美国国家公共电台 NPR Demand For Veteran Counseling Puts Stress On The Counselors

 

DAVID GREENE, HOST:

All right. U.S. combat veterans dealing² with post-traumatic stress or depression often turn to Vet¹ Centers. These are clinics run by the federal government. Now some of the counselors⁴ at those centers say they are dealing with stress themselves because of the number of cases they've been asked to take on. New Hampshire Public Radio's Peter Biello has more.

PETER BIELLO, BYLINE⁵: Ted⁶ Blickwedel is a 63-year-old Marine⁷ Corps⁸ veteran living in Smithfield, R.I. And recently, when he was working as a clinical social worker at his local Vet Center, he began to think about suicide.

TED BLICKWEDEL: You know, I didn't sit around and ruminate⁹ about how I'm going to go about taking my own life or anything. But nonetheless, it was just that sense of I just don't want to be here anymore.

BIELLO: Blickwedel says he felt a rising sense of hopelessness about his job. It began a couple of years ago, when the Department of Veterans Affairs changed the way it measured counselor³ productivity. Instead of asking counselors to track what percentage of their time they spend with clients, the VA asked counselors to meet a minimum headcount. Blickwedel says that's when his focus began to shift.

BLICKWEDEL: I would be in session trying to engage somebody but being more worried about, you know, getting them out the door so they can do notes and get the next person in on the hour every hour.

BIELLO: Blickwedel says if a veteran with PTSD needed an extra-long session. He'd spend extra time with him and see fewer clients. That would have consequences. The VA wants counselors to have 25 visits each week to be, quote, "fully¹⁰ successful." The VA says that should take about 17 hours. The problem is that even by the VA's own analysis, the average visit takes 77 minutes. That's 32 hours.

BLICKWEDEL: That doesn't leave adequate time to get all of your other administrative¹¹ duties done with your progress notes, your treatment plans, your assessments¹², with staffing, consultation¹³, with other providers that are working with the veteran.

BIELLO: Many of the dozen Vet Center employees interviewed for this story worked extra hours, often without compensation to keep up. Some say they went on medication to manage the stress, others lost weight. And when they suffered, they say, so did services. Mike Fisher leads the VA's Vet Centers.

MIKE FISHER: When we talk about accounting¹⁴ for 25 encounters in a week, I think that's reasonable given that the vast majority of our staff are already doing that.

BIELLO: He says those who don't make the numbers simply have to create a plan to boost them.

FISHER: That plan can include increased outreach. It could include I'm going to try as a clinician this one type of group. There's complete flexibility¹⁵ in that.

BIELLO: Group sessions can give your visit count a boost since each member of the group is counted individually. But getting enough groups can be tricky¹⁶ says Rick Stouffer, a Vet Center counselor from Knoxville, Tenn.

RICK STOUFFER: It would be nice to have a full caseload of clients, but I have no control over how many clients I have.

BIELLO: He says sometimes clients don't show up for appointments, which can hurt productivity. Demand for Vet Center services varies by location. Some are simply busier than others, but the standards are mostly uniform. There has been no formal survey of how Vet Center social workers feel about these requirements. Ted Blickwedel tried to conduct one by email. The VA told him to stop, and when he didn't, they cut off his email access. The VA says he was using email in an unprofessional manner. Now Blickwedel is retiring over these requirements, which he says need to be reduced to a reasonable level.

BLICKWEDEL: That's No. 1. No. 2, there needs to be more hiring at higher echelons¹⁷ of people in managerial leadership positions that have clinical backgrounds so they can make common-sense clinical decisions.

BIELLO: And only then, Blickwedel says, can Vet Center employees stop worrying about metrics and focus more on their clients. For NPR News, I'm Peter Biello in Smithfield, R.I.

(SOUNDBITE OF THE LIMINANAS' "UGLY DEATH")

1 vet   

n.兽医，退役军人；vt.检查

参考例句：

• I took my dog to the vet.我把狗带到兽医诊所看病。
• Someone should vet this report before it goes out.这篇报道发表之前应该有人对它进行详查。

2 dealing   

n.经商方法，待人态度

参考例句：

• This store has an excellent reputation for fair dealing.该商店因买卖公道而享有极高的声誉。
• His fair dealing earned our confidence.他的诚实的行为获得我们的信任。

3 counselor   

n.顾问，法律顾问

参考例句：

• The counselor gave us some disinterested advice.顾问给了我们一些无私的忠告。
• Chinese commercial counselor's office in foreign countries.中国驻国外商务参赞处。

4 counselors   

n.顾问( counselor的名词复数 )；律师；（使馆等的）参赞；（协助学生解决问题的）指导老师

参考例句：

• Counselors began an inquiry into industrial needs. 顾问们开始调查工业方面的需要。 来自《现代英汉综合大词典》
• We have experienced counselors available day and night. ) 这里有经验的法律顾问全天候值班。） 来自超越目标英语 第4册

5 byline   

n.署名；v.署名

参考例句：

• His byline was absent as well.他的署名也不见了。
• We wish to thank the author of this article which carries no byline.我们要感谢这篇文章的那位没有署名的作者。

6 ted   

vt.翻晒，撒，撒开

参考例句：

• The invaders gut ted the village.侵略者把村中财物洗劫一空。
• She often teds the corn when it's sunny.天好的时候她就翻晒玉米。

7 marine   

adj.海的；海生的；航海的；海事的；n.水兵

参考例句：

• Marine creatures are those which live in the sea. 海洋生物是生存在海里的生物。
• When the war broke out,he volunteered for the Marine Corps.战争爆发时，他自愿参加了海军陆战队。

8 corps   

n.(通信等兵种的)部队；(同类作的)一组

参考例句：

• The medical corps were cited for bravery in combat.医疗队由于在战场上的英勇表现而受嘉奖。
• When the war broke out,he volunteered for the Marine Corps.战争爆发时，他自愿参加了海军陆战队。

9 ruminate   

v.反刍；沉思

参考例句：

• It is worth while to ruminate over his remarks.他的话值得玩味。
• The cow began to ruminate after eating up grass.牛吃完草后开始反刍。

10 fully   

adv.完全地，全部地，彻底地；充分地

参考例句：

• The doctor asked me to breathe in,then to breathe out fully.医生让我先吸气，然后全部呼出。
• They soon became fully integrated into the local community.他们很快就完全融入了当地人的圈子。

11 administrative   

adj.行政的，管理的

参考例句：

• The administrative burden must be lifted from local government.必须解除地方政府的行政负担。
• He regarded all these administrative details as beneath his notice.他认为行政管理上的这些琐事都不值一顾。

12 assessments   

n.评估( assessment的名词复数 )；评价；（应偿付金额的）估定；（为征税对财产所作的）估价

参考例句：

• He was shrewd in his personal assessments. 他总能对人作出精明的评价。 来自《简明英汉词典》
• Surveys show about two-thirds use such assessments, while half employ personality tests. 调查表明，约有三分之二的公司采用了这种测评；而一半的公司则采用工作人员个人品质测试。 来自百科语句

13 consultation   

n.咨询；商量；商议；会议

参考例句：

• The company has promised wide consultation on its expansion plans.该公司允诺就其扩展计划广泛征求意见。
• The scheme was developed in close consultation with the local community.该计划是在同当地社区密切磋商中逐渐形成的。

14 accounting   

n.会计，会计学，借贷对照表

参考例句：

• A job fell vacant in the accounting department.财会部出现了一个空缺。
• There's an accounting error in this entry.这笔账目里有差错。

15 flexibility   

n.柔韧性，弹性，（光的）折射性，灵活性

参考例句：

• Her great strength lies in her flexibility.她的优势在于她灵活变通。
• The flexibility of a man's muscles will lessen as he becomes old.人老了肌肉的柔韧性将降低。

16 tricky   

adj.狡猾的，奸诈的；(工作等)棘手的，微妙的

参考例句：

• I'm in a rather tricky position.Can you help me out?我的处境很棘手，你能帮我吗？
• He avoided this tricky question and talked in generalities.他回避了这个非常微妙的问题，只做了个笼统的表述。

17 echelons   

n.（机构中的）等级，阶层( echelon的名词复数 )；（军舰、士兵、飞机等的）梯形编队

参考例句：

• Officers were drawn largely from the top echelons of society. 这些官员大都来自社会上层。 来自《简明英汉词典》
• Except in the higher echelons, extensive classification has no place in the classification of vegetation. 除高阶类级之外，外延分类在植物分类中还是没有地位的。 来自辞典例句