Table of Contents:
I. Definition and Goals of Psychoanalytic Education
Psychoanalysis is a set of theories of structure, function and development of mental life, psychopathology, and treatment. The application of these theories forms the basis of both a specialized form of individual psychotherapeutic treatment, psychoanalysis, and the principles of the psychodynamic psychotherapies.
The current Educational Standards apply to psychoanalytic education and training (adult, combined adult and child/adolescent, and child focused training) in member-institutes of the American Association for Psychoanalytic Education. Throughout these Educational Standards, the term “institutes” refers to the psychoanalytic education and training component of psychoanalytic institutes, centers, and programs. These Standards do not refer to other education or training components of psychoanalytic institutes, such as psychotherapy training.
Psychoanalytic education and training provides knowledge and critical understanding of theoretical and clinical psychoanalysis, and proficiency in the practice of clinical psychoanalysis. Completion of education and training, and graduation from a member institute are based upon the acquisition of sufficient knowledge and skill to conduct psychoanalytic treatment independently and competently.
AAPE requires that the “tripartite model” of psychoanalytic education be implemented in each of the two training models. The three required components of the tripartite model of psychoanalytic education and training include:
A non-reporting analysis with a training analyst. This analysis should be conducted with the analysand on the couch at a frequency of five, with a minimum of four sessions, per week, on separate days in person.
A didactic curriculum described in detail in Section IV, below.
Supervised psychoanalytic treatment experience of sufficient duration and depth: The supervision of at least three psychoanalytic cases, which should include different genders, each conducted at a frequency of five, with a minimum of four sessions, per week. For those candidates enrolled in the combined adult and child/adolescent training, the number of cases is five which would include two adult cases, two child/adolescent cases, and one “crossover” which could be either an adult or a child/adolescent case.
The American Association for Psychoanalytic Education requires a Training and Supervising Psychoanalyst system in member institutes. The appointment process, modifications and waivers, are described in Section VIII, below.
II. Responsibility for Psychoanalytic Education and Clinical Training
Psychoanalytic education and clinical training is a shared responsibility of AAPE and its member Institutes. Establishing and promoting standards for psychoanalytic education and clinical training is a responsibility of the Board of Directors of the American Association for Psychoanalytic Education.
Member Institutes are responsible for ensuring that the training analysis, didactic curriculum, and supervision of psychoanalytic work of all candidates are consistent with these standards.
Member institutes will participate in periodic site visits for the purpose of approval and accreditation. These site visits are designed to review the institute’s educational and training programs and to assess the institute’s compliance with the AAPE standards. When institutes are not in full compliance with standards, AAPE consults with the institute to assist in strengthening its programs to return to full compliance. If these collaborative efforts fail to result in full compliance with these standards, suspension of membership from AAPE may be considered based on policies and procedures adopted by the AAPE Board of Directors.
III. Selection for Candidates for Psychoanalytic Education and Training
It is the policy of American Association for Psychoanalytic Education that an applicant for candidacy is never excluded on the basis of race, color, ethnicity, age, gender, sexual orientation, religion, nationality, or physical disability. Selection is based on an applicant’s eligibility, suitability, and readiness. All applicants for clinical training must (i) have a license recognized by the jurisdiction of their institute that permits the clinical practice of psychoanalysis; or (ii) be in training in a jurisdiction in which the clinical practice of psychoanalysis is exempt from or not regulated by licensure; or (iii) with respect to institutes that are authorized by their jurisdictions to offer training leading to the licensure of graduates in the clinical practice of psychoanalysis, be eligible within that jurisdiction to provide clinical services as part of their institute training.
Applicants who hold the following degrees and post-graduate clinical training are eligible for training:
- Doctors of Medicine or of Osteopathic Medicine who have graduated from an accredited medical school or osteopathic school; and have completed or are near completion of a psychiatry residency program.
- Mental health professionals who have completed a doctoral level degree from an accredited mental health program and a minimum of 3000 hours or two years full time mental health clinical experience post-graduation, including in-patient and/or emergency care experience.
- Mental health professionals who have graduated from an accredited masters program which is generally recognized as the highest clinical degree in the field (currently a masters degree in social work, psychiatric nursing, or marriage and family counseling), and have completed at least two additional post-masters degree years of didactic and clinical training including 3000 hours of clinical immersion, 60 post-masters hours of psychodynamic psychotherapy supervision and 60 post-masters hours of psychodynamically oriented coursework and clinical seminars, or a two year organized post-masters psychodynamic psychotherapy program including supervised clinical experience. They must be licensed in the jurisdiction in which they practice, or practice in a jurisdiction in which their practices are exempt from or not regulated by licensure.
- Other persons who qualify under applicable law for admission to a member institute that is authorized within its jurisdiction to offer a training program leading to licensure in psychoanalysis. (In New York State, such programs are formally designated as “Licensure Qualifying Programs” under the regulatory oversight of the State Education Department).
Applicants must demonstrate a level of maturity, as well as the personal, professional, and ethical integrity necessary for full psychoanalytic training.
- Eligible applicants must fulfill the prerequisite didactic education and clinical experience specified in A, above, prior to matriculation.
- The applicant should be able to demonstrate some knowledge of psychoanalysis as well as the ability to meet the demands inherent in psychoanalytic training.
- Personal and professional readiness for matriculation is determined through the application process using interviews and a review of clinical material provided. Individuals accepted for analytic training but evaluated as not fully prepared for matriculation (i.e. starting seminars) should participate in didactic and supervised clinical activity commensurate with their skill and educational level in preparation for matriculation.
D. Modifications of Eligibility Standards
The American Association for Psychoanalytic Education will consider requests from participating psychoanalytic institutes choosing to accept candidates who do not fall within the Eligibility criteria outlined above.
The American Association for Psychoanalytic Education has developed procedures and criteria for the modification of the usual eligibility standards for psychoanalytic training for Institutes wishing to accept candidates who do not fully meet the above eligibility criteria:
Institutes should consult the AAPE Committee on Candidate Preparedness for clinical and non-clinical applications when modifications of eligibility are necessary. These may include licensed professionals, scholars, researchers, and other professionals.
IV. Components of Psychoanalytic Education and Clinical Training
Psychoanalytic education and training has three essential and required components:
A. The Non-reporting Training Analysis:
A non-reporting training analysis: The training analysis should be conducted with the analysand on the couch at a frequency of five, with a minimum of four, sessions per week, on separate days, in person. It is expected that the candidate’s training analysis begins (preferably six months to a year) prior to matriculation, and should continue through a substantial portion of the candidate’s supervised clinical psychoanalytic work. The training analysis should be conducted by an analyst who was appointed a training analyst by BOPS prior to 2016 or by AAPE after 2016. A waiver is required if the candidate’s analysis will be conducted by an analyst who is not a Training Analyst. (see VIII, C) Waiver requests are evaluated by relevant committees and their recommendations presented to the AAPE Board for approval.
AAPE recognizes that modifications of the frame may occur, e.g., changes in the spacing of sessions, sitting up vs. use of the couch, and treatment conducted via the telephone or other electronic means. It is important to consider the potential ramifications of these modifications, and it is recommended that training analysts consult with others before making these modifications. Training analysts and/or Institutes considering such modifications are encouraged to confer with the AAPE’s Distance Training Task Force as part of the decision-making process.
A non-reporting analysis is defined as completely confidential, without any participation of the candidate’s analyst in progression decisions. The decision to participate together in a class that is part of the didactic curriculum by a candidate and their training analyst should be determined at the Institute level with input from the analyst and the analysand dyad.
B. Psychoanalytic Curriculum
A curriculum of psychoanalytic study must provide a comprehensive understanding of the fundamentals of and interrelationship between psychoanalytic theory and clinical practice. It should teach critical thinking about the historical and conceptual structure and developments of psychoanalytic theory and practice.
The candidate’s tripartite training experience should involve substantial overlap of course work, training analysis, and supervised clinical work. Simultaneous immersion in these three aspects of training enables the candidate to understand the empirical basis of theoretical formulations and their revisions, to develop insight and self-reflective skills crucial in the treatment of patients and conceptualization of case material. When a candidate’s participation in seminars occurs during a period of less than optimal clinical immersion, a program of post-seminar study may be required to provide candidates maximal opportunities for such integration.
The adult didactic curriculum consists of a scheduled series of seminars distributed over a period of a minimum of four years or a minimum of 450 hours. For those candidates enrolled in child/adolescent training, additional coursework and supervision are required, see section IX below.
Although the titles and timing of seminars vary among Institutes the curriculum should be organized to include the following subject matter:
1. Psychoanalytic Treatment Situation and Technique
The study of psychoanalysis as a treatment process includes diagnosis, indications for and appropriateness of psychoanalysis, the establishment of the psychoanalytic situation, and the theoretical and technical issues relevant to the development and unfolding of the psychoanalytic process. Subsequent readings and clinical case seminars include the technical considerations presenting in the beginning, middle, and ending phases of the analytic process, and may include the conceptual and technical aspects of combined psychoanalytic and psychopharmacological treatments, and other appropriate, adjunctive therapeutic modalities (e.g. couples, child, or family therapies). Technique seminars should explore the applications of theory to clinical process.
2. Psychoanalytic Theory
The basic concepts of psychoanalysis and the major models of the mind are studied from a historical and critical perspective. This includes the critical exploration of the basic writings of Freud and subsequent major psychoanalytic theorists.
A psychoanalyst must develop a dynamic understanding of a broad range of psychopathology. Seminars on psychopathology typically consider historical and contemporary psychoanalytic theories of the neuroses, character disorders, borderline and narcissistic disorders, affective disorders, psychosomatic disorders, and the psychoses. Clinical examples should illustrate the multiplicity of dynamic, structural, genetic, and developmental factors leading to the formation of the presenting clinical picture.
Understanding the ways in which psychic functions and structures originate, evolve, and progress throughout the life cycle is essential to a psychoanalytic understanding of the human mind, and essential to an understanding of the psychoanalytic clinical situation. The curriculum should include study of psychoanalytic theories of psychological development beginning with the parents’ experience of the pregnancy and extending through adulthood. Where possible, it is recommended that Institutes integrate clinical and didactic experience of child/adolescent analytic training with adult analytic training.
5. Continuous Case Seminars and Clinical Conferences
Case seminars and other types of clinical conferences are intended to offer opportunities for learning about the deepening of the analytic process and the phases of treatment. They should also offer exposure to a range of differing clinical methods and approaches in special situations.
6. Research Courses
Courses should be designed to cover basic knowledge and developments in empirical research studies of psychoanalytic theory and practice, research studies of psychoanalytic education, and interdisciplinary or applied psychoanalytic studies and methods.
7. Interdisciplinary and Allied Fields of Knowledge
The curriculum should include courses such as cognitive neuroscience, gender and sexuality, combined treatment methods, the writing of case reports and other psychoanalytic work and the ethics of psychoanalytic practice. Electives offer opportunities for candidates to develop and deepen individual interests.
C. Supervision of Adult Psychoanalysis (for Standards related to child/adolescent supervision see section IX below)
The supervision of analytic cases should teach the relationships between theory, clinical process, self-awareness, and technique, thereby providing the knowledge and skill to conduct effective psychoanalytic treatment. The AAPE model requires three supervised psychoanalytic treatments during training. Supervised psychoanalytic treatments should be conducted with the analysand on the couch at a frequency of at least four, preferably five, sessions per week on separate days. AAPE recognizes that modifications of the analytic frame, including the frequency of sessions, the use of the couch, and the need for condensed and distance analysis may be clinically indicated for periods of time.
The supervision of clinical work should occur weekly with a supervising analyst to review and discuss the case the candidate is learning to analyze. Candidates should have a separate supervisor for each case and should meet weekly with each one. As the supervised psychoanalytic treatment progresses, and as the candidate progresses in the educational program, the supervisor and candidate may change the frequency of supervision. The candidate’s training analyst should not serve as one of the candidate’s supervisors.
Candidates should be encouraged to begin a first case by the middle of their first year of training upon evaluation of the candidate’s readiness to begin supervised psychoanalytic work by the Progression Committee or its functional equivalent. Once a first case is established, capable candidates should be encouraged to pursue additional cases early in their training.
Candidates are required to have at least three adult non-psychotic cases, including patients of different genders. The supervision of cases should occur over a length of time that allows the candidate to develop sufficient knowledge and skill to conduct psychoanalysis independently and competently. Demonstration of this competency is a component of graduation.
Institutes may allow a candidate to substitute one child or adolescent psychoanalytic case supervised by a Child Supervising Analyst for one of the required adult supervised cases, provided that the candidate also has supervised psychoanalytic treatment experience with cases of different genders. If the candidate is not already trained as a child mental health clinician it is expected that the supervision of this case would continue through termination even if termination occurs beyond graduation. Institutes should be clear with candidates who are not trained as child or adolescent mental health clinicians but who choose to conduct a supervised treatment of a child or adolescent analysis as a part of their training, that they should continue in supervision through the termination phase of this treatment.
Ongoing assessment and feedback is a crucial dimension of the candidate’s supervision. Each supervisor is expected to periodically assess the progress of the candidate’s ability to conduct psychoanalytic treatment through written reports or evaluations, which should be communicated to both the candidate and the Progression Committee or its functional equivalent.
V. Assessment of Adequacy of the Candidate’s Education in Adult, Child and Adolescent Psychoanalytic Training
A. Assessment of Candidate Progress
A candidate’s progression towards graduation is determined by a thorough assessment of the candidate’s evolving competency in understanding and conducting psychoanalysis. Direct feedback to the candidate about their progression based on assessments by instructors and supervisors is an essential component of the educational process.
All Institutes of the Association are responsible for the periodic formal evaluation of a given candidate’s progress by their Progression Committee, or its functional equivalent. This should include the candidate’s performance in didactic seminars and clinical work, and an assessment of the degree to which clinical work is progressing in concert with their overall educational progression. Assessment of progress should begin at the first opportunity upon admission and continue until graduation.
B. Assessment Methodology
Optimal training outcome requires both facilitating and assessing steps in progression. Institutes may choose one of two pathways for facilitating and assessing the progression of candidates: The traditional pathway and the developmental pathway, although there is much overlap between the two. Candidate evaluations should include written assessments communicated to the candidate, the candidate’s supervisors, and the Progression Committee, or its functional equivalent. The Progression Committee, or its functional equivalent approves all requests to begin supervised cases, as well as requests for graduation. Minutes should be kept of all such committee meetings.
The components of candidate evaluation:
- Instructor assessments of the candidate’s mastery of the course material, class participation and ability to work effectively with classmates, critical thinking, and competence in presenting clinical material. Faculty evaluations of the candidate’s performance in seminars should, at a minimum, occur at the end of each seminar.
- Written supervisory reports assessing the candidate’s progress in conducting clinical work should occur at a minimum on a yearly basis. The content of these reports should be communicated to the candidate.
- All Institutes are encouraged to use academic colloquia to assess competency and progression. Developmental Pathway Institutes are required to conduct two colloquia; one during the third year or prior to beginning a third case and a second pre-graduation colloquia. Colloquia should consist of two elements: Submission of case write-ups and a formal meeting or series of meetings with several faculty preceptors to discuss the candidate’s clinical work and mastery of psychoanalytic theory and technique. The preceptors recommend to the Progression Committee or its functional equivalent any remedial educational measures that should be undertaken.
- The Board of Directors of AAPE and its committees gather information to develop and evaluate guidelines for best practices for progression, including colloquia. It serves as a consultative resource to those institutes developing and using progression measurement tools.
VI. Completion of Psychoanalytic Education and Readiness for Graduation
An AAPE member-institute will graduate a candidate when, in its opinion, the candidate has satisfactorily completed all educational requirements of that Institute. Such requirements shall fully adhere to the Standards for Education and Training in Psychoanalysis of the American Association for Psychoanalytic Education. Graduation shall be construed as an indication that the Institute has adequately and carefully evaluated the candidate and considers the candidate competent to conduct psychoanalytic treatment independently. A written statement confirming completion of training shall be furnished to the candidate.
A. Graduation Criteria
Graduation is predicated on the candidate’s demonstration of an adequate command of clinical and theoretical psychoanalytic knowledge and the capacity to conduct competent and independent psychoanalytic work. Three adult cases, including cases of different genders, are required to demonstrate the candidate’s competency to conduct an analysis in the opening, middle, and if possible, termination phase. Candidates who are in combined adult/child psychoanalytic training are required to have only two adult cases of different genders in addition to their child and adolescent cases.
Each institute should ensure that a suitable methodology is used to assess candidate readiness for graduation. Assessment for graduation should include a review of reports by instructors and supervisors, review of case write-ups, meetings between the candidate and faculty preceptors to discuss the candidate’s ability to conduct competent and independent psychoanalytic work. A colloquium model in which candidates present their clinical work may also be used in assessing readiness for graduation.
AAPE and its committees will, over time, gather information, evaluate and develop guidelines and best practices for graduation colloquia or their equivalent, and serve as a consultative resource for institutes developing and using graduation colloquia or their equivalent.
B. Institute Self-Assessment and Evaluation
The Progression Committee, or its functional equivalent, should periodically conduct a comprehensive critical review of the evaluation methods and standards used to determine completion of training and competence for graduation.
VII. Selection and Development of Institute Faculty
A. Faculty Appointment
The Institute must establish clear policies and procedures for faculty appointment including an appeals procedure. These should include published eligibility criteria, assessment of suitability, and clear and transparent procedures for the process of appointment. A faculty committee can serve this function. Graduates who are appointed to the Institute faculty can participate in teaching, research, scholarship, advising and mentoring, committee service, administration, representation of the institute in organizations, and educational outreach.
B. Faculty Development
Institutes should have policies and procedures designed to encourage and develop individual talents of faculty members, especially recently appointed faculty. This may be a system of mentoring, study groups, or post-graduate seminars. Faculty should be encouraged to deepen their own individual interests, which may result in publications or development of courses in a chosen area.
C. Termination of Faculty Appointment
Institutes must have clear and transparent policies and procedures for the removal of any individual from faculty appointment, including an appeals procedure. This requires ongoing assessment of competence in the performance of the duties of faculty in the following areas: Ethical conduct, personal conduct, clinical competence, and cognitive functioning.
VIII. Selection and Development of Adult Training and Supervising Analysts
N.B. The sections from the introductory paragraphs through section VIII are the general standards for Training and Supervising appointments that apply to all AAPE institutes. The sections that follow these–Appendices I through IV–are models for the Direct Model, Developmental Models A and B, and an Appeals Model, and are included to serve only as examples and guides for institutes.
Member institutes of the American Association for Psychoanalytic Education (AAPE) have a Training and Supervising Analyst system to develop and appoint graduate analysts from their institutes who conduct the analyses and supervision of candidates. The prospective TSA must be a graduate of the sponsoring institute or another AAPE member institute, or an institute that has training standards that are deemed substantially equivalent by the sponsoring institute and the AAPE. The analyst must be a post-graduate member of the sponsoring institute for a period of time deemed sufficient enough for the institute to get to know the analyst’s suitablity for Training and/or Supervising Analyst appointment.
The analyst must be in good ethical standing; have been certified by either APsaA’s Board on Professional Standards prior to December 31, 2015, or by the American Board of Psychoanalysis, and have maintained their certification; have extensive clinical experience; demonstrate a commitment to psychoanalytic education; and agree to an in-depth peer review of their clinical and supervisory experience.
Training Analysts have responsibility for the personal, non-reporting analyses of candidates. Supervising Analysts have responsibility for the supervision of candidates’ psychoanalytic training cases. In addition, both Training and Supervising Analysts participate in the educational programs of the institute. The criteria for appointment as a Training Analyst and/or Supervising Analyst are outlined below.
I. Appointment of Training and Supervising Analyst, and Supervising Analyst
Institutes can apply for an individual to be appointed as a Training Analyst only (TA), a Supervising Analyst only (SA), or a Training and Supervising Analyst (TSA), provided that the criteria for appointment for both designations have been met.
Institutes are expected to have established committees that are responsible for the development, evaluation and approval of Training and Supervising Analysts.
Institutes are encouraged to contact the Chair of AAPE’s Training and Supervising Analyst Development and Appointment Committee (TSAC) if they have any questions about the application process or any other items in this document. Sometimes it is useful to discuss the qualifying criteria as they apply to a given situation even before the application process is begun.
A.All Training Analysts and/or Supervising Analysts must meet the following criteria:
- The analyst is in good ethical standing.
- The analyst has had five years of post-graduate clinical experience.
- The analyst has conducted analyses of different genders.
- The analyst has had experience with the termination of psychoanalytic treatment. This experience may include the handling analytically of an interruption or a premature ending of the analysis on the part of the patient based on circumstances largely not within the patient’s control or preference. In any case, it is expected that the analysis progressed to a late phase, preferably the termination phase.
- The analyst has shown evidence of clinical immersion, conducting a minimum of four analytic treatments of adults of different genders at a frequency of at least four times a week over the five-year period prior to application, with a minimum of two cases per year during that period. The total number of patient analytic hours since graduation needs to total 3000 hours. All control cases continued post-graduation, whether supervised or not, will count towards immersion, but two adult cases need to have started independently after graduation and continued for at least three years.
Graduates of Child and Adolescent Psychoanalytic training programs can have one child or adolescent case that continued post graduation from the Adult program credited toward the 3000 hours of immersion.
Treatments are expected to be conducted in person and, for adult patients, on the couch except under circumstances where modifications are needed at the discretion of the analyst-patient pair.
Under special circumstances and based on the needs of the institute and the qualifications of the applicant, standard immersion requirements may be waived. Institutes can contact the Chair of AAPE’s Training and Supervising Analyst Development and Appointment Committee (TSAC) to inquire about such a request.
6. The analyst is certified in adult psychoanalysis by the American Psychoanalytic Association’s (APsaA) Board on Professional Standards prior to December 31, 2015, or the American Board of Psychoanalysis.
7. The analyst has had experience supervising psychodynamic psychotherapy as part of a training program, clinic, hospital, privately, or other.
8. Institutes can add criteria that address their own requirements.
II. Training Analyst Appointment
AAPE recognizes, as delineated in our standards, that the position of Training and Supervising Analyst involves a high degree of clinical skill in handling the sensitive situation of psychoanalysis within an educational institution, and that these skills are generally not innate nor do they just suddenly appear, but rather are best achieved through a gradual process of study, experience and development, whether formally through an analytic program, or individually by the applicant.
While setting forth the basic standards for the appointment of Training and Supervising Analyst by all AAPE member Institutes, AAPE’s Board of Directors recognizes there may have evolved among the various Institutes a diversity of approaches to the process by which these standards are achieved by the TSA applicants and ultimately evaluated. Some approaches may favor a developmental model, beginning in the early years after graduation, whereby applicants participate in post graduate clinical study groups. Others may include mentoring or other forms of collegial guidance and oversight. Still others may prefer the traditional direct model of application and evaluation. With all approaches for Training and/or Supervising Analyst, a thorough review of the applicant’s clinical work, including work with patients of different genders, as well as a review of the applicant’s supervisory experience is necessary at some point in the institute’s procedures.
We value the originality of the AAPE institutes who may wish to be flexible in devising their own training analyst programs, within the basic standards. As an aid to these projects, we offer examples of both developmental and direct models which are already in practice and are currently under review and study by their institutes as well as by AAPE.
*The Direct Model and two examples of a Developmental Model (A and B), along with an Appeals Model, are appended. For Supervising Analyst only, please see the next section (III.) Neither Developmental Model A or B provide for Supervising Analyst only. Institutes that wish to have a Developmental model for Supervising Analyst only should consult with the TSAC.
III. Supervising Analyst Appointment Procedure
In addition to the criteria listed above in Section I., appointment as a Supervising Analyst only, or as Training and Supervising Analyst requires that:
- The assessment of the analyst includes an evaluation of the analyst’s clinical immersion and pedagogic competence in the conduct of supervision.
- The institute has determined the applicant’s suitability by the institute’s relevant committee. This committee will have assessed the analyst’s pedagogical knowledge and skills relevant to supervision, including the ability to clearly and effectively conceptualize and articulate theory and technique, and establish and maintain an appropriate supervisory relationship.
- It is recommended that the evaluation of the prospective Supervising Analyst only also include a detailed review of the applicant’s clinical work, including work with patients of different genders.
- The institute’s procedures for the review procedures in b. and c. must have been approved by the Board of Directors of AAPE.
- All Supervising Analysts are expected to participate in Institute and faculty activities, including the education of candidates.
Application to AAPE
1. When all criteria have been met, the Institute can apply to AAPE’s TSAC or, in the case of child supervisor appointments, AAPE’s Committee on Child and Adolescent Training for review of the application.
2. Following successful review by the above committees and AAPE’s Board of Directors, AAPE will authorize the Training and/or Supervising Analyst appointment.
IV. Institute Waiver of the Requirement of an Analysis with a Training Analyst
Institutes are not required to adopt this policy.
- Institutes may request a waiver of the requirement for a training analysis should they have an applicant or prospective applicant for admission who is already engaged in an ongoing analysis, preferably for at least one year, with an analyst who is not a training analyst, and the institute believes the waiver is in the best interest of the candidate’s analysis.
- To be eligible for consideration of this waiver the analyst must meet the following criteria:
- a. The analyst must be in good ethical standing.
- b. The analyst must be a member in good standing or a graduate of the institute applying for the waiver or a member of an AAPE member institute.
- c. If a waiver of the training analyst requirement is being sought by an AAPE institute for a psychoanalyst trained at a non-AAPE institute, equivalency of training must be determined. In many instances, this may prove to be very difficult, if not impossible. If training equivalency cannot be determined, or adequately assessed, an in-depth assessment of the psychoanalyst’s clinical work becomes essential. This evaluation of clinical competence might be accomplished in different ways. One way is through prior certification either by BOPS or ABPsA, which is strongly recommended. If certification is not possible, then the applying institute should arrange multiple in-depth clinical interviews with at least two senior training analysts. Consultation with the AAPE TSA Development and Appointments Committee is strongly recommended at the outset of this process.
- d. The analyst must be five years post-graduation.
- e. The analyst must meet the following clinical immersion requirements:
- i. Experience post graduation with at least 4 non-psychotic patients of different genders in analysis conducted at a minimum frequency of 4 times per week. This may include control cases continuing post graduation, but at least two new cases need to have been started after graduation.
- ii. The total number of analytic hours conducted by the analyst since graduation needs to be a minimum of 1800 hours of 4-5x/week cases.
- f. Certification by the American Psychoanalytic Association’s board on Professional Standards prior to December 31, 2105 or the American Board of Psychoanalysis is recommended but not required.
- The institute must have an explicit procedure for determining the suitability of the analyst for performing this function. The procedure needs to respect the boundaries and integrity of the candidate’s analysis. And, without breaching the confidentiality of the analysand, the application for a waiver should include an explanation of how it was determined and concluded that the waiver is in the best interest of the candidate’s analysis.
- Institutes should avoid requesting multiple waivers for the same analyst.
- The institute’s procedure needs to be submitted to AAPE’s Training and Supervising Analyst Development and Appointment Committee (TSAC) and Board of Directors for approval prior to any applications for waiver. Institutes should feel free to consult with AAPE’s TSAC for guidance or advice when considering a waiver situation.
- The TSAC, at its discretion, will allow flexibility in its evaluation of these requirements if so recommended by AAPE’s Board of Directors.
* Waivers are granted on a case-by-case basis with the understanding that the waiver does not constitute a Training Analyst appointment. All waiver requests are reviewed to ensure that policies and procedures of the standards were followed during the waiver evaluation process. These waivers are granted upon the approval of the AAPE’s Board of Directors.
V. Geographic Rule Training and Supervising Analyst Appointments
- AAPE member institutes who apply for Geographic Rule status for a Training and/or Supervising analyst who is a member of another AAPE member institute need to gain approval from AAPE’s TSAC and Board of Directors.
- Training and Supervising analysts from non-member AAPE institutes who apply for Geographic Rule status need to meet the institute’s requirements for Training and Supervising Analyst and be approved by that institute and AAPE’s TSAC and Board of Directors.
- Approval of a Geographic Rule Training analysis is given on a case by case basis. Geographic Supervising Analysts can be appointed for ongoing supervisor status at the discretion of the institute.
VI. Standards for Continued Competence of Training and Supervising Analysts.
Every appointment of a Training Analyst and a Supervising Analyst is contingent upon the individual’s continued demonstration of ethical, professional, clinical and cognitive competence. Each Institute must have policies and procedures to evaluate such competence, and committees and subcommittees to perform this evaluative function. This requirement includes:
- A clear and transparent procedure for TA/SA appointment and reappointment
- A clear and transparent procedure for revoking TA/SA appointment
- An Analyst Assistance Committee which has clear and transparent Procedures for evaluating competence and personal conduct
- An Ethics Committee which has clear and transparent policies to process and evaluate ethics inquiries and complaints
- A clear and transparent appeals process available to TAs/SAs who do not agree with the conclusions of any one of these committees.
IX. Education in Child and Adolescent Psychoanalysis
Two pathways for child analytic training are offered: Combined Adult, Child and Adolescent Training, and Child Focused Training
A. Combined Education in Adult, Child and Adolescent Psychoanalysis
1. Selection for Education and Clinical Training in Child and Adolescent Psychoanalysis
An applicant is eligible for admission concurrent to or following acceptance as an active candidate at an accredited Institute of the American Psychoanalytic Association.
- a. Eligibility for education and clinical training in child and adolescent psychoanalysis is based in part on prior clinical mental health experience with children and adolescents. The candidate should have experience with normal children and adolescents, pathological conditions in children and adolescents, diagnosis and the treatment of children and adolescents with psychoanalytically oriented psychotherapy. Institutes may need to assist their applicants in gaining these experiences which, in appropriate situations, may be attained during candidacy in child analysis and before graduation.
- b. To assess suitability and eligibility for training in child and adolescent psychoanalysis, interviews conducted by child and adolescent faculty are required.
2. Components of Education and Clinical Training in Child and Adolescent Psychoanalysis:
Education and clinical training in child and adolescent analysis, consistent with the tripartite model, includes an analysis with a training analyst, a didactic curriculum, and supervised clinical work. Institutes have flexibility in the construction of their educational program within the following core requirements:
a. Non-reporting Training Analysis: If child training begins subsequent to the termination of the candidate’s training analysis it is strongly recommended that the candidate resume a non-reporting training analysis during their supervised clinical work with children.
b. Curriculum for Child and Adolescent Psychoanalysis Institutes are encouraged to integrate the child, adolescent and adult psychoanalytic curricula to the fullest extent possible. The curriculum should include the following subject matters:
- i. Treatment Situation and Technique
- These seminars should include the study of the various phases of the child analytic process, including the diagnostic issues related to case selection and the theoretical and technical issues to be considered upon beginning psychoanalysis with a child or adolescent. Topics that are specific to child and adolescent treatment such as theory and technique related to working with parents are also essential for study.
- ii. Psychoanalytic Theory
- These seminars should include the study of basic psychoanalytic theories relevant to child development including current developmental theories and research.
- iii. Psychopathology
- These seminars should include study of psychoanalytic perspectives on the manifestations of psychopathology in children and adolescents.
- iv. Development
- These seminars should include the study of child and adolescent development in greater depth than usually offered in seminars in development in the adult psychoanalytic curriculum. Direct observation of infants, children, and adolescents is an important enrichment of the study of development.
- v. Research
- These seminars should include basic knowledge and current research in infant and child development and the treatment of children and adolescents.
- vi. Continuous Case Seminars and Clinical Conferences
- Candidates should attend continuous case seminars in child and adolescent analysis for the duration of clinical training in child and adolescent psychoanalysis.
3. Supervised Clinical Experience
a. Child and adolescent patients in supervised psychoanalysis should be seen at a recommended frequency of at least four times per week on separate days through termination barring exceptional circumstances necessitating temporary alteration of this frame.
b. All standards for supervised casework for adult psychoanalytic training apply to adult cases of candidates in combined adult, child and adolescent training with the exception of the reduced required minimum number of adult cases from three to two of different genders. Candidates in combined adult, child and adolescent programs are required to analyze at least three child and adolescent patients, including different genders and preferably a pre-school child in addition to a latency child and an adolescent. However, an acceptable alternative is that the three cases include at least one child in latency and one adolescent. Each of the three required cases should demonstrate a period of significant analytic work and process beyond the opening phase. At least one of the three cases should be analyzed through termination if possible.
c. The three cases of candidates in child and adolescent psychoanalytic training should be supervised by three different child and adolescent supervising analysts, if possible, and no fewer than two.
d. The candidate should have a minimum of 50 hours of supervision for each case. Supervision should occur on a weekly basis until the supervisor determines that the candidate can work more autonomously with supervision at less frequent intervals. However, those candidates who are not child and adolescent mental health clinicians should continue in regular supervision through termination, even if beyond graduation, for each case involving a developmental stage not previously supervised.
4. Graduation in Child and Adolescent Psychoanalysis
The Child and Adolescent Committee of an Institute in collaboration with its Education Committee or its functional equivalent must participate in the evaluation of the candidate’s progression and readiness for graduation. Graduation from a combined program of child, adolescent and adult psychoanalysis requires completion of all educational requirements for graduation in adult psychoanalysis, and all educational requirements for graduation in child and adolescent analysis. At the discretion of the institute, a candidate in a combined program may graduate in either Adult Psychoanalysis or Child and Adolescent Psychoanalysis prior to the completion of the requirements of the other component.
B. Education in Child and Adolescent Analysis – Child Focused Training
1. Introduction: Child focused training can be developed by Institutes that already offer combined adult, child and adolescent analytic training. The requirements for training these candidates must meet the minimum standards of AAPE for child and adolescent training in regards to candidate suitability, admissions, case requirements, supervision, didactic work and a training analysis. To offer this option, the Institute must present their plan to train Child and Adolescent Analysts who are not concurrently or previously trained in adult psychoanalysis to the Committee on Child and Adolescent Training. Guidelines for submission of a proposal for a child-focused program may be obtained from the AAPE Committee on Child and Adolescent Training.
2. Selection for training in Child and Adolescent Psychoanalysis: Applicants for child-focused psychoanalytic training must first meet the criteria for admission to the Institute. Eligibility should be based in part on prior experience with children, adolescents, and families. The applicant must have experience with normal children and adolescents and with the diagnosis and treatment of pathological conditions in this population. Institutes can assist applicants with less optimal backgrounds to gain these experiences. Interviews conducted by child and adolescent faculty determine general suitability for work with children.
3. Components of Education and Clinical Training in Child Focused Child and Adolescent Psychoanalysis
a. Non-reporting Training Analysis: The Candidate must have a non-reporting training analysis. This analysis should continue during the candidate’s supervised work with children.
b. Curriculum for Child Focused Child and Adolescent Psychoanalysis: Candidates in child-focused programs are expected to obtain adequate exposure to general psychoanalytic theory and technique. Whenever possible, institutes are encouraged to integrate the child and adolescent and the adult curricula to the fullest extent possible. The curriculum should include the following child and adolescent focused courses:
- i. Treatment Situation and Technique
- ii. Psychoanalytic Theory
- iii. Psychopathology
- iv. Development
- v. Research
- vi. Clinical Case Seminars and Clinical Conferences
c. Supervised Clinical Experience
The standards for supervision are the same standards as those described in the child and adolescent component of the combined program. A minimum of 200 hours of supervision is required.
d. Graduation in Child and Adolescent Analysis
Once it is determined that a candidate in child and adolescent psychoanalytic training qualifies for graduation, the Child and Adolescent Committee of the Institute should recommend to its Progression Committee or its functional equivalent that the candidate is ready for graduation from the child and adolescent psychoanalytic program.
Graduation requires completion of all the educational requirements for child and adolescent psychoanalytic training. Ultimately, the decision to graduate a candidate resides with the Progression Committee or its functional equivalent. Most important is the candidate’s demonstrated capacity to conduct the psychoanalysis of children and adolescents competently and independently.
X. Requirements and Procedures for the Development and Appointment of Child and Adolescent Supervising Analysts and Associate Child and Adolescent Supervising Analysts
Member institutes of the American Association for Psychoanalytic Education (AAPE) have a procedure to develop and appoint Child and Adolescent Supervisors who conduct the supervision of candidates’ child and adolescent analytic control cases. Prospective Child and Adolescent Supervising Analysts should be graduates of the child/adolescent analytic training program of the sponsoring institute or of another AAPE member institute, or of an institute that has child and adolescent analytic training standards that are substantially equivalent to the AAPE standards. When the prospective Child and Adolescent Supervisor is not a graduate of the sponsoring institute, he or she should have been a member of the sponsoring institute for a period of time to be determined at the discretion of the Institute.
The prospective Child and Adolescent Supervisor should also be in good ethical standing, should have been certified either by the American Board of Psychoanalysis (ABP) or (prior to December 31, 2015) by the American Psychoanalytic Association’s Board on Professional Standards, and should have maintained this certification by following the ABP procedures for annual renewal. Child and Adolescent Supervising Analysts have responsibility for the supervision of candidates’ psychoanalytic training cases. In addition, they participate in the educational programs of the institute. The criteria for appointment as a Child and Adolescent Supervising Analyst are outlined below.
A. Intent of Child Supervising Analyst Appointment Procedures
AAPE recognizes, as delineated in our standards, that the position of Child and Adolescent Supervising Analyst involves a high degree of clinical skill in handling the sensitive situation of psychoanalysis within an educational institution, and that this skill is neither innate nor suddenly apparent, but is best achieved through a gradual process of study, experience and development.
While setting forth the basic standards for the appointment of Child and Adolescent Supervising Analysts by all AAPE member institutes, AAPE’s Board of Directors recognizes there may have evolved among the various Institutes a diversity of approaches to the process by which these standards are achieved by the Child and Adolescent Supervising Analyst applicants and ultimately evaluated. Some approaches may favor a developmental model, beginning in the early years after graduation, whereby applicants participate in post graduate clinical study groups. Others may include mentoring or other forms of collegial guidance and oversight. Still others may prefer the traditional direct model of application and evaluation. With all approaches for Child and Adolescent Supervising Analyst, a thorough review of the applicant’s clinical work is necessary at some point in the institute’s procedures.
We value the originality of the AAPE institutes who may wish to be flexible in devising their own supervising analyst programs, within the basic standards.
Institutes are expected to have establish committees that are responsible for the development, evaluation and approval of Child and Adolescent Supervising Analysts.
Institutes are encouraged to contact the Chair or co-Chairs of AAPE’s Child/Adolescent Training Committee if they have any questions about the application process or any other items in this document. Sometimes it is useful to discuss the qualifying criteria as they apply to a given situation even before the application process is begun.
B. Criteria for Appointment as a Child and Adolescent Supervising Analyst
- The analyst is in good ethical standing.
- The analyst has had five years of post-graduate clinical experience prior to the application.
- The analyst is certified in child and adolescent psychoanalysis either by the American Board of Psychoanalysis (ABP) or (prior to December 31, 2015) by the American Psychoanalytic Association’s Board on Professional Standards and has maintained this certification by following the ABP procedures for annual renewal.
- The analyst has conducted analyses of different genders.
- The analyst has had experience with the termination of a child or adult psychoanalytic treatment. This experience may include a case in which the analysis was interrupted or prematurely ended, provided that the analysis had progressed into at least mid-phase and that the ending was analytically understood.
- The analyst has shown evidence of clinical immersion, conducting a minimum of two analytic treatments of children or adolescents at a frequency of at least four times a week in each year during the five-year period prior to application.
- Treatments are expected to be conducted in person except under circumstances where modifications are needed at the discretion of the analyst-patient pair.
- Given the realities of maintaining a full child analytic practice, potential child and adolescent supervisors may apply for an exception to these immersion requirements for one of the two cases. Such exceptions may include the analysis of a young adult or a condensed analysis.
- In addition, supervisors may either be granted more than five years to accrue the requisite immersion or be permitted to count more cases over a briefer period of time to establish immersion. For example, a potential supervisor who maintained two to three cases in analysis for six or seven years would be eligible for appointment as would be an applicant who saw four or five cases over a three year period. In general, it is expected that an appointed supervisor will have had at least two active child and adolescent cases for a substantial period of time prior to his or her appointment.
- Finally, the potential supervisor’s full (i.e., adult, as well as, child and adolescent) analytic immersion and role as an active teacher in the child training program, may be considered in determining adequate child and adolescent immersion.
- When applying for an exception to the immersion requirements, the potential supervisor’s institute should state in writing the reason for the exception and how the potential appointee’s practice and institute activity demonstrate a clear identity as a child analyst and a commitment to the psychoanalytic treatment of children and adolescents.
- The analyst has had experience supervising child or adolescent psychoanalytic cases if previously appointed as an Associate Child and Adolescent Supervisor, or has had prior experience supervising psychodynamic psychotherapy with children and/or adolescents.
C. Procedures for Appointment of Child and Adolescent Supervising Analyst
The assessment of the analyst includes an evaluation of the analyst’s clinical immersion and pedagogic competence in the conduct of supervision. The Institute’s procedures for the review procedures described below require approval by the Board of Directors of AAPE.