Assessing Psychologists' Intentions to Become Licensed Prescribers in Pennsylvania Using the Theory of Planned Behavior.

Objective: To describe the beliefs associated with the intention to become licensed to prescribe among psychologists in Pennsylvania using the Theory of Planned Behavior. Methods: We conducted a survey (March-May 2023) of attitudes, subjective norms, and perceived control among members of the Pennsylvania Psychological Association, generating a response rate of 24.2% (n = 284). The primary outcome was how likely the respondent was to become licensed to prescribe if authorizing legislation passes in Pennsylvania, followed by an open-ended question about their rationale. The association between the likelihood of becoming a prescriber and the attitudes, subjective norms, and perceived control about prescribing was estimated using logistic regression, adjusting for demographic and professional information. Results were calculated as average marginal effects (AME) and corresponding 95% confidence interval. Open-ended responses were assessed using inductive thematic coding. Results: Approximately 35% of psychologists reported being likely to become a prescriber. Direct social norms were associated with a 15.4 percentage-point increase ([0.12, 0.19]) in the probability of becoming a prescriber, and indirect attitudes were associated with a 9.7 percentage-point increase ([0.06, 0.14]). These results were supported by the qualitative themes that emerged: Personal Reasons, Professional Reasons, and Improving Patient Care. These themes included concerns about age, changing professional psychology, medication, increasing access to care, and licensure requirements. Conclusion: Psychologists' attitudes and social norms about prescribing psychology are key indicators of their intention to become licensed to prescribe. These findings could inform interventions to improve licensure rates and policymakers considering the adoption of psychologist prescriptive authority.