Advanced practice psychiatric nursing continues to evolve and develop as a significant contribution to overall mental health care. From the beginning under Hildegard Peplau’s direction the central focus of psychiatric mental health nursing has been the interpersonal relationship between the patient and the nurse. Until the 1980’s the role has solidly involved psychotherapy from a wide array of therapeutic modalities and theories. It is time for the pendulum to swing back to center and reincorporate psychotherapy and psychopharmacology into the holistic paradigm of advanced practice. This chapter presents the evidence of the efficacy of uniting the various treatment approaches compared to the common practice of splitting the delivery of psychotherapy and pharmacotherapy. It presents the argument for returning to a full scope of practice in providing services for our patients. Full scope of practice is based on the understanding that pharmacological therapy is psychotherapy.