We are an organization of psychologists who have had extensive experience in teaching, training, research, and clinical practice. We are profoundly committed to advancing the interests of psychology as a behavioral science and we are proud of its achievements in many areas of research and practice. However we do not believe that psychologists have sufficient training in basic and biological sciences to be able to prescribe drugs. We are committed to promoting maximum safety and competence in the prescription of psychotropic drugs, which, we believe, can play a significant role in the treatment of many mental disorders. Because psychotropic drugs are medications that have multiple effects on the human body that are affected by patients’ health status and that interact with other prescribed drugs and-self-selected substances, we believe that they should be prescribed only by professionals who have undergone suitable medical training. Rather than allowing psychologists to prescribe medications in their psychological practices, we support collaborative models in the delivery of mental health care, in which psychologists work in tandem with medically-qualified prescribers to provide safe and effective healthcare services. Patients have a right to expect that their prescriptions are provided by professionals with education and training that adequately equips them to understand their health history, general health status, and potential broad systemic effects of the medications that they are advised to take.
Psychologists have made major contributions to human health and well-being and will continue to do so. The profession of Psychology has made major contributions to understanding human development through the life cycle and most aspects of human functioning as individuals, groups, communities, societies and cultures. But there are limits to the practices that psychologists can undertake responsibly within the context of their profession, and prescribing medications is one of such endeavor.
We believe that:
- Because drugs currently play major roles in mental health services, every graduate program in clinical and counseling psychology should require coursework in: (1) the basics of psychopharmacology; (2) methods of integrating drugs into other forms of psychological interventions;(3) methods of assessing the effectiveness of these combined treatments; and (4) techniques for collaboratively offering combined treatments. Although such training augments psychologists’ understanding of clinical psychpharmacology, it is not sufficient to prepare psychologists to prescribe.
- Psychologists can be as effective in prescribing drugs as medically trained providers only if they obtain training that is directly comparable in content and duration to that of prescribing professionals in other disciplines (e.g., physicians, osteopaths, nurse practitioners, advance practice nurses, physician assistants). We strongly encourage those psychologists who wish to develop the diverse competencies necessary for safe prescribing to obtain the required additional training to meet the requirements for licensure in these other health professions so as to bridge the gap between psychology and those other professions and to ensure that they are prepared to manage medications on par with these other professions.
- Although psychologists who wish to prescribe should be trained in one of the medically-oriented programs (listed above), it is recognized that some psychology training programs may offer training in psychopharmacology practice. Any program that seeks to provide training for prescribing should meet specifications that are more demanding and comprehensive than those outlined by the American Psychological Association.
- Candidates must: (1) have earned doctoral degrees from accredited programs in psychology; (2) have obtained a significant proportion of their Psychology doctoral training in health care settings; (3) as a prerequisite for admission, have completed undergraduate coursework in basic sciences that is identical to that required of prescribers in other disciplines1; and (4) prior to being admitted to advanced training in psychopharmacology, have obtained a competitive score on a standardized test of scientific knowledgeas required by other health professional training programs2.
- Programs intended to prepare psychologists to prescribe must: (1) be offered by accredited institutions of higher learning that have adequate resources to provide quality training; (2) must be accredited explicitly to provide training to prescribe; (3) provide complete programs that at minimum match the content, duration, and format of basic and clinical training offered to nurse practitioners or physician assistants; (4) have clinical and academic faculty who are qualified by virtue of their training and experience to provide training in psychpharmacology and related medical areas (e.g., physical diagnosis) that is equivalent to that provided in medical schools or nurse practitioner or physician assistant programs.
- Graduates must: (1) pass a post-graduate examination of knowledge and competence that has been developed and administered by qualified organizations that are independent of the training program providers; and (2) at intervals of three years or less, pass postgraduate examinations of knowledge and competence developed by qualified organizations that are independent of the training programs; (3) obtain the minimum continuing education credits directly related to prescribing at levels required by their jurisdiction.
Unfortunately, current proposals for training psychologists to prescribe fall far short of the training for other prescribers (see tables below). Any program that fails to meet these standards risks producing graduates who do not meet minimal requirements for safe and competent prescribing practice that is consistent with expectations for prescribers. Therefore such programs constitute an unnecessary risk to the public health for improper medication management.
It is expected that legislative bills will be introduced during 2008 in the following states: California, Florida, Georgia, Hawaii, Minnesota, Mississippi, Missouri, New Hampshire, New Jersey, Ohio, Oklahoma, Tennessee, Texas, Utah, Virginia and Washington. We believe it is incumbent on psychologists to alert legislators, governors, regulators and citizens, in jurisdictions that are contemplating legislation that would enable psychologists to prescribe, of the flaws and risks inherent in psychologist prescribing.
1 Anatomy, biology, biochemistry, inorganic chemistry, mathematics, organic chemistry, human physiology, physics
2 (e.g., equivalent to the “Medical Comprehensive Achievement Test”).