Practices of prescribing psychologists: Replication and extension.

Abstract

Few studies have examined the practices of prescribing psychologists, and the extant literature suffers from small sample sizes due to the nature of the profession. The current study was based on data from 43 prescribing psychologists, the largest sample of prescribing psychologists examined to date. It was found that prescribing psychology is distinctive from both traditional psychological and psychiatric practice. Prescribing psychologists tend to work in multiple settings. Although respondents espoused a preference for combination therapy, monotherapy-whether medication or psychotherapy-remains the dominant option. Prescribing psychologists reported minimal interaction with pharmaceutical drug representatives. It is also prescribing psychologists' sense that nonprescribers in their community experience them in positive ways. Future studies should further address patient treatment themes within this practice, as well as looking into changes in interactions with pharmaceutical representatives. Public Significance StatementFive states are now awarding prescriptive authority to appropriately trained psychologists, which has the potential to change mental health practices in those states markedly. This study is the largest to date on the practices and activities of prescribing psychologists, and examines issues such as patient demographics, job duties, relations with nonprescribing psychologists, and interactions with pharmaceutical representatives.

Examining psychologist prescriptive authority as a cost-effective strategy for reducing suicide rates.

“…While it seems logical that increasing the number of prescribers would increase the number of prescriptions, it has been suggested that RxP may result in the deprescribing of psychotropic medications in patients who may see more benefits from psychotherapy or other nonpharmacologic interventions. One recent survey of prescribing psychologists found that they had decreased the dosage or removed a medication from 28.3% to 29.5% of their current patients, respectively (Peck et al, 2021), suggesting the increase in medication costs associated with this policy may be smaller than anticipated.…”

Prescriptive authority for psychologists: The next step.

“…Peck et al (2021) found that “prescribing psychologists have developed a style of practice that overlaps with both psychology and psychiatry, but it is distinctive of both” (p. 199). The 43 psychologists surveyed used a combination of treatment, psychotherapy and medication, combined treatment rated as “the best option.” Sessions were shorter than nonprescribing psychologists, but longer than psychiatrists.…”

“…Prescribing psychologists are not psychiatrists or nurse practitioners, but rather "psychologists first and prescribers second." Peck et al (2021) found that "prescribing psychologists have developed a style of practice that overlaps with both psychology and psychiatry, but it is distinctive of both" (p. 199). The 43 psychologists surveyed used a combination of treatment, psychotherapy and medication, combined treatment rated as "the best option."…”

“…A third measure of improved access is how other health professionals view the care of prescribing psychologists. Services of prescribing psychologists have been documented to be very well received by other health care providers (Levine et al, 2011; Linda & McGrath, 2017; Shearer et al, 2012; Vento, 2014; Peck et al, 2021). Such approval from other providers is likely to result in more referrals to prescribing psychologists, which greatly improves access to care.…”

“…In the largest study to date of the practices of prescribing psychologists, Peck et al (2021) surveyed 43 of the over 200 prescribing psychologists nationally. Those surveyed overwhelmingly believed that their colleagues did not see them as “harmful to their practice” (p. 199).…”