The following are selected items from The Board on Professional Standards and the Executive Council reports of the December 1980 meeting in New York. Other items appear separately elsewhere in this issue.
Dr. Laurence B. Hall commented on a variety of problems that have beset the Board and the Association recently, beginning with the concerted attempts of the National Accreditation Association for Psychoanalysis to become the officially recognized accrediting and certifying agency for psychoanalysis in the country. After much effort by the Officers of the American, NAAP's attempts have been checked, at least for the time being. A Joint Committee of Board and Council, consisting of Drs. Herbert Gaskill (Chairman), Paul Fink, and James McLaughlin, has been appointed to study the question of whether the certification process might be extended to members of other organizations.
Outside pressures include mounting legal hazards, which require coordination by the Association and the individual institutes and societies. Dr. Hall expressed also concern about a reported decrease in candidates and suitable cases for training purposes.
Responding to a preliminary draft of a new membership proposal to the Executive Council (known as the “Chicago Proposal”), Dr. Leonard L. Shengold, chairman of the Membership Committee, remarked that, although circulated, the proposal had not been called to the Board's attention. The proposal involves provisions for an automatic membership with extensive voting rights on graduation, and the conversion of the Standing Committee on Membership of the Board into a Joint Board-Council Committee. Dr. Shengold reminded the Board that membership was one of its primary responsibilities, clearly spelled out in the By-laws. He then quoted the relevant By-laws defining the Board's responsibility for educational standards as well as the administration and evaluation of membership. Noting that the Council had appointed a Committee to Study the By-laws, he cautioned that precipitous action should be avoided. Dr. Shengold then called attention to a resumé of statistical results of the questionnaires to institutes regarding categories of membership. While all institutes had responded, not all societies did, so that data were incomplete.
Because there was so much important but incomplete research, the Committee on Membership recommended that (1) All proposals involving By-laws changes be kept in abeyance until the research is completed; and that (2) the Board continue its support
of the Committee on Membership as a Standing Committee of the Board.
After a vigorous discussion, a motion was made and carried by a majority of the Fellows of the Board: “The Board urges the Council to study and examine the membership issue further, to include in such study the thoughts and findings of the Membership Committee and the deliberations of the Board, and to include the Board in its dialogue. It further suggests that the Council not initiate action on any membership proposal before such study and deliberations.” A second motion, proposing that “The Board on Professional Standards accepts the Committee on Membership's report,” was also passed.
Dr. Justin Krent, chairman, reported that the Committee had acted on 36 new applications and 11 reapplications. Twenty-eight were accepted (see page 6). Dr. Krent mentioned that many more are now applying for certification within two years following graduation. This year almost half of the applicants fell in this category, which would seem to indicate an endorsement by recent graduates of the value of certification and membership in the American. Dr. Krent drew attention to a number of problematic areas, as revealed by the applicants' records: An inadequate analysis of oedipal derivatives, especially aspects of aggression and sexuality; an exclusive concern with pre-oedipal determinants; and
hardly any mention of anger during the termination phase but, rather, an emphasis on feelings of gratitude and regret for terminating the analytic work.
The Committee was, however, satisfied that standards were being on the whole maintained and evolving successfully.
Dr. Selma Kramer, chairman, reported on activities in various training centers, in particular the UNC-Duke, San Diego, St. Louis, and Michigan programs. She then recommended and the Board granted a waiver for the appointment of Elizabeth Bremner Kaplan to be a supervisor for Baltimore child candidates who reside in Florida.
Dr. Shelley Orgel, chairman, reported on recently completed and on forthcoming site visits, along with the work of those liaison subcommittees with matters to report. Seventeen institutes were discussed in some detail. Other issues examined were the need to maintain the integrated tripartite character of psychoanalytic training, the frequency and length of analytic sessions, and problems which arise when candidates undertake supervised analysis with patients formerly treated in psychotherapy.
Dr. Jerome Beigler, chairman, reported that there have been new legislative battles in Congress regarding several bills protecting the privacy of medical records; in fact, they could be more accurately described as “discovery” bills in that they provided complete access to records by law enforcement agencies even without notifying patients. The American Psychoanalytic Association participated vigorously and successfully in defeating the passage of these bills.
The Committee considered a suggestion that the Association's Code of Ethics was too permissive for the disclosure of confidential information when demanded by courts, and should be modified to encourage “hazarding” contempt of court to protect patients. The Committee felt that the present ethical code was adequately strong in this regard, in that it specified that all legal means to safeguard a patient's right to confidentiality be used. This would include dissenting within the law, and imply even “hazarding” contempt of court as a means of appealing adverse judicial decision.
Dr. Herbert J. Schlesinger, chairman, reported that the very early results emerging from the committees study are “quite encouraging,” and they show that “at the very least, the total medical utilization including costs of mental health treatment were no more for those persons who got mental health treatment than for those who did not.”