Can a Therapist Prescribe Psychotropic Medication?

Norma Lee, MA, MD, LMFT: There are a variety of practitioners that work in mental/behavioral health. A psychiatrist is a physician (MD) who, after medical school, has completed additional training in psychiatry. An advanced practice or psychiatric/mental health nurse practitioner (ARNP or PMHNP) is a nurse who has completed additional training in psychiatry. A psychologist is someone who has received a PhD in psychology, and may be called “Dr.” Psychologists are able to administer a variety of tests. Master’s level clinicians include social workers (LICSW, MSW), mental health counselors (LMHC), licensed professional counselors (LPC), and marriage and family therapists (LMFT).

All of the above can provide therapy but most psychiatrists do not. Psychiatrists and nurse practitioners are licensed to prescribe psychotropic medication in every state. With additional training, psychologists in New Mexico and Louisiana are also allowed to prescribe psychotropic medication. Often, a psychologist or a master’s level clinician will provide therapy to a person and work jointly with a psychiatrist or nurse practitioner who will prescribe and manage their medication. Not everyone in therapy needs medication. Sometimes, for very straightforward issues, diagnosis and medication management may be done by a person’s primary care physician.

Cynthia W. Lubow, MS, MFT: There are several kinds of psychotherapists, such as clinical social workers, psychologists, psychiatrists, marriage and family therapists, and mental health counselors. Traditionally, the only psychotherapists who have been allowed to prescribe medication have been psychiatrists.

Psychiatrists are medical doctors who, after medical school, specialize in treating mental health issues. They get post medical school training in psychotherapy, psychological theory, and psychotropic prescribing. After training and certification, psychiatrists may or may not do psychotherapy. Some just prescribe medication, some just do psychotherapy, and some do both.

Psychologists have been fighting for years to be able to prescribe as well, and New Mexico and Louisiana have granted specially trained psychologists that right. Also, some advanced psychiatric nurses have limited prescribing privileges.

Psychotherapists in private practice who are not permitted to prescribe medication often have a relationship with a psychiatrist they trust, so that they can refer someone to the psychiatrist for diagnosis, medication evaluation, and prescribing medication when needed. In that case, the person in treatment will see the psychiatrist much less frequently than their psychotherapist, who will provide the therapy.

John Sovec, LMFT: A therapist with just a master’s degree cannot prescribe psychotropic medication, as this is not within their scope of training or practice. Any doctor can prescribe medication, including your general MD, but it is best left to psychiatrists who have a medical degree and specialize in dispensing appropriate medication to people dealing with psychological issues.

In working closely with a reputable psychiatrist, you will be able to find the best match of medication for your needs, and a psychiatrist will be able to monitor your experience making sure that your body is reacting appropriately to the prescription.

A therapist can assist in the process of finding a psychiatrist who will be a good match for your needs, as well as provide a therapeutic environment in which to process the questions and feelings that arise from starting medication for a psychological issue. Many therapists work closely with psychiatrists in their community and are a valuable addition to your team of healthcare professionals.

For many people, starting medication is a big step and having the support of your therapist during this process can make it a safer, less-challenging experience.