The American Psychoanalytic Association has embarked on a process of transformation. The Task Force on Reorganization was appointed and endorsed by the membership last spring, and began its work in June. The group has the responsibility of recommending changes in our structure and governance, which the membership will have to approve by a two-thirds majority. This task force is a group representative of our membership, and I am optimistic about its chances for success. In this column, I will outline the functions of the Board on Professional Standards (BOPS) and explore options for their fate in the reorganization of APsaA.
Viewed broadly, the role of the BOPS is to set standards and oversee the educational functioning of psychoanalytic training programs (adult and child) in the Association's institutes. BOPS functions can be divided into two major categories: First, the regulatory functions (standard setting, accrediting, and certifying), and second, the supportive functions (research and development for all aspects of psychoanalytic education and certification).
The supportive functions of the BOPS, those committees and task forces that serve as think tanks for psychoanalytic education and certification, could theoretically remain within the membership organization in a reorganized APsaA. Indeed, many professional membership organizations have committees devoted to education and training as part of their activities. However, the supportive functions of the BOPS ideally should remain structurally related to the regulatory functions of the BOPS, because the supportive functions inform revisions in the regulatory functions. In a reorganized APsaA, there should be a functioning relationship between BOPS's regulatory functions and its supportive functions, as there is now.
Regardless of the fate of the supportive functions of the BOPS in a reorganized APsaA, it is essential for the regulatory functions of the BOPS to function independently of the membership organization. Standard setting, accrediting, and certifying bodies of most professions are completely external to and independent from the membership organizations of those professions, because this is considered essential to ensure the integrity of the accreditation and certification processes. There is an inherent conflict in our current structural arrangement, which places these regulatory functions within the same corporate structure as our membership organization. Although this structural arrangement has led to creative tension, it has been the source of chronic strife within our Association relating to BOPS's autonomy.
We could abandon the regulatory functions of the BOPS, hoping that other groups outside the Association will perform these functions for us. The Accreditation Council for Psychoanalytic Education (ACPE) is currently developing an accreditation process for psychoanalytic institutes, using the standards adopted by the Psychoanalytic Consortium. These standards require a personal analysis (3 to 5 times per week for a minimum of 300 hours), a minimum of 2 supervised psychoanalytic cases (3 to 5 times per week for a minimum of 2 years), at least 150 hours of supervision, and a didactic curriculum with a minimum of 300 hours. The ACPE might develop a certification process for psychoanalysts but has not yet done so. The American Board of Professional Psychology (ABPP) currently has a certification exam for psychoanalytic psychologists.
These entities (and any new ones) are unlikely to adopt the standards of our Association. Much of value would be lost to our institutes and to our profession if we were to abandon the regulatory functions of the BOPS. We have a strong psychoanalytic educational system. Our principles and standards, our accreditation process, and certification procedure provide the structure, quality control, and accountability for that educational system.
BOPS, or the regulatory functions of the BOPS, could be externalized from the Association by becoming an independent corporation or corporations. This new corporation (or corporations) would represent both those institutes willing to receive accreditation at a level approximating our current standards and graduates seeking certification at those standards. These institutes, their graduates, and their members would bear the costs. If we were inventing the entire structure for the first time, this model might be optimal.
Given our culture, structure, and traditions, there are disadvantages to this course of action. First, we would need to create an infrastructure paralleling our National Office; financing this would be a formidable challenge. Second, the Association would lose the creative tension that exists by having our educational system structurally within our membership organization, an aspect of our Association that many of our members value.
A third alternative, structural separation within a newly reorganized APsaA, may be our best option. This would require the creation of a subsidiary corporation or corporations within APsaA for the BOPS, or for the BOPS's regulatory functions. Structural separation would safeguard the functional independence of regulatory functions necessary for the integrity of those processes. The creative tension between educational interests and membership interests could then continue to enrich our Association. Any subsidiary entity would have the opportunity to develop a sound financial plan to support its activities. Structural separation would preserve precious assets, as our Association continues to evolve. At this point in our history, structural separation is preferable to abandonment or divorce.
Eric J. Nuetzel, M.D., is chair of the Board on Professional Standards.