Table 1.

Therapeutic assessment components.

Imminent Risk Evaluation	Risk Stratification	Level Assignment	Treatment Planning
• Care manager will evaluate:  ∘ Ability of youth/parent to identify strengths in the youth and family environment  ∘ Ability of the youth to consider their pattern of emotional regulation, using a “feeling thermometer”  ∘ Willingness and ability of youth to develop and use a safety plan that identifies behavioral, cognitive, and interpersonal strategies  ∘ Ability of youth to commit to safety plan use rather than self-harm for a specific duration (at least until next scheduled session) • Imminent risk determination:  ∘ If imminent risk is evident, youth will be triaged to emergency services and recontacted to continue the SC-SP intervention when the youth is evaluated as safe for outpatient care  ∘ For youth evaluated as safe to continue with outpatient care, care manager will continue to risk stratification	• Additional assessment of:  ∘ Mental health symptoms  ∘ Psychosocial functioning  ∘ Protective processes  ∘ Prior treatment  ∘ View of treatment • Assessment guided by the “Stress & Distress Brochure”1 • Information used to:  ∘ Determine appropriate assignment of stepped care intervention services  ∘ Develop initial case conceptualization and treatment plan/goals	• Stepped care level assigned based on degree of recent suicidal ideation, suicidal behavior, or NSSI reported • Level 1 (low risk)  ∘ No reported SI, SA, or NSSI in the past 3 months, and  ∘ PHQ-9 score <10 • Level 2 (moderate risk)  ∘ PHQ-9 score ≥10, or  ∘ Passive SI with no intent or plan in the past 3 months • Level 3 (high risk)  ∘ Active SI with intent or plan in past 3 months, or  ∘ SA in past 3 months, or  ∘ ≥3 episodes of NSSI, or 2 NSSI episodes (one of which required medical attention) within the past 3 months	• Intervention service options presented based on stepped care level • “Stress & Distress Brochure”1 used to guide development of collaborative treatment plan

¹Modeled after the “Stress and Your Mood Brochure” used in the Youth Partners in Care Trial.²⁷