Legislation granting prescribing rights to psychologists in two states sets
out different training requirements to qualify for those privileges. Compared
with Louisiana, New Mexico requires more extensive and specific training,
including the completion of a supervised clinical experience, according to an
analysis by Paula Johnson, deputy director for state affairs in APA's
Department of Government Relations.
The Louisiana regulations require that applicants for prescribing
privileges hold a current state license to practice psychology with an applied
clinical specialty. In addition, applicants must earn a postgraduate master's
degree in clinical psychopharmacology or the equivalent, as approved by the
Louisiana State Board of Examiners of Psychology, and must pass a national
proficiency examination in psychopharmacology.
Instruction must include "anatomy and physiology, biochemistry,
neurosciences, pharmacology, psychopharmacology, clinical
medicine/pathophysiology, and health assessment, including relevant physical
and laboratory assessment."
The psychology board does not specify the amount of time to be spent on
such studies, and no practicum is required.
New Mexico requires not only licensure but specifies that applicants hold a
doctorate in psychology. Pharmacological training courses and the proficiency
exam must be approved by both the New Mexico Board of Psychologist Examiners
and the state's Board of Medical Examiners, implying at least some medical
oversight of the process.
The New Mexico regulations also specify a minimum of 450 classroom hours of
instruction in "neuroscience, pharmacology, psychopharmacology,
physiology, pathophysiology, appropriate and relevant physical and laboratory
assessment, and clinical pharmacoptherapeutics." They also call for an
80-hour practicum in clinical assessment and pathophysiology, and at least 400
hours of supervised treatment of 100 patients. Both practica must be overseen
by a psychiatrist or other "competently trained physician."
The New Mexico law further requires that the educational component and the
supervised practica be completed within the five years preceding application.
There are two prescribing levels stated in the law. Psychologists hold a"
conditional prescribing certificate" for two years and practice
under the supervision of a licensed physician. A full prescription certificate
is issued after successful completion of this initial period. Psychologists
must have malpractice insurance to obtain both the conditional prescription
and prescription certificates.
At present, psychopharmacological training in Louisiana is offered by the
California School of Professional Psychology, a division of Alliant
International University of San Francisco, in cooperation with the Louisiana
Psychological Association. Classes leading to a postdoctoral master of science
degree in clinical psychopharmacology are offered on weekends in Baton Rouge.
Alliant has conferred such degrees in California, Texas, and Louisiana,
according to its Web site.
"California School of Professional Psychology's program requires
psychologists to complete 450 hours of instruction and includes training that
sensitizes practitioners to different cultural views and differences in the
ways that men and women respond to prescription drugs," said an Alliant
press release.
The primary training provider in New Mexico is the Southwestern Institute
for the Advancement of Psychotherapy, in Las Cruces. "The goal is to
provide high-quality training regarding psychopharmacology, helping
psychologists to work as primary health care providers, supporting emotional
and physical well-being," says the institute's Web site. The institute
has had a collaborative arrangement with New Mexico State University (NMSU) in
Las Cruces for about five years.
The institute's director, Elaine LeVine, Ph.D., said she had just completed
the program, taught by experts from around the country, and had received her
license to prescribe.
Two rounds of students, totaling 20 individuals, have taken the classroom
portion of the training, and several were in the midst of the 400-hour
practicum. Classes have been taught for the last five years on the NMSU campus
by medical professionals, including doctors and nurses, said Luis Vazquez,
Ph.D., an associate professor and head of the department of counseling and
educational psychology in the School of Education. These courses meet the same
requirements as other university credit courses. The department also oversees
the 400-hour practicum, although the psychologists are directly supervised by
physicians.
Academic psychologists, including those from the department of psychology
at NMSU, are not involved in training postdoctoral candidates for prescribing
privileges.
Louisiana legislation specifically calls for a "postdoctoral"
master's degree. A proposal to include psychopharmacology in the predoctoral
curriculum at Louisiana State University was rejected by the university
administration, said Alan Baumeister, Ph.D., a professor and chair of the
department of psychology, who teaches neuropharmacology.
At the University of New Mexico, John Gluck, Ph.D., a professor who holds
appointments in psychology and in psychiatry, said in an interview there are
ethical issues for both prescribers and patients in the way psychologists will
be trained. Psychologists would do better returning for another degree at a
comprehensive university, where faculty committees set up the curriculum and
where there are other disciplines from which to learn. Adding an entirely new
subject area to one's scope of practice is not "continuing
education," he said.
"Is this new training program adequate for the purposes for which it
was intended?" asked Gluck, who served on a joint commission convened by
the state psychology and medical boards to explore prescribing privileges for
psychologists. "We don't know. Patients are being asked to participate
in an experiment."
Information on the California School of Professional Psychology at
Alliant International University is posted at<www.alliant.edu/cspp/>;
information on psychopharmacology training for psychologists at Southwestern
Institute for the Advancement of Psychotherapy is posted at<www.siaprxp.com>.
The text of Louisiana's psychologist-prescribing law and licensure
requirements are posted on the Louisiana State Board of Examiners of
Psychologists' Web site at<www.lsbep.org>.
The same information for New Mexico is posted on the New Mexico Board of
Psychologist Examiners' Web site at<www.rld.state.nm.us/b&c/psychology/index.htm>.▪