Psych CASC / OSCE · Child and adolescent psychiatry — family assessment and therapy
Engage high-conflict parents and match family therapy — CASC communication station
MRCPsych/FRANZCP-style CASC: non-blaming engagement, FBT rationale, medical safety, refuse coercive holding, manage parental split without triangulation.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
Parents of a 14-year-old with anorexia nervosa attend angry and split. Mother wants inpatient nasogastric feeding immediately and blames father for being 'too soft.' Father wants individual therapy only because 'family therapy means we are the problem.' A Facebook group recommended holding the child down at meals. The adolescent is medically unstable enough to need urgent medical review but is currently in clinic.
Station brief
Format. Communication station, approximately 7–10 minutes active time. You are the CAMHS psychiatry registrar. [1]
Candidate instructions. Engage both parents without taking sides; prioritise medical safety; explain family-based treatment as empowering parents against the illness (not blaming them as the cause); refuse coercive holding at meals; outline next concrete steps (medical review pathway, FBT orientation, crisis plan); check understanding. [1][2][3]
References5ShowHide
- [1]Lock J, Le Grange D, Agras WS, et al. Randomized clinical trial comparing family-based treatment with adolescent-focused individual therapy for adolescents with anorexia nervosa Arch Gen Psychiatry, 2010.PMID 20921118
- [2]Hay P, Chinn D, Forbes D, et al. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of eating disorders Aust N Z J Psychiatry, 2014.PMID 25351912
- [3]Chaffin M, Hanson R, Saunders BE, et al. Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems Child Maltreat, 2006.PMID 16382093
- [4]Couturier J, Kimber M, Szatmari P Efficacy of family-based treatment for adolescents with eating disorders: a systematic review and meta-analysis Int J Eat Disord, 2013.PMID 22821753
- [5]Retzlaff R, von Sydow K, Beher S, et al. The efficacy of systemic therapy for internalizing and other disorders of childhood and adolescence: a systematic review of 38 randomized trials Fam Process, 2013.PMID 24329407