When clinicians discuss psychotropic drugs with prescribers, their approach is often cautious and nuanced. This caution can stem from various factors, including their educational background, the environment in which they practice, and their adherence to professional codes of ethics. Each of these elements plays a significant role in shaping how comfortable and competent a clinician feels in engaging in conversations about psychotropic medications.
The Role of Educational Background
A key reason why clinicians may be hesitant to discuss psychotropic medications is their educational background. A study by Hernandez and Doherty (2005) found that the likelihood of a client being recommended psychotropic medications correlates strongly with the clinician’s educational training. The study revealed that clinicians with a Marriage and Family Therapy (MFT) educational background were less likely to have clients on medication than those with broader educational training in fields such as psychology, social work, nursing, or counseling. This suggests that the specific focus of an MFT education might not emphasize the use of psychotropic drugs as part of treatment, whereas clinicians with more interdisciplinary backgrounds may feel more comfortable with this option.
Practice Setting and Its Influence on Medication Discussion
Another important factor is the clinical setting in which the therapist works. Hernandez and Doherty’s research indicated that 71% of therapists who reported medicating clients worked in private practice settings. This statistic suggests that private practitioners may encounter fewer institutional barriers to discussing medication with prescribers. In contrast, clinicians working in larger organizations or clinics may be bound by more stringent rules, policies, or even philosophical stances that limit their engagement in medication discussions. These clinicians might feel less empowered or obligated to bring up psychotropic medications, especially if they believe it falls outside their professional role.
Collaboration and Ethical Considerations
When a clinician does engage in discussions about psychotropic medications, collaboration with the prescribing provider is crucial. Both parties must bring their expertise and familiarity with the client to the conversation to determine the best treatment plan. Mutual respect and understanding of each professional’s scope of practice are essential for this collaboration to be effective.
This is underscored in the American Counseling Association (ACA) Code of Ethics (2014), which stresses the importance of forming collaborative relationships with colleagues from other disciplines. Section D of the ACA Code highlights that clinicians must respect other approaches to client care and actively participate in interdisciplinary discussions to best serve their clients. In this context, harassing or undermining colleagues acting in a responsible and ethical manner is discouraged, and the focus should remain on cooperative treatment planning.
Competence and Scope of Practice
Another aspect that contributes to clinicians’ hesitation is concern about competency and scope of practice. Some clinicians might worry that discussing psychotropic medication falls outside their area of expertise. The American Association for Marriage and Family Therapy (AAMFT) Code of Ethics explicitly states that MFTs should not diagnose, treat, or offer advice outside their recognized competencies (AAMFT, n.d.). Similarly, the ACA Code of Ethics (2014) in Section C.2.a reinforces the idea that counselors should only practice within their competencies, which are determined by their education, training, and supervised experience. Given these clear boundaries, it’s understandable that some clinicians would be cautious about recommending psychotropic medications, even in collaboration with a prescriber, if they feel it exceeds their professional knowledge.
Conclusion
In summary, clinicians’ caution in discussing psychotropic medications with prescribers is influenced by multiple factors, including their educational background, work environment, and ethical considerations. Clinicians must balance their responsibility to the client with their professional competencies, ensuring that they remain within their ethical and legal boundaries. Collaboration with prescribers, when done with mutual respect and clear communication, can result in better, more holistic care for clients. However, the varying levels of comfort with these discussions are shaped by a clinician’s specific training and the guidelines laid out by professional codes of ethics.
References
American Counseling Association. (2014). ACA Code of Ethics.
https://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-codeof-ethics.pdf?sfvrsn=55ab73d0_1
Code of Ethics. (n.d.). https://www.aamft.org/Legal_Ethics/Code_of_Ethics.aspx
Hernandez, B. C., & Doherty, W. J. (2005). Marriage and family therapists and psychotropic medications: Practice patterns from a national study. Journal of Marital and Family Therapy, 31(3), 177–189. https://doi.org/10.1111/j.1752-0606.2005.tb01562.