Can counselors help patients by prescribing medicine, or are they limited to talk therapy services? This is an important question for anyone considering a career in psychology, counseling or social work. Most therapists cannot prescribe medication, but there are exceptions based on area and training. Here's a complete breakdown of who can and cannot approve patients for prescription mental health medications.
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The majority of mental health providers in the United States are social workers. These professionals can become Licensed Clinical Social Workers (LCSWs) after completing a master of social work (MSW) degree and an extensive practicum. Social workers cannot prescribe medication in any state, and this is unlikely to change. Because social workers receive limited medical training, they don't have the knowledge base necessary for prescribing powerful medications. However, many LCSWs work in group practices and can partner with other mental health professionals to ensure patients get all available treatments. Social workers generally earn the least of all graduate-level therapists.
Licensed medical doctors can prescribe medications of any kind to their patients. General practitioners, sometimes called family doctors, provide many prescriptions for anti-depression and anti-anxiety medications but don't offer extensive counseling services. One field of medicine, psychiatry, focuses on mental health issues. Psychiatrists provide counseling and medication management. In larger facilities and offices, a psychiatrist might concentrate on prescription management and leave the talk therapy to other mental health providers. That's because focusing on prescriptions often brings in more revenue per hour than counseling sessions. Psychiatrists have the highest earning potential out of all therapist career options.
According to the APA Practice Organization, only four states allow psychologists to prescribe medications to patients. Proponents of giving prescriptive authority to psychologists say that the growing mental health crisis in the United States needs to be addressed, and psychologists have advanced training in mental health management. Opponents argue that psychology coursework does not cover pharmacology or physical health, so psychologists might not understand the full risks of certain medications. For now, psychologists who want to prescribe medications must practice in Iowa, Illinois, Louisiana, New Mexico or Guam and take additional classes.
Advanced Practice Psychiatric Nurses
After earning a master's degree in nursing (MSN), nurses can become eligible to prescribe medication to patients. In mental health, Registered Nurses (RNs) study to become Clinical Nurse Specialists (CNSs) or Nurse Practitioners (NPs). Some universities offer specialized degrees in psychiatric nursing, but all CNSs and NPs can prescribe psychiatric medications. Advanced practice nurses have great flexibility in the roles they seek. Some may follow a path similar to psychiatrists and focus on medication management or advanced mental health cases. Other nurses are more interested in face-to-face counseling services and talk therapy.
It's possible to build a mental health practice that offers holistic or herbal medications. Some patients will seek out therapists who focus on whole-body solutions. Counselors can also partner with other providers to ensure patients have access to as many services as possible.