Bridging Psychoanalysis and Community: An Interview with Audrey Dunn, LCSW, Access Institute’s Spectrum 2025 Community Service Awardee

By Bart Magee, Ph.D

For over three decades, Audrey Dunn, LCSW, has worked at the intersection of psychoanalytic thinking and community mental health. From her early training in adolescent day treatment centers to her long-standing work in public schools, Dunn has remained committed to integrating deep psychological understanding with the real-world needs of marginalized children and families. Audrey has been a member of Access Institute's volunteer faculty since the training program's inception in 2004. She has served as teacher, supervisor, school program consultant and advisor.
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There are few individuals who embody the commitment to training, deep thinking and community work than Audrey. We are pleased to honor her on March 20th 2025 at Access Institute’s Spectrum Gala.

I recently sat down with Audrey to get to a better understanding of the nuances of her work and to reflect on our shared values. In this interview, Audrey reflects on her professional journey, the challenges of working within public systems, and the enduring value of psychoanalytic thought in schools. 

Audrey, why don’t we start with your professional pathway tell me how you got to this unique place, because I think it’s truly special and rare to be working psychoanalytically in community mental health and in the community with kids, families and schools.

I think I have to start with where my roots are, which is that my own parents have both of those things inherently in them. My father was a neuropathologist, fascinated by the brain, and I grew up hearing him talk about its complexities. He had also undergone psychoanalysis in the 1940s and 50s, which gave me early exposure to that world. My mother, on the other hand, came from a poor Irish Catholic background. She was a dancer, and her mother played piano for silent films and dance schools. So, I was raised in a home where intellect and art, privilege and struggle, coexisted.

Initially, I pursued dance, but I always felt pulled toward understanding the mind. I earned a psychology degree at NYU, studying the dopamine hypothesis of schizophrenia in rat brains. But I wanted a broader, more humanistic approach, so I moved into social work. When my husband and I relocated to San Francisco in 1982, I continued this trajectory, drawn to both psychoanalysis and community work.

One pivotal experience was my internship at the Adolescent Day Treatment Center at Children’s Hospital in San Francisco. This was before managed care transformed mental health services. Back then, funding was more flexible, allowing for deeper, more individualized treatment. But by the late 1980s, managed care shifted decision-making from clinicians to administrators. Because of that, many of the community mental health places, including the Adolescent Day Treatment Center, were closed down, and corporations were taking over health care systems. I found myself, rather than going into private practice at that point, still drawn to continue this integration of the two, psychoanalysis and community mental health, because it really fit who I was.

Psychoanalysis in the Schools: Following the Kids
With these closures, how did you transition into working in schools?

I followed the kids. Many of us who had been working in community clinics were suddenly finding that schools were expected to take on children they weren’t equipped to support. Schools were struggling, and we were called in to help.

I got very involved in that, initially starting something in a very small school for five years, which then eventually got closed as well, and then ending up being asked to develop my own program in a public middle school, Francisco Middle School. That initiative lasted 20 years. The idea was to provide comprehensive services—not just therapy, but after-school support, parent guidance, and staff training—all while remaining independent from the school district. The goal was integration: to build long-term relationships within the school community rather than spreading services thin.

I should say, initially, we were all struggling like crazy. I mean it was just a very hard time of transition. But what became clear was that for us to be able to think about how psychoanalytic work could be relevant in a school-based setting, we had to first feel like we were developing a relationship with the school. We had to apply the same kinds of thinking and understanding about the mind that we do with individual children about the school itself and everyone there.

We saw how schools weren’t just educational spaces; they were places of immense conflict—between students’ needs, administrative policies, teacher burnout, and systemic underfunding.

The Rise of Managed Care and the Shift Toward Behavioral Models
It seems like working dynamically with families in schools runs counter to the dominant behavioral approach. How did managed care influence this shift?

Absolutely. Managed care prioritized efficiency and accountability over depth and nuance. It emphasized measurable outcomes, which meant that psychoanalytic and relational approaches were often devalued in favor of short-term behavioral interventions.

A group of us—clinicians from various school-based programs—saw this happening and formed a coalition. We wanted to explore how psychoanalytic thinking could remain relevant in school settings. We held conferences, published papers, and worked to ensure that clinical training in schools maintained an emphasis on deep psychological understanding rather than just symptom management.

We knew that psychoanalysis had something vital to offer. Schools weren’t just dealing with children’s behaviors; they were dealing with complex emotional histories, systemic inequities, and intergenerational trauma. A checklist approach wasn’t going to address that.

Why Psychoanalytic Thinking Matters in Schools
How does psychoanalytic thinking help in school-based work?

First, we had to understand the schools as systems. Just as we would with a patient, we needed to build relationships with schools rather than impose our own expectations. Schools were under immense pressure—staffing shortages, budget cuts, bureaucratic demands. If we didn’t acknowledge that reality, we’d be met with resistance.

Once we established trust, we could apply psychoanalytic concepts. Schools, like individuals, project anxieties onto the most vulnerable. Kids with behavioral issues often became scapegoats. Teachers, overwhelmed and unsupported, reacted with frustration or punitive measures. Psychoanalytic thinking allowed us to slow things down, recognize these dynamics, and help teachers respond with curiosity rather than punishment.

For example, instead of seeing a disruptive child as “bad,” we encouraged teachers to consider what the behavior was communicating. Was it a response to trauma? Anxiety? Shame? By shifting the perspective from discipline to understanding, we helped create environments where children felt seen rather than just managed.

Training the Next Generation of Community Clinicians
Access Institute places trainees in schools and you’ve worked closely with them, teaching and supervising them. What’s the value of that kind of clinical training?

It’s invaluable. Working in schools exposes trainees to populations they wouldn’t typically see in private practice. Many children and families we serve wouldn’t otherwise seek therapy, often because they don’t recognize their struggles as psychological. That’s why having therapists embedded in schools is crucial—many people need help but don’t know how to ask for it.

Training in schools also teaches therapists to think contextually. You’re not just working with an individual child; you’re working within a family system, a classroom, a school culture, a larger socio-political landscape. That kind of multi-layered thinking is essential for effective clinical work, but it’s something you won’t develop in a private office alone.

The Future of Community Mental Health
Given everything happening—budget cuts, political shifts—what do we need to do to sustain community mental health work?

I think we’re at another crossroads, much like when managed care first took over. Schools are facing massive deficits. The Department of Education is under threat. Immigration fears are rising again. People are scared, and when fear dominates, we see more projections, more scapegoating, more reactivity.

What we need is what psychoanalysis has always emphasized: thinking together, holding complexity, tolerating uncertainty. That’s how we get through transitions like this—not by rushing to solutions, but by staying present with what’s happening, even when it feels unbearable.

San Francisco has historically been a place of innovation, resilience, and radical thinking. If we can hold onto those values—if we can continue building community, fostering dialogue, and training the next generation of thoughtful, socially-conscious clinicians—I believe we can weather this storm. But it will take commitment.

It sounds like it’s about having faith in the process.

Exactly. Psychoanalysis teaches us that transformation isn’t immediate. It requires patience, deep engagement, and the willingness to sit with discomfort. That applies not just to individuals, but to communities. If we can do that together, I think we’ll find a way forward.
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More than ever, we all need to keep that in mind. Thank you, Audrey. I look forward to seeing you, and celebrating you at Spectrum on March 20th. 


JOIN US IN HONORING AUDREY DUNN AT  SPECTRUM GALA & ART AUCTION THIS MARCH 20th! GET YOUR TICKETS BELOW!​

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