Review of Individual Psychotherapy at the Northport VA Medical Center in New York

The VA Office of Inspector General (OIG) initiated a healthcare inspection of the Northport VA Medical Center (facility) on February 9, 2026, to evaluate allegations that a facility leader instructed psychotherapists to limit individual psychotherapy treatment to 24 sessions and that two patients had their psychotherapy terminated as a result.

The OIG did not substantiate that individual psychotherapy was limited to 24 sessions as the facility standard operating procedure allowed extensions based on clinical need. The facility standard operating procedure also offered peer consultation as a resource “to allow for interdisciplinary input” when extended care was considered. While many psychotherapists reported feeling supported in extending care beyond 24 sessions, consulting with peers created inconsistent experiences and, for some, contributed to hesitancy seeking input through the peer consultation process.

The OIG also identified a concern with linking extended-care caseload limits (patients treated beyond 24 sessions) to Focused Professional Practice Evaluations (FPPE) for Cause. This practice introduced the risk of influencing clinical decision-making and potentially discouraging necessary extended psychotherapy care, although no adverse clinical outcomes were identified.

The OIG made two recommendations to the Facility Director to evaluate the use of extended care caseload metrics in performance measures and to assess whether any patients discharged during an FPPE for Cause experienced harm. The Veterans Integrated Service Network and Facility Directors concurred with the recommendations and provided acceptable action plans.