Candidate progression in analytic institutes: a multi-center study.

This study documents the criteria for graduation and for awarding credit for training cases used by thirteen institutes of the American Psychoanalytic Association (APsA). At the time of this study, these thirteen institutes were training 63% of all candidates enrolled at institutes of the APsA. Questionnaires were sent to the progression committee chairperson (PCC), a junior candidate and a senior candidate, and a recent graduate at each institute. Each participant also had a follow-up semi-structured telephone interview. Return rate was 100%. 92% per cent of the institutes reported that in order to receive credit for cases, the patient needed to be in treatment for some minimum amount of time (average 18.3 months). Many PCCs were skeptical about writing down the criteria for credit, stating that this made candidates overly focused on the time requirement. 85% per cent of PCCs felt that graduation from the institute was based primarily on obtaining credit for cases. Few required a terminated case and only one felt that classroom work was an important factor. 47% per cent of candidates felt that the need to keep patients in treatment to receive credit for cases affected their treatment of patients and only 46% of candidates could state the minimum time requirement used by their institute. These results indicate that graduation from institutes of the APsA depends primarily on receiving credit for cases, that case length is an important criterion for awarding credit and that this method of evaluating candidates may not be the best way to support educational objectives.