Prescriptive Privileges for Clinical Psychologists

Prescriptive Privileges for Clinical Psychologists Erin E. Wood In the last thirty years, many parties within the American Psychological Association have made motions to promote the motion for clinical psychologists to have prescriptive privileges. With the motions made to promote prescriptive privileges, there have also been motions to counter the arguments made supporting prescription privileges. To research the claims made by both sides of the issue, the American Psychological Association has created a task force to assess the effects that prescriptive privileges will have on education as well as psychology as a whole. This paper will discuss the arguments revolving around professional integrity, financial implications, the amount of professionals interested in prescriptive privileges, safety, and educational consequences of prescription privileges as well as my own opinions as to whether I support or oppose the motion for clinical psychologists to obtain these privileges. Since the birth of psychology, American society has evolved to the point that individuals demand instant gratification. The desire for instant gratification has caused individuals â€Å"‘one-stop shop’ for mental health services† and medical professionals who can directly prescribe medications—causing physicians to become increasingly popular in comparison to psychologists (McGrath, 2010: Levine Schmelkin, 2006). By being able to prescribe medication while proving effective treatments to patients, prescriptive privileges will not only assist patients by cutting out the middle-man, it will also, according to Barnett and Neel (2000), â€Å"result in higher quality care.† Although physicians are currently able to provide medication, they are often uneducated on the effects drugs have on mental health (Barnett Neel, 2000). Psychologists in favor of prescriptive privileges argue that, through training and practice, they are more apt to deal with prescri bing medications and treatments that will treat mental health disorders than physicians who have very little training on mental health disorders (Barnett Neel, 2000). While some psychologists believe that prescription privileges is essential to keep psychotherapy from becoming superfluous in comparison to pharmacology and will assist in increasing the care for patients, others believe that these privileges will change the change the â€Å"professional identity† of those practicing psychology (Wiggins Wedding, 2004). Those who believe that psychologists should be allowed prescription privileges believe that not only will prescription privileges keep psychologists from becoming overshadowed by physicians, they also believe that clinical psychologists would be â€Å"in a unique position to assess and to monitor† when it comes to prescribing medication because, through doctoral training, they are more apt to study the effects of medications on patients (Barnett Neel, 2000). This would allow clinical psychologists to retain and extend their psychotherapeutic roots by giving them the opportunity to research the effect medications have on mental disorders while giving behavioral and cognitive therapies to patients. While psychologists in support of prescriptive privileges argue that prescriptive privileges will give way to many new opportunities in psychology, those in opposition to these privileges claim that the authority to prescribe medication will not create such a large window of opportun ity and will cause psychologists to fall prey to advertising from pharmaceutical companies. Many of the psychologists in opposition to prescriptive privileges believe that the addition of prescription privileges will change the direction of psychology towards an undesired direction—ultimately jeopardizing their professional integrity. They believe that, by placing more of an emphasis on medical treatments rather than behavioral treatments, â€Å"psychology as we know it will come to an end† because psychologists will be more interested in providing medications than therapy (Caccavale, 2002). Psychologists may not prescribe medications to patients based on their effectiveness, but more because will be encouraged by pharmaceutical companies. Currently, pharmaceutical companies create advertisements that strategically influence the opinions that physicians have on medications and bribe psychologists – through means of money and continuing education – to encourage them to prescribe these medications (Antonuccio, Danton McClanahan, 2003). Bribing and advertising does not only affect practicing physicians, according to Antonuccio, Danton and McClanhan (2003), pharmaceutical companies assert their influence as early as medical school—meeting with students to promote medication. This influence asserted by pharmaceutical companies over physicians and medical students can taint the objectivity of psychologists and, in extreme cases, place the patient in harms way. Although psychologists who are against prescriptive privileges believe that the integrity of the profession will be negatively impacted by the bribes and advertising of pharmaceutical companies, those who support prescriptive privileges believe th at these privileges will increase the financial status and interest in the profession. The pharmaceutical industry is one of the fastest growing industries in the United States being dubbed â€Å"the most profitable industry in the United States† (Antonuccio, Danton McClanahan, 2003). By being one of the most profitable industries in the nation, if psychologists were given the right to prescribe, it would not only give clinical psychologists an ‘edge’, it would also encourage individuals to join the profession. With prescriptive privileges, psychologists will also be able to partake in the benefits of pharmacology by receiving insurance reimbursements and increased status within health institutions (McGrath, 2010). McGrath (2010) claims that this increased status will not only benefit psychologists in private practice, hospitals, and other intuitions, it will also benefit the academic community by funding research projects. Although there are many financial benefits to both the counselling and academic communities of clinical psychology, there are also drawbacks that could potentially outweigh the benefits. First, while pharmaceutical companies have been known to provide bribes and false information to professionals with prescription privileges to increase drug sales, they have also been responsible for increasing levels of â€Å"commercialism and malpractice allegations† within health professions (Antonuccio, Danton McClanahan, 2003: Stuart Heiby, 2007, p. 6). Commercialization of medications has further tainted the objectivity of health professionals because, according to Stuart and Heiby (2007), although prescribers are able to deny medication to patients, they are more likely to give medications that have been â€Å"requested† by the client—even if they are ill-informed of the drug. Physicians may be becoming more willing to prescribe requested medications because the negative side effects of drugs have drastically decreased making it less of a risk for them to prescribe them (Levine Schmelkin, 2006). While medications have become safer to prescribe, when com plications arise, the professionals who prescribe the medications will be the ones at risk for malpractice lawsuits—not the pharmaceutical companies. In the article To Prescribe of Not to Prescribe: Eleven Exploratory Questions, Stuart and Heiby (2007) discuss the lack of support insurance companies have for professionals in malpractice lawsuits. Many insurance companies have created new policies when dealing with malpractice because â€Å"the rate and cost of settlements [that have] risen so sharply during the past decade† (Stuart Heiby, 2007, p. 22). Because of this, it can be very expensive for a psychologist to pay for the insurance to cover malpractice, or pay for the legal counsel because their insurance does not cover malpractice. According to Wiggins and Wedding (2004) only a small majority of psychiatric nurses – clinical psychologists who have gone through training to prescribe medication – have insurance policies that cover malpractice—even when it is in many ways cheaper than other forms of insurance (p.150). This could be because, although psychiatric nurses are able to prescribe medicatio ns, very few of them actually utilize prescription privileges (Wiggins Wedding 2004, p. 149). Due to the amount of psychiatric nurses who refrain from prescriptive privileges, before the APA -financial -military -RNP -coursework References Antonuccio, D. O., Danton, W., McClanahan, T. M. (2003). Psychology in the prescription era: Building a firewall between marketing and science.American Psychologist,58(12), 1028-1043. Barnett, J. E., Neel, M. L. (2000). Must all psychologists study psychopharmacology?Professional Psychology: Research and Practice,31(6), 619-627. Caccavale, J. (2002). Opposition to prescriptive authority: Is this a case of the tail wagging the dog.Journal of Clinical Psychology,58(6), 623-633. DeLeon, P. H., Dunivin, D. L., Newman, R. (2002). The tide rises.Clinical Psychology: Science and Practice,9(3), 249-255. Levine, E. S., Schmelkin, L. P. (2006). A move to prescribe: A change in paradigm.Professional Psychology: Research and Practice,37(2), 205-209. McGrath, R. (2010). Prescriptive authority for psychologists.Annual Review of Clinical Psychology, (6), 21-47. Retrieved from clinpsy.anualreviews.org Muse, M., Neel, R. E. (2010). Training comparison among three professions prescribing psychoactive medications: psychiatric nurse practitioners, physicians, and pharmacologically trained psychologists.Journal of Clinical Psychology, 66(1), 96-103. Robiner, W. N., Bearman, D. L., Bearman, M., Grove, W. M., Colon, E., Armstrong, J., Marack, S. (2002). Prescriptive authority for psychologists: A looming health hazard?Clinical Psychology: Science and Practice,9(3), 231-240. Stuart, R.B., Heiby E.E. (2007). To prescribe of not to prescribe: eleven exploratory questions. The Scientific Review of Mental Health Practices, 5(1),4-32. Wiggins, J. G., Wedding, D. (2004). Prescribing, professional identity, and costs.Professional Psychology: Research and Practice,35(2), 148-150. (McGrath, 2010) (Antonuccio, Danton McClanahan, 2003) (Wiggins Wedding 2004) (DeLeon, Dunivin Newman, 2002) (Caccavale, 2002) (Levine Schmelkin, 2006) (Robiner et al., 2002) (Muse Neel, 2010) (Stuart Heiby, 2007)

Philosophy: On the Elucidation of various Philosophers Essay

The Age of Reason is an impetus for arrival of new stance regarding cosmogenesis or natural philosophy since new scientific advancements are being discovered. During this time, Age of Reason becomes the emancipating precursor from shackles of dogmatism that held the classical skepticism and religious perspective of the cosmos. The principal precursor in the change of thought is Rene Descartes who rebels against the dogmatism of his present time, while providing valid arguments on doubting and on ideas in relation to Providence, thus his philosophy landscaped a new philosophical stance during the Age of Reason. Descartes is the first philosopher who goes against a prevalent thinking established during the Dark Ages, which only accepts ideas bounded by the church. Descartes’ definitive doubt is the mirror image of his definitive certainty. Having raised, as he claims, all possible doubts, he will be able subsequently to claim that whatever principles survive his skeptical scrutiny has been established with metaphysical finality. Classical skepticism, even if used as a methodological device, could support no such claim. With the emergence of a new idea, the balance, even if at present dramatically tipped, might always be restored or even tipped the other way. Ordinary doubting, and its sophisticated extension, classical isosthenia, are always contingent on the current state of knowledge. They offer no test for absolute certainty. The first point Descartes makes is that he cannot trust his senses without qualification, because they have often deceived him about objects that are barely perceptible or very far away. Nevertheless, this leaves untouched beliefs about objects close by and in plain view. To call these in question, he needs the dreaming argument. But even the dreaming argument, as Descartes understands it, leaves unscathed beliefs about things that are ‘very simple and very general’, and to undermine the credibility of these, he has to raise questions about his origin, nature, and relation to Providence, a line of thought encapsulated in the conceit of the evil deceiver. Moreover, even this final, hyperbolical doubt seems implicitly to concede Descartes some knowledge. This stratification of doubt imposes a corresponding stratification of knowledge. Through the progressive development of his doubt, Descartes effects a context- and subject-matter-independent partitioning of his beliefs into broad epistemological classes, ordered according to how difficult it is to doubt them. First in the order come the beliefs that are never doubted, subsequently to be identified as those that involve Descartes’ immediate knowledge of his own ‘thoughts’, whose exemption will be retrospectively justified on the grounds of their supposed incorrigibility. The progressive development of Cartesian doubt insinuates, without ever directly arguing for, a foundational conception of knowledge, the view of knowledge that sees justification as constrained by just the sort of context- and subject-matter-independent order of epistemic priority that is implicit in Descartes’ stratified doubt. One of the major criticisms in Descartes philosophical stance is its appeal to epistemological solipsism, which means that everything an individual thinks is to be considered as truth. In epistemological solipsism, all ideas that reside in the mind are indubitable truth, and those that exist in the external world are nothing but unnecessary hypothesis. The problem here is that Descartes failed to realize that the there is a certain extent wherein human mind cannot explain or elucidate certain ideas that can be elucidated through empirical ways. On Hegel Geist makes itself what it implicitly is, its deed, and its works; in that way it has itself before its own eyes as object. So is the spirit of a people. . . . In these its works, its world, the spirit of a people finds enjoyment of itself and is satisfied. Lectures on the Philosophy of History) We come to self-awareness by finding ourself in our ‘Other’, that which is distinct from us, set over against us. So if the Idea is to rise to self-consciousness, as the ultimate purpose of things demands, there will have to be something set in opposition to it which is its ‘Other’, and yet which is at the same time a reflection of it. And so there is: nature, concrete where the Idea is abstract, particular where it is universal, thing where it is thought, but none the less its embodiment and manifestation, in Hegel’s vocabulary ‘identical’ with it. Geist, the third element of the great triad, arises out of this opposition of intimately related items which provides the necessary basis for the emergence of self-consciousness. The better Geist’s grasp of this ‘identity’ the closer has the Idea come to full consciousness of its own essence. The dialectical progression which Hegel saw in cultural forms and social institutions, in short in the life of the human race, he also saw in the life of the individual; the fall from childhood happiness and its reattainment so hardly won, the suffering that goes with nobility of soul and the subsequent recovery of joy. He is also able to assimilate the story of the fall of man, treating it as mythical representation of aspects of the history of mankind which are then played out again in each human life. It tells of a fall from a state of unthinking, unknowing wholeness to one of separation and the pain that comes from consciousness of it. And in his diagnosis Hegel seizes another chance to link arms with a theme of romantic as well as religious literature: what brings this fall about is the increase of knowledge. ‘Would I had never gone to your schools! is Hyperion’s cry; and what so afflicted the graceful youth of Kleist’s tale was knowledge as well, the realization of his own beauty; for Schiller, writing ‘Die Gotter Griechen-lands’, it was the knowledge of the natural scientist which had banished spirit from the world and left it alien and hollow. Historicism for Hegel is defined as a means of understanding the world and all human activities in terms of the histo rical context of the world and such activities; anything is circumstantiated based on the history of a given phenomenon. Historicism is important because it concretized the mechanism of dialectical materialism such as the thesis, antithesis, and synthesis of the event. Organicism is a means of understanding a single developing organism operates on its interdependent parts, in order to grasp its whole meaning in terms of human psyche and behavior. Hegel develops this idea along lines indicated by his highly individual conception of logic and strongly encouraged by the communal romantic metaphysic. Precisely because the dialectic works, in Hegel’s view, with fluid boundaries, the connections it reveals to us are invisible to the understanding. Reason, by virtue of its appreciation of fluidity and its disdain for divisive conceptual barriers, in short by its acceptance of the romantic principle of Unity-in-Difference as a principle of logic, is to let us see the aspect of identity between items which Verstand had hitherto represented as unalterably different and opposed. Hegel’s dialectics influenced Karl Marx in conceiving a utopian society with his structuring of Dialectical Materialism. Hegel also influenced Marx in terms of his stance on master-slave relationship, which is viewed by the former as the prevalent form of government. Hegel rebels against it because the person is deemed as a thing. On Husserl My transcendental method is transcendental-phenomenological. It is the ultimate fulfillment of old intentions, especially those of English empiricist philosophy, to investigate the transcendental-phenomenological â€Å"origins† †¦ the origins of objectivity in transcendental subjectivity, the origin of the relative being of objects in the absolute being of consciousness. Husserl’s lectures of 1923–1924) Edmund Husserl’s transformation of phenomenology from an unfortunately named â€Å"descriptive psychology† to transcendental idealism thus extended the earlier critique of naturalism and psychologism in logic to philosophical naturalism generally. The crucial move in this transition is the methodological procedure of the pheno menological reduction, the suspending or â€Å"bracketing† or â€Å"putting out of action† all of the existential posits of the natural attitude. Considered as a â€Å"transcendental†, this operation first opens up the â€Å"absolute being of pure consciousness†, the â€Å"residuum of the world’s annihilation† (Residuum der Weltvernichtung). With it, phenomenology necessarily becomes transcendental inasmuch as phenomenological investigation is concerned to give an exhaustive description of this revealed region of â€Å"transcendental subjectivity† together with its structures of intentionality. Consequent to the phenomenological reduction, all reality (Realitat), ideal as well as actual, is exhibited as having being in virtue of â€Å"sense-bestowal† (Sinngebung), and indeed, the notion of an â€Å"absolute reality† independent of consciousness is as nonsensical as that of a â€Å"round square†. By the same token, â€Å"pure consciousness†, the ultimate origin of all â€Å"sense-bestowal†, â€Å"exists absolutely and not by virtue of another (act of) sense-bestowal†. It is the ultimate conferee of sense or meaning, the source of all representations, and so of all objectivity. Martin Heidegger position on second intuition is greatly influenced by Husserl. Like Husserl, Heidegger also espoused that in order to elucidate a phenomenon, one must take into account all the descriptive experience of that phenomenon, and this understood in Husserl’s term as intentionality and for Heidegger it is care. Hence, for Heidegger phenomenology is encapsulated in the catchphrase: â€Å"to the things in themselves†. Jean-Paul Sartre Transcendence of the Ego is greatly affected by Husserl’s intentionality. Sartre elucidates how the power of consciousness and intentionality can unravel or show the authenticity of object in relation to the being, and of course of the ontology of the being-for-itself. For Sartre, constitution should not be misconstrued as means of â€Å"creation† because the former should only be viewed in context of consciousness. Hence, constitution is a way of conceiving things that surrounds the being, or when being makes sense of the things that surrounds him/her. And through constitution, being is able to individuate himself/herself from other beings and the tings that surround the being. Thus, objects are elucidated in their own-ness and the object of consciousness is ego, which is a departure from Husserl. On the other hand, Soren Kierkegaard influenced Sartre in terms of objectification the being, which can lead to angst or nausea, and bad faith. Kierkegaard posits that the crowd can lead to the objectification of the being that can cause fear, and eventually leads to untruth. Sartre postulates that once the being is consumed by the others and being-in-itself, the being is automatically in bad faith and objectified, thus losing its authenticity. On Plato and Aristotle Plato’s theory of forms suggests that the world that we know of and that which we live in is not the real and objective world. This world is where the material objects exist, and the very material objects are not the essences of these very objects. Rather, in the Platonic view, real objects are the forms, such that latter is the very essence of these objects, that it is where objects of the material world are framed upon. These forms are not of this material world but exist instead in the world of forms or ideas. Thus, real knowledge for Plato is not the commonsensical notion of knowledge derived from what we directly experience through our senses but is rather the knowledge of the forms. To know and understand the forms is to know the very essence of things. Hence, this leads to the dichotomization of world of object and world of ideas, in which the latter is the end-all of all things, or the truth in-itself. Quite on the contrary, Aristotle believes that knowledge can be obtained empirically and that a grasp of the nature of things can be acquired through careful observation of phenomena. The senses of man, then, pose great centrality to Aristotle’s method of arriving at the understanding of objects. Through the use of sensory perception, one can obtain the critical facts which are directly observable from the object and are constitutive of its physical existence. The observation on objects allows one to acquire the basic information about the object. The corresponding sensory experience on the object creates the very core of what seems to be the ultimate components that comprise the very form of the object of the perception. The way the objects represent themselves before the senses is the real way things are as they are. Roughly speaking, the very form of the object is its unique characteristic which is primarily constitutive of its overall existence. The very essence of objects for Aristotle cannot be separated from the object itself and, hence, the way to understand the essence of a thing is to experience the object through sensory perception. Aristotle tries to arrive at generalizations out of specific observations. More generally, he attempts at proceeding to the general knowledge on the essences of things from an analysis of specific phenomena. This ascent from particulars to generalizations is considered to be inductive in principle and deductive to a certain extent since these generalizations derived can then be utilized as the general claim upon which specific claims can be inferred from. Yet, broadly speaking, Aristotle’s logic revolves around the notion of deduction (sullogismos). Aristotle then says of deduction: A deduction is speech (logos) in which, certain things having been supposed, something different from those supposed results of necessity because of their being so. (Prior Analytics I. 2, 24b18-20) Thus, the form of an object for Aristotle is its specific characteristic, its very essence or essential attribute manifested by its physical existence or the very fact that it is tangible, and this we can derive principally through the use of deduction and of logic in general to our immediate sensory perception of objects. On the other hand, Plato’s method of philosophizing is seen to be as deductive in nature. From an understanding of the universals or generalizations, specifically that of the forms, man can derive the particulars through contemplation on the objects, objects which are mere imitations of the forms in the Platonic sense. Thus, Plato’s mode of inference can be seen as a descent from the general a priori principles down to the specifics.

The No Child Left Behind ( Nclb ) Act Of 2001 Essay

The United States Constitution is silent on the role of the federal government in public education. Thus, each state and locality has assumed the responsibility of educating their children. The role of the federal government is largely to support the states in this extremely important endeavor, as long as each state does their job effectively. Several events, such as Sputnik and the A Nation at Risk report, have led to the federal government increasing their role in public education. The disparity in the quality of education among states and deficiencies in equitable learning among sub groups has amplified the involvement of the United States government in public education. This trend reached its climax with the implementation of the No Child Left Behind (NCLB) Act of 2001. Over a decade has passed since the full implementation of this landmark legislation and many involved in education and pondering the true success of the program. Has the NCLB agenda improved the quality o f learning in America or created a culture of failure that is hindering the efforts of educators? The primary goal of NCLB was to create a unified set of standards that would provide an equal measuring stick for each and every student, regardless of their ethnicity or educational classification. This structure, in theory, should clearly define the content and level of comprehension expected for each child. High stakes assessments would be the gauge to determine adequate levels ofShow MoreRelatedThe No Child Left Behind Act Of 2001 ( Nclb )1007 Words   |  5 PagesGeorge W. Bush is the No Child Left behind Act of 2001 (NCLB). This is a landmark educational reform designed to improve student achievement and drastically change the culture of American’s schools. 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Effects Of Children s Television On Language Development...

Nelson and Co. reported that children between the ages of two and five watched television on average 32 hours a week - an eight year high. Parents’ opinions on their children’s television viewing has contributed to this upward trend. In 2014, the Joan Ganz Cooney Center surveyed 1,557 parents of children between the ages of 2 and 10; they found that 44% of parents believed that children’s television enhanced learning. In addition, the center reported that 78% of parents of children between the ages of two and five believed that educational television improved their children’s language and cognitive development. The burgeoning years of language development are not only capricious and vulnerable in nature, but they are also easily influenced by external factors. Therefore, it is imperative to evaluate the effects of children’s television on language development. Children’s television negatively impacts language development because it impedes wo rd acquisition, delays language acquisition and negatively affects literacy outcomes. Educational television negatively impacts language development because it hampers vocabulary acquisition. Vocabulary acquisition is characterized by an infant’s first words and word spurt (i.e., the rapid growth in a child’s vocabulary). Zimmerman, Christakis and Meltzoff (2007) investigated the relationship between media exposure and language development in children under two years of age. 1,008 parents of children between the ages of two months andShow MoreRelatedIs Entertainment Technology Beneficial?902 Words   |  4 Pageshas a negative side effect to the conveniences of it. 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When they want something some might point to the subject, some might scream or cry. Smiling is the more common way to show happiness. Obviously crying is an indication of problems such as hunger, thirst, or sleep. However, when they grow up they start to speak. EspeciallyRead MoreThe Social And Emotional State Of Good Tv Shows1243 Words   |  5 PagesMichelle Seiler 11-11-15 Child Development #10 Do you know what your kids are watching on TV these days? My topic is What is the social and emotional state of good TV shows vs bad TV shows. I think my topic is important because TV is very influnetly to children. There are many positive aspects of good TV shows. It can promote early reading, teach songs, and teach good values children need in life. The negative aspects of bad TV shows are that it can teach children bad language, violence, and inappropriateRead More Censorship on Television Essay1204 Words   |  5 PagesThe government is correct in trying to censor what is seen on television. Censorship does not violate the first amendment and it prevents the harmful effects of graphic television. Many people are in favor of censorship and it may be accomplished without violating the rights of broadcasters or any other individuals. Censorship refers to suppression of information, ideas, or artistic expression by anyone, whether government officials, church authorities, private p ressure groups, or speakers, writersRead MoreWhatever Hapenned to Morality and Values on Television1206 Words   |  5 PagesI walked into my living room, plopped down on the couch and picked up my television remote. When I turned on the television I arrived just in time to witness a man being violently shot in the head as a product of a drive by shooting. To my dissatisfaction, I quickly changed the channel to the supposedly child friendly Cartoon Network to view a more decent program. Unfortunately, not even Cartoon Network could save me from the hideous and gruesome truth of the society need for violence. The creaturesRead MoreThe Is The Method Of Human Communication1510 Words   |  7 Pageswatching useless junk that wouldn’t benefit them for later on in their life? Yes they’re children and it wouldn’t matter as much in that moment, but still it’s not beneficial and it won’t help them. They could spend their time doing something more helpful that could actually help them later in life like interacting with another kid or talking to their parents. As defined by Webster’s Dictionary, television is a system for transmitting visual images and sound that are reproduced on screens, andRead MoreManaging Your Child’S Media Use In Three Easy Steps. It’S1638 Words   |  7 Pagesover five million results, all of which offer their own two cents about the ideal way to raise children in the digital world. How could anyone possibly navigate his or her way through that? What is one supposed to make of constantly changing information regarding healthy media habits? I’m here to offer three simple steps parents can take to solve the problem of how to use media with your young children. Be educated. Be smart. And don’t be afraid. The first step--becoming educated--is by far the most