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Psych CASC / OSCEPublic-community — military and veteran psychiatry

Psych CASC / OSCE · Public-community — military and veteran psychiatry

Recently transitioned veteran with combat nightmares and firearm access — CASC communication station

MRCPsych/FRANZCP-style CASC: trauma-informed veteran engagement, weapons-aware risk assessment, formulation, and stepped plan without stereotyping.

communication2 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A recently discharged combat veteran with nightmares, hypervigilance, heavy drinking, and passive death wishes; a licensed firearm is at home. You must build alliance despite stigma about 'weakness,' assess suicide and weapons risk, elicit paced service/trauma history without forcing graphic detail, explore moral injury themes if present, and agree a collaborative plan including therapy pathway and safety.

Station brief

Format. Communication station, approximately 7–10 minutes active time after reading. You are the community psychiatry registrar. No interpreter required. [1]

Candidate instructions. Build rapport while acknowledging service. Assess suicide risk and firearm access/storage. Elicit a paced service and trauma history without forcing graphic combat detail in the first minutes. Explore guilt/shame themes if offered (moral injury formulation language). Name alcohol as a clinical target. Agree a collaborative safety and follow-up plan including trauma-focused therapy pathway. Avoid stereotypes ("all veterans have PTSD") and avoid inventing compensation rules. [1][2][5]

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References5ShowHide
  1. [1]Hoge CW, Castro CA, Messer SC, McGurk D, et al. Combat duty in Iraq and Afghanistan, mental health problems, and barriers to care N Engl J Med, 2004.PMID 15229303
  2. [2]Litz BT, Stein N, Delaney E, Lebowitz L, et al. Moral injury and moral repair in war veterans: a preliminary model and intervention strategy Clin Psychol Rev, 2009.PMID 19683376
  3. [3]Monson CM, Schnurr PP, Resick PA, Friedman MJ, et al. Cognitive processing therapy for veterans with military-related posttraumatic stress disorder J Consult Clin Psychol, 2006.PMID 17032094
  4. [4]Steenkamp MM, Litz BT, Hoge CW, Marmar CR Psychotherapy for Military-Related PTSD: A Review of Randomized Clinical Trials JAMA, 2015.PMID 26241600
  5. [5]Pompili M, Sher L, Serafini G, Forte A, et al. Posttraumatic stress disorder and suicide risk among veterans: a literature review J Nerv Ment Dis, 2013.PMID 23995037
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