Integrated behavioral care training in family practice residency: opportunities and challenges.

The value of integrated behavioral care has been noted for many years, but there are few descriptions of integrated training of primary care physicians, prescribing psychologists, and psychological/behavioral specialists. The authors describe a family practice residency program that trains family medicine physicians, prescribing psychology practicum students, and pre-doctoral and post-doctoral behavioral health consultants. Barriers to training in integrated care are described and solutions offered. The unique clinical and teaching roles of licensed prescribing psychologists in primary care are described.

The revised 2019 standards for psychopharmacological training: Model education and training program in psychopharmacology for prescriptive authority.

The American Psychological Association (APA), under the oversight of the Board of Educational Affairs, and the Board of Professional Affairs, is responsible for the education and training of psychologists in prescriptive authority. All APA standards and guidelines are required by Association Rule 30-8.3 to be revised at least every 10 years. The standards for training psychologists in the safe and responsible practice of prescribing psychotropic medication have been recently updated (Model Education and Training Program in Psychopharmacology for Prescriptive Authority, APA, 2019). A departure from the 1996 and 2009 versions of that document is that training may now be conducted at the doctoral level; however, a postdoctoral supervised clinical fellowship can only occur after the attainment of licensure as a practicing psychologist. Two novel features of the 2019 revision are the use of a competency-based model of learning and assessment, and increased emphasis on supervised clinical experiences in physical assessment and medication management. By the time of completion of their fellowships, practicing psychologists are expected to have clinical competence in the measurement and interpretation of vital signs; neurological examination; therapeutic drug monitoring; systems of care; pharmacology; clinical pharmacology; psychopharmacological research; and finally, professional, ethical, and legal issues. The updated standards were approved as APA policy in February 2019. This article briefly reviews the revision process and highlights the updates made in the most recent version of the standards. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Medication efficacy: the impact of variability in defining and measuring ADHD and executive functioning.

Attention-deficit hyperactivity disorder (ADHD) is a heavily studied topic in neuropsychology and general psychology, psychiatry, and pediatrics. The Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition, Text Revision (DSM-IV) is used to diagnose ADHD, but its criteria are behaviorally defined, while ADHD is a neurological dysfunction. The DSM-IV diagnostic criteria do not differentiate between attention and inhibition or executive functions (EF). As well, there is little agreement in the field about what constitutes ADHD and EFs or how to measure or diagnose them, let alone rule them out. When rendering an ADHD diagnosis, the responsible clinician considers DSM-IV criteria along with other reasons why an individual may express symptoms of ADHD, for reasons other than ADHD. This article discusses postulated mechanisms of action for some medications prescribed for ADHD, the variance of medication outcomes in research, the variance of assessment measures used in identifying ADHD subjects for research, and flaws with DSM-IV-based diagnosis. An argument is posed that the field of neuropsychology needs a cohesive and agreed-upon definition of ADHD and EF and how to measure it to more exactly research the topic, accurately diagnose the disorder, and assist prescribing professionals to use medications with improved first-trial precision.