The eight clinical domains

Professional boundaries scenarios test whether you can keep a therapeutic relationship therapeutic when something pulls it towards an ordinary social one — a gift, a friend request, a chance meeting, a client who wants to know about your life.

Risk scenarios test whether you assess before you act. They present a disclosure — self-harm, suicidal thoughts, harm to others, safeguarding — and ask what you do with incomplete information and no time to consult.

Ethical scenarios set two defensible principles against each other and ask which takes precedence. There is rarely an option with no cost; the test is whether you can identify which cost is the one to accept.

These scenarios test whether you notice difference without making assumptions from it. They involve culture, faith, language, disability, sexuality, gender and class, and usually turn on whether you ask or presume.

These scenarios test how you choose and change a course of treatment: what to do when an intervention is not working, when a client wants something different from what the evidence recommends, or when new information changes the formulation.

These scenarios test how you work with colleagues who have different training, different priorities and sometimes more seniority than you — psychiatrists, nurses, social workers, GPs, teachers.

These scenarios test how you use supervision, handle the limits of your competence, and respond when you have made a mistake or are struggling. They are about being a safe learner rather than an infallible one.

These scenarios test decisions about the system rather than the individual: waiting lists, capacity, resource rationing, service policy, and what you do when a service constraint conflicts with a clinical need.