The Case for a Joint External Credentialling Body

Donald Meyers, M. D.

Both the Executive Council and the Board on Professional Standards of the American Psychoanalytic Association have voted to support the American's membership in the Psychoanalytic Consortium* and its participation in the consortium's effort to establish a national accrediting body for psychoanalytic educational institutes and also the ultimate goal of establishing a certifying board for psychoanalytic practitioners. For the past year, the Committee on Accreditation of the Psychoanalytic Consortium has been hard at work organizing a provisional draft of Standards of Psychoanalytic Education with the active involvement, indeed leadership, of our committee representatives: Marvin Margolis, President of the American, and Don Rosenblitt, Chairman of the Board on Professional Standards of the American. Cal Narcisi, Leon Hoffman, and myself are participant observers representing the Joint External Credentialling Committee and the Executive Council of the American. On completion of the provisional draft, it will be submitted for review and discussion locally at societies and institutes and at the central governing bodies of the member organizations of the consortium. What follows is an updated statement of reasons for support of this effort originally put forth by Allan Rosenblatt, the chairman of the Joint Committee on External Credentialling which preceded the current one, a longtime member of the Executive Council of the American, a founder and first president of the San Diego Psychoanalytic Society and Institute, and an early graduate of the Columbia University Center for Psychoanalytic Training and Research:

An external credentialling agency is vitally needed because our field must have a generally accepted set of minimal standards by which to judge the adequacy of psychoanalytic training. So-called psychoanalytic institutes are proliferating at a rapid rate. In New York State alone, there are currently more than fifty-eight self-designated psychoanalytic institutes. The public has no way to determine which training programs are adequate and which are bogus. The field is in a position analogous to that of medicine 70 years ago, before the Flexner Report, when medical diplomas could be bought from diploma mills, and untrained or poorly trained persons could claim the title of "Medical Doctor."

Moreover, we have been given to understand by informed observers in Washington that continuing our current stance of opposing the application of the American Board for Accreditation in Psychoanalysis of the National Association for the Advancement of Psychoanalysis (ABAP/NAAP) to be the national accrediting body in psychoanalysis while offering no positive proposal for an alternative organization damages our credibility. In the absence of any generally acceptable alternative, the Council on Higher Education Accreditation (CHEA) and the U.S. Department of Education (DOE), the two national accrediting bodies, will eventually accede to repeated applications by NAAP and award it recognition. If NAAP gains recognition as the national accrediting body, psychoanalysis will be redefined in terms of NAAP's totally inadequate standards as a therapy that can be conducted once a week by individuals with no graduate degree, no mental health background and little, if any, clinical training.

To purvey falsely another modality of psychotherapy as though it were psychoanalysis and represent those trainees as psychoanalysts who practice psychoanalysis, would put the unsuspecting public at considerable risk of dangerously incompetent evaluation and treatment. Regardless of whatever organizations may later be also recognized, this lowest common denominator will be perceived by the public, lay and professional, as representing psychoanalysis. Analogous to Gresham's Law of bad money driving out good, when the profession is so devalued, bad therapists will drive out good ones.

Were the American to go it alone and set up an independent accrediting body with the training standards of the American, the other members of the Psychoanalytic Consortium would not only oppose it as representing only a minority of the psychoanalytic community, resulting in a serious disruption of the Consortium and alienation of the other member organizations of the Consortium which are allied with us in representing psychoanalytic interests to the federal government and the public, but they would, no doubt, set up a competing accrediting body with their own standards. The stage would then be set for NAAP or a similar organization to also seek recognition with the credible claim that, since there are no standards generally accepted by the national psychoanalytic community, their standards also deserve recognition. Thus, going it alone would increase the likelihood that NAAP would obtain recognition, with the disastrous consequences described above.

Only a joint Consortium-sponsored effort will provide a generally accepted national "floor" of minimum standards that would preclude the recognition of NAAP-like organizations. Such a jointly sponsored accrediting organization which is now being considered by the Consortium would have recommended standards equivalent to those of the American Psychoanalytic Association: four to five times a week training analyses but with a minimum of three times a week and three supervised cases with a minimum of two. The IPA requires two supervised cases and we belong to that organization although its standard is lower than ours. Our own internal standards would be guaranteed against any erosion by a requirement that any institute seeking accreditation that is affiliated with a national psychoanalytic organization (such as the American) must first meet the standards of that organization to be eligible to apply.

An added bonus accruing from an accrediting organization that is recognized by the Department of Education is the availability to students of such accredited institutes of low-cost leans up to $25,000 per student. In these days of diminished income in our field that increases the hardship of expensive psychoanalytic training, such loans would greatly benefit students, especially those who would otherwise be unable to finance their training.

By taking an active leadership role in working with the other psychoanalytic organizations of the Consortium toward such an accrediting organization, the American is now greatly increasing its influence on psychoanalytic education. Certainly the participation of high-quality medical schools, such as Harvard, Johns Hopkins, and Tulane, in accrediting organizations along with schools that have lower standards, has not eroded their standards. Instead, they have acted as role models to lesser training centers, stimulating emulation of their excellent programs. Similarly, the American is now in a position to educate the psychoanalytic community on the advantages of our higher standards and through such education to encourage upgrading minimal standards to optimal ones. If fact, this is now happening.

*The Consortium consists of representatives of the American Academy of Psychoanalysis, the American Psychoanalytic Association, the Division of Psychoanalysis (#39) of the American Psychological Association, and the National Membership Committee in Clinical Social Work (affiliated with the National Federation of Societies for Clinical Social Work).