Practical Crisis Management for Parents and Clinicians: Adolescent Suicidal, Aggressive, Elopement Behaviours: Intensive Treatment Settings.
Bibliographic record
Abstract
OBJECTIVE: In the many guidelines, recommendations and strategies for crisis management of suicide-related behaviours, aggression/vandalism and elopement in adolescents, immediately usable and specifically detailed descriptions and rationales of the strategies, especially for parents, are noticeably absent. This paper describes a feasibility project to develop one overall detailed strategy with specific adaptations for each of the three crises for adolescents in intensive services. It is a contribution to the discussion and joint service/parent management of these crises. METHOD: The factors to consider and the development of the strategy and PARENT GUIDE are described. Examples are provided. While the main work was done by the psychiatrist and staff of a day treatment service many other colleagues and families contributed over the seven years. The accompanying PARENT GUIDE is a necessary, separate and available document. RESULTS: Since the purpose was to develop and evolve the strategy, it did not lend itself to a clear research outcome. However, careful estimates using the approximately 30 adolescents (of about 350 adolescents) for whom the strategy was used showed: no deaths, assault and vandalism stopped and elopement was managed. Parents regained skills, hope and improved relationships with their adolescents. They developed the confidence, specific knowledge and skills to manage for the future. CONCLUSIONS: The successful development and evolution of the strategy demonstrated feasibility of the concept. The hope is that such strategies contribute to the advancement of patient care, the discussion in the literature and provide the basis for future research.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.014 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".