psychology_Sons_(2003)

The Prescriptive Authority (RxP-) Agenda 41

TWO ASSOCIATIONAL DEVELOPMENTS

The essence of a profession is daily involvement with
patients or clients. The context in which this interaction
occurs, including the very important issue of reimbursement
for services rendered, falls within the jurisdiction of public
policy (e.g., the political process). For psychology to become
an active participant within primary care (or to expand its
scope of practice to include prescriptive authority) requires
institutional collective knowledge of the evolving “bigger
picture” and ongoing interrelationships existing within soci-
ety and the generic health care arena. Historically, profes-
sional psychology has, at most, seen itself as solely one of
the mental health disciplines and has not concerned itself
with broader public policy or public health issues (DeLeon,
VandenBos, Sammons, & Frank, 1998). These two program-
matic initiatives have significantly changed that perspective.

The APA Congressional Science Fellowship Program

In 1974, Pam Flattau served as the first APA Congressional
Science Fellow, under the program established in conjunction
with the American Association for the Advancement of
Science (AAAS). Over a quarter of a century later, approxi-
mately 125 colleagues have had the opportunity to serve on
Capitol Hill (or in the administration) as APA Fellows,
Robert Wood Johnson Health Policy Fellows, or in other sim-
ilar national programs. In this capacity, they experienced
personal involvement in the public policy process. Initially,
the APA focused only on providing the experience for recent
doctoral graduates; as the program matured, however, a
concerted effort was made to attract more senior fellows. The
APA Fellows have included individuals from almost every
psychological specialty area, including several who also pos-
sessed degrees in law (Fowler, 1996).
Over the years, a number of psychologists have gravitated
to positions of high-level public policy responsibility. During
President Lyndon Johnson’s era of the “Great Society,” John
Gardner served as secretary of the Department of Health,
Education, and Welfare. Psychologists have served as depart-
mental assistant secretaries, subject to Senate confirmation;
director of one of the National Institutes of Health (NIH), as
well as of other federal research institutes; head of the federal
Bureau of Prisons; commanders of federal health care facili-
ties; and as Chief State Mental Health officials. In the 107th
Congress (2001–2002), three psychologists were elected to
U.S. House of Representatives, and 12 psychologists served
in the various state legislatures during that same time.
With firsthand experience in the public policy process, psy-
chologists have been influential in the gradual modification

of statutes and implementation of regulations that recognize

psychology’s expertise. In the clinical arena, psychology’s

expertise is now independently recognized throughout the

judicial system and under all federal and private reimburse-

ment systems. Psychology’s professional graduate students

are supported under almost every federal training and service

delivery initiative.

The underlying unanswered question remains, however:

Has professional psychology matured sufficiently to establish

its own programmatic agenda via the public policy process

(VandenBos, DeLeon, & Belar, 1991)?

APAGS

In 1988, the APA Council of Representatives formally estab-

lished the American Psychological Association of Graduate

Students (APAGS). Over the years, psychology has contin-

ued to be one of, if not the, most popular undergraduate

majors. By 2001, the APA membership (and affiliate) num-

bers had grown to 155,000, with the APAGS possessing

59,700 members.

An APAGS representative attends the open portions of the

APA board of directors meetings (and another individual is

seated on the floor of the Council of Representatives as a

nonvoting member). Increasingly, as with other professions,

the student voice is being heard. Several divisions, state asso-

ciations, and council caucuses provide the APAGS with a

voting seat on their boards of directors.

Student participation brings to the APA governance delib-

erations a unique focus upon the “here and now” practical

consequences. The APAGS’s presence constantly reminds

those within the APA governance that their deliberations do

have very real consequences on future generations of profes-

sional psychologists.

THE PRESCRIPTIVE AUTHORITY (RxP-) AGENDA

In November 1984, Senator Daniel K. Inouye addressed the

annual meeting of the Hawaii Psychological Association and

in closing suggested to them an entirely new legislative

agenda that he proposed would fit nicely into their conven-

tion theme “Psychology in the 80’s: Transcending Traditional

Boundaries” (e.g., seeking prescriptive authority in order to

better serve their patients). After his challenge, the executive

committee of the Hawaii Psychological Association agreed to

pursue legislation that would study the “feasibility of allow-

ing licensed psychologists to administer and prescribe med-

ication in the treatment of nervous, mental and organic brain

diseases.” At that time there was little enthusiasm for the