Status: Ready — Start Intake
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Auto-save: Active
Prototype / Demo: This tool is a working demonstration. Not for final clinical use. Can be customized and finalized for approved research protocols.
PRE-SESSION DATA

0. Patient Intake, Demographics & Clinical History

Prototype / Demo: This is a customizable demonstration tool for clinical research workflows (not for final clinical/production use). Can be adapted and finalized for specific approved protocols. Part of Tervik's tools for human services research.
IMPORTANT (Prototype): This is a demo and prototype tool for approved clinical research workflows. Not intended for final production or clinical use without customization and validation by qualified teams. Everything stays local. Can be adapted for any research protocol.
De-identified Patient / Study ID
Session / Visit Date
Clinician Initials
Assessment Type / Timepoint
Demographics
Age Range
Gender Identity
Education
TRD & Treatment History
Duration of current episode (months)
Number of adequate failed antidepressant trials
Prior treatments tried (check all)
Concomitant Medications & Washout Log
Current medications at screening (list all)
Washout details (medication + last dose date)
Substance Use & Psychedelic History
Psychedelic use in past 12 months?
PRE-SESSION DATA

1. High-Risk Disqualification & C-SSRS Screening

STRICT LOGIC GATE — Any Yes flags the record and blocks clearance.

1. Lifetime Schizophrenia, Schizoaffective, Bipolar I/II with psychosis, or psychotic episode?
2. Currently on Lithium, any MAOI, or high-risk interacting medications?
3. Uncontrolled hypertension, serious arrhythmias, recent MI/stroke, or unstable CV disease?
4. Currently pregnant, breastfeeding, or planning pregnancy?
C-SSRS Screening Version
C1. Wish to be Dead?
C2. Non-Specific Active Suicidal Thoughts?
C3. Thoughts with Method (no plan/intent)?
C4. Some Intent to Act (no specific plan)?
C5. Active Suicidal Ideation with Specific Plan and Intent?
Suicidal Behavior (lifetime or since last assessment)?
PRE-SESSION DATA

2. Baseline Symptom Scales — Full Instruments

MADRS (primary), GAD-7 and PHQ-9 (secondary). All items included exactly as validated.
MADRS — Full 10 Items (Live Total)
Total: 0/60
Severity: —
1. Apparent Sadness
? (0-6)
2. Reported Sadness
? (0-6)
3. Inner Tension
? (0-6)
4. Reduced Sleep
? (0-6)
5. Reduced Appetite
? (0-6)
6. Concentration Difficulties
? (0-6)
7. Lassitude
? (0-6)
8. Inability to Feel
? (0-6)
9. Pessimistic Thoughts
? (0-6)
10. Suicidal Thoughts
? (0-6)
Score ≥4 requires immediate review.
GAD-7 — Full 7 Items

Over last 2 weeks: 0=Not at all, 1=Several days, 2=More than half days, 3=Nearly every day.

1. Feeling nervous, anxious, or on edge
2. Not being able to stop or control worrying
3. Worrying too much about different things
4. Trouble relaxing
5. Being so restless that it is hard to sit still
6. Becoming easily annoyed or irritable
7. Feeling afraid as if something awful might happen
GAD-7 Total: 0/21 —
PHQ-9 — Full 9 Items

Over last 2 weeks: Same 0-3 scale.

1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling/staying asleep or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself or a failure
7. Trouble concentrating
8. Moving/speaking slowly or fidgety/restless
9. Thoughts of being better off dead or hurting yourself
PHQ-9 Total: 0/27 —
PRE-SESSION DATA

3. Preparation Sessions & Therapeutic Alliance Building

This section includes guidance on how to cover each topic effectively during preparation sessions.
Number of dedicated preparation sessions completed
Topics Addressed in Preparation

Click on each topic to expand guidance and sample questions. Check the box once the topic has been sufficiently covered.

Rapport & Therapeutic Alliance Established
Why it matters: Trust is the foundation of safety during a high-dose psychedelic session.
Sample Questions:
• "What has it been like for you to talk about your depression with people in the past?"
• "Is there anything I can do to help you feel more comfortable during our sessions?"
Psychoeducation on Effects & Timeline
Why it matters: Reduces fear of the unknown.
Sample Questions:
• "The strongest effects are usually between 90 minutes and 3 hours. Does that timeline feel manageable?"
Reviewed Personal Depression History & Current Patterns
Why it matters: Helps identify core themes that may surface during the session.
Sample Questions:
• "When you think about your depression, what is the most painful or recurring thought or feeling?"
Explored Hopes, Fears, and Expectations
Why it matters: Unrealistic expectations or unaddressed fears can create resistance.
Sample Questions:
• "What are you hoping might change after this experience?"
• "What worries you most about taking the medicine?"
Collaborative Flexible Intention Setting
Why it matters: Gives direction without rigid expectations.
Sample Questions:
• "If you could ask the medicine one question, what would it be?"
Mindset Cultivation: Openness, Curiosity, Surrender
Why it matters: These attitudes correlate strongly with positive outcomes.
Sample Questions:
• "What does 'surrender' mean to you personally?"
Addressed Fear of Losing Control
Why it matters: One of the most common sources of resistance.
Sample Questions:
• "What does that fear feel like in your body when you imagine it?"
Logistics: Arrival, Clothing, Support Person, No Driving
Why it matters: Practical safety reduces background anxiety on dosing day.
Sample Questions:
• "Who will bring you to the session and take you home?"
Safety Procedures, Boundaries & Consent for Supportive Touch
Why it matters: Clear consent is essential for psychological safety.
Sample Questions:
• "If you become distressed, would you like us to offer a hand to hold, or stay close but not touch you unless you ask?"
Inner-Directed Nature; Role of Music, Eyeshades & Facilitators
Why it matters: Helps the participant understand the work is largely internal.
Sample Questions:
• "We will be present the whole time, but we won't talk much unless you need support. How does that feel?"
Preview of Integration Process
Why it matters: Sets realistic expectations that the real work continues after dosing day.
Sample Questions:
• "After the session we will meet again to help you make sense of what came up. Integration is where many people find the deepest changes."
Clinician global rating of therapeutic alliance / rapport (0–10)
Participant self-report: "I understand the process, trust the facilitators, and am willing to approach with openness and surrender."
Clinician notes on preparation / alliance / concerns
PRE-SESSION CLEARANCE CHECKPOINT

4. Pre-Session Clearance Checkpoint

CRITICAL GO/NO-GO DECISION POINT — This evaluates all pre-session data.

Complete Tabs 0–3 then click "Evaluate Pre-Session Clearance".
Clinician Final Clearance Decision
DAY-OF PRE-DOSING

5. Immediate Pre-Dosing Readiness (Day of Dosing)

Administered on dosing day, shortly before ingestion. Final confirmation of readiness.

Current anxiety about the upcoming session (0–10)
Prepared to surrender to the experience with openness and curiosity?
Have you reviewed your personal intention with facilitators today?
Final confirmation: Participant appears calm, oriented, and has no new acute safety concerns?
IMMEDIATE POST-SESSION

6. Immediate Post-Session Safety & Aftercare (24-72h)

Time since dosing
Physical symptoms since dosing (check all)
Emotional/psychological state compared to pre-dosing baseline
Current overall psychological safety and support needs
PHENOMENOLOGICAL & FOLLOW-UP

7. Phenomenological Efficacy & Follow-Up

MEQ-30 Total Score (0–150)
Key Acute Phenomena Checklist
Most Meaningful or Insightful Aspects
Integration Challenges or Lingering Effects

8. Patient Dashboard — Longitudinal View

Enter a Patient ID to view historical scores from the local vault.

9. Review, Verify & Exports

Review all data. You can export the full vault or individual phases/sections.

Overall Summary
Complete previous tabs then refresh.
T
Tervik

Clinical Administration Guide & Protocol Reference (v1.14)

Tervik Lens: This guide supports complete, mission-driven care. We turn lived, qualitative experience into clear, ownable systems so teams and participants gain lasting capacity. Every step prioritizes dignity, autonomy, and measurable human outcomes.

💻 Tervik Software Basics & The Traffic Light Rule

Auto-Save & Recovery (Tervik Ownership): Data lives only on your device. The tool saves every 20 seconds. If the device fails, reopen the page — drafts are offered for recovery. You own the data; Tervik just provides the structure.

Hover Tooltips (?): Hover over MADRS questions to see exact clinical scoring criteria. This turns qualitative observation into reproducible data.

The Tervik Traffic Light Rule:

  • GREEN — Cleared to proceed. Participant and team own the next step with confidence.
  • YELLOW — Requires review. Pause, reflect, and strengthen the plan together.
  • RED — High-risk flag. Stop immediately and escalate. Safety and trust come first.

Designed so that protocols feel complete — not fragmented — across the entire participant journey.

📋 Phase 1: Pre-Session Intake, History & Safety Screening

Tervik Goal: Gather the full story so the participant feels seen and the team has clear, ownable data from the start.

Key Actions:

  • Complete Tab 0 (Intake & TRD History) and Tab 1 (High-Risk + C-SSRS) thoroughly.
  • The High-Risk screen is a hard stop — no exceptions.
  • Use the C-SSRS items exactly as written to maintain reliability across raters.
Tervik Sample Opening Questions:
  • “Tell me about the last few months — what has depression taken away that you most want back?”
  • “Have you ever experienced a period where you felt unusually euphoric or didn’t need sleep?” (bipolar screen)
  • “Have there been any changes to your medications or life circumstances since we last spoke?”
  • “On a scale of 0–10, how much does this depression interfere with the life you want to live?”

Documentation Tip (Tervik Style): Capture the participant’s own language. These qualitative notes often become the most powerful part of later integration and outcome tracking.

🧠 Phase 2: Preparation, Therapeutic Alliance & Readiness

Tervik Core Principle: The 0–10 Alliance rating is one of the strongest predictors of outcome. Preparation is where participants begin to own their journey.

Critical Goals:

  • Establish genuine rapport and psychological safety.
  • Review expectations, risks, and the inner-directed nature of the work.
  • Assess readiness for surrender and support needs.
Tervik Sample Scripts:
  • “This medicine often brings up exactly what needs to be seen. We won’t direct the experience — we hold the space so you can.”
  • “What does ‘surrender’ mean to you right now? There’s no right answer — we just want to understand how you’re approaching this.”
  • “If difficult or beautiful things arise, how would you like us to be with you? Hand to hold? Quiet presence? Music change?”
  • “After the session we’ll meet again. The real transformation often happens in how you make sense of what came up.”

Pro Tip: Low alliance (<5) or “Disagree” on readiness should trigger a yellow flag and extra preparation sessions. Ownership starts here.

💊 Phase 3: Dosing Day — Grounding, Set & Setting
Tervik Pre-Dosing Framing:
“Today we create a safe container. Approach with openness and non-judgmental acceptance. Trust that whatever arises belongs to the process. We are here with you the entire time — you are not alone.”

Grounding Techniques for Acute Distress

  • Vocal Anchoring: “I am right here. You are safe. This is the medicine doing its work. Tell me what you need.”
  • Breath Syncing: “Let’s breathe together. In for 4… out for 6. You lead the pace.”
  • Reorientation: Gently remove eyeshades if requested. “Name three things you can see in the room.”
  • Physical Grounding: Offer a cool cloth, weighted blanket, or hand to hold — only with explicit permission.

Medical Emergency Protocol: Severe hypertension, loss of consciousness, seizure, or panic that does not respond to grounding → immediately notify the medical monitor / on-call physician. Do not leave the participant alone.

Tervik emphasis: The participant remains the expert of their own experience. Our role is to hold the container so they can do the work.

🗣️ Phase 4: Post-Session, Integration & Long-Term Ownership

Tervik Integration Philosophy: The medicine opens the door. Integration is where lasting capacity is built. The real work is turning insight into owned, repeatable practices.

Sample Integration Prompts (use in follow-up sessions):
  • “What was the most meaningful part of the experience — and what does it mean for how you want to live?”
  • “When depressive patterns show up again, what did you learn in the session that you can now use as a new response?”
  • “Who or what in your life needs to know about the shifts you’re making?”
  • “What small, concrete action can you take this week that would be evidence that something has changed?”

Long-Term Follow-Up (Tervik Lasting Capacity):

  • Schedule integration at 24–72 h, 1 week, 1 month, and 3 months (or per protocol).
  • Re-administer MADRS / PHQ-9 / GAD-7 at each point to track owned progress.
  • Use the Patient Dashboard to show participants their own trajectory — this reinforces autonomy.
  • Document qualitative shifts in the participant’s own words whenever possible.
🔗 Tervik Integration & Data Ownership

TRD Clinical Assessment Report (Prototype)

Record ID: ${d.record_id || 'current-' + Date.now()}
Generated: ${new Date().toLocaleString()}
Patient ID: ${d.patient_id || '—'}
Date: ${d.session_date || '—'}
Clinician: ${d.clinician || '—'}
Type: ${d.assessment_type || '—'}

Pre-Session Clearance Decision

Final Decision: ${d.clearance_decision || 'Not documented'} ${d.high_risk_flag ? 'HIGH RISK FLAG' : ''}

Baseline Scores

MADRS: ${d.madrs_total} (${d.madrs_severity}) | GAD-7: ${d.gad7_total} | PHQ-9: ${d.phq9_total}

DISCLAIMER: Local clinical research support tool / prototype. For approved research protocols only. Not medical advice. Data stored locally. Can be customized for any protocol.

Clinician Signature: _______________________________ Date: _______________

TRD Clinical Assessment Tool (Tervik Prototype) | For research use only — customizable
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`; win.document.write(html); win.document.close(); setTimeout(() => { win.focus(); }, 450); } // Patient Dashboard let progressChartInstance = null; let meqChartInstance = null; function loadPatientDashboard() { const patientId = document.getElementById('dashboardPatientId').value.trim(); if (!patientId) { alert('Please enter a Patient ID'); return; } const vault = JSON.parse(localStorage.getItem('trd_psilocybin_vault_v1_13') || '[]'); const patientRecords = vault.filter(r => r.patient_id === patientId).sort((a, b) => new Date(a.timestamp) - new Date(b.timestamp)); if (patientRecords.length === 0) { alert('No records found for this Patient ID in the local vault.'); return; } document.getElementById('dashboardContent').style.display = 'block'; const labels = patientRecords.map(r => new Date(r.timestamp).toLocaleDateString()); const madrsScores = patientRecords.map(r => r.madrs_total || 0); const phq9Scores = patientRecords.map(r => r.phq9_total || 0); if (progressChartInstance) progressChartInstance.destroy(); if (meqChartInstance) meqChartInstance.destroy(); const ctx1 = document.getElementById('progressChart'); progressChartInstance = new Chart(ctx1, { type: 'line', data: { labels: labels, datasets: [{ label: 'MADRS', data: madrsScores, borderColor: '#3182ce', tension: 0.3 }, { label: 'PHQ-9', data: phq9Scores, borderColor: '#38a169', tension: 0.3 }] }, options: { responsive: true, scales: { y: { beginAtZero: true, max: 60 } } } }); const latest = patientRecords[patientRecords.length - 1]; const ctx2 = document.getElementById('meqChart'); meqChartInstance = new Chart(ctx2, { type: 'radar', data: { labels: ['Mystical', 'Positive Mood', 'Transcendence', 'Ineffability'], datasets: [{ label: 'MEQ-30 Subscales', data: [ latest.meq_mystical || 0, latest.meq_positive_mood || 0, latest.meq_transcendence || 0, latest.meq_ineffability || 0 ], backgroundColor: 'rgba(49, 130, 206, 0.2)', borderColor: '#3182ce' }] }, options: { scales: { r: { beginAtZero: true, max: 40 } } } }); let summaryHTML = `Records found: ${patientRecords.length}
`; summaryHTML += `Latest MADRS: ${latest.madrs_total} (${latest.madrs_severity})
`; if (latest.meq_total) { summaryHTML += `Latest MEQ-30 Total: ${latest.meq_total}`; } document.getElementById('dashboardSummary').innerHTML = summaryHTML; } function initializeTool() { const dateInput = document.querySelector('input[name="session_date"]'); if (dateInput) dateInput.value = new Date().toISOString().split('T')[0]; document.getElementById('statusText').textContent = 'Ready — Complete Intake & History'; setupAutoSave(); const form = document.getElementById('clinicalForm'); if (form) { form.addEventListener('input', updateProgress); form.addEventListener('change', updateProgress); } setTimeout(updateProgress, 100); // initial progress console.log('%c[TRD Tool v1.14] UI/Validation improvements. Scoring + progress tested via static analysis.', 'color:#276749'); switchTab(0); } window.onload = initializeTool; window.TRDTool = { getData: () => getFormData(), evaluateClearance: () => evaluatePreSessionClearance(), exportVaultCSV: () => exportVaultToCSV(), clearVault: () => { localStorage.removeItem('trd_psilocybin_vault_v1_13'); alert('Vault cleared.'); } };
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