Prescriptive Authority for Psychologists
Many of you know the American Psychological Association is hell-bent for leather to gain prescriptive authority for psychologists. An oft-mentioned tagline for prescriptive authority—the ability to prescribe carries with it the ability NOT to prescribe—seems satirical. Psychiatrists, at one time, were trained as psychotherapists. Despite the underwhelming data supporting drug efficacy, and under the intoxicating influence of massive marketing and increased personal income, psychiatrists regressed into the pill pushers they are today. The current fervor for prescriptive authority combined with a disturbing lack of awareness of the data does not inspire confidence in psychologist’s abilities to swim upstream against the strong rapids of corporate influence and personal financial success.
Discovering a psychiatrist who doesn’t prescribe occurs with about the same frequency as a discussion of the evidence or a dissenting opinion on the pages of the APA Monitor on Psychology (hereafter Monitor). Drug efficacy is portrayed as a foregone conclusion and prescriptive authority as a necessary step to expand the practice of psychologists. For example, a column (“Neuroscience and Prescriptive Authority”) by APA President Sharon Stephens Brehm (2007) lamented the rift between science and practice and asserted that the rising interest in biology among scientists (neuroscience) and practitioners (prescriptive authority) might bridge the divide. Brehm called for the unity of science and practice “to serve psychology’s common self-interests” (p. 5). And the tale is told: The push for prescriptive authority seems more about self-interest than science, and is far removed from our consumer base. A never cited finding from a 2004 APA survey is that 91% preferred a helper who would emphasize talk therapy as a first course of action, not drugs. A letter challenging the assumptions of the column was sent but not published.
Returning to the tagline, consider a special feature on psychopharmacology that appeared in the February issue of Monitor. Prescriptive authority was lauded as providing “one-stop shopping for patients” and the following example provided:
"Thinking about how being able to prescribe has improved patient care, he mentions a patient diagnosed with bipolar disorder. Fain put him on a combination of medications no one had tried with him before. The medication brought relief from his manic symptoms for the first time. Fain says, “He tells me every time, he pats me on the shoulder and says, ‘You saved me.’”
The ability NOT to prescribe? The psychologist put the client on a combination of medications never tried before. No combination of medications is FDA approved so all combinations are guinea pig experimentations. So much for NOT prescribing—sounds exactly like the whatever comes to mind multiple medication concoctions that psychiatrists regularly inflict on clients! And what about the “You saved me” part! Holy cow! Talk about a God complex and doctor wanna be. And we are supposed to believe that psychologists won’t wind up under the sway of corporate influence and personal financial success pushing unsupported and unapproved poly-pharmaceutical solutions just like psychiatrists. Yeah, right!
Discovering a psychiatrist who doesn’t prescribe occurs with about the same frequency as a discussion of the evidence or a dissenting opinion on the pages of the APA Monitor on Psychology (hereafter Monitor). Drug efficacy is portrayed as a foregone conclusion and prescriptive authority as a necessary step to expand the practice of psychologists. For example, a column (“Neuroscience and Prescriptive Authority”) by APA President Sharon Stephens Brehm (2007) lamented the rift between science and practice and asserted that the rising interest in biology among scientists (neuroscience) and practitioners (prescriptive authority) might bridge the divide. Brehm called for the unity of science and practice “to serve psychology’s common self-interests” (p. 5). And the tale is told: The push for prescriptive authority seems more about self-interest than science, and is far removed from our consumer base. A never cited finding from a 2004 APA survey is that 91% preferred a helper who would emphasize talk therapy as a first course of action, not drugs. A letter challenging the assumptions of the column was sent but not published.
Returning to the tagline, consider a special feature on psychopharmacology that appeared in the February issue of Monitor. Prescriptive authority was lauded as providing “one-stop shopping for patients” and the following example provided:
"Thinking about how being able to prescribe has improved patient care, he mentions a patient diagnosed with bipolar disorder. Fain put him on a combination of medications no one had tried with him before. The medication brought relief from his manic symptoms for the first time. Fain says, “He tells me every time, he pats me on the shoulder and says, ‘You saved me.’”
The ability NOT to prescribe? The psychologist put the client on a combination of medications never tried before. No combination of medications is FDA approved so all combinations are guinea pig experimentations. So much for NOT prescribing—sounds exactly like the whatever comes to mind multiple medication concoctions that psychiatrists regularly inflict on clients! And what about the “You saved me” part! Holy cow! Talk about a God complex and doctor wanna be. And we are supposed to believe that psychologists won’t wind up under the sway of corporate influence and personal financial success pushing unsupported and unapproved poly-pharmaceutical solutions just like psychiatrists. Yeah, right!
posted by Barry at
6:42 PM
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