[July 2022 Update] Psychology 101: The Basics of Shrinkin'

[Zulu0009]

This is a short guide on how to approach the role of Psychiatrist or Psychologist. Firstly, I must mention that I am not a mental health expert, and the people playing this role likely are not, either. If you are, good job! Thank you for your real life work and for bringing your expertise to Aurora! This guide will go over the very basics and how you should approach a round, starting from:

1. Know the difference.

There is a very important difference between the two available roles, Psychiatrist and Psychologist. Understand what it is before starting as the wrong specialist. Psychiatrists are the ones who diagnose mental illnesses, prescribe medication, provide advanced therapy methods and handle serious conditions. Psychologists are not authorized to prescribe medication, and only really handle basic conditions and issues. You will not see a Psychologist conversing with a man strapped to a chair with a straitjacket, that's some serious psychiatric work. If you would like a quick way to understand the difference, Psychiatrists are professional, full-time airline pilots, while Psychologists are hobbyist Cessna owners: they both know how flying works, one is just trained to handle bigger planes. That does not mean they are useless. Every gear in the complex medical machine is there for a reason. Furthermore, the difference in-game is often blurred, so try to keep to your specialty as much as you can.

2. Understand your role.

You are part of the Medical Department, working in the Medical Bay. Great! Sit down. You are not a surgeon, or an EMT, you are a mental health expert. Once that Unathi is out of lifesaving surgery after the explosion in engineering, that's when you step in to talk about how they feel about it. Medical frequently suffers from Idle Player Syndrome, whereas Medical players will sit in the reception until a situation occurs; for you, this applies even more. Most players do not bother considering their characters' possible psychological conditions or situations, and when they do, they are likely too busy to ask for a consultation, or forget about it. You will likely spend entire shifts staring at a wall. At most, if the department is empty, you may ask or be used as a local nurse, giving low-urgency patients bandages and lollipops while saying "there, there." Nothing more than that, though, unless your character is trained for it. However, you may also encounter situations you are not prepared for, and you may be the one that players decide to reveal a character's important backstory event to. You may have to face trauma you yourself have faced in real life. This role can be either empty and plain, or incredibly moving and important.

3. Respect the process and the field.

Mental health is a serious matter. This is not a debatable subject. You are working in one of the most complex, delicate, sensitive and arduous fields of medicine. There's a way to teach neurosurgery, there's no way to teach how to act when a patient reveals their trauma to you. Do not play around with mental health, do not say "teehee you might have PTSD," do not call someone out on the radio for having anger issues. That's a quick way to discredit yourself. Respect the privacy of records or receive a quick IR and be booted from the department. Furthermore, you are not suddenly a shaman who can say "hmm, you have severe antisocial personality disorder" because someone disobeyed an order. Act accordingly to your expertise, and respect how mental illnesses are diagnosed. You will not be able to point to a specific condition during your first consultation with someone, and you shouldn't anyway. The diagnosis of a mental illness includes a physical exam, laboratory testing, and a psychological evaluation. You will likely never diagnose anything in-game unless it's a long, multiple-round affair.

4. Know how to speak.

This is not something I can teach you. It has taken me years of learning and living to understand how to approach the topic of mental health. You will not learn how to speak and act like a professional with a YouTube video, however, I can give you some pointers:
- Firstly, the focus is not you: this may seem obvious, but keep the focus of the conversation to the patient.
- Discover with care: do not push if the patient doesn't feel comfortable giving, or they might isolate themselves or even lash out.
- Scout the problem: pay attention to every word, every movement and how the patient is behaving.
- Know the questions: "how do you feel" is a good, but basic question. How does this affect you? What makes the problem better? How do you deal with this problem?
- Write things down and keep an eye on the records of the patient.

5. Learn, learn, learn.

Before playing this role, learn the more common therapy methods, such as exposure therapy, CBT, interpersonal therapy. Do not be afraid to ask for help to your Chief Medical Officer, or admit that you are uncertain of the issue and you "must process what you've told me and meet another time." You may ask in LOOC for information, especially if you're tackling an important moment of the character's arc. Keep a Google tab open to research any conditions a patient may have, or check websites for symptoms, causes and solutions. In this case, Wikipedia is a reliable source. At the end of the day, you are likely not an expert, and the players know you are not. They probably do not expect you to be 100% accurate and flawless, however, you should aim for the best possible result. Do not rush things, and take it easy. You're always learning.

Personal Tips:

These are some of the things I do during a round, or how I prepare beforehand.
1. Check the library for books that may be useful and give them a read. I have saved some information gathered from them in a private Discord server that I keep on hand.
2. Prepare some tools of the trade. You receive three random plushies at the start of the round, but I carry a slime plushie from the loadout menu, since it's a very neutral and plain subject. People who are scared of monkeys or squids may not enjoy a monkey or squid plushie. I also carry knitting supplies, since knitting is a calm and patient hobby (beware for the needles in case of a known trigger), and a handkerchief for the occasional cry.
3. Scout the records preemptively: at the start of the round, check the records for any outstanding issues you should be worried about, and print those subjects' records. Keep them in a folder and give the noted issues a look online if you don't know what they are. If they are severe enough, inform the rest of the team over the radio or hold a small meeting to tell them (that's RP, baby).
4. Make yourself known: not many people even know that this role is available. Shoot out a radio message now and then, post on the Relay, post a news article, yell into the void. Eventually, the void will answer.
5. Have fun: you are playing a role that is HEAVILY RP. You will basically just talk to people. Have fun with it, invent new therapy methods, host lectures in the holodeck, scold the ninja and make them reveal the fact that their father left at the age of five through complex combat psychological methods. Be creative and everyone will have fun.

Finally, I'd like to mention once again, mental health is important. The character sitting at your desk is played by someone who may suffer from trauma they are projecting onto the character, in order to relieve some of the stress it causes them or relate more easily to the character. Within my second consultation with someone, I was faced with a patient telling me that they felt lonely, depressed, dragged into a pit that threatened to swallow them. That hit hard, and we both agreed in LOOC that we related to it. Take this role seriously and be proud of it. You may help convince someone to seek professional help, or alleviate some of their pain or stress through this medium.

Any professional inputs are highly appreciated and will be edited into this guide. Thank you for reading!

The July 2022 form is attached here, but the older one is still present below!

https://docs.google.com/document/d/12HR3XqSNT0XoHy18LVLqR0hSf8LCR9zqodIYTpcuNB4/edit?usp=sharing

 

Edited July 26, 2022 by Zulu0009
Touched up, added the form.

[Zulu0009]

Form Update!

Below I have attached a form I made, following the Washington State Department of Social and Health Services' format. It includes:
A. Information: basic information about the patient and you.
B. Clinical Interview: a couple of questions about the patient's history (attach the full record to this form for clarity).
C. Medical Source Statement: a series of statements based on work performance and how well the patient can do their job.
D. Mental Status Details: a series of mental health basics and whether they are within normal limits or not.
E. Diagnosis / Symptomps: list the symptoms or likely diagnosis based on the above.
F. Prognosis: list what should happen to the patient in your opinion.

Psychological Evaluation Form.txt

[SatinsPristOTD]

Won't lie to you chief, AS someone with a Psych degree, this isn't half bad at all! I suggest players read into Personality Theory, and you can find the full text (all 12 chapters, but it's a good read) online.

[Zulu0009]

Surprise Form Update!

After some time not updating this, I decided to improve it by streamlining it and making it more accessible and easy to use. It is now a Google Doc, which I recommend using instead of the formatted, in-game version due to typing limits in-game. These evals can get pretty long, and you don't want to run out of space. Furthermore, a Google Doc is easier to share! Just open the template, click on File > Make a copy and rename it to the patient's name, such as "Psych Eval - John Doe." Enjoy!

It is divided into five sections, and here I provide some information for you:

1. Patient Information: their name, date of birth, age, sex (including preferred pronouns if they state so), marital status (single, divorced, etc.) and financial status, something around lower class, middle class, upper class and in between.
2. Clinical Interview: the patient's history, if they have any symptoms and what you make of them, if the patient has any objectives regarding these symptoms (getting rid of depression, for example) and what is stopping them from achieving them.
3. Patient History Review: some questions regarding the patient's situation, inform them that they can avoid answering them if they are not comfortable doing so; remember, you need to build trust with your patient!
4. Mental Status Details: the chunky part. The words stated under each category are supposed to help you describe their symptoms or provide guidance towards what to ask.
   1. Emotional State: something that you need to gauge yourself. Are they closed off? Are they reactive to questions? Maybe they get angry when questioned?
   2. Orientation: quite simply the patient's orientation skills. Can they tell where they are and who they are?
   3. Perception: ask the patient if they suffer from hallucinations of any kind, whether they can see, hear, smell, touch things that are not there.
   4. Thought Content: ask the patient if they sometimes feel delusional thoughts, such as "someone wants to kill me", "I am a god" or "The Skrell are out to destroy the galaxy". Remember that intrusive and impulsive thoughts, such as suddenly wanting to stab yourself when holding a knife, are common and are not always the sign of an ailment!
   5. Thought Process: something that you should gauge. Is the patient's way of thinking coherent and concrete, or do they change their mind often, fail to keep a straight line of thinking, etc.?
   6. Judgment: ask typical questions, such as "You find a wallet on the street, what do you do with it?" or "You find an envelope ready to be mailed, what do you do with it?" You should use your own judgment and keep in mind the patient's origin, condition and mental state before writing down your answer. A unique question is: "You find a shopping cart next to its stall. Do you put it inside or leave it alone as you pass by?" There is no reason to put the cart back aside from simply a strong moral compass, and the reward of the coin that was in the cart!
   7. Memory: ask the patient to remember a word at the start of the section, then ask them at the end. Furthermore, ask them something memorable in the previous day, then in the present month, then in the present year, to gauge whether they can remember those memories.
5. Prognosis: the final part of the evaluation!
   1. Summarizing Notes: what goes after PASSED or FAILED in the patient's records. Briefly include what the evaluation revealed, whether the person is fit for duty or not, and what they should do in the future.
   2. Diagnoses/Justification: any diagnosis you think is legitimate for the patient, and why you think so. Remember that only psychiatrist can diagnose mental illnesses! If you are a psychologist performing this, and you believe the patient is at risk or needs intervention, contact the CMO or a head of staff.
   3. Follow-Up Plan: what you think the patient should do in the future, be it therapy sessions, further consultations, a rest period, etc.

And that's all! You've successfully performed your evaluation. It is best to contact the player via Discord or send them the shared link via LOOC. It is also best to agree with the player if you wish to FAIL their evaluation, since that means the character would ideally be restricted from working until a solution is found. That said, as always, if you have any suggestions or would like to discuss this, my Discord is Zulu#8899 and I would love professional input regarding this. Finally, here is the template's link, which you are free to make a copy of and edit, improve or decorate.

Thank you, and have a healthy day!

https://docs.google.com/document/d/12HR3XqSNT0XoHy18LVLqR0hSf8LCR9zqodIYTpcuNB4/edit?usp=sharing

[Playbahnosh]

Great job, Zulu! This should really help new shrink players!