After considerable discussion, a proposal from the Committee on Preparedness and Progress (COPAP) to revise the requirements for selecting applicants for analytic training was passed at the May 13 meeting of the Board on Professional Standards in San Diego. The proposal will be put in the form of a by-law amendment and voted on by the membership. If passed, this change will give institutes greater autonomy in accepting candidates with Masters of Social Work and Masters of Marriage, Family, and Child Counseling degrees. Surprisingly, there was little debate during the discussion of external credentialing — a formerly divisive topic which appears to be resolving in an alliance with the Psychoanalytic Consortium. A third area of concern was the current difficulties in child psychoanalysis. At the meeting's conclusion, Lawrence Chalfin, completing his term as chair of BOPS, spoke on his three-year experience.
Phyllis Tyson, chair of COPAP, brought to the floor the latest in a series of drafts revising candidate selection standards. The draft specified criteria for suitability and eligibility. Suitability requirements include such character traits as integrity, maturity, and honesty, plus evidence of analyzability. Eligibility requirements include education, experience, and a solid professional identity.
The change that generated the greatest debate was revising eligibility to allow institutes to accept, without waiver, applicants possessing the highest post-baccalaureate degree generally obtained in their mental health profession. Requirements for all applicants include extensive education and clinical experience. Applicants without a doctorate would need two years of post-graduate didactic and clinical training or two years in a doctoral program. Institute extension divisions provide this type of experience.
COPAP's proposal arose both from its extensive monitoring of institutes' evaluation of mental health professionals without doctorate degrees and such individuals' successful educational progression. Tyson considered the proposal “the best possible compromise” because some institutes wanted to continue the waiver requirement while other institutes wanted to eliminate waiver requirements entirely.
During the wide-ranging discussion, several changes were made to clarify the language of the proposal. Robert Michels raised several substantive issues. He was concerned that the document diluted “hard criteria” and increased “soft criteria.” He felt it contained several paradoxes, such as accepting marriage counselors while requiring knowledge of psychopharmacology. He doubted that residency programs produce psychiatrists who would meet all criteria. He cautioned that requiring curricula that may not exist could have the insidious effect of encouraging institutes to flout the rules.
Marvin Margolis agreed that many residency programs do not provide training that would fulfill the proposal's requirements; he pointed out, however, that institutes provide remedial experience. Tyson said that the proposal suggests remediation by institutes. She added that the better masters programs provide teaching that familiarizes students with many aspects of treatment including medication. Ronald Fleishmann felt that “soft criteria” were most relevant in selecting a candidate. A degree of vagueness was important, he said, because it allowed greater local autonomy.
Several fellows worried that The American was moving toward setting up psychoanalysis as an independent profession, divorced from the mental health professions including psychiatry. Tyson responded that the proposal emphasized a strong professional identity requiring immersion in an applicant's particular clinical field.
Daniel Greenson reported that the proposal would not be a great change in San Francisco. That institute has accepted many masters-level candidates, with no decrease in number of psychiatric applicants. Warren Procci of Southern California said his institute had instructed him to vote against the proposal because it was too limiting. Both Southern California and Los Angeles are losing applicants to local institutes that do not belong to The American because potential applicants misperceive the waiver as a symbol of The American's unfriendliness.
After an hour and a half of discourse, Michels moved to postpone the vote so the committee could formulate various options taking into account the Council's discussion. Several fellows spoke for and against Michels's proposal. Both President Margolis and BOPS Chair Chalfin opposed the motion, which was defeated by a large majority.
Edward Hartmann then proposed an amendment that would require social workers applying to institutes to undergo a CSW or peer review examination. Helen Rosen informed the Board that there were three examinations — the CSW and two different Board Certified Diplomats — none of which was preeminent. These examinations do not confer degrees; they are peer review accreditations and are not necessarily clinical. Hartmann changed his motion so a MSW would be “complemented with peer review accreditation.”
The vote was close, but the motion was defeated. Hartmann proposed a second amendment that marriage counselors not be included in the proposal at this time. This amendment was defeated by a margin of about two to one. BOPS then voted, by a large majority, to accept the report.
A preliminary report of the new Ad Hoc Committee on External Credentialing, chaired by Calvern Narcisi and Leon Hoffman, had been distributed prior to the Board meeting. There was no disagreement with its tentative recommendation to proceed with the Psychoanalytic Consortium and IPS toward establishing an external board of psychoanalysis. A full report is planned for September, with a vote expected during the December meeting.
The committee had reviewed the reports of previous external credentialing committees and the regulations of the Council for Higher Education Accreditation (CHEA, the new name for a reorganizing CORPA) and the Department of Education (DOE). The report answered some disputed questions. Both DOE and CORPA have accepted more than one accrediting agency per profession. After speaking at length with Karen Kershenstein, head of DOE, the DOE criteria was clarified. CHEA was still in the process of change; the committee will contact it later. It was not clear how long it would take DOE to recognize the
proposed board; however, Narcisi said that DOE was eager to facilitate the application. DOE informed the committee of ways to select members of an external credentialing board.
Chalfin and Rosenblitt had sent a letter to the Fellows on April 14, proposing a compromise to the question of whether or not The American should join the Consortium. They proposed the Association move forward with the Consortium and IPS to form a National Accreditation Board, provided safeguards were created protecting the work of the BOPS Committee on Institutes and the Committee on New Training Facilities. In addition, the board's training standards should be those of The American, or The American and IPA. If the Consortium had made no progress toward establishing a board after three years, BOPS would apply to DOE and CHEA independently.
Narcisi reported that the May 2 meeting of the Consortium had been encouraging. He was very favorably impressed with the cooperation and the seriousness of the members in discussing the need for high standards of training. The Consortium developed a draft of training standards which was distributed to the fellows.
Margolis, a representative to the Consortium, said a sea change had occurred in the attitudes of both the Consortium and The American. Consortium members now recognize The American's good faith and its need for internal consensus. Margolis added that it was probable that IPS would join the Consortium. Rosenblitt, The American's other representative to the Consortium, said his attitude had changed “from hopeful pessimism to hopeful optimism.”
Discussion from the floor was brief and primarily directed to additional clarification. Lee Shershow summed up the feelings of many Fellows when he commented that he came to the Board expecting to witness a fight, but what actually took place seemed like a dream.
The third major item for discussion involved the report of the Committee on Child and Adolescent Analysis (COCAA), presented by co-chairs Sam Rubin and Martin Silverman. Silverman spoke on how to rescue a seriously ill patient: One needs to value the patient, to recognize the seriousness of the illness, and to institute effective measures. To the surprise of the audience, Silverman was referring to psychoanalysis in general. Revitalizing child analysis, he said, would have a beneficial effect in all areas of the profession. Rubin said COCAA was developing a dialogue with components and members of The American. (For a full description of this topic, see the special section “Crisis in Child Analysis” in TAP 31/1.)
Myron Hurwitz, chair of the Committee on Certification, was troubled to have read e-mail advising graduates applying for certification to shape reports to conform to an Oedipal conflict model, imagining that this was what the committee wanted to see. An example of this thinking was one recent certification report replete with the phrase “classical analysis without parameters.” Several additional fellows expressed their dismay that after a long effort to educate applicants, the misconception still exists that the committee only accepts one viewpoint.
David Carlson and Richard Fox, co-chairs of the new Ad Hoc Committee on Governance Issues, are exploring both a structural and a functional approach to governance within The American. A structural approach involves establishing an institutional hierarchy. A functional approach, which the committee favors, describes the functional relationship between the various elements of the Association and develops a set of recommendations. The original Articles of Incorporation are ambiguous, setting up many potential conflicts within the organization. For example, the president is the elected leader of the organization, the chair of the Executive Committee, and the chair of the Council.
Susan M. Fisher and Charles M. Jaffe of Chicago, Vivian Blotnick of Columbia, Jeffrey A. Levine and Joseph Mark Thompson of Los Angeles, and Daniel M. Brener of New Orleans were appointed training and supervising analysts. Henry C. Mallard and Eslee Samberg of New York, Leonard Barkin and Barry Opatow of NYU, and Edward L. Hicks of the Philadelphia Institute were also appointed, as were Martin Miller of PINE, Mary L. Ramsey of St. Louis, Sergio Delgado of Topeka, and Ingrid Pisetsky of UNC-Duke. Appointed child-adolescent supervising analysts were Alan B. Zients of NYU, Rhoda Frenkel of Dallas, Alan Sugarman of San Diego, and Sergio Delgado of Topeka.
Donald Rosenblitt, chair of the Committee on IPA Membership, proposed three new members. Ahmed Fayek of Canada, Peter Fonagy of Britain and Topeka, and Richard Laskey of IPTAR received unanimous approval.
Phyllis Tyson proposed for waivers 10 applicants from four institutes; all passed.
The Board indicated to Richard Fox, chair of the Committee on Membership, that the committee should proceed with a proposal that would automatically confirm new candidates' affiliate membership and waive their dues for the first year.
Deanna Holtzman, chair of the Committee on Research and Special Training, received approval for two waivers. Marcia Cavell is a highly creative philosopher of psychoanalysis and winner of JAPA's Kanzer Prize. She will attend the San Francisco Institute. Talma Scherson was approved for the Southern California Institute. She is researching the physiological basis of memory formation at UNC-Irvine with a particular interest in memories of emotional and traumatic events. Holtzman announced the establishment of an annual CORST essay prize of $1,000.
Ronald Benson, chair of the Committee on Institutes, reported on the recent survey on retirement policy at institutes. Of the 22 institutes that responded to the survey, 13 had a formal policy of not assigning candidate analysands over a particular age. Most institutes review training analysts' capability, some on a regular basis and some for cause.
Chalfin, completing his three-year term as chair, addressed the Board at the meeting's conclusion and thanked the many colleagues and Fellows with whom he had worked during “an exciting time.” He emphasized what he considered the three most significant achievements: Candidates became active participants in the activities of BOPS, the COPAP proposal was approved, and external credentialing moved toward consensus. He received a standing ovation.