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Ansari, S.G. Kliman, G. (2015). A Basis for Creating a Reflective Network in Schools: Reflective Network Therapy in a Small Middle and High School. Psychoanal. Inq., 35(7):714-732.

(2015). Psychoanalytic Inquiry, 35(7):714-732

A Basis for Creating a Reflective Network in Schools: Reflective Network Therapy in a Small Middle and High School

Sandy G. Ansari, M.A. and Gilbert Kliman, M.D.

Expanding the utility of Reflective Network Therapy (RNT) schoolwide and to school pupils far beyond preschool age is now occurring. The process encouraged my integration of several psychoanalytic theories, as well as shed light on the unique dynamics of classroom life. Several psychoanalytic concepts germane to dyadic interaction are reviewed and new approaches are brought into new light by exploring the multiperson world of the school classroom teacher. Reflective Network Schools (RNS) can serve as vehicles for creating spaces in today’s classrooms for both investigation and application of various psychoanalytic orientations. The model used shows how a few basic tenets of psychoanalytic thinking allowed a lay analyst to rediscover many theorists who followed Freud’s discovery. With the use of its time-tested method in new ways, along with the inception of an article series starting here, RNT has a wider clinical and academic scope than previously expected.

When I became a child analyst in the 1960s, there was nearly a line around the block waiting for my intensive treatment in the form of four- and five-times-a-week analytic sessions and, customarily, a weekly parent guidance session. Few child analysts have that in-demand experience today. The decline of demand for child analysis, despite enormous numbers of children in need, is caused by many factors. Among them are financial barriers, logistic difficulty, insufficient numbers of practitioners, and scientific outcome collection obstacles. The treatment is expensive and the logistics of bringing a child to treatment multiple times a week are daunting to many modern families. A full-scale child analysis is financially out of the reach of most of the population in need. It is not a treatment that most third-party payers will fully support. That is partly because the profession has not achieved the scientific credibility, feasibility, and outcome research it richly deserves. Even if demand for child analytic treatment were as great as it should be, there are insufficient numbers of practitioners to meet a greater demand. Relevant to the following article, U.S. professional training lacks widespread and affordable pathways for engaging and training young child analytic practitioners. Little hope exists to engage and train child psychiatrists as child analysts. Recruiting for child psychiatric jobs is the most difficult of all medical recruiting tasks and the small profession of child psychiatry is mostly prescription-oriented. Perhaps this is because insurance will not pay for psychotherapy at medical rates. Nonmedical child analysts are also in short supply. There are probably fewer than 3,000 nonmedical child analysts in the world trained sufficiently to receive child analytic certifications from the International Psychoanalytic Association and/or an institute accredited by the American Psychoanalytic Association. Despite the shortage of treaters, the need for treatment of children who are disturbed and/or developmentally disordered is vast, immensely greater than the numbers of analytically trained practitioners. Thus, it is important to me that, in contrast to taking the usual pathways into the diminishing practice of child analysis, the author is a licensed educational therapist. Her profession, like those of little-appreciated thousands of licensed special education teachers, occupational therapists, play therapists, and speech therapists, is outside the orthodox box of child analysis. Yet such professionals are widely and intensively involved in what are essentially interpersonal therapeutic modalities with children and adolescents. It is also a regularly compensable matter for such practitioners to treat children and have their sessions paid for by third-party insurers. Methods such as the one the author has piloted provide for natural expansion of child analytic understanding, training, and practice to that burgeoning set of professionals and give hope for the otherwise dwindling future of child analytic contributions to public health. The author has emerged as a psychoanalytic thinker and experimenter from outside the constraining cadre of licensed professions such as physicians, psychologists, social workers and marriage and family counselors whose child-analytic analytic societies and institutes ordinarily encourage training. Like many educational therapists, her background includes years of dyadic educational therapy carried on multiple times per week, so she is comfortable with the intensity and frequency of sessions that facilitate classical child analytic work. She has been in, and is still in, a personal analysis, which clarified for her many of the vicissitudes of transferences and countertransferences, so essential to her school-based work discussed herein. Best of all, and leading me to encourage readers to follow and emulate her work, she has hit upon a method she calls Reflective Network Schools, which opens the benefits of intensive psychodynamic psychotherapy to a previously hard-to-reach population: middle and high school students. Such children’s lives are so busy, and parents so preoccupied, that school is the natural place to provide hundreds of sessions per year for multiple years. The author’s account of her Reflective Network Schools pilot experience is persuasive and moving. Within a few essays, she chronicles the excitement of personal discovery, and intellectual and technical growth. She needed no training or supervision from the method’s originator beyond reading his how-to-do-it manual (Kliman, 2011) aimed at treatment of younger children in preschools, and attending two days of his seminars that featured demonstrative videos linked to the manual. Her growth gives hope that other professions (educational therapists, school psychologists, speech therapists, special educators) within the educational system may be able to learn, apply, and, ultimately, successfully bill third-party payers for evidence-based psychoanalytic derivatives. This kind of pioneering work will demonstratively improve school climates (Cohen, 2001; Cohen et al., 2009; Cohen and Geier, 2010) and measurably benefit increasing numbers of children.

[This is a summary excerpt from the full text of the journal article. The full text of the document is available to journal subscribers on the publisher's website here.]

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