Pharmacological Adjuncts

Abstract:

Clinical psychologists provide services to children and adolescents who are often on psychoactive medication for psychiatric or neurological disorders, or for challenging behaviors that have not been amenable to psychosocial treatments alone. Regardless of whether clinical psychologists aim to prescribe pharmacological adjuncts or to refer children and adolescents to child psychiatrists for adjunctive pharmacological treatment, it behooves them to have basic competencies in psychopharmacology. The basic competencies that clinical psychologists should know well and utilize in their practice include recognition and assessment of symptoms, developmental course of childhood disorders, protective and risk factors, maintenance factors, principles and practice of evidence-based treatment approaches, cost-effectiveness of various treatments, drug algorithms, and mechanisms of change underlying psychopharmacological interventions. The APA Board of Educational Affairs has identified three levels of training in psychopharmacology for clinical psychologists: Level 1 is a single semester doctoral-level training program focusing on basic psychopharmacology that enables a clinician to provide assessment and treatment services to their patients. Level 2 is a post-doctoral training program focusing on collaboration between clinical psychologists and physicians to provide an integrated psychosocial and psychopharmacological treatment. Level 3 is another post-doctoral training program focusing on psychopharmacology training at the expert level that is prerequisite for prescribing privileges. The knowledge base of psychopharmacology is increasingly scientific, but its practical application with children and adolescents in alleviating psychological distress is an art. Thus, clinical psychologists need to have basic competencies in both the science and art of pharmacological adjuncts.

1 Unless otherwise specified, in this chapter, the terms child and children are used to denote both children and adolescents.