Most institutes of the APsaA have been moving in new directions to meet today's challenging times. The Committee on Institutes (COI) has witnessed dramatic changes at first hand, including increased activity of boards of directors, the development of psychoanalytic foundations, ever-expanding community outreach and creative volunteerism, the proliferation of adult and child psychotherapy programs, the development of therapeutic nurseries, and a more active approach to the cultivation of potential candidates.
Over the past ten to fifteen years, while retaining its primary task of evaluating psychoanalytic education, the COI has also developed a more prominent consultation role. The committee conducts approximately four site visits a yean during which the six-member team (including a representative of the Committee on Child and Adolescent Analysis) becomes immersed in a particular institute's life.
The site visit team shares its accumulated knowledge of potential solutions found by other institutes in grappling with similar problems. In the give-and-take of the site visit the COI has become a repository for these creative solutions to common problems. Trends become apparent across institutes, although size, geography, and institute culture play an important role in the utility of particular solutions.
Over the years, many members of the COI have been concerned about how to optimize this cross-fertilization and better disseminate their first-hand knowledge of psychoanalytic educational development and institute growth. This article attempts to do just that with regard to candidate recruitment.
In the two years between May 1, 2000 and May 1, 2002, the COI participated in eight site visits, including trips to the Seattle, Cincinnati, and Washington psychoanalytic institutes. Concern about candidate recruitment was felt at every institute. Initiatives from these institutes illustrate some of the innovative ways in which many institutes have begun to deal with this issue. (Numerous other institutes also offer creative solutions to candidate recruitment problems. In the interest of space, we discuss here only the programs of institutes the COI visited within this limited time frame.)
Andrea Weiss, Ph.D., is an advanced candidate at the Los Angeles Psychoanalytic Society and Institute. John Hall, M.D. is director and training and supervising analyst at the Cincinnati Psychoanalytic Institute. He is a member of the Committee on Institutes.
The success of the Seattle Psychoanalytic Society and Institute (SPSI) in candidate recruitment has been fueled by hard work, energy, and a general belief in the efficacy of psychoanalysis. The institute has consistently been able to enlist between seven and nine new candidates in alternate years. A combination of factors seems to keep analysis exciting and relevant in this mid-size metropolitan community.
Establishing a community presence is one important factor In 1989, SPSI became more democratically organized into a faculty-run entity with a board of directors at its head. The board now consists of analysts and community members. This gives the community greater exposure to the utility of psychoanalytically based treatment and understanding.
Underscoring this involvement are the volunteer efforts emanating from the institute. Members and candidates regularly teach and consult with hospitals, internists, pediatricians, schools, churches, parent groups, and post-graduate professional training programs. SPSI members are active in the Northwest Alliance for Psychoanalytic Study, a general analytic membership group in the Seattle area. Mental health practitioners from many specialties attend monthly meetings and a yearly conference where members of the local professional community present and discuss papers. The alliance also sponsors visiting lecturers, eminent in their field. Participating in this venue allows SPSI members to share their expertise and points of view and give them an opportunity to interact with the greater analytic community.
There is a less tangible factor. In SPSI there is optimism about the efficacy of analysis and its place as a preferred form of treatment and body of knowledge. This spirit seems to encourage potential candidates to see psychoanalysis as a necessary professional tool in treating emotional disorders. Candidates at SPSI have the cases they need for graduation and immersion. Dynamic outreach efforts certainly contribute to case finding, but senior faculty members generate many cases for the institute and for the candidates in particular. Cases make analysis come alive; candidates see the positive result of analytic work with their own patients and those of their colleagues. They develop an analytic identity that is communicated to other professionals in the community.
In terms of actual recruitment, SPSI has relied on personal contact. In 1995, the director himself returned phone calls, inviting upwards of forty-five prospective candidates a year to learn more about the institute. The current director still returns many calls and meets with prospective applicants. Last year, the director and the Admissions Committee chair met with local psychiatry residents. Other faculty spread the enthusiasm for SPSI through their teaching and supervision work with psychiatry and psychology residents. These efforts set the tone for SPSI being approachable, interested, and accessible.
The success of the Seattle Psychoanalytic Society and Institute (SPSI) in candidate recruitment has been fueled by hard work, energy, and a general belief in the efficacy of psychoanalysis.
SPSI's excellent child psychoanalytic program brings many candidates to the institute; currently there are twelve child analytic candidates. At least thirteen child cases were being treated as of early this year. This is a stimulating and enthusiastic environment for fostering the development of a child analytic identity. Outreach on the part of both faculty and candidates helps to generate cases. Faculty referrals to clinical associates contribute greatly to candidate morale. Candidates seem to feel that good supervision has been the most crucial factor helping them keep cases in analysis. Grants from the Edith Buxbaum Foundation are available both to child and adult candidates and others in the community to support treatment of low-fee child analytic cases. Several SPSI child candidates have received these grants.
Two pioneering measures to enhance candidate involvement made by the Washington, D.C., and Cincinnati institutes are noteworthy: the sliding fee scale for training analysis, and the establishment of regional centers as hubs for candidate recruitment.
The Washington Psychoanalytic Institute, a vital organization with a deep reach into the community, had reported a decrease over the past six years in the number of candidates applying for training. The most frequently heard problem among those attending the institute's recruitment open houses, especially among younger potential applicants who were just beginning to establish their practices, was the cost of training. The Washington institute did not want these qualified younger applicants to forego psychoanalytic training because they couldn't afford the training analysis. After much discussion within the institute, the fee structure for training analysis was changed to make the total cost of analytic training more affordable. A sliding fee scale was established called the Adjusted Fee Procedure (AFP).
For the candidate, the AFP works like this. All applicants are informed of the AFP when they apply to the institute. Upon request, they are given the adjusted training analysis fee based on a formula that considers their financial circumstances, which has led to meaningful fee reductions. For the training analyst, the AFP is critical. The retention of TA status is mandated by the analyst's availability to take on one AFP analysis.
However, within the AFP arrangement, there is flexibility. Candidates choose their analyst from a list of TAs available, and TAs form their own evaluations whether to take on a particular patient. TAs can have more than one analysand within this AFP structure.
The implementation of the AFP has resulted in a significant increase in applicants. Without this change, it is unclear if the Washington institute would have had a class in 2001. Four admitted applicants applied for sliding fee scale payment. For 2003, three accepted applicants thus far have required the sliding fee scale for psychoanalysis.
While the new fee scale represents a significant financial sacrifice by the training analysts, the institute's education committee felt it to be a wise and necessary intervention.
Some time ago, the Cincinnati Psychoanalytic Institute established the innovative idea of becoming a regional psychoanalytic training center for five outlying cities (Louisville, Indianapolis, Dayton, Columbus, and Lexington) in which there was no organized psychoanalytic presence. Thus, potential candidates were drawn from a wide geographical circumference.
The institute has recently contemplated having the commuter candidates develop and implement outreach efforts in their own communities. This arrangement will not drain the energies of the main geographic center of Cincinnati; in fact, the idea of mini-hubs for recruitment might stimulate more interest in each of these participating communities. This innovative program can easily be replicated by institutes that draw candidates from their sprawling suburbs.
Some of these ideas are portable to other institutes. Some are not. All of them are stimulating and have the potential to open up new ways of looking at candidate recruitment. Each institute does not have to go it alone or reinvent the proverbial wheel. The COI is in a unique position to facilitate awareness of our common problems and of our constituent institutes' best practices and innovations in grappling with these challenges. For further information about these programs and ideas, please contact John Hall at .
Future articles in TAP from the COI will address the topics of endowments, faculty development, and institute/society reorganization.