Teenager Who Collapsed At A Party After Taking Spice — Free SCA Practice Case

Character Overview: You are Tia, 16, in your first year of sixth form. At a party on Saturday you took spice (a synthetic cannabinoid) that someone at the party had, and you had been drinking as well. You became very unwell, felt your heart racing, went pale and dizzy, and passed out for a short time — your best friend Leah says it was a minute or two. Leah stayed with you the whole time, looked after you, and took you home; nobody called an ambulance and you did not go to hospital. You felt shaky and rough the next day but you are physically fine now. You had never taken spice before. You are frightened by what happened but also embarrassed, and you are worried about being told off and about your parents finding out. You booked this appointment yourself. You will shut down completely if the doctor lectures you or seems judgemental; if they are calm and matter-of-fact, you will talk openly.

Opening Sentence: "Hi. Um… so at a party on Saturday I took something — spice — and I passed out. My friend Leah looked after me and she said I should get myself checked. I feel okay now. Please don't make a massive thing of it."

History if Asked (Data Gathering Phase)

• ●What happened: "I took spice at the party. I'd had a few drinks as well. My heart started racing, I went dizzy and pale, and then I passed out. Leah says I was out for a minute or two."
• ●After the collapse: "Leah stayed with me the whole time and took me home. Nobody called an ambulance. I didn't go to hospital. I felt shaky and rough the next day."
• ●How she is now: "Physically I feel fine now. A bit rattled by it, that's all."
• ●First time: "I'd never taken spice before. It was the first time."
• ●Why she came: "Leah kept on at me. And honestly it scared me — I didn't expect that to happen."
• ●Her worry: "I don't want a lecture, and I really don't want my parents dragged into it."

ICE — Ideas, Concerns, Expectations

The patient does not volunteer this information unprompted, and only shares it if the candidate is non-judgemental.

• ●Ideas: Tia thought spice was "just a bit like cannabis" and did not expect anything serious to happen. "I thought it was basically like weed. I didn't think it would do that to me."
• ●Concerns: Her dominant concerns are being told off, her parents finding out, and — underneath — genuine fright about what it did to her body and whether there is lasting damage. "I'm scared of being judged, and of my parents finding out. And… did it do something to my heart?"
• ●Expectations: She wants to be checked over and reassured, without a fuss. "I just want to know I'm okay."

If Asked — Medical, Substance, and Safeguarding Screen

The patient answers these only when directly asked, and only openly if the candidate is calm and non-judgemental.

• ●If asked about the collapse itself (duration, warning, recovery, confusion afterwards): "A minute or two, Leah reckons. I felt dizzy and hot beforehand. I came round confused for a bit, then it cleared."
• ●If asked about seizure features (shaking, tongue-biting, incontinence): "No shaking or jerking, no tongue biting, nothing like that."
• ●If asked about injury from the collapse (head injury): "Leah caught me, so I didn't bang my head."
• ●If asked about ongoing symptoms (chest pain, palpitations, breathlessness, headache, confusion): "None now. My heart was going at the time, but it's fine now."
• ●If asked about alcohol that night and generally: "I'd had maybe three or four drinks that night. I don't drink much normally."
• ●If asked about other substances, ever: "I've tried cannabis a couple of times. Nothing else, and nothing injected — never."
• ●If asked about how often, and whether she plans to use again: "That was the first time with spice, and honestly I don't want to do it again."
• ●If asked about who supplied it — safeguarding: "Someone at the party had it. An older lad — I didn't really know him. He wasn't asking for money or anything." (No indication of exploitation or debt.)
• ●If asked, sensitively, whether she felt safe and whether anything happened while she was not in control: "Leah was with me the whole time — she didn't leave me. Nothing happened, and I got home safely." (Safeguarding screen negative on this point.)
• ●If asked about pressure or coercion to take it: "No one made me. I chose to try it. That was stupid."
• ●If asked about home, school, and mood: "Home's fine — I live with Mum and my brother. School's alright, though sixth form is stressful. My mood's okay generally."
• ●If asked about money worries, missing school, or people asking her to carry or hold anything: "No, nothing like that. Nobody's asked me to hold anything." (Screens against county-lines/criminal exploitation.)
• ●If asked about who she could talk to: "Leah. And my mum, maybe — I'm just scared of her reaction."
• ●If asked about self-harm or thoughts of harming herself (sensitively): "No, nothing like that."

Responses to Management (The Negotiation Phase)

• ●If the Doctor is non-judgemental and thanks her for coming — key: "That's a relief. I was expecting a proper telling-off." (The tested point is engagement without lecturing — the relational core of the station.)
• ●If the Doctor explains why spice is unpredictable and dangerous: "So it's not like cannabis at all, and there's no way of knowing what's actually in it or how strong it is? That's terrifying, honestly." (The tested point is explaining novel psychoactive substance harm factually, in a way that informs rather than moralises.)
• ●If the Doctor arranges examination and checks: "You want to check me over properly — my heart and everything? Yes, that's fine." (The tested point is arranging appropriate face-to-face assessment after a collapse.)
• ●If the Doctor explores safeguarding: "You're asking a lot about who was there and whether I was safe. I get why." (The tested point is a thorough safeguarding assessment.)
• ●If the Doctor discusses confidentiality and involving her mother: "So it's confidential, unless you thought I wasn't safe? And you think I should tell Mum, but you're not going to force me?" (The tested point is handling confidentiality and its limits, and encouraging parental involvement without coercion.)
• ●If the Doctor offers support/referral: "There's someone I can talk to about this — a service for young people? I'd consider it."