Praxical.Psych
Session simulator

A first session, end to end

The complete first hour: consent, the presenting problem, history, mental state, risk, measurement, a first formulation, a plan, and the documentation afterwards. Every decision is yours.

Modality-neutralfoundationalSession 1 · Intake and assessment~55 min

What you are practising

  • 1Deliver informed consent as a conversation rather than a form
  • 2Take a history without turning the hour into an interrogation
  • 3Screen for and then properly assess suicide risk in a patient who does not look at risk
  • 4Recognise and take up a cultural opportunity
  • 5Produce a first-pass formulation and a plan the patient has agreed to
  • 6Write a defensible progress note

Briefing

Before he comes in

Daniel Okonkwo, 41, self-referred through his employer’s scheme. Structural engineer, married, two children aged 9 and 6. The referral form says: "Difficulty coping with workload. Requesting support to return to full performance."

He completed the online measures yesterday: PHQ-9 = 17, GAD-7 = 11. Item 9 of the PHQ-9 is endorsed at "several days".

What you are trying to achieve in the first hour

  1. 1A relationship he wants to come back to. Alliance formed early predicts outcome and dropout better than almost anything else you could do today.
  2. 2Enough history to formulate — not all of it.
  3. 3A risk assessment you would be content to have read back to you.
  4. 4A shared statement of what is wrong and what you propose to do.
  5. 5Hope. Not reassurance — a specific reason to believe this is treatable.

The case

Daniel Okonkwo

41, he/him, structural engineer, married, two children

Longstanding low mood, exhaustion and loss of interest, framed by him as "burnout".

Read the full case first

The phases

  1. 1

    Opening and consent

    Establish the frame, obtain informed consent as a conversation, and let him arrive.

  2. 2

    The presenting problem

    Hear the problem in his terms, and find out why now.

  3. 3

    History

    Collect what you need to formulate — including one relationship episode in detail.

  4. 4

    Risk assessment

    Assess properly, address means, and build a plan he will actually use.

  5. 5

    Mental state and measurement

    Record what you observed, and establish a baseline you can track.

  6. 6

    First formulation and plan

    Say what you think is going on, in his language, and agree what to do.

  7. 7

    Closing the hour

    Agree the first task, ask for feedback, and end on time.

  8. 8

    After he leaves

    Document, notice your own reactions, and decide what you are taking to supervision.

Educational use only

Praxical.Psych is a teaching tool. It is not medical, clinical, psychological or legal advice, not a diagnosis, not treatment, not supervision, and not a credential. Nothing here creates a clinician–patient or solicitor–client relationship. Every patient, case, transcript and simulated session is fictional. Clinical and legal requirements vary by jurisdiction and change over time — verify anything that bears on a real decision against your own regulator, statute and current professional guidance, and consult a qualified professional.

Do not enter real patient information. If you or someone else is in crisis: US & Canada 988 · UK & Ireland 116 123 · Australia 13 11 14 · elsewhere findahelpline.com · immediate danger, your local emergency number.

Full disclaimerScope, method & limitsEthics & lawYour data

Praxical.Psych · © 2026 Moonlit Social Labs. All rights reserved.

Before you begin

What Praxical.Psych is, and is not

Praxical.Psych is an educational tool. It teaches the theory, evidence base and clinical method of psychotherapy at the level of an advanced survey course, and it lets you rehearse a complete session in a simulator.

It is not medical, clinical, psychological or legal advice. It cannot diagnose or treat anyone, and it does not state the law where you practise — requirements differ by jurisdiction and change. Nothing here creates a clinician–patient or solicitor–client relationship.

  • Every patient, transcript and case in this app is fictional — a composite written for teaching. None depicts a real person.
  • Praxical.Psych is not therapy, not a substitute for supervision, and not a credential. Competence to practise comes from training, supervised hours and licensure.
  • Scores from the instruments here are for learning how they behave. They are not a diagnosis and not a risk assessment, and must not inform a decision about a real person.
  • Do not enter real patient information. Everything you type stays in this browser, but that is not the same as a compliant clinical record system.
If you are in crisis

In the US and Canada, call or text 988. In the UK and Ireland, call 116 123 (Samaritans). Elsewhere, find a local line at findahelpline.com. In immediate danger, use your local emergency number.

Read the full disclaimer