Explain CBT and co-design a first experiment — CASC communication station

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in outpatient clinic. [1]

Candidate instructions. The patient has social anxiety and has been offered CBT. Explain what CBT is in plain language, map a simple five-area formulation of a recent social situation, introduce the idea of safety behaviours, and co-design one small behavioural experiment with a clear prediction and review plan. Address a brief question about whether tablets will still be needed. Check understanding; avoid promising cure; keep collaborative tone. [1][3][5]

Candidate scenario

Your patient is 24, avoids team meetings, over-prepares scripts, wears dark clothes “to disappear,” and replays conversations for hours. Last week in a meeting their heart raced; they thought “everyone can see I’m incompetent,” spoke once, then left early. They want CBT explained “without psychobabble.” They take escitalopram 10 mg and ask if they must stop it to do CBT. No active suicidal plan; low mood secondary to avoidance. [2]

Marking domains

• Warmth, collaboration, jargon control
• Accurate plain-language definition of CBT (structured, here-and-now, skills, homework)
• Five-area map of the meeting example (situation, thoughts, emotion, body, behaviour)
• Names safety behaviours (script over-prep, dark clothes, early exit, post-event rumination)
• Co-designs a specific behavioural experiment with prediction and review
• Mentions homework/between-session practice
• Medication: combined care acceptable; do not advise abrupt unsupervised stop
• Checks understanding; realistic hope without overpromise [1][3][4][5]