Collaborative and Proactive Solutions for irritability in children and adolescents

The intervention is a psychological therapy called Collaborative & Proactive Solutions. It will be delivered by study trained clinicians. The intervention comprises 8x1 hour sessions once a week for six weeks and then once every two weeks for the final 2 sessions (total of 8 sessions over 10 weeks). The intervention is administered face-to-face, or via telehealth, with the child and parent/s. Sessions can include time with the parent/s alone, with the child alone, and with both the child and parent/s present. The structure of the intervention is as follows: (a) Identification of lagging skills and unsolved problems that contribute to temper outbursts, and a discussion of how existing parental responses may be counterproductive; (b) Prioritization—helping parents prioritize which unsolved problems will be the focal point of initial problem-solving discussions; (c) Introduction of the Plans framework— helping parents understand the three potential responses to solving problems: Plan A (solving a problem unilaterally, through imposition of adult will and often accompanied by adult-imposed consequences), Plan B (solving a problem collaboratively and proactively), and Plan C (setting aside the problem for now); and (d) Implementing Plan B—helping parents and children become proficient in the use of Plan B and largely discontinuing the use of Plan A. Although the clinician actively guides the problem-solving process initially, the goal of treatment is to help the child and parents become increasingly independent in solving problems together. Clinicians will complete a Clinical Record Form (CRF) for each session to document adherence to intervention protocols.