If anyone will know the answer to this, this crowd will. Can psycho-therapists write perscriptions? Thanks.
You have to have an MD to prescribe medications
Psychiatrists are able to give prescriptions
Plain-old therapists are unable too.
Psychiatrists can do therapy though…
I don’t think so. IIRC only doctors can write prescriptions. That means you need a psychiatrist, not a therapist.
However, there may be a category of drugs these days that can be prescribed by therapists. For instance, I believe certain classes of nurses can prescribe certain medications (such as birth control).
Psychotherapist is a broad term. Only MD’s can prescribe meds - typically psychiatrists in that field. Psychotherapist is typically used to describe “talk treatment,” and can be used for a title by psychologists, social workers, and in some states probably just about anyone.
In the Massachusetts, an “R.N.C.S.” (registered nurse clinical specialist) can also write prescriptions for psychotherapeutic reasons. This is a nurse with specialized training who works under the supervision of a doctor.
Many practicing psychologists have a working relationship with psychiatrists, who assist and do the prescribing and managing of medication while the psychologist does most of the talk therapy.
In addition to what is noted above, in the US, Physicians’ Assistants, Optometrists, Dentists, and Podiatrists (none of whom are MDs) can prescribe medications. PA’s and nurses can typically prescribe “under supervision” of a doctor, and Optometrists, Dentists, and Podiatrists are generally limited to prescribing within their area of specialization (eyes/mouth/feet).
Psychotherapists (non-MD) need an MD, PA, or nurse to write the actual prescription, although as pointed out, many of them have pre-existing relationships with doctors who will do so.
-mok
In some states, a psychologist (a non-MD) is alllowed to prescribe.
And don’t think that the drug companies don’t encourage all the prescriptive legislation they can. If they could get a flower-shop
girl to give you prozac, they would.
And remember, someone who is a doctor might have a PhD, not an MD.
Prescription Drugs? I didn’t know that. What states allow this?
New Mexico, evidently. http://www.schizophrenia.com/newsletter/allnews/2002/psychologistsprescribe.htm
Sound like they’re the first.
Oh my God. Bad freakin’ law.
“Intensive training?” Yeah, it’s called MED SCHOOL!
MY SIL has PhD in psychology, and she doesn’t want anything to do with prescribing meds! WAAAAY too much liability for someone with no medical degree!
New Mexico is the first. This prescription right is based on studies conducted by the army, which showed that psychologists whom the army allowed to prescribe spent more time with patients, and prescribed at lower levels, than psychiatrists.
Some other states have lobbies pushing for prescription rights for psychologists. If you’re curious about your state, you can contact their psychology licensing board (there is a list available from asppb.org). Note that psychologists who want to prescribe will need to complete additional training. At this point, it looks like an additional 2-year master’s degree focusing on psychopharmacology, plus supervised direct service training.
EJsGirl–
Yes, psychologists agree with you. That’s why additional, formal training would be required.
What would be the attraction for a psychologist to go through costly additional training and operate under intense scrutiny with a much higher level of personal and professional liability?
Is there a monetary attraction? Would they receive cash from the manufacturers of the drugs they prescribe? Or could they charge their patients higher fees because they can prescribe drugs without consultation with a fully qualified MD?
In my admittedly limited experience, people with serious psychological disorders requiring medication are seen by MDs rather than psychologists. Does this hold true with the Doper experience?
IAA Psychologist and have discussed this extensively with other psychologists. The attraction is not monetary. If that were the primary consideration, we’d all work in Industrial/Organizational settings. The attraction is better care for our clients. Unlike many (not all, but many) of the people prescribing medications for psychological issues,
- Psychologists have much more training in actually working with people with psychological issues;
- Psychologists generally function as psychotherapists, and it’s considered likely that this will still be the case with prescription privileges (this means we actually see people for more than a 10-minute “med check” once a month, and that insurance will allow this);
- We are trained not only to build rapport (“bedside manner”), but to ask questions that encourage people to talk about the complex details of their circumstances and capacities.
I’n not saying that medical professionals don’t do these things, just that they are standard training/skills for psychologists.
Note that psychologists would only prescribe the medications associated with the practice of psychology. This means that the set of medications and interactions we’d learn would be a subset of those an MD or PA would be able to prescribe.
If you mean for therapy/services other than medication, I’d have to say that the answer is “no.”
- While psychiatrists do sometimes practice psychotherapy, these days insurance sometimes won’t pay for a psychiatrist to provide ongoing services other than medication;
- “People with serious psychological disorders requiring medication” are often, or become, poor. For psychotherapy/counseling/case management, they often see a master’s-level (or bachelor’s level) counselor. If they’re in hospital, they see their doctor for 5-20 minutes a day on average (in acute care); the rest of the day they are typically working with nurses, master’s-level (or bachelor’s level) counselors and interventionists, and perhaps a psychologist.
- Most of my psychotherapy clients have had their medications prescribed by a GP, not by a psychiatrist.
As a psychologist, I already keep up with drug effects, side effects, and interactions between medications so that I can spot potential drug-related problems, as well as assessing the effectiveness of the prescription. Because I see the client more often than the prescriber does, I am in a position to provide observations to the prescriber (with a release of information). I often have a better diagnostic handle on the client’s condition, and I often know things the GP doesn’t (e.g., clients will talk to me about concerns about sexual side effects of SSRIs, but may not raise this concern with the GP). A number of my clients have trauma histories, which means that under the stress of talking with an MD, they can look worse than they are. I’ve had a few clients misdiagnosed as bipolar on the basis of a 15-minute interview, when they actually appear (on the basis of a number of hours of psychotherapy) to have PTSD. Clarifying the diagnosis is another way that I can be helpful to the prescriber. Because I’m keeping up with a much smaller number of medications, I often know about new drugs, or new studies, before the GPs I work with.
For my clients with relatively straightforward problems, it would be nice at least to have the capacity to maintain the prescription and evaluate its utility over time. I could also be assured that the prescription is being taken in conjunction with some form of therapy or behavioral intervention. For people with more complex issues, I would want to consult with a psychiatrist, but would also like my clinical judgement to carry some weight. Finally, for my poorer clients, I would like the opportunity to provide prescription services that they can afford (e.g., embedding the med check in the low-cost counseling session).
Thanks Shoshana, this is really interesting.
I asked my SIL about it, and whether it would be something that she’d take advantage of. She wouldn’t, but only because she is not in private practice and does not want to treat patients (she works in behavioral genetics research, same as her PhD field).
Especially interesting to me, because over on a nother board I have a thread about a family friend who has finally been diagnosed as schizophrenic after a long-time misdiagnosis as bipolar. I wonder if things would have been different under the NM system.
It’s a hard call sometimes–schizophrenia, schizoaffective disorder, and the bipolar spectrum can look pretty similar even in adults. Whenever there’s a question about diagnosis–especially if medication that’s often helpful for that diagnosis is not helping–a good clinical interview, a review of charts and records, and sometimes testing can be useful. Unfortunately, it’s time-consuming; I was able to do a lot more of it as a student and when I was performing psychological testing for general assistance.