Medical psychology

Medical psychology is the application of psychological principles to the practice of medicine for both physical and mental disorders. The American Psychological Association (APA) defines medical psychology as "that branch of psychology that integrates somatic and psychotherapeutic modalities into the management of mental illness and emotional, cognitive, behavioral and substance use disorders". A medical psychologist does not automatically equate with a psychologist who has the authority to prescribe medication.[1] Psychologists who hold prescriptive authority for specific psychiatric medications such as antidepressants and other pharmaceutical drugs must first obtain specific qualifications in Psychopharmacology.[2]

Medical psychologists apply psychological theories, scientific psychological findings, and techniques of psychotherapy, behavior modification, cognitive, interpersonal, family, and life-style therapy to improve the psychological and physical health of the patient. Psychologists with post doctoral specialty training as medical psychologists are the practitioners with refined skills in clinical observation in of the field of psychology, learning, central nervous system adaptation and change, and adaptation and lifestyle change applying a number of different methods in several different mediums of treatment. Highly qualified and post graduate specialized doctors are trained for service in primary care centers, hospitals, residential care centers, and long-term care facilities and in multidisciplinary collaboration and team treatment. They are trained and equipped to modify physical disease states and the actual cytoarchitecture and functioning of the central nervous and related systems using psychological and pharmacological techniques (when allowed by statute), and to provide prevention for the progression of disease having to do with poor personal and life-style choices and conceptualization, behavioral patterns, and chronic exposure to the effects of negative thinking, choosing, attitudes, and negative contexts.[3]

Behavioral medicine

Behavioral medicine (related to behavioral health, clinical health psychology and psychosomatic medicine) is a related branch of clinical practice in which psychologists emphasize the biopsychosocial approach to medicine, a model which recognizes the importance of addressing the interaction between physical, psychological and social factors in both the prevention and management of disease. Practitioners of behavioral medicine differ from medical psychologists in that they focus on the scientific application of behavioral interventions to a wide variety of medical conditions (e.g., asthma, gastrointestinal illnesses, cardiac conditions, spinal cord and brain injuries, chronic pain, headaches, and addictive illness).

Certifications

The Academy of Medical Psychology defines medical psychology as a specialty trained at the post doctoral level and designed to deliver advanced diagnostic and clinical interventions in Medical and Healthcare Facilities utilizing the knowledge and skills of clinical psychology, health psychology, behavioral medicine, psychopharmacology and basic medical science. The Academy of Medical Psychology makes a distinction between the Psychopharmacologist who is a psychologist with advanced training in psychopharmacology and may prescribe medicine or consult with physician or nurse practitioner prescribers to diagnose mental illness and select and recommend appropriate psychoactive medicines, and the Medical Psychologists who are prepared to do the psychopharmacology consulting or prescribing, but also must have training which prepares them for functioning with Behavioral and Lifestyle components of physical disease and functioning in or in consultation with multidisciplinary healthcare teams in Primary Care Centers or Community Hospitals in addition to traditional roles in the treatment of mental illness and substance abuse disorders. The specialty of Medical Psychology and this distinction from Psychopharmacologist is recognized by the National Alliance of Professional Psychology Providers (the psychology national practitioner association; see www.nappp.org).[3]

A specialty of medical psychology has established a specialty board certification, American Board of Medical Psychology and an Academy of Medical Psychology requiring a doctorate degree in psychology and extensive post doctoral training in the specialty and the passage of an oral or written examination.

Although the Academy of Medical Psychology defines medical psychology as a "specialty" and has established a "specialty board certification," and is recognized by the national psychology practitioner association (www.nappp.org) there is a split in national psychology associations between NAPPP and APA and the American Psychological Association and the National Alliance of Professional Psychology Providers do not currently recognize the same specialties with the APA being a group that represents scientists, academics, and practitioners (as a minority) and NAPPP being an organization that represents only practitioners. However, Louisiana does recognize and restricts the term and practice of medical psychology by statute (the Medical Psychology Practice Act) as a "profession of the health sciences" with prescriptive authority. It is equally important to note than the American Psychological Association does not recognize that the term medical psychology has, as a prerequisite, nor should the term be equated with having, prescriptive authority.

In 2006, the American Psychological Association (APA) recommended that the education and training of psychologists, who are specifically pursuing one of several prerequisites for prescribing medication, integrate instruction in the biological sciences, clinical medicine and pharmacology into a formalized program of postdoctoral education. In 2009, the National Alliance of Professional Providers in Psychology recognized the education and training specified by the American Board of Medical Psychology (www.amphome.org; ABMP) and the Academy of Medical Psychology as the approved standards for post graduate training and examination and qualifications in the nationally recognized specialty in Medical Psychology. Since then numerous hospitals, primary care centers, and other health facilities have recognized the ABMP standards and qualifications for privileges in healthcare facilities and verification of specialty status.

The following Clinical Competencies are identified as essential in the education and training of psychologists, wishing to pursue prescriptive authority. These recommended prerequisites are not required or specifically recommended by APA for the training and education of medical psychologists not pursuing prerequisites for prescribing medication.:

I. Basic Science: anatomy, & physiology, biochemistry;

II. Neurosciences: neuroanatomy, neurophysiology, neurochemistry;

III. Physical Assessment and Laboratory Exams: physical assessment, laboratory and radiological assessment, medical terminology;

IV. Clinical Medicine and Pathophysiology: pathophysiology with emphasis on the principal physiological systems, clinical medicine, differential diagnosis, clinical correlation and case studies, chemical dependency, chronic pain management;

V. Clinical and Research Pharmacology and Psychopharmacology: pharmacology, clinical pharmacology, pharmacogenetics, psychopharmacology, developmental psychopharmacology;

VI. Clinical Pharmacotherapeutics: professional, ethical and legal issues, combined therapies and their interactions, computer-based aids to practice, pharmacoepidemiology;

VII. Research: methodology and design of psychopharmacology research, interpretation and evaluation, FDA drug development and other regulatory processes.

The 2006 APA recommendations also include supervised clinical experience intended to integrate the above seven knowledge domains and assess competencies in skills and applied knowledge.

The national psychology practitioner association (NAPPP; www.nappp.org) and top national certifying body (Academy of Medical Psychology; www.amphome.org) have established the national training, examination, and specialty practice criterion and guidelines in the specialty of Medical Psychology and have established a national journal in the specialty. Such certifying bodies, view psychopharmacology training (either to prescribe or consult) as one component of the training of a specialist in Medical Psychology, but recognize that training and specialized skills in other aspects of the treatment of behavioral aspects of medical illness, and mental illness affecting physical illness is essential to practice at the specialty level in Medical Psychology. The Louisiana Academy of Medical Psychology (LAMP), currently the largest organization of psychologists with prescriptive authority in the world and the only organization representing practitioners of medical psychology in Louisiana as defined by Louisiana statute within any jurisdiction in the United States, no longer recognizes the Academy of Medical Psychology as an adequate certifying body for its practitioners, and its members have resigned from the Academy of Medical Psychology en masse. Similarly, virtually all members of LAMP have also resigned from the Louisiana Psychological Association (LPA) after many LPA members uncovered that the LAMP's prescriptive authority movement covertly came to an agreement with Louisiana's medical board to transfer the entire practice of psychology for psychologists with prescriptive authority to the medical board. Louisiana is the only state in which the practice of psychology, including psychological testing, psychotherapy, diagnosis, and treatment for some psychologists (i.e., medical psychologists) is regulated by a medical board.

See also

References

  1. ↑ Moore, B. & Muse, M. (2012). Handbook of Clinical Psychopharmacology for Psychologists. Wiley.
  2. ↑ http://www.pprpsych.com/psychopharm-courses
  3. 1 2 http://www.health-psych.org/MedPsych.cfm

External links

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