competitive, and prescription privileges would pro-
vide an advantage to clinical psychologists over
other health care professionals (e.g., social workers).
Finally, some view obtaining prescription privileges
as a natural progression in clinical psychology’s
quest to become a“full-fledged”health care profes-
sion rather than just a mental health care profession.
Last, many argue that psychologists, due to their
unique training, are most qualified to consider
psychopharmacological treatment as an adjunctive
option to psychosocial treatment. In contrast to the
psychiatric tradition, psychologists typically have
longer sessions with clients than do psychiatrists
(i.e., 50 vs. 15 minutes), and consequently have
developed a more thorough understanding of their
client’s psychological symptoms. Psychologists also
more frequently use an empirical approach to moni-
tor their client’s symptoms, using repeated evidence-
based assessments to track symptoms over different
types of treatment or varying doses of medication.
Psychologists with prescription privileges also are
most likely to be able to offer “combined”BOX3-3 Clinical Psychologist Perspective: Patrick H. DeLeon, Ph.D., J.D.Dr. DeLeon is a prominent clinical psychologist who
serves as chief of staff for Senator Daniel K. Inouye
(D-HI). Dr. DeLeon has been very active in the American
Psychological Association (APA) as well. Over the years,
he has served as president of the APA, as APA secre-
tary, as a member of the APA Board of Directors, as
chair of the APA Board of Professional Affairs, and as
president of the APA Divisions of Clinical Psychology
(Division 12), Psychotherapy (Division 29), and Psychol-
ogy and Law (Division 41). Dr. DeLeon has been per-
haps the most outspoken proponent of pursuing
prescription privileges for psychologists. We asked him
several questions about his background and activities.Could you tell us a little about your background and
interests?
I grew up in a family that was very politically active.
Both of my parents were attorneys. My mother was
one of the first female lawyers in Connecticut and the
first elected female alderman in our hometown. I
always knew I would become a lawyer. If I had not
gone to graduate school first, I would undoubtedly
have become an elected official. Working on Capitol
Hill seems a“natural fit.”Specifically, I began working
for Senator Inouye the day that the Watergate hear-
ings started—slightly over three decades ago. At that
time I was enrolled at the University of Hawaii School
of Public Health and working for the State of Hawaii
Division of Mental Health. The university required an
internship, so I took the summer off, came to our
nation’s capital, and, except for a brief period to run a
congressional campaign, have not left yet. Over the
years, I have learned that many senior congressional
staff have grown up in families that were very active inthe political process. One learns from an early age to
value public service. The political process and the public
policy process become“natural”—personally mean-
ingful and, in essence, a way of life.
Prior to working for Senator Inouye, I was a clini-
cal psychologist with the State of Hawaii’s Division of
Mental Health. I first worked on an inpatient ward in
our state hospital; then, as a result of the community
mental health center movement, our inpatient and
outpatient responsibilities were combined. I essentially
functioned as deputy director of our center, clinically
specializing in“dangerous”and“chronic”patients.
Prior to that, my wife and I worked as Field Assessment
Officers (FAOs) for the Peace Corps, staffing a Fiji and
Philippines project. That was really interesting, espe-
cially the time we spent in the host countries.What is the biggest challenge facing psychology
today?
I think the biggest challenge we face today as a pro-
fession is an internal one—collectively appreciating the
extent to which we really are one of the“learned
professions”and, thus, that we have a societal obliga-
tion to provide effective, data-based care and proac-
tive leadership. Too many of us do not seem to
appreciate that we really are one family. For example,
an individual psychologist will gravitate to a high-level
administrative position and then seem to act as if he or
she is no longer a psychologist. Unlike organized med-
icine, which is always looking out for the future of
their profession, far too few of us go out of our way to
systematically foster“growth”experiences for the next
generation. That is why, in my judgment, the estab-
lishment of the Committee for the American76 CHAPTER 3