Child and Adolescent Psychoanalytic Psychotherapy Training ... · The frequency, of course, may...

Child and Adolescent

Psychoanalytic

Psychotherapy Training

Program

Student

Manual

2016-2019

Child and Adolescent Psychoanalytic Psychotherapy Training Program

To: Students and Advisors

From: Edward P. Kaufman, Director, and Judith Feigon Schiffman, Asst. Director

Subject: Orientation to Certification Requirements for Diagnostic Evaluations and

Treatment Cases.

A. Diagnostic Evaluation

General Considerations:

Twelve (12) diagnostic evaluations are required of each student during the three years of the

program, under supervision of CAPPT program faculty. It is recommended that students begin

on diagnostics after the completion of first quarter of classes. Students can receive credit for up

to two diagnostic evaluations by fulfilling the requirements for the two year infant observation

sequence.

Diagnostic studies should include an process interview by the student with the child or

adolescent in addition to the diagnostic formulation. Student should have experience with a range

of ages, male and female,.

Age & Sex: Pre-school child, latency child, adolescent, parent. Both sexes should be

represented.

Some Examples of Types of Disturbances

Psychotic disorder, character disorder, organic brain disorder, neurotic disorder,

psychophysiological disorder.

Your first diagnostic evaluation and one diagnostic during each successive year should be with

your assigned advisor. Supervision for successive diagnostic evaluations should be arranged

between you and a faculty member of your choice. If you wish, you can contact us for

information regarding faculty members who have time for supervision. To provide continuity in

learning after the first supervised diagnostic evaluation with your advisor, students should

thereafter do three successive diagnostic with the same supervisor.

A diagnostic interview with the child, when the child is the patient, must be included in the

history. On the rare occasion when this is not possible, omission must be explained.

Certification Requirements

Page 2

Procedures For Completing Diagnostic Evaluations:

1. All diagnostic evaluations should be current or very recent cases at the time they are

presented to the supervisor. Exceptions need to be justified. Students may call the

supervisors directly for their preference regarding the point in the evaluation process

when a case should first be brought in for discussion.

2. The diagnostic report need not be written before the supervisory session. The case

material should be presented verbally and diagnostic impressions discussed with the

supervisor.

3. Following the supervisory session or sessions, or at a point agreed upon with the

supervisor, the material is written up and submitted to the supervisor. The enclosed

“Suggested Outline for Diagnostic Evaluations” should be used as a guide. A

discussion and assessment of the write-up is part of the supervisory process.

4. Upon completion of the supervisory process with each supervisor, the student should

submit the diagnostic cards and the supervisory report to the CAPPT office to be

included in their file. The diagnostic cards are to be filled out by the student, and the

supervisory report be completed by the student and the supervisor.

5. Please try to limit your diagnostic reports to no more than five pages (single space).

The CAPPT office does not generally require copies of the diagnostic reports.

(However, diagnostic reports should be submitted to the CAPPT office for those

cases that are or will be in supervised treatment).

Timetable for Supervised Diagnostic Cases:

Completed Diagnostic Evaluations

By the end of the first year 1-3 cases

By the end of the second year 4-7 cases

By the end of the third year 8-12 cases


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B. Treatment Cases

General Information

After the first quarter , you should begin to look for a case for diagnostic evaluation. A

diagnostic evaluation including the interview with the child should be done on a case being

considered for supervised treatment. If this case may be suitable for a treatment case , with the

supervisors agreement, the psychotherapy may begin.. credit will be given for and submit it as a

diagnostic evaluation in order that it may be screened and accepted as a supervised case by the

end of the first quarter. Three treatment cases with the faculty supervision are required during

the course of the Program.

Procedure for Supervised Treatment Cases

After having determined that you have a case that may potentially become a supervised case,

make arrangements for supervision with a treatment case supervisor, unless the diagnostic

supervisor will be the treatment supervisor. You will then complete a diagnostic evaluation with

your diagnostic supervisor. You are free to contact any faculty member or to check with us if you

have any questions regarding supervisions availability.

Frequency of supervision is determined between you and the supervisor based on needs of the

student and the needs of the case. The frequency, of course, may change as the case progresses.

Following the completion of each case, a treatment summary which has been approved by the

supervisor, and the supervisor's report of the clinical work is sent to the CAPPT office for

inclusion in your file.


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Criteria for Case Selection

Three treatment cases are required with faculty supervision These are to be children, and/or

adolescents. of different age ranges. Both sexes are to be represented. The child and adolescent

cases should be three of the following four diagnostic categories: 1) psychotic, pre-psychotic, or

borderline; 2) neurotic; 3) character disorder, and 4) psychophysiological disorder. Exceptions

need to be discussed with the student’s advisor.

Frequency of Treatment

It is suggested that one child case be seen intensively at a frequency of two or more times a

week; the others should be seen at least once a week.

Work with Parents

Each student is expected to work with the parent or parents of at least one of the child cases. In

the work with parents, the goal will be to learn about the child and the environment and to

provide the parent with guidance around child-management problems.

Students and their supervisors are urged to b explicit in planning the concurrent contact with

and/or therapy of the parents.

Third Treatment Case

The kind of case chosen as a third treatment case is elective. The student may choose to treat a

child or adolescent of any age, an older adolescent under 21 years of age, or a suitable parent.

The Student Evaluation Committee may recommend that this third case be of a particular kind if

it seems indicated for the student’s learning.

If a parent case is chosen as the third case, the presenting request of the parent should be the

problems with the child or a disturbed parent-child relationship. Cases of marital counseling,

husband-wife treatment, or family therapy are not acceptable. The frequency of a parent case is

to be at least once a week.


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Additional Requirements

One cases to be carried in supervision for a minimum of two years , one case for at least one

year, and one case for a minimum nine months.

Timetable for the Beginning of Supervised Treatment Cases

By the end of the first year ---------------------------------------------- 1 case

By the end of the second year ---------------------------------------------- 2 cases

By the end of the third year ---------------------------------------------- 3 cases

C. Supervision

The fee for supervision is no longer part of the tuition charged by the Institute for educational

programs. Students will pay $20 per session for supervision. directly to the supervisors.

Financial arrangements regarding payment are to be worked out with the supervisors.,

After the student has fulfilled the program’s time requirements for a supervised case, it is

recommended that some form of periodic consultation continue until the end of the treatment. A

specific plan to that effect can be decided on by the student and supervisor before formal

supervision ends.

D. Tuition and Fees

For tuition and fees consult the Institutes' website www.chicagoanalysis.org.

E. Scholarships

Limited scholarships are available.

Contact the program director for details regarding application for these scholarships


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F. Attendance

It is the policy of the Institute, as determined by the Education Council, that the following

minimal requirements must be completed in order to be granted credit for any course:

1. The Student must attend all classes, with only one unexcused absence permitted.

Excused absences are obtained only from the program director, not from the instructor.

2. The Student must complete the evaluation form at the end of the course

REITERATION OF CRITERIA FOR CAPPT DIAGNOSTIC

AND TREATMENT CASES

:

1. Twelve written diagnostic studies must be completed for graduation. The

diagnostics must be current in-progress diagnostics. Supervision should be

arranged either prior to the start of the diagnostic evaluation or no later than the

second meeting with the patient or his/her family. This criteria enables the

student and the supervisor to observe the unfolding of the diagnostic process as

leading to the formulation of a diagnosis of the patient and his/her situation.

2. No diagnostics may be formulated with supervision from a retrospective situation;

i.e., the student has previously met with the family and child or adolescent prior to

receiving CAPPT supervision and is utilizing the circumstance to make an

academic diagnosis from this review. These “retrospective diagnostic evaluation

will not be given credit toward graduation.

3. Only cases that have an in-process diagnosis will be eligible for credit as a

supervised treatment case. Arrangements for supervision of the treatment must be

established prior to the completion of the diagnostic evaluation. The treatment

supervisor may be someone who was not involved in the diagnostic process.

4. In order to proceed with a third treatment case, permission must be received from

the supervisors of the first two cases and in addition, the request must be made

from the student to his advisor who, in turn, will submit this request along with

the supervisory recommendations to the Evaluation Committee for the student to

receive permission for progression for this third treatment case.

5. A student may do no more than three diagnostics with any given supervisor with

the exception of the four annual required diagnostics to be done with the student’s

advisor. The student may only do one treatment case with each given supervisor.

6. For further details, see the Memo to New Students regarding an “Orientation to

Certification Requirements for Diagnostic Evaluations and Treatment Cases.”


Page 7

Procedure for Student Evaluation and Progression

The Evaluation Committee consists of faculty clinical supervisors. It is expected that the

students will consult with their advisors with any questions or problems they may have regarding

the program. The role of the advisor is to help you progress through the program.

A. All students are expected to start a first supervised treatment case and to

complete a minimum of 3 diagnostic evaluations by the beginning of the

second year of the program..

B. Students may begin a second supervised treatment case at any time they feel

ready with the approval from the first case supervisor.

C. Prior to beginning a third supervised treatment case, students must submit a

“Student Request Evaluation” form. This notification will set into motion an

evaluation by the Evaluation Committee. The advisor of the student is

responsible for discussing the Committee’s impressions and recommendations

regarding starting a third case.

D. Each treatment case must have a clinical case summary written by the student

and approved by the supervisor . An written evaluation from the three case

supervisors required for graduation.

E. Twelve supervised written diagnostic evaluations are required in order to

complete the program. The following are the minimal yearly requirements for the

completion of diagnostic evaluations:

3 diagnostic evaluations by the end of the first year.

7 diagnostic evaluations by the end of the second year.

12 diagnostic evaluations by the end of the third year..

F. Any student may request an evaluation of his/her performance at any other time

than those stated above by filling out a “Student Request for Evaluation” form.

Also, any faculty member may for good reason request that a specific student be

evaluated at other than the above stated times.

G. The Evaluation Committee’s routine decisions will not be reviewed by the

faculty. However, in cases when supervision or probation are recommended, or

when decisions involving major changes in the status of the student are made,

these will be taken to the faculty for full discussion and approval.

H Forms for some of the above procedures are in this manual and also are

available in the CAPPT office.


Diagnostic Evaluation

(Outline for Loose Guidance only)

Reason for Referral and Identifying Information:

Johnny is an x year old Caucasian boy who was referred for evaluation by his parents on the

advice of his school social worker. Johnny’s father is an electrician and his mother a nurse. He

has two brothers, Jimmy, age x, and Bill, age y. Johnny has come to the attention of the school

social worker because of academic/social/behavioral difficulties in his fourth grade classroom.

The parents were surprised by the recommendation, as they had not been aware of problems at

home. (So: name, age, family structure, reason, and source referral. Obviously, many children

come from much less structured backgrounds- just try to briefly alert the reader to the current

situation.)

History of Presenting Problem: Recent (last 6 months? Whatever makes sense) history of

referral symptoms as seen by parents and reported to them by whoever else is concerned.

Social and Developmental History: Say something that alerts the reader to the social and

educational and occupational background of the parents. Married? Divorced? Re-married? Life

events that would have affected the parents’ capacity and/or the child’s course of development –

e.g. frequent moves, stressors on the parents, etc. Developmental history: planned/unplanned

pregnancy? Difficulties during pregnancy? Delivery? Early feeding and sleeping? Primary

caretaker? Age and ease of weaning to cup or bottle? Thumb-sucking? Pacifiers? Motor and

speech milestones within normal range or not? Difficulties around toilet training or not? Early

medical problems or healthy? Reaction to early separations for childcare or pre-school?

Reactions to arrival of sibs? Success or not of social and academic processes over the course of

the child’s school career to date.

Miscellaneous: Other background info. That may not fit anywhere else but is central to your

case.

Interview with Parents: The parents were seen for x number of sessions during the course of

the diagnostic evaluation. Say something about how they present –co-operative? Hostile?

Angry? Desperate? Informed? Say something about how they seemed to get along with each

other, or not. What was their attitude toward their child and toward the referrer? Is this their

first encounter with someone in mental health, or have they been the rounds? If they’ve been the

rounds, what’s the history or satisfaction/frustration with previous attempts at help? How

easy/difficult was it to get them there for first appointment? If divorce, who did you see and

why? Separately or together? Keep this to a few paragraphs, reporting facts as you gathered

them, and impressions as you experienced them. How did you feel with parents? Defensive?

Connected? Distanced? Eager to help? Put off? Suspicious? Trusting?

Sessions with Child: Describe unfolding of first 3-4 sessions, 1-2 paragraphs per session. How

did the child separate from the caregiver in the waiting room? How did the child engage or not

with you and/or the toys in the first session? Describe child’s level of anxiety, cooperativeness,

verbal engagement, etc. How did this evolve over three or four sessions.

Use these paragraphs to give a flavor of what it was like to be in the room with the child over the

course of these sessions. No theory required here - just observations, a few direct quotes if that

will help give a flavor, plus a sense of the child’s emotional experience and your own with the

child. These paragraphs should allow the reader to join you in your office and have some sense

of what it feels like to be with this child.

Formulation: Using whatever theoretical model makes sense to you or your supervisor, put the

presenting symptom in some developmental context. Relate this both to whatever environmental

contributions you think may have been active, as well as whatever intrapsychic conflicts may not

have been mastered. For example, do you see the child’s presenting social or behavioral

difficulties as expressive of primary attachment problems? Failure to manage sibling rivalry or

Oedipal problems? Failure of self-object functioning? Compounding of some or all of the

above? A paragraph or two should suffice – just be sure to refer both to the presenting problems,

social and/or developmental history, and the child’s capacities to modulate and manage impulses

and feelings. Include also whatever strengths have allowed the child to manage as well as he has

- e.g., defenses, capacity for symbolic play, capacity for verbal language, and capacity to elicit

possible feelings and help in parents, teachers, other relevant caregivers.

Recommendations: Is treatment called for? Frequency? Parental involvement?


Criteria for Supervisory Reports on Diagnostic Studies

The following categories are suggested for your guidance in writing up your report and to

facilitate comparison and research, which may be done in the future. You may feel free to write

your report as you see fit.

Please submit a report on each diagnostic study by each student you supervise. It is suggested

that you submit your reports as soon as possible after the supervision of the cases.

1. General impression of student.

2. Rapport with child, mother and father.

3. Comprehension of unconscious and intrapsychic elements.

4. Ability to obtain clear picture of presenting problems.

5. Ability to organize material in accordance with psychoanalytic framework.

6. Ability to obtain significant background history.

7. Ability to formulate dynamic diagnosis; genetic diagnosis; clinical diagnosis; social

diagnosis.

8. Capacity for self-evaluation, awareness of personal reactions, and ability to use them

diagnostically.

9. Relationship with supervisor.

Child and Adolescent Psychoanalytic Psychotherapy Training Program EVALUATION REPORT ON DIAGNOSTIC STUDIES

STUDENT: __________________________________ CLASS __________________ YEAR________

SUPERVISOR: ___________________________________

Student’s Goals:

1. ____________________________________________________________________________________

______________________________________________________________________________________

2. ___________________________________________________________________________________

______________________________________________________________________________________

3. ___________________________________________________________________________________

Diagnostic Cases: Names, Ages, Diagnosis:

1. ____________________________________________________________________________________

2. ____________________________________________________________________________________

3. ___________________________________________________________________________________

Dates of Supervision:

1. _____________________________2. ____________________________3. _____________________

EVALUATION: Response to Goals:

1. ____________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

2. ___________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

3. ____________________________________________________________________________________

______________________________________________________________________

_______________________________________________________________________________________

Evaluation Report on Diagnostic Studies

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OVERALL EVALUATION

A. How Student Relates to Patient and Family:

Rating (Circle): Poor Fair Good Excellent

Comments: ______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

B. The Student’s Understanding & Sensitivity of Resistance & Transference Issues:


Comments: ______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

C. The Student’s Confidence in Making Tentative Psycho-Dynamic Formulations:


Comments: ______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

D. The Student’s Statement of His/Her Ideas, Orally & in Writing:


Comments: ______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

STUDENT’S SIGNATURE_____________________________________________DATE____________

SUPERVISOR’S SIGNATURE_________________________________________DATE____________


Criteria for Supervisor Report on Treatment Cases

The Following categories are suggested for your guidance in writing up your report and to

facilitate comparison and research, which may be done in the future. You may feel free to write

your report as you see fit.

1. General impression.

2. Rapport with patient (and parents).

3. Empathy with patient (and parents).

4. Techniques with patient (and in work with parent).

5. Comprehension of unconscious and psychodynamics.

6. Use of comprehension of unconscious in technique.

7. Relationship with supervisor.

8. Capacity for self-evaluation and awareness of personal reactions.

9. Supervisor’s diagnostic impression of the case – a brief statement.

10. Conclusion and recommendations.

11. Which of the problems that you have indicated are evident have you brought to the

student’s attention?


CRITERIA FOR FINAL REPORT ON A TREATMENT CASE

Both for educational and administrative purposes, it is necessary that we have a final

report in writing on all treatment cases.

1. It is suggested that the report from the supervisor follow the guide for supervisory reports

available in the CAPPT office.

2. A treatment summary by the student should include:

A. A complete statement of the dynamic formulation of the case

B. A brief summary (one page) of the treatment process, phases and trends

including some indication of the therapist’s activity in the treatment and in the

contacts with the parents.

C. Regarding the status of the child:

1. Have the symptoms disappeared or abated?

2. Is there evidence of more energy available for sublimatory activity?

3. Is the child back on the developmental course?

4. Has the functioning in areas such as school, social life, family etc.,

improved?

D. The student’s dynamic assessment of the reasons for the termination, if this is

a case, which has been ended.

This summary should be sent to the supervisor for his approval and signature. A copy of

the approved report should also be sent to the CAPPT office.


Institute for Psychoanalysis

122 N. Michigan Avenue, Suite 1300

Chicago, Illinois 60603

(312) 922-7474

_______________________________________ ____________ ___________

Name Class Date

Treatment Case Supervision

Case Supervisor Card Dx Evaluation Summary Spv Report Completed Ongoing

#1 #2 #3

Total of your supervisory hours is _________ as of __________________________________.

Total of remaining supervisory hours is __________.

Case Duration Supervisor

Yrs. Mths.

Yrs. Mths.

Yrs. Mths.

Yrs. Mths.

Diagnostic Case Supervision

You have completed ___________ diagnostic cases

Please request supervisory report(s) on the following case (s).

Case Patient Supervisor Date(s) of Supervision

CAPPT

Student Request for an Evaluation

_______________________________________ ____________ ___________

Name Class/Year Date

I wish to request that the Student Evaluation Committee review my work in the

Program because: (check one)

_____ I wish permission to go on to my third supervised case.

_____ I have completed all my requirements and wish to obtain my certificate (12 diagnostic

cases; credit for 3treatment cases; diagnostic evaluations and summaries of treatment cases;

and payment of all tuition owed).

_____ Other reason (list on back of this sheet).

Diagnostic Supervision

Name of Supervisor C* SR* Name of Supervisor C* SR*

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

Treatment Supervision

Name of Supervisor Date Treatment Started Date of Termination C DE* SR S*

1. 2. 3.


Classroom Evaluation Form

Date:

Class:

Instructor:

Year in Program:

Quarter:

1. List the three most important things you learned from this class:

2. Did the class meet the goals described by the teacher or syllabus? Explain.

3. Was the content of the class appropriate for the year it was taught? Explain.

4. Should other areas on the subject be included? Should areas covered be deleted?

5. How would you change the class? Should this class be included in the curriculum?


Declaration of Legal and Ethical Standing

1. Has anyone asserted or filed a claim or lawsuit against you contending that you breached any

duty in providing professional care to a patient?

Yes ______

No ______

If yes, on a separate page please identify the claimant, the name of any lawsuit, where it was

filed, and the outcome of the lawsuit or claim.

2. Has anyone asserted or filed a claim or lawsuit against you which would be regarded as a

serious reflection on your integrity and moral character?

Yes ______

No ______

If yes, on a separate page please identify the action against you and its outcome.

3. Have you ever been required to report an ethical violation to your licensing board or paid a

settlement in a malpractice lawsuit?

Yes ______

No ______

If yes, on a separate page please describe the circumstances including the name or names of

the persons being paid a settlement, name of any lawsuit involved, and the court in which the

lawsuit was filed.

I understand that my application and progress within this program will be subject to assessment

by the instructors and supervisors in the program and I agree to abide by this assessment.

In addition, I understand and agree that consideration of this application by the Institute and my

participation in the program, including the awarding of a certificate is at the sole discretion of

the Institute and under no circumstances will the Institute, its officers, faculty, employees or

members be liable to me for reason of any action or inaction in relation thereto.

Signed___________________________________________ Date____________________

INSTITUTE FOR PSYCHOANALYSIS


CONSENT FOR PARTICIPATION IN THE INFANT OBSERVATION CLASS

2017--18

I _______________________________, acting for my child and myself agree to take part in the class entitled: Infant Observation by permitting ________________ _________________, a student in the Child and Adolescent Psychoanalytic Psychotherapy Training Program (CAPPT) to observe my infant. Judith Feigon Schiffman, faculty member, is the teacher of the Infant Observation class. This class is part of the requirements for completion of CAPPT. This program is under the auspices of the Institute for Psychoanalysis, 122 S. Michigan Ave., Suite 1300, Chicago, IL 60603, (312) 922-7474.

PURPOSE The purpose of this class is to observe the development of an infant. PROCEDURES The infant will be observed on a weekly basis for a time span of one hour for eighteen months. There will be no payment involved in this observation. Participants are able to stop or terminate an observation if they feel uncomfortable continuing.

PRIVACY/CONFIDENTIALITY The notes recorded from the observations will not contain any identifiable information, thus it will not be possible to reference back to a particular participant. The observation notes will be kept separate from the consent form. When discussing the observations, the observer will utilize fictitious names.

SIGNATURES

I HAVE READ THIS CONSENT FORM AND I AGREE TO TAKE PART IN THIS

OBSERVATION AS PART OF ____________’S CLASS AS IT IS EXPLAINED IN THIS

CONSENT FORM.

Signature of Participant Date

____________________________ ________________

I CERTIFY THAT I HAVE EXPLAINED THE CLASS TO___________________

AND BELIEVE THAT THEY UNDERSTAND AND THEY HAVE AGREED TO

PARTICIPATE FREELY.

Signature of Student Date

___________________________ _________________

___________________________ _________________

INSTITUTE FOR PSYCHOANALYSIS Child and Adolescent Psychoanalytic Psychotherapy Training Program

Classroom Evaluation Form

_____________________________________________________________________________

COURSE

_______________________ _______________ __________________________________

INSTRUCTOR CLASS QUARTER, YEAR

STUDENT NAME COMMENTS

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