Psych CASC / OSCE · General adult psychiatry — anxiety disorders
Explain selective mutism and a school speech plan (not forced assembly talking) — CASC communication station
MRCPsych/FRANZCP-style communication station: explain anxiety-based selective mutism, school-inclusive behavioural plan, accommodation reduction, benzodiazepine limits, optional SSRI framing, and check understanding.
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Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the child outpatient clinic. [1]
Candidate instructions. Explain selective mutism in plain language (anxiety-related difficulty speaking in some places despite speaking in others), why "stubborn elective silence" is not the modern framing, the rationale for graded practice speaking at school with teacher involvement, why public forced talking is not the plan, optional medicine discussion at high level, expected hard work and benefits, and safety-netting. Check understanding and invite questions. The examiner plays a parent. [1][2][3]
References4ShowHide
- [1]Muris P, Ollendick TH Children Who are Anxious in Silence: A Review on Selective Mutism, the New Anxiety Disorder in DSM-5 Clin Child Fam Psychol Rev, 2015.PMID 25724675
- [2]Bergman RL, Gonzalez A, Piacentini J, Keller ML Integrated Behavior Therapy for Selective Mutism: a randomized controlled pilot study Behav Res Ther, 2013.PMID 23933108
- [3]Oerbeck B, Stein MB, Wentzel-Larsen T, et al. A randomized controlled trial of a home and school-based intervention for selective mutism Child Adolesc Ment Health, 2014.PMID 32878377
- [4]Black B, Uhde TW Treatment of elective mutism with fluoxetine: a double-blind, placebo-controlled study J Am Acad Child Adolesc Psychiatry, 1994.PMID 7961338