Psychology's Expanding Scope of Practice: An Historical Analysis of Relations with Psychiatry, Prescriptive Authority, and Legislation

The vastness of psychology requires its professionals to master multiple skills. However, professional psychologists cannot just determine they would like to expand their scope of practice and then start offering that service. They must first gain legislative approval for whatever professional activity they are seeking. It is during this process that other interested parties can lobby for or against the sought after activity. Psychologists are currently seeking prescription privileges in several states in order to prescribe psychotropic medications to clients in need, a practice currently limited to professionals with medical training. Organized medicine and psychiatry have consistently opposed psychologists' attempts to gain prescriptive privileges, despite the successful implementation of prescribing psychologists in federal agencies, Louisiana, New Mexico, and Guam. In fact, organized medicine and psychiatry have repeatedly opposed attempts by psychologists to expand their scope of practice. They also have consistently used the same arguments suggesting the motivation is more politically-based than evidence-based. Through a brief history of psychology and psychiatry, it will become clear that although they both treat diseases of the mind, the professions differ in theory, tradition, or, like with prescriptive privileges, political power. Analyses of how psychologists gained the right to practice psychotherapy and provide expert witness testimony and their attempts to gain hospital privileges provides further evidence of the consistent and persistent effort physicians put forth to obstruct psychology's expanding scope of practice. The arguments used by medical associations communicate little empirical evidence, and thus, there is an insufficient basis to justify their opposition.