One of the first issues addressed by Ronald Benson, the newly elected chair of the Board on Professional Standards, in May was the status of the Committee on Accreditation of Free-Standing Institutes (CAFI). We felt that a review of its history and mission would be helpful as we move forward in this promising but complex initiative.
CAFI is a standing committee of BOPS. It was created in December 1999 when the final report of the Task Force on Accreditation of Independent Training Facilities was formally accepted by the BOPS Fellows by a vote of 35 in favor, 14 opposed, and 2 abstaining. The report is known as the Carlson Report, after David Carlson, chair of the original task force.
CAFI was charged by the Budget and Finance Committee to “maintain a close liaison with independent groups that express an interest in affiliation with the American Psychoanalytic Association and provide guidelines for processes to help those groups toward accredited status.” CAFI thus serves two functions: outreach and accreditation.
In presenting the report, Carlson stressed that one of the ultimate questions in the process is whether or not a group seeking affiliation (and thereby accreditation) would really want to be compatible with the American Psychoanalytic Association's educational policies, practice standards, and administrative processes. A related issue is whether the APsaA would regard a given free-standing institute as potentially compatible. The Carlson Report recognized that the work of CAFI would be inescapably political. The tasks of CAFI are complex, delicate, and sensitive.
The Carlson Report serves as the guiding document for CAFI. The report recognizes two fairly distinct types of independent institutes: long-established institutes (LEIs) and recently established institutes (REIs). LEIs were usually founded before 1980 and generally have well-defined structures and procedures, as well as established systems for the appointment of training and supervising psychoanalysts. REIs have varying administrative policies and procedures and varying traditions regarding the personal psychoanalysis of candidates.
The Carlson Report allows for the “grand-parenting” of members and training and supervising psychoanalysts in LEIs. Those who were “grandparented” become eligible for membership in our association, contingent upon action by the Executive Council. As a step toward full affiliation and accreditation, the status of “allied institute” is recommended as an intermediate designation. The steps leading to allied institute status and the steps toward full accreditation are carefully outlined in the Carlson Report.
Before the Carlson Report was approved, preliminary informal discussions took place between representatives of the APsaA and some free-standing institutes. These discussions continued once CAFI began its work, when Ralph Engle assumed the chair of BOPS. Calvern Narcisi, then serving as BOPS secretary, also served as the first chair of CAFI. Glen Gabbard, Leon Hoffman, and Alan Zients were the committee's members. Gabbard simultaneously served as chair of the Executive Council's Task Force on Independent Societies, resulting in a close coordination of efforts between CAFI and the task force.
By the summer of 2000, talks with one of the LEIs were on hold because of the issue of frequency of training analyses and control cases. The institute felt philosophically committed to psychoanalysis at a frequency of three times per week. This conflicted with the educational principles and standards of the APsaA, which require a minimal frequency of four times per week for training analyses and supervised psychoanalytic cases.
Discussions continued with other institutes on both coasts. The discussions with one west coast institute became a focus of concern because they were taking place without the collaboration of a component institute of the APsaA in the same region. The Carlson Report does not specifically require such collaboration.
In retrospect, all involved could appreciate the wisdom of informing and seeking input from local APsaA institutes as CAFI explores possibilities with free-standing institutes. No institute of the APsaA can unilaterally determine the decisions of BOPS about an institute seeking affiliation, but the ideas and attitudes of an institute in the same locale should be prominent among the data considered by the CAFI and the Board.
Engle's resignation in early 2001 necessitated a new election for BOPS chair and the appointment of a new BOPS secretary. In May 2001 Benson was elected chair and Eric Nuetzel was affirmed as BOPS secretary. Benson then appointed Nuetzel as chair of CAFI. CAFI members are now Erik Gann, Leon Hoffman, June Greenspan Margolis, Alvin Robbins, and Alan Zients. The appointments reflect regional representation of respected psychoanalytic educators. Hoffman and Zients have continued informal discussions with free-standing institutes in New York. The New York area institutes are aware of these activities, and their input will continue to be welcome.
The philosophy guiding CAFI's mission needs clarification. What is the APsaA trying to achieve through this method of outreach? Are we trying to increase our membership? Are we trying to bring together more institutes that subscribe to essentially similar educational standards throughout the nation? Are we prepared to accommodate any free-standing institute in the United States willing to adopt our
educational standards? How should we integrate CAFI's gatekeeper functions with those of identifying and serving as the liaison for psychoanalytic institutes expressing interest in formal affiliation with the APsaA? Balancing outreach and accreditation is a formidable but necessary task.
CAFI also needs to develop clear guidelines. How should CAFI decide that a free-standing institute is compatible with the American Psychoanalytic Association? Are both qualitative and quantitative tests of compatibility involved in these determinations? If so, how will CAFI diplomatically determine the more sensitive qualitative issues?
The Carlson Report made clear that even the most authoritative published standards of an institute must be more deeply understood in the context of the institute's educational practices. We will have to get to know such an affiliating institute through comfortable long-range discussion.
CAFI will next meet in December 2001 to further formulate its mission and develop a clear process for determining the potential compatibility of free-standing institutes.