Clinical Psychopharmacology (MS) Program

Why Psychopharmacology?

Reprinted from Networker, newsletter of the New Hampshire Psychological Association, Inc. August 2003

By Sandy Rose, Ph.D.

My first year of psychopharmacology training is over and as we "freshmen" like to think, we are now the upperclassmen of the Massachusetts School of Professional Psychology (MSPP). It is a good time to reflect on this year of training and its potential role in helping NH psychologists to prepare for prescriptive authority and consultation.

The Massachusetts School of Professional Psychology is a 26 year-old institution which has graduated over 660 Psy.D. degrees and which is regionally and nationally (APA) accredited.

MSPP's M.S. Degree in Psychopharmacology is a new program developed in response to regional meetings by its founders after consultation with proponents of prescriptive authority in New England. This program is accredited by the New England Association of Schools and Colleges. The program's course schedule includes 2 years of (30 total) weekend courses in areas of psychopharmacology modeled after the APA's model curriculum for consultation and RxP. Last year, it increased the hours and curriculum to emulate New Mexico's curriculum of 450 hours, which passed legislative approval for prescriptive privileges for psychologists. The courses amount to every second or third weekend (8 hour days) through the school semester. Although there are residency requirements, most of the lectures maybe viewed on line in real time at home, or viewed later at one's own pace via computer. I and almost all my classmates chose to come to classes anyway.

The courses are offered by a range of faculty which include psychologists specializing in psychopharmacology, Ph.Ds in Pharmacology or Pharm Ds, and MDs in internal medicine, endocrinology, neurology, and psychiatry. The faculty are affiliated with New England colleges including Harvard, Boston College, BU, MIT, and UMass. They have years of experience not only in practice but in teaching and research settings where they train medical prescribers and/or consult with medical teams in psychopharmacology.

The faculty's wealth of experience in clinical settings is complemented by the academic perspectives offered by experimental and clinical psychologists who integrate the medical model with our own professional model. These faculty provide not only didactic material but labs in patient examination and laboratory. The faculty are warm and personable and invite us to contact them for information. They are highly accessible, and given the small nature of the classes, are able to get to know us and our needs and have been responsive to our feedback.

The students are psychologists (and one psychiatric nurse practitioner and pastoral counselor) from the New England area, including NH, MA, RI, CT, and ME. My class of 11 are bright, energetic, successful psychologists representing a diverse group of practice areas and lifestyles. We range in age from mid-twenties to late mid-life, leading to a discussion among some as to which ID (student or senior citizen) to use at the movies. We include administrators, such as one working in a community mental health center for the chronically mentally ill, a hospice director, and a number of behavioral medicine specialists working in medical settings. We even have a psychoanalyst. Some of us work with children, in nursing homes, do psychometric testing and teach at local colleges. Not all are interested in gaining privileges, but seek training to better understand medication issues for collaboration with staff or colleagues who prescribe. While most commute to class, some drive long distances and stay over at the discounted Hilton nearby. Although commutable from the NH Seacoast, I choose to stay over given rush hour traffic, which can take 2.5 hours on a Friday night home.

The costs of study are considerable. During the semester I spend an average of 8 to 10 hours a week either in class and/or studying. Tests are given and although largely take-home, require even more time. The cost of tuition is presently $9,995.00 (the discounted rate for NHPA members) which is spread out in payments over the two years. Texts are minimal in expense and are valuable resources for use in my practice and would have been worth it regardless of the program. We have more handouts than I know what to do with. While cost is deductible for some, and there are enough continuing education credits to get you through the next millennium, it is obviously a burden on our already shrinking pay. Practicum supervisors are not yet part of the faculty and thus must be secured by students after their degree is granted. There are many weekends trudging through the snow with my suitcase and books, when I wonder whether I should have gone to therapy rather than class. But as always happens, I realize it is not pathology driving me (at least not towards this training).

The school and its director, Dr. Stan Berman, are highly dedicated to helping ease this process for the student body. Stan is a highly regarded practicing clinician of many years who understands the demands of the field and has an intimate understanding of the student perspective. In fact, he is taking the class with us. There are amenities including breakfast, snacks, and unlimited coffee waiting for us and during class to ease the long days sitting still. The technical support staff makes us CDs of lectures so the more compulsive among us can repeat lectures repeatedly and at our own pace. If we opt to stay home, we may sit in real time and listen to lectures and type questions directly to the class for clarification, and real time feedback. There is wireless internet available and so some of us with laptops can not only type notes during class, but access the web. You can't really appreciate being a student in the 21st Century until you have had questions about steady state equilibrium, search the concept and get back a great description of its properties and graphs and charts to supplement what your teacher is saying, all while sitting in class. In my previous student life, I never imagined one day being able to e-mail the guy across the room to ask what the teacher is talking about, and get back a website definition of a term or comments and discussion among a subgroup of us.

On the day of the war, we had one of our more capable multi-tasking students monitoring the news so we could all focus on the lectures. After class, at our homes, we use e-mail to send each other articles of interest, refer patients, and discuss clinical issues or prescriptive advocacy. For take-home tests where collaboration is invited, we discuss and compare answers to questions on the net and all learn from each other. Needless to say, we have formed what I believe will be long-lasting connections that I will value both personally and professionally.

The material itself is state of the art, intensive, and highly relevant to my patient's lives. I will never take another pill without looking at it differently. I am already much more able to recognize side effects, drug interactions and be on the alert for risks of medication overdoses or under-doses. It has helped, for example, to understand how or why someone is not responding to medication, the effects anticipated with taking alcohol or even grapefruit juice with their medications and how this might be impeding recovery. I anticipate that with completion of the program I will be able to consult with prescribers effectively. After my supervised practicum and passing the APA's proficiency (PEP) test, I will be competent to prescribe.

The program is a pioneering effort and combines a warm atmosphere with high standards for learning. We are lucky to have such a high-quality local program available. MSPP's administrators have forethought and the creativity to expand to meet the needs of psychologists. They have partnered with NHPA, and are connecting wit local NH colleges to determine new possibilities for growth and partnership to meet NH's specific needs. For example, NH-based classrooms are a goal, and consultation-only programs are being considered for those with more limited goals in training (e.g., the 300 hour APA model) and course waivers for those who have taken similar courses.

I feel fortunate to be a student at this stage of my life. Having practiced for a long time, I am more readily able to use the information in a meaningful way. As an experienced psychologist, I have a foundation upon which to build, not to replace. The tools of learning are so much more sophisticated than when I last went to school, making it easier and more fun than before. It is exciting to learn as an adult, as there is a sense of professional equivalency between faculty and students and a more genuine interest in learning without fear of "failing."

Although there are more demands on me as a working student, the work itself is relevant and important to training, and the pace of the program is manageable. The Friday and Saturday format means I don't have to miss patient hours and the breaks between weekends give some time to recoup between classes. My kids and my husband miss me more. I and others have confided that we actually enjoy the break from our normal lives. It has definitely helped professional burnout to be involved in something new and enriching at this stage of my career. Most importantly, I think that others in the program would agree that it has been well worth the effort not just for ourselves and our patients, but for our profession.

Updated 10/1/07