Monday, May 10, 2021

Comments by Iski

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  • I appreciate the cautious approach to the issue surrounding prescription privileges, however, I actually think this is a potential step forward for a profession (and professional association) that has been passive, complacent and frankly delusional that the public (and outcome studies) can accurately differentiate psychologists from other “helping professionals” such as social workers, counselors, life coaches, etc. In business terms, psychology has had a major problem identifying it’s value proposition for years–to consumers and prospective psychologists considering the cost-benefit ratio of education to practical/differentiated competence.

    Psychology and the APA may be one of the most fragmented and divisive professions in existence today and the excuse that it’s a “young science” is more about avoiding its own “difficult conversations.” Applied (Clinical/Counseling) Psychology is becoming less and less relevant with so many other practitioners in the space yet the APA continues to lower the bar for accreditation standards to the degree that “anybody who wants to help others” can find a degree somewhere to establish his or her credentials. Can you imagine if medicine permitted the same thing?

    So it’s a paradox. Based on the amount of training and education in a typical psychology doctoral program, you’ve gotta be asking “what the hell are we spending time learning if outcome research or public perception sees it as no more effective than a 2 year or less social work or executive coaching certification (believe me–they ARE addressing issues that would often be reserved for psychologists). I fear that a rejection of our potential competence to prescribe (which a MSN with two years post Bachelor’s can do mind you) we are concurrently indicting the intellectual capability and ineffectiveness of the doctoral psychology curriculum.

    I’m also pretty annoyed at the idea that pharmacology, biology and neuroanatomy is somehow “out of our league”. As someone who worked in medical residency programs (teaching behavioral medicine rotations to ER, Family, Pediatricians) I knew WAY more about neuroanatomy and neurology in addition to behavioral research and psychotherapy. With two more years of training exclusively in pharmacology and physiological study, I’d certainly put that knowledge against any test or certification required by these specialties who are KNOWN to probably prescribe more psychoactive drugs that psychiatrists by far. And from what I witnessed, it was more about trial/error based on PDR recommendations and hearsay more than good science. The biological paradigm is primarily all that physicians have so to introduce psychologists into the mix where discretion based on multiple paradigms is present–how much more capable could you get with that formula.

    As it stands to day, I’d guide any bright student considering a doctoral program in psychology to medicine in a heartbeat. I’d push this recommendation because as it stands, psychology will never get out of its own way to focus, enforce high standards, and effectively articulate and advocate for its own differentiated brand in the public eye. Psychology is change resistant for a lot of reasons and few of them for the best interest of current and future psychologists in my opinion.