Most therapists can't prescribe medication except in five states, and even then they have to be specially trained with an additional graduate degree, which most won't have. Therapists do counseling. Psychiatrists are doctors and can prescribe medication, but in my experience, few of them do much in the way of therapy-style counseling.
Are you insinuating therapists don't refer their patients to psychiatrists when they deem medication is the answer and get a referral bonus in many cases?
A therapist is trained to solve psychological problems using counseling, not medication. Medication is not a solution they are trained to use. They can suggest that a patient try a medication if they want, but their suggestion doesn't legally carry any more weight than your friend suggesting a medication.
A therapist needs to know what medications you're on in case they might be influencing your behavior in some way. Unless they are a prescribing psychologist (very rare), they are not going to be thinking about how to use medication to solve your problem, because that is beyond the scope of authority of the average therapist.
I have never heard of a therapist getting a bonus for referring a patient for medication, because medication would have to come from a doctor. Psychiatric medication can come from literally any doctor. A psychiatrist is not required to get psychiatric meds. A primary care doctor can do it, and in many cases, is the one who is prescribing those meds.
So a therapist can say, "You should try an SSRI," and the result would be that the patient goes to any random doctor and gets the prescription if the doctor agrees that it's appropriate. Since no specific doctor is required for these meds, I can't see how the therapist could get a payout from it.
Except those payouts do happen. The therapists refer their clients to either a doctor or psychiatrist, and often get referral fees for it in states where it's not barred by state law.
Excellent article. I had not known to this to be a noteworthy enough problem for a full article, but I'm glad they addressed it.
And I'm not saying that it can't happen. But the article demonstrates that it is clearly against the written code of the APA for a therapist to be paid for referrals, which means it's actionable if an ethics complain is lodged against them. They can straight up lose their license to practice. Rightfully.
Your decision to go to a doctor for meds is your decision, not the decision of your therapist. A doctor might take the written suggestion for an SSRI from a therapist a bit more seriously than the suggestion from your plumber, but it's still ultimately the doctor's decision.
The point I'm making is this: you can go to a therapist and do work with them. And they can say, "I think you should try this medication, go to this person." And you can say, "I don't really want to use psychiatric medications."
That's the end of the conversation. The therapist at that point will 99% of the time drop it. If they don't, then you can fire them and, if you feel it's appropriate, lodge an ethics complaint with the APA.
Being referred for medication by a therapist means nothing legally. Nobody is going to care if the therapist put in your file that you should be on medication, because they almost never have the legal power to make that decision. No courtroom is going to take your guns because you told a therapist you weren't interested in being medicated.
The only times you can be absolutely compelled (as in, held down and injected) with medication is if you're an IMMINENT danger to yourself or others. And even then, it's not by a therapist. A therapist can say whatever they want, but even if they DO get payouts for referrals (and want to risk their license for that), you can still just say no and they get no payout. Find a better therapist. Problem solved.
Most therapists can't prescribe medication except in five states, and even then they have to be specially trained with an additional graduate degree, which most won't have. Therapists do counseling. Psychiatrists are doctors and can prescribe medication, but in my experience, few of them do much in the way of therapy-style counseling.
Are you insinuating therapists don't refer their patients to psychiatrists when they deem medication is the answer and get a referral bonus in many cases?
Well, not really, no.
A therapist is trained to solve psychological problems using counseling, not medication. Medication is not a solution they are trained to use. They can suggest that a patient try a medication if they want, but their suggestion doesn't legally carry any more weight than your friend suggesting a medication.
A therapist needs to know what medications you're on in case they might be influencing your behavior in some way. Unless they are a prescribing psychologist (very rare), they are not going to be thinking about how to use medication to solve your problem, because that is beyond the scope of authority of the average therapist.
I have never heard of a therapist getting a bonus for referring a patient for medication, because medication would have to come from a doctor. Psychiatric medication can come from literally any doctor. A psychiatrist is not required to get psychiatric meds. A primary care doctor can do it, and in many cases, is the one who is prescribing those meds.
So a therapist can say, "You should try an SSRI," and the result would be that the patient goes to any random doctor and gets the prescription if the doctor agrees that it's appropriate. Since no specific doctor is required for these meds, I can't see how the therapist could get a payout from it.
Except those payouts do happen. The therapists refer their clients to either a doctor or psychiatrist, and often get referral fees for it in states where it's not barred by state law.
https://www.apaservices.org/practice/update/2014/09-25/referral-fees
Excellent article. I had not known to this to be a noteworthy enough problem for a full article, but I'm glad they addressed it.
And I'm not saying that it can't happen. But the article demonstrates that it is clearly against the written code of the APA for a therapist to be paid for referrals, which means it's actionable if an ethics complain is lodged against them. They can straight up lose their license to practice. Rightfully.
Your decision to go to a doctor for meds is your decision, not the decision of your therapist. A doctor might take the written suggestion for an SSRI from a therapist a bit more seriously than the suggestion from your plumber, but it's still ultimately the doctor's decision.
The point I'm making is this: you can go to a therapist and do work with them. And they can say, "I think you should try this medication, go to this person." And you can say, "I don't really want to use psychiatric medications."
That's the end of the conversation. The therapist at that point will 99% of the time drop it. If they don't, then you can fire them and, if you feel it's appropriate, lodge an ethics complaint with the APA.
Being referred for medication by a therapist means nothing legally. Nobody is going to care if the therapist put in your file that you should be on medication, because they almost never have the legal power to make that decision. No courtroom is going to take your guns because you told a therapist you weren't interested in being medicated.
The only times you can be absolutely compelled (as in, held down and injected) with medication is if you're an IMMINENT danger to yourself or others. And even then, it's not by a therapist. A therapist can say whatever they want, but even if they DO get payouts for referrals (and want to risk their license for that), you can still just say no and they get no payout. Find a better therapist. Problem solved.