prescription privileges: A reply to Walters. Canadian Psychology, 42(2), 126-130. Pagliaro, L. A. (1995). Should Canadian psychologists follow the APA trend and seek prescription privileges? Of course they should! An invited critical commentary of Dozois and Dobson. Canadian Psychology, 36(4), 305-312. Pettifor, M. E. J., & McCrea, S. (1997). The Canadian code of ethics and the prescription privilege debate. Canadian Psychology, 38(1), 49-51. St-Pierre, E. S., & Melnyk, W. T. (2004). The prescription privilege debate in Canada: The voices of today’s and tomorrow’s psychologists. Canadian Psychology, 45(4), 284-292. Walters, G. D. (2001). A meta-analysis of opinion data on the prescription privilege debate. Canadian Psychology, 42(2), 119-125. White, J. H. (2003). APNA participates on task force on psychologists prescribing. Journal of the American Psychiatric Nurses Association, 9(2), 68-70.

  23. What do you think?

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