ABSTRACT
This chapter discusses the clinical problems associated with working with patients around the issues of referral for medication management, patient noncompliance, the “meaning” of the medicine, and refusal to accept medicine. It offers a historically based discussion of the ongoing debate in psychology about prescription privileges for psychologists. The chapter provides balance exploration of the expanding scope of practice concerns for psychologists, the economics of these issues, and political, ethical, and legal considerations. It includes a discussion of some contemporary issues in the areas of chemical dependency and addictions related to the processes of psychotherapy. Many patients initially oppose the idea of medication because of the conventional meanings or associations of taking pills. The paradigm shift to a psychological/biological continuum seen in mental health areas has also occurred throughout the scientific community and in most other spheres of health care. Managed care forces continue to control and limit access to care, intensifying the turf battle.
