Clinical Psychology

in “pharmacological issues” appear in McGrath
(2010).
These recommendations for training, if imple-
mented, would affect graduate training in clinical
psychology in a number of ways. First, because of
additional course requirements (for Levels 2 and 3),
it would take longer to complete graduate school.
In many cases, additional faculty would need to be
hired to teach the new required courses; most of
these courses are not currently offered in clinical
psychology graduate programs. For this reason,
most training to obtain prescription privileges will
likely be offered at the postdoctoral level. Finally,
the average graduate student of clinical psychology
has completed significantly less coursework in the
physical sciences (e.g., neuroanatomy, biochemis-
try, biology, or pharmacology) than psychiatric resi-
dents (Robiner et al., 2003). Therefore, in order to
close this gap, programs that seek to prepare psy-
chologists for prescribing at a later point in their

career may screen out applicants who do not have

a good foundation in undergraduate courses in the

physical sciences.

The levels of training outlined by the Task

Force seem reasonable and, if followed, help to

ensure some degree of quality control. Further, to

date, some psychologists who have completed the

training necessary to obtain prescription privileges

in their respective states appear to have undergone

a comprehensive and rigorous program of training

(e.g., LeVine, 2007). However, many are concerned

over an apparent trend to“water down”some of the

initially proposed and endorsed requirements, as well

as the offering of courses over the Internet or during

weekend retreats. Perhaps the major concern over

these developments is whether this initiative will

change the very nature of the practice of clinical

psychology as we know it. As Cummings (2006)

noted:“It remains to be seen whether prescribing

psychologists will maintain their psychotherapy

BOX3-4 Clinical Psychologist Perspective: Elaine M. Heiby, Ph.D. (Continued)

students currently interested in the discipline. The

graduate training would also be overhauled. Adding

several years of medical training to clinical programs

would necessarily have to come at the expense of psy-

chology training. Applied psychologists would be less

expert in the science of behavior, and there would be

fewer psychology faculty conducting both basic and

applied research.

Nevertheless, I believe there have been some

positive effects of the prescription privileges pro-

posal. Applied psychologists are being encouraged to

become more competent in making recommenda-

tions to physicians and in evaluating the effectiveness

of medical treatment. Researchers are being encour-

aged to synthesize clinical psychology and behavioral

neuroscience. Greater collaboration and integrative

research undoubtedly will promote comprehensive

services and advance the science of psychology. In

the long term, these changes may result in a hybrid

discipline and profession that involves the current

domains of psychological and medical sciences. At

this point in time, however, I believe the attempt to

legislatively transform psychology into a medical

specialty is premature. Psychologists who want

prescription privileges are free to seek training

that is already available, such as in nursing,

without reallocating resources away from

psychology.

Elaine M. Heiby

Elaine M. Heiby Psychology Dept., Univ. of Hawaii

80 CHAPTER 3