Clinician's Digest

Clinician's Digest

Extending the Circle of Care

By Chris Lyford

May/June 2016

Justin Constantine doesn’t remember much from the day a sniper’s bullet tore through the back of his left ear and exited the front of his mouth as he walked down a dusty road in Iraq in 2006. He doesn’t remember trying to push off fellow soldiers as they attempted to staunch his bleeding and perform an emergency tracheotomy. And he doesn’t remember bits and pieces of his stay in Germany’s Landstuhl hospital days later, where—heavily medicated—he told his wife they should go sightseeing. After all, they’d never been to Germany before.

But for Constantine, the struggle that followed years later was a much more vivid experience as he found himself increasingly filled with seemingly random outbursts of anger, constant hypervigilance, and terrifying nightmares, which undermined his relationships and work life.

For help, in 2008, Constantine turned to the Department of Veterans Affairs, which offers counseling to all returning troops but whose therapists had limited daytime hours, conflicting with his work schedule. “Impersonal and brief,” is how Constantine describes his initial meeting with a non-VA therapist later recommended by the association. “He didn’t even look me in the eye. Didn’t even look up from his checklist.”

Finally, in 2009, Constantine found the support he’d been looking for. At a Red Cross event, he met a psychologist named Barbara Van Dahlen, four years out from building a fledgling organization called Give an Hour. The mission behind Give…

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1 Comment

Wednesday, May 18, 2016 1:51:14 PM | posted by M Fried
As a lay person who refers and sometimes pays for therapy for others, I was heartened by the statement that "while some clinicians say they once believed paying a fee enhances client's motivation to succeed in therapy, they've since discovered that pro bono therapy can be no less transformative, for clients and themselves." I have often pondered why a client would be more vested in therapy if my organization pays for it, then they would be if the sessions are pro bono. Perhaps it is less disingenuous to say the therapist is more vested when they are remunerated.