Lesson 1When to refer and collaborative care models: criteria for urgent psychiatric referral, outpatient therapy referral, collaborative care integration with school and community resourcesExplains criteria for urgent, regular, and specialist referrals, describes teamwork models linking primary care, mental health services, school, and community aid, and gives steps for shared care plans and talks.
Red flags requiring urgent psychiatric referralIndications for routine therapy referralDesigning shared care plans with specialistsWorking with school-based mental health teamsPartnering with community and youth servicesLesson 2Follow-up, documentation, and safety planning: follow-up intervals, relapse prevention, documentation templates, crisis resource planningCovers planning follow-up visits, tracking symptoms and daily life, noting assessments and plans, creating personal safety plans, and giving crisis contacts and relapse prevention for teens and families.
Setting follow-up intervals by risk levelTracking symptoms with brief rating scalesKey elements of clear clinical documentationDeveloping written safety plans with teensCrisis lines, apps, and local emergency optionsRelapse prevention and early warning signsLesson 3Focused psychosocial history: symptom onset, sleep, appetite, concentration, school functioning, relationships, substance use, family history of mental illness or suicideGuides a targeted psychosocial and mental health history, including symptom start, sleep, eating, focus, school work, relationships, trauma, substance use, and family mental health or suicide history for diagnosis and risk.
Clarifying symptom onset, duration, and triggersAssessing sleep, appetite, and energy changesSchool performance, attendance, and bullyingPeer, family, and online relationship stressorsScreening for substance use and risky behaviorsFamily history of mental illness and suicideLesson 4Epidemiology and how presentations differ by age and sex, common comorbidities (substance use, ADHD)Reviews rates of teen anxiety and depression, symptom differences by age and sex, and links with ADHD, substance use, and other issues to guide focused screening and early help in practice.
Prevalence and global burden in adolescentsAge-specific symptom patterns 12–14 vs 15–18Sex differences in presentation and help-seekingOverlap with ADHD and learning disordersLinks with substance use and risk behaviorsLesson 5Validated screening tools and administration: PHQ-A/PHQ-9 modified for adolescents, GAD-7, Columbia-Suicide Severity Rating Scale (C-SSRS), usage and scoringCovers picking and using PHQ-A, teen-modified PHQ-9, GAD-7, and C-SSRS, including scoring, reading, cultural aspects, and weaving results into clinical choices and family discussions.
Choosing tools for anxiety versus depressionAdministering PHQ-A and teen PHQ-9Using and interpreting the GAD-7 in teensColumbia-Suicide Severity Rating Scale basicsScoring, cutoffs, and false positive handlingCommunicating results to adolescents and parentsLesson 6Pharmacologic strategies and monitoring: SSRIs with evidence in adolescents (fluoxetine, escitalopram), dosing principles, side effect monitoring, black-box concerns and informed consentReviews proven SSRI use in teens, including when to use, medicine choice, dosing and adjustments, tracking side effects and suicide risk, black-box warning talks, and joint decisions with teens and caregivers.
When to start medication versus wait or referChoosing between fluoxetine and escitalopramStarting doses, titration, and trial durationMonitoring side effects and activationDiscussing black-box warnings and consentCombining SSRIs with psychotherapy effectivelyLesson 7Initial nonpharmacologic management: cognitive behavioral therapy fundamentals, brief behavioral interventions in primary care, parental involvement and school liaisonExplores first-choice non-drug strategies, including CBT basics, short interventions in primary care, motivational methods, education, and planned teamwork with parents, schools, and community supports.
Explaining diagnosis and normalizing help-seekingCore CBT concepts for anxiety and depressionBrief behavioral strategies in short visitsEngaging parents as therapeutic partnersCoordinating with school counselors and staffWhen to add structured psychotherapy referralLesson 8Safety assessment and suicide risk triage: direct questions about self-harm, plans, means, protective factors, when to enact emergency protocolsDetails structured suicide risk checks, including straight questions on thoughts, intent, plans, and means, assessing protective factors, risk levels, and when to start emergency or higher care paths.
Creating a safe, private interview settingDirect questions on ideation, intent, and plansAssessing access to means and recent behaviorsEvaluating protective and buffering factorsRisk stratification and triage decisionsIndications for emergency referral or hold
