Psych CASC / OSCE · Addiction psychiatry — behavioural addictions
Explain gaming disorder and a CBT plan — CASC communication station
MRCPsych/FRANZCP-style communication station: explain ICD-11 gaming disorder vs high engagement, negotiate a collaborative CBT/family plan, refuse magical medical fixes, address risk and school, without shaming or colluding.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar. Examiner may play parent and/or young person. [1]
Candidate instructions. Engage both parties. Explain when gaming becomes a disorder (control, priority, harm, impairment — not hours alone). Outline CBT and family-based care as first-line. Correct myths about detox admission and "addiction injection." Address school non-attendance and risk if limits are forced. Agree next steps with teach-back. [2][3]
Candidate scenario
Young person minimises; parents are angry and frightened; attendance is failing; there may be passive suicidal talk after fights. No current medical withdrawal syndrome. [1]
Marking domains
- Empathy and balanced alliance with youth and parents
- Accurate plain-language ICD-11-style explanation without moralising
- Clear that hours alone do not equal diagnosis
- CBT + family/harm-reduction plan named
- Honest "no licensed magic injection/detox default" counselling
- Risk and school addressed
- Collaborative goals and teach-back [2][3][4]
Reveal assessor key
Open. Name role/time; ask each party their top concern (school failure, being controlled, shame, fear of violence). [1]
Explain GD. "We look at whether gaming has taken control — prioritised over school and sleep, continued despite harm — not at a single hour count. Many people game a lot without a disorder; some develop a pattern that needs clinical help." Avoid "lazy" or "addict" pejoratives.[1]
Explain first-line care. "The treatments with the best evidence are structured psychological therapies — CBT packages that work on urges, routines, sleep, and gaming beliefs — together with family agreements and school re-entry. Research trials of specialised programmes support this approach." [2][3]
Myths. "There is no standard medical detox admission for pure gaming, and no injection licensed to permanently delete gaming desire. Medicines are sometimes used if depression or ADHD is also present, but they do not replace skills and family work." [1][2]
Risk and limits. Explore self-harm after fights; negotiate limits with a plan rather than sudden total cut-off if that has caused crises; safety contacts. School catch-up as a shared goal.[4]
Close. Summarise: safety, CBT/family referral, sleep plan, school liaison, early review, teach-back. [1][2]
References
- [1]Saunders JB, et al. Gaming disorder: Its delineation as an important condition for diagnosis, management, and prevention J Behav Addict, 2017.PMID 28816494
- [2]Stevens MWR, et al. Cognitive-behavioral therapy for Internet gaming disorder: A systematic review and meta-analysis Clin Psychol Psychother, 2019.PMID 30341981
- [3]Wölfling K, et al. Efficacy of Short-term Treatment of Internet and Computer Game Addiction: A Randomized Clinical Trial JAMA Psychiatry, 2019.PMID 31290948
- [4]King DL, et al. Policy and Prevention Approaches for Disordered and Hazardous Gaming and Internet Use: an International Perspective Curr Addict Rep, 2018.PMID 28677089