Psych CASC / OSCE · Forensic psychiatry — stalking and harassment
Explain stalking risk and safety planning to a victim's support person — CASC communication station
MRCPsych/FRANZCP-style CASC: explain multi-domain stalking risk, parallel safety and treatment tracks, and residual uncertainty without graphic detail or victim-blaming.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar supporting the community/forensic interface. The examiner plays the sibling of a woman subjected to post-separation stalking. [2]
Candidate instructions. Explain in plain non-sensational language: what stalking means; that harm includes fear and life disruption not only assault; why ex-intimate context matters for violence concern; why a private "clear the air" meeting is usually unsafe; that treatment of the person who stalks and legal safety steps run in parallel; residual uncertainty. No graphic detail. No victim-blaming. Check understanding.[1][3][5]
Candidate scenario
The sibling says: "He says he still loves her and just wants to talk. She is exhausted and scared but people tell her she is overreacting because he has not hit her. Can psychiatry stop him? Should she meet him once with me there so he can move on?" There have been repeated messages, workplace appearances, and a threatening text after a protection order. [1][3][4]
Marking domains
- Empathy; non-stigmatising, non-victim-blaming language
- Explains stalking as repeated unwanted fear-inducing behaviour
- Names multi-domain harms (violence, persistence, psychosocial impact)
- Links ex-intimate context to higher violence concern without fatalism
- Advises against contact/"talk it out" as default
- Describes parallel victim safety and stalker treatment/legal measures
- Conveys residual uncertainty; checks understanding [2][5]
Reveal assessor key
Open. Acknowledge fear and exhaustion; take the sibling's concern seriously; set purpose/time. Validate that fear without assault is still serious harm. [1]
Explain stalking. Stalking is a pattern of unwanted contact that causes fear — messages, appearances, threats count. We look at more than whether someone has already been hit: ongoing pursuit, threats, access, alcohol, and the toll on sleep, work, and safety matter. [2][1]
Why ex-partner context matters. After a relationship ends, some people pursue with mixed hopes of reunion and anger. That context is associated with higher concern for violence than many stranger situations, which is why safety planning is active — not because every case ends in assault. [3][4]
Do not meet to "clear the air". Contact often reinforces pursuit. Safety usually means reducing access, using lawful protection processes, workplace measures, and support — not a mediated reunion meeting. [2]
What services can do. Treat mental health or substance problems if present; psychological work on the pursuit; multi-agency coordination. We cannot promise zero risk. We manage and monitor it. [2][5]
Close. Summarise; invite questions; offer appropriate contact points within confidentiality rules. [5]
References
- [1]Pathé M, Mullen PE The impact of stalkers on their victims Br J Psychiatry, 1997.PMID 9068768
- [2]Mullen PE, Mackenzie R, Ogloff JR, et al. Assessing and managing the risks in the stalking situation J Am Acad Psychiatry Law, 2006.PMID 17185471
- [3]McEwan TE, Mullen PE, MacKenzie RD, et al. Violence in stalking situations Psychol Med, 2009.PMID 19215627
- [4]Mullen PE, Pathé M, Purcell R, et al. Study of stalkers Am J Psychiatry, 1999.PMID 10450267
- [5]Large MM, Ryan CJ, Nielssen OB Helpful and unhelpful risk assessment practices Psychiatr Serv, 2010.PMID 20439381