Prescribing Psychologists in Integrated Primary Care: Introduction to the Special Section

The authority to prescribe could differentiate psychologists from other non-physicians in primary care, achieving a significant step for the growth of our profession. Psychologists are currently prescribing in primary care settings in a number of public service venues, as well as medical school training facilities. In this Special Section of the Journal of Clinical Psychology in Medical Settings, results of a survey of physicians working with a prescribing psychologist indicate that the psychologist is highly valued and seen as a competent prescriber. A series of papers providing case examples demonstrate how psychologists are evolving in these new clinical roles, as well as participating in behavioral and psychopharmacology training of primary care physicians.     

The Primary Care Prescribing Psychologist Model: Medical Provider Ratings of the Safety, Impact and Utility of Prescribing Psychology in a Primary Care Setting

Family medicine providers at a large family medicine clinic were surveyed regarding their impression of the impact, utility and safety of the Primary Care Prescribing Psychologist (PCPP) model in which a prescribing psychologist is embedded in a primary care clinic. This article describes the model and provides indications of its strengths and weaknesses as reported by medical providers who have utilized the model for the past 2 years. A brief history of prescribing psychology and the challenges surrounding granting psychologists the authority to prescribe psychotropic medication is summarized. Results indicate family medicine providers agree that having a prescribing psychologist embedded in the family medicine clinic is helpful to their practice, safe for patients, convenient for providers and for patients, and improves patient care. Potential benefits of integrating prescribing psychology into primary care are considered and directions for future research are discussed.     

Application of the APA ethics code for psychologists working in integrated care settings: Potential conflicts and resolutions

ABSTRACT

Increasingly, there is evidence of the potential benefits of an integrated care model. In fact, the American Psychological Association (APA) supports the role of psychologists in integrated healthcare given the positive outcomes for patients in primary care settings such as increased access to mental health services, reduced mental illness stigma, and improved health associated with recognizing the impact of psychosocial factors on physical wellbeing. Less attention has been paid, however, to ethical dilemmas that may arise for psychologists working in integrated healthcare. This paper explores considerations for resolving potential ethical conflicts that may arise for psychologists working in integrated care settings.     

The Future of Psychology in Medical Specialities: Introduction to the Special Issue

The continuing evolution of the health care delivery system in the United States presents threats and opportunities to psychologists in medical settings. This special issue explores the future of psychology in psychiatry, family medicine, rehabilitation, geriatric medicine, and pediatric medicine. The challenges facing neuropsychology and pain management are explored also. Finally, the professional issues of ethics in managed care, psychology in the public sector, and training future psychologists are addressed. Each paper summarizes concerns and provides recommendations for clinical practice, research, and training.     

Primary Care Prescribing Psychologists in the Indian Health Service

Some of the largest health care disparities are those related to services for American Indians and Alaska Natives (AI/ANs), who show significantly greater prevalence for diabetes, coronary heart disease, smoking, obesity, heavy alcohol use, depression, and PTSD than the general population. Given the recognition of the behavioral components of all of these conditions, the Indian Health Service, the federal agency responsible for providing comprehensive health care services to AI/ANs, has been focusing on increasing the integration of behavior health and primary care. One innovation has been to hire prescribing psychologists on primary care teams. This paper describes the role of a prescribing psychologist on three treatment teams at an IHS facility in Montana. Prescribing psychologists in the Indian Health Service can serve as valuable members of comprehensive care teams, providing exceptional wrap-around care for some of our most vulnerable and underserved citizens. This model could be an example of how a prescribing psychologist could contribute to primary care clinics in a variety of other settings.     

Rediscovering James' Principles of Psychology

This paper is an introduction to a special issue celebrating the 125^th anniversary of William James' Principles of Psychology. The special issue demonstrates the continued relevance and insight offered by James. It reviews the articles in this issue and delineates three main themes: (1) he recognition of the inherent relationality of psychological phenomena, (2) a science of psychology ought to include biology and sociocultural phenomena (e.g. language); and (3) human consciousness is addressed as the flow of experience from the perspective one living it. It discusses each theme and briefly touches on how they continue to be developed in James' later work, which also provides innovative new directions for psychologists. Undergirding each of these contributions is James' admonition that psychological research is especially difficulty due to the complexity of psychological phenomena. As such, this paper also discusses challenges to doing psychological research that James raises and his ideas that can inform future endeavors.     

Women And Depression: Introduction

Although women's 2 to 1 likelihood of developing a depressive disorder is a well-established fact, research over the last decade has expanded our knowledge of risk factors and issues of treatment and service delivery. The American Psychological Association convened an interdisciplinary Summit in 2000 on Women and Depression to examine these findings and to make recommendations on future research and policy needs, and to highlight treatment implications. This special section contains five articles from the Summit addressing a range of issues, including the relationship between women's depression and their lesser power and status in society (resulting in physical and sexual abuse and poverty), and the menstrual cycle and depression. Additionally, the special section includes articles on the rehabilitation of women with depression and treatment of depressed women in primary care settings.     

Interprofessional Education: Preparing Psychologists for Success in Integrated Primary Care

Rapidly occurring changes in the healthcare arena mean time is of the essence for psychology to formalize a strategic plan for training in primary care settings. The current article articulates factors affecting models of integrated care in Academic Health Centers (AHCs) and describes ways to identify and utilize resources at AHCs to develop interprofessional educational and clinical integrated care opportunities. The paper asserts that interprofessional educational experiences between psychology and other healthcare providers are vital to insure professionals value one another’s disciplines in health care reform endeavors, most notably the patient-centered initiatives. The paper highlights ways to create shared values and common goals between primary care providers and psychologists, which are needed for trainee internalization of integrated care precepts. A developmental perspective to training from pre-doctoral, internship and postdoctoral levels for psychologists in integrated care is described. Lastly, a call to action is given for the field to develop more opportunities for psychology trainees to receive education and training within practica, internships and postdoctoral fellowships in primary care settings to address the reality that most patients seek their mental health treatment in primary care settings.     

Community Psychology and Global Climate Change: Introduction to the Special Section

Global climate change is not just a distant environmental or future problem but a crisis that has a clear human face already causing the suffering of millions around the globe. It is an issue of high relevance for community psychologists and the communities we work with but has received little attention within the field of community psychology. This special section is intended to promote more thinking and dialogue on this important topic. Six articles are presented that feature both theoretical consideration and empirical research related to global climate change and related environmental issues.     

Introduction to the Special Section on Teaching,Training, and Supervision in Personality and Psychological Assessment

This special section contains empirical and conceptual articles pertaining to the broad topic of teaching, training, and supervision of assessment. Despite some evidence of a decline in recent decades, assessment remains a defining practice of professional psychologists in many subfields, including clinical, counseling, school, and neuropsychology, that consumes a consequential proportion of their time. To restore assessment to its rightful place of prominence, a clear agenda needs to be developed for advancing teaching and training methods, increasing instruction to state-of-the-art methods, and defining aims that could be elucidated through empirical inquiry. The 7 articles in this special section provide a developmental perspective of these issues that collectively provide practical tools for instructors and begin to set the stage for a research agenda in this somewhat neglected area of study that is vital to the identity of professional psychology. Additionally, 2 comments are provided by distinguished figures in the field concerning the implications of the articles in the special section to health services psychology and the competencies-based movement in applied psychology.     

Pain assessment: state-of-the-art applications from the cognitive-behavioural perspective

This brief report highlights some basic issues in pain assessment. This serves to set the stage for the articles that are presented in this issue of the Behavioral Assessment section. Topics covered include an overview of the cognitive-behavioural perspective, consideration of important dimensions for assessment, and a summary of some of the key issues affecting the state-of-the-art. An overview of the articles that follow as well as future research directions are also presented.