Dwarakanath Rao and Dionne Powell
Dwarakanath Rao, M.D., is chair of the Board on Professional Standards.
Dionne Powell, M.D., is secretary of the Board on Professional Standards.
Standards are not established by your proclamations they are established by your routines.
—T. Jay Taylor
Many candidates are asking “What do the changes in APsaA mean for my education?”
As the historic Six Point Plan moves forward to sunset the Board on Professional Standards, and change APsaA governance, a number of factors will affect regulation of standards in our institutes and centers. They include choice of educational standards, shifting of educational responsibility to local groups, the externalization of regulatory functions to AAPE (American Association for Psychoanalytic Education), certification of members externally through the ABP (American Board of Psychoanalysis), and the creation of the DPE (Department of Psychoanalytic Education), an internal consultative body.
The Six Point Plan is a nuanced set of compromises designed to reduce decades of tension within APsaA. A main source of tension was between those who felt our standards were inflexible, and those who felt they were appropriately rigorous. As these changes are put into motion, the Board on Professional Standards, along with the rest of the leadership of APsaA, is committed to ensuring a smooth transition for candidate education. This will require transparency and clarity, as well as candidates familiarizing themselves with the changes and its local implications.
What will happen to standards when the Board on Professional Standards sunsets as planned in June 2017? Institutes that choose external regulation of standards by joining AAPE will initially follow existing APsaA standards, and have mandatory joint site visits by AAPE and the Accreditation Council for Psychoanalytic Education (ACPEinc) for the purpose of accreditation. Certification will be encouraged for all faculty, and required for TSA appointment. Seven institutes have joined AAPE so far; several others are in discussion about AAPE. These institutes remain a part of APsaA.
Institutes that choose not to join AAPE will follow IPA standards as guidelines, use local governance of standards, use the DPE for consultation as needed, and will not require mandatory site visits. Unlike current APsaA standards, IPA standards do not require certification for TSA appointment, and require two instead of three cases for graduation. IPA is considering, although this is by no means certain, changing the frequency of supervised cases from 4-5/week to 3-5/week.
It is important to remember that no institute is required to change existing standards. We encourage each institute to study the available choices before making a decision. Unless a local institute has chosen to make changes, or is in the process of modifying standards, candidates should not see any difference in clinical training in the near term. However, as local groups conclude their deliberations, we anticipate some institutes will make the choice of following AAPE standards, others will follow IPA standards as guidelines, and conceivably, some will follow AAPE standards but not necessarily join AAPE. It is important to emphasize that certification via the ABP remains for those non-AAPE institutes as an important professional developmental opportunity for those individuals who choose it. Since there are many standards and accreditation issues involved, and discussion will involve local and national issues, we encourage candidates to learn more by staying in touch with institute leadership. The Board on Professional Standards, the DPE, and AAPE, and APsaA leadership are available to answer questions.
Choice of standards will allow for a respectful and thoughtful discussion within institutes about what is valuable and essential in the training of psychoanalysts of the future. The Board on Professional Standards, which established and monitored standards for seventy years, has strived to ensure that standards be relevant and rational.
Standards are tools of the trade; they are for everyday and lifelong use, not just for passing examinations. We believe that standards should represent a threefold set of functions—evaluative, developmental, and aspirational. Too often, there is emphasis on one, rather than all three, of these functions, leading to valid criticism of the basic purpose of standards. Standards must also strive to meet contemporary scientific and practical demands, keeping in mind the unusually subjective nature of our profession, inner and outer resistances to self-awareness, and the long period of training and lifelong learning necessary for mastery of this difficult work.
The role of candidates and new graduates is crucial in the discussion about the future of standards. No one is closer to the training experience than candidates, who know first-hand about how standards enrich their learning environment. We hope your teachers and supervisors listen to what you have to say about your training, national accreditation and peer review, as well as the place of psychoanalysis as a modern profession with regulatory demands that are increasingly evident across the nation.
In conclusion, we would like to suggest open discussion among candidates and new graduates about standards and the changes within APsaA. Doubts and questions are natural during a time of change. We want to reassure candidates that we will work with them during this time of transition to a pluralistic future. Here are links on various organizations referenced above: AAPE—aape-online.org, DPE on APsaA website—apsa.org, ACPEinc—ACPEinc.org, IPA—ipa.world.