Psychoanalytic Association, the Minnesota Psychoanalytic Society (MPS) is a ... If
you have any questions, please feel free to contact the MPSI office at.
Dear Colleague:
Thank you for your interest in the Minnesota Psychoanalytic Society. A constituent Society of the American Psychoanalytic Association, the Minnesota Psychoanalytic Society (MPS) is a professional organization comprised of individuals interested in the study, practice, research, education, and other applications of psychoanalysis and psychoanalytic psychotherapy. Activities of the Society include outreach to the professional community through monthly seminars, weekly classes, and process groups in which you may already be involved. We provide the Psychoanalytic Psychotherapy Training Program, lectures, and discussion groups. In addition, the Society and its members promote and support the Minnesota Psychoanalytic Institute, a training facility dedicated to training future Psychoanalysts. As a member of MPS, you will receive early notification to a variety of lectures, study groups and seminars on psychoanalytic thinking, and invitations to participate in ongoing educational opportunities. You will be welcomed to participate with the Society by serving on committees which promote psychoanalytic thinking in the community. All members of the Minnesota Psychoanalytic Society are given access to the American Psychoanalytic Association’s PEPweb, which offers you Internet access to search, research, read, and print papers for your personal educational use. The PEPweb literature includes 18 psychoanalytic journals, twenty-three classic psychoanalytic books, and Freud's complete correspondence with Abraham, Ferenczi, Fliess, Jones, and Jung. For complete information regarding this benefit, please refer to the following link: http://www.p-e-p.org/universities_new.htm I hope you will apply for membership so that you can enjoy affiliation with this stellar group of psychoanalytically informed professionals. Dues for the July 2013 – June 2014 membership year are $125 for Affiliate Members, $50 for student members and $500 for Full Members who have completed psychoanalytic training. Enclosed you will find an application for membership. If you have any questions, please feel free to contact the MPSI office at (612) 200-4141. We look forward to hearing from you soon.
Sincerely,
Elise Sanders President Minnesota Psychoanalytic Society
Questions? Please contact MPSI Administrator Gwen Williams at (612) 200-4141 or email
[email protected]
Application to the
Minnesota Psychoanalytic Society Date ________________
Biographical Information
Name _____________________________________________________________________________________ Mailing Address ____________________________________________________________________________ City/State/Zip ______________________________________________________________________________ Phone: Direct) _________________ Cell) _________________ e-mail _______________________________ Business Name/Organization _____________________________________ Bus Phone) _________________ Business Address __________________________________________________________________________
Education / Professional Experience 1. Professional and/or Academic Degrees (dates earned/schools):
2. Postgraduate training/education/activities (dates, places earned):
3. Current field of work:
4. Psychoanalytic training/psychoanalytic psychotherapy training (dates, places earned):
5. Current or previous psychoanalytic society affiliation:
6. Please describe your interest in psychoanalytic thought, study or practice:
(Please use the back of this application, or attach additional sheets as needed)
Licensure
7. Professional License(s) (date earned, State, type):
8. Licensure status: a) Have there ever been any professional ethical findings against you by a professional body? Yes____________ No _____________ b) Has a disciplinary action of any sort ever been taken against you by a licensing board, professional association, or educational/training association? Yes____________ No _____________ A copy of your current license as well as a current copy of your Malpractice Insurance will be required in order to have a listing under the “Find a Therapist” section of the mpsi.org website. 9. If there is a current member of the Minnesota Psychoanalytic Society who knows you and will introduce you in order to facilitate your membership, please note the name of the member: _________________________________ If no, may we have someone from the office or the Membership Committee contact you? Yes ______ No_______
Mission Statement of the Minnesota Psychoanalytic Society The mission of the Minnesota Psychoanalytic Society (MPS) is to provide psychoanalytically informed educational services to the community at large, the professional community, and its own members and to provide for the collegial affiliation of its members. Educational services include psychoanalytically oriented training programs for clinicians, such as training in adult psychotherapy. MPS shall support and facilitate the development of the Minnesota Psychoanalytic Institute. MPS may undertake joint sponsorship of educational activities with MPI and other psychoanalytically informed organizations.
Applicant’s Statement I certify that to the best of my knowledge, the information in this application is correct. I agree to adhere to the ethical guidelines of the American Psychoanalytic Association: “PRINCIPLES AND STANDARDS OF ETHICS FOR PSYCHOANALYSTS” (http://www.apsa.org/ABOUTAPSAA/ETHICSCODE/tabid/200/Default.aspx), and to the mission statement of the Minnesota Psychoanalytic Society.
Applicant’s Signature ________________________________ Date _________________________
Please mail application to: Minnesota Psychoanalytic Society & Institute 825 Nicollet Mall, #1950 Minneapolis, MN 55402 You may also scan and email to:
[email protected] or fax to: (612) 465-5320
The Minnesota Psychoanalytic Society & Institute does not discriminate on the basis of race, creed, color, gender, age, sexual orientation, national origin, or handicap in admissions or administration of its education programs or employment.
