Psychologists Prescribe Medicine?

Discussion in 'Nursing and medical-related degrees' started by CCBapt, Jan 23, 2006.

  1. Michael Lloyd

    Michael Lloyd New Member

    CCBapt, perhaps you should do some research becoming a psychiatric nurse practitioner. Depending on where you are licensed and set up practice, you can have quite broad counseling and prescribing privileges.
  2. Steve Levicoff

    Steve Levicoff Well-Known Member

    My children, I have come down from the mountain to grant you a brief audience because, for a change, I actually find a thread interesting (rather than merely perversely humorous).

    I see an underlying discussion here about the value of "meds" (the common lingo) versus no meds. First, let me assure you that meds are valuable, despite what some nouvelle-agers would like people to believe.

    A few years back, I did counseling in an emergency psychiatric hospital, one that served a combination of depressed folks threatening suicide and the usual assortment of schizophrenics and people with conditions identified by letters (ADD, OCD, ODD, ad inifinitum, ad nauseam). As a general rule, patients would come into the hospital in la-la land and, within a week or two on the right medications, they would come into reality. Meds work - that's the bottom line.

    The problem, as anyone who has worked in this field knows, is that psychiatric patients tend to be non-compliant in taking their meds. "I'm cool now, I don't need the Haldol (or whatever drug) anymore" would result in discharged patients returning within weeks as whacked out as they were previously. They get back on their meds, return to reality, and repeat the process. Hence the term "frequent fliers" often used to describe psychiatric patients. One of the biggest challenges is to get the message home that these same patients would never consider being non-compliant with, say, blood pressure or cholesterol medications. Treating their mental illness like they would any phsical illness thus becomes a tool to aid compliance - when it works.

    That said, let's use blood pressure as an example. If you have hypertension, you don't merely have a choice of drug brands, you have a choice of drug types ranging from diuretics to ACE inhibitors to alpha blockers to beta blockers to a combination of any other above. Why does one patient benefit from one type of therapy but another patient require a different type?

    Obviously, the same question applies to psychiatric patients, which is why I'm on the side that says psychiatrists - not psychologists - should be prescribing the drugs. There are far too many physiological issues involved, not to mention too many types of what we loosely call "psychotropic" drugs, to leave the judgment call to psychologists who are not trained in the total realm of medicine.

    It is, indeed, true that psychiatrists have basically become medication specialists. I've always been open about being an ADD'er myself. Several years ago I decided to try Ritalin to see if it would do anything for me. I scheduled an appointment with a psychiatrist, who spent the entire half-hour (50-minute hours were already out of vogue) questioning me as to whether I had any prediliction toward addiction. (I didn't - in fact, I"ve always been anti-drug in terms of its recreational uses.) Once he determined that I did not have an addictive personality, then he wrote the prescription.

    (For what it's worth, two weeks of Ritalin use produced only one revelation - that I had earned my B.A., M.A., and Ph.D. in under six years total without Ritalin. My conclusion? Screw the Ritalin.)

    I do take issue, however, with the notion that psychiatrists merely prescribe while psychologists counsel. For better or worse, that has not been the case for several years now. Psychologists do not intrinsically counsel, they primarily do testing and assessment. In most states, the actual counseling is done by licensed professional counselors, most of whom have a master's-level degree in counseling. (The abbreviations used depend on the state - these professionals are known as LPC's, LMHC's, LMFT's, RPC's, etc. If you don't know what all the abbreviations are, that's your homework.) And just as all states now require a doctoral degree for psychology licensure (those with just master's degrees were either grandfathered in or earned their licensure before doctoral requirements came about), you can expect to see the same requirements instituted for LPC's, etc., down the line.

    Incidentally, courses in psychopharmacology have been part of both the psychology and counseling graduate-level curricula for several years (as well as some curricula in addiction studies), in most cases as an elective study area. Whether or not a psychologist has the right to prescribe, knowledge of psychotropic drugs is essential to understanding the total realm of treatment options.

    Another incidental question to ponder: If psychologists are licensed to prescribe, why not professional counselors (especially as the field moves toward a doctoral standard)?; Just some food for thought (since I do not support licensing psychologists to prescribe).

    Final thought: Put 20 psychologists in a room and you'll have 20 different schools of thought. Keep in mind, especially considering some of the religious whack jobs who post here at, that there are also those for whom psychology on the whole is, for lack of a better term, sinful. (I'm sure that some of our evangelical participants are familiar with the work of Martin & Diedre Bobgan, whose books refer to the field as psychoheresy and who throw the psychology baby out with the bath water, believing that only biblical or "nouthetic" counseling has any legitimacy.)

    Psychiatrists, unlike psychologists, are trained according to a more standardized, um, standard - the medical model. They are not limited to being Freudian, Jungian, Adlerian, ad infinitum, and are trained within the entire realm of medicine - as well it should be.

    End of sermon. I return now to my twuck. Um, truck. :D
  3. CCBapt

    CCBapt New Member

    Levicoff !!!!!

    Levicoff !!!!

    We're not worthy!

    We're not worthy!

    We're not worthy!


  4. CCBapt

    CCBapt New Member

    Michael Lloyd - Nurse Psych Online??

    Michael Lloyd -

    perhaps you should do some research becoming a psychiatric nurse practitioner.

    Methinks I smell third option???

    Any takers on where a psychiatric nursing practitioner DL - yeah, I said it - DL, might be?

    Depending on where you are licensed and set up practice

    Licensing in GA??

    Any takers?? Pretend I am lazy :p

    By the way, how does the nursing thing work? Get a a regular nursing degree and THEN specialize? Pretend I am stupid :confused:

  5. PatsFan

    PatsFan New Member

    Re: Michael Lloyd - Nurse Psych Online??

    I am a licensed clinical social worker (MSW). From working with many Psychiatric Nurse Clinical Specialists (MSN) over the years, I think it would be an excellent option. There are some MSN programs that help students also obtain their RNs. Otherwise one can become an RN with either an associates degree or a bachelor's degree. In some places there may also be some diploma programs left. I'd say the costliest part of the process would be the MSN. Good luck.

  6. BlackBird

    BlackBird Member

    To Lord Levicoff!

    Lord Levicoff!

    I am always amused by your posts, Steve. Never mind that I USED TO tangle with you a lot in the old days of the Distance Ed Newgroup. I used to tangle with you on everything from your "gayness" to your trashing of state approved institutions (or degree mills) Remember Ray Chasse?.

    Well, here I am about to wrap up a regionally accredited Ph.D.

    Even though we did not see eye to eye, and I slapped the label on your "highness" with "Lord Levicoff," nevertheless, thanks for your insistence on going always with Regional accreditation.

    Glad to see you around these parts!
  7. Michael Lloyd

    Michael Lloyd New Member

    CCBapt, if you are interested in pursuing the psychiatric nurse practitioner option, you should first work backward: identify the state you wish to practice in. Having done that, you can investigate the licensure and training laws in that state. As an example, by contacting the Georgia state Board of Nursing, or looking at its website, you can find out what Georgia's requirements are for nursing training and licensure. For example, are graduates of DL nursing programs eligible for licensure in that state? Are graduates of certain types of training programs (for example Excelsior) eligible for licensure in that state? It would be unfortunate if you live and want to practice in Georgia, to undertake a schooling program that would not make you eligible for licensure.

    Having determined how to get licensed in that state, you can then look for training programs to take. I am sure that Georgia has numerous training programs; are any of them DL? You can possibly find DL training programs for the MSN/psychiatric nurse practitioner portion, but you most likely will have to attend a B&M school for the undergrad nursing degree. The usual progression for an advanced nurse practitioner is to first obtain a RN, usually via a bachelor's degree, and then be admitted to a MSN program, leading to a masters' degree, the ability to take the ARNP exam, and finally be granted the nurse practitioner credential.

    Were I also in your shoes, I would visit some of the nursing forum websites, and read and post some questions about psychiatric nurse practitioners, to see if this is something you want to do.

    If you want to both counsel and prescribe in the behavioral health field, this is the quickest route I can think of. There may be psychiatric physician assistants, but I have never heard or encountered one; I have met many psychiatric nurse practitioners.
  8. PatsFan

    PatsFan New Member

    I have had a similar experience. In 20 + years in the field I have also never encountered a psychiatric PA. I wonder if they exist?
  9. Michael Lloyd

    Michael Lloyd New Member

    Wow, they do exist. Look here:

    Late last year, I was approached about being a proctored clinical site for a radiology physician assistant, another specialty that I had never previously heard of. Apparently, there is one PA program in the Midwest that trains this specialty.
  10. chrislarsen

    chrislarsen New Member

  11. PatsFan

    PatsFan New Member

    Imagine that! Interesting articles. Thanks.

  12. BlackBird

    BlackBird Member

    In my opinion, if CCBapt wants the ability to prescribe medicine, do psychotherapy, and IF he wants to have a private practice then his only choice may be to get an M.D. degree. The Nurse Practitioner and Physicians Assistant roles depend on being connected forever to another supervising M.D. That makes the private practice option difficult. Maybe not impossible but difficult depending on whether one can find an M.D. to take on that added risk without physically being present. Another downside to this option is that the general public already confides in independent providers such as Masters level clinicians (licensed), psychologists, and psychiatrists. All of these are "self-standing." In one sense, these last three categories are autonomous and portable in taking almost anywhere you want without much legal/political hassles to practice.

    In my humble opinion, if CCBapt feels he's got to have prescriptive powers then his most flexible and powerful option is to go for his M.D. with a specialty in psychiatriy.

    Last edited by a moderator: Jan 29, 2006
  13. Michael Lloyd

    Michael Lloyd New Member

    Blackbird, not necessarily. FYI, in many states, nurse practitioners can practice with complete autonomy and even open an independent practice. Washington is such a state.

    In contrast, in every state that I am aware of, a physician assistant does have to practice under the supervision, oversight or employ of a physician.

    So depending on where he would want to practice, CCBapt could indeed have an independent counseling and prescribing practice without going to medical school by becoming a psychiatric nurse practitioner.
  14. CCBapt

    CCBapt New Member

    Psych/ PA / Psych Nurse

    Thanks for all the GREAT information-

    Here - in summary - are the choices at present, beginning with the shortest time to the longest:

    1. Psychiatric Nurse Practitioner

    2. Physicians Assistant - in Psychiatric

    3. Clinical Psychologist - with a Doctor's degree - in ( what now
    seems small hopes) getting prescription privileages.

    4. M.D.

    Am I right?

  15. hikergirl

    hikergirl New Member

    Re: Psycologisy Rx

    I don't know the name of the school right off the bat, but I'd be happy to ask him. :)
  16. hikergirl

    hikergirl New Member

    Re: Michael Lloyd - Nurse Psych Online??

    Any nurse practitioner program will give you prescriptive rights except in GA where I live, but you can still work with a physician and write prescriptions with their signature (if that makes any sense).

    Earn your RN degree somewhere then work towards the NP degree. I'm currently enrolled in a Family Nurse Practitioner program through Indiana State University that is fully DL. Enjoying it so far!
  17. hikergirl

    hikergirl New Member

    Michael's correct. Every state except GA allows NPs to write prescriptions autonomously, and we're working towards making GA part of that group as best possible. The PA, on the other hand has much less independence in practice.
  18. hikergirl

    hikergirl New Member

    Re: Psycologisy Rx

    Ok. Looks like you already found the degree program my friend is in. It's the Nova Southeastern University MS & PsyD in Clinical Psychology with a post-doc MS: Psychopharmacology.
  19. japhy4529

    japhy4529 House Bassist

    Re: Psych/ PA / Psych Nurse


    Switch #1 with #2. Most PA programs are about 24 months in length. Not sure how long it would take after graduation from P.A. school to obtain a Psych specialty, but I'm sure it would be less than obtaining licensure as a Psychiatric Nurse Practioner. UNLESS, you could select Psych as a specialty in one of those accelerated MSN programs that I mentioned to you in another post. Those programs generally take about one year to complete.

    Good luck!

    - Tom

    P.S. If you decide to go the N.P Psych route (and you want to prescribe independently, which is obviously the case), why not just move to another state? If GA is the only state in the Union that doesn't allow N.P prescription autonomy, just move to Florida or some other nearby state.
  20. Ted Heiks

    Ted Heiks Moderator and Distinguished Senior Member

    Re: Re: Psych/ PA / Psych Nurse

    Just out of curiosity, does a Nurse-Practitioner need a Doctor of Nursing (or PhD in Nursing) to qualify? If not, what is the degree that qualifies one for N-P status?

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