Psych CASC / OSCE · Addiction psychiatry — psychosocial interventions
Negotiate contingency management and mutual-help after stimulant relapse — CASC communication station
MRCPsych/FRANZCP-style communication station: explain CM mechanism and protocol, destigmatise testing, offer secular mutual-help, set boundaries against coercive AA, shared plan and teach-back.
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Study tools
Target exams
FRANZCPMRCPsychABPNMD-DNB
Prompt
A 32-year-old man who uses methamphetamine weekly is offered a 12-week contingency management programme with thrice-weekly urine tests and escalating gift-card rewards. He thinks it is 'bribery' and humiliating. His mother wants him forced into AA daily. He will consider SMART Recovery if it is 'not religious.'
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. Examiner may play patient and/or mother. [1]
Candidate instructions. Explain contingency management in plain language. Address the bribery concern without defensiveness. Describe thrice-weekly testing as clinical verification, not moral judgment. Offer SMART Recovery as secular mutual-help; do not force AA. Negotiate a collaborative 12-week plan. Check understanding. [2][3]
References5ShowHide
- [1]Roll JM, et al. Contingency management for the treatment of methamphetamine use disorders Am J Psychiatry, 2006.PMID 17074952
- [2]Prendergast M, et al. Contingency management for treatment of substance use disorders: a meta-analysis Addiction, 2006.PMID 17034434
- [3]Zemore SE, et al. A longitudinal study of the comparative efficacy of Women for Sobriety, LifeRing, SMART Recovery, and 12-step groups for those with AUD J Subst Abuse Treat, 2018.PMID 29606223
- [4]Humphreys K, et al. Self-help organizations for alcohol and drug problems J Subst Abuse Treat, 2004.PMID 15063905
- [5]Dutra L, et al. A meta-analytic review of psychosocial interventions for substance use disorders Am J Psychiatry, 2008.PMID 18198270