The teaching of psychoanalytic psychotherapy at an increasing number of institutes of the American around the country was discussed at the meeting of the Board on Professional Standards in San Diego. Many Board members raised concerns about such programs, and there are plans to continue these discussions in New York in December.
Shelley Orgel, Chairman of the Committee on Institutes, began by summarizing the discussion which had taken place at his committee's meeting several days earlier, where considerable misgivings had been expressed. Carl Davis, Secretary of the Board, summarized the wide-ranging discussion which followed Dr. Orgel's remarks several days later for the Meeting of Members. His report will soon be available to all. What follows is a briefer review.
These psychotherapy programs range widely in scope, structure, and purpose, but in some cases, reach far beyond the previously well-established extension division courses where principles of psychoanalytic theory or practice were taught. Some are, in effect/degree-granting programs offering clinical training; they are highly organized and conducted by the faculty and under the aegis of the institute.
Programs are often structured according to the model of psychoanalytic training itself: a specified number of years of course work, supervision, and, in some instances (at the San Diego Institute, for example) a required personal therapy experience of some kind. The programs are usually offered to a wide array of mental health professionals; the majority are generally nonphysicians.
Such programs are attractive to institutes for many reasons: Institutes can reach out to wider segments of the community. Teaching opportunities are
gained for those who are unable to find places in the regular teaching program of their institutes. Referral souces might be facilitated. (Many disagree that this is so.) Additionally, many believe that the therapy being practiced by many therapists can benefit from access to quality teaching such as our institutes can offer.
But there are also causes for concern, many think. Individuals who undertake such programs attain the prestige and credentials associated with the institute. Some even call themselves analysts, and some of these believe they are analysts once they have “graduated.”
The programs tend, some say, to take on a life of their own and to split a faculty or drain or displace the resources of a smaller institute from its major educational responsibilities. The lines between psychoanalysis and psychoanalytic psychotherapy can become blurred and ambiguous to trainees and even more easily to outsiders, defeating the purpose of increasing analytic consciousness (and analytic referrals).
Further, people can be “accredited” by an institute without any of the safeguards and monitoring which are built into gaining accreditation through analytic training itself at institutes of the American, where such functions are attended to by the Board.
One Fellow claimed that with such programs an institute enters the field of nonmedical training without the necessity for an honest, proper debate on the subject. Others asserted that until we can tell and teach the differences between psychotherapy and psychoanalysis, we should stick to what we can and do know—teaching psychoanalysis—and not risk lending our authority and reputation to individuals who, even unwittingly and with good intentions, might exploit it. Further, say some, institutes become liable for law suits when they try to deny training to an individual when the requirements for admission to a program are as wide and loosely structured as is necessarily the case here.
A major argument of those speaking in favor of such programs is that a legitimate need exists, that programs will arise to fill that need, that our institutes can do it better than anyone else, and that it is not harmful to an institute, and may often be to an institute's credit and benefit. Further, some assert that scrutiny of such programs is beyond the legitimate domain of the Board, which should be limited to psychoanalytic training itself.
The issue is complex, and overlaps in many ways with the presently unresolvable debate on training nonmedical candidates. A joint ad hoc committee of Board and Council will be appointed to review the nature, extent, and scope of such programs past and present and report its findings in New York in December, where the discussion will continue. The hope was expressed that any institute considering undertaking such a program consult with the Board and Committee on Institutes while this deliberation is going on.