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XIIIDENTIFYING AND MANAGING ANXIETY AND DEPRESSION IN CHILDREN & ADOLESCENTS: A PRIMER19.08.2026WORKBOOK
This workbook is intended solely for educational and training purposes and should not be used as a substitute for professional clinical judgment. Developed by: Department of Youth Mental Health Team, SCARF Design, layout and compilation: Ms. Sowmya Dhanasekaran, Clinical Psychologist AI Disclosure Selected illustrations and graphic elements included in this workbook were created with the assistance of generative artificial intelligence and were subsequently reviewed, edited, and incorporated into the final workbook design. All educational content, clinical material, and editorial decisions were developed and reviewed by the Department of Youth Mental Health, SCARF. SOCIALSCLINIC TIMINGS MORNINGS 9:30 - 1pm MONDAY THURSDAY SATURDAY EVENINGS 1:30 - 5pm WEDNESDAY FRIDAY CONTACT US ymh@scarfindia.orgEMAIL WEBSITE www.scarfymh.org CALL “9150587361” FOR APPOINTMENT SCARF (I), R/7A, North Main Road, Anna Nagar (W), Chennai – 600101
This workbook is your space to: Think about your own experiences of working with young people. Explore different perspectives with your group. Reflect on your assumptions and attitudes. Work through case scenarios. Practise conversations and difficult situations. Record ideas that you want to take back to your own setting. You do not need to write down everything that is discussed. HOW TO USE THIS WORKBOOK Instead, use this workbook to capture: What I notice. What I wonder. What I want to remember. What I want to do differently. Belongs to :
AGENDA TOPIC 1 Phenomenology & Developmental Signs TOPIC 3 Risk Stratification, Safety planning TOPIC 2 Clinical Assessment Evidence-based Behavioural Interventions Psychoeducation TOPIC 4 Integration & Referral Pathways
CASE VIGNETTE 1 WHAT ARE THE SIGNS/ SYMPTOMS THAT YOU SAW ELICITED? WHAT ADDITIONAL QUESTIONS WOULD YOU WANT TO ASK? PHRASE THEM AS IF YOU WERE GOING TO ASK THE QUESTION
WHAT DILEMMA WOULD YOU FACE IN THIS CASE? WHAT OTHER CHALLENGES HAVE YOU FACED IN A SIMILAR CASE?
CASE VIGNETTE 2: WHAT ARE THE SIGNS/ SYMPTOMS THAT YOU SAW ELICITED?
WHAT ADDITIONAL QUESTIONS WOULD YOU WANT TO ASK? PHRASE THEM AS IF YOU WERE GOING TO ASK THE QUESTION WHAT DILEMMA WOULD YOU FACE IN THIS CASE? WHAT OTHER CHALLENGES HAVE YOU FACED IN A SIMILAR CASE?
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YesYesYesNoNoNoNot difficult at allPHQ-A (Adolescent version, ages 11-17)Name:Somewhat difficultVery difficultDate:Extremely difficult//Have you ever in your whole life, tried to kill yourself or made a suicide attempt? (circle one)In the past year have you ever felt depressed or sad most days, even if you felt okay sometimes? (circle one)Has there been a time in the past month when you have had serious thoughts about ending your life? (circle one)Instructions: How often have you been bothered by each of the following symptoms during the past two weeks? For each symptom put an “X” in the box beneath the answer that best describes how you have been feeling.If you are experiencing any of the problems on this form, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? (circle one)
YesYesYesNoNoNoNot difficult at allPHQ-A (Adolescent version, ages 11-17)Name:Somewhat difficultVery difficultDate:Extremely difficult//TotaScore 1. Feeling down, depressed, irritable, or hopeless? 2. Little interest or pleasure in doing things? 3. Trouble falling asleep, staying asleep, or sleeping too much? 4. Poor appetite, weight loss, or overeating? 5. Feeling tired, or having little energy? 6. Feeling bad about yourself - or feeling that you are a failure, or that you have let yourself or your family down? 7. Trouble concentrating on things like school work, reading, or TV? 8. Moving, or speaking so slowly that other people may have noticed? Or the opposite - being so fidgety or restless that you were moving around a lot more than usual? 9. Thoughts that you would be better off dead, or of hurting yourself?l=Not at all (0)_______Several days (1)+______Haveyou ever in your whole life, tried to kill yourself or made a suicide attempt? (circle one)+_______More than half the days (2)Inthepast year have you ever felt depressed or sad most days, even if you felt okay sometimes? (circle one)Hasthere been a time in the past month when you have had serious thoughts about ending your life? (circle one)Instructions: How often have you been bothered by each of the following symptoms during the past two weeks? For each symptom put an “X” in the box beneath the answer that best describes how you have been feeling.+______Ifyouare experiencing any of the problems on this form, how difficult have these problems made it for you to do your work,take care of things at home, or get along with other people? (circle one)Nearly every day (3)
Arjun, 13 years old, is brought to the pediatric clinic by his mother with recurrent abdominal pain and headaches for the past six weeks. His mother reports that the symptoms are particularly severe on Monday mornings, before tests, and on days when he has to participate in group activities at school. On these days, Arjun frequently asks to stay home. When allowed to stay home, he usually spends the morning watching videos or playing games and appears much more comfortable. Over the past month, he has also stopped playing football with his friends and has declined invitations from classmates. His mother says, “He used to be the first one ready to go out. Now he says he doesn't feel like doing anything.” His teachers report that he has become quieter in class and has stopped volunteering answers. His academic performance has declined slightly, although he continues to complete most of his homework. Arjun says: “I don't know why everyone keeps asking me what's wrong. My stomach really hurts. I just don't feel like going.” When asked about school, he says: “What if I get the answer wrong? Everyone will think I'm stupid.” His mother has started allowing him to stay home whenever his symptoms become severe because she does not want to “force him when he is genuinely unwell.” There is no reported self-harm, suicidal ideation, psychotic symptoms, substance use or significant trauma history. CASE VIGNETTE 1. What stands out clinically? Circle the TWO most important features: 1.Recurrent physical symptoms 2.Symptoms linked to specific situations 3.Reduced social/activity engagement 4.Mild academic decline 5.Parent allowing school avoidance What makes you consider anxiety/depression rather than viewing this only as a physical complaint?
2. What might be maintaining the problem? 3. What could you say/do in a brief consultation? Choose ONE response that would be most appropriate and explain why. A. “If your stomach hurts, stay home until you feel completely better.” B. “The pain is caused by anxiety, so there is nothing physically wrong.” C. “I believe that your stomach hurts. Worry can sometimes make our body react this way. Let's work out how you can manage the discomfort without letting it stop you from your usual activities.” D. “You need to stop worrying about what other people think.” Why? What might happen to the avoidance over time?
4. Is brief behavioural intervention appropriate? Yes / No / Unsure Based on the case, identify ONE feature supporting behavioural intervention and ONE thing you would still assess before proceeding.
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