Psychotherapeutic issues in a Veterans Administration outpatient clinic. 1982

J P Byrne, and E V Valdiserri

Psychotherapeutic issues encountered by beginning therapists in a Veterans Administration outpatient clinic are described. Emphasis is placed on the differences between the VA outpatient setting and the traditional dyadic, fee-for-service model of psychotherapy. In particular, issues of institutional transference, third-party presence, and disability compensation are discussed as possible obstacles to psychotherapy. Illustrative case vignettes are provided. The need for the beginning therapist to recognize these issues is stressed, in order to overcome potential therapeutic pessimism and improve treatment.

UI MeSH Term Description Entries
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D010044 Outpatient Clinics, Hospital Organized services in a hospital which provide medical care on an outpatient basis. Ambulatory Care Facilities, Hospital,Hospital Outpatient Clinics,Clinic, Hospital Outpatient,Clinics, Hospital Outpatient,Hospital Outpatient Clinic,Outpatient Clinic, Hospital
D010554 Personality Disorders A major deviation from normal patterns of behavior. Avoidant Personality Disorder,Impulse-Ridden Personality,Inadequate Personality,Avoidant Personality Disorders,Impulse Ridden Personality,Personality Disorder,Personality Disorder, Avoidant,Personality Disorders, Avoidant,Personality, Impulse-Ridden,Personality, Inadequate
D011613 Psychotherapy A generic term for the treatment of mental illness or emotional disturbances primarily by verbal or nonverbal communication. Psychotherapies
D003130 Combat Disorders Neurotic reactions to unusual, severe, or overwhelming military stress. Neuroses, War,War Neuroses,Combat Neuroses,Combat Neurosis,Combat Stress Disorders,Shell Shock,War Neurosis,Combat Disorder,Combat Stress Disorder,Disorder, Combat,Disorder, Combat Stress,Disorders, Combat,Disorders, Combat Stress,Neuroses, Combat,Neurosis, Combat,Neurosis, War,Shell Shocks,Shock, Shell,Shocks, Shell,Stress Disorder, Combat,Stress Disorders, Combat
D004185 Disability Evaluation Determination of the degree of a physical, mental, or emotional handicap. The diagnosis is applied to legal qualification for benefits and income under disability insurance and to eligibility for Social Security and workmen's compensation benefits. Disability Evaluations,Evaluation, Disability,Evaluations, Disability
D005260 Female Females
D006787 Hospitals, Veterans Hospitals providing medical care to veterans of wars. Veterans Hospitals,Hospital, Veterans,Veterans Hospital
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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