• AKA: Therapist, Psychotherapist, Psychiatrist, Counselor, Life Coach
• Access: Medbay, Morgue, Psych Office, Medbay Storage
• Difficulty: Medium
• Qualifications: At least 30 years of age, PhD from accredited university in applicable field, 5+ years experience in related field preferred.
• Supervisors: Chief Medical Officer
• Duties: Assist the crew in overcoming their mental shortcomings, go insane yourself.
• Guides: Guide to Medicine, The guide you're reading.

As the Psychologist, you are tasked with identifying (and solving) personal and mental issues within the station's crew. This is a job that you may or may not be able to accomplish successfully. If need be, you have the power to deem someone mentally unstable and, with the approval of the Chief Medical Officer, strip them of any authority they might've had. Ultimately, you are responsible for the mental health and well being of the crew.

This job is very roleplay-oriented, and it can be very boring if not played correctly. More often than not, you will be spending your time listening to your patients and then talking to them. Most of the players who will approach you already have something in mind, and because there is no easy, straightforward way to treat psychological issues, it falls to you to make your patient's roleplay experience an enjoyable one.

A very well-written in-character outline of this common psychology technique written by forum user Curien can be found here.

Introduction

Since being transferred from NanoTrasen Colonial Division, I’ve noticed that psychological care is a somewhat neglected aspect of medical treatment offered aboard the various space stations and ships in the NanoTrasen fleet. While I understand it hasn’t been very long since psychologists were first stationed aboard most stations and ships in the fleet, I still believe this is a problem, especially considering the immense stress that comes with working on board an isolated vessel or station.

My solution to the issue is to publish a number a papers outlining different treatment plans, theories and diagnostic tools commonly used in the psychology industry. These papers, or to some extent ‘Guides’, will hopefully allow you to expand on your current understanding of psychology.

Psychology training is something that takes years of study into many different areas of psychology, many in-depth theories and the neurology studies associated with them, so it’ll take more than just a quick glance at “Psychology For Dummies” before you’ll anywhere near qualified as a psychologist.

This paper will be about Cognitive Behavioral Therapy, a form of treatment I find extremely useful and one which may be the most common treatment plan I use with my patients. Cognitive Behavioral Therapy can be used to treat and manage a wide variety of issues of varying severity, making it a useful thing for any psychologist to be trained in.

What is Cognitive Behavioral Therapy?

Cognitive Behavioral Therapy, or CBT, is a short-term psychological treatment plan that focuses on an individual's cognitions (Thought patterns), behaviour and how they influence each other and their emotions. Cognitive Behavioral Therapy is all about finding a way to change how an individual thinks about, or react to, a situation to better impact their emotional response.

Cognitive Behavioral Therapy is similar to most other forms of talking therapy but differs in that it focuses more on the present than the past; Cognitive Behavioral Therapy is about learning how to control your emotions and is not directly focused on the causes of any issues you may have, although the roots of certain issues will be discussed as part of treatment.

How Does it work?

Cognitive Behavioral Therapy theory suggests that it’s not actually events that we find upsetting or distressing, but the meaning we give to them and its the meaning that impacts how we feel and therefore our actions. Depression, anxiety and most other strong negative emotions can cause a rather vicious cycle which is rather difficult to escape; the negative meaning you give to an event may cause you to feel depressed, which could cause you to withdraw from other people which will lead to a feeling of isolation and further your depression. I’ll explain this a little more when we move onto the ‘Five Areas’ model.

When Can It Be Used?

Cognitive Behavioral Therapy is commonly used to treat personality and behavioral conditions such as depression, anxiety and most other emotional instabilities. Cognitive Behavioral Therapy can even be used to help manage bipolar, schizophrenia, Post-traumatic stress disorder, many forms of psychosis, Body dysmorphic disorder, sleeping problems, even eating disorders and phobias.

Treatment Plan

First I need to explain the different levels of Cognitive Behavioral Therapy and how to identify what kind of patient needs each level. For simplicity, let’s think of there only being two levels of CBT treatment: Soft and Pure. Soft CBT treatment focuses on guided self help; the psychiatrist or psychologist will work as a ‘coach’ and help the patient manage their own feelings and is suitable for patients who would be considered low to medium severity. Pure CBT treatment is for patients who have more complex issues and involves a lot more interaction between the psychiatrist and the patient; Pure CBT usually involves an assessment period during which the patients problems will be identified and explored, followed by an examination of the patient’s thought patterns and feelings to identify where changes would be most effective.

Of course each patient will need a treatment plan tailored to their needs so it’s entirely up the the psychiatrist how best to treat their patient, Cognitive Behavioral Therapy can be used in conjunction with other forms of therapy or medication.

A treatment plan I would recommend is a combination of regular therapy sessions with the patient, which I believe is important in all forms of psychological treatment, and what I like to call ‘Homework’. Homework is usually a simple task for the patient to help them manage their feelings and remain in control of their issues, sometimes it can also help the psychiatrist develop a deeper understanding of the patient’s needs. Simple assignments such as writing a diary of events that provoke strong negative emotions, writing a problem and goal list or behavioral exposure activities can play a large part in the self-help aspect of Cognitive Behavioral Therapy.

The Five Areas Model

One of the most useful resources applied to Cognitive Behavioral Therapy is the Five Areas Model; the Five Areas Model allows both the patient and the psychiatrist to identify what can be changed during a situation to affect the patient’s emotional and physical response for the better. Here are the ‘Five Areas’ that make up the model:

1. The situation- Where were you, what time of day was it, who else was there, what was said, what happened?

2. Thoughts - What went through your mind at the time? How did you see yourself and how you were coping? What did you predict was the worst thing that could happen? How did you think others saw you? What did you think about your own body, behaviour or performance? Were there any painful memories from the past? Did you notice any images or pictures in your mind?

3. Feelings - How did you feel emotionally at the time? Were you anxious, depressed, ashamed, angry or guilty? (It’s worth pointing out here that we often use the word ‘feel’ to describe a thought for example, the sentence ‘I feel that nobody cares about me’ is a thought, that may be associated with a feeling of sadness or guilt. Usually, single words describe feelings and sentences describe thoughts).

4. Physical Symptoms - A wide range of physical reactions may occur, such as a rapid heartbeat and breathing, feeling hot, sweaty and clammy, feelings of muscle tension, jitteriness or pain. Feelings of low energy, pressure or pain may often be associated with low mood whereas difficulty breathing and accelerated heart rate can be linked to anxiety.

5. Behavior - How did you react to the situation? This included short term and long term reactions; how did you react to similar situations in future? How was the rest of your day affected? What was your immediate reaction?

Each of the five areas shown here will influence each other; How you think can affect how you feel and how you’ll Behave. The aim of Cognitive Behavioral Therapy is to try to change one or more of the five areas in order to positively influence the others. It’s also important to be able to recognise when each of the five areas are having a negative impact on each other and are causing a cycle of negative feelings.

Exposure Therapy

Exposure Therapy is commonly used in Cognitive Behavioral Therapy to help patients with phobias or obsessions; the patient is exposed to, or exposes themselves to, the situation or object that has been identified to induce fear, anxiety, depression or other negative feelings and tries to alter one of the five areas to reduce the negative feelings associated with the situation or object.

Obviously there are certain risks involved with Exposure Therapy and although the patient needs to be challenged, they must never be placed in any danger or thrust into a situation they find too distressing.

In Closing

Hopefully you now know what Cognitive Behavioral Therapy is, when it can be used and have a basic understanding of how a patient can benefit from it. Remember that Cognitive Behavioral Therapy is a much better alternative than the long term prescription of antidepressants or mood stabilizers as patients who self medicate can develop dependence on medication, addiction and even move on to illegal drugs.

Also try to keep in mind that although Cognitive Behavioral Therapy has a large focus on self-help, regular therapy sessions play a large part in the treatment as it provides an opportunity for patients to discuss their problems and to explore them.

Special Thanks

I would like to give thanks to Doctor Hildegard Galila and Doctor Sherrinford Holmes who took the time to read through my manuscript and gave me some useful feedback, I would also like to thank Doctor Darcey Grey who suggested I write and publish this paper.

- Written by LPsy Oliver Mason\Curien

As the station psychologist, you can prescribe a number of anti-depressants, sedatives, painkillers, and other pharmaceutical drugs in order to help your patient to recover. A list of all of the possible drugs that may be prescribed can be found in the guide to chemistry.

So let's face it… not every patient you treat is going to be coming into your office ready to talk politely about their problems. Sometimes, you're going to be dealing with people who simply aren't thinking straight, or who are even outright violent.

Hallucinations can be caused by drugs, poisons, and radiation. You'll see them on a large scale if the supermatter goes critical, and on a small scale if the botanist or chemist has been producing recreational substances. One type of antidepressant you can prescribe, paroxetine, also has the risk of causing hallucinations, meaning that it should be prescribed under your supervision or that of a member of the medical staff. People who are hallucinating will see things, hear things, and sometimes believe things that aren't actually there.

You will also deal with severe mental illness, including everything from the effects of having found out that one has just been cloned to the garden-variety schizophrenia, depression, and anxiety every psychologist encounters. Most of the time, people who are mentally ill are not violent. Some people who are hallucinating due to drugs or radiation–especially if they've experienced it before–will know that they're hallucinating and try to stay safe. But it's entirely possible that a patient with psychosis will throw a punch at you, believing you are trying to harm them. Your main goal when dealing with a hallucinating patient is to keep them safe until the hallucinations wear off, or the doctors can treat them for whatever is causing the hallucinations.

Occasionally you will deal with a patient who is homicidal or suicidal. Depending on how bad it is and how clearly they are thinking, you may be able to simply talk them down, which is the preferred option, or you may have to restrain them in some way. If the worst happens and your patient commits suicide, remember that cloning is not an option for those who died by suicide.

In order of increasing urgency, treatments for psychiatric emergency can include:

• Antidepressants. These work slowly and are of the most help to people who are already somewhat rational. If a person is just barely in control, this can help.
• Soporific pill or injection. A sedative will make your patient sleepy and help them calm down.
• Straight jacket. This keeps your patient from hurting themselves, but it is uncomfortable and can even be traumatic. Only use it if your patient is in immediate danger.
• Muzzle. This keeps your patient from speaking or biting–only really useful if they are desperate enough to try to chew their own hands off. Like the straitjacket, a last resort.
• Chloral hydrate. This is a very strong sedative that causes overdose starting at only 15 units, but its strength means it can be put into an autoinjector and be effective at stopping anyone without armor on (ask the chemist to make you one). Once the chloral hydrate has taken effect, the patient can be more easily restrained, and its effects can be reversed with Dylovene.

Some of your patients will be criminals who happen to also have a mental illness. Others will be people who have come to Security's attention because of their erratic behavior. Either way, you may need to coordinate with Security to get these people treated.

Remember that the people you see as patients, Security may very well see as criminals. Advise Security as to the nature of the crisis and stress that your patient is hallucinating, depressed, confused, etc. Explain to them any particular triggers your patient may have.

Ensure that any physical injuries your patient has are taken care of first.

If Security has been unnecessarily rough with your patient, do not hesitate to make complaints. In many cases, you will be the only one speaking out on behalf of your patient's welfare.

Handcuffs are an effective way of restraining a patient while you speak to them, but just like a straitjacket, they are uncomfortable and can cause a patient to panic. If they're necessary for your safety, use them, but don't just slap them on your patients willy-nilly.

Don't be afraid to ask for a guard on a particularly violent patient. Letting your patient beat you up is not approved clinical practice.

You may also encounter insanity in the form of a cult. As a psychologist, you don't know anything about the cult itself, but you will probably come to realize that they are suffering from mental impairment unlike any you've seen before–personalities altered, motives changed, and morals turned upside down to the point that a pacifist may become a killer and a usually joyful person may become a near-suicidal nihilist. How you respond to this strange new type of psychosis is up to you–remember who your character is. But your duty as a psychologist remains the same: Criminal or not, violent or not, you treat mental illness and aid those who suffer from it. Until you see obvious evidence of the supernatural (and perhaps not even then), a cult member may seem like just another patient to you. Of course, since cults are often violent, you will likely be working with Security and using restraints. Remember to stay safe, because if you're dead, you can't do your job.

As the Psychologist, you are tasked with identifying (and solving) personal and mental issues within the station's crew. This is a job that you may or may not be able to accomplish successfully. If need be, you have the power to deem someone mentally unstable and, with the approval of the Chief Medical Officer, strip them of any authority they might've had. Ultimately, you are responsible for the mental health and well being of the crew. The Psychologist isn't expected to know how to (or required to) perform the vast majority of medical tasks or duties and lacks access to most of Medical. While you're expected to know resleeving and how to set cryos, you will only be required to resleeve the dead if you are the only Medical personnel online (or the other medical doctors mysteriously died).

This job is very roleplay-oriented, and it can be very boring if not played correctly. More often than not, you will be spending your time listening to your patients and then talking to them. Most of the players who will approach you already have something in mind, and because there is no easy, straightforward way to treat psychological issues, it falls to you to make your patient's roleplay experience an enjoyable one.

Keep in mind the majority of this guide consists of suggestions. While you can't really go wrong with them, you are not required to follow any treatment practices here. You'll also find it's fairly common for psychologists to practice alternative medicine to treat patient drama, assuming you ever see a psychologist online since they're fairly rare.

Cognitive Behavioral Therapy centers around identifying a problem and setting up a plan to fix it step by step. It focuses on developing coping strategies that can help with the current problems with cognitions, behavior and emotional regulation. For roleplay purposes BCBT, or Brief Cognitive Behavioral Therapy can be used following a step by step plan.

• Have the patient declare a commitment to their treatment
• Plan for crisis response and safety.
• Restrict the patient's access to problematic objects, such as substances in case of addiction.
• Put together a little survival kit of items that can help your patient through episodes.
• Establish a reminder, like a card or a piece of paper with their motivation or reason to live on it.
• Set up a treatment journal.
• Make note of any lessons the patient has learned.

• Make a worksheet about how the patient is going to develop their skill to cope with their problem.
• Give the patient reminders of how they are going to solve their problems. Like a sheet of paper or cards with suggestions printed on them.
• Demonstrate how they'd use them.
• Practice their usage with the patient.
• Refine their skill at solving their own problems.

Have your patient apply the solution frequently to themselves once they are good enough at it to do it on their own Have your patient find ways in which the solutions you've reached would work even better.

Treatable afflictions: Lesser forms of depression and anxiety, PTSD, tics, substance abuse, eating disorders, borderline personality disorder, OCD, major depressive disorder and psychosis. It may also help with conduct disorders.

EMDR, or Eye Movement Desensitisation and Reprocessing, is a therapy that helps relieve emotion from memories, reprocessing them and thus aiding with solving trauma. It is a psychotherapy used to help with symptoms of PTSD and helps threat memories that override normal coping mechanisms.

Asking questions EMDR treatment consists of a series of five questions, two of which are visualization exercises, the rest measure the patient's condition. During the second time the patient visualizes their negative memories, the therapist either distracts their eyes with a finger or uses headphones with an alternating click on the left and right side to distract the patient.

• Ask the patient about their traumatic experience, including associated thoughts, images and feelings.
• Ask them to think of it again while distracting them with
• Ask the patient how they feel.
• Ask the patient how their body feels.
• Ask the patient on a scale of 1 to 10, how much does their memory bother them?

If you get an answer of 6 or lower to the last question, you've got your patient to the safe zone. Doing this constitutes a set; it is advised to take a break after a set. Up to three sets can safely be done, after that side effects like headaches will show up. It will sometimes occur that during a set another memory surfaces, pick up on it and process it like you did the first.

EMDR may also help with borderline personality disorder and phantom limb pain.

If you prefer to play the psychiatrist, you can prescribe a number of anti-depressants, sedatives, painkillers, and other pharmaceutical drugs in order to help your patient to recover. A list of all of the possible drugs that may be prescribed can be found in the guide to chemistry although you'll need a chemist or pharmacist to synthesize them as you lack access to chemistry. Please note though for roleplay purposes that a psychologist is not actually a medical doctor, a psychiatrist is.

So let's face it… not every patient you treat is going to be coming into your office ready to talk politely about their problems. Sometimes, you're going to be dealing with people who simply aren't thinking straight, or who are even outright violent.

Hallucinations can be caused by drugs, poisons, and radiation. You'll see them on a large scale if the supermatter goes critical, and on a small scale if the botanist or chemist has been producing recreational substances. One type of antidepressant you can prescribe, paroxetine, also has the risk of causing hallucinations, meaning that it should be prescribed under your supervision or that of a member of the medical staff. People who are hallucinating will see things, hear things, and sometimes believe things that aren't actually there.

You will also deal with severe mental illness, including everything from the effects of having found out that one has just been resleeved to the garden-variety schizophrenia, depression, and anxiety every psychologist encounters. Most of the time, people who are mentally ill are not violent. Some people who are hallucinating due to drugs or radiation–especially if they've experienced it before–will know that they're hallucinating and try to stay safe. But it's entirely possible that a patient with psychosis will throw a punch at you, believing you are trying to harm them. Your main goal when dealing with a hallucinating patient is to keep them safe until the hallucinations wear off, or the doctors can treat them for whatever is causing the hallucinations.

Occasionally you will deal with a patient who is homicidal or suicidal. Depending on how bad it is and how clearly they are thinking, you may be able to simply talk them down, which is the preferred option, or you may have to restrain them in some way.

In order of increasing urgency, treatments for psychiatric emergency can include:

• Antidepressants. These work slowly and are of the most help to people who are already somewhat rational. If a person is just barely in control, this can help.
• Soporific pill or injection. A sedative will make your patient sleepy and help them calm down.
• Straight jacket. This keeps your patient from hurting themselves, but it is uncomfortable and can even be traumatic. Only use it if your patient is in immediate danger or they like being in one for some reason.
• Muzzle. This keeps your patient from speaking or biting–only really useful if they are desperate enough to try to chew their own hands off. Like the straitjacket, a last resort.
• Chloral hydrate. This is a very strong sedative that causes overdose starting at only 5 units, but its strength means it can be put into an autoinjector and be effective at stopping anyone without armor on (ask the chemist to make you one). Once the chloral hydrate has taken effect, the patient can be more easily restrained, and its effects can be reversed with sugar to convert it into soporific and dylovene to treat the soporific.

Some of your patients will be criminals who happen to also have a mental illness. Others will be people who have come to Security's attention because of their erratic behavior. Either way, you may need to coordinate with Security to get these people treated.

Remember that the people you see as patients, Security may very well see as criminals. Advise Security as to the nature of the crisis and stress that your patient is hallucinating, depressed, confused, etc. Explain to them any particular triggers your patient may have.

Keep in mind your position comes with the highest level of confidentiality out of all of medical. Unless your patient confesses something dangerous (such as a plan to murder the Captain) or suffers from a condition related to a threat (e.g. they're waving a gun around due to hallucinations), not even Code Red or a warrant grants access to psychological records (excluding an evaluation determining mental fitness for a job promotion, for example). Only the Chief Medical Officer may override this.

Ensure that any physical injuries your patient has are taken care of first.

If Security has been unnecessarily rough with your patient, do not hesitate to make complaints. In many cases, you will be the only one speaking out on behalf of your patient's welfare.

Handcuffs are an effective way of restraining a patient while you speak to them, but just like a straitjacket, they are uncomfortable and can cause a patient to panic. If they're necessary for your safety, use them, but don't just slap them on your patients willy-nilly.

Don't be afraid to ask for a guard on a particularly violent patient. Letting your patient beat you up is not approved clinical practice.

As the psychologist you will likely get to know very private and very sensitive information about people, it is of the utmost importance that you keep what is discussed between you and the patient. If you start to talk and gossip about all the intimate details of what is wrong with your patients, people will no longer trust you and them no longer trusting you leads to them not telling you the important details you need to do your job. Keep that zipper shut, buddy. Medical confidentiality is no joke.

You may also encounter insanity in the form of a cult. As a psychologist, you don't know anything about the cult itself, but you will probably come to realize that they are suffering from mental impairment unlike any you've seen before–personalities altered, motives changed, and morals turned upside down to the point that a pacifist may become a killer and a usually joyful person may become a near-suicidal nihilist. How you respond to this strange new type of psychosis is up to you–remember who your character is. But your duty as a psychologist remains the same: Criminal or not, violent or not, you treat mental illness and aid those who suffer from it. Until you see obvious evidence of the supernatural (and perhaps not even then), a cult member may seem like just another patient to you. Of course, since cults are often violent, you will likely be working with Security and using restraints. Remember to stay safe, because if you're dead, you can't do your job.

Tips

• As a roleplay job, this position is very commonly used for ERP. Don't be surprised if somebody asking for an appointment is doing so just for a scene.
• Keep in mind not everybody wants an appointment for ERP and you may be contacted for a more traditional psychologist appointment. If you only want ERP sessions and you're going to disregard anybody coming in for a traditional appointment, you're better off playing Visitor.
• Don't be intimidated if you don't think you're capable of playing a professional psychologist. Often just listening to a patient's difficulties and letting them know they can trust you is enough for an enjoyable roleplay.
• Seriously, even if you do just want ERP it's not rare to get this from a traditional appointment. Many players prefer getting to know your character before easing into kinkier things, so it may be a good way to get a scene later.
• You could consider calling crew in for routine evaluations but should keep in mind they're not required to. Be aware some may come even if OOC notes don't match and they don't to roleplay an evaluation, so it never hurts to ask in LOOC if they don't mind roleplaying an evaluation.
• Feel free to be creative with your treatments. If you see something in a patient's OOC notes, you may be able to make a treatment based on it.
• This is one of the worst jobs to play a jaded, asshole-ish character with. You really shouldn't.