Prescriptive authority and psychology: A Delphi study.

Even though the American Psychological Association has formally endorsed that appropriately trained psychologists be afforded prescriptive authority (APA, 1996b, 1996c), this issue continues to be divisive within the profession. In an attempt to further assess disagreement between psychologists regarding this issue as well as explore areas of agreement, a two round Delphi study was used to predict the probability and desirability of specific occurrences if prescriptive authority is obtained within the next 10 years. A 37 statement Delphi questionnaire was developed from the literature addressing psychologists obtaining prescriptive authority. Twenty-two experts (11 in favor of psychologists obtaining prescriptive authority and 11 opposed) were asked to participate in the study. These participants were chosen as experts because each had either published an article addressing the subject of psychologists obtaining prescriptive authority or, in some way, had made a significant contribution to this proposed practice extension. Experts were requested to rate each statement according to both its probability and desirability of occurring within the next ten years. Experts were also encouraged to make comments in support of their responses. An ANOVA for repeated measures (P =.01) was used to compare differences between round one and round two results, as well as disagreement between experts for probability and desirability of a statement occurring for second round results. Agreement between experts for a specific statement was defined as those statements showing a standard deviation of less than one for second round results. No significant differences were found between round one and round two responses for experts, suggesting that round one responses were independent and did not influence round two responses. In general, disagreement between experts mirrored the opposing arguments in the literature addressing prescriptive authority and those opposed agreed that several specific occurrences would be undesirable and should be avoided if psychologists obtained prescriptive authority within the next ten years. In conclusion, it was suggested by this author that an addendum to formally address psychopharmacological treatment standards could be added to the Ethical Principals of Psychologists in an attempt to address the major concerns of both those in favor of and those opposed to psychologists obtaining prescriptive authority. Those major concerns were identified as being those potential future occurrences which both the pro and con experts of this study agreed should be avoided