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Psychologists' right to prescribe--should prescribing privileges be granted to South African psychologists?

Current changes in legislation regarding prescription rights increase the possibility of non-medical practitioners being authorized to prescribe medication. There has been ongoing debate about granting psychologists in South Africa a limited right to prescribe (RTP) psychotropic medication. The main reasons advanced for granting psychologists RTP include the advantage of delivering integrated treatments, with psychologists well placed to offer such treatment, and the shortage of mental health practitioners in South Africa. If psychologists were granted the RTP they would have to undergo extensive training in psychopharmacology. Curricula for such training are currently being prepared with the help of the American Psychological Association. But there is also considerable opposition to psychologists being granted the RTP, both from within psychology and from other quarters. Opposition from outside psychology is based largely on safety considerations relating to lack of relevant training among psychologists. Opposition from within psychology is based on a concern about the loss of the distinctive contribution of psychology to mental health care in South Africa. Various aspects of this debate are examined in this paper.

Curriculum↗

Attitudes of psychologists and psychologists-in-training to homosexual women and men: an Australian study.

Homophobic reactions of Australian psychologists (n = 43), postgraduate psychology students (n = 17) and undergraduate psychology students (n = 44) were compared using Van de Ven's (1994) measures of cognitive, affective and behavioral dimensions of homophobia. Results suggested that undergraduates were significantly more homophobic than psychologists in their thinking, intentional behavior and feelings of fear or discomfort in relation to lesbians and gay men. No other significant group differences were found. Gender differences were found only in relation to one affective dimension of homophobia. Low levels of positive affective response to homosexuals were observed across groups and gender. The study underscores the importance of assessing homophobic response multidimensionally. Implications for the training of Australian psychologists are discussed.

Adult↗

Clinical and "actuarial" evaluation of organic brain damage by psychologists and non-psychologists using the Memory-for-Designs.

This study examined the effects of type of training and level of education on clinical judgment, as demonstrated in "clinical" and "actuarial" evaluation of the Graham-Kendall Memory-for-Designs (1960). Protocols of 6 organic and 6 non-organic patients matched for age and IQ were evaluated by 18 judges. Nine of the judges were psychologists and nine had degrees in some field other than psychology. In each group 3 judges had PhDs, 3 had Master's degrees and 3 had Bachelor's degrees. There was no significant difference (p greater than .01) between the 2 groups in clinical or actuarial diagnoses of brain damage regardless of level of education, and inter-rater reliability was all but identical. Results were consistent with other research on clinical judgment.

Adult↗

The naive epistemology of a working social psychologist (or the working epistemology of a naive social psychologist): the value of taking "temporary givens" seriously.

In this article I first describe the origin of 6 recent lines of inquiry. In describing these 6 case studies, I attempt to determine the inspirations for my ideas. I also attempt to determine (a) whether these specific inspirations (or, perhaps, strategies) have occurred in my past research and (b) whether, in conclusion, some general principle can begin to account for how I generate my ideas.

Humans↗

Comparison of psychiatrists and psychologists in clinical practice.

OBJECTIVE: The authors compared data from psychiatrists and psychologists in California to determine whether long-standing differences in clinical practice remain after the introduction of managed care and other changes in mental service delivery. METHODS: Responses from practicing clinicians in California who participated in the 1998 National Survey of Psychiatric Practice and the 2000 California Survey of Psychological Practice were compared on items related to patient caseload, practice profile, and insurance or reimbursement arrangements. RESULTS: Data from 97 psychiatrists and 395 psychologists were available for the study. Psychiatrists reported spending more hours on most aspects of practice and working more total hours per week than psychologists. The weekly caseloads reported by psychiatrists included a greater percentage of persons treated for psychotic conditions than did the caseloads of psychologists. Psychologists reported that their weekly caseloads included a greater percentage of persons treated for anxiety disorders, personality disorders, and other disorders. Psychiatrists reported receiving a greater average payment for services from public insurance, and psychologists reported treating a greater average percentage of patients who did not have insurance coverage. Significant differences in income sources and fee arrangements were observed, and the net reported income of psychiatrists was nearly 80 percent greater than that of psychologists. CONCLUSIONS: Long-standing differences in clinical practice patterns remain between psychiatrists and psychologists despite managed care staffing arrangements and treatment strategies that streamline the practices of both provider groups. The significant income and wage differences between psychiatrists and psychologists may be partly due to supply dynamics of the mental health workforce that adversely affect psychologists.

Female↗

Differences regarding job satisfaction and job involvement of psychologists with different dominant career anchors.

In order to contribute to higher levels of job satisfaction, job involvement and productivity, a match or fit should be established between the dominant career anchor associated with a specific occupation and that of the employee. A career anchor is an individual's set of self-perceived talents, abilities, motives, needs and values that form the nucleus of one's occupational self-concept. Psychologists have always been part of the service orientated careers and therefore one would expect that it is likely that their dominant career anchor would be service orientation. If this is the case, psychologists with service as their dominant career anchor are supposed to have greater job satisfaction and job involvement compared to those with different career anchors. However, according to literature, this assumption is not necessarily correct. The primary goals of the current study were to determine whether in fact service is the dominant career anchor of psychologists in the Free State and whether there are significant differences regarding job satisfaction and job involvement between psychologists with and without service as their dominant career anchor. A third goal was to determine whether psychologists with different dominant career anchors differ significantly from one another regarding job satisfaction and job involvement. Questionnaires measuring career orientations, job satisfaction and job involvement were sent to 165 of the 171 registered psychologists in the Free State region. Only 75 psychologists (45,5%) responded which exceeded the traditional return rate of 20 to 30%. Due to the small sample of respondents, a nonparametric statistical test, namely the Mann Whitney U test was conducted to determine possible differences. An analysis of the data showed that 21 respondents had entrepreneurship as their dominant career orientation while 12 fell in the technical/functional, 12 in the challenging, 9 in the service and 8 in the autonomy categories of dominant career anchors. No significant differences regarding job satisfaction between psychologists with and without service as dominant career orientation could be determined. Both groups experienced a fairly high degree of job satisfaction and a higher level of intrinsic job satisfaction occurred compared to extrinsic job satisfaction. A significant difference between the two groups in terms of job involvement occurred. Psychologists with service as dominant career orientation showed a higher level of job involvement, although the degree of job involvement for both groups was fairly low. No significant differences regarding job satisfaction and job involvement among psychologists with different career orientations could be found.

Adult↗

[The psychologists in Argentina. Quantitative data].

A partial report from a study dealing with Psychology's current status in Argentina is presented. Pursuant to this preliminary study 36,128 psychologists have taken their degree at both State and private universities in Argentina--between 1956, when the first Department of Psychology was created, and 1992. So, over a 32.5-million population (as per the 1991 census), there is a psychologist every 897 inhabitants, or 111 psychologists every 100,000 inhabitants. According to psychologists' geographical distribution, the highest density is to be found in the capital city of Buenos Aires (one psychologist every 246 inhabitants) while the lowest density is to be found in the Province of Chaco (one psychologist every 17,465 inhabitants). During year 1993, a total of 26,726 students have been studying Psychology at the different Argentine universities: Of these, 6,858 have taken their Psychology degree during this academic year. A great majority of psychologists work in the clinical field, being Psychoanalysis their prominent theoretical orientation. Ladies psychologists supposedly account for 85% of the overall number of psychologists. Psychological Associations have 24,878 active psychologists recorded, of which a great majority work in the clinical field.

Argentina↗

Recognition of names of eminent psychologists.

Faculty members, graduate students, undergraduate majors, and introductory psychology students checked those names they recognized in the list of 228 deceased psychologists, rated for eminence, provided by Annin, Boring, and Watson. Mean percentage recognition was less than 50% for the 128 American psychologists, and less than 25% for the 100 foreign psychologists, by the faculty subjects. The other three groups of subjects gave even lower recognition scores. Recognition was probably also influenced by recency; median year of death of the American psychologists was 1955, of the foreign psychologists, 1943. High recognition (defined as recognition by 80% or more of the faculty group) was achieved by only 34 psychologists, almost all of them American. These highly recognized psychologists also had high eminence ratings, but there was an equal number of psychologists with high eminence ratings that were poorly recognized.

History, 19th Century↗

Ethical beliefs and behaviors of pediatric psychologists: a survey.

There is an absence of data concerning the beliefs about and compliance with ethical principles of pediatric psychologists. Survey data were collected from 169 psychologist members of the Society of Pediatric Psychology (Division 12, Section 5 of APA) regarding the degree to which they engaged in each of 101 behaviors and the degree to which they considered each behavior ethical. The data were categorized and examined in terms of the APA Ethical Principles. Results indicated that pediatric psychologists show significantly different beliefs and behavior comparing children, adolescents, and their parents. A "majority belief" scale was developed where 80% of pediatric psychologists agreed that a clinical behavior was ethical or not ethical. Female pediatric psychologists, compared to males, more strongly endorsed the majority belief items (p less than .01). In addition, psychologists who graduated from APA-approved graduate programs more strongly endorsed the majority belief items than did psychologists from non-APA programs (p less than .05). Increased awareness of ethical issues is hoped to improve self-regulation by psychologists.

Adult↗

Prescription privileges for psychologists: a comprehensive review and critical analysis of current issues and controversies.

The debate over whether clinical psychologists should be granted the right to prescribe psychoactive medications has received considerable attention over the past 2 decades in North America and, more recently, in the UK. Proponents of granting prescription privileges to clinical psychologists argue that mental healthcare services are in crisis and that the mental health needs of society are not being met. They attribute this crisis primarily to the inappropriate prescribing practices of general practitioners and a persistent shortage of psychiatrists. It is believed that, as they would increase the scope of the practice of psychology, prescription privileges for psychologists would enhance mental health services by increasing public access to qualified professionals who are able to prescribe. The profession of psychology remains divided on the issue, and opponents have been equally outspoken in their arguments. The purpose of the present article is to place the pursuit of prescription privileges for psychologists in context by discussing the historical antecedents and major forces driving the debate. The major arguments put forth for and against prescription privileges for psychologists are presented, followed by a critical analysis of the validity and coherence of those arguments. Through this analysis, the following question is addressed. Is there currently sufficient empirical support for the desirability, feasibility, safety and cost effectiveness of granting prescription privileges to psychologists? Although proponents of granting prescription privileges to psychologists present several compelling arguments in favour of this practice, there remains a consistent lack of empirical evidence for the desirability, feasibility, safety and cost effectiveness of this proposal. More research is needed before we can conclude that prescription privileges for psychologists are a safe and logical solution to the problems facing the mental healthcare system.

Drug Prescriptions↗