In June 1992 a remarkable document was produced for the Chicago Psychoanalytic Society in response to its request, unprecedented in The American, for a formal consultation regarding the status of psychoanalytic practice in its locality and the manner in which the Society has responded or not to challenges and barriers to practice. This consultation involved an in-depth study and analysis of the structure and functioning of the Society as these impinged on issues related to psychoanalytic practice locally, as well as a number of other surveys and studies, with the ultimate aim of making recommendations to the Society regarding the successful marketing of its services.
The American's Committee on Psychoanalytic Practice, in conjunction with the Task Force on Practice, became aware of the report's applicability far beyond the Chicago area. Arrangements finally were made, in April 1993, to make it available to presidents of affiliate societies, to directors of institutes, and to members of various committees of The American now hard at work on issues related to practice. The full-length document is informative and stimulating—it includes data from areas around the U.S. other than Chicago—and is available to members of The American through their local society president or institute director. We hope that many analysts will become familiar with this study. As an introduction, Lee Brauers abstract of the full report, “Marketing and the Organization: A Report to the Chicago Psychoanalytic Society,” appears below.
For four months during the Spring of 1992, the Laboratory in Management Process of the University of Chicago School of Business conducted a consultation with the Chicago Psychoanalytic Society to study how to market psychoanalysis in the Chicago area. The consultation was conducted by means of (1) regular meetings with the Practice and Marketing Committee of the Chicago Society and Institute; (2) interviews with forty members; (3) six discussion groups held with over fifty members of the society; (4) a survey of members to study their practices and their understanding of the current structure of the society.
The consultants found that “the Society is currently not capable of implementing an effective and sustainable marketing plan. The Society first needs to concentrate its efforts internally, to define its goals, to determine what the members wanted, and to build cohesion within the organization.”
The problem for analysts stemmed from the decline in practice due to competition from other providers, third-party pressure for shorter term treatments, the impact of psychopharmacology, and the diminished image of analysis in the public eye, where it is often portrayed as anachronistic, idiosyncratic, or corrupt. The consultants considered whether it would be best to market analysis through the Society, the Institute, or a separate organization that might be established solely for that purpose. They recommended that analysis be marketed under the aegis of the Society, since the Institute had other goals that were primary. Creating a new organization would be distracting. The task of marketing was more appropriate to the mission of the Society, which has greater flexibility due to its larger membership, and is inherently less closed to the community than is the Institute.
The consultants identified four problem areas within the Society to be addressed before undertaking a more general marketing effort. These were (1) lack of clear organizational identity; (2) low involvement; (3) lack of communication among members; (4) limiting organizational structure. The consultants felt that success in marketing would require a clear sense of mission and organizational identity, and a sense of purpose and belonging among the members. The lack of identity involved lack of agreement about whether the Society should be involved in marketing, and lack of a sense of urgency about the matter. The Society was seen as being run by a few key members, and its principal task confined to scientific presentations. It was not seen as proactive. Members felt estranged from the Society and felt its activities were not germane to their problems or practice issues. There was little incentive to be involved in its activities, and poor communication about them. Members on the Institute faculty were felt to be an “in group,” with others feeling excluded. The structure of the organization was not understood, and the committees functioned in a desultory way. There was little coordination, and frequent changes of leadership did not promote effective functioning around tasks.
The consultants recommended the following remedies to address the issues:
It was important to clearly define the mission of the Society and its committees through mission statements.
Involvement of the membership could be fostered by practice workshops, retreats, and social events.
Communication could be improved by circulating a newsletter, welcoming new members, conducting a survey of practice and discussing the results with the membership, and establishing a liaison group between the Society and the Institute to foster cooperation between the two bodies and enlist the talents of the Institute in the Society's activities.
Organizational structure would be redefined and restructured by a series of ad hoc committees working in conjunction with the practice and management committee.
Training in organizational techniques would occur through group process workshops, and a central office would also be established and staffed.
The public image of analysis might be strengthened by the activities of members who consult, teach, publish, and talk to relevant audiences such as psychologists and social workers.
Access to psychoanalysis by patients for consultation and treatment should be provided both by individuals and by a clinic.
Appendices to the report are rich in content. The results of the survey are reported, and the efforts of other societies to approach these issues are detailed, including descriptions of activities in Michigan (Dr. Marvin Margolis), Houston (Dr. Jorge de la Torre), New York (Dr. Arnold Richards), Boston (Dr. Joyce Root), San Francisco (Dr. Erik Gann), Cleveland (Dr. Norman Clemens), Washington, D.C. (Dr. Marvin L. Adland), and elsewhere. One appendix makes recommendations on how to foster a private practice. The functioning of the clinic was evaluated, and recommendations were made to enhance its visibility and effectiveness. A summary of the mental health field on a national level was provided to give perspective. Reports on focus groups described attitudes toward therapy, analysis, and analysts held by both patients and other mental health professionals concerning when to seek help, whom to see, and the qualities felt important in a therapist or analyst. Analysts were seen as elitist and inflexible, and analysis was felt to be a luxury. There was considerable lack of understanding of what analysis is and what analysts do. As for the size of the potential market for psychoanalysis and psychoanalytic psychotherapy, it was estimated that enough patients could be generated by pinpointing selected populations. (It should be noted that this perspective focuses on the needs of analysts and not on the needs of the patient population.) HMOs were felt to be a relatively minor issue for analysis, since most analytic patients are self-funded.
Lee David Brauer, M.D., chairs The American's Committee on Psychoanalytic Practice.