Our innovative preliminary survey describes a body of analysts in training who are diverse in age, gender, and professional background but who are quite united in their commitment to psychoanalytic education. Conducted in 1995-96 by the Affiliate Council of the APsaA, with the data analysis completed in 1997, the survey represents the first candidate effort to study those in training within the organization. Although conclusions to be drawn from the data are limited by several factors — particularly a low response rate — the survey will be the standard of comparison for the future.
The two-part survey was developed by Lee Jaffe with the help of Joni Liebermann. It was distributed through local candidates' organizations at each institute. One questionnaire, distributed to each candidate, solicited personal and professional information. A second questionnaire, given to the head of each institute's candidate organization, collected general information about that institute. The authors took care to guard the confidentiality of data; they took particular care to ensure that no individual could ever be matched to the responses on his or her questionnaire. A similar but less stringent level of confidentiality was maintained for identification of institutes, so that it would not be possible to sort the data by institute.
The survey posed questions regarding demographic data, training status, institute policies, and financial information. Two hundred twenty-one of approximately 600 candidates nationwide completed questionnaires, yielding a response rate of 37 percent. Candidates' organization leaders provided data for 17 of 27 institutes, including most of the larger institutes; the response rate for institutes was 63 percent. Thus, this survey suffers from the same difficulty encountered by the Committee on Psychoanalytic Practice: low response rate.
Among the most striking features of the body of respondents was its diversity. Two-thirds of respondents were female; 36 percent were male. This disproportion tended to be less pronounced in larger institutes. There was a marked tendency for gender to correlate with professional degree; 100 percent of candidates with a degree in social work were female; 67 percent of psychologist respondents were female; 52 percent of physician respondents were female. Of total respondents, 53 percent were physicians, 40 percent were psychologists, and 7 percent were social workers. Social workers tended to be distributed evenly between institutes. The larger institutes followed these percentages more closely.
In considering important training issues, candidates were questioned about supervision. Sixty percent of respondents felt they were free to change supervisors. This overall result was depressed by response from a cohort at one large institute where the percentage was only 48 percent. Seventeen percent of all respondents had actually changed supervisors. Fifty-two percent of the respondents said they felt free to change training analysts, but only 3 percent had actually done so.
Questioned about financial data, responding candidates as a group reported that they spent 26 percent of their gross income on psychoanalytic training, excluding opportunity cost. Efforts to calculate the actual cost of training required a complex assessment of factors including tuition, supervision fees, control case fees, and institute policies regarding whether candidates could keep the fees they earned. This assessment did not include the cost of the training analysis. One finding was clear: The variation was enormous. In some institutes, candidates appeared to be breaking even; in others, the cost appeared to be in the range of $5,000 per year. No geographic pattern was evident. Eight responding institutes had policies in place that regulated supervision costs; one institute included the cost of supervision in its tuition.
Broken down by degree, physicians spent the smallest percentage of their gross income on training, social workers the most, and psychologists held the middle ground. Fifty-eight percent of responding physicians reported they spent 20-30 percent of their gross income on training; 59 percent of responding social workers reported that 30-40 percent of their gross income went for training; and 70 percent of responding psychologists spent between 20 and 40 percent of their gross income on training. A very interesting finding was that the average weekly fee for the psychoanalytic control case was $84 for four to five sessions.
The more general information questionnaire looked at the candidates' participation in policymaking within individual institutes. Findings indicated that while two-thirds of the institutes included candidate representatives on the curriculum committee, less than a third permitted candidates on the education committee or the equivalent. Only five institutes addressed practice development in their curriculum. Five institutes required completion of a thesis to graduate.
Generalizations about the data collected in this survey are limited by the response rate. For example, we cannot know the extent to which the candidates who did not respond are typical of those who did respond. Generalizations about institutes are also limited by the incomplete sample of the institute survey. This report is further limited by our concern that the disclosure of specific information might represent a violation of the trust implicit in participation in this survey. For this reason, we do not plan to report highest and lowest responses on the individual surveys where such data are potentially more harmful than helpful.
Despite its limitations, this report is, to our knowledge, the first candidate survey of nationwide demographics of psychoanalytic candidates. Thus, it offers a glimpse of the institution of psychoanalysis from a unique perspective: the eyes of the trainees who represent its future. More data are currently being analyzed and will be available in future issues of TAP.