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Preserving Parity and Long Term Treatment: Psychoanalysis and Psychodynamic Therapy in Danger

Commentary

March 24, 2017 - by Crayton Rowe. Presented at the AAPCSW Conference, Mind & Milieu: From the Consulting Room to the Community and Back during the panel, Preserving Parity and Long Term Treatment: Psychoanalysis and Psychodynamic Therapy in Danger.

Presenters

Crayton Rowe, MSW, BCD-P
Judy Ann Kaplan, LCSW, BCD-P

Preserving Parity and Long Term Treatment: Psychoanalysis and Psychodynamic Therapy in Danger
by Crayton Rowe

I appreciate the opportunity to speak today about an extremely serious subject of preserving parity and long term treatment. I am aware that there some of our members have questioned the term “psychoanalysis” in the name of our organization. They reasoned that the term “psychoanalysis” applies to a specific modality of treatment that has little to do with current thinking about more modern modalities of treatment. In other words the term “psychoanalysis” is outdated and can be off-putting to attracting new members to our organization. I certainly agree that it would be off-putting if the term “psychoanalysis” is viewed as an outdated modality and with little relevance to current treatment modalities.

However, I would like to suggest that the term “psychoanalysis” is a code word for the full range of all psychodynamic treatment. For example, Wikipedia, the largest and most popular internationally recognized encyclopedia reference on the internet, states that psychoanalysis is a set of psychological and psychotherapeutic theories that include 22 theoretical orientations regarding human mental development.

From its inception by Sigmund Freud in Vienna in the 1890’s, psychoanalysis has included a widening development of theory and treatment that has retained the basic tenets of (1) an unconscious that influence thoughts and behavior; (2) resistances to awareness of unconscious influences, and (3) conflicts between the conscious and unconscious that appear as symptoms. Wikipedia is clear that these basic tenets are fundamental to psychodynamic modalities. Wikipedia points out that some of the 22 theoretical orientations that are under the broad umbrella of psychoanalysis include ego psychology, object relations theory, modern conflict theory, self psychology, interpersonal psychoanalysis, Lacanian psychoanalysis, cultural psychoanalysis, feminist psychoanalysis, adaptive paradigm of psychoanalysis and psychotherapy, relational psychoanalysis, interpersonal-relational psychoanalysis, intersubjective psychoanalysis, and modern psychoanalysis.

I think that we can agree that the majority of clinical social workers in the nation practice a form of psychodynamic treatment or at least would like the option to do so. Our organization was founded on the need to protect your right as clinical social workers to practice the full range of psychodynamic treatment. It can be emphasized that our organization is the only organization that is dedicated to ensuring that clinical social workers will be able to practice the full range of psychodynamic treatment. Removing the umbrella term “psychoanalysis” from the name of our organization defeats this purpose.

The Endeavors Implemented to Maintain Standards of Psychoanalytic Education
by Judy Ann Kaplan

The Psychoanalytic Consortium formed as an autonomous agency, the Accreditation Council for Psychoanalytic Education – known as ACPEinc - to accredit, as it does now, psychoanalytic institutes, and training programs, including those affiliated with hospitals and universities as well as free standing institutes. The Consortium, composed of the major psychoanalytic organizations, including AAPCSW (which at that time was NMCOP) represented psychoanalysts from the three disciplines of psychiatry, psychology and social work, who worked together to create standards that promote excellence in psychoanalytic training and practice. Earlier AAPCSW also helped develop the Board Certified Diplomate (BCD) status and the BCD-P for the specialty in psychoanalysis through an external Board – The American Board of Examiners in Clinical Social Work (the ABE). See the AAPCSW Winter 2017 Newsletter for an article on the history of and how important the BCD-P is to social work.

As these standards were developed, they were put on the ACPEinc website (where you can find them now – www.acpeinc.org) and the community of interest was invited to review, comment and make suggestions on each.

There have been controversies about the standards – one of which is the controversy about frequency of personal analysis. It took many years for the Consortium to unanimously agree on the frequency of 3-5 times a week on separate days. This was due to the recognition of the broad range of psychoanalytic theories and training traditions in the US. Subsequently, the International Psychoanalytical Association (IPA) did a great deal of research, and is only now canvassing all institutes and planning to put to a vote the 3-5 times a week model.

When a program or institute applies and is approved for an ACPEinc site visit, the site visitors assess the program to validate that the program is following its objectives in terms of curriculum, faculty, and supervision. To verify that all aspects of the program follow a high level of standards, the site visitors sit in to observe classes, as well as supervisory sessions and they assess the criteria for selecting faculty and supervisors. It is extremely important for our future in psychoanalytic education that our supervisors are highly trained to supervise and the teachers are highly trained to teach. In the next ten years it is very important that we have highly trained supervisors and teachers for psychoanalysis and psychotherapy to flourish.

To facilitate the awareness of these high standards, since its inception, the ACPEinc has worked to become a federally recognized accrediting agency for psychoanalytic training programs. Recognition by the U.S. Secretary of Education – a process that is detailed, lengthy and requires justification and explanation of all aspects of psychoanalytic education, will provide increased awareness of the importance of these high standards.

The standards are fluid as they reflect the ever-evolving psychoanalytic education focus. The standards are flexible in allowing for a diversity of theoretical and clinical orientations, academic approaches and creative endeavors.

Changes and adaptation are occurring across many organizations and we are working together to preserve the profession of psychoanalysis and prepare for the future.

We have worked long and hard to develop psychoanalytic education and the high quality of the standards. To have the Department of Education approval of these standards and programs will be a way to help preserve long-term psychoanalysis and long term psychoanalytic psychotherapy and help diminish any dangers that may lie ahead.

DISCLAIMER: The opinions or assertions contained in this communication are the private views of the writer and are not to be construed as official or reflecting the views or policies of the Accreditation Council for Psychoanalytic Education, Inc.