New draft on training defuses RxP brouhaha

By James Bradshaw Assistant Editor
May 1, 2005



Washington – A furor that arose in February over what constitutes an adequate training program in psychopharmacology largely dissolved March 7 as a new draft of proposed criteria was released by the National Register of Health Service Providers and the Association of State and Provincial Psychology Boards.

“We have opened up the criteria to make it available to all training programs,” said Judy Hall, Ph.D., executive officer for the National Register. She said the new draft will judge training programs based on content “regardless of format.”

An earlier draft would have limited acceptable training to programs affiliated with accredited universities.

Neither The Psychopharmacology Institute in Lincoln, Neb., which is operated by Matthew Nessetti, Ph.D., M.D., president of the American Society for the Advancement of Pharmacology (ASAP), nor Prescribing Psychologists’ Register, which has trained the most psychologists to date for RxP certification, is affiliated with a university.

Morgan T. Sammons, Ph.D., president and chairman of the National Register’s board of directors, said the criteria were rewritten to accommodate any program that offers proper instruction, including those “outside traditional brick-and-mortar institutions.”

Proper instruction is defined as 300 hours of appropriate postdoctoral didactic instruction and a supervised practicum overseeing medications for 100 patients in both inpatient and outpatient settings.

Hall and Sammons calmed the stormy waters by announcing the new draft proposal during the American Psychological Association’s 2005 State Leadership Conference at the Washington Grand Hyatt Hotel.

Nessetti subsequently told The National Psychologist the redrafting had taken care of his and other’s major concerns.

Russ Newman, Ph.D., J.D., executive director of APA’s Practice Directorate, said the goal is to develop quality training programs and bumps can be expected along the way as problems are met and resolved.

“This thing is being built, and in some regards it’s being built as we fly it,” Newman said. He said it is crucial that psychologists band together behind an acceptable model training program to prevent bickering that could be interpreted as doubt about the training’s adequacy. “We can’t give our enemies that ammunition,” Newman said.

Several sessions at the conference centered on efforts to expand prescription privileges to psychologists in more states now that RxP legislation has been enacted in New Mexico and Louisiana.

A Tennessee delegation held a mock session of testimony before legislators to demonstrate how to compress RxP information into a half-hour to 40-minute presentation without sacrificing content.

One of the most effective pieces of the package was when Anne McKee, Ph.D., gave testimony as president of T-FACT – Tennessee Families for Access to Comprehensive Treatment.

McKee told of her experience as mother of a teenage daughter suffering bipolar disorder. McKee said even as a licensed psychologist she could not overcome the limits of Tennessee law and available mental health care to get her daughter optimum care.

Instead, her daughter’s medications were prescribed by a psychiatrist who saw the girl only 10 to 15 minutes every four to six weeks. The result was under-medication or over-medication at various times with the girl at one point taking eight medications simultaneously with such severe side effects that she was unable to go to school or work.

McKee said the experience led her and her husband to form T-FACT, based in part on Louisiana’s citizen’s action group, La Fact.

She said T-FACT provides legislators brochures describing similar experiences of a mother who must drive her teenage son 25 miles once a month for a 15-minute “prescription session” and the personal story of a woman who as a teen suffered anorexia nervosa and had to be admitted to a long-term mental health facility when a psychiatrist could not see her often enough to control her illness.

McKee said many legislators get the message that greater access is needed when parents describe their anxiety in trying to find the most qualified person to trust with the care of a suicidal child.

Tennessee is often mentioned as the state most likely next to authorize privileges for psychologists, but bills are also under consideration in Connecticut, Illinois, Missouri and Oregon. A senate bill in West Virginia appears to have died in committee, ending hopes there in the current legislative session.

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