Explain combined treatment and co-design a plan — 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 moderate–severe depression, has started sertraline, and was referred for CBT. They believe they must pick either tablets or talking therapy. Explain complementary roles, what structured CBT involves, why continuing medication can make sense now, how progress will be measured, and when to seek help. Check understanding; no cure promises; collaborative tone.[1][2][4]

Candidate scenario

Your patient is 31, PHQ-9 was 19 two weeks ago, now 16 on sertraline 50 mg oral daily (started 10 days ago; some nausea). They stop socialising, ruminate “I’m broken,” and sleep poorly. GP said CBT is available in 6 weeks. Patient: “If I do real therapy I shouldn’t need chemicals — my partner says meds are a crutch.” No active plan for suicide; intermittent passive thoughts. No mania or psychosis.[2][3]

Marking domains

• Warmth, non-judgmental stance toward both modalities
• Corrects false dichotomy without shaming partner’s view
• Plain-language complementary mechanisms (intensity vs skills/cycles)
• Explains CBT structure (goals, agenda, homework, behavioural activation) not “just chat”
• Continues/optimises medication plan appropriately; no unsupervised stop
• Mentions evidence that combination can help more than meds alone without overclaiming personal guarantee
• Measures, side effects, crisis plan, check understanding
• Realistic hope; time course of SSRI and therapy start