VA Mental Health Provider Venting / Problem-solving / Peer Support Thread

[Sanman]

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I am running on fumes, but celebrating my wins. I have gotten a stream of straight-forward EBP cases where the patients seem engaged and motivated. It's been nice.

Impossible. We all know that combat related PTSD only improves after 10 years of non-directed therapy on slightly cloudy days (not so nice that a veteran feels good and no-shows, not so grey that they feel depressed and also no show). Then the VA cuts off their life line because no one cares about veterans anymore.

 

[futureapppsy2]

I have some wonderful ongoing EBP cases too. They really keep me going! I totally understand why research shows that more EBP usage is associated with lower burnout.

Helping people actually get better is so nice!

 

[aim-agm]

Second this. I still did therapy for PTSD as a neuropsych when I was in the VA and this was my experience as well. I hate the self-serving myth that CE/CPT are only for easy cases that the snakeoil people peddle.

Thirded, I don't do CPT/PE but I haven't found complexity to be inimical to psychotherapy succees, except when the complexity is that they also have a Cluster B PD.
Although I do cheat and use chemicals to mess with their brains.

 

[Therapist4Chnge]

Second this. I still did therapy for PTSD as a neuropsych when I was in the VA and this was my experience as well. I hate the self-serving myth that CE/CPT are only for easy cases that the snakeoil people peddle.

Back on internship (during the olden times!), some of my best outcomes were using PE with medically complex and multiple-trauma veterans….likely bc they committed and put in the work, funny how those things help treatment outcomes.

 

[futureapppsy2]

Thirded, I don't do CPT/PE but I haven't found complexity to be inimical to psychotherapy succees, except when the complexity is that they also have a Cluster B PD.
Although I do cheat and use chemicals to mess with their brains.

Even in people with co-morbid BPD and PTSD, PE/CPT has been shown to be effective for PTSS, IIRC.

 

[cara susanna]

Even in people with co-morbid BPD and PTSD, PE/CPT has been shown to be effective for PTSS, IIRC.

It has, yes!

This isn't VA related, but I wish they would come up with a name for sub-clinical PTSD that's shorter than "other specified trauma and stressor-related disorder"

 

[Fan_of_Meehl]

It has, yes!

This isn't VA related, but I wish they would come up with a name for sub-clinical PTSD that's shorter than "other specified trauma and stressor-related disorder"

Agreed.

They also need to add two additional disorders to DSM-6.0-ChatGPT:

- Adult Developmental Disorder

and

- Service-Connection Deficit Disorder

though that last one may be more appropriate as a 'V-Code'

And there are some who would say that we should add a "Pseudo-PTSD" option to the trauma- and stressor-related d/o spectrum. I could write the criteria in my sleep.

 

[Sanman]

Watching the real-time collapse of the VA at this point. One broken promise at a time.

 

[WisNeuro]

Watching the real-time collapse of the VA at this point. One broken promise at a time.

Are they making you participate in a candlelight vigil for that piece of trash or something?

 

[Sanman]

Are they making you participate in a candlelight vigil for that piece of trash or something?

Revisiting already approved leave because no more union CBA.So, messing with Thanksgiving and Christmas plans.

 

[psy.d. 2021]

Revisiting already approved leave because no more union CBA.So, messing with Thanksgiving and Christmas plans.

Must be local to your VA because I haven't heard this...can you share more detail?

 

[psy.d. 2021]

I have been getting emails that there are payroll problems but we should be still getting paid on time. I'm sure this will happen more as they consolidate payroll to national and more stuff doesn't work

 

[WisNeuro]

Revisiting already approved leave because no more union CBA.So, messing with Thanksgiving and Christmas plans.

Time to use some of that sick time...

 

[Sanman]

Time to use some of that sick time...

I was taking more than a week of annual leave. Plus I have use or lose left. Headaches when you already got the stuff approved a year ago.

 

[Sanman]

Must be local to your VA because I haven't heard this...can you share more detail?

Well, it is not just local but the news may have only filtered down locally. I don't have more detail. Simply that the AFGE master agreement with the VA dictated annual leave policy among other things (including step and within grade pay increases). Now that the VA no longer recognizes the union, they are revisiting the leave policy for Fiscal year 2026 (which starts Oct 1 2025). This means no one is sure right now if any of the already determined holiday schedule will be honored or not and they are not approving annual leave post 10/1 at the moment (at my hospital anyway). Now that the master agreement is gone, I am not sure who is making the rules (local MCD, OPM, VA central office?). I imagine the will also be true for pay and other things in the master agreement.

 

[Shiori]

I'm not looking forward to explaining groypers/the black pill this coming week, but it might keep a couple of folks out of jail.

 

[PsyDuck90]

I have been getting emails that there are payroll problems but we should be still getting paid on time. I'm sure this will happen more as they consolidate payroll to national and more stuff doesn't work

So umm…did anyone else not get paid? Or just me?

 

[WisNeuro]

So, who's still dead set on going down with the Titanic here?

 

[PsyDuck90]

So, who's still dead set on going down with the Titanic here?

Well, I just finished my residency there (and would still very much like my last paycheck) and am very excited to be starting my staff position at an AMC soon.

 

[Therapist4Chnge]

So umm…did anyone else not get paid? Or just me?

Don’t worry, TRUMP has a looooong history of being trustworthy and paying his debts.

*checks notes*

Just kidding, you have a better chance he’ll accidentally tell the truth while lying about something else before he actually does something he promised to do. Promises Made, Promises Kept….really quiet hoping others won’t remember what he actually said bc he doesn’t actually remember.

Morbid jokes aside, I’m sorry you are being negatively impacted by that Traitor and his fellow grifters.

 

[Shiori]

Yeah, I got paid. Leadership gave us a heads up that there was a delay because of how some things are processed. The LES came out later than usual too for the same reason.

 

[Sanman]

Yeah, I got paid. Leadership gave us a heads up that there was a delay because of how some things are processed. The LES came out later than usual too for the same reason.

Same.

 

[RxPsych]

As I'm preparing my neuro postdoc apps, only one site (my current internship) is a VA. I don't want any part of this

So, who's still dead set on going down with the Titanic here?

 

[Sanman]

So, who's still dead set on going down with the Titanic here?

It's not so much going down with the titanic as it is being at the rear of the boat with my own life raft. I have runway and the current headaches have impacted me minimally. So, I'll look for the good silverware and the fancy jewelry on my way out.

 

[psy.d. 2021]

So umm…did anyone else not get paid? Or just me?

I got paid

 

[PsyDuck90]

As I'm preparing my neuro postdoc apps, only one site (my current internship) is a VA. I don't want any part of this

I will say that my postdoc site did a great job at shielding trainees from a lot of the nonsense and chaos. Because of our trainee status, the TD had some leeway in how some of the WFH rules and such impacted us. While I absolutely would not want to be staff at a VA at the current moment, I feel like you would still get quality training at most VAs. I think that may significantly depend on how much the MH chief values psych training though.

 

[AcronymAllergy]

As I'm preparing my neuro postdoc apps, only one site (my current internship) is a VA. I don't want any part of this

Which is sad, because overall, one of the things VA has typically done very well is training. But you can't train if you don't have any providers around to actually do the training.

 

[cara susanna]

Like I said, I'm here until they get rid of me.

Also, how many average attempts daily do you all have to make to open CPRS? I think I'm at three.