PCH EXPAAND Nested Intervention: Evaluating Therapeutic Assessment as a brief intervention for children and adolescents who self-harm at the time of a mental health emergency.

Group 1: Control: treatment as usual Group 2: Expanded assessment including standardized measures of attentional conditions and difficulties with emotional processing, and the semi-structured diagnostic interview (K-SADS). Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL) is most widely used diagnostic interviews in research. It is a standardized semi-structured interview to measure current and past symptoms of mood, anxiety, psychotic and disruptive behaviour disorders (including ADHD) in children aged 6-18 years old. Administration time is between 45-75 minutes. The K-SADS diagnostic interview takes between 1-2 hours to administer Group 3: Expanded Assessment with Nested Intervention - Therapeutic Assessment: a brief, manualised psychological assessment technique developed specifically to make the assessment for children and adolescents who have self-harmed more therapeutic Therapeutic Assessment (TA; Ougrin et al., 2009) is a brief, manualised psychological assessment technique developed specifically to make the assessment for children and adolescents who have self-harmed more therapeutic (Ougrin et al., 2009). TA is a therapeutic intervention where the clinician and patient co-construct a narrative with regards to their DSH / suicidal crisis behaviours within the context of a theoretical model developed by Ougrin and colleagues (2009) over a single 1-hour to 1.5-hour session. The content of this session is then recorded in a ‘therapeutic letter’ and provided to the patient in paper mail form (with an additional electronic form provided if requested. The intervention will be delivered by a Clinical Psychologist, and/ or masters-level provisionally registered Clinical Psychologists, supervised by a Clinical Psychologist. Therapeutic assessment takes between 1-1.5 hours to complete with the patient. Both the K-SADS and the Therapeutic Assessment are delivered as a one-off intervention. The intervention is delivered at the Perth Children’s Hospital in an outpatient clinic available to clinical researchers. Clinicians delivering the interventions receive training and supervision. Output generated from interventions (K-SADS results and Therapeutic Assessment letter) are reviewed by the PI and/ or CPI to ensure correct administration. Both the K-SADS and Therapeutic Assessment are readily available and have not been modified for use in this study. Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL) is most widely used diagnostic interviews in research. Ougrin, D., Zundel, T., & Ng, A. V. (2009). Self-harm in young people: A therapeutic assessment manual. CRC Press.