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Mental health parity law
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Should Psychologists Have Prescription Privileges?
The debate over the right of clinical psychologists to prescribe psychoactive medications is certainly not new to the scene. In fact, the debate spans over the past two decades with strong arguments on each end of the spectrum. While opponents to the issue question, among many other things, the qualifications of psychologists, advocates on the issue stress the important public needs that are not currently being met in our mental healthcare system (Lavoie & Barone, 2006). Although the issue of prescription privileges for psychologist stems back many years with plenty of arguments on both sides, I believe the evidence presents a clear and evident solution on the topic. Based on research articles and journals in this field of study, I find that new standards for prescription privileges would pose a substantial benefit for mental health professionals, both psychologist and psychiatrists. Prescription privileges in today’s world would essentially broaden public access and availability to the mental health professionals who have the powers to prescribe (Lavoie & Fleet, 2002).
We have already seen numerous changes in the field of psychology, and these have yielded new opportunities and roles for psychologists not to mention the added benefits and new comprehensive services presented to the public. In his publication titled, Responding to Society’s Needs: Prescription Privileges for Psychologists, in the Journal Of Clinical Psychology, Norfleet urges the need for this continued trend in our future, and strongly advocates the need for prescription privileges to be a part of the equation. The author clearly lays out the importance of this advancement in the field of psychology by stress...
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References
DeNelsky, G. Y. (1996). The case against prescription privileges for psychologists. American Psychologist, 51(3), 207-212. doi:10.1037/0003-066X.51.3.207
Heiby, E. M. (2002). Prescription Privileges for Psychologists: Can Differing Views Be Reconciled?. Journal Of Clinical Psychology, 58(6), 589-597.
Lavoie, K. L., & Barone, S. (2006). Prescription Privileges for Psychologists: A Comprehensive Review and Critical Analysis of Current Issues and Controversies.CNS Drugs, 20(1), 51-66.
Lavoie, K. L., & Fleet, R. P. (2002). Should Psychologists Be Granted Prescription Privileges? A Review of the Prescription Privilege Debate for Psychiatrists. Canadian Journal Of Psychiatry, 47(5), 443.
Norfleet, M. (2002). Responding to Society's Needs: Prescription Privileges for Psychologists. Journal Of Clinical Psychology, 58(6), 599-610.
A physician has an unenviable position; he is closest to man approaching a god-like stature. And despite the demise of 'doctor knows best', we still need to trust his diagnosis-something that is increasingly difficult in a world where information is widely available, and Google substitutes for a doctor. In the case of psychiatry the issue of trust is amplified since diagnosis is based on a patient's expressed thoughts and overt behaviours rather than solely on biological phenomena. And these thoughts and behaviours are influenced by the patient's environment-a mix of his social, cultural and technological experiences.
Szasz, Thomas. Coercion as Cure: A Critical History of Psychiatry. New Brunswick, New Jersey: Transaction, 2007. Print. Braslow, Joel T. Mental Ills and Bodily Cures: Psychiatric Treatment in the First Half of the Twentieth Century. California: University of California, 1997. Print.
Understanding psychological disorders are very important in human development, the first step is to define what is meant by a disorder. How do psychologists determine that there something is psychologically wrong with a person? What behaviours are abnormal? A psychological disorder, also known as a mental disorder, is a pattern of behavioural or psychological symptoms that impact multiple life areas and/or create distress for the person experiencing these symptoms. A clear sign of abnormal behaviour or mental state is when an individual's behaviour is destructive to themselves or their social group, such as family, friends. Above all psychological disorders create a maladaptive pattern of thoughts, feelings, and behaviours that lead to detriments in relationships and other life areas. There are several ethical issues in treating psychological disorders. There two ways of treating psychological disorders through; psychotherapy this form of treatment involves social interactions between a trained professional (therapist) and client. This is delivered on a one-to-one, face-to-face meeting. Another way of treating psychological disorder is through pharmacological treatments. This is the use of proactive drugs to treat certain disorders. This essay will aim to highlight the pros and cons of using pharmacological and psychological treatments.
Forcing someone to take medication or be hospitalized against their will seems contrary to an individual’s right to refuse medical treatment, however, the issue becomes complicated when it involves individuals suffering from a mental illness. What should be done when a person has lost their grasp on reality, or if they are at a risk of harming themselves or others? Would that justify denying individuals the right to refuse treatment and issuing involuntary treatment? Numerous books and articles have been written which debates this issue and presents the recommendations of assorted experts.
In today’s society, a lot of emphasis is placed on administering drugs and medicating people with psychological issues; however, most of these ailments and issues have the ability be treated through the use of talk therapy rather than medication. Americans are particularly guilty of over medicating when it comes to our more common mental health diagnosis such as, ADHD, depression, and anxiety. We as a society expect things to be done at the snap of a finger; in our advancement of science, we have been able to discover ways of offering the results we want quickly, inexpensively, and with little effort. Unfortunately, although the use of medications, also known as psychoactive drugs, occasionally remove the symptoms, but they do little to remove the causes of these mental health issues. In addition, to the lack of solution that the use of psychoactive drugs offer, they can also have unwanted and dangerous side effects. These can include simple physical irritants such as dry mouth and head aches, and can range up to dependency and substance abuse, and in some cases even death. Moreover, there are cases of inappropriate prescribing, where doctors are authorizing the use of medications that don’t work or are not pertinent to the issue the patient is experiencing. Furthermore, some of these doctors are issuing these medications without subjecting the patient to a proper mental health evaluation by a psychological professional.
The author explains how randomized clinical trials put physicians in ethically intolerable positions of choosing between the good of the patient and that of society. A kantian argument is formed when the author explains how the physician has the duty to tell the truth and not use the patient as a mere means to satisfy the needs of a majority. The well being of the patient is far more important than that of the society when it comes to treatment by personal physician, the Author suggests that there should be alternatives to randomized clinical trials to deal with observer bias and patient selection. The overall message of the article stresses the importance of a patient’s well being over the well being of a society because the physician has the duty to help the patient improve his/her health.
As science has evolved, so have treatments for mental illnesses have over time. The medical model is described as the view that psychological disorders are medical diseases with a biological origin (King, 2010, pg. 413). Abnormal behavior that categorizes some disorders can be impacted by biological factors such as genes, psychological factors such as childhood experiences, and even sociocultural factors such as gender and race (King, 2010). Treatments such as psychosurgery (lobotomy) , drug therapy (pharmaceuticals), electroconclusive therapy, and psychoanalysis are used to treat a wide range of psychological disorders. Back then, the public’s negative views on mental illnesses also went as far to associate with the people who treated it; psychiatrists. “Nunnally (1961) found that the public evaluated professionals who treated mental disorders significantly more negatively than those who treat physical disorders,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). People back then didn’t see the point in “paying to be told that they were crazy”. However, in today’s society, it is now acceptable to seek help from psychiatric professionals; we are seeing more and more people seek mental health treatment. “In terms of facility-based records of utilization (Manderscheid and Henderson 1998), the data suggest that the rate of utilization of professional mental health services has at least doubled and maybe tripled, between the 1950’s and today,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). In the 1950’s, neuroleptic drugs like Thorazine were introduced to treat the symptoms of schizophrenia. These drugs block a neurotransmitter called dopamine from getting to the brain, which in turn reduce schizophrenic symptoms, however there are some side effects such as substantial twitching of the neck, arms, and legs, and even dysphoria or lack of pleasure. (King, 2010, pg.
Allen Frances spends his time concluding his thoughts about the DSM and diagnostic inflation in the third part of “Saving Normal”. Frances appears to be passionate about reducing over-diagnosing and unnecessary medication. Frances did a good job providing us with ways that can change the future of diagnosis. Having a complete culture change will be difficult, but we can begin by educating ourselves.
Although founded and held to the ethical guidelines of the APA, I/O psychology has struggled with licensure. Should I/O Psychologists be Licensed? An article written by Howard and Lowman (1985) address the initial findings of the result of poorly developed licensing requirements. Few articles discuss the gaps between current laws and regulations. However, research reported within the article stated that there was a study conducted of the directory of the American Psychological Association in 1981 which revealed that “fewer licenses were obtained by younger I/O practitioners” (Howard & Lowman, 1985, p.40). The results of the study indicated 22% of those age 34 or younger were licensed, compared with 39% of those age 35 to 44, 51% of those age 45 to 54, and 67% of I/O psychologists age 55 to 64 (Howard & Lowman, 1985). The results may not have been seen as a major concern during the early 1980s however the article continues to highlight the many hurdl...
Psychiatry is one of the oldest medical methods; it is also the most exciting form of medicine. In 1812, Benjamin Rush, who was also a signer of the declaration of independence, published the first psychiatry text book in the United States (5). Recently, circa 2000s, an organization, American Psychiatric Press, is using its subsidiaries¬¬¬¬- the American Psychiatric Foundation, the American Psychiatric Institute for Research and Education, and many more- to position the organization for a greater role of advocacy. (5)
...ments. In psychotherapy the psychologist must ensure that there is a high level of trust between him and the patient. There must also be high confidentiality rate between both parties. Only at necessary times should a patient’s record be disclosed to third parties. There must also be set boundaries between the patient and his or her psychologists and there must be no form of sexual interaction between both parties. In terms of pharmacological treatments with patients who suffer from ADHD, the over prescription of Ritalin must be revised as more and more young children are forced to take the drug which often times leads the child to lose his or her freedom of personality. These ethical issues must be looked into as these drugs are given to children so that they can fit into a socially normal behavioural society which in turns makes them be subject of discrimination.
Doward, J. (2013), Medicine's big new battleground: does mental illness really exist? The Observer 12 May.
King, J. H., & Anderson, S. M. (2004). Therapeutic implications of pharmacotherapy: Current trends and ethical issues. Journal of Counseling and Development, 82(3), 329–336.
The purpose f this paper is to answer the following question- where does patient autonomy leave off and professional expertise begin in the practice of medicine? Also, a brief personal analysis about the differences between doctors encouraging patients to question their judgment and doctors who believe that such deference is “pandering.”
Torry, Zachary D., and Kenneth J. Weiss. "Medication Noncompliance and Criminal Responsibility: Is the Insanity Defense Legitimate?" Journal of Psychiatry & Law 40 40.2 (2012): 219-42. Web. 21 Mar. 2014.