At the June 2007 APsaA meeting, the Board on Professional Standards approved a new training program in child and adolescent psychoanalysis. A pilot program designed to train child and adolescent analysts without the requirement of previous or simultaneous adult analytic training had been operating and under a five-year formative evaluation study since September 2002. Four institutes participated, Columbia, Denver, Houston-Galveston, and St. Louis.
The pilot program project was implemented by the Consortium, a subcommittee of the Committee on Child and Adolescent Analysis (COCAA), which also conducted the research component. The Consortium included Karen Gilmore, Art Farley, Julio Morales, Jay Alan Davis, and me. Ruth Karush, COCAA's chair, was the program's inspiration, initiating, implementing, and overseeing the project from the beginning. In January 2006, Phyllis Tyson became the chair of COCAA with plans to see the project through to its conclusion. Robert Emde was the liaison consultant from CORE, the BOPS Committee on Research and Education, and was an invaluable contributor throughout the project, offering advice and guidance.
The Consortium designed a formative study with the intent of answering five questions.
Can a program like this be implemented?
What is the level of satisfaction in the program from four perspectives: candidates, teachers, supervisors, and program directors?
Are candidates in the program learning and progressing and are they meeting APsaA standards for child analytic training?
How important is the context of the local institute in shaping participants' experience?
What are the lessons learned and what recommendations can be made?
This project did not look at the question of outcome, i.e., how competent or active these individuals are as child analysts post graduation.
Part I of the study was designed to answer the first question. The Consortium developed a questionnaire by considering what information was needed to understand the educational and clinical makeup of the candidate population, which included pilot candidates, traditional child candidates, and adult-only candidates. This questionnaire was administrated to each participant upon entry into the study. Once in the study, subjects continued to be followed regardless of their trajectory, since, as with all candidates' educational trajectories, they would be expected to vary.
Candidates and directors were positive about child and adult candidates training together as the two groups complemented and augmented each other.
Part II was devised to answer questions two and three. Three questionnaires were developed to be administered at the end of each academic year, one for all candidates that looked at candidate satisfaction, and two that evaluated pilot candidates' learning and progression from the point of view of teaching faculty and supervisors.
The final two questions were considered in Part III. In order to gather data to answer these questions, I conducted a semi-structured interview with each director of the four child programs in the study, in which the local context and culture of the institute and the child program were discussed. Also, as part of the interview, the institute's response to the program, the impact of the pilot program, its success or failure, as well as advantages, disadvantages, and challenges were considered.
At the conclusion of the study, it was evident that all four programs could be implemented. The level of satisfaction was high from all perspectives, and the candidates were learning and progressing. Instructors and supervisors rated the pilot candidates at least on an equal level with traditional child candidates and all of them had control cases that were proceeding satisfactorily. A total of 11 candidates across the four sites entered the study as pilot candidates. Some changed their trajectory, becoming combined candidates, which was seen as a positive outcome. One candidate has graduated.
Candidates and directors were positive about child and adult candidates training together as the two groups complemented and augmented each other. Thus, one outcome was the increased integration of child, adolescent, and adult trainings. Directors were pleased with the flexibility the pilot program allowed and the potential it offered to rejuvenate their programs. They thought there were few if any disadvantages. BOPS was interested in whether the requirement of analyzing one adult would make any difference. In terms of the progression and ability of the pilot candidates as child and adolescent analysts, the data collected appeared to indicate that it did not matter. However, this issue may fall under the rubric of the history and culture of the institute. St. Louis thought the adult requirement was important, Denver and Columbia disagreed. Houston, on the other hand, found it valuable in the sense of pilot
Jill M. Miller, Ph.D., M.S.W., received her child and adolescent training at the Anna Freud Centre and adult training at the Denver Institute for Psychoanalysis. She is a child, adolescent, adult training and supervising analyst and child and adolescent program director at the Denver Institute.
candidates adding full adult training, but could go either way on the issue as a requirement.
The four directors of child programs involved in this study strongly recommended that the program be available to other APasA institutes that requested it, and definitely wanted the program to continue at their institutes. Although across institutes candidates experienced in common the training COCAA specified, the nature of child training was strongly influenced by the history and culture of each institute. Directors stressed that it was important to consider the local context when designing and implementing other programs such as this.
In consultation with COCAA, institutes with APsaA approved child and adolescent psychoanalytic training programs may now offer this training without the requirement of adult training. No subsequent training in adult psychoanalysis is required unless the child and adolescent analyst (or candidate) wishes to practice or represent him or herself as an analyst of adults.