As part of the long-standing relationship between American psychoanalysts and psychotherapists, member institutes of the American Psychoanalytic Association have welcomed psychotherapists into psychoanalytic psychotherapy training programs. Of the 32 psychoanalytic institutes (including the three new training facilities), at least 27 now offer some form of training in psychoanalytic psychotherapy, and others plan to start programs within the next year or two. The format for the training, the eligibility requirements for students, and the relationship graduates will have with the institutes and societies after they complete their training vary considerably.
The format for the training, the eligibility requirements for students, and the relationship graduates will have with the institutes and societies after they complete their training vary considerably.
In 1997, to expand its engagement with psychotherapists, the American Psychoanalytic Association established the affiliation category of psychotherapist associate. By the summer of 2004, there were 368 associates. The Committee on Psychotherapist Associates is charged with recruiting psychotherapist members, organizing a discussion group at each of the national meetings of APsaA, and helping to establish and support Associations for Psychoanalytic Thought (APT). These associations function to involve psychotherapists as well as the general public in looking at various aspects of psychoanalytic thinking.
Under the leadership of Richard Fox, the American Psychoanalytic Association convened, in 2003, the Psychotherapy Task Force, a new initiative to raise the profile of psychotherapy within the Association and to understand more about the relationship of psychotherapists to institutes and societies, the Committee on Psychotherapist Associates undertook an informal review in April 2004.
The most common training program takes two years, focuses on either child or adult psychotherapy, and includes theoretical and clinical seminars and supervision. Occasionally, institutes have less formal or involved arrangements, providing, for example, continuing education courses in an extension program or six-week modules two or more times a year. Several programs do not offer supervision. Most institutes train master and doctoral level psychotherapists. Columbia, for example, admits only doctoral level students.
Looking at how institutes and societies integrate (or fail to integrate) their students and graduates into the activities and structure of their organizations, the committee's study found a wide variety of practices. Some societies see the inclusion of psychotherapists as a strengthening factor for their organizations and for psychoanalysis in general. “In my view, psychoanalytic psychotherapy is the future of psychoanalysis, the way to spread knowledge about analysis,” says Richard Gottlieb, chairman of the Education Committee of the Berkshire Institute for Psychoanalysis. The Berkshire Institute admitted its first class of analytic candidates in July 2004 and does not yet offer psychotherapy training. But Gottlieb expects they will have training for psychotherapists. “The sooner, the better,” he says.
The Boston Psychoanalytic Society and Institute offers associate membership in the society to graduates of its three-year Advanced Training Program in psychotherapy. Two representatives of the Graduate Student Organization—a trainee alumni group organized by graduates of the training program and encouraged by the society—are voting members of the society's Executive Council. The Advanced Training Program Graduate Student Organization presents at least two large conferences with outside speakers each year.
At the Baltimore Washington Center for Psychoanalysis, where the APT group requires its members to be psychotherapists, the APT president represents the group as a non-voting member on the society board, replacing the society board member who formerly served as liaison between APT and the society. APT members also serve on society committees, some of which are joint society and APT enterprises.
The Minnesota Psychoanalytic Society and Institute invites graduates of its two-year psychotherapy certificate program to become voting members of the society and to hold any office except that of president. Peter Grant, president of the society, states that his group is “trying to abolish the hindrances to participation in the activities of the society. We have really opened the society to the interested professional world.”
In San Diego, graduates may apply for membership in the society/institute, although those admitted have no voting rights. There are, however, two positions on the board for psychotherapists, who can vote on some issues. Psychotherapy members can also be involved in committees and can request to teach in the psychotherapy or extension program.
Mae E. Kastor, M.S.W., is co-chair of the Committee on Psychotherapist Associates of the American Psychoanalytic Association and president of The Association for Psychoanalytic Thought, an affiliate of the Baltimore Washington Center for Psychoanalysis.
The Seattle Institute, finding that they lost track of those graduates of psychotherapy training who did not go on to become candidates, changed its bylaws. Now psychotherapy graduates can become members of the society and institute (although not on the “teaching side of the Institute”), and some of the psychotherapist members have accepted the society's invitation to serve on its board.
Some societies and institutes have not yet woven psychotherapy graduates into their programs. Each has its own reasons, including fear of liability. One spokesperson from an institute that does offer some training for psychotherapists noted that “for liability purposes, the institute and society don't even want to say that they train psychotherapists.” For some, there are not sufficient personnel to carry out the responsibilities that accompany training and then involving psychotherapists. However, at least one institute felt psychotherapist training was sufficient: “We train them, and they go about their business.”
Perhaps the movement towards more training and inclusion of psychotherapists, however it progresses within psychoanalytic circles, can help lead us back to the days when psychoanalytic thought was such a crucial and creative part of training for all mental health practitioners. And, for the analysts, interaction with these other professionals can lead to more active, varied and stimulating practices and professional lives within their societies and institutes, and within the American Psychoanalytic Association as well.