Question For Nurse Psychotherapists

PMHNP10 · Nov 18, 2006

Hi!
I was wondering if there is any difference in scope of practice between a psych CNS practicing psychotherapy and a psych NP practicing psychotherapy?
Also, is there any difference (beside educational preparation) between nurse psychotherapists and other masters level psychotherapists (ie. MFT, LCSW etc..)?
Thank You!

I don't believe a CNS can prescribe medication or diagnose a patient, whereas a NP can (of course, I suspect this can vary by state).

Otherwise they are nearly identical. In fact, I believe they will be the same in the near future--or that is the push at least.

ILoveIceCream · Nov 18, 2006

Thank you!

Any thoughts on how CNS/NP compares with MFT or LCSW?

Editorial Team / Admin · Nov 18, 2006

In most all states, the CNS and NP function in the same way, have prescription privileges and function as the HCP for the patients. The CNS has prescription privileges like an NP, but not sure if every state for the CNS. traumaRUs can answer that question. I am NP and she is CNS.

ILoveIceCream, there is no comparison of CNS/NP and MFT/LCSW for the former are advanced practice nurses and the latter are not.

ILoveIceCream · Nov 18, 2006

My question is about psychotherapy. Since CNS/NPs, MFTs, and LCSWs all practice psychotherapy, surely they can be compared.

Obviously MFTs and LCSWs can't prescribe medication, but are there differences between the professions as far as their abilities to provide psychotherapy (ie. types of clients, length of treatment, work setting, etc...)?

np_wannabe · Nov 19, 2006

Maybe I can help here. In my previous life, I went through graduate school and studied the theory, research, and clinical skills to practice as a Marriage and Family Therapist. All courework was related to M&F. In my outpatient setting, I provided therapy, while the Psych NP's provided meds and continued to assess how those medications were working.

I am under the impression that Psych NP's are not permitted to provide therapy....their training is in nursing, not counseling....someone please correct me if I am wrong....

MFT's provide counseling to individuals, couples, and families, whereas LCSW's have a broader scope of practice. LCSW's can provide counseling and more....

HTH.

Editorial Team / Admin · Nov 19, 2006

I am under the impression that Psych NP's are not permitted to provide therapy....their training is in nursing, not counseling....someone please correct me if I am wrong....

The psych NP is educationally and clinically well-grounded in psychopathology, individual, group, family therapy, and crisis intervention. The psych NP can work with psychiatric patients in a variety of settings such as ambulatory care clinics, psychiatric outpatient clinics, inpatient units, and private group practices. The psych NP is an example of a mesh of psychotherapeutic skills, of neurobiological knowledge, behavioral interventions, and physical assessment skills.

The psych NP offers advantages by addressing these three issues: high cost, limited access and quality by providing psychotherapy and physical assessment skills in cost efficient, at on-site clinics and with improved quality.

The Psych NP can:

Refer mentally ill patients who need a more specialized or complex workup to the primary care physician and/or specialist;

Provide on-the-spot health promotion and preventive services for medical problems;

Provide routine physical health screening;

Offer continuing primary health care for routine physical problems, saving both patient and facility additional hospital/medical costs; and

Conduct short term psychotherapy and psychoeducation.

Hope this helps a little.

ILoveIceCream · Nov 19, 2006

Thanks to both of you for the replies!

I've read that some psych CNS's choose that specialty mainly to become psychotherapists in private practice. Can these CNS's function with the same level of autonomy in this setting as MFT's and LCSW's? If so, then can psych NP's also? (I suppose CNS's and NP's are limited by their population specialty--child & adolescent or adult. But what about Family Psychiatric Mental Health NP's?)

zenman · Nov 19, 2006

Thanks to both of you for the replies!
I've read that some psych CNS's chose that specialty mainly to become psychotherapists in private practice. Can these CNS's function with the same level of autonomy in this setting as MFT's and LCSW's? If so, then can psych NP's also? (I suppose CNS's and NP's are limited by their population specialty--child & adolescent or adult. But what about Family Psychiatric Mental Health NP's?)

I trained as a psych CNS (individual, group, family therapy) but never went into private practice. However, a classmate went into practice with a psychiatrist and carried her own caseload.

romie · Nov 19, 2006

I was under the impression that the issue was not that PMHNP weren't "allowed" to do psychotherapy, but that it wasn't as lucrative as medication management, just as psychotherapy isn't lucrative for psychiatrists.

Editorial Team / Admin · Nov 19, 2006

Can these CNS's function with the same level of autonomy in this setting as MFT's and LCSW's? If so, then can psych NP's also?

The psych CNS and NP go beyond the level of the MFT/LCSW for they (the former) also provide primary health care in many situations. (see above duties). The latter can only address mental health issues and not provide healthcare for this patient population.

Trauma Columnist · Nov 19, 2006

Siri is right: the differences between NP and CNS is what the state says it is. For instance, in IL (where I am licensed), APN's are lumped together as far as prescriptive authority (CNS, NP and CNM).

I am an adult health CNS and enjoy the same rights and priviledges (and responsibility) as my NP co-workers.

If I was a psych CNS, I would bring more medical approach to psychotherapy and include med prescribing, perhaps more diet modification, a holistic approach.