Can a Psychiatric Nurse Practitioner Provide Therapy Only?
Yes, psychiatric nurse practitioners (Psych NPs) can absolutely provide therapy only, as psychotherapy is a core component of their advanced practice scope and training.
Scope of Practice for Psychiatric NPs
Psychiatric NPs are advanced practice registered nurses trained to deliver the full spectrum of mental health services, including psychotherapy, medication management, and integrated care 1. Their curricula specifically include training in "diagnosing and managing mental illnesses, providing therapies, and promoting mental health" 1.
- Psychotherapy is considered the essence of the PMHNP role, with programs specifically designed to teach various psychotherapeutic modalities and techniques 2
- Training includes competencies in applying psychotherapeutic interventions, interviewing clients, and maintaining ethical standards across diverse populations 3
- PMHNPs have the "education, certification, and licensure to address the need for providers who can deliver the full scope of mental health services" 4
Practice Models and Role Flexibility
Some prescribers restrict their role to pharmacotherapy only, others will prescribe medication only if they are also responsible for the psychotherapy, and some who can prescribe may restrict their practice to assessment/consultation or psychotherapy only 5. This clearly establishes that limiting practice to therapy alone is an accepted model.
- The American Academy of Child and Adolescent Psychiatry explicitly recognizes that clinicians can delimit their roles, with some choosing to provide "psychotherapy only" 5
- Psychiatric NPs are uniquely positioned to deliver multimodal treatment approaches, combining pharmacotherapy with evidence-based psychosocial interventions, or providing either component independently 6
Evidence-Based Psychotherapy Capabilities
Psychiatric NPs are trained to implement specific evidence-based psychotherapies for complex conditions:
- For schizophrenia: PMHNPs can provide cognitive-behavioral therapy for psychosis (CBTp) and deliver psychoeducation 6
- For depression: They can deliver cognitive behavioral therapy (CBT) and interpersonal therapy (IPT-A) 5
- For bipolar disorder: They can provide therapeutic relationships and implement cognitive remediation, social skills training, and self-management skill development 6
Common Pitfall to Avoid
Do not assume that prescriptive authority mandates medication management practice. While state Nurse Practice Acts determine prescriptive autonomy 1, having prescriptive authority does not obligate a PMHNP to use it. The clinician can choose to focus exclusively on psychotherapy while maintaining their full credentials and scope of practice. This is particularly valuable in addressing the significant workforce shortage, where 91 million persons live in areas with shortages of mental health professionals 5.