EDUCATION

DPE Progression Committee: Building an Inter-Institute Network for Collegial Consultation and Enrichment

Arden Rothstein

When this piece appears, I will have chaired five DPE Progression Committee meetings. In nearly all institutes, there is a committee composed of a group of faculty members who follow the development of candidates throughout training and ultimately determine when to recommend graduation. My first meeting as chair of this DPE committee, held in February 2020, was also serendipitously the initial meeting for nearly all the participants, representing 21 APsaA institutes. Many were newly appointed chairs, and others were first-time representatives sent by chairs who were unable to attend. Oblivious to the pandemic that was about to dramatically reshape our lives, we anticipated assembling twice a year. Instead, a core group of 15 to 20 progression chairs has been meeting remotely far more often, providing inter-institute collegial consultation and enrichment.

The Committee’s work prioritizes the educational value for candidates of progression work while securing the necessary conditions and resources for doing so. We pursue our original objectives: to share ideas about meeting the many challenges in candidate progression and eventually to develop recommendations for best practices. In addition, the persistence of the pandemic has created greater need for input from colleagues as we must rethink some fundamental aspects of progression work, while maintaining an analytic stance and optimal educational environment. Relationships between members also provide opportunities to consult between meetings and share important documents used to make decisions about candidates’ progress (e.g., criteria for advancement and graduation, supervisory report forms, and educational policy statements that appear in candidate manuals).

Contrasting Institute Settings and Approaches

Committee members have come to appreciate the considerable range and variability of institute settings and cultures in which we work. While most institutes organize the progression committee as part of the education committee, two institutes abolished their progression committees and created other structures to carry out aspects of this work. Some committees convene monthly or bi-monthly to review a small group of candidates each time. Others hold all-day meetings once or twice yearly to review everyone at once. Committee composition ranges from all institute TA/SAs to a cohort of advisors specifically designated to oversee individual candidates.

Most progression chairs encounter persistent difficulty in receiving frank and timely evaluations from supervisors and securing their compliance with the policy of sharing full reports with candidates.

Other differences involve the size of the institutes and degree of integration of the adult psychoanalytic program with other programs, such as training in psychotherapy and child analysis. Small institutes—where there are few active faculty members and classes launch every other, or every third, year—have different needs and concerns than large institutes that contain many faculty members and robust annual classes. In some institutes, changes in APsaA since the sunsetting of the Board on Professional Standards (BOPS) have fueled conflicting perspectives about educational practices. Faculty members with different visions and expectations of their candidates’ learning may work at cross-purposes rather than having a healthy dialogue.

Common Ground

Our discussions, nevertheless, underscore much common ground. Foremost is our shared concern about securing useful feedback to ground progression decisions and communicating this feedback transparently to candidates. Most progression chairs encounter persistent difficulty in receiving frank and timely evaluations from supervisors and securing their compliance with the policy of sharing full reports with candidates. Candidates vary greatly in producing effective and timely clinical process reports; this challenge is less pronounced in institutes with a robust clinical writing curriculum. With one exception, all institutes employ competency criteria for evaluating candidates’ progress, whether in combination with, or instead of, quantitative immersion criteria. Nearly all institutes employ formal procedures for approving each new case at a specified time in candidacy (whether in the progression committee or a colloquium); by contrast, in a handful of institutes, candidates can begin new cases at any time, assuming their ongoing clinical work presents no concerns and clinical reports are up to date. Providing feedback to candidates is approached in a variety of ways. In some institutes, written summaries of the committee’s deliberations are prepared by progression chairs or co-chairs, or by the candidate’s advisor, while in others feedback is conveyed orally by advisors or supervisors who attended the review. In yet others, candidates access supervisory reports online for discussion with their supervisors.

A Case Study in Common Ground and Contrasts: Two Institutes Identify Common Challenges in Candidate Progression and Adopt Dramatically Different Responses

As a platform for the DPE Progression Committee to explore common ground and contrasting approaches, an extended dialogue took place at two of its meetings in 2020 between two Committee members from two New York City training institutes. Justin Richardson (Columbia University Center for Psychoanalytic Training and Research) and I, Arden Rothstein (Psychoanalytic Association of New York (PANY) affiliated with NYU Grossman School of Medicine), discussed the principles and concerns guiding major changes in progression in our institutes. We had both elaborated on this material in publications. Richardson and his colleagues did so in a JAPA paper entitled “Beyond progression: Devising a new training model for candidate assessment, advancement, and advising at Columbia” (2020). I described my institute’s process in an International Journal of Psycho-Analysis paper entitled “Fostering the educational value of candidate evaluation” (2017). Remarkably, both groups identified nearly identical problems in their existing progression process but formulated and implemented sharply contrasting changes.

Both found:

At Columbia, the changes implemented were responsive to negative views from candidates and some faculty members about the way progression was carried out. Candidates experienced progression advisors as double agents, both mentors and evaluators, and did not form the close bonds that were hoped for. Learning in supervision was sometimes compromised by candidates’ motivation to meet numerical immersion criteria. Some candidates tried to keep patients in treatment by avoiding sensitive issues or did not openly report aspects of their work to their supervisors. By contrast, at PANY, changes were catalyzed by a new chair’s view that existing criteria were vague, internally contradictory, and most importantly, did not promote an educationally valuable analytic perspective; the substance and regularity of supervisory and advisory feedback also needed much improvement.

At Columbia:

At PANY:

Central to PANY’s approach is recognition that evaluating candidates is a complex endeavor. It is essential to be sensitized to and remain aware of the potential shaping influence of countertransferential and other personal reactions from all involved, supervisors and advisors alike. Distortions deriving from such reactions can occur even when evaluative criteria are clearly delineated. The progression committee can serve a critical check and balance function on such reactions.

Many progression chairs participating in the DPE committee were familiar with these issues. When supervisors write reports that feature the patient’s, rather than the candidate’s, development or do not convey honest impressions of the challenges with which a candidate struggles, this can seriously compromise the progression committee’s ability to make optimally informed decisions. The presence of committee members/advisors who do not fulfill their roles in an active, independent manner—for example, those who are less than thorough in reviewing all feedback about a candidate, or inhibited in attempting to understand divergent opinions when they exist, or deferential to idealized supervisors—is another common impediment in the ability of a progression committee to successfully fulfill its role. In such instances, committees may have difficulty functioning as a third that perceives trends in a candidacy that may not be evident to individual advisors or supervisors and minimizes the intrusion of personal reactions to candidates.

When supervisors write reports that feature the patient’s, rather than the candidate’s, development or do not convey honest impressions of the challenges with which a candidate struggles, this can seriously compromise the progression committee’s ability to make optimally informed decisions.

Sharing Recurring Issues: How to Handle Them Most Effectively and with Greatest Educational Benefit

Members of the DPE Progression Committee are invited to consult with the group about recurring issues in candidate progression at their institutes. Such exchanges can catalyze communication outside of our group meetings among individual members. At times especially sensitive, confidential matters can be discussed fruitfully with colleagues outside of the local institute community.

We have considered the following issues:

Helping Each Other Cope with the New Normal of Pandemic (and Post-Pandemic) Life

As all of us struggle to adapt to the extraordinary challenges of the pandemic, the DPE Progression Committee devotes a portion of each meeting to issues specific to this context. The practice of working remotely with ongoing cases, supervision, and personal analyses had already been established by the time of our second (June 2020) meeting. Members shared their institutes’ perspectives on candidates beginning new supervised analyses remotely, especially first cases and new personal analyses. Despite APsaA’s June 2020 announcement that work done remotely would count toward graduation, several Committee members remarked that beginning candidates, who can be especially anxious, often express their anxiety through questions about what counts. We considered that such manifest candidate concerns represent a view that remote analysis is not real analysis. We wondered: Is this message being subtly conveyed by training and supervising analysts and other educators?

To allow for the complexities of working remotely, institutes that require a specific number of supervised cases to progress to the next year of classes extended the deadline for beginning a first or second case. Some institutes postponed their incoming 2020-21 classes for a year. Most proceeded as usual but with remote classes; many remarked that having a new class was “a bright spot” for faculty last year.

Some institutes found creative, sometimes whimsical ideas for celebrating graduation: sending a bottle of Champagne to each graduate or asking graduates to prepare a personal video.

Throughout, our Committee emphasizes the importance of helping candidates think analytically about the significance to individual patients of working remotely; this involves responding to their questions in terms of their clinical meanings rather than emphasizing administrative policies. Which aspects of psychoanalysis are crucial? It is not the frame per se that makes for an analytic process but rather a psychoanalytic perspective, even though aspects of the frame surely facilitate the development of analytic process.

Justin Richardson and his colleagues at Columbia reported, in a 2020 JAPA article entitled “Emergency remote training in psychoanalysis and psychotherapy: An initial assessment from Columbia,” the results of their survey of candidates’ early responses to remote training in questionnaires circulated several months into the pandemic. They found candidates favored remote classes and supervision but strongly preferred in-person personal analyses and clinical work. Several other progression chairs agreed that many candidates continue to appreciate remotely conducted supervision and classes because they afford more accessibility and save commuting time.

Several specific issues will need to be confronted in the aftermath of Covid by all institutes, and perspectives of faculty working in progression will play an important, even decisive, role in charting our way forward:

In conclusion, progression chairs regularly meeting together and sharing creative solutions to commonly experienced issues enhances our journey in psychoanalytic education. We have built a network that provides the benefit of counsel and knowledge of the effective practices of colleagues. APSAA


Dr. Arden Rothstein, Training/Supervising Analyst and former Student Progression chair at the Psychoanalytic Association of New York, catalyzed a major revision of candidate evaluation emphasizing its educational value. Her publications focus on psychoanalytic education, learning disabilities, and diverse clinical topics.