At present, the Board on Professional Standards is re-assessing the roles and methods of certification and defining its current perspective. In December, BOPS affirmed the appointment of an Ad Hoc Committee to Study Certification. This committee, co-chaired by Calvern Narcisi and Donald Rosenblitt, will make a status report to the Board in May and will complete its work and make a final report in January 2003. [See box on page 12.]
The ad hoc committee will be helped in formulating its recommendations by two surveys. I asked Robert Galatzer-Levy to survey the experiences of certification among those who have applied since the present procedures were instituted in 1999. The Board affirmed this request and, along with Council, supported the appointment of a joint Board and Council committee to survey the entire membership's views about certification.
Fellows attending the December BOPS meeting expressed a wide range of opinions about the rationale and processes of certification but reached no final conclusions. It was my impression that most Fellows felt a certification process was important to the educational programs of our Association. Many saw the certification process as a work in progress and felt that while substantial changes had occurred fairly recently, more were needed.
The consensus seemed to be that the certification process is imperfect but that continuous improvement is preferable to giving up the attempt to accomplish its goals. The opinions expressed at BOPS and those expressed at the Executive Council will be included in the BOPS ad hoc committee's deliberations.
Though the Board has not yet made its decision about its current position, BOPS has expressed views about certification many times in the past. Several task forces and surveys concerning certification have been reported to BOPS, as well as ongoing reports from the committee itself. The Board has consistently asserted its view that there are substantial affirmative purposes served by certification.
Among the most compelling is the advantage of a national standard of clinical competence deriving from an impartial review. Every clinical profession has some procedure for review of individual competence. This is generally seen as a means of establishing the profession's bona fides and as a protection for the public.
A national certification procedure is an important self-affirming developmental step for some analysts. Examination by peers who are not directly and personally involved in their training confirms their professional adequacy. It is a post-graduate test of competence that measures performance, not potential. The certification process distinguishes criteria of achieved professional competence from those of potential for continued development, the standard on which accredited institutes lean heavily.
While the credential afforded by our certification process is not as widely known as in some other fields, it is of some value in the wider world and could be more important if our Association devoted resources to promoting it. One means of accomplishing this might be a special designation such as “Fellow” or “Diplomate,” but this could be perceived as fostering divisions within our membership. We know that any educational standard or achievement creates distinctions, but they are justifiable if they are related to a worthwhile objective.
Certification is an active demonstration that education in our affiliated institutes is a shared responsibility of the institute and the APsaA. In this way we enhance our educational quality and help to prevent an overly parochial approach.
Certification by direct review promotes ideals of transparency, peer review, and consultation within our organization. Our profession is practiced in private; comparison of clinical work among honest and respected colleagues is an advantage to individuals and to the profession. Furthermore, because the Committee on Certification reports, in aggregate, on its results and demonstrates its processes in APsaA workshops, it promotes transparency.
Psychoanalysis as a clinical profession has difficulty specifying in objective terms what constitutes clinical competence. Certification provides a means of assessing competence by consensus and is important for the development of mutual confidence in our professional integrity and in each other's work. The examiners are also under a form of review, as the committee reports the results of its examinations and the modifications of its procedures to BOPS at each national meeting of the APsaA. This, too, promotes transparency and confidence.
Inevitably, given our understanding of the analytic process today, the personality of the analyst is anticipated to be part of the clinical interaction. This may be a source of anxiety to some applicants. The Committee on Certification understands this and tries to be sensitive and tactful. Some applicants may feel more vulnerable than others. Despite the discomfort of individual applicants, the greater problem is the danger to our profession of working without peer review. Although some discomfort is irreducible, our goal is to minimize hurt and maximize personal growth. I hope that the results of the survey of recent applicants will tell us more about this important matter and will lead to innovative recommendations from the ad hoc committee.
Certification is not essentially designed to educate. However, education is often a byproduct. Certification probably helps promote a psychoanalytic identity in many applicants.
The bedrock of the certification process is fairness, honesty, and the absence of bias. I believe there is greater trust now that these values are prevailing because of the changes in the process and the accumulated experience under several chairs of the Committee on Certification. The Board believes our processes must always reflect these ideals and supports the methodology to assure it. Yet suspicion still remains.
Certification is no longer a formal part of the political life of our organization. It is a requirement for appointment to a BOPS committee and a first step in the process of being appointed a training analyst. Some institutes require certification as a prerequisite to being appointed to other faculty ranks, but that is entirely a local option.
Certification arouses very strong feelings within our membership. It is my hope that careful and thoughtful consideration within our established procedures will lead us to the wisest decisions about its status at this time in our Association.
Ronald M. Benson, M.D., chairs the Board on Professional Standards. He is a training and supervising analyst at the Michigan Psychoanalytic Institute.