I have what I hope will be a quick and easy question to answer: Can a psychologist prescribe medication for the treatment of mental disorders (specifically Lithium) in the state of Pennsylvania?
I’ve Google searched left and right, usually under ‘prescription drugs Pennsylvania’ with no luck.
Thanks in advance,
YD
IANAD, but I believe that no psychologist anywhere can prescribe anything. That is the domain of the MD’s, and D.O.s and a few others that can prescribe certain pain medications, like podiatrists.
A Psychologist working “under” an MD can “prescribe” things that the supervising doctor actually writes the prescription for.
Psychologists do not have prescription privileges. Whether they should or not is an ongoing debate.
Try having Google search for “prescription privileges psychologists”, and it’ll unearth a ton of stuff on the topic.
http://www.apa.org/monitor/sep98/prescrip.html
From a Canadian paper, but still relevant here in the US:
http://www.ottawacitizen.com/national/970817/1074106.html
Thanks a lot for the help, KeithB and AudreyK. I suspected as much, but wasn’t sure. I think I’m going to branch off and start a GD thread about this issue.
Thanks again,
YD
Some psychologist lobbying groups are fighting like the devil for prescription privileges and making asses of themselves in the process. They propose that interested psychologists would undergo what they consider rigorous training in the dispensation and monitoring of psychotropic meds and then be allowed to prescribe as they see fit. Psychologists, of course, receive not one day of formal training in medical school.
This flaccid trial balloon will never see the light of day, of course, given this nation’s litigiousness and the sheer nuttiness of the proposition. If anyone with the interest in meds–and the ability to pass a test–is allowed to prescribe potentially dangerous medications, where does the slippery slope end–mail-order credentials for high-school drop outs?
A Psychiatrist is a full medical doctor, which includes the 8 (?) years of medical school, along with having to get a Doctorate in psychiatry.
A psychologist is not a doctor of medicine but goes only through, at the minimum, a 2 year course on psychiatry and a maximum of 4 years. They have little medical training.
A psychiatrist understands the effects of the medications on the body and brain, which a psychologist might only know the basics of psychiatric medications and their effects but nothing about how they will combine with any other types of over the counter or prescription drugs.
All psychiatric medications have side affects, and the Psychiatrists have to judge which is best for the patient at what dosage and risking what effects.
Just an aside, but my SSRI is prescribed by a nurse practitioner.
One of my friend’s has a stepdad who’s a psychologist. He’s been mounting a campaign for years, apparently, lobbying the government to allow certain psychologists to dispense medication. I have no idea what his angle is (presumably, he just figures he knows enough about the various medications to be as competiant as a psychiatrist in this area). On another note, don’t some psychologists scoff at the “quick fix” approach of psychotropic medication? I was under the general impression that a psychologist was more interested in understanding how the mind works, well, psychologically, rather than as a physical organ.
[QUOTE]
*Originally posted by Container20 *
**A Psychiatrist is a full medical doctor, which includes the 8 (?) years of medical school, along with having to get a Doctorate in psychiatry.
A psychologist is not a doctor of medicine but goes only through, at the minimum, a 2 year course on psychiatry and a maximum of 4 years. They have little medical training.**
[QUOTE]
Wrong, wrong, wrong. Psychologists receive no formal “psychiatric training”–certainly not medical training. Whether PhD or PsyD, a given psychologist’s academic training focuses on quantitative research methods, therapeutic clinical interventions, psychological theory, and the like. While they may gain a familiarity with psychotropic meds, they have zero training in understanding the other body systems. To wit, how can one posit a mind-body connection, yet be “trained” only on the effects of psychotropic meds–while being ignorant of the big picture?
As for occ’s question, yes, some psychologists do scoff at psychotropic meds–at their own expense or, rather, at their patients’ expense. The general efficacy of such meds is proven beyond a shadow of a doubt, though they are rarely “magic bullets.” The savvy psychiatrist, psychologist, clinical social worker, or counselor understands the big picture–the biopsychosocial aspects of treatment.
Actually, some would argue that psychologists are poorly trained for direct clinical intervention, thus the recent interest in the more clinically-oriented PsyD.
tsunamisurfer
Nurse practicioners and physician’s assistants do write prescriptions, but they are supervised by an MD or DO. I think that the NPs and PAs are also limited in which drugs they can prescribe, though I’m not sure. These medical care providers are usually pretty good at knowing their limits, too. The best health provider I ever had was a PA. He was an excellent diagnostician, and he had a great bedside manner.
From the APA Monitor Online: Psychologists enroll in nursing program to gain prescription privileges
I know of no Nurse Practitioners nor any form of nurse who may prescribe medication without a doctors approval. I do know of the same who prescribe on something like a blanket approval, meaning that the overseeing physician gives them permission to write prescriptions within a certain range.
One of my friends is under the care of a psychologist at a clinic, and on medication prescribed by the rarely seen Psychiatrist, but he sees a Nurse Practitioner to discuss and change the medication as needed and to re-up the prescription. Any major changes, like getting tranquilizers, require the NP to get the MDs approval. 99% of the time, the Dr just tells him to use his judgment, but now and then, he wants more information and may deny the new medication.
All psychologists that I am familiar with have taken psychiatric theory in college, then studied the various forms of applied therapy, from Reality to Group, and the works of predominate psychiatrists. A 2 year psychologist is basically a social worker, but most in practice by themselves or associated with a clinic have 4 year degrees. Masters, Bachelors or whatever. They select, after the first year, the form of theory they wish to practice then pursue it, or a combination of many. A qualified psychologist is one who knows and uses many theories and they are trained in patient contact.
Facing patients is a requirement for going into general practice because their professors know that all classroom theory is useless if the student in unable to interact with real people. All degreed psychologists are also run through psychiatric tests themselves, first for actual experience and secondly to weed out those who subconsciously are seeking to understand and cure hidden problems of their own.
It is not a good idea to send a trained psychologist out to deal with patients when he might project his own problems unwittingly onto them and apply the wrong therapy. They do find quite a few students who need psychiatric treatment before being given their degrees.
Most psychologists and psychiatrists that I know agree with a combined therapy policy, in that medication must be reinforced with therapy. You will find the medication only policy, applied after a few sessions, mainly in areas where clinics or psychiatrists treat the poor public and are reimbursed by the Government. The low level of payment by Medicare/Medicaid discourages them from spending expensive time with a patient, so does the case loads.
Doctors often prescribe antidepressants without suggesting any visits to psychiatrists. This might work in mild depression or anxiety problems, but not for more serious conditions. Then again, a medical doctor studies mainly your body, and very little of your mind. Thanks to the big budget cuts in mental health in the late 70s by the government, the big progressive boom in psychiatry has all but stalled.
The grants and loans and budgets have not even come close to being fully restored even now and the government is closing State psychiatric facilities. Some great, progressive previously private institutions that lost funds and grants had to join the State, which has archaic rules about therapy and restricts new ideas. In the private sector, due to the major increase in personal wealth, new concepts and ideas flourish but treatment is expensive and the price of the drugs have soared.
Physicians (MDs and DOs) with valid sate licenses to practice medicine and DEA certificates (to prescribe controlled substances) may prescribe and dispense prescription medications. Psychologists are not physicians, and no US jurisdictions allows them to write prescriptions or dispense medications except under an MD/DO’d supervision. Dentists and podiatrists (DMD/DDS or DPM licentiates may prescripe certain medications, primarilly analgesics. Veterinarians (DVMs) may prescribe controlled substances and antibiotics to non-human animals. Chiropractors (DCs) and practicioners of “Oriental Medicine”, such as accupuncturists and “DOMs” may not prescribe any controlled substances. NPs and PAs may write prescriptions, but always under the supervision of a physician. RNs may administer medications, but only under a physicians order and supervision.
The word, “physician” is by law limited to those who possess an MD or DO. People without these degrees who hold themselves out as “physicians”, e.g. chiropractors, DOMs, accupuncturists, homeopaths, psychologists, etc, are guilty of misdemeanors or felonies, depending upon the jurisdiction.
As regards the issue of psychologists prescribing any controlled substances or other “prescription” medication…this would be a crazy idea. I’m sure the non-physician practioners would like to be able to do so. They should go to med school if that’s what they want to do.
Nick Capozzoli, MD