Dr Alice Horton, one of our counselling psychology alumni, has recently published the research she carried out for her Doctorate in the journal: Advances in Mental Health. The research was supervised by PSRG members: Miltos Hadjiosif and Miles Thompson.
The research is titled: Gaining prescription rights: a qualitative survey mapping the views of UK counselling and clinical psychologists. It explores whether clinical and counselling psychologists should be able to prescribe medication for mental health conditions. In the UK, this is currently something that only psychiatrists and other non-medical prescribers can do. However, psychologists gaining prescription rights is something that the British Psychological Society (BPS) has been exploring. As a result, this mainly qualitative study surveyed UK-based, qualified counselling and clinical psychologists to gather their views on this possibility.
The study collected data from 82 participants, of whom 37 were counselling and 45 were clinical psychologists. Participants completed an online survey to gather their thoughts and feelings on this important issue. Providing a snapshot of their overall views, one question asked ‘Overall, do you think psychologists should gain prescription rights?’ Of the 82 participants: 18 (22%) answered yes; 42 (51.2%) answered no; and 22 (26.8%) were unsure. While most participants answered no, just over a fifth answered yes, with a quarter remaining unsure.
More nuanced feedback is found in the three themes reported in the study:
- Theme 1: Prescription rights: A crossroads in our identity
- Theme 2: If the drugs (don’t) work, I should(n’t) prescribe them
- Theme 3: The cost of power
In short, theme 1 explores how gaining prescription rights would be a significant departure from current practice. It would have implications for who psychologists are, what they do, and the values that underpin the profession. The theme discusses how psychologists grapple with their professional identity within structures dominated by the medical model of distress, and how various framings of the prescription rights debate point towards a crossroads for both discipline and profession.
Theme 2 explores participants’ views about psychiatric drugs and how they seem to serve as a springboard for their views on the prescription rights debate. In other words, participants’ assumptions about psychiatric drugs seem to influence whether or not they believe psychologists should gain prescription rights.
Finally, theme 3 examines how gaining prescription rights might mean psychologists gain increased status and power in the workplace and wider society. The theme also discusses the current level of confidence (or lack of) in the profession and what might be gained or lost as a result of gaining these rights.
In the discussion, the authors advocate for increased criticality in how UK psychology continues to consider this issue. They note that wider issues like understaffed mental health services and broader social issues such as income inequality contribute heavily to the burden of mental health and are unlikely to be shifted by the profession gaining prescription rights.
They note that relational therapeutic work calls for disentanglement from both the mainstream medical model and the ‘expert/doctor’ position. And that prescribing psychologists risk becoming further entrenched in both if the profession goes down that route.
They also highlight the risk of taking an “optionality approach”. If psychologists do take on prescribing rights, it will be an option, requiring individuals to pursue further training. Those who want to do it can, those who don’t, won’t have to. While this sounds like a sensible individual choice – the authors worry about the wider implications for the entire profession, and how over time, it may mean that all psychologists have to gain prescription rights to remain competitive for job roles.
The published article is open access, so it can be freely read and downloaded by anyone at this link.