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Everyone has an inner RAINBOW
Hey all,
Back in graduate school, I completed my dissertation on Multicultural Identity Development. My chair, Dr. Mark Rosenblatt urged me to create my own minority identity development model. But at that time, it seemed like an overwhelming task and I was too scared of thinking outside the box. So, I attempted to improve someone else’s work. Dr. Pamela Hays had already come up with the very thorough: ADDRESSING Model. Using the word ADDRESSING as a mnemonic, each letter represents a category of social diversity. Here is her work:
Age
Developmental and acquired Disabilities
Religion
Ethnicity
Socioeconomic status
Sexual orientation
Indigenous heritage
National origin
Gender
Like I said, for the time (this was 10+ years ago) it was very inclusive. However, I saw few ways in which it could be expanded to incorporate LGBT+ people. Therefore, for my project, I simply expanded a few items within her existing framework.
Here is Chandler’s LGBT+ Adapted ADDRESSING Model:
Age & Generational influences
Disorders
Disabilities
Religion & spiritual orientation
Ethnicity, race & Culture
Socioeconomic status & education
Sexual identity (see chart)
Ideology
Nationality & Indigenous heritage
Gender identity (see chart)
Also, I expanded the Center for Gender Sanity’s Diagram of Sex and Gender:
Here’s a slightly expanded model, called:
Dr. Chandler’s Complete Sexual Identity Model:
You can also see it referenced in this YouTube video, or in the embedded video at the bottom of this post…
For many years after graduation, I was presenting those expanded ADDRESSING & Sexual Identity Models to encourage corporations, agencies, therapists, and individuals to be more inclusive and accepting of diversity all over the country.
Then, a day after presenting at the Southern PFLAG Conference in New Orleans, it hit me. Here I am presenting this wonderful information but highlighting other people’s work. I revisited the idea of coming up with my own model. Once I sat down, I realized it was right in front of me, all along. The categories are similar to Dr. Hays’ work. BUT, I MADE MY OWN MODEL:
Chandler’s RAINBOW Model (of course, that’s the name!)
Race: ethnicity, culture, family structure and spoken/written language(s)
Age and generational influences
Inherent and Acquired Disorders, Diseases and Disabilities: physical, neurological, mental, psychological, emotional, and behavioral
Nationality & Indigenous heritage: immigration status
Belief systems: religion, spirituality, political ideology, how you perceive others, the world and yourself
Orientation: complete sexual identity including: sex, gender identity, gender expression, gender expression attraction, practices, and sexual identity (see chart above)
Work status: socioeconomic status, education, employment/career, class, housing, safety, food security, life experience and income level
There you have it! Chandler’s RAINBOW Model in a nutshell. It is a handy mnemonic to trigger each category of diversity. Further, it is a way to do some much needed introspection about our privileges, biases, and stigmas. Just like with people, when utilized correctly there are no 2 RAINBOW’s alike. Once you’ve had a chance to identify, understand and accept your RAINBOW, you can begin working towards positive changes of accepting other’s RAINBOWs.
Watch my latest training for more information and as always, sharing is caring!!
Dr. Jon Chandler
Page 2-Medical Apps that Save Time & Lives
Take a look at RxP’s 2nd page of apps:
The following Medical apps are listed:
- Interactions: UPDATE-Don’t bother, already removed from iPhone!
- When I started making these reviews, I decided to clean it up a little. So I deleted Interactions and a few other apps. Interactions started out being a pretty easy to use, bare bones, drug interaction check. However, an update (or lack there of) made it where you can only search generic medications. Additionally, I don’t trust that it is entirely accurate in its findings. I wouldn’t even bother with this one. See below:
- When I started making these reviews, I decided to clean it up a little. So I deleted Interactions and a few other apps. Interactions started out being a pretty easy to use, bare bones, drug interaction check. However, an update (or lack there of) made it where you can only search generic medications. Additionally, I don’t trust that it is entirely accurate in its findings. I wouldn’t even bother with this one. See below:
- WebMD:
- Now, I’m sure almost everyone (whether you are in the medical field, just curious, or a hypochondriac) has heard of and probably uses WebMD on a regular basis. It’s a great app and comes in handy when a patient tells me they have a rare disease, or medical disorder. Helps the user with Symptom Checker, Med Reminders, Conditions, Rx, First Aid Info, Local Health Listings, Medical terms, and Tests and Procedures.
- Also, from the link above you will find every WebMD app available. WebMD Pregnancy & WebMD Baby were particularly helpful when my wife was pregnant and we had our son!
- **Bonus: They recently teamed up with Walgreens to allow a quick scan of your bottle to refill, or transfer meds to your nearest Walgreens, right inside the app! Of course, you could use the Walgreen’s app for a few more features.
MDLinx Oncology Articles:
- I realize Oncology articles, while interesting, seem unrelated to psychology, or medical psychology. However, I decided to download this app in order to learn more information about cancer and their treatments because #CancerSucks. Furthermore, I currently have patients (and friends) in recovery from various forms of cancer. This app provides access to the latest medications, treatments, and trials.
(Dedicated to my buddy, Scott, who lost his battle to cancer in 2014.) - For a bonus, go over to MDLinx.com was extremely helpful when I was studying for the Medical Exam (PEP). It gives you a free, board-like examination to prepare for whatever board you are taking. They are the same makers of The Smartest Doc board prep, just select your specialty and voila! You’re on your way to a few practice tests.
- I realize Oncology articles, while interesting, seem unrelated to psychology, or medical psychology. However, I decided to download this app in order to learn more information about cancer and their treatments because #CancerSucks. Furthermore, I currently have patients (and friends) in recovery from various forms of cancer. This app provides access to the latest medications, treatments, and trials.
- Psychiatry: UPDATE: Don’t bother with this one, either.
- This app is pretty limited. I only realized that after I downloaded it. It wants you to buy the videos? I was initially curious but that is gone, now. I will likely delete this one, as well.
- LactMed:
- This app has come up recently on the LAMP (Louisiana Academy of Medical Psychologists) listserv. At times during our practice, we have a patient who becomes pregnant, or a new patient comes in with pregnancy-onset depression, or with post-partum depression, or psychosis. Therefore, we have a dilemma of wanting to help the patient maintain, or gain their stability while not endangering the fetus/child. The reality of it is that there just aren’t that many studies done with pregnant women and psychotropic medications. You can guess why that may be… who wants to put their unborn child at risk? That said, the studies that have been conducted have mixed results. Therefore, the FDA assigns a category based on how the medication has been (and if) studied and their effects, see below:
- Therefore, a prescriber has to weigh the risks vs. the benefits (Risk-Benefit Ratio) and analyze the situation with the patient in order to come to a consensus about whether to continue with the current medications, change to “safer” medication(s), or taper off all medication(s). This can apply when the mother is breastfeeding, as well. As some medications will pass through the mother’s milk. LactMed provides a lot of valuable information to assist with the decision process.
- This app has come up recently on the LAMP (Louisiana Academy of Medical Psychologists) listserv. At times during our practice, we have a patient who becomes pregnant, or a new patient comes in with pregnancy-onset depression, or with post-partum depression, or psychosis. Therefore, we have a dilemma of wanting to help the patient maintain, or gain their stability while not endangering the fetus/child. The reality of it is that there just aren’t that many studies done with pregnant women and psychotropic medications. You can guess why that may be… who wants to put their unborn child at risk? That said, the studies that have been conducted have mixed results. Therefore, the FDA assigns a category based on how the medication has been (and if) studied and their effects, see below:
- Mango Health:
- Now, this app is cool. It’s extremely user-friendly so I frequently recommend it to patients to set reminders for their medications. Especially, those who are required to take their medication(s) more than once per day and/or take multiple medications. It uses a “token economy” (a Cognitive Behavior concept) to reward you when you take your meds! Highly effective when dealing with teens and other non-adherent patients.
Stay tuned…
- Now, this app is cool. It’s extremely user-friendly so I frequently recommend it to patients to set reminders for their medications. Especially, those who are required to take their medication(s) more than once per day and/or take multiple medications. It uses a “token economy” (a Cognitive Behavior concept) to reward you when you take your meds! Highly effective when dealing with teens and other non-adherent patients.
- Psychiatry Lite
- NCSBN’s Rx Flashcards
- Mastering Psychiatry
Medical Apps that Save Time and Lives
Yesterday, I told you about Epocrates. It has been a god-send since I started using it. **See my original post to see what I like and dislike about that particular app**
Today, I want to tell you about a few (okay a lot of) other medical apps I use on a regular basis. Most of them are free, so why not?! Here are some screenshots of my iPhone’s RxP (Rx=Medical Psychologist) Medical App folder.
As you can see, I have collected quite a few. I would say they are pretty much in order of importance from left to right screenshots. Inside each screenshot, I tend to position the apps I use more frequently in the middle and corners. Don’t ask me why, it’s just how my brain works. (And yes, that’s my little boy in my background image. He just turned 1!)
The 1st page (far left screenshot) you will see:
- Rx Shortages:
- This is extremely useful when you are attempting to prescribe a slightly rare medication because you can save yourself and your patient a lot of time (and money) by making sure there is not a shortage in your area. A little more user-friendly than theFDA Drug Shortage app listed below.
- This is extremely useful when you are attempting to prescribe a slightly rare medication because you can save yourself and your patient a lot of time (and money) by making sure there is not a shortage in your area. A little more user-friendly than theFDA Drug Shortage app listed below.
- Epocrates:
- See my previous post about why I use Epocrates on a daily basis.
- FDA Drug Shortages:
- Similar to Rx Shortages but shows a slightly different view of drug shortages in your area and is run by FDA. That is both a blessing and a curse, as it is both exhaustive and cumbersome.
- Similar to Rx Shortages but shows a slightly different view of drug shortages in your area and is run by FDA. That is both a blessing and a curse, as it is both exhaustive and cumbersome.
- About Herbs: or Herbal Guide on Google (Disclosure: I have not used, yet!)
- This used to be a great app but is currently buggy and I can’t even open it, at the moment. Ugh! When it was working, it showed most OTC herbal remedies that can be used for mild (to moderate) mental health issues.
- MPR:
- Basic, but user-friendly and free.
- Basic, but user-friendly and free.
- Formulary: At quick glance there does not seem to be an equivalent Google app (please correct me if I’m wrong.)
- A very useful app for checking if a particular insurance will approve a medication you are thinking about prescribing. This is extremely important for working with patients with Medicaid! (About 95% of my caseload.) Downfall is that it is not always 100% accurate.
- A very useful app for checking if a particular insurance will approve a medication you are thinking about prescribing. This is extremely important for working with patients with Medicaid! (About 95% of my caseload.) Downfall is that it is not always 100% accurate.
- MobilePDR:
- This is a highly useful app and competes with Epocrates pretty well.
- This is a highly useful app and competes with Epocrates pretty well.
- LabGear: (there are a few Lab Value app on Google but I have not tried any.)
- This is one of the only apps for which I paid. It was a whopping $2.99, or you can bundle it with a few other Medical apps to make each one cheaper. I highly recommend purchasing it as it is invaluable when analyzing Lab Values and explaining them to your patient.
- This is one of the only apps for which I paid. It was a whopping $2.99, or you can bundle it with a few other Medical apps to make each one cheaper. I highly recommend purchasing it as it is invaluable when analyzing Lab Values and explaining them to your patient.
- PocketRx:
- This is app is pretty cool. It’s a lot like the MobilePDR, MPR, and Epocrates. However, what I think sets it apart is the ability to have make a “Med Box.” In the med box, you can add your Patient’s medications. It will show you: Interactions, Precautions, and Side Effects. That’s not even the best part! It will also save the profile for later reference. That is a huge time saver!
Click the Back button to go the Epocrates Review. Or if you’re ready to see the Next page of Medical Apps, press NEXT!
- This is app is pretty cool. It’s a lot like the MobilePDR, MPR, and Epocrates. However, what I think sets it apart is the ability to have make a “Med Box.” In the med box, you can add your Patient’s medications. It will show you: Interactions, Precautions, and Side Effects. That’s not even the best part! It will also save the profile for later reference. That is a huge time saver!
Q: What’s the difference between a psychologist, a psychiatrist and a medical psychologist?
Haha, there has to be a joke in there somewhere!!
But, for real, this is a common question I’m asked when I tell people about the psychopharmacology program.
A: The simple answer is:
“not very much” and “a whole lot” …read on.
A: The complicated answer is:
A psychologist has a minimum of the following:
- BA in clinical psychology, sociology, or related field
- MA in psychology (can be obtained interim)
- Supervised by licensed clinician for 1500 pre-doc hours
- Doctorate in psychology (Either PsyD, or PhD, EdD, etc.)
- Sup. by licensed psychologist for 1500 post-doc hours
- Successful passing of the National Exam
- In the United States that is the Examination for Professional Practice in Psychology, or EPPP
- Successful passing of the State Ethical Exam
- In California it is the California Psychology Supplemental Examination, or CPSE
- Accepted application and initial fee to State of licensure
- California Board of Psychology, or CA BOP
source:
Please also refer to my other post discussing the requirements that a licensed psychologist must meet prior to licensure.
A psychiatrist has a minimum of the following:
- BA in psychology, or a related field
- MD from medical school completion
- Residency completion
- The United States Medical Licensing Examination USMLE is a multi-part professional exam sponsored by the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME)
- Passing of the State medical board
- Accepted application and initial fee to State of licensure
sources:
-Cloud, J. (2010). Psychology vs. Psychiatry: What’s the Difference, and Which Is Better? Time.
-http://www.usmle.org/
Okay, here is where it gets a bit confusing…
A Medical Psychologist can be a:
1-highly trained and licensed psychologist
WHO CAN PRESCRIBE PSYCHOTROPIC MEDICATIONS:
- With a Postdoctoral Master of Science in Psychopharmacology
- Licensed psychologist by the Louisiana State Board of Examiners of Psychologists
- Licensed Medical Psychologist from the Louisiana State Board of Medical Examiners
- Who prescribes psychotropic medications with consultation for the 1st 3 years, in Louisiana
OR
2-highly trained and licensed psychologist
WHO CANNOT PRESCRIBE ANY MEDICATIONS
- With a Doctorate in Psychology
- Board Certified Speciality from the American Board of Psychological Specialties,
- A Division of the American College of Forensic Examiners
sources:
upon request.
CONCLUSION:
The lines between psychiatry and medical psychology are becoming blurred. Though, they are admittedly VERY different fields with different qualifications and degrees. It is this author’s belief that the blur happens from a variety of sources: depictions on television and other media outlets, misinformation, miseducation, interpretation and perception. But, the most important blur is occurring due to the nation-wide scarcity of prescribers, in general! You may have noticed the increasing amount of Nurse Practitioners, Physician’s Assistants and dun-dun-dun-dun-duuuuun… Medical Psychologists!
Some people prefer to call a psychologists who can prescribe a “prescribing psychologist” in Louisiana, New Mexico, Guam, Native American territories, and some state and Federal departments (currently the only places said professional can prescribe.) Makes sense, but in Louisiana, many entities, (including the ones who license folks) call a psychologist who can prescribe psychotropic medications a “medical psychologist” even using the suffix “MP.” ex-Jen Chandler, PsyD, MP
Other similar names have popped up over the years, including: psychopharmacologist, pharmacopsychologist, pharmacology psychologist, psychology pharmacologist, prescribing psychologist, RxP, and as discussed medical psychologist. In my opinion, the varying names for this practice may highlight the general disorganization of the field of psychology. Historically, we have not been our own best advocates…
Hope this clears up some misinformation, or confusion. Thanks for reading.
Sharing is caring,
Dr. Jen Chandler
I started this blog because…
I want to hold myself and other colleagues accountable for learning and implementing the material we are learning in our Post-doc Master of Science in Clinical Psychopharmacology so that we will pass the Psychopharmacology Examination for Psychologists (AKA PEP) the first go-round.
Here is a brief introduction to what the heck all that means!
A Post-doc Master of Science in Clinical Psychopharmacology is a post-doctoral degree that can only be obtained when the following prerequisites have been met:
- Licensed clinical psychologist
- BA in clinical psychology, sociology, or related field
- MA in psychology (can be obtained interim)
- Supervised by licensed clinician for 1500 pre-doc hours
- Doctorate in psychology (Either PsyD, or PhD)
- Sup. by licensed psychologist for 1500 post-doc hours
- Successful passing of the National Exam
- In the United States that is the Examination for Professional Practice in Psychology, or EPPP
- Successful passing of the State Ethical Exam
- Preferred to be actively practicing as a psychologist
- Time, dedication and money for the course work ahead
- Passing of the Psychopharmacology Examination for Psychologists, the PEP
- In Louisiana, it is required to become licensed as a psychologist and medical psychologist, and
- Consult with a medical doctor, psychiatrist, or medical psychologist for 3 years
I hope this gives you a helpful introduction to the field of medical psychology, prescribing psychology, psychopharmacology, or otherwise known as pharmacopsychology — more on this next time!
Thanks for reading!
Sharing is caring,
Dr. Jen Chandler
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