A survey of school psychologists' knowledge and training in child psychopharmacology

In this article, we present a balanced view of the prescriptive authority debate in relation to five major issues and within the context of the practice of psychology in the schools: (a) appropriate training, (b) quality of care, (c) access to services, (d) continuity of care, and (e) professional identity. We also provide an analysis of the quality and relevance of each issue within the school practice context. Despite the increasing momentum of the prescriptive authority initiative at the state level, it seems unlikely that prescription privileges will be extended to psychologists working in school-based practice settings. Nevertheless, informed school psychologists have the opportunity to become involved in this issue at both the national and state levels. These efforts may take the form of supporting or opposing the initiative or of lobbying for extension of prescriptive authority into some school settings. At the individual level, informed school psychologists will have the opportunity to develop strong working relationships with prescribing psychologists in their communities and to exercise appropriate professional judgments when referring students or families for services in the community. C 2009 Wiley Periodicals, Inc.The issue of limited prescriptive privileges for professional psychologists has been a longstanding topic of debate both within and outside the field for nearly two decades. The American Psychological Association (APA) strongly supports the lobby for prescription privileges, and has invested significant time and financial resources to support advocacy efforts at the national and the state levels. New Mexico and Louisiana have passed legislation allowing psychologists who meet stringent training requirements to obtain limited prescription privileges, and similar efforts are underway in several other states. The U.S. Department of Defense has also conducted trials to assess the feasibility of training professional psychologists to prescribe psychotropic medication in military health care settings.Nevertheless, the effort on the part of psychologists to obtain limited prescription privileges is staunchly opposed by some members of the medical community, particularly persons in the field of psychiatry. Moreover, there is no clear consensus within the profession of psychology that the pursuit of prescription privileges is an appropriate goal. A plethora of opinion studies has been conducted, most of which reveal varying of degrees of disagreement on this issue. In general, researchers have found that psychologists have more favorable attitudes toward the issue of limited prescription privileges than do psychiatrists, pediatricians, and other primary care providers (Rae, Jensen-Doss, Bowden, Mendoza, & Banda, 2007). Walters (2001) conducted a meta-analysis of the opinion data and reported that, overall, slightly more than half (52%) of surveyed psychologists supported the prescription initiative, with slightly more than one third (35%) expressing opposition. Other studies have also found that opin...

contrasting

confidence: 43%

Section: Implications For School Psychologistsmentioning

confidence: 94%

Limited prescription privileges for psychologists: Review and implications for the practice of psychology in the schools

Ball

Kratochwill

Johnston

et al. 2009

“…Empirical information now appears regarding routine psychological practices that encompass health issues. For example, Carlson, Demaray, and Hunter-Oehmke (2006) found that 62% of school psychologists surveyed said that they collaborate with health care professionals in psychotropic medication trials. In another practitioner survey, Wodrich and Spencer (in press) found that more than 95% of school psychologists were currently involved in identifying students for other health impairment (OHI) services, including those with epilepsy, asthma, diabetes, and cancer.…”

mentioning

confidence: 97%

School‐based tertiary and targeted interventions for students with chronic medical conditions: Examples from type 1 diabetes mellitus and epilepsy

Wodrich

Cunningham

2007

Approximately 15% of children experience a significant illness prior to age 18 years. For many of them, school absenteeism, substandard academic performance, and social problems ensue. When disorders affect the central nervous system, some suffer global developmental delays or selective neuropsychological deficits. As health service providers, school psychologists understand both the educational process and the ways in which childhood illnesses can impact it. This article argues that school psychologists' breadth of knowledge enables consultation with teachers about health-related classroom accommodations and communication between medical professionals and educators. Epilepsy and type 1 diabetes mellitus are two conditions associated with a risk of school problems. Using these two disorders as examples, this article outlines roles for school psychologists and provides specific guidance about how they can promote success among all students with chronic illnesses. C 2007 Wiley Periodicals, Inc.The first decade of the 21st century may be a turning point in school psychologists' practice due to the 2004 reauthorization of the Individuals with Disabilities Education Act (PL 108-446), which now encourages consultative services when students present with learning problems. As a result, gatekeeping-associated psychoeducational testing, sometimes equated with perfunctory IQ testing, may be greatly diminished by new guidelines for specific learning disability determination. If these legislative changes extend to practice, school psychologists may have more flexibility to consider practice alternatives. Division 16 of the American Psychological Association and the National Association of School Psychologists have advocated for health promotion for all students and focused consultation for the relatively few with documented illness (American Psychological Association, Division 16, 1998;Ysseldyke et al., 2006). This article concerns the second task-how to help students with recognized health problems and, in doing so, forge new and expanded ways to practice.School psychologists' concern with health-related issues is expanding. A literature search, which reviewed studies published in leading school psychology journals over a 21-year period, found that the publication of health-related articles has significantly increased (Wodrich & Schmitt, 2003). Furthermore, diverse health disorders (e.g., asthma, cancer, diabetes, epilepsy) are now addressed in these journals. Empirical information now appears regarding routine psychological practices that encompass health issues. For example, Carlson, Demaray, and Hunter-Oehmke (2006) found that 62% of school psychologists surveyed said that they collaborate with health care professionals in psychotropic medication trials. In another practitioner survey, Wodrich and Spencer (in press) found that more than 95% of school psychologists were currently involved in identifying students for other health impairment (OHI) services, including those with epilepsy, asthma, diabetes, and cancer.Frequen...

“…Although it is generally recognized that one of the main difficulties for school psychologists is to determine what constitutes the acceptable and recognized level of their competency, the majority of school psychologists actively advise parents on types and effects of psychostimulants as a part of evaluations, consultation, and intervention activities (Carlson, Kilpatrick Demaray, & Hunter-Oehmke, 2006).…”

Section: Role Of the School Psychologistmentioning

confidence: 99%

“…Most practicing school psychologists admit limited exposure to the issues of psychoactive medications and brain physiology during their academic training. In many cases, school psychologists' knowledge of psychopharmacology and psychopharmacokinetics is obtained through workshops and related reading (Carlson, Kilpatrick Demaray, & Hunter-Oehmke, 2006;Kratochwill, 1994).…”

Section: Role Of the School Psychologistmentioning

confidence: 99%

Legal issues in school health services and school psychology: Guidelines for the administration of medication

Mazur-Mosiewicz

Pierson

McIntosh

2009

The use of psychoactive medications to augment behavioral and psychosocial interventions in schools has significantly increased within the last few decades. Yet, advising, administrating, and supervising the dispensation of medication (including psychostimulants and psychoactive substances) tend to be some of the most risky tasks of school administrators and personnel. Medication administration is not only an increasing source of civil and administrative liability for school districts, but may lead to legal questions for school counselors, psychologists, and social workers. In response to growing concerns, this article provides guidelines necessary for safe medication administration and monitoring in the school setting. Federal, state, and district guidelines are reviewed. Possible implications for school and district policy makers, principals, teachers, school nurses, school psychologists, social workers, counselors, and parents are outlined. © 2009 Wiley Periodicals, Inc.