Practitioner Update, February/March 1999
Public Relations and Communications
Practice Directorate

Last December, Guam became the first jurisdiction of the United States to enact legislation granting limited prescription privileges to clinical psychologists. The Guam legislature unanimously overrode a gubernatorial veto in the final hours of its 1998 session to pass the bill.

Guam psychologists who seek to prescribe must do so under a "collaborative practice agreement" with a licensed physician who, according to the statute, "practices in the area of specialty." To qualify for prescriptive authority, practitioners must submit for approval to three designated boards a scope of practice description and a list of drugs routinely administered within their scope of practice that they are competent to prescribe. Interested psychologists must also provide proof that they have completed a "nationally and professionally accepted pharmaceutical curriculum in the area of clinical mental health psychology."

The Practice Directorate helped advocate for passage of the prescription privileges law through correspondence with members of the Guam legislature. APA Executive Director for Professional Practice Russ Newman, Ph.D., J.D., addressed the need for appropriate and effective psychoactive medication, obstacles to patient access and the role that trained psychologists can play in filling the gap. Dr. Newman’s letter also discussed organized psychiatry’s history of strident opposition to evolving professional roles for psychologists such as gaining prescriptive authority.

The recent development in Guam ushered in a year when the directorate’s legal and regulatory affairs staff anticipates increasing state-level activity related to securing prescription privileges for licensed psychologists. Directorate attorneys are aware of nearly 20 state psychological associations that have organized activities planned for 1999. These include introducing or reintroducing legislation, developing and implementing postdoctoral training curricula in psychopharmacology, sponsoring continuing education activities for practitioners and building support for psychology’s agenda throughout the health care community.

To provide coordinated technical guidance at the national level and to assist states that elect to pursue prescription privileges activities, the APA Committee for the Advancement of Professional Practice (CAPP) has established a Prescription Privileges Subcommittee. Further, APA President-elect Patrick H. DeLeon, Ph.D., MPH, J.D., has identified prescriptive authority for psychologists as a major priority for his presidential year in 2000. Dr. DeLeon recently created a working group on prescription privileges to plan initiatives consistent with CAPP and Practice Directorate activities in this area.