The Reiss-Davis Child Study Center is a memorial to two Southern Californian pediatricians, Oscar Reiss and David Bennett Davis, who were interested in the field of mental health and child guidance. Its purpose was to provide diagnostic and treatment services to emotionally disturbed children in families who could not afford private care, to engage in clinical training programs in those disciplines related to this field, and to carry on investigation and research leading to new knowledge. Started in 1950 as a clinic, the Center acquired a psychoanalytic orientation when its Board turned to Dr. Ralph Greenson for consultation and advice. Dr. Rocco L. Motto became its full-time Director in September, 1953 and was given carte blanche to reorganize the staff and develop a program along psychoanalytic lines. Its professional Advisory Committee now has members from both the Los Angeles Psychoanalytic Society and the Southern California Psychoanalytic Society.
Beginning with a full-time staff of one pyschiatrist, one clinical psychologist, two pyschiatric social workers, and two secretaries, a budget of $60,000, and a remodelled warehouse of approximatel 4000 sq. ft., the Reiss-Davis Center has undergone a remarkable period of growth
in the intervening years. After successive stages of make-shift expansion, it moved in 1961 to a new, 20,000 sq. ft. facility which houses 25 play-therapy rooms for children, 15 administrative and secretarial offices, an auditorium for 180 persons, a research wing with modern recording facilities and observation windows, and the Anna Freud Research Library, which now has over 5000 volumes and 200 professional journals. The posts of Director of Training, established in 1955-56, and Director of Research, established in 1957-58, have been held by individuals trained either in psychoanalytic institutes or in the Hampstead Child Therapy Clinic in London.
Clinical training has been a major activity of the Center, carried out with the volunteer or part-pay services of many psychoanalytic colleagues in Los Angeles in addition to its full-time staff. In 1961 the training programs in pre-doctoral clinical psychology, in child psychiatry (both as full residency training and as part of an affiliation with a three-year general psychiatric residency program), and in psychiatric social work (pre-master's training as part of an affiliation with both USC and UCLA Schools of Social Work)— were all being supported in full or in part by the National Institute of Mental Health. Representing these various disciplines were 18-20 students in training at any given time, and there were usually more applicants than places available.
In 1962 the Clinic's two-year Fellowships in Child Psychiatry received the approval of the Residency Review Committee of the American Medical Association, and so far 17 individuals have been enrolled with 11 completing the course. After providing training for 20 students, the one-year Pre-Doctoral training program in Clinical Child Psychology was discontinued in favor of a two-year Post-Doctoral program, which so far has attracted nine graduates. To date, 48 physicians have had a one-year training experience as part of their general residency training in psychiatry. Twenty social workers had a one year training period before receiving their Master's degree. Three persons have completed a two-year Fellowship in Psychiatric Social Work, instituted in 1966 for individuals with three years of experience after the Master's degree, and three more are now enrolled.
Along with the developments in training have been expanded interests and activities in the realm of research. Over the years there have been projects devoted to studies in childhood autism, psychological tests, reactions of children to naturally occurring crises, and the correlation of biochemical and psychological data of newborns in the first 96 hours of life. Currently the active research projects are concerned with the following areas: 1) Childhood psychosis; 2) Comparison of the efficacy of once-a-week versus four-times-a-week psychotherapy; 3) Decision making in psychiatry, with the application of data processing techniques to clinic case records.
In the realm of clinical services, all of the diagnostic and therapeutic work of Reiss-Davis had been carried out on an outpatient basis until this current year. From a beginning maxium capacity of 20-25 cases per month, its Division of Clinical Services is currently able to handle 250-260 active cases in diagnosis or therapy. With the aid of Hill-Burton Funds, a three-story wing in which to house a Day Treatment Program for children between 3 and 12 was completed in May, 1967. When supporting NIMH funds were curtailed, the Board of Directors and local community rallied to the need and raised sufficient funds to open two of the three classrooms. The new facility will add another challenging aspect to the clinical services at Reiss-Davis.
In 1965, in recognition of the expanded nature of the programs at the Reiss-Davis Clinic for Child Guidance, the Board of Directors changed the name to the Reiss-Davis Child Study Center and reorganized it around four divisions: 1) The Division of Clinical Services; 2) The Division of Clinical Training; 3) The Division of Research; and 4) The Division of Community Education and Prevention.
The last Division acknowledged the importance of day-long Institutes and Seminars of 2-3 hour weekly sessions extending over 10-12 weeks, which had been given over the years on topics related to the work and interests of the Reiss-Davis Center. Seminars were offered first to pediatricians, then to teachers. When funds and manpower become available, the Division of Community Education and Prevention will extend the current activities and expand its interests to law, probation, religion, and community work with children.
The current budget of the Center is $850,000, and it supports 104 staff members and trainees. About one-third comes from grant support from either NIMH or private foundations. Another third currently is derived from the efforts of 8 local
philanthropic groups who raise funds for the Clinic. The remaining third is the responsibility of the Board of Directors who each year develop new sources of interest and support for Reiss-Davis' many programs. Patient fees represent a negligible source of income, no more than 4-5% of the total budget. Seventy percent of the families are able to pay a fee of only $3.00 or less. Children are seen 2-3 times a week in psychotherapy, parents 1-2 times per week, and the treatment of child and parent is carried on for as long as is necessary. The average length of treatment at Reiss-Davis is 2½-3 years.
Some research cases have been in treatment over a 10-12 year period, and the current cases in the Childhood Psychosis Project have been carried an average of four years, with 2-3 psychotherapy appointments per week.
Psychoanalysis has played a most significant role in the development of the Reiss-Davis Child Study Center since 1953. Without the direction and leadership provided by psychoanalytic colleagues it is unlikely that the institution would have arrived at its present stage, one of tremendous value to the community in services and training. In the face of the current interest and pressure for “brief intervention,” for “walk-in,” “short-term,” and related “brief therapies,” it will require a great deal of further effort and commitment to the psychoanalytic approach in order not only to maintain the gains that have been achieved but to make even more meaningful contributions in the future.
(R.L.M.)