Here is our struggle! The cry for flexibility pervades every area of our organization. How do we respond to this cry and still maintain our organizational integrity? The committees of the Board on Professional Standards and the Board itself have been conscientiously immersed in an attempt to speak to the needs of our institutes and members.
Over the past years the Committee on Institutes (COI) has developed a series of waivers, granted on an individual basis, for both immersion and time following graduation. These have permitted increased flexibility in allowing the appointment of training and supervising analysts who did not meet the originally defined criteria.
Is this all a slippery slope? Are we abandoning our standards in an attempt to be responsive both to our members and to the needs of our institutes? What effect are we having on our profession in general and on those students we train and who are our future? As the body charged with maintaining and establishing our national educational standards, these questions permeate all of the deliberations and decisions of BOPS and those of our committees.
The Committee on Child and Adolescent Analysis (COCAA) is actively discussing the impact of more flexible graduation requirements of child analysts. Eight institutes are already offering a child focused track.
The Committee on New Training Facilities (CNTF) is overseeing the development of several training programs as they move toward fully approved institute status. This process of growing new institutes necessitates a balance between flexibility and integrity.
The Committee on the Accreditation of Free Standing Institutes (CAFI) has been working with two longstanding and respected non-APsaA institutes. For the first time, BOPS welcomed two non-voting representatives from the American Institute of Psychoanalysis (The Horney Institute). Intensive discussions with the William Alanson White Institute (WAWI) are ongoing. At this meeting we heard the final report of a joint task force on training models. This report clearly demonstrated a remarkable degree of congruence between APsaA and WAWI training. Based on this, BOPS overwhelmingly agreed with the CAFI recommendation to formulate a mechanism for affiliation. This affiliation will ultimately require flexibility and rigor.
In spite of all of the criticism there is no BOPS committee working more diligently and successfully to be flexible while maintaining its integrity than the Certification Examination Committee (CEC). Over the past years numerous initiatives have been created to enable our applicants to present their work in the best possible light. The Alternative Pathway to Certification is now in place. The CEC has developed a mentorship program for pre-applicants as well as for applicants. An exit survey, as well as an exit interview, has been implemented. A national system of case review is in place.
All of these innovations challenge the CEC to be even more careful as they do their work. A new small inter-rater reliability study applying the core competencies to clinical case write-ups has produced extremely encouraging results. After all, what good is a certification process if the bar is too low? What are we saying to our present and future patients if our certification process has no bearing on the quality of analytic work? How do we maintain our standards while being user friendly? These are the questions with which we continue to grapple as a board responsible for education.
The Project for Innovation in Psychoanalytic Education (PIPE) has embedded in its title the exploration of flexibility For years this esteemed group of senior educators has struggled with the balance of flexibility and integrity as it applies to the training analyst system. Before our next meeting we will receive their final report on the training analyst system. Their attempts continuously highlight the basic dialectic between flexibility and integrity. It is a constant challenge to implement innovations, while maintaining a meaningful training analyst system.
After this long and costly bylaw fight, we are back where we began. Perhaps we do not have to be. We do have the opportunity to come together as analytic professionals. The Educational Flexibility bylaw that BOPS put forward would offer significant opportunities for change with integrity.
Might it be possible for both sides of the current conflict to support this endeavor to remove certification from the bylaws? We certainly hope so.
Might this be a way of regaining the center? We believe so.
Cal Narcisi, M.D., and Myrna Weiss, M.D., are co-chairs of the Board on Professional Standards.