Needing to take leave during internship

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BlueLu

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Hi all, I’m currently on internship at the VA. Due to some personal issues, I am having such a difficult time managing my life while on internship. I struggling with a dissociative disorder, and I’m working through my trauma, my symptoms have progressed to where I am overwhelmed. I have been hospitalized twice for SI, one of my own choosing and another again my wishes.

I’m so lost. Work is aware of some of my external difficulties and have been so supportive thus far. With my dissociative disorder, I’m having a tough time managing structure and all of the stress that is internship. I want to take a leave, and my psychiatrist is supportive. I want to get a routine and structure down and focus on building up my coping and general executive functioning skills before.

I feel like a failure. And I’m lost on even how to begin this conversation with internship. Is this a good enough reason for leave? What happens with hours, finances, and licensure? Any experience is greatly appreciated.
 
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Therapist4Chnge

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They likely are aware that you are struggling, but don't know the details. Setup some time w. your DCT to talk about your struggles because it all starts there. FWIW, my initial transition to internship was bumpy between a death in my immediate family and my (at the time) undisclosed and unmedicated ADHD. My DCT told me she was relieved I had an explanation for my rough start. Just getting it out there helped, even though it was anxiety provoking at first. Once I was able to establish some accommodations and get back on my ADHD meds, things ran much better. While not your exact scenario, I understand the hesitancy for how to talk about this with your DCT/internship. Trainees can be skeptical of training staff, but the vast vast majority want what is best for you.
 
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summerbabe

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I want to take a leave
Sorry to hear that this has been a really rough patch. I'm assuming you're nearing the end of the internship year - how much time would you have left and how much leave do you think would be beneficial? It can be hard to answer those questions given the uncertainties in life but having a concrete plan on how you'd spend your time off would likely be beneficial for your recovery.

Leave is not unheard of, either planned (pregnancy) or unplanned (medical, family, etc) but communication is a must, especially if you hope to return to the site and finish. A DCT can let you know options such as feasibility of taking time off and returning to finish, even if your cohort has graduated and other important logistics.
And I’m lost on even how to begin this conversation with internship. Is this a good enough reason for leave?
Agreed 100% with @Therapist4Chnge and their advice. You'll also need to loop in your advisor/graduate program as well since they may be expecting you to finish internship soon and potentially graduate, if you haven't done so already.

And yes, medical leave is very much a valid reason. You can't provide great clinical care when you need some care yourself.
What happens with hours, finances, and licensure?
I know somebody who formally withdrew from an internship for what I believe was medically related reasons and did not return to that site. In order to finish their degree and get licensed, they had to reapply and complete another internship during a future cycle.

Since you're likely close to the end and have accrued a decent number of hours, it might be in your best interest to work with your current site & DCT to explore options for taking some leave and returning when you feel capable. Being at a VA, a hospital system may be more able to absorb an extra trainee for part of the next cycle, if that's feasible, than other types of sites

Hopefully somebody else with more direct info on intern finances and things like how to maintain your intern health insurance (if you've been using those benefits). Good luck!
 
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WisNeuro

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Sorry to hear that this has been a really rough patch. I'm assuming you're nearing the end of the internship year - how much time would you have left and how much leave do you think would be beneficial? It can be hard to answer those questions given the uncertainties in life but having a concrete plan on how you'd spend your time off would likely be beneficial for your recovery.

Leave is not unheard of, either planned (pregnancy) or unplanned (medical, family, etc) but communication is a must, especially if you hope to return to the site and finish. A DCT can let you know options such as feasibility of taking time off and returning to finish, even if your cohort has graduated and other important logistics.

Agreed 100% with @Therapist4Chnge and their advice. You'll also need to loop in your advisor/graduate program as well since they may be expecting you to finish internship soon and potentially graduate, if you haven't done so already.

And yes, medical leave is very much a valid reason. You can't provide great clinical care when you need some care yourself.

I know somebody who formally withdrew from an internship for what I believe was medically related reasons and did not return to that site. In order to finish their degree and get licensed, they had to reapply and complete another internship during a future cycle.

Since you're likely close to the end and have accrued a decent number of hours, it might be in your best interest to work with your current site & DCT to explore options for taking some leave and returning when you feel capable. Being at a VA, a hospital system may be more able to absorb an extra trainee for part of the next cycle, if that's feasible, than other types of sites

Hopefully somebody else with more direct info on intern finances and things like how to maintain your intern health insurance (if you've been using those benefits). Good luck!

It actually could be harder, the VA budget is set well in advance. It may be theoretically possible, but would likely have to come from some sort of discretionary funds. Either way, given the speed of VA HR, OP would be encouraged to have these discussion sooner rather than later.
 
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smalltownpsych

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Self-care is key. One of my colleagues and friends has had very similar issues and struggles and she would joke with me how every review she ever received stated self-care as number on goal to work on. She would also make fun of me about my own negligent self-care and though it was less essential for me in some ways as I didn’t have the same degree of vulnerability, we all need to take care of ourselves and learn how to recognize and work within our limits. I hope that you have some accepting non-judgmental people that are supportive of you as you grow through this.

Double up or even triple up on therapy if need be. If you don’t have a therapist where extra time would be experienced as beneficial, then you might have to evaluate that. If it is about your own fears of “being too dependent“ then I would say that it is probably the opposite and that you might want to learn to rely on people, be vulnerable, ask for help, etc. Just saying that because high achievers such as myself or doctoral students in general tend to struggle with that stuff. I have gotten a little bit better at it, but still tend to wait till the water is boiling a bit before I ask for help getting out of the pot.
 
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AcronymAllergy

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Hi all, I’m currently on internship at the VA. Due to some personal issues, I am having such a difficult time managing my life while on internship. I struggling with a dissociative disorder, and I’m working through my trauma, my symptoms have progressed to where I am overwhelmed. I have been hospitalized twice for SI, one of my own choosing and another again my wishes.

I’m so lost. Work is aware of some of my external difficulties and have been so supportive thus far. With my dissociative disorder, I’m having a tough time managing structure and all of the stress that is internship. I want to take a leave, and my psychiatrist is supportive. I want to get a routine and structure down and focus on building up my coping and general executive functioning skills before.

I feel like a failure. And I’m lost on even how to begin this conversation with internship. Is this a good enough reason for leave? What happens with hours, finances, and licensure? Any experience is greatly appreciated.

Just to quickly jump in RE: the final question, typically you'll need to "make up" any hours temporarily missed via leave. So, for example, if you take a month of leave, your internship would be extended for one month. Licensure shouldn't be affected assuming you complete internship, you just wouldn't be eligible for licensure until completion. It may also delay graduation from your grad program, depending on their requirements and deadlines.

As far as finances, typically, this would be considered leave without pay, so your salary would be paused. Given that it's VA, they are allotted a certain total amount of money to pay you, and they would need to pause that pay (and inform their HR people along with VA's national training folks). Which could also mean your benefits might be suspended, so that's something you'd just want to discuss with your DCT.

Edit to say that people have definitely taken periods of leave, such as for pregnancy and other personal or family situations, during internship. If your current internship has been around for more than a few years, they've probably managed this in the past and know what to do. Even if they don't, the folks at central office can guide them through it.
 
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borne_before

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I feel like a failure. And I’m lost on even how to begin this conversation with internship. Is this a good enough reason for leave? What happens with hours, finances, and licensure? Any experience is greatly appreciated.

My dearest brother or sister, I want you know that you to know that it's okay to feel lost, overwhelmed, and hopeless during these times. While I cannot decide for you if this situation is a good enough reason for leave, you seem understandably very concerned and distressed about possible downstream effects. I hope you understand that internship, moving away from support systems, wrapping up grad school, and the stress of a new job and duties is very challenging for anyone involved.

I like the idea of doubling or tripling up therapy sessions. Perhaps a med consult is needed. Personally, I love an antidepressant when **** gets tough (e.g., being placed on a corrective action plan during my internship/having trouble at a job that just wasn't a good fit/almost failing my comps).

I hope you have some self-compassion and there is hope. This might be the best worst thing to ever happen to you. Sometimes the obstacle becomes the source of so much growth and meaning and this might be the thing that makes you one hell of a psychologist. Do the funeral exercise to get some perspective (think about who you want at your funeral, family, friends, future kids, past dogs, etc., imagine what the most important people in your life would say about how you handled this. What would you want them to say about it?).

Better now then when you are licensed (and you will be someday). You still have training wheels on your bike and great safety net. I seriously doubt you are only grad student to ever deal with this stuff. Rely on family and support networks.

Lastly, you cannot become licensed if you are dead. Take the damn leave if you need it - worry about the consequences later - you're underestimating your ability to deal with them.
 
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