A Program to Introduce Psychodynamic Consultation to Community Mental Health Centers
In keeping with our mission -- to explore ways in which psychoanalytic thinking and practice can be applied to the broader community – in January 2017 our Section launched a new initiative to provide pro bono, one on one psychodynamic clinical consultations to staff therapists in community mental health centers across the country. A daylong onsite workshop is followed by twelve months of weekly individual clinical consultations between CMHC therapists and senior psychoanalysts who have volunteered their time. It is estimated that each consultant and therapist will have a total of forty sessions (by telephone, Zoom, Facetime, and sometimes in person) in the course of the twelve-month period. Check here for the status of current CMHC interventions.
Supervisory support is essential in helping early career professionals in particular meet the daily challenges of their work: developing clinical skills, maintaining job satisfaction, and minimizing burn-out. At the same time, for those who work in the public sector, more often than not, agency supervisors are required to ensure that state and federal regulations are met, leaving little time to supervise the treatments themselves. Therapists and supervisors are constantly pressured to meet productivity and paperwork requirements, thus there is rarely an opportunity for therapists to discuss actual cases, to reflect on their experience with the patient, and to think about the patient's experience with them; skills that are among the basics of psychodynamic clinical training.
As the pressure to meet these regulations mounts, the emphasis on Cognitive Behavioral Therapies continues unabated, knowledge about and the ability to practice psychodynamically has all but disappeared. With this intervention, we hope to demonstrate to the directors of CMHCs in the not-for-profit sector, regardless of discipline, that psychodynamic training and treatment are relevant to the populations they serve. We are aware that this latter goal is a tall order, however we have been encouraged by the enthusiastic welcome we have received from the Clinical Director at the Family Service League in Huntington, N.Y. and the Director of Psychological Services at Clarity Child Guidance Center in San Antonio, Tx. They are only too aware of the challenges facing their staff and the demoralization that threatens.
The consultants, to whom we are eternally grateful and without whom we would not have a program, are members of the psychoanalytic community from across the country. They are senior psychoanalysts who share our concern about the lack of interest in psychodynamic work in the public sector and share our hope that this program, and others like it, will start to reverse this trend. They generously volunteered their time when this initiative was announced.
Simultaneously, we are collecting and analyzing data to measure the outcome of these interventions and preparing papers for publication. Quantitative measures gauging professional satisfaction and professional development are administered to each therapist at the beginning of the project, mid-way through, and at the conclusion of the twelve-month period. While the number of subjects limits generalizability, preliminary findings from the Family Service League reveal significant changes in work satisfaction and self-perceptions of development as a therapist. Qualitative data collected from both therapists and consultants in the month after the consultations ended is being analyzed will be reported at the Division 39 meetings in Philadelphia in 2019.
Since this is a pilot study, which we hope will be replicated in other sites, we have carefully documented this project as it has unfolded and will make that documentation available to interested parties.
If you are interested in volunteering to become a consultant or you would like to explore the possibility of undertaking an intervention like the one described here, please email:
At the end of January we completed our pilot study bringing weekly individual psychodynamic consultations to therapists at the Family Service League in Huntington, Long Island. Preliminary reports about the outcome of this intervention were made at the April 2017 Division 39 meetings in New Orleans. Details about this project, including plans for further analysis are described on the CMHC Outreach screen here. Meanwhile, a member of the Section V board visits the Family Service League in person every other month to hold "psychodynamic grand rounds."
We are grateful for a grant from the FAR Fund Foundation that covered the costs of this pilot program.
In mid May, the second wave of the CMHC Outreach got under way at the Clarity Child Guidance Center in San Antonio, TX with 14 clinicians paired with 14 psychodynamic consultants for weekly consultation sessions.
Psychoanalysts Cara Barbierri, Jacqueline Gotthold, Jane Hassinger, Ari Kellner, Bill McGillivray, Ellen Nasper, JoAnn Ponder, Larry Rosenberg, Ben Rubin, Cristiano Santostefano, Jessica Sharky, Gretchen Shmutz, Sheryl Silverstein, Salam Solomon have volunteered their time and are currently consulting with clinicians in Texas. We are grateful to them and to Josh Essery, Director of Psychological Services at the Clarity Child Guidance Center, for making this new phase of the project possible.