Psychologist prescribing psychiatric drugs

should they be allowed to do so?

no

I don't think they legally can?

depends on the state but i don't think they should be able to, they do a different thing

intersting http://www.nami.org/Template.cfm?Section=Issue_Spotlights&template=/ContentManagement/ContentDisplay.cfm&ContentID=8375

haven't read that yet, but:

to the best of my knowledge, psychologists do not generally receive any extensive training in pharmacology. drugs don't just, like, do stuff w/magic. it's pretty vital for anyone prescribing to understand pharmacokinetics, pharmacodynamics, neurology, physiology and ~drug interactions~ (and they things interact the way they do).

if a complex medical patient comes in with a bunch of other meds, a psych has to be able to understand what those other meds are doing, and prescribe appropriately. while maybe they could do this with the guidance of a pharmacist or references (there are a lot of drugs, after all), it seems a little crazy lol to have people dispensing potentially serious meds w/o any education.

psychologists are obv very valuable, and we need them. but if they're gonna start slinging medicine, then they need to have the appropriate education. as far as i know, someone can get a PhD in psych w/o ever going further than high school chemistry. UH

(and WHY things interact the way they do)

the thing says states that allow it require an additional certification with training in stuff like pharmacology, etc. and that it's allowed because there aren't enough psychiatrists around

i mean in new mexico, which i guess was the one state that allowed it when the thing was written in 2002. i don't know what states allow it now.

http://www.cchr.org/#/videos/marketing-of-madness-introduction

http://en.wikipedia.org/wiki/Citizens_Commission_on_Human_Rights

In December 2005, CCHR opened the "Psychiatry: An Industry of Death" Museum on Sunset Boulevard in Hollywood, California. The museum has displays alleging psychiatry's long-standing "master plan" for world domination, Adolf Hitler's central role in the plan, and in the words of reporter Andrew Gumbel, "a display holding psychiatry to blame for the deaths of Ernest Hemingway, Del Shannon, Billie Holiday, and Kurt Cobain..."

In the UK, a psychologist can't prescribe. Simple as that. I'd always assumed this was the same across the US; what harbl says is interesting.

As for "should they be allowed to do so": as psychology student myself, I'd argue that no, they shouldn't, for the reasons gbx eloquently explains.

Indeed, all of what gbx says is bang on the money: of course, being the kind of psychology student whose view of psychiatry is very strongly influenced by Bentall, Moncrieff and so forth, I'd use that very argument to, umm, argue that (some) psychiatrists are far too reliant on a purely medical/neo-Kraepelinian model ... anyway, let's not go there, shall we?

(I could also write an awful lot more here about GPs prescribing anti-depressant medication, but I won't, because I spend enough time involved in this argument when I'm not reading ILX.)

I've walked past that Industry of Death museum a bunch of times but I can never make myself go in. It is like the houses everybody said were haunted when I was a kid

(I could also write an awful lot more here about GPs prescribing anti-depressant medication, but I won't, because I spend enough time involved in this argument when I'm not reading ILX.)

i think this is the more interesting question tbh

lol max is your appetite for 1000-post threads really so long that you wanna get into questions about pharmaceutical companies dictating practice for profit & the complicity of the entire health care industry in it - you realize 1) all such discussions end up with one side accusing the other of being either conspiracy-theory nutballs or apologists for the illuminati, and 2) here it'll probably end up being Health Care Bill Thread v2.0

yay let's do it!!

I love the illuminati and the anti-psychiatry! Rap on!

I tend to be more sympathetic than your average anti-big-pharma person but I also think that medical models of mental illness are, for all their usefulness, only one view of a problem that's multi-faceted, and that that's the sliver of truth that gets people really anti-psych. I'm sympathetic to anti-psych sorts insofar as I believe that the industry is very quick to diagnose meds whose effect is systemic even when its usage is specifically targeted, and I also think that private industry is about the worst place for such wide-spectrum-of-side-effects drugs to be tested out in. once there's any kind of profit motive in place, the potential for incredible damage to real human beings is high. so while I don't think big pharma has come to enslave us all using their evil agents the psychiatrists, I do think psych meds are 1) not as well-understood as their PR would have people believe and 2) very attractive to overworked GPs who want to help their patients and aren't sure how, and who're treated to the same PR program in re: antidepressants (and other psych meds) as everybody else

---first line should read "I tend to be more sympathetic to medical models than your average anti-big-pharma person"; I believe that the motives of both the researchers & the psychiatrists are at core good, not evil, but that the system as it exists isn't really compatible with for lack of a better term "goodness"

And let's not forget 3): that a pill is sometimes the most immediately attractive option to patients whose schema for "illness" includes the concept of a "cure", which they understandably expect to come in some kind of neat medical package.

This, I think, is a point that's often overlooked: it's not just about doctors punting the pills but patients preferring them as a seemingly instant solution, especially when the alternative is a lengthy waiting list for therapy.

Across the different parts of the UK, there are many different projects and proposals -- one of which I'm marginally involved with now -- to reduce reliance on antidepressant meds. It's not going to be a quick process. For a long time, I lazily blamed lazy GPs: but now I appreciate that, if you're sitting in your surgery with a massive backlog of patients sitting outside, opposite someone who's poo-poohing every other suggestion and just wants you to give them a pill like the one their mate/mum/neighbour got last year: well, it's not as simple as it seems, is it?

Oh man my mom-in-law, who is a licensed clinical social worker w/a Master's degree in same, does talk therapy for a living. She's a therapist. She's worked in the type of clinics that tend to have a psychiatric nurse practitioner or sometimes a psychiatrist on staff. What it comes down to is she decides her clients need Lexapro (anti-depressant), Lamictal (anti-seizure med w/off-label use as a mood stabilizer), or both. She either tells the client to say "my therapist said to put me on Lexapro and/or Lamictal" to the person who legally can write prescriptions, or just tells her coworker who writes the prescriptions, "Hey, client X needs Lexapro/Lamictal, write them a scrpit." She's gotten fired four times for this and still is baffled why this behavior keeps getting her fired. "Lexapro and Lamictal, they're the only things that work!"

Now the game is: guess which meds *she* takes (besides the funtimes klonopin, some of which was prescribed to her dog).

a social worker from my college's health services office tried this with me once ('go to the nurse and tell her you need antidepressants') and so i stopped seeing him (there were other factors contributing to that, too but that was the last straw). the gp thing irritates the fuck out of me.

My cynical side immediately suspects this idea originated with the big pharma companies, so they could sell even more SSRI drugs to even more millions of people who don't need them and can't benefit from them.

my psychologist is also a drug dealer

I wish mine was. Maybe that's why I quit seeing him. I'm exaggerating. I addressed my anxiety problems. He brushed them away. Didn't even address them. When I mentioned pills might help, he said they were useless as I would need stronger and stronger ones. Okay, dude, I get that, but WHY THE FUCK DIDNT YOU TALK ABOUT MY ANXIETY PROBLEM. Honestly I am still conflicted about it all. Therapy and pills. Do I live with this (granted mild) problem or do I address it? At times I do feel like I'm "suffocating" and even when I'm not in my strong anxiety periods, I still worry and fret.

I had GPs just prescribing anti-depressants like their candy.

i once went to a therapist - for one session - who told me - in that first (and last) session - that the best thing would be if I went on a low dose of prozac, so i should go and buy some off the internet.

i said (leaving everything else aside) i wasn't really comfortable with the idea of medicating what i thought was quite mild depression exacerbated by circumstances, i mean, for a start, what about potential side effects.
he said: oh, it's a low dose, it won't do anything.

I hope you did the right thing and reported him to whatever licensing board gave him a license. A good therapist is a great thing in the world; bad ones need to be weeded out.

I didn't even think of doing that. (i was in a foreign country: no idea how i would have found his licensing board out). I just thought 'oh god fuck even trying' and went back to my exciting routine of never leaving my room except to go for walks at night-time when i wouldn't have to talk to anyone.

A good therapist is a great thing in the world; bad ones need to be weeded out

This is the kind of thing that needs writ large above the doors of practices everywhere. The new HPC regulation in the UK might, theoretically, go some way to help. Then again ... :(

On which note: Nath, I've no idea how it works in Belgium, but is there any way you can go back to your first point of contact (eg GP) and say, yo, can I see a different psychologist, please? There should be no problem with that at all: even if a client doesn't have doubts about the quality of the therapy, for example, they might still find they just don't "click" with the therapist, and (in the UK, anyway) have every right to say, OK, I don't like this person: can I see someone else?

OK, the practicalities of that aren't necessarily always the simplest. But what I'm realising very fucking quickly is that the quality of NHS care -- in all areas, not just mental health -- varies *staggeringly* from location to location: I'm guessing that's the same with health systems worldwide. (Old hands and cynics, forgive my naivety here: this is all very new to me and what I thought was a reasonable understanding of the NHS has been all but blown to little smithereens.)

Nath, I agree with grimly – try and see someone different. They're working for you and if your needs are being ignored, you don't need to continue seeing that person.

Grimly, please can I ask what you're retraining as? I ask because I'm interested in retraining myself and am looking at different options. Webmail if that's better.

I'm doing a conversion MSc in psychology: which, in the UK, is the fastest way for an honours graduate in another discipline -- in my case English -- to study for and obtain a basic degree in psychology. Assuming all goes to plan, when I graduate I'll automatically get my graduate basis for chartership with the British Psychological Society and be able to apply for vocational postgrads.

I'll not go into any more detail because it'll be incredibly boring for everybody else. Feel free to drop me a line via the webmail link, though, and I'll explain as much more as you want!

I had an unpleasant GP/antidepressants experience recently. After finally getting my health insurance set up (was late going about it because it's crazy expensive and the exhaustion and sleeplessness I needed to see a doctor about weren't really conducive to getting shit done), I had to find a doctor to list as my primary care provider. Nobody I could find was taking new patients except for an osteopathic practice, so I signed up and made an appointment. I list the symptoms I'm experiencing, the doctor periodically nods and makes noncommittal noises, then she looks at the history I filled out, notices I've been on antidepressants in the past, and says it sounds like I'm just depressed again and immediately writes me a prescription for Lexapro. I've been on Lexapro before, with unimpressive results and a lot of side effects, and tell her so, and ask whether she'd like to perhaps see a treatment history or something first? On my next appointment to follow up on blood work, I get a prescription for Wellbutrin. Awesome.

I ended up leaving that doctor- their response for every symptom was HERE HAVE SOME ANTIDEPRESSANTS, the sleep lab they repeatedly attempted to do never contacted me to set up a time, and they charged me $45 that my insurance won't cover for "osteopathic manipulation" that turned out to have been ten seconds of poking at my sinuses when I mentioned I was having frequent headaches. I've got a much more competent-seeming doc now; kind of a shame it took passing out on the side of the road and spending a couple of days in the hospital to get an appointment to see him.

Sorry for the bitching; I am just a bucket of sunshine about health care right now.

On which note: Nath, I've no idea how it works in Belgium, but is there any way you can go back to your first point of contact (eg GP) and say, yo, can I see a different psychologist, please? There should be no problem with that at all: even if a client doesn't have doubts about the quality of the therapy, for example, they might still find they just don't "click" with the therapist, and (in the UK, anyway) have every right to say, OK, I don't like this person: can I see someone else?

You don't really need a referral here, I think. You just ring one up and... well, see him. And talk. It never clicked. Never clicked with the woman who "treated" my eating disorder more than a decade ago. What an incompetent woman that was: she ASKED me if I wanted to have more sessions. WAH? I'd only been going a few times and SHE ASKS ME? Urgh. Of course I said no. What did she expect?

Anyhow, I don't know, I am not sure if I really need a therapist. When do you think it's necessary, y'know? I don't know. I know I can go through the day, but am I really capable of really enjoying life as one should (lol)? But would a therapist be able to strip away that layer of me?