The fate of training cases

The authors regard the treatment of analytic patients as a crucial, formative and ultimately integrative experience in a candidate's development that has received remarkably little direct attention as an aspect of analytic education. From 1983 to 1992 a questionnaire was sent to all graduates of the Columbia University Psychoanalytic Center for Training and Research asking for information on training cases, both those terminated before graduation and those still ongoing at the time of graduation. The authors report data on pre-graduation candidate case experience, treatment duration of training cases, the impact of graduation on the course of analysis and on a global assessment of the outcome. 70 per cent of the 71 who graduated between 1983 and 1992 returned the questionnaire. The survey showed that before graduation the average candidate had a cumulative nine-year experience of treating training cases. 35 per cent of cases terminated before graduation and were invariably considered to have an unsuccessful outcome. Thus the 'failed case' was a common event and should be anticipated as part of a candidate's education. There was no evidence of precipitous termination of cases after graduation; in fact the data suggest that graduation has no discernible effect on the timing of termination. The vast majority of candidates at Columbia continue to be supervised after graduation, which suggests that graduation is only a marker in the training of an analyst, rather than the point of completion. With respect to outcome, 23 per cent of the 151 terminated cases were rated successful. Though this finding is consistent with previous reports, the methodological limitations of this study limit the confidence in this result. One of the important issues raised by these results is the impact of training requirements on the candidate's education and the Fate of Training Cases.