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ICP Training, Supervising Analyst Policy & Procedures

Requirements for ICP Training & Supervising Analysts:

In order to become a Training and Supervising Analyst at ICP, an analyst must meet two basic requirements. First they need to have participated in an ICP Study Group for a minimum total of five years. At least two years of that five-year requirement must be participation in an ICP peer consultation group, and the remaining three years may be divided in accordance with the candidate’s individual choice, either in further participation in a peer consultation group or in a supervision training group. In an attempt to establish and maintain high standards related to postgraduate psychoanalytic education and practice, ICP expects that members will demonstrate their dedication and commitment to the practice of psychoanalysis by consistent and regular attendance in these groups (70% minimum yearly attendance is required, for five years). These study groups offer members a continued psychoanalytically informed atmosphere in which to present and discuss psychoanalytic clinical case material, and opportunities for integration of diverse theories, and consideration of alternatives in therapeutic action based upon a pluralistic contemporary psychoanalytic lens.

Second, the applicant for Training and Supervising Analyst must demonstrate competence by means of one of two options:

(1) Become Board Certified with a specialty in psychoanalysis, or gain certification as a Training and Supervising Analyst, through one of the following organizations: The American Board of Professional Psychology (ABPP); the American Psychoanalytic Association Board of Professional Standards (APsaA BOPS); the American Board of Psychoanalysis (AAP); or the American Board of Examiners in Clinical Social Work (ABE BCD-P).

(2) Because Board Certification is not available for all licensed health care professionals that participate as members of ICP, a second option is made available; that is, the option to present an analytic case before a committee composed of five members – three members from the ICP Training and Supervising Analyst Committee, and two members who are Training and Supervising Analysts from other approved outside Psychoanalytic Institutes.

Institutes that are designated “approved” may be members of ACPE or of a psychoanalytic organization with commensurate standards (e.g. IPA, APsaA). These outside members serve to provide the necessary external validation of applicants for ICP Training and Supervising Analysts. The five examiners, appointed to a committee in order to determine the suitability of a given candidate for Supervising and Training Analyst status, are asked to achieve consensus on their decision, rather than to reach a decision by majority vote.  Criteria for determining the readiness of the given applicant are provided by ICP, based on ICP’s Core Psychoanalytic Competencies (see addendum). These criteria are made available to the five-member examining committee to facilitate the achievement of consensus on the decision.

These two requirements for the status of Training and Supervising Analyst at ICP, that of five years participation in ICP Study Groups, and either Board Certification or approval by the ICP Training & Supervising Committee, were newly established as of April 2017, and pertain to all analysts beginning the process of becoming an ICP Training & Supervising Analyst after September 2017. In addition, foundational requirements established before April 2017 for Training and Supervising Analyst remain in place for all ICP analysts. Those requirements determine that before initiating the process of applying for Training and Supervising Analyst status, the individual must be recognized by the ICP Board of Directors as a certified Psychoanalyst. This means that he/she has successfully completed all of the elements of the ICP Psychoanalytic Training Program,  including four years of psychoanalytically informed didactic coursework; participation in a personal Training Analysis; and completion of three supervised control cases, each one under the supervision of an ICP approved Training and Supervising Analyst, along with the completion of the required control case reports for each patient. ICP analysts who graduated from the ICP training program and joined a recognized ICP study group by September 2017 are “grandfathered” into ICP’s previous Training & Supervising Analyst requirements. Those requirements had permitted certified analysts who had participated for two years in an ICP study groups to request approval from the ICP Board to become a Training & Supervising Analyst. With the ICP Board’s approval of the Training & Supervising Analyst status, the individual had to remain active in an ICP study group for three additional years, for a total of five consecutive years of study group participation.

All ICP candidates, active members, and members designated as Training and Supervising Analysts are expected to hold a current and active license in a mental health profession issued by his/her respective licensing board. In addition, ICP expects that every candidate and member assumes responsibility to meet any and all requirements to maintain licensure as outlined by his/her respective licensing board, as well as to follow the legal and ethical guidelines and standards that are outlined by the licensing boards, ICP, and other relevant professional organizations.

 

ICP’s Training & Supervising Evaluation Process:

An ICP analyst may request an evaluation by the ICP Training and Supervising Committee, after the completion of five years in ICP Study Groups. The committee chair will facilitate the formation of a panel of five Training and Supervising Analysts after the applicants written case material has been reviewed. Two of the five analysts chosen shall be Training & Supervising Analysts from an outside psychoanalytic institute. The five selected analysts should have adequate knowledge and appreciation of the applicants theoretical orientation, and they will use ICP’s core psychoanalytic competencies to determine whether the applicant is suitable to be a training and supervising analyst. Previous supervisors or personal analysts should recuse themselves from the panel.

The applicant will prepare for the oral exam by writing up an analytic case that they will discuss with the panel. In addition to the case report, the verbatim script of one or two sessions should be included. Three copies of the report and process notes need to be turned into the chair for an initial review, before the committee is selected and a date and time (two hours) is chosen for the exam. The applicant will be notified of the five committee members, and is given one week to notify the chair if they would like to request a change in the composition of the panel.

The comprehensive clinical case report usually includes, in formal terms: identifying data; presenting complaint and history of present illness; history of psychiatric/psychological treatment; developmental history; initial diagnostic and prognostic impressions; a working psychodynamic formulation; and a review of therapeutic work elaborating an analytic process. The creation of a psychoanalytic formulation is necessarily subjective, individualized, speculative, and comprehensive. It contains more than a DSM diagnosis, as it attempts to convey a deep understanding of what it is like to live as that person, and it takes into consideration the complexity of influences that have shaped and organized the patient’s conscious and unconscious experience of him/herself, others, intimate relationships, and the world. The comprehensive case report should also convey how you think about, conduct, and participate in an analytic process with this person, including examples of attending to unconscious processes and transference-countertransference phenomenon.

Listed below are important elements for consideration in your comprehensive case report. Nevertheless, there is no set formula for how to compose this report, both because there is no singular “right” way, and because we would prefer not to impinge on your efforts to bring the experience of your patient and the process to life. While the length of a report does not directly correlate with it’s quality, most reports are 15-30 pages (double spaced), and it should be well written and thorough enough to demonstrate that you have developed the necessary knowledge and skill to work psychoanalytically and act as a mentor for candidates.

Things you may include or elaborate on in a comprehensive case report:

  1. Description of the Patient – basic identifying information, and your subjective experience of the patient (how it feels to be with and interact with him/her).
  2. Presenting Problem–  patient’s initial complaints, including why they are seeking help now.
  3. Relevant History– developmental issues, neglect/abuse/traumas, significant events & memories, F.O., biological & socio-cultural influences, previous treatments, etc.
  4. Assessment of Patient’s Deficits & Strengths– psychological capacities, sense of self, and coping strategies – adaptive & maladaptive defenses, values, etc.
  5. Basic Unconscious Organizing Principles– the way the patient has learned to organize his/her world in terms of basic beliefs, expectations, relational patterns, internalized representations of others/relationships, etc.
  6. Aims of Treatment– what core dynamics and issues were addressed (i.e. developmental deficits, primary anxieties & defenses, maladaptive patterns & beliefs, problems w/ affect & impulse control, unresolved conflicts, etc.).
  7. Analytic Process– reflect on and explain the analytic process as it unfolded, including work with transference & countertransference. Provide sufficient details about the process to exemplify your thinking and psychoanalytic approach (what attitudes, beliefs, and theories influence your choices and perspective).
  8. Therapeutic Outcome – describe and give examples of how the patient changed (i.e. achieved greater insight, developed psychological capacities, strengthened and expanded sense of self, modified organizing principles & internal representations, etc.), what experiences facilitated change (what constituted therapeutic action), and what remains to be done.

 

Addendum: ICP Core Psychoanalytic Competencies

Contemporary psychoanalysis is a treatment for emotional discomfort and pain, an avenue for self-discovery and personal growth, and a means toward establishing and enhancing relationships with others. It is an interpersonal experience that emphasizes the healing properties of two or more people working collaboratively to make sense of things in a way that is meaningful to the patient. It is a form of psychotherapy that aims to explore unconscious processes and relational patterns, in order to expand understanding, facilitate development of psychological capacities, and enable character change. Psychoanalytic work is characterized by depth and intensity, achieved through frequent sessions over a long term, and by the use of the therapeutic relationship as an important vehicle for understanding and change. Candidates acquire core psychoanalytic competencies through undergoing their own personal analysis, participating in didactic learning of psychoanalytic theory, concepts, and skills, and by conducting three supervised control cases. Psychoanalysis has evolved over time to include many different theoretical models, and candidates learn how different theories influence their understanding and approach to psychoanalysis. Candidates are encouraged to find their own analytic voice and a way of working that is responsive to the uniqueness of each patient and analytic dyad. The following core competencies are used as a guideline to develop curriculum and assess a candidates growing capacity to use psychoanalytic knowledge to formulate an in-depth understanding of their patients and develop certain clinical skills, and to reflect on the analytic process and communicate their knowledge:

 

Assessment & Diagnosis

  1.  Formulate a psychoanalytic understanding of the patient’s psychology and unconscious dynamics. Make appropriate clinical diagnoses and treatment recommendations, with consideration of the patient’s history, symptoms, level of functioning, and psychological capacities- both strengths and vulnerabilities.
  2.  Identify unconscious organizing principles, ways of being, beliefs, and patterns. Understand the effects and interplay of various factors such as internal object relations, attachment dynamics, deficits, traumas, phenomena of self experience, central conflicts, and defenses.
  3. Consider the person in context – including developmental, biological, and socio-cultural influences.

 

Analytic Listening & Attitude

  1.  Listen on multiple levels, for multiple meanings.
  2.  Develop and demonstrate an analytic attitude – such as being: empathic, reflective, nonjudgmental, curious, open-minded, tolerant of ambiguity/uncertainty/complexity, sufficiently flexible, interested in discovering the truth about the patient’s emotional experience, and being respectful of the patient’s individuality.

 

The Treatment – Facilitating a Psychoanalytic Process

  1. Working alliance & frame – establish and maintain a working relationship with the patient, and address issues related to handling of fees, use of couch, frequency of sessions, and communication outside of session.
  2. Technique- choose appropriate interventions to facilitate the deepening of a psychoanalytic process, such as: empathic inquiry, interpretation, free association, exploration of fantasies and dreams, clarification, confrontation, following affect, noticing what’s avoided, containment, and holding.
  3. Transference- use the therapeutic relationship as a central vehicle for understanding and change, and show the ability to work with positive and negative transference. Understand the differences and inter-relationship between the repetition of old patterns in the transference, the need/hope for new relational experience, and the way experience is co-created in the present by two interacting subjectivities – the patient’s and analyst’s.
  4.  Countertransference – use countertransference to facilitate understanding of patients’ unconscious processes, demonstrate a capacity to contain reactivity in response to countertransference pressures, and explore how countertransference reactions stem from one’s own dynamics and are co-created out of intersubjective experience.
  5.  Working through- conduct ongoing work with the patient’s unconscious dynamics as they are revealed over time in the transference and extra-transferential material.
  6. Resistance- address fears and defenses (self protective measures) that interfere with understanding, change, or the analytic process.
  7. Enactments- explore and work through impasses, and consider unconscious factors emerging from both the patient and the analyst.
  8. Termination- be able to recognize characteristics that may indicate readiness for termination, and describe the termination process.

 

Supervision

  1. Supervision- remain open to feedback from supervisors, as well as peers and other mentors. Be able to consider alternative interventions and theories.
  2. Is increasingly able to develop ideas independently, using supervision more for discussion rather than direction.

 

Evaluating the Process & Outcome

  1. Demonstrate the capacity for ongoing self reflection- understand the analyst’s contribution to the process, be aware of feelings/fantasies/reactions to the patient, avoid imposing personal agendas on the patient or the treatment, and be able to admit possible mistakes or misjudgments.
  2. Use feedback from the patient- assess the effects of interventions, noticing what deepens or disrupts the process. Make adjustments in the wording and timing of interpretations to accord with the patient’s readiness.
  3. Outcome- describe your understanding of what helped the patient (therapeutic action) and what changed in the patient (i.e. developed new capacities and insights, improved relations, more integrated sense of self, etc.). Assess what was accomplished and what was left undone.

 

Writing

  1. Write clinical reports and comprehensive case summaries that demonstrate a psychoanalytic understanding of the patient, their major dynamics and the process – including important transference themes, countertransference experience, and an assessment of what changes. Demonstrate coherence, without rigidity, between one’s espoused theory and one’s understanding and approach.
  2. PsyD candidates complete a dissertation. It should be the application of the single case study method, integrating theory and clinical practice, or a well researched investigation or exposition of a subject relevant to the practice of psychoanalysis or relevant to the application of psychoanalytic knowledge in other contexts. It should make a scholarly contribution to psychoanalytic knowledge and be publishable by a peer-reviewed journal.

 

Ethics

  1. Conduct self professionally, with uncompromising commitment to the patient’s well-being.
  2. Act with integrity, upholding boundaries and ethical standards. Seek consultation when needed.
  3. Protect the patient’s confidentiality and anonymity in all communications.