The Cleveland Course on the Technique of Child & Adolescent Psychoanalytic Psychotherapy.

For a first time, in 2009-2010, the Subcommittee on Child Analysis, which is an arm of the Education Committee of the Cleveland Psychoanalytic Center and of which I am the Chair, offered to the professional community a course entitled, “Technique of Child and Adolescent Psychoanalytic Psychotherapy,” TCAPP, in shorthand. It ran for 20 weeks, September, 2009 through May, 2010.  It was offered on Tuesday evenings, 7:30PM—9PM at the Cleveland Psychoanalytic Center offices.Thirty CME/CEU credits for attended sessions were included in the purposely modest tuition of $950.  Participants were expected to arrange and pay for private, individual, clinical consultations/supervisions with a practicing child/adolescent psychoanalyst of their choice. A minimum of 16 consultations was required during the course of TCAPP. Fees for the consultation/supervision were individually negotiated between participants and consultant/supervisor.By having such a course we are reaching out to our community.  We are meeting professionals where they are, in whatever trainings they have had.  We began a dialogue about children and teens and their struggles to grow up. The goal of this course is to increase the psychotherapist’s professional competence by applying psychoanalytic ideas to psychotherapy with children and adolescents. In our flyer we stated: Our focus is that behavior has meaning.  Its understanding is the basis of all therapeutic interventions. We state that participants would learn: How to recognize and utilize the child’s unconscious fantasies; How to recognize transference and how best to communicate this to the child; How to recognize countertransference—the strong feelings evoked in the therapist; How to use the techniques of containment and interpretation. In our flyer our website was cited, www.childtherapy.webs.com. All twenty sessions of the course were co-taught by the same two experienced analysts, myself, Ms. Joanne Naegele, and my colleague and fellow member of the Subcommittee on Child Analysis, Rimvydas Augis, Ph.D. We both have adult psychoanalytic trainings, Dr. Augis through the Finnish Psychoanalytic Society, myself through the Cleveland Psychoanalytic Center, as well as adolescent and child psychoanalytic trainings. We are known to be grounded well within the Anna Freudian tradition and in addition to have an interest in object relations, from Kernberg to Melanie Klein to the modern Kleinians of Betty Joseph, Elzabeth Spillius, John Steiner, Michael Feldman to Meltzer to Bion and beyond. The object relations perspective and clinical psychotherapy readings had an appeal to the clinicians we taught. The broad point of view was appealing. We both had energy and enthusiasm to give to this new venture.The response was terrific.  We started with ten participants and ended with nine.  Some participants were just starting their careers. Others had careers well established.  One participant felt he had “retired too early” and was looking for a way to get back into  clinical work.  The request by participants was that we hold the group to no more than ten participants. They wished to have discussion and a chance to dialogue and to learn from each other. All had an interest in the psychoanalytic point of view in dealing with children in psychotherapy. The fields of the participants include psychiatry, psychology, social work, school psychology, alcohol and addictions. We used a text out of the Tavistock Clinic Series, a paperback by Margot Waddell, published in 2002.  The text is entitled: Inside Lives: Psychoanalysis and the Growth of the Personality. This book the participants bought. The author happened to be at the Bion Conference, “Turbulence in the Container/Contained” held in Boston in July, 2009.  Waddell was very interested that we were using her textbook and wondered how it would be received. I wondered about this as well and promised to let her know. In addition to the text, for each class we cite references to short, pithy psychotherapy case references, many from the Journal of Child Psychotherapy, which is headquartered in London. Participants accessed these readings for their personal education via the internet and the content was discussed in our sessions.CONCLUSION: Giving practitioners a chance to think from a psychoanalytic point of view and to dialogue with colleagues about the problems presented by children and teens is a unique opportunity.  It can be the beginning of a wish to have a chance to treat children in a way that can enable them to grow and to know their internal life. It is a chance to become familiar with the working concepts of transference and countertransference.  At the very least it will guarantee that more children and teens will be seen in our community, since many of the participants are thinking about how to extend their practices to children.  The course focused on  challenging topics of interest to the modern day psychotherapist, including “the effect of real life trauma in childhood,” “acting out,” “mutilation and suicide,” “work with handicapped or chronically ill children,” “containment and parents’ role,” “adoption and foster care,” “termination.”  The opportunity for the participants was to discover there are two psychoanalytic training programs in Cleveland, one through the “Institute”, i.e., the Cleveland Psychoanalytic Center, and another through the Hanna Perkins Center.  There would be a place to “go further” once their appetites were whetted if there was a wish and interest to pursue child and adolescent psychoanalysis as a career.Regardless of whether this happens or not, we were touched by points of view of the “other.”  In so doing we were enriched. When and if this course is repeated, twenty sessions will be offered but four of them might be devoted to “clinical presentations” from the participants.  This was a suggestion from the group.  They would like to have more than “vignettes” from each other in class.  They would like to get a feel of how their colleagues work and think clinically. We also had the thought that if there is sufficient interest for “the next time around,”   participants might be limited to those who are currently working in some kind of a clinical practice, be it in child, adolescent or adult therapy. In this way all that was discussed would be immediately applicable to the clinical work of the participant.This article appears in the Spring Issue, 2011, of  "The Newsletter of the Association for Child Psychoanalysis, Inc." Members may access the newsletter at www.childanalysis.org.