Do Clinical Psychologists Have a Role in Clients' Use of Psychotropic Medication?: A Mixed Methods Investigation Exploring Current Forms of Involvement

Background: Involvement with psychotropic medication is not traditionally viewed as an aspect of the clinical psychologist’s job, and there are currently no professional guidelines advising on a role. International research suggests that psychologists are likely to encounter a variety of opportunities to become involved, and are frequently (indirectly) involved in the process of prescribing and managing of clients’ psychotropic medications. There is a lack of research into psychologists’ involvement with psychotropic medication in the United Kingdom (UK), but given the widespread use of psychotropic medication similar opportunities and practice may occur. The collective clinical psychology profession is also taking an increased stance against biological approaches towards mental health, such as issuing guidance on use of diagnosis and promoting movement away from its use. The question remains as to whether the professional movement with diagnosis extends into any role with psychotropic medication, be this a critical stance or any other. Aims: This study aimed to explore whether clinical psychologists in the UK have a role with their client’s psychotropic medication by exploring forms of involvement undertaken, and decision-making behind involvement. Method: A mixed method design was employed; 147 clinical psychologists took part in an online survey, and 11 respondents were interviewed. Descriptive statistics, logistic regression, and thematic analysis were used to analyse the quantitative and qualitative data respectively. Results: Results suggest that clinical psychologists are engaging in various forms of involvement with medication on a regular basis, often with intent to influence prescribing based on their agendas. A thematic map was created identifying a process by which clinical psychologists weigh up factors prior to deciding to have involvement in order to establish their rationale, and then flexibly navigate their approach and actions. This all occurs within the context of professional uncertainty and conflict, under dominant societal narratives around epidemiology of mental health difficulties and the effectiveness of medication. Following involvement, participants reflected on their strategy which led them to consider future approaches. Conclusions and Recommendations: Findings echo previous international research; clinical psychologists recruited in the study are regularly engaging in roles with their client’s psychotropic medication. This is despite lack of guidance from professional bodies, no professional position statement, and minimal (or no) teaching during training. To the author’s knowledge this is the first study to explore the topic area within the UK. Study findings are considered important due to uncovering the extent to which involvement forms part of the role, which was previously unknown. Findings translate into two main clinical implications: 1) supporting the idea of training on psychotropic medication for clinical psychologists, and 2) professional guidance to inform clinical psychologists’ practice