In 2002, New Mexico became the first state to approve prescription privileges for psychologists. Louisiana followed shortly thereafter (2004), as did Illinois (2014), Iowa (2016), and Idaho (2017). These landmark pieces of legislation are paving the way for other states to take similar action. However, the move remains controversial. In 2010, the Oregon legislature passed a bill (SB 1046) granting prescriptive authority to psychologists, but the Governor Ted Kulongoski vetoed the bill, in response to pressure from various lobbying groups, including psychiatrists. The issue in Oregon continues with the 2017 veto by Governor Kate Brown of a similar bill (House Bill 3355).
There are several arguments against the granting of prescription privileges to psychologists. Unlike psychiatrists, psychologists do not receive medical training and therefore do not have the undergraduate premedical training or the years of medical school, internship, and residency that physicians receive. Philosophically, research-oriented psychologists argue that the granting of prescription privileges will refocus the profession away from science and instead emphasize the role of psychologists as practitioners. Psychologists should not be in the business, they argue, of handing out medication. A second argument against prescription privileges concerns the role of medication in psychological treatment. From this perspective, psychologists should be focused on psychotherapy. The long-term benefits of psychotherapy, these critics argue, are equal to if not greater than the long-term benefits of medication for the majority of disorders including major depression, anxiety disorders, and other nonpsychotic disorders. In the exceptional cases of serious mental illness, such as schizophrenia and bipolar disorder, psychologists can work as a team with psychiatrists to maintain their clients on long-term medication regimens.
The arguments in favor of prescription privileges are also compelling. If psychologists have the power to prescribe medications, they can do a better job than psychiatrists do integrating medication into psychotherapy. From the clients point of view, there is greater continuity of care, in that the individual does not need to see more than one mental health practitioner. Psychologists in favor of prescription privileges also point to the fact that with prescription privileges, psychologists can also intervene to reduce or discontinue a patients medications. A second argument in favor of prescription privileges is that there are other nondoctoral-level health professionals with this legal power including psychiatric nurse practitioners and psychiatric nurse specialists, among others, although the exact nature of their privileges varies across states. In any case, specialized training is required for a clinical psychologist to meet the legal requirements for prescribing psychotherapeutic medications.
Practitioners who belong to the American Psychological Association continue to lobby in favor of more widespread acceptance of prescription privileges across the United States. As the Oregon case demonstrates, however, this legislation is likely to face a rocky road in other states.
You be the judge: Does having prescription privileges reduce the scientific status of psychology as a profession? Would you prefer that the psychologist you might see for treatment can also incorporate medications into your treatment? Be sure to use academic sources and research articles to back up your opinion. Good arguments should also present the counterargument, as well as how to defend against it. Your response should be no more than 3 pages, double-spaced, APA style (references not included in the page count).
