Starting an SSRI with black-box counselling (CASC)

Station instructions (candidate)

You have 7 minutes. Engage the patient and parent. Validate fears about suicide risk and addiction language online. Explain accurately that SSRIs are not addictive in the substance-use sense but can cause discontinuation symptoms if stopped abruptly, and that a black-box warning means closer early monitoring because a minority of young people experience increased suicidal thoughts after starting — while untreated depression also carries suicide risk.^[1][2][5] Offer a collaborative plan: optional sertraline start low, early review, safety plan, sexual side-effect discussion, and psychological therapy pathway. Do not coerce. Do not claim zero risk. Do not dismiss the parent.