I think you and I may be assuming different tones in understanding what the article is describing. The article is not suggesting ways around running afoul of the referral payments, its describing how some people choose to enter into these types of transactional relationships in a way that is difficult to legally combat. I don't see it as an endorsement of the behavior.
The APA has enforceable standards that are independent of the law. Someone can lose their license for behavior that is 100% legal and unable to be combatted in court. And that's what they're describing here: situations where therapists have avoided legal problems, but still create ethical conundrums for the APA, which has made its stance pretty clear.
So if I am a therapist in an office FOR a psychiatrist, and I say, "Hey, I think the office psychiatrist should try prescribing you Zoloft" to my patient, and then they go get Zoloft, and then the psychiatrist pays me my salary as his employee, that's not necessarily an ethics violation. That's me getting a salary.
If I tell a patient to go to the in-office psychiatrist for meds, and then I get EXTRA money because the psychiatrist prescribed my patient meds, then now I'm in an ethically problematic area, and I can be complained about.
It is not a problem for a therapist to say that someone should try meds. It's a problem for a therapist to receive kickbacks specifically for referring someone for meds. I can be a therapist who gets a consultation fee for working with a psychiatrist, but I can't be a therapist who gets a fee for getting my patient on medication. I am not certain I agree with the interpretation of these statutes that kickbacks are considered by the APA to be ethically okay.
That being said, you can absolutely be suspicious of your therapist and ask them these kinds of questions. You can absolutely say no to psychiatric medication and your therapist ethically needs to be okay with that. If they can't be, then file a complaint.
Who cares whether the behavior is endorsed or not? It's a common practice and I broke down exactly how it happens legally.
It's an unfortunate fact many people are prescribed antidepressants just so their therapists can increase their take home pay. You act like there's a difference between a "consultation fee" and a "kickback", when the end result is a patient getting meds and the therapist making extra money.
Also, SSRIs cause people to either commit suicide or react violently in many cases. I've yet to see a school shooter who hasn't had a history of being prescribed SSRIs at some point.
As I said, what is legal is not necessarily protectable.
The APA can revoke your therapy license for unethical but legal behavior. You can be legally protected and still lose your ability to practice.
The APA is not a law-based organization. What is legal or illegal doesn’t have a direct correlation to what the APA is permitted to address and act upon.
For instance, APA psychologists can’t be involved in torture interrogations. Torture may be legal if the government says so, but the APA will take your license to practice if you accept a job where you interrogate water boarded detainees.
Which is why I’m pointing out that the APA writing an article like this should be more comforting than alarming. Because they’re telling you that they see the problem you are worried about and are not okay with it, and are willing to take action on their own even if local laws don’t specifically prohibit this behavior. It’s not being endorsed or protected by the people who matter here.
I think you and I may be assuming different tones in understanding what the article is describing. The article is not suggesting ways around running afoul of the referral payments, its describing how some people choose to enter into these types of transactional relationships in a way that is difficult to legally combat. I don't see it as an endorsement of the behavior.
The APA has enforceable standards that are independent of the law. Someone can lose their license for behavior that is 100% legal and unable to be combatted in court. And that's what they're describing here: situations where therapists have avoided legal problems, but still create ethical conundrums for the APA, which has made its stance pretty clear.
So if I am a therapist in an office FOR a psychiatrist, and I say, "Hey, I think the office psychiatrist should try prescribing you Zoloft" to my patient, and then they go get Zoloft, and then the psychiatrist pays me my salary as his employee, that's not necessarily an ethics violation. That's me getting a salary.
If I tell a patient to go to the in-office psychiatrist for meds, and then I get EXTRA money because the psychiatrist prescribed my patient meds, then now I'm in an ethically problematic area, and I can be complained about.
It is not a problem for a therapist to say that someone should try meds. It's a problem for a therapist to receive kickbacks specifically for referring someone for meds. I can be a therapist who gets a consultation fee for working with a psychiatrist, but I can't be a therapist who gets a fee for getting my patient on medication. I am not certain I agree with the interpretation of these statutes that kickbacks are considered by the APA to be ethically okay.
That being said, you can absolutely be suspicious of your therapist and ask them these kinds of questions. You can absolutely say no to psychiatric medication and your therapist ethically needs to be okay with that. If they can't be, then file a complaint.
Who cares whether the behavior is endorsed or not? It's a common practice and I broke down exactly how it happens legally.
It's an unfortunate fact many people are prescribed antidepressants just so their therapists can increase their take home pay. You act like there's a difference between a "consultation fee" and a "kickback", when the end result is a patient getting meds and the therapist making extra money.
Also, SSRIs cause people to either commit suicide or react violently in many cases. I've yet to see a school shooter who hasn't had a history of being prescribed SSRIs at some point.
As I said, what is legal is not necessarily protectable.
The APA can revoke your therapy license for unethical but legal behavior. You can be legally protected and still lose your ability to practice.
The APA is not a law-based organization. What is legal or illegal doesn’t have a direct correlation to what the APA is permitted to address and act upon.
For instance, APA psychologists can’t be involved in torture interrogations. Torture may be legal if the government says so, but the APA will take your license to practice if you accept a job where you interrogate water boarded detainees.
Which is why I’m pointing out that the APA writing an article like this should be more comforting than alarming. Because they’re telling you that they see the problem you are worried about and are not okay with it, and are willing to take action on their own even if local laws don’t specifically prohibit this behavior. It’s not being endorsed or protected by the people who matter here.
There are thousands of therapists who receive commissions for patient referrals. That's the point.
Anything else you say after that is simply semantics.
SSRIs are bad news and are over-prescribed. There's a clear profit motive for that.