For confidentiality purposes (NMC, 2008), patients' real names will not be used. Introduction Within this essay I will reflect on and critically analyze an OSCE that has raised my awareness or challenged my understanding, in assessing the holistic needs of a service user (John), referred by his GP, incorporating at the same time a care plan using the Care Program Approach (CPA). Using this program and other sources of current literature, I hope to demonstrate my knowledge and understanding in relation to this skill, as well as identify areas with opportunities for learning. In practice, there are other assessment tools such as….which I may have used but the CPA is a recommended national standard framework for mental health, introduced in 1991, to provide a framework for effective mental health care (DOH 1999; DOH 2008) and to safeguard all service users (SUs) through appropriate assessment and review (Gamble, 2005). But it takes time, in practice and in paperwork. Service user participation was repeatedly disappointing; studies consistently report low awareness of CPA policy (CPAA, 2006; McDermott, 1998). Analysis/Discussion The literature regarding assessment, communication and interpersonal skills is vast and extensive. After reading a small portion of the vast literature available, the student was able to analyze the OSCE and see how poorly this situation was handled. However, even though I felt like I wasn't communicating effectively at the time (due to anxiety), upon reflection and reading the literature I found that I had done something positive. Environment There was a good choice of room, as the physical environment is very important and should not be overlooked. We were positioned about 20 inches apart from each other diag... center of the paper... beck, SL (2009) Lippincott Manual of Psychiatric Nursing Care Plans. 8th ed. Philadelphia: Wolters Kluwer/ Lippincott Williams & Wilkins. Simpson, C. (2007) 'Mental health part 3: assessment and treatment of depression' British Journal of Healthcare Carers. pp 167-171.Stickley,T. & Freshwater, D. (2006). “The art of listening in the therapeutic relationship” Journal of Mental Health Practice. 9 (5) pp12 - 18.The Care Program Approach Association (2006) The CPA Association's National Standards and Audit Tool for Monitoring the Care Program Approach. Chesterfield: CPAA.Walsh, A & Clarke, V. (2009) Foundations of Mental Health Nursing New York: Oxford University Press.Norman I and Ryrie I (2004). Assessment and care plan cited in Norman I and Ryrie I (2004) The Art and Science of Mental Health Nursing: Maidenhead, Open UniversityPress