MS Clinical Psychopharmacology

[PublicHealth]

So what happened in Tennessee?

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[Allotheria]

So what happened in Tennessee?

I don't know... this is all I could find on it.


2005 RxP Bill for Tennessee --



AN ACT to provide prescriptive
authority for psychologists
and to amend TCA,
Titles 39, 53, 63 and 68.



BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF TENNESSEE:


SECTION 1. TCA 63-11-203(a) is amended by adding the following sentence after the sentence that concludes with the word "consultation" and before the start of the sentence beginning "Psychological services may be rendered":


Practice of psychologist also includes the authority to prescribe and dispense drugs and/or other treatment procedures within the scope of practice for psychologists as defined by this section. Such prescriptive authority practices include writing orders for a drug, laboratory test, or any medicine(s), devices(s), or treatments including controlled substances rational to the practice of psychology. Licensed pharmacists, laboratories, and health care facilities may fill prescriptions and orders for laboratory tests and devices when written by prescribing psychologists.


SECTION 2. TCA 63-11-208 is amended by adding the following new subsections to be appropriately designated:


(e) "Prescribing psychologist" as used in this chapter, means a psychologist with a health service provider designation as defined in TCA 63-11-208(d) and who has been certified as a prescribing psychologist as defined by the board of examiners in psychology. This board shall certify that a psychologist has met the training, education, experience and examination requirements necessary for certification as a prescribing psychologist. Such certification authorizes prescriptive authority practice including writing orders for a drug(s), laboratory test(s), or any medicine(s), devices(s), or treatment(s) including controlled substances rational to the practice of psychology. Only the board of examiners in psychology shall certify a psychologist as a prescribing psychologist who for the first two years after obtaining prescribing certification shall perform such prescribing under a collaborative practice agreement with a physician licensed under Title 63, Chapter 6 or 9. After completing two years of a physician collaborative practice agreement, the prescribing psychologist shall no longer be required to prescribe under a physician collaborative practice agreement. After completion of the two year physician collaborative practice agreement, the prescribing psychologist must establish and maintain effective intercommunication with a physician to make provision for the diagnosis and treatment of medical problems by a physician with an unlimited license to practice the healing arts in this state. Such postcollaborative practice communications shall be at the discretion of the prescribing psychologist and physician(s), although the prescribing psychologist will not treat any patients who do not have an established relationship with a primary care physician.


(f) "Collaborative practice agreement" means a formal relationship between a prescribing psychologist and a physician, licensed under Title 63, Chapters 6 or 9. Such relationship shall be in writing and shall include a drug formulary, arrangements for telephonic or other access, referral procedures and review of 20% (twenty percent) of charts of patients for whom medications were prescribed. Such agreements shall be filed with the board.


(g) The board of examiners in psychology is responsible for the promulgation and administration of all of the rules and regulations governing the practice of psychology. The board shall convene a multidisciplinary health professionals group specifically charged to advise the board in the development of rules and regulations governing prescribing psychologists and collaborative practice agreements between physicians and prescribing psychologists. This multidisciplinary group, chaired by a member of the current board of examiners in psychology, shall be comprised of five (5) members, each of whom is a member of the current health related boards of healing arts in the following professions: psychology, medicine, nursing, optometry, pharmacy. The promulgation of these initial rules for collaborative practice agreements shall be completed by 12/31/05.


(h) The board of examiners in psychology shall set the standards and requirements for prescribing psychologist certification based on current educational guidelines stated in the American Psychological Association's
publication of Recommended Training in Psychopharmacology for Prescription Privileges. Such standards and requirements shall include, but not be limited to, the following didactic subject areas and preceptorship-supervision requirements.


(1) Pharmacology/psychopharmacology: child, adult, geriatric, general clinical;


(A) pharmacokinetics and pharmacodynamics, drug interactions, side effects, substance abuse; and


(B) serology, laboratory and maintenance of therapeutic drug levels.


(2) Related sciences:


(A) neuroanatomy, neurophysiology, neurochemistry; and
(B) pathophysiology, organ and anatomy systems of functioning and nonfunctioning and metabolism/biotransformation.


(3) Treatment applications:


(A) consultation with other professionals;
(B) ethics and professional issues; and
(C) computer-enhanced record and history accountability.


(4) Preceptorship-supervision: a minimum of one (1) calendar year of supervision with at least one hundred (100) patient contacts.
(5) In addition to any other requirements imposed pursuant to this chapter, at least four hundred and fifty (450) hours of didactic educational instruction in accordance with the model curriculum standards for prescriptive authority as currently recommended by the American Psychological Association (APA) such as those offered by Fairleigh Dickinson University, the Prescribing Psychologists Register or other training programs meeting APA's educational requirements.


(6) In addition to successful completion of the aforementioned components of the training, education, and experience necessary for prescriptive authority, those seeking certification as a prescribing psychologist must also successfully pass a national examination testing competency to engage in the practice of prescriptive authority such as the examination offered by the American Psychological Association Practice Organization's College of Professional Psychology or the International College of Prescribing Psychologists Examination with the board of examiners in psychology determining passage levels for any such national examination.


SECTION 4. TCA 63-11-204(a) is amended by deleting the period at the end of the subsection and by adding the following language:


with the exception of diagnosis and treatment rendered by a prescribing psychologist in accordance with 63-11-203.


SECTION 5. TCA 53-10-105 (a) is amended by inserting the language "prescribing psychologist pursuant to 63-11-203" between the phrase


63-8-102 (12) and "or veterinarian".


SECTION 6. TCA 53-10-105(b)(2) is amended by inserting the language "or prescribing psychologist authorized pursuant to 63-11-203" between the words "licensed physician" and the phrase "and who meets".


SECTION 7. TCA 63-10-404(34) is amended by inserting the language "prescribing psychologist authorized pursuant to 63-11-203" between the phrase "63-8-102(12)" and the words "or other allied medical practitioner".


SECTION 8. TCA 63-7-103(a)(2)(D) is amended by inserting the language "prescribing psychologist authorized pursuant to 63-11-203" between the word "podiatrist" and the phrase "or nurse".


SECTION 9. TCA 39-17-402(22)(A) is amended by inserting the language "prescribing psychologist" between the word "optometrist" and the word "veterinarian".


SECTION 10. TCA 68-29-121(a) is amended by inserting the phrase ", or a prescribing psychologist" after the words "chiropractic physician" and before the phrase "or other health care professionals".


SECTION 11. TCA 68-29-121(b) is amended by inserting the phrase ", or a prescribing psychologist" after the words "chiropractic physician" and before the phrase "or other health care professionals".


SECTION 12. TCA 63-11-218(a) is amended by adding the following language immediately before the period of the first sentence of the subsection:


as well as any initial application fees and other costs specifically associated with the any renewal of certification requirements as a prescribing psychologist.


SECTION 13. This act shall take effect upon becoming law, the public welfare requiring it.

 

[PsyDStar]

Some thoughts about the MS in Psychopharmacology... are these programs that offer this degree not indepth systematic training programs that thouroughly train those that take it in multidimentional ways of understanding drugs and their psychopharmacology? Do not most MD programs (at least the first 4 years) devote only one measly class to this topic? Is not the topic of psychopharmacology and the knowledge required to saftely and most effectively prescribe these most powerful drugs more indepth that what can be covered in a single course pertaining to the topic? Granted, much of the rest of MD schooling is devoted to basic sciences and complete anatomical understanding of the human body, along with the pharmacology of the universe of drugs that do not directly impact psychopharmacology, but how is this knowlege of relevence to psychology and psychopharmacology?

Psychology and psychological problems is what psychoactive drugs are used for, yes? Psychologists can become greater, more powerful healers with the ability to prescribe psyc-meds.

Anyways, just some thoughts.

 

[Allotheria]

Some thoughts about the MS in Psychopharmacology... are these programs that offer this degree not indepth systematic training programs that thouroughly train those that take it in multidimentional ways of understanding drugs and their psychopharmacology? Do not most MD programs (at least the first 4 years) devote only one measly class to this topic? Is not the topic of psychopharmacology and the knowledge required to saftely and most effectively prescribe these most powerful drugs more indepth that what can be covered in a single course pertaining to the topic? Granted, much of the rest of MD schooling is devoted to basic sciences and complete anatomical understanding of the human body, along with the pharmacology of the universe of drugs that do not directly impact psychopharmacology, but how is this knowlege of relevence to psychology and psychopharmacology?

Psychology and psychological problems is what psychoactive drugs are used for, yes? Psychologists can become greater, more powerful healers with the ability to prescribe psyc-meds.

Anyways, just some thoughts.

I agree with you one class isn't enough, but I guess they get years of clinical experience.

I'm just happy to see that after their intern/externship psychologists have to be supervised for 2yrs and then at least 20% of all their clients have to be be supervised too.

 

[Pterion]

Some thoughts about the MS in Psychopharmacology... are these programs that offer this degree not indepth systematic training programs that thouroughly train those that take it in multidimentional ways of understanding drugs and their psychopharmacology? Do not most MD programs (at least the first 4 years) devote only one measly class to this topic?

One measly class with this specific title, yes. However, drug activity and multisystem impact is woven throughout all classes. You may not care to learn the biochemistry behind Ehler-Danos, but that doesn't mean that a patient with that disorder is a good candidate for MAOI's. Is there any risk to a diabetic patient to whom you wish to prescribe Geodon? Would a 2-yr MS teach you to consider this? I don't know the answer, but I have doubts.

Is not the topic of psychopharmacology and the knowledge required to saftely and most effectively prescribe these most powerful drugs more indepth that what can be covered in a single course pertaining to the topic?

Sure. That's why after 4 years of basic science, integrative simulations, innumerable evaluations, supervised direct patient contact each specialty in medicine requires a multi-year apprenticeship focusing on that area's scope of practice. I don't suggest an MD is inherently superior to a PhD, nor do I endorse the reverse. They are trained to do different things.

Granted, much of the rest of MD schooling is devoted to basic sciences and complete anatomical understanding of the human body, along with the pharmacology of the universe of drugs that do not directly impact psychopharmacology, but how is this knowlege of relevence to psychology and psychopharmacology?

See above. Just because a person seeks a psychologist does not mean that their difficulties are entirely higher-order neuro, IE amenable to the psychopharmacopia. Certainly this field's own research has demonstrated the efficacy of non-pharmacological treatments. What next? ECT? Subdural ablation?

Psychology and psychological problems is what psychoactive drugs are used for, yes? Psychologists can become greater, more powerful healers with the ability to prescribe psyc-meds.

Not necessarily. I wonder if many psychologists would be comfortable reducing all "psychological" problems to biochemistry. It's a necessary but not sufficient. To say that psychologists will become greater and more powerful healers is a non sequitur. That outcome is simply not known. We all hope that is the case, but not all of us believe it will be.

Once real-life intrudes on the carefully-laid fantasies of the current trainees, I wonder what their true breadth of practice will be. After ~5yrs graduate school, a year internship (possibly another year post-doc) and another 2 years for the MSpharm, who will be able to afford to do psychotherapy anymore? Oh - right, the master's level people. Forgot.

 

[john182]

What do psychiatrists feel would make psychologists competent psychotropic providers? What education and supervision? And don’t say an M.D. degree and notice that I said psychotropic medication.

Joining in here late I know but it seemed to be asking for it:
I suppose you may have specifically said "psychotropic medication" but this underpins the risks itself i.e., psychotropic medication prescribing does not exist in any more isolation from "non-psychotropic medication" (if there is such a thing), than mental illness exists in isolation from "non-mental illness". That is a view from perhaps the 1800s. That separation is stigma.

- psychotropic medication is medicine just like any other medicine
- it is not an issue of "providing psychotropics" - it is an issue of people without a license or training in practicing medicine attempting to legislate the privilege of practicing medicine "psychotropic" or *not*.

To even ask the above question demonstrates why it is a bad idea as you blatantly show from it that you believe psychoactive medication exists in some sort of isolated vacuum. Perhaps in ye olden times when one theorised on mania being due to demonic possession that may have been so but not in the 21st century.

It appears that the clinical psychologist is being financially squeezed - by the social workers on one hand performing the CBT and psychotherapy, and on the other hand the ever increasing neurobiological basis of mental illness as being biological illness which is the domain exclusively of psychiatry.

So what better to do than lash out and try and legislate a medical degree?

"Prescription priveleges" is a fallacy - it is a re-branding of the reality that it is practicing medicine by people without a medical degree.

 

[edieb]

Just received an email alert saying that the Illinois RxP has passed out of one chamber (house) and expected to pass in the senate this week. Can anybody corroborate this?

Joining in here late I know but it seemed to be asking for it:
I suppose you may have specifically said "psychotropic medication" but this underpins the risks itself i.e., psychotropic medication prescribing does not exist in any more isolation from "non-psychotropic medication" (if there is such a thing), than mental illness exists in isolation from "non-mental illness". That is a view from perhaps the 1800s. That separation is stigma.

- psychotropic medication is medicine just like any other medicine
- it is not an issue of "providing psychotropics" - it is an issue of people without a license or training in practicing medicine attempting to legislate the privilege of practicing medicine "psychotropic" or *not*.

To even ask the above question demonstrates why it is a bad idea as you blatantly show from it that you believe psychoactive medication exists in some sort of isolated vacuum. Perhaps in ye olden times when one theorised on mania being due to demonic possession that may have been so but not in the 21st century.

It appears that the clinical psychologist is being financially squeezed - by the social workers on one hand performing the CBT and psychotherapy, and on the other hand the ever increasing neurobiological basis of mental illness as being biological illness which is the domain exclusively of psychiatry.

So what better to do than lash out and try and legislate a medical degree?

"Prescription priveleges" is a fallacy - it is a re-branding of the reality that it is practicing medicine by people without a medical degree.

 

[Allotheria]

Joining in here late I know but it seemed to be asking for it:
I suppose you may have specifically said "psychotropic medication" but this underpins the risks itself i.e., psychotropic medication prescribing does not exist in any more isolation from "non-psychotropic medication" (if there is such a thing), than mental illness exists in isolation from "non-mental illness". That is a view from perhaps the 1800s. That separation is stigma.

- psychotropic medication is medicine just like any other medicine
- it is not an issue of "providing psychotropics" - it is an issue of people without a license or training in practicing medicine attempting to legislate the privilege of practicing medicine "psychotropic" or *not*.

To even ask the above question demonstrates why it is a bad idea as you blatantly show from it that you believe psychoactive medication exists in some sort of isolated vacuum. Perhaps in ye olden times when one theorised on mania being due to demonic possession that may have been so but not in the 21st century.

It appears that the clinical psychologist is being financially squeezed - by the social workers on one hand performing the CBT and psychotherapy, and on the other hand the ever increasing neurobiological basis of mental illness as being biological illness which is the domain exclusively of psychiatry.

So what better to do than lash out and try and legislate a medical degree?

"Prescription priveleges" is a fallacy - it is a re-branding of the reality that it is practicing medicine by people without a medical degree.

John182, I agree with a few of your comments although I don't think you needed to be quite so pompous as you were. I believe you missed the ENTIRE point of my post. I want to know what will make psychologists competent providers and the reason why I specified psychotropics is because I don't want to deal with med students or stressed residents going on for 20 posts about how psychologists will end up prescribing antibiotics, etc.

I currently don't feel that the M.S. training is sufficient for psychologists to prescribe, if you would like the answer the first two lines that you quoted from me, that would be fantastic. I really am interested in what it will take to make PhD's competent providers, short of an MD degree.

To even ask the above question demonstrates why it is a bad idea as you blatantly show from it that you believe psychoactive medication exists in some sort of isolated vacuum.

Where you got this I have no idea…. But nothing happens in a vacuum. I'm just curious did you read my post at all? The point I was attempting to make was that indeed only having a background in psychotropics is dangerous which is why I'm not in favor of the current M.S. psychopharmacology degree and would like to have a discussion on what it would take to make the psychologist a safe provider.

It appears that the clinical psychologist is being financially squeezed - by the social workers on one hand performing the CBT and psychotherapy, and on the other hand the ever increasing neurobiological basis of mental illness as being biological illness which is the domain exclusively of psychiatry.

Oh, I agree with this. I believe that some of the major motivation behind this is indeed financial, but I also feel that there are a few providers out there who actually want to become better providers for their clients. But overall, I feel that it is indeed about the almightly dollar.

 

[john182]

John182, I agree with a few of your comments although I don’t think you needed to be quite so pompous as you were. I believe you missed the ENTIRE point of my post. I want to know what will make psychologists competent providers and the reason why I specified psychotropics is because I don’t want to deal with med students or stressed residents going on for 20 posts about how psychologists will end up prescribing antibiotics, etc.

I currently don’t feel that the M.S. training is sufficient for psychologists to prescribe, if you would like the answer the first two lines that you quoted from me, that would be fantastic. I really am interested in what it will take to make PhD’s competent providers, short of an MD degree.



Where you got this I have no idea…. But nothing happens in a vacuum. I’m just curious did you read my post at all? The point I was attempting to make was that indeed only having a background in psychotropics is dangerous which is why I’m not in favor of the current M.S. psychopharmacology degree and would like to have a discussion on what it would take to make the psychologist a safe provider.



Oh, I agree with this. I believe that some of the major motivation behind this is indeed financial, but I also feel that there are a few providers out there who actually want to become better providers for their clients. But overall, I feel that it is indeed about the almightly dollar.

OK, sorry for sounding pompous. I've been doing a lot of background reading on this, and it seems it has been pushed by a core group of clinical psychologists since the late 80s. It was interesting to see that the US DoD report revealed it cost just over $600,000 per psychologist for the psychopharamcology training they trialled back in the 1980s - might be cheaper sending them to Harvard for that money for a medical degree!!

The same names seem to crop up again and again. I've also read and wI will try and find this again, one psychologist saying that the original branch into clinical work (as in, the more acute clinical) in the 1950s with psychotherapy, etc., was questioned at the time as many psychologists felt it was turning away from "true" psychology.

Most of the psychologists I know are academic, PhDs, etc. so I see psychology as more a research speciality - one where it's about cutting edge treatments like say Dialectical Behaviour Therapy and so on, stuff that eventually drifts down to the "real" world so to speak.

Again, I did a lot fo Googling on the topic and the same names have come up again and again for what I found a very surprising number of years. It seems that they have almost made it a raison d'etre to gain this "prescribing privilege" which I do believe is a rebranded misnomer to make it sound so simple that hey, why not.

Answering your question about what it would take to create competent prescribing by psychologsts: for comparison, to become a competent prescriber takes an MD degree and then many many many years to really be competent - and yes, I am not being smart - you can't legislate competence. Even a basic MD just graduated after 4 years knows squat about how thigns work in the real world - then they take *another* 4 years to learn that PLUS the relationships to the other medical specialities.

Quite a lot of doctors with years of practice aren't competent as in - 100% knowledgable. The evidence base grows at an incredible rate in psychiatry and psychopharm. People who graduated 4 years ago with board certification will be out of date now if they haven't been reading up the latest journals, etc., .

In short, if you are a PhD in Clinical Psychology it's prcisely for the same reason that a board certified psychiatrist is not - because they are too totally different fields. The psychiatry side has pushed and researched the neurobilogical aspects for 50 years now and more - psychology appears to have been side-tracked into commoditised "therapies" and research has slowed down as the managed care, etc., has decided on the value of commoditised care.

Perhaps instead of trying to legislate extra skills, the direction should be to criminalise managed care for destroying mental health care?

 

[Allotheria]

Answering your question about what it would take to create competent prescribing by psychologsts: for comparison, to become a competent prescriber takes an MD degree and then many many many years to really be competent - and yes, I am not being smart - you can't legislate competence. Even a basic MD just graduated after 4 years knows squat about how thigns work in the real world - then they take *another* 4 years to learn that PLUS the relationships to the other medical specialities.

Quite a lot of doctors with years of practice aren't competent as in - 100% knowledgable. The evidence base grows at an incredible rate in psychiatry and psychopharm. People who graduated 4 years ago with board certification will be out of date now if they haven't been reading up the latest journals, etc.,

Thank you for your comments, this is what I was looking for a discussion!

I disagree that you have to have an MD to be a competent provider. What about ND's and NP's? I agree wholeheartedly that you cannot legislate competence. I did some research on the actual degree and I don't believe that the current MS program is sufficient for training PhDs to prescribe medication. If you look at some of my other posts you'll see that I feel that MS should be more of a post-doc program. I feel that it should have more entrance requirements such as health psych where the psychologist actually had to take the intro med school classes.

What I did like about the MS program was the supervision. It required 2yrs direct supervision, after you obtain the MS, and then supervision of at least 20% of your patients for your entire career. I like the fact that this forces psychologists to be mid-level providers and keeps communication open between MDs and PhDs. I like that this is basically 4yrs, 2yrs MS program and then 2yrs supervision + continued professional supervision.

Perhaps instead of trying to legislate extra skills, the direction should be to criminalise managed care for destroying mental health care?

I agree with this. This is one of the reasons why I think psychologists are having so many problems in the field. Between the MA's and managed care I think psychologists are really getting squeezed.

 

[john182]

Thank you for your comments, this is what I was looking for a discussion!

I disagree that you have to have an MD to be a competent provider. What about ND’s and NP’s? I agree wholeheartedly that you cannot legislate competence. I did some research on the actual degree and I don’t believe that the current MS program is sufficient for training PhDs to prescribe medication. If you look at some of my other posts you’ll see that I feel that MS should be more of a post-doc program. I feel that it should have more entrance requirements such as health psych where the psychologist actually had to take the intro med school classes.

What I did like about the MS program was the supervision. It required 2yrs direct supervision, after you obtain the MS, and then supervision of at least 20% of your patients for your entire career. I like the fact that this forces psychologists to be mid-level providers and keeps communication open between MDs and PhDs. I like that this is basically 4yrs, 2yrs MS program and then 2yrs supervision + continued professional supervision.

This is one of the reasons why I think psychologists are having so many problems in the field. Between the MA’s and managed care I think psychologists are really getting squeezed.

It's not just psychology you see, and this is why I think it's ultimately dangerous for psychology to go down the road of psychopharm. For example, psychiatry itself has (in the US it seems, I am actually in EU so don't have first hand experience) become side-lined into commoditised "medication management" units - which in itself is virtually the antithesis of psychiatry.

So, the HMOs have pushed psychiatrists into practicing only psychopharm and it's pushed the psychologists into trying to get the rights to prescribe psychpharms because again the pressure is to cut costs forever.

Instead, why not become more "clinical" and less isolated - more psychologists should become part of the multidisciplinary team and advance their own skills. Perhaps it comes down to the private-practice style of care in the US that makes it practice money based as opposed to evidence-based.

I absolutely think this is a knee jerk response to financial pressure. Are there clinical psychology unions in the US? I know the APA (ology and iatry!) but who negotiates on contracts with HMOs?

As I see it, mass unionisation for a nationally agreed contract would sort out problems sharpish but maybe it's too european!!

So what happens eventually when some states legislate and some don't? It makes a farse of any sort of national health policy on mental health then does it not?

 

[Psychologyfiend]

Sheesh, that is one of the most intelligent (yet idealistic) responses I have yet heard. Props!

 

[PublicHealth]

So what's the current status on psychologist RxP bills in other states? There was some noise about Tennessee possibly being the next "domino." Any news? The Division 55 and related websites have not been updated in a long time.

 

[PublicHealth]

Just found this: http://www.division55.org/Readers/Current.htm

Lots of dying bills...

 

[PsyDRxPnow]

Interesting reading: http://www.nursing.ohio.gov/PDFS/NextMeeting/9.1.pdf

 

[psychgeek]

It's not just psychology you see, and this is why I think it's ultimately dangerous for psychology to go down the road of psychopharm. For example, psychiatry itself has (in the US it seems, I am actually in EU so don't have first hand experience) become side-lined into commoditised "medication management" units - which in itself is virtually the antithesis of psychiatry.

Thank you,

Someone is finally discussing the reality of US healthcare rather than just sniping at people with different degrees (except for your "clinical" comment, but I’ll ignore that for now).

Prescription privileges may be terribly harmful to the field of psychology in the same way that the advent of SSRIs and managed care has critically injured the field of psychiatry. Rising malpractice insurance rates coupled with modest compensation levels for therapy may force all psychologists to make medication management part of their clinical practice. This could result in a two-tiered medication management system where all of the straightforward cases are handled by psychologists, the difficult cases are handled by psychiatrists, and very few doctors perform therapy. The true danger of PP for psychologists doesn’t involve diabetics taking Geodon; it involves every client being treated with Lexapro and a Dr. Phil book. While this is a fantastic situation for insurance companies, it kinda sucks for everyone else involved.

Prescription privileges for psychologists will likely gain widespread acceptance despite the concerns of psychologists and psychiatrists; the political power of insurance and drug lobbies is just too great, and the current system is just too broken. As this change occurs it is all or our professional responsibilities to make certain that all those who suffer from psychopathology are able to access all of the psychological services they need. We’ve done a terrible job of this in the previous 30 years. Hopefully we’ll do better in the future.

 

[john182]

Yup. I don't think drugs should be in psychology's treatment bin. But, I think insurance companies including/especially government ones (medicaid and medicare) are attempting to kill psychology.

I think groups have been positioned to face-off against each other (e.g., nurse prescribing vs. interists, anaesthetic nurse prescribing vs. anaesthetists, now psychologists vs. psychiatrists) because basically people's livlihoods are being ****ed with. Not that you won't earn a living but that you wil have no control over your life.

I am watching this from afar - in Ireland. It's a disturbing message of how private insurance can direct health care rather than collaborative practice by expert groups which is what should be happening.

So what can be done? So much political will seems to be directed at this that there seems to be far less emphasis on the essential qualities of true/classical clinical psychology? So does the clinical psychologist end up being a cheap "medicine manager" and refers to psychiatry when things go more complicated?

The cost cutting will *not* stop when psychologists prescribe. Next it will be how to reduce the cost of psychology prescribing by limiting contracts for re-embursement, etc., ?

The more I learn of the US system the more I like it here!!

 

[sunnyjohn]

Q? Who offers the MS in Clinical Psychopharmacology?

Thank you

 

[PublicHealth]

Q? Who offers the MS in Clinical Psychopharmacology?

Thank you

http://prescribingpsychologist.com/psychopharmacology_training_prog.htm