This is one of a series of articles informing members about the Association's various offices, governing bodies, and committees. Dr. Lilleskov is Chairman of the Committee on Child and Adolescent Psychoanalysis.
The Committee on Child and Adolescent Analysis is one of the six standing committees of the Board on Professional Standards. Its functions with respect to programs of child and adolescent analysis are analogous to the functions of the Committee on Institutes and the Committee on New Training Facilities. Thus it is responsible for setting and maintaining standards for established programs as well as for “enabling” new programs to meet those standards while becoming established.
Until 1951, the Board on Professional Standards took little notice of child analytic training. In December of that year, Dr. Ives Hendrick, the Chairman of the Board, appointed Dr. Sarah Bonnett to head a Subcommittee on Standards of Training for Child Analysts. The Committee's first task was to survey the existing child analytic training programs. At that time there were only four institutes with child analytic training: Boston, Chicago, New York and Philadelphia.
The child analytic programs were relatively informal and variable in their curricula and other requirements. It was a common complaint that child analytic training had a low priority in institute values. Nevertheless, with the help of representatives from each of these four programs, a preliminary set of minimal standards for training were proposed by the Committee by 1958. They also recommended the establishment of a Standing Committee on Child and Adolescent Analysis of the Board on Professional Standards.
The Standing Committeee, COCAA, was charged “to delineate and define child analysis and child analytic techniques; to set and maintain standards for training in child analysis; to stimulate and develop new training programs in child and adolescent analysis; and to determine and advance the contribution to be made from child analysis to psychoanalytic training generally.” The fulfillment of these charges has occupied the COCAA ever since with varying emphases from time to time.
During the early years the stimulation and development of new programs was in the forefront. An enabling subcommittee of COCAA was appointed to help any institute that desired to provide child analytic training. By 1961, eight more of the fifteen institutes had begun programs in child and adolescent analysis. By the mid 1970's there were nineteen programs among the twenty-six institutes by then active. In 1982, three more programs started, to bring the current total to twenty-two. Two of the other four institutes participate actively in the child analytic programs at neighboring institutes.
Concurrently with the “enabling” work, the COCAA formulated standards for training in child and adolescent analysis. They were first published in 1966 and then in a revised and clarified edition in 1977. The standards were arrived at after several years of discussion in the COCAA which is made up of approximately twelve members from different institutes. Before they were published, their content was also discussed in Workshops for Representatives of Institutes that had been organized by COCAA. The final form thus represents a consensus of opinion by child analysts from all over the country.
The COCAA sponsors a Workshop for Institute Representatives at most meetings of the American Psychoanalytic Association. The representatives,
usually chairmen of the child program, meet to exchange information about problems of mutual interest and their solution at various institutes. The topics discussed are varied and in addition to standards have included such questions as the form and content of the curriculum, the role of the continuous case seminars, the development of faculty and supervisors, the problems of finding appropriate cases, the differentiation of child psychoanalysis and child psychotherapy, the problems of maintaining a child program in a small institute and many others.
In addition, for a number of years the COCAA sponsored a Workshop on the Developmental Core Curriculum. Representatives from each institute met once or twice a year to discuss ways in which child analytic concepts could be utilized and integrated into the adult analytic curricula of institutes. The success of these meetings can be measured in part by the degree to which child analytic concepts are taught in our institutes. Courses on child and adolescent development are virtually universal and many institutes also include courses in child observations, child psychopathology, and child and adolescent continuous case seminars either as required or elective subjects.
A member of COCAA is assigned to each site visit subcommittee of the Committee on Institutes. On these subcommittees, which visit each institute periodically, the child analyst member is able to monitor and evaluate the child analytic training, as part of the overall assessment of the psychoanalytic training at the institute. These first-hand observations are a valuable addition to the written and verbal reports available to COCAA.
At a typical meeting of the COCAA, which takes place all day Monday preceding each Wednesday meeting of the Board on Professional Standards, a major portion of the time is devoted to the discussion of reports of the Enabling Subcommittees. At present four of the twenty-two programs are in the process of being “enabled”, that is, working toward meeting the standards for full approval. A variable amount of time is devoted to the other responsibilities of the Committee. We review the data submitted to the Board for the approval of appointments of new supervisors in child and adolescent analysis. If it has been demonstrated that the standards of training have been met leading to Certification and that the prospective supervisor has subsequently been able to immerse himself in the clinical practice of child and adolescent analysis, we are able to recommend approval of the appointment.
Attention is also given to particular problems in various child programs that are brought to our attention by inquiries from institutes or by reports from our site visitors. Ordinarily the questions can be resolved by advice and recommendations. When the problems are severe, as for instance where the departure, retirement or death of supervising analysts threatens to bring the number of supervisors below the acceptable standard for approval, an Enabling Subcommittee may be reappointed to work with that child and adolescent program toward resolution.
Matters of policy and procedures and the advisability and necessity of changing them usually arise from the exigencies of particular situations. Currently, we are struggling with the practical and conceptual questions raised by child and adolescent programs in small institutes. How can a curriculum be implemented and the group process advantages of a class provided, when there is only one candidate accepted every year or two? Could regional or national classes be provided to supplement the teaching available locally?
Members of the COCAA are appointed for three-year terms by the Chairman of the Board. They usually serve for two terms. During these six years they are usually quite busy. In addition to attending the two all-day meetings of the Committee each year, they usually serve on one or more Enabling Subcommittees. During each three-year term they also can expect to represent the COCAA on at least one site visit committee of the Committee on Institutes.
In our work we are guided and sustained by the conviction that the future of child analysis as a treatment modality depends upon the training of candidates in an atmosphere of high analytic standards. We have no doubt about the great value of child and adolescent training for child therapists, researchers in child development and even to enhance the abilities of adult analysts. However, for analysts to become practitioners of child and adolescent analysis and for them to become capable of transmitting their knowledge as supervisors, they must learn the validity of the child analytic process as distinct from the various child therapeutic processes. So most of our efforts are geared toward ensuring that child and adolescent analysis continue to be well taught.