Inside Scoop: Navigating Entry into Psychoanalytically Grounded Therapy Training from an APRN Background

Prepared by the Advanced Practice in Nursing Committee with the
American Psychoanalytic Association:

Brooke A. Finley (Chair; Columbia-TFP Program), Linda Grey (WBCP), Sidney Miller (Chicago), Nadege Dorcelly (PANY), Miriam Lundy (SFCP), Wendy Peterson (Western New England), Kelsey Breder (NYPSI), Tina Marie Dale (St. Louis), & Domenic Ciampa (Boston College)

Why Pursue Psychoanalytically Grounded Therapy Training?

Psychoanalytically grounded therapy is a depth-oriented, evidence-supported treatment approach associated with enduring and often increasing therapeutic gains over time (Shedler, 2010; Leichsenring & Rabung, 2008). Meta-analyses and randomized controlled trials, including longitudinal studies conducted in Sweden, have demonstrated that long-term psychodynamic treatments show sustained symptom reduction and structural personality change beyond the termination of treatment (Leichsenring & Rabung, 2008; Town et al., 2012). Importantly, outcome studies suggest that benefits of psychodynamic treatment often continue to accrue after therapy ends, in contrast to many short-term manualized interventions where gains may plateau (Shedler, 2010).

Public-facing psychoanalytic scholars have also argued that depth therapy addresses root causes of distress rather than symptom suppression alone (Essig, 2016). Contemporary patient-preference data further suggest that therapy consumers increasingly value understanding the origins of their suffering, expect treatment to take time, and prioritize relational depth with their clinician (PsiAN, 2023).

For APRNs, pursuing psychoanalytically grounded training may:

Deepen clinical understanding of complex patients
Improve long-term patient outcomes
Enhance professional satisfaction
Broaden referral networks
Support higher fee structures associated with specialized psychotherapy

In short, it can enrich both the quality of one’s clinical life, financial stability, and the intellectual richness, and satisfactory sustainability of one’s practice.

Why Wasn’t I Taught This Way of Working in Graduate School?

Graduate APRN education emphasizes broad clinical competency and population-based care standards as outlined by the National Organization of Nurse Practitioner Faculties (NONPF, 2022). While exposure to psychotherapy modalities is required, training standards do not mandate intensive supervised psychotherapy practice or personal treatment experience.

There are pragmatic and systemic reasons for this. Manualized, short-term therapies are easier to teach, measure, and evaluate within constrained academic timelines (Shedler, 2010). Additionally, graduate psychiatric APRN education has increasingly emphasized diagnostic assessment and psychopharmacology, partially reflecting healthcare reimbursement structures and workforce needs (Delaney, 2024). Scholars have also noted the historical decline of psychodynamic nursing education following mid-20th-century institutional shifts away from Peplau’s relational model (Callaway, 2002).

Many APRN faculty and preceptors have limited formal psychotherapy training beyond graduate coursework. Thus, psychoanalytic psychotherapy — which requires years of supervised immersion — cannot realistically be contained within standard APRN curricula (NONPF, 2022).

Psychoanalytic training is an intensive post-graduate endeavor requiring sustained clinical experience, supervision, and often personal analysis. It is not an omission of competence that it was not taught in graduate school; rather, it reflects the structural limits of professional education models.

How Do I Begin Engaging with the Psychoanalytic Community?

Unlike university-based graduate programs, psychoanalytic institutes are typically independent, nonprofit educational organizations affiliated with national or international psychoanalytic bodies.

You may begin by:

Attending institute open houses
Enrolling in introductory seminars
Participating in fellowships
Attending national conferences
Joining study groups

Institutes affiliated with the American Psychoanalytic Association (APsA) can be found on the Approved Training Institutes page. Many programs now offer hybrid (online and in-person) training components.

What Types of Psychoanalytic Training Are Available?

Introductory Training

Short-term seminars, webinars, fellowships, and study groups provide foundational exposure. These programs typically do not require personal analysis or active psychotherapy cases.

They are ideal for APRNs who are new to psychoanalytic thinking.

Psychoanalytic Psychotherapy Training

Typically two years in duration. Includes:

Weekly didactics
• Required readings
• Ongoing supervision of weekly psychotherapy cases
• Often personal psychoanalytic psychotherapy

This level is appropriate once you are seeing patients on a weekly basis for individual psychotherapy.

Psychoanalytic Training (Full Analytic Training)

The most intensive level of training.

Typically includes:

Conducting psychoanalysis 3–5 sessions per week per patient
Weekly supervision for individual psychoanalytic cases being seen 3-5x/week
Personal psychoanalysis (3–5 sessions per week)

Training standards are defined by individual institutes affiliated with APsA (APsA, 2024).

How Do I Prepare for Advanced Psychoanalytic Training?

Preparation typically includes:

Several years of clinical practice
Psychoanalytic psychotherapy training
Ongoing supervision
Personal psychoanalytic treatment

Institutes often evaluate readiness using criteria related to emotional maturity, clinical depth, and immersion in psychoanalytic study (APsA, 2024).

Graduate APRN education alone is not considered sufficient preparation for analytic training. Many clinicians complete fellowships or psychotherapy certificates before applying.

Financial planning is essential. Tuition, supervision, and personal treatment are significant investments. However, APsA and many institutes offer scholarships, payment plans, and loan programs (APsA, 2024).

Practicing Psychoanalytically in a Prescribing-Focused Market

Healthcare systems often incentivize short visits and medication management. However, workforce data indicate that patient demand for mental health treatment exceeds supply (Delaney, 2024). Public survey findings suggest that patients increasingly seek relational depth and meaning-oriented treatment (PsiAN, 2023).

Clinicians who develop strong psychotherapeutic identities often find that patients self-select for longer-term work when offered. Over time, specialization can differentiate one’s practice and support financial sustainability.

Financial Considerations

Training Costs

Costs typically include:

Tuition
• Personal analysis
• Supervision
• Opportunity costs (reduced prescribing hours)

However, specialized psychotherapy training may allow higher fee structures over time, particularly in private practice settings (Shedler, 2010).

Many institutes offer:

Scholarships
Reduced-fee supervision
Candidate loans
Sliding-scale analytic treatment options

How Can I Afford My Own Psychoanalysis?

Psychoanalysis is a mental health treatment and may be partially covered through PPO out-of-network insurance benefits, depending on the plan. Psychoanalytic psychotherapy (once or twice weekly) is more commonly reimbursed than classical analysis (3–4 times weekly).

Training analysts and analytic candidates often provide reduced-fee treatment under supervision. Fees are frequently negotiated.

What Is the American Psychoanalytic Association (APsA)?

The American Psychoanalytic Association (APsA), founded in 1911, is the oldest national psychoanalytic organization in the United States (APsA, 2024). It offers membership to psychoanalysts, psychoanalytic psychotherapists, academics, researchers, and students.

APsA’s mission is to advance psychoanalytic knowledge through research, education, and professional development (APsA, 2024). The organization sponsors national meetings, publishes the Journal of the American Psychoanalytic Association, and supports initiatives such as the Holmes Commission on Racial Equity and Diversities Section programs addressing systemic bias.

APsA includes 36 approved training institutes and numerous affiliate societies across the United States (APsA, 2024).

Why Become a Member of APsA?

Membership offers:

Community
National referral networks
Professional listserv access
Educational discounts
Discounted malpractice insurance options
Access to national conferences
Cross-regional professional networking

Learn more about APsA membership.

Mentorship Opportunities

The Advanced Practice in Nursing Committee of APsA offers:

Quarterly open mentorship events
Structured mentorship pairings for nurse members

References

American Psychoanalytic Association [ApsA]. (2024). About APsA. https://apsa.org

Callaway, B. J. (2002). Hildegard Peplau: Psychiatric nurse of the century. Springer Publishing.

Delaney, K. R. (2024). Inclusion of psychiatric–mental health advanced practice nurses in federal behavioral workforce planning. Psychiatric Services, 75(6), 594–596. https://doi.org/10.1176/appi.ps.20230288

Essig, T. (2016). The future of psychoanalysis in a digital age. Psychoanalytic Dialogues, 26(5), 555–569.

Leichsenring, F., & Rabung, S. (2008). Effectiveness of long-term psychodynamic psychotherapy: A meta-analysis. JAMA, 300(13), 1551–1565. https://doi.org/10.1001/jama.300.13.1551

National Organization of Nurse Practitioner Faculties [NONPF]. (2022). NP role core competencies. https://www.nonpf.org

Psychotherapy Action Network [PsiAN]. (2023). Public attitudes toward psychoanalytic therapy survey findings. https://psian.org

Shedler, J. (2010). The efficacy of psychodynamic psychotherapy. American Psychologist, 65(2), 98–109. https://doi.org/10.1037/a0018378

Town, J. M., Abbass, A., & Bernier, D. (2012). Effectiveness and cost effectiveness of intensive short-term dynamic psychotherapy. American Journal of Psychiatry, 169(1), 14–25.