Certification has been and probably always will be a thorny subject. One consequence of this is a certain degree of mystification, misinformation, and false accusations about the certification procedure and the functions and attitude of the Committee on Certification. I hope the following description will clarify the current certification procedure, which was established in December 1999.
The procedure consists of two parts: a review of written reports and an interview. The applicant's identity is kept as anonymous as possible. Only the chair of the committee knows the name and institute of the applicants so he can assign or recuse committee members as reviewers.
For certification in adult psychoanalysis, the applicant submits two written reports of the analysis of a male and a female, one of which has terminated successfully. The work submitted can be new or old, supervised or unsupervised. The written reports are read by every member of the committee except those who need to be recused. Two members initiate the committee's review of the written work by serving as primary discussants. They also conduct the interview with the applicant.
This interview takes place shortly after the entire committee has discussed the written work, so that any questions about this work can be posed to the applicant while they are fresh in the committee members' minds. The interview also gives the applicant the opportunity to participate in a discussion with the two committee interviewers about his or her work. The applicant brings process material from the two written cases and from a third patient's analysis (one not written about) to the interview. These session notes give the committee a further window into how the analyst works with patients. The procedure for child/adolescent and combined applications is the same, with slight variations.
The information gathered from the interview is brought back to the committee so the entire group can deliberate with the benefit of the maximum amount of material available. The free discussion of the work by all members of the committee (except the chair and those who need to recuse themselves for a particular applicant) constitutes the ultimate fairness of the procedure. Committee members from various institutes voice their opinions, and an open discussion ensues until the committee finally feels it can make the most reasonable decision.
The committee members strive to be open-minded and aware of the multiple theories of mind and technique that have evolved over the years and are accepted as contemporarily legitimate versions of psychoanalysis. The committee's guidelines are constructed to be as theory-neutral as possible and focus more on psychoanalytic understanding and skill and less on psychoanalytic process per se. Many of these guidelines have been incorporated into the “Standards, Procedures, and Guidelines Manual of the COC,” distributed to those who request an application for certification.
The entire committee votes on each applicant. The chair does not have a vote. If there is a tie, the decision is in favor of the applicant. If there is not a recommendation for certification, the application is continued. This usually means the committee needs more information from the applicant to make a confident assessment. During the course of the several days the committee meets, any committee member has the option of asking the group to reopen an application that has been continued.
If an application is continued, the committee member who is most familiar with the application provides feedback from the committee to the applicant. The committee liaison then works with the applicant so he or she can understand what more the Committee on Certification needs to know in order to make a recommendation for certification.
Most applicants decide to present a written supplement and to appear for another interview. Sometimes the same patient material is used, including more information or a better explanation of the work. Sometimes one or more different cases are submitted because the first case or cases did not sufficiently demonstrate competent analytic work. As with the initial review, the decision regarding a continuing application is made by the entire committee.
Since December 1999, when the new procedure was put into effect, the average rate of recommendations for certification after the first review has been 65 percent. (In the preceding decade, the rate was 56 percent.) The rate approaches 90 percent for those who persist in their attempts to achieve certification.
Some say that applicants, after repeated attempts, finally learn how to supply what the committee is looking for. Perhaps, but what seems to happen is that the applicant eventually understands something about the work he or she did not previously understand, often with the help of a supervisor. This process has been an educational breakthrough for some analysts.
In order to help analysts write about their work for certification — that is, to help ensure that they include examples and evidence of the basic skills one would look for in the report of an analysis — the Committee on Certification offers guidelines in the “Standards, Procedures, and Guidelines Manual of the COC.” The committee also runs a semiannual discussion group at the APsaA meetings, in which a case report is reviewed and discussed in a format that simulates the workings of the committee. In addition, the committee gives a semi-annual workshop to answer potential applicants' questions about the procedure or their cases.
The question about the purpose of certification for the organization has been raised quite often. Currently certification is considered primarily a post-graduate peer review, assessing core competence to conduct psychoanalysis. Its usage is considered separately by others in this issue of TAP. Many also regard the process of preparing for and attaining certification as an important educational and developmental step.
The principal methodology — the written account of an entire analysis — is considered the most sensible and valid way for a psychoanalyst to convey the complex and often personal details of working analytically with a patient over time. The report written for certification is
Michael H. Singer, D.O., chairs the Committee on Certification. He is a training and supervising analyst, past director of the NYU Psychoanalytic Institute, and a clinical professor of psychiatry at NYU Medical Center.
a record of the unfolding of an analytic process, as well as a record of the analyst's role in enabling this to happen and in helping the patient benefit from the analytic enterprise.
I hope the membership will bear in mind, as it considers the fate of certification, that the certification procedure has been an evolving process, modified from time to time to keep up with the sensibilities of the organization, its methodology paralleling the natural evolutionary tendency that characterizes developments in psychoanalysis.
The committee's standards have also incorporated the many changes in contemporary psychoanalytic theory and practice, much in the way any modern open-minded psychoanalyst incorporates these changes over time into his or her thinking and practice.
The current methodology of certification attempts to engage the full measure of how a developed analyst thinks and works. Radically altering this methodology could disregard the advantages of a process uniquely psychoanalytic.