Psychologist

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MEDICAL STAFF
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Psychologist, Psychiatrist
Access: ETC, Psych Room, Maintenance
Difficulty: Mind Bending
Supervisors: Chief Medical Officer
Duties: Assist the crew in overcoming their mental shortcomings despite having untreated PTSD yourself
Guides: Guide to Medicine, The guide you're reading, Curien's Psychology 101


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).

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.

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

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 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 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 guide to chemistry although you'll need a chemist 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.

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 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 overpowered and didn't need another buff 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.

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.
  • 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 Colony Director) 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.

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 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.

Antag Encounter

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 nudge into 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.
Jobs on CHOMPstation

IconJobs.png

Command Colony Director, Head of Personnel, Head of Security, Chief Engineer, Research Director, Chief Medical Officer
Security Head of Security, Security Officer, Warden, Detective
Engineering Chief Engineer, Engineer, Atmospheric Technician
Cargo Quartermaster, Cargo Technician, Shaft Miner
Medical Chief Medical Officer, Medical Doctor, Paramedic, Psychologist, Chemist, Search and Rescue
Science Research Director, Scientist, Roboticist, Xenobiologist, Pathfinder, Explorer
Service & Civilian Intern, Visitor, Bartender, Botanist, Chef, Chaplain, Command Secretary, Janitor, Librarian, Pilot
Station-Bound AI, Cyborg, Maintenance Drone, Personal AI, Ghost, Mouse