Table 1.

Adaptations of the Collaborative Care Model for Adolescent Patients

CCM Health System Component	Features of the Original Collaborative Care Model	Adaptations for the Adolescent Collaborative Care Intervention
Self - management support	Patient education with a specific focus on anticipated treatment effects and anticipated course of depression Patient choice of treatment Availability of a care manager who helps patients identify depressive symptoms and troubleshoot treatment side effects	Adolescent specific educational materials including a video to normalize depression and decrease stigma Patient choice of treatment with parent involvement Selection of a care manager who can relate well to adolescents in a non-judgmental and supportive manner Development of a list of resources including available youth groups and school programs in the community.
Delivery system design	More frequent depression follow-up aided by non-physician depression care manager (DCM) Care manager case supervision by a mental health professional in the primary care setting who is available for formal and informal consultation Half of DCM visits in person/half by telephone	Care manager availability after school in the primary clinic setting Supervision by a child psychiatrist and psychologist 80% of DCM visits in person and 20% by telephone
Decision support for providers	Educational seminars for providers Distribution of depression treatment guidelines Increased availability of mental health support for informal consultation Training a non-physician provider to be a DCM as a resource for physician providers	Development of an adolescent-specific intervention manual based on available guidelines Availability of a child psychiatrist and psychologist for informal consultation Availability of the DCM to address questions in the primary care clinics
Clinical information systems	Computerized disease registry to allow for easy follow-up and tracking of depressive symptoms and medication adherence	Integration into the Electronic Medical Record system to allow for confidential provider communication