A White Institute Clinical Services Conference

Case conferences at the Clinical Services of the White Institute focus on specific areas of the psychoanalytic process. The therapist does not try to tell everything about his case. He does, however, try to tell the conference as much as possible of those matters that bear upon and reveal one essential aspect of the treatment, such as the transference, the countertransference, the state of the therapeutic alliance, the resistance, or a crisis.

The cases presented are from the Institute's analytic service, through which psychoanalysis, conducted in the usual manner and in a private setting, is provided for patients who could not otherwise afford such treatment. In the selection process, prospective patients are interviewed by the clinic social worker and a psychoanalyst, whose screening reports describe the applicants' problems, evaluate their suitability for psychoanalytic treatment, and predict its course and outcome. Patients and candidates are matched in a meeting between members of the Training Committee, who know the candidates, and of the clinic staff, who are familiar with the patients, adding a further refinement to the process of selection and providing research data for retrospective studies.

At the clinical conference, all those who have had contact with the patient—the social worker, the analyst screener, and the therapist's supervisor, as well as the clinic staff—take part in discussing the material. The cases may be presented in the first weeks or months of treatment, often a crisis period for the young therapist, during which he is likely to be in sharp disagreement with the optimistic forecast of the clinic staff. Cases may also be presented at a later stage in treatment or at termination, when a more subtle focusing on the transference and countertransference operations may be possible. Particularly instructive cases may be presented at intervals in a continuing group scrutiny of selection and treatment procedures.

Insight and perspective are ad