News and Views - Pennsylvania State Board of Psychology Update


		News and Views Columnists and Correspondents Malpractice and Risk Management		PENNSYLVANIA STATE BOARD OF PSYCHOLOGY UPDATE by Dan Egli, Ph.D.
				Numerous states have addressed the issue of whether or not it is within the scope of a psychologists practice to discuss issues relating to psychopharmacology with either the patient or the prescriber. In some states this has even resulted in formal rulings in which the respective State Board indicates that as long as the psychologist has had adequate training and supervision, it is within a psychologist's scope of practice to do so (often seen as a "Level 2" collaborative role). In Pennsylvania, this has most recently been debated and individual psychologists and various officers within the state association are collaborating with the Board to address this issue. In an adopted July 17, 2000 memo, the Pennsylvania State Board of Psychology indicated that "once a psychologist has completed a comprehensive assessment of a patient/client, he/she has the duty to advise each patient/client of all treatment options, one of which may be medications." The ruling also allows the psychologists, in cases of noncompliance to stress "the importance of the medication and how it is an important compliment to the psychotherapy." Two points to note in the ruling are that "the psychologist MAY inform a patient generally about CLASSES of drugs, but not recommend specific drugs or dosages. Additionally, the ruling did not specifically address whether or not this may be part of the interaction/collaboration with the prescriber. It simply states that "once the patient's/client's permission has been secured, the psychologist should talk directly with the physician about the patient's/client's symptoms and behaviors. These discussions afford the psychologist and the physician an opportunity to share information from their unique vantage points. It appears this ruling goes further than what seemed to be allowed from previous State Board suggestions/rulings but still restricts practitioners from a type of interaction that this author, from speaking to many clinicians around the country in the context of providing psychopharmacology CE workshops, hears as being very common and typical. That is to say, most clinicians indicate that the interaction with the prescriber almost always gets into specific drugs and dosages above and beyond mentioning general classes. These clinicians indicate, furthermore, that this is something the prescriber most often is asking for in no uncertain terms while simultaneously acknowledging the need for that level of specificity from the collaborating/consulting psychologist. One leading state clinician (a former PPA President) testifying before the Board was even open and honest enough to indicate that they felt they had no doubt violated this standard numerous times that very week before coming to the convention, and that this was a practice they (and many others in the state) commonly engaged in for many years. Where this leaves Pennsylvania clinicians remains unclear and hopefully efforts will be directed and continuing to both clarify and expand the language regarding this crucial issue.
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