Clinical Psychology

(i.e., psychosocial + psychopharmacological) treat-
ment since they would be thoroughly trained in
both approaches. Research has strongly suggested
that combined treatment is more efficacious than
either psychosocial or psychopharmacological alone
for a variety of disorders in adults and youth.

Cons. Other clinical psychologists have voiced
concerns about the possibility of obtaining prescrip-
tion privileges (Albee, 2002; Hayes & Heiby, 1996;
Heiby, 2002). These critics point out that prescription

privileges may lead to a de-emphasis of“psychologi-

cal” forms of treatment because medications are

often faster acting and potentially more profitable

than psychotherapy. Many fear that a conceptual

shift may occur, with biological explanations of emo-

tional conditions taking precedence over psychologi-

cal ones.

The pursuit of prescription privileges may also

damage clinical psychology’s relationship with psy-

chiatry and general medicine. Such conflict may

result in financially expensive lawsuits. This new

Psychological Association of Graduate Students

(APAGS) is so important for the profession. APAGS

currently has in excess of 55,000 members and repre-

sents the future of our profession. We have to reach

out to them, particularly at the State Association level,

and institutionally foster an entirely different

“mind-set.”If we can accomplish this, I am confident

that we possess the expertise and creative ability to

prosper, notwithstanding whatever might seem to be

the daily crisis—managed care, budgetary constraints,

and so on. The 21st century will be an era of educated

consumers demanding timely access to gold-standard

care. The extraordinary advances occurring within the

computer and communications fields will result in an

entirely new therapeutic paradigm. Together, we will

do extraordinarily well; as isolated individuals, it is hard

to predict what will evolve.

In your opinion, why should clinical psychologists seek

and obtain prescription privileges?

Summarized from DeLeon and Wiggins (1996):

■ All objective evidence to date concerning the

quality of care provided by non-physician practi-

tioners (such as nurses, physician assistants, clinical

pharmacists, optometrists) indicates that it is con-

sistently high and cost-effective.

■ It has been demonstrated that it is possible to

successfully train non-physicians to prescribe

medications.

■ Psychologists are interested in obtaining the

psychopharmacological training and clinical expe-

rience necessary to prescribe in a competent

manner.

■ By obtaining prescription privileges, psychologists

will also gain the legal authority to determine

whether medications are necessary and appropri-

ate (the ability to not prescribe).

In my view, psychologists will rely less on medica-

tion than physicians (this has been found in the pilot

projects to date), and this should lead to a higher

quality of care than is currently available. Finally, the

critical psycho-social-economic-cultural gradient of care

will be included in society’s definition of“quality”care.

Aloha.

Patrick H. DeLeon

Patrick H. DeLeon

CURRENT ISSUES IN CLINICAL PSYCHOLOGY 77