The COPE Study Group on Supervision in Child and Adolescent Analysis has met at each APsaA meeting for several years. Our group includes supervisors in child analysis from a number of institutes throughout the country. Initially, we discussed our supervisory experiences, and members of the group were very helpful in teaching one another, as challenging situations were presented in the supervision of work with children, adolescents, and their parents. Examples from supervision of children of various ages provided us with an opportunity to study the role of development on the manifestations of transference and countertransference and the attendant pressures upon the analyst or therapist with respect to ethical practices.
After several meetings, our group decided to add a workshop, in which we still present “live” supervisory sessions with candidates in child analysis. Lively discussions stimulate many thought-provoking questions. These meetings are attended by supervisors, candidates, and persons interested in the process of supervision. Examining this material from the perspective of transference and countertransference in the supervisory situation has enriched our work and our contributions to the field.
During both study group and workshop sessions, questions emerge with respect to ethical practice. Searching the literature, we found little written on the subject of ethics in the treatment of children and consultation with their parents. While courses and seminars on ethics exist, hardly any present, in detail, the particular problems of work with children and parents. The paucity of this material struck us as remarkable, especially since questions arise regularly about how ethical lapses might be avoided. From our discussions, it has become clear that the notion of ethical problems that focus on boundary violations is too restrictive. Ethical practice with children and adolescents involves multiple decisions in their treatment and also in consultation with parents, teachers, clergy, divorce attorneys, and the like. Ethical decisions abound in our choice of intervention, our respect for privacy, and in the supervisory experience.
While most studies of ethics are compendia of injunctions and prohibitions, we study both conscious and unconscious factors that contribute to the establishment of guidelines for behavior in clinical work with children.
In our view the crucial questions are: What limits our view of what represents an ethical issue? To what degree do unconscious conflicts and defenses interfere with our work and open the way to the potential for ethical lapses? How do unconscious conflicts and defenses affect our practicing in an ethical manner with respect to our work with our child patients, their parents, and other involved persons, as well as with our supervisees? How might we work to identify such issues and prevent ethical lapses?
The articulation of these questions and our discussions of them led to the decision to work on a book dedicated to the subject. The result is a Jason Aronson published book (released in 2011) entitled Ethical Practice in Child and Adolescent Analysis and Therapy. We examine ethics from the perspective of unconscious processes and the ways in which they serve to interfere with ethical practice. While most studies of ethics are compendia of injunctions and prohibitions, we study both conscious and unconscious factors that contribute to the establishment of guidelines for behavior in clinical work with children. We expand the definition of ethical behavior and examine reasons for this. We explore issues related to clinical theoretical models, transference, countertransference, the supervisory process, working with parents, pitfalls for the therapist, forensics, and writing for journals.
Anita Schmukler, D.O., is a training and supervising analyst and child supervisor at the Philadelphia Center for Psychoanalysis; supervisor of child analysis at the Psychoanalytic Institute of NYU, the Western New England Psychoanalytic Institute, and the Cincinnati Institute of Psychoanalysis.
Paula Atkeson, Ph.D., is a training and supervising analyst, and supervisor of child analysis, at the Baltimore Washington Institute for Psychoanalysis. Atkeson is one of the founders and governing board members of the Jenny Waelder Hall Center for Children.
We decided this material would be relevant for a wider audience and therefore we addressed issues for both analysts and therapists. Members of the study group contributed many examples that illustrate the multitude of probing questions. Given the depth and complexity of this material and the fact that there are no simple or single answers to many of these dilemmas, we organized the text in the form of a workbook. In the preface we offer a review of the literature and provide a historical perspective for the study of ethics that also refers to Web sites where the interested reader may pursue various aspects of this topic. In addition, our appendix includes suggestions for a course or seminar on ethical practice in treating children and their parents, along with study questions for a variety of subjects.
This book is the result of our COPE study group's commitment to investigating fundamental issues in the supervision of child and adolescent analysis. We look forward to identifying further issues of critical importance and making educational contributions based on our group's discussions. If you have a particular interest in child and adolescent analysis that you feel deserves attention, we hope you will be in touch with us.