Psychologist
As the Colony 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 Biolab Overseer, 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 set up cryo, or treat patients. They have limited access in medical as a result.
Psychology and You
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.
Cognitive Behavioral Therapy
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.
Orientation
- 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.
Skill Focus
- 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.
Preventing relapses
- 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
EMDR, or Eye Movement Desensitization 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 of 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.
Other applications
EMDR may also help with borderline personality disorder and phantom limb pain.
Pharmaceuticals
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 MIRC app on your PDA.
Psionic Empathy
Many psychologist and psychiatrist choose to become psions, often going towards using their empathic abilities to aid patients by altering there mind. These powers should be used carefully, as a patient may not wish to have their mind directly meddled with. As always, permission and respect should be adhered to when considering the use of your powers. It would not be frowned upon for you to use your powers to put a violent patient to sleep, nor would it be wrong to use your powers to heal someone. Your best judgement is advised, you can find more information on Psionics here.
Psychosis & Violent Patients
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.
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.
Working with Security
- 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.
Confidentiality and why it is important
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, the patient and the Central Command Mental Health department. 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.
