ptsd Inappropriate Group Discussions?

[purple]

If you are upset by or sensitive to discussions of homosexual topics; this could be triggering to you. Just be forewarned. Thank-you.

I was participating in a PTSD Women's group recently at the VAMC. The focus of the group was supposed to be trauma issues. During one group mtg a group member mentioned that she was/is homosexual. No big deal. Another group member made mention of the same...again, no big deal. However, they kept talking about their lifestyles and preferences throughout the group. I found it odd as I thought the group was about trauma. The tdoc said nothing.

The following week, one of these members made a very disturbing comment about having fantasies of a particular young girl she used to watch on TV and described what she was wearing, etc. Again, the tdoc said nothing.

I've never returned to the group. In my last appt with this tdoc I told her that I found this extremely disturbing and why didn't she do anything about it during group? Her comment was that there was nothing wrong with this other vets comments and that I should be prepared for diverse conversation during groups.

Really?

Am I way off base here or is my tdoc off her rocker????

[sharon]

Purple,

What they said is totally inappropriate. They are as much a pedophile as if they were men. They don’t get a pass because they are women. I don’t care what their sexual preference is, they are sexual deviants. Those were children on the Mickey Mouse Club. Dirty Old B*tches!

[luvHIM]

Rental, This the the pure Catch 22 of VA's PTSD "treatment" or "therapy". Where the VA counselors or facilitator's encourage discussion, but then limit that discorse to nicey-nice talk, rather than dealing with the emotional gristle of trauma survivors. These are harrowing experiences, life and death, and the VA counselors may well be very unprepared for the consequences of lifting the lid on Pandora's Box. The result of this supression is either more mind numbing, or, like you said, possible in-patient confinement for the willingness to be brutally honest in treatment. There seems to be no "safe place" within the VA medical system to deal with PTSD. Maybe Vietnam Vets have had some good group discussions, I would be curious to know if that's the case. ~Wings

My group is great and so is the Doc who leads it. I think, however, that where I am has one of the best programs in place in the country, in particular for women. We do have a couple of women in the group who live a lesbian and or "bi" (whatever the heck that is) lifestyle but it rarely comes up in our discussions.

Now, having made that statement, I still agree with Wings' post. In fact, I can recall a time when our Doc brought up that very subject matter. She also indicated how disturbed she is by some VAMC's treatment of PTSD vets, especially women who have suffered from sexual trauma. So, I do know that some women feel "safer" in these groups to "tell all"...if you will.

IMHO, if the groups go off topic and you are not in a place in your healing to exercise some assertiveness then you do what you did and dismiss yourself from the group. I personally would have nipped the matter in the bud and explained that they could have that discussion off the clock with those that cared. You have as much right to the therapy for your own healing/recovery as anyone else does and there just needs to be that element of respect demanded...no matter the setting.

[carlie]

I have PTSD from active duty MST and after duty ST.

I have attended plenty of one on one therapy.

I have attended at least five PTSD Therapy Groups.

I am gay.

The type of conversation regarding Mickey Mouse Club

is totally unacceptable and revolting.

This "therapy group" virtually has no "professional facillitator".

Straight or Gay is not even relevant.

This is no therapy group, it is simply a prime example of another

failed VA program. It is filling slots with warm bodies in order to

continue receiving more funding for inferior and inadequate treatment.

carlie

[purple]

Thank-you Carlie.

More reason than ever why I want to report her (the tdoc, not the woman who made the comments). I haven't trusted her since our first mtg. I have another appt with her; but doubt I will be keeping it. She knows that I don't trust her---it's quite obvious, I don't try to hide it!

I believe she has done me more harm than good in these past few months. Now I just have to find someone in the VA who will listen....ROFLMAO.

[out_here04]

At my first and only (to date) ptsd group I introduced myself and the reasons I had ptsd in the first place. It involved viewing casualties. One of the older vets, one who like a previous poster said "controlled" the group, said "I thought we werent' going to talk about death for a while". So I left no better than I showed up.

[Pete53]

Out I would give it another try.

[halos2]

I was going to my PTSD group for a few yrs till out facilitator left(Psych Dr with PTSD specialization) and the VA replaced her with a social worker who had no knowledge of PTSD...well needless to say nothing was to be gained having a social hour session of visiting...I didn't drive 130 miles one way to have a "What's new group!" A chit chat of how's it going.

I did attend it for 6 months to give her a chance but with only 5 or 6 people in the gp she didn't even know my name. What a waste of my time. I see a new psych dr who is more atuned to the needs and issues I have. Only prob with the new dr is her VA only has PTSD gp for Iraq and Afgan women vets...I too don't care about ones sexuality or preference but when the goal is how to deal with the trauma's experienced that's what should be addressed.

If people want to visit and talk about other things going on in their lives not pertaining to the subject matter do it on their time, not mine. I am down at least for 2 days after having to drive their for any of my appointments with my chronic back pain and disc herniations and fibro, my time needs to be focal time on quality issues. So purple I too feel as you. :D

If you are upset by or sensitive to discussions of homosexual topics; this could be triggering to you. Just be forewarned. Thank-you.

I was participating in a PTSD Women's group recently at the VAMC. The focus of the group was supposed to be trauma issues. During one group mtg a group member mentioned that she was/is homosexual. No big deal. Another group member made mention of the same...again, no big deal. However, they kept talking about their lifestyles and preferences throughout the group. I found it odd as I thought the group was about trauma. The tdoc said nothing.

The following week, one of these members made a very disturbing comment about having fantasies of a particular young girl she used to watch on TV and described what she was wearing, etc. Again, the tdoc said nothing.

I've never returned to the group. In my last appt with this tdoc I told her that I found this extremely disturbing and why didn't she do anything about it during group? Her comment was that there was nothing wrong with this other vets comments and that I should be prepared for diverse conversation during groups.

Really?

Am I way off base here or is my tdoc off her rocker????

[mike/3/8/cav]

I was going to my PTSD group for a few yrs till out facilitator left(Psych Dr with PTSD specialization) and the VA replaced her with a social worker who had no knowledge of PTSD...well needless to say nothing was to be gained having a social hour session of visiting...I didn't drive 130 miles one way to have a "What's new group!" A chit chat of how's it going.

I did attend it for 6 months to give her a chance but with only 5 or 6 people in the gp she didn't even know my name. What a waste of my time. I see a new psych dr who is more atuned to the needs and issues I have. Only prob with the new dr is her VA only has PTSD gp for Iraq and Afgan women vets...I too don't care about ones sexuality or preference but when the goal is how to deal with the trauma's experienced that's what should be addressed.

If people want to visit and talk about other things going on in their lives not pertaining to the subject matter do it on their time, not mine. I am down at least for 2 days after having to drive their for any of my appointments with my chronic back pain and disc herniations and fibro, my time needs to be focal time on quality issues. So purple I too feel as you. :D

I guess I'm in a unique situation in that there are not any group therapy sessions for PTSD within 2-3 hundred miles. I don't thing group would work for me anyway as I am very anti-social, I stay in my little world void of strangers. Like I said before, There are a few of us vets here who occasionally get together. Sometimes weekly and sometimes it will be a month or so. We seem to almost alway resolve our anguish and get sh.t off our shoulders. But, I don't think it would be an approved therapy session by VA or any medical facility. It works for me.

[luvHIM]

I didn't want to further the conversation or hurt ppl's feelings.

Plus I didn't want to say something that I would most likely regret later as I was fuming mad!

Question...is there a patient advocate at your VAMC for you to report this incident/tdoc to?

[purple]

Yes...I plan to address it in my ltr to the director as one of the many reasons why I should be granted approval for fee-based care.

I may or may not talk to the pt advocate about it as I've been down that road too many times and it's a dead end road.

[Wings]

Yes...I plan to address it in my ltr to the director as one of the many reasons why I should be granted approval for fee-based care.

I may or may not talk to the pt advocate about it as I've been down that road too many times and it's a dead end road.

Purple, You have to submit your request to the right person! The Fee Base Office had me write them the letter, but permission/approval came from higher up (don't know who). I could have saved a month, had I known exactly who to address my letter to! Here's an abbreviated copy of my request, you can tailor it to your liking! ~Wings

October 7, 2008

VA Claims File No. SSN xxx-xx-xxxx

From: Veteran's Name and Address

To: Dept of Veterans Affairs Medical Center

Dear VA Fee-Base-Care Staff Members,

Please consider my application for a VA Fee Base Card.

I’m a service-connected, woman veteran with severe PTSD and other health concerns. I’ve been 100% TDIU, permanent and total, since December 1999.

March 2000, your office issued me a Fee Base Card for routine medical care, not to exceed $125.00 per month. I was responsible with that privilege, and for 6 years appreciated the fact that I could use my familiar local xxxx Clinic, rather than drive (4) hours round-trip to VAMC xxxx.

The car ride to VAMC would not be so bad, if it weren’t for my horrible anxiety and panic attacks driving any further than the county line. I am chronically depressed, fear for my life and worry that I will not make it back home to care for my 13 y/o daughter. If something happened to her, I would not be able to reach her fast enough to make a difference.

For me, the VA Fee Base Card reduced PTSD “stress” and made going to a medical appointment an act of genuine self-care, rather than a desperate do-or-die attempt to “make it” across Donner Pass, especially in winter.

In order for me to consent to and participate in treatment for my PTSD and other woman veteran’s health issues, I really do need to see a woman health care provider. Presently, there is not one such woman health care provider at VAMC xxxxx.

One last consideration is that, in my case that Fee Base Card saves the VA money. The fact that I use the card responsibly, and actually go to a local medical appointment, means a healthier veteran in the long run. My health care becomes

pro-active, and I’m much more likely to follow up on routine care with VAMC appointments when it becomes necessary for the larger health care issues.

Please also consider an additional Fee Base Authorization for continued PTSD Counseling. I haven’t seen a Counselor for well over a year, and I am hurting myself and my family. I would like once again, to secure a local, community based woman therapist for psychotherapy, 2-3 times per month would help me be more sane and independent.

Sincerely,

Veteran's Name and Signature

FEE BASIS DETERMINATIONS

Under 38 USC 1703(a)(1)(A), before the Secretary is permitted to contract with a

non-VA facility in order to procure fee-basis care, it must be established not only that the applicant is a veteran and that s/he seeks treatment for a

service-connected disability, but also that VA facilities are either (1) geographically inaccessible; or (2) not capable of providing the care or services that s/he requires. Therefore, a determination as to an applicant’s eligibility for fee-basis outpatient care must necessarily include a factual determination as to whether either prong (1) or (2) has been satisfied.” (Meakin v. West, 11 Vet.App. 183, 186 (1998) citing 38 USC 7261(a)(4)).

[purple]

Thanks very much Wings!!

Yes, the pt advocate told me the Doc's name that I need to address it to (the chief of the mental health care), she said from there it would be forwarded to the facility chief and most likely disapproved. :D

I wish that the RN person that I used to see was still seeing pts because she had told me that she thought it was in my best interest to have fee-based care....but she isn't allowed to get involved at all now. So I'm going to scour my records to see if she happen to write it down anywhere. I thought I remember one place where she may have made a note of it...now I just have to find it....or it might have just been in conversation.

[Wings]

x

x

x

Check this out http://search.vetapp.gov/

Your search for "eligibility for fee-basis" found 13 documents. (0.01 seconds)

See http://search.vetapp.gov/isysquery/f8cdf7b...b75a9091/3/doc/

The appellant again appealed, and the Court

reversed the March 1996 BVA decision and remanded

the matter to the Board for proceedings consistent

with Meakin v. West, 11 Vet.App. 183, 186 (1998)

(holding that Board has jurisdiction over all cases

involving eligibility for outpatient treatment,

not just cases involving eligibility for VA outpatient

treatment). Webb v. West, 16 Vet.App. 290 (1998)

(table), No. 96-502, 1998 WL 778288 (Oct. 15, 1998)

In April 1999, the appellant's private

ophthalmologist submitted a

statement noting the following:

(1) He has treated the appellant's eye condition

for more than 20 years; (2) a change in physicians

and place of treatment would be disruptive to the

appellant's care; (3) such a disruption makes the

Northport VAMC incapable of furnishing the care

needed; and (4) the distance from the appellant's

home to the Northport VAMC, when considered in

light of his [disabilities] eye disorder, blurred vision, and

headaches, makes that VAMC medically and geographically

inaccessible to the appellant.

In September 1999, the Board remanded the matter

for medical reassessment of the type and frequency

of care required by the appellant and a determination

whether the Northport VMAC has the capability of

providing that outpatient care.

Specifically, the Board directed the RO to take

the following action:

1. The veteran should be scheduled for a VA examination to

assess his outpatient needs. The examining doctor should

answer the following questions: Given the veteran's service-

connected disability (a right eye disorder), what specific type

of outpatient treatment is medically required for such ailment;

what is the frequency at which such services would be required;

and would the veteran medically be able to drive following

episodes of such treatment?

2. Thereafter, the director of the VAMC in Northport (or any

other appropriate VA health care official) should provide a

written statement which explains whether or not the Northport

VAMC has the capability of providing the outpatient care which

is medically required for this particular veteran. It should

also be reported whether the VAMC would provide transportation

for the veteran to and from that facility when he needed

outpatient care, and whether there are any other VA medical

facilities which are more geographically accessible to the

veteran's home and which would be capable of providing needed

outpatient care.R. at 507-08.

In April 2000, the Northport VMAC issued a Supplemental

SOC concluding that (1) its eye clinic could provide the

treatment required by the appellant and (2) the Disabled

American Veterans (DAV) organization provides free

transportation for veterans with appointments at that facility.

In May 2000, the appellant filed a Substantive Appeal

seeking reinstatement of fee-basis treatment status.

In accompanying letters, he asserted that his October

1999 VA medical examination was "not . . . professional"

and that VA had failed to comply with the directives set

forth in the Board's September 1999 decision.

In the May 2001 BVA decision here on appeal,

the Board again denied eligibility for fee-basis

treatment status; the Board concluded that "the [appellant]

does not satisfy the fee basis eligibility requirements

concerning geographic accessibility

and capability of the [Northport] VAMC."

In his informal brief, the appellant asserts that

(1) his fee-basis treatment status should not have

been discontinued because there have been no changes

in the circumstances under which he was initially

determined to be eligible for such status and

(2) the Board should have appointed a "non-bias[ed]"

member to review his case on remand.

II. Analysis VCAA Applies!!

Edited February 11, 2009 by Wings (see edit history)

[10thFO]

OutHere, Some groups can be like that. The group I goto is a group of all Vietnam guys, I'm at least 20 years younger than all of them. Most of them were in the group before I got there. We are kind of the same way, and have lost one or two guys even older ones, who came in and didn't think the group was serious enough. The Leader has a lot of experience, worked on a cancer ward for years before coming to the Vet Center. He keeps things pretty real for us, and is pretty capable of steering the conversations back on track. Our group has a lot of close relationships in it from guys just getting to know each other, and picking each other up on the phone chain. I'm glad I stuck with that group, as at the time there weren't a lot of younger guys coming in for help. You might just want to lay back a little and see how the group intermingles before giving them all of the low down. There will be a time very soon, where you can hurt like hell in front of them, and they will be there for you.

[ruby]

I rarely go beyond the one section and I miss all the good stuff.

I am 100 straight or asexual who knows won't let anyone get that close due to my PTSD. I would make a comment concerning others that I found attractive but not sure I would say anything more he could park his shoes under my bed anytime. OR I might say nice butt.

I have no problem with a women or a man making a comment on the same sex in a generality like I did. Bit I do not want to here in detail your thoughts/wishes or desire, that you can keep to your self.

I would have said something to the effect, while I am heterosexual, I am not bias but I don;t wan to her about your fantansies. Then I would change the subject.

Most of the groups I have attended went in all directions and the therapist never said anything if it went on the wrong track, but there are some strong people in my group and they would let you know. Speak up and tell please keep your bedroom thoughts to your self.