Collaborative and Proactive Solutions for irritability in children and adolescents

INTERVENTION: 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. CONDITION: Irritability; ; Irritability Mental Health ‐ Other mental health disorders PRIMARY OUTCOME: Change in irritability as measured by the Clinician Rated Affective Reactivity Index (CL‐ARI) [4‐months post‐randomisation] SECONDARY OUTCOME: Change in irritability as measured by the Clinician Rated Affective Reactivity Index [12 months post‐randomisation] Change in irritability as measured by the parent reported Affective Reactivity Index[4 and 12 months post‐randomisation] Change in irritability as measured by the self‐reported Affective Reactivity Index[4 and 12 months post‐randomisation] Change in irritability as measured by the teacher reported Affective Reactivity Index [4 and 12 months post‐randomisation] Child mental health measured by the Child Behavior Checklist[4 and 12 months post‐randomisation] Child quality of life measured by the CHU‐9D[4 and 12 months post‐randomisation] Family functioning measured by the McMaster Family Assessment Device[4 and 12 months post‐randomisation] Parent psychological distress measured by the K6[4 and 12 months post‐randomisation] INCLUSION CRITERIA: Children aged 6‐15 years with a score of 3 or higher on the parent rated Affective Reactivity Index.