| Module 1: Adherence and Safety Plan |
| Motivational Interviewing |
| Used as framework for all modules |
| Adherence |
| Promote engagement with patient and family by developing truce and increasing supportive behaviors and positive communication; enhance motivation for behavior change and treatment adherence |
| Psychoeducation |
Expanded education of parents and patients on risk and protective factors; keeping the environment safe Education on helpful communication at home; avoidance of high conflict topics until stability is achieved
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| Safety Plan |
Review the index attempt, including risk and protective factors Chain analysis (functional analysis), including vulnerabilities, cognitive and behavioral factors, and stressors Identify and complete safety plan; identify parents role in safety plan and review with parents
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| Module 2: Affect Protection: Reasons for Living, Mood monitoring, Pleasant events |
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Review Safety Plan and orient to BRITE (in this and each subsequent session) |
| Behavioral Activation and pleasant event scheduling |
Review reasons for living, tie into safety plan Mood monitoring Building positive affect; pleasant activities planning and savoring; include parents in review. Review App and session related content
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| Module 3: Affect Protection: Savoring |
| Affect Regulation Strategies: Savoring, Switching, Distress Tolerance |
Savoring: Visual imagery for recent and future positive experiences, including savoring cognitions such as recalling details of positive experiences (26). Affective switching: Practice flexibility to activate positive affect when youth catch themselves in a ruminative cycle. Also, during calm times, practice (with therapist assistance) engaging in negative affect for brief periods, followed by planned activation of positive affect to build flexibility for switching out of negative states. Distress tolerance: Skills for relaxation, self-soothing and distraction to manage painful emotions. Review App and session related content
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| Consolidation and Review |
Review of skills with patient and family; practice skills as needed in session (including use of phone app); Troubleshoot barriers and plan implementation. Assess linkages with treatment providers and plan for case management.
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| Bridging Calls (2 calls within 1-2 weeks) |
Review strategies and safety plan Evaluate need for adjustments in plan or need for additional care
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| Case Management/Liaison (continuing through transition to community provider) |
Utilize Motivational Interviewing strategies and skills to enhance motivation for adherence with follow-up treatment. Provide written summary and consult with treatment provider as needed.
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