RxP training issue still boiling

By James Bradshaw Assistant Editor
September 1, 2005



Washington – The controversy over proposed psychopharmacological training standards fueled heated concerns from training school administrators and others at the 2005 convention of the American Psychological Association.

Several members of Division 55, the American Society for the Advancement of Pharmacotherapy (ASAP), viewed efforts of the National Register of Health Services Providers in Psychology (NR) and the Association of State and Provincial Psychology Boards (ASPPB) to draw up training criteria as a takeover attempt that could usurp APA’s oversight of RxP training.

In a “town hall” meeting on Aug. 18, the opening evening of the four-day convention, ASAP leaders announced a policy approved by the division’s board of directors to reject the NR/ASPPB proposal and to recognize the APA model curriculum as “the current basis for any official criteria for training in psychopharmacology.”

The NR/ ASPPB coalition announced a “final draft” of training criteria just before the convention opened that set the curriculum at 350 hours of didactic training – 50 more than the APA model – and added a one-year practicum not called for in the association’s model.

The didactic hours were reduced from 450 required in an earlier version circulated by NR. A still earlier version mandated that training be conducted in conjunction with an accredited university, but that requirement was eliminated following objections from free-standing program operators. Each of those versions also was presented as a “final” draft.

The ASAP board also called for any future modifications of the training criteria to be based on the experiences of prescribing psychologists and training directors and demanded that any proposal put forth for program accreditation be submitted for a vote by the division’s 1,200 members.

Matthew Nessetti, Ph.D., M.D., president of Division 55 and program administrator for the Psychopharmacology Institute in Lincoln, Neb., objected that adopting hard-and-fast accreditation requirements so early in the RxP movement could hamper growth.

“The goal has been to move the process along and pass it in more states,” Nessetti said, drawing nods of agreement from the majority of the two dozen or so RxP leaders attending the session.

Russ Newman, Ph.D., J.D., executive director of the Practice Directorate, said efforts to develop an updated model curriculum were prompted by the desire to give training programs recognition that would help in considerations by state legislatures. “We did not want it to be called an accreditation,” Newman said.

The Practice Directorate’s cooperation with the NR/ASPPB effort to impose guidelines for training programs has been viewed by many ASAP members as an abdication of the duty to protect the interest of the practicing psychologists whose dues support the directorate.

Jack Wiggins, Ph.D., editor of Division 55’s newsletter, The ASAP Reader, said disgruntlement over the proposal to place credentialing with outside agencies has been growing within the division since last spring.

Wiggins, a long-time standard bearer for the RxP movement, said he has stepped back from leadership positions and no longer has an official role in setting RxP policy, but he has watched closely in recent months as tempers flared in a barrage of e-mail and list-serve comments discussing the credentialing flap.

Robert McGrath, Ph.D., director of the psychopharmacology program at Fairleigh Dickinson University, said the training directors were never asked for input on the criteria and the result was an unrealistic proposal. “Basically, none of the programs in the nation could meet the criteria,” McGrath said.

Newman said NR and ASPPB were called in to speed the process, not hamper it. He said discussion with theCommittee for the Advancment of Professional Practice (CAPP) led him to believe developing an in-house update of the 1996 APA model curriculum would be time-consuming.

“My understanding of what I was hearing was it was going to be a long drawn out process stretching out to 2010 before we would have something done,” Newman said.

He said NR and ASPPB are established authorities that could be well received by state licensing boards. Newman conceded the approach might not work but said it should not be abandoned too quickly. “In my opinion, it’s still worth a shot,” he said.

Glenn Ally, Ph.D., a prime mover in gaining RxP authority for Louisiana psychologists, said it is too early to establish rigid guidelines. “We are etching things in stone that I don’t think need to be etched in stone at this point,” he said.

Ally said he also is troubled that the move would place control of training criteria outside APA’s purview.

John Caccavale, Ph.D., president of the National Society of Clinical Psychopharmacologists, was the most heated in his comments, criticizing the way decisions were made without discussion with those representing psychologists who will seek prescribing authority.

Caccavale has been among the most vocal critics of the NR/ASPPB proposal, suggesting at one point that the Practice Directorate should secede from APA and establish its own criteria.

In a social hour later in the week at NR’s offices, Judy Hall, Ph.D., who is NR’s executive officer, said overseeing the criteria needs to be removed from APA to establish credibility. She said allowing an internal group to oversee training qualifications would equate with “letting the fox guard the chicken coop.”

Nessetti said it is still possible the NR/ASPPB coalition could develop standards acceptable to RxP stakeholders but it is unlikely the dispute will be resolved quickly.

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