The Prescription Privilege Debate in Canada: The Voices of Today's and Tomorrow's Psychologists.

Abstract

Abstract Canadian psychology professionals (n = 591) and psychology students (n = 272) were asked for their opinions about prescription privileges for psychologists. A majority of respondents indicated that properly trained psychologists should be allowed to prescribe, and that the Canadian Psychological Association (CPA) should advocate for such privileges. Few people felt that prescribing was theoretically or philosophically opposed to the field of psychology or that it would compromise psychological service delivery. Not surprisingly, clinical students were more likely than other psychology graduate students to indicate that they would seek prescription privileges if these were available. The prescription privilege debate in Canada has generated a surfeit of arguments for, and against, the movement. The debate has considered both the heritage of psychology and the future of psychology. The debate has also considered topics such as liability, professional competency, and ethical issues (e.g., Dozois & Dobson, 1995a, b; Hayes, Walser, & Follette, 1995; McCrea, Enman, & Pettifor, 1997; Pagliaro, 1995). It has even been questioned whether or not psychologists want prescription privileges in the first place (Dobson & Dozois, 2001). Glenn D. Walters (2001) discussed his meta-analysis of survey data on the issue of prescription privileges. He sampled 16 studies that tapped into the attitudes of psychological professionals as well as students. Walters found that respondents agreed that properly trained psychologists should be allowed to prescribe medication, a view that was especially strong among graduate students. Graduate students were also more likely than practicing psychologists to express an interest in seeking prescription privileges. Moreover, Walters found no clear consensus on a question of whether the American Psychological Association (APA) should advocate for prescription privileges. When the attitudes of practicing psychologists and graduate students were considered together, support for APA advocacy was close to evenly split. Graduate students, when considered separately, supported APA advocacy for prescription privileges. Walters articulated the possibility that medical professionals would train prescribing psychologists, a circumstance that he felt would open psychology up to assimilation by the medical field. He also expressed concern that psychologists, burdened with the required training to competently prescribe medications, would fail to develop and maintain expertise in the practice of psychotherapy. Nonetheless, according to the APA, jurisdictions in the United States have moved forward with the granting of prescription privileges to psychologists. For example, Louisiana recently became the second state in that country to gain a law authorizing properly trained psychologists to prescribe certain medications for the treatment of mental disorders. New Mexico enacted such legislation in 2002 (Daw, 2002). Canadians have also participated in this debate (e.g., Dobson & Dozois, 2001; Nussbaum, 2001). Specifically, Nussbaum debated some of Walters' (2001) conclusions. For example, Walters' meta-analysis led to the conclusion that a majority of students, but roughly half of practicing psychologists, were interested in seeking prescription privileges. Walters interpreted these finding as indicating a more general attitude of nonpursuit and nonsupport among practicing psychologists. Nussbaum argued that support from nearly half of practicing psychologists, while not a majority, was noteworthy. Moreover, Nussbaum argued that it should not be construed that practicing psychologists are unmotivated to seek prescription privileges. Instead, he proposed that many older more established psychologists might be less likely to pursue prescription privileges because they feel that the effort would provide little reward to them at mid-career. Nussbaum argued that while these professionals may not desire the privilege for themselves, they might recognize that prescription privileges could afford some advantage to their young students. …