diff --git a/public/therapy-compass-data/pathways.json b/public/therapy-compass-data/pathways.json
index 0acff7afc..66a7d0f9f 100644
--- a/public/therapy-compass-data/pathways.json
+++ b/public/therapy-compass-data/pathways.json
@@ -1 +1 @@
-[{"slug":"anxiety-pathway","name":"Anxiety pathway","clinicalProblem":"Anxiety","summary":"Source-grounded workflow assembled from therapies indexed to Anxiety. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"psychoeducation","label":"Initial option","description":"Broadly useful across most psychiatric disorders. Highest-yield in psychosis, bipolar disorder, depression, anxiety disorders, OCD, eating disorders, and relapse-prevention work. It is especially important early in treatment, after diagnosis clarification, at discharge planning, and after relapse."},{"therapySlug":"brief-supportive-psychotherapy","label":"Alternative option","description":"Best as a pragmatic short-term intervention in inpatient psychiatry, CL psychiatry, ED/crisis recovery, early engagement, post-discharge follow-up, adjustment to diagnosis, medical illness, grief/stress reactions, and bridging while waiting for more specific therapy. RANZCP identifies supportive psychotherapy as one of the forms of psychotherapy practised by psychiatrists, within psychotherapy as a core component of psychiatric treatment."},{"therapySlug":"crisis-intervention-crisis-oriented-brief-therapy","label":"Alternative option","description":"Best for acute crisis presentations where the person needs immediate containment and a short practical intervention. Common settings include ED, crisis team, inpatient admission, CL psychiatry, urgent community review, post-self-harm follow-up, post-discharge vulnerability, and acute psychosocial crisis."},{"therapySlug":"cbt-informed-psychological-intervention-for-self-harm","label":"Follow-up option","description":"Best for adults who self-harm and are receiving continuing support after an episode or repeated episodes. Especially high-yield in ED follow-up, community mental health, post-discharge planning, personality vulnerability, recurrent crisis presentations, mixed depression/anxiety/self-harm presentations, and patients where self-harm is linked to identifiable triggers or problem states."},{"therapySlug":"coping-skills-interventions","label":"Follow-up option","description":"Best used as a low-intensity or adjunctive intervention for common mental health problems, subthreshold or mixed distress states, adjustment-related difficulty, stress-related functional decline, and as a bridge while waiting for or building toward more specific treatment. Particularly useful where the main task is teaching practical skills rather than deep formulation or disorder-specific exposure or processing work."},{"therapySlug":"applied-relaxation-relaxation-based-therapy","label":"Follow-up option","description":"Strongest formal guideline support is for generalised anxiety disorder, where NICE includes applied relaxation as a high-intensity psychological treatment option alongside CBT. It can also be a useful adjunct in broader anxiety care when body tension and rapid arousal are prominent."}]},{"slug":"crisis-risk-pathway","name":"Crisis/risk pathway","clinicalProblem":"Crisis/risk","summary":"Source-grounded workflow assembled from therapies indexed to Crisis/risk. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"exposure-and-response-prevention-for-tics-erp-for-tics","label":"Initial option","description":"Best used for Tourette syndrome and persistent motor or vocal tic disorder when tics are distressing, impairing, painful, socially disruptive, or functionally limiting. European guidance and recent reviews treat ERP as one of the main evidence-based behavioural therapies alongside HRT and CBIT."},{"therapySlug":"family-intervention-for-psychosis","label":"Alternative option","description":"Best supported for adults with psychosis or schizophrenia who live with or are in close contact with family members or carers. NICE quality standards state that family members of adults with psychosis or schizophrenia should be offered family intervention because it improves coping skills and relapse rates."},{"therapySlug":"family-psychoeducation-for-psychosis","label":"Alternative option","description":"Most useful for schizophrenia-spectrum and other psychotic disorders when family members or carers are closely involved and need a clearer illness model, relapse plan, and coping framework. Compared with full family intervention, family psychoeducation is most defensible when the main need is education and coping support, not a broader family-therapy programme."},{"therapySlug":"psychoeducation-for-psychosis","label":"Follow-up option","description":"Broadly useful across first-episode psychosis, established schizophrenia-spectrum illness, relapse prevention, discharge planning, rehabilitation, and self-management work. It is especially high-yield when the person needs a clearer model of symptoms, treatment, relapse risk, and what to do if symptoms worsen."},{"therapySlug":"peer-support","label":"Follow-up option","description":"Most useful in psychosis rehabilitation, community recovery work, discharge transition, engagement support, group activities, and broader recovery-oriented service delivery. NICE recommends that rehabilitation services for complex psychosis provide opportunities for sharing experiences with peers, include peer support workers in multidisciplinary teams, and ensure community-activity programmes involve peer support."},{"therapySlug":"carer-focused-education-and-support-carer-psychoeducation-in-psychosis","label":"Follow-up option","description":"Best supported for carers of adults with psychosis or schizophrenia. NICE makes this a specific quality standard and states carers should be offered carer-focused education and support programmes."}]},{"slug":"eating-body-image-pathway","name":"Eating/body image pathway","clinicalProblem":"Eating/body image","summary":"Source-grounded workflow assembled from therapies indexed to Eating/body image. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"client-directed-feedback-informed-brief-work","label":"Initial option","description":"Most useful as an adjunct across many therapies rather than a stand-alone primary treatment. High-yield in outpatient psychotherapy, community mental health, brief therapy services, and stepped-care settings where early detection of poor progress or alliance rupture matters."},{"therapySlug":"habit-reversal-training-for-trichotillomania-and-excoriation-disorder","label":"Alternative option","description":"Best used for trichotillomania (hair-pulling disorder) and excoriation disorder (skin-picking disorder) when symptoms cause distress, impairment, visible damage, infection/scarring risk, or major shame/avoidance. Current professional manuals describe CBT focused on HRT as the preferred initial therapy in trichotillomania and the psychotherapy of choice in excoriation disorder."},{"therapySlug":"exposure-and-response-prevention-for-tics-erp-for-tics","label":"Alternative option","description":"Best used for Tourette syndrome and persistent motor or vocal tic disorder when tics are distressing, impairing, painful, socially disruptive, or functionally limiting. European guidance and recent reviews treat ERP as one of the main evidence-based behavioural therapies alongside HRT and CBIT."},{"therapySlug":"cognitive-processing-therapy-cpt","label":"Follow-up option","description":"Strongest use is PTSD. Australian guidelines give a strong recommendation for CPT in adults with PTSD. It is especially useful when maladaptive trauma meanings, guilt, shame, and self-blame are central."},{"therapySlug":"family-psychoeducation-for-psychosis","label":"Follow-up option","description":"Most useful for schizophrenia-spectrum and other psychotic disorders when family members or carers are closely involved and need a clearer illness model, relapse plan, and coping framework. Compared with full family intervention, family psychoeducation is most defensible when the main need is education and coping support, not a broader family-therapy programme."},{"therapySlug":"psychoeducation-for-psychosis","label":"Follow-up option","description":"Broadly useful across first-episode psychosis, established schizophrenia-spectrum illness, relapse prevention, discharge planning, rehabilitation, and self-management work. It is especially high-yield when the person needs a clearer model of symptoms, treatment, relapse risk, and what to do if symptoms worsen."}]},{"slug":"grief-loss-pathway","name":"Grief/loss pathway","clinicalProblem":"Grief/loss","summary":"Source-grounded workflow assembled from therapies indexed to Grief/loss. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"vocational-rehabilitation","label":"Initial option","description":"Best used in rehabilitation for complex psychosis and other severe mental illness when the person’s recovery goals include work, study, or structured occupation. NICE recommends educational and skill-development opportunities, supported employment for those wanting mainstream work, and alternatives such as transitional employment or volunteering for those not ready for paid work."},{"therapySlug":"family-based-treatment-for-adolescent-anorexia-nervosa-ft-an","label":"Alternative option","description":"Best used for children and young people with anorexia nervosa. NICE recommends anorexia-nervosa-focused family therapy (FT-AN) as the main first-line psychological treatment in this group."},{"therapySlug":"guided-self-help-for-binge-eating-disorder","label":"Alternative option","description":"Best used for adults with binge eating disorder as the initial psychological treatment step. NICE makes this a clear first-line recommendation."}]},{"slug":"mood-pathway","name":"Mood pathway","clinicalProblem":"Mood","summary":"Source-grounded workflow assembled from therapies indexed to Mood. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"psychoeducation","label":"Initial option","description":"Broadly useful across most psychiatric disorders. Highest-yield in psychosis, bipolar disorder, depression, anxiety disorders, OCD, eating disorders, and relapse-prevention work. It is especially important early in treatment, after diagnosis clarification, at discharge planning, and after relapse."},{"therapySlug":"brief-supportive-psychotherapy","label":"Alternative option","description":"Best as a pragmatic short-term intervention in inpatient psychiatry, CL psychiatry, ED/crisis recovery, early engagement, post-discharge follow-up, adjustment to diagnosis, medical illness, grief/stress reactions, and bridging while waiting for more specific therapy. RANZCP identifies supportive psychotherapy as one of the forms of psychotherapy practised by psychiatrists, within psychotherapy as a core component of psychiatric treatment."},{"therapySlug":"crisis-intervention-crisis-oriented-brief-therapy","label":"Alternative option","description":"Best for acute crisis presentations where the person needs immediate containment and a short practical intervention. Common settings include ED, crisis team, inpatient admission, CL psychiatry, urgent community review, post-self-harm follow-up, post-discharge vulnerability, and acute psychosocial crisis."},{"therapySlug":"cbt-informed-psychological-intervention-for-self-harm","label":"Follow-up option","description":"Best for adults who self-harm and are receiving continuing support after an episode or repeated episodes. Especially high-yield in ED follow-up, community mental health, post-discharge planning, personality vulnerability, recurrent crisis presentations, mixed depression/anxiety/self-harm presentations, and patients where self-harm is linked to identifiable triggers or problem states."},{"therapySlug":"problem-solving-therapy-pst","label":"Follow-up option","description":"Most useful for less severe depression, stress-linked depression, adjustment-related difficulty, executive overload, and patients whose distress is closely tied to unresolved current-life problems. It is especially high-yield when the person needs structure more than deep cognitive restructuring."},{"therapySlug":"relapse-prevention-psychotherapy","label":"Follow-up option","description":"Strongest guideline-backed use is recurrent depression, especially after remission or partial remission in people at higher relapse risk. It is most clearly used either by continuing the same psychological therapy adapted for relapse prevention or by using group CBT or mindfulness-based cognitive therapy for relapse prevention."}]},{"slug":"neurodevelopmental-pathway","name":"Neurodevelopmental pathway","clinicalProblem":"Neurodevelopmental","summary":"Source-grounded workflow assembled from therapies indexed to Neurodevelopmental. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"client-directed-feedback-informed-brief-work","label":"Initial option","description":"Most useful as an adjunct across many therapies rather than a stand-alone primary treatment. High-yield in outpatient psychotherapy, community mental health, brief therapy services, and stepped-care settings where early detection of poor progress or alliance rupture matters."},{"therapySlug":"graded-exposure","label":"Alternative option","description":"Most useful for phobic avoidance, panic disorder with avoidance, social anxiety disorder, and broader anxiety presentations where the main perpetuating factor is avoidance of feared situations rather than compulsions or trauma re-experiencing. NICE social-anxiety guidance specifically supports exposure to feared or avoided social situations within individual CBT."},{"therapySlug":"illness-management-and-recovery-style-interventions-imr-style-interventions","label":"Alternative option","description":"Most useful in severe mental illness, especially schizophrenia-spectrum disorders and other long-term psychotic illnesses, when the clinical task is ongoing recovery and self-management rather than acute symptom containment alone. It fits best in rehabilitation and continuing community care."},{"therapySlug":"recovery-oriented-psychosocial-interventions","label":"Follow-up option","description":"Best supported in rehabilitation for adults with complex psychosis. NICE recommends recovery-orientated rehabilitation services that help people choose and work towards personal goals, find meaningful occupations, build support networks, gain skills to manage everyday activities and mental health, share experiences with peers, and develop confidence through positive risk-taking."},{"therapySlug":"eating-disorder-focused-cognitive-behavioural-therapy-cbt-ed-cbt-e","label":"Follow-up option","description":"Strongest current guideline-backed use is in adults with bulimia nervosa, adults with binge eating disorder, and as one of the main options for adults with anorexia nervosa."},{"therapySlug":"adolescent-focused-psychotherapy-for-anorexia-nervosa","label":"Follow-up option","description":"Best for children and young people with anorexia nervosa when FT-AN is unacceptable, contraindicated, or ineffective. NICE places AFP-AN after FT-AN, alongside individual CBT-ED, rather than as the usual first-line youth anorexia psychotherapy."}]},{"slug":"pain-somatic-pathway","name":"Pain/somatic pathway","clinicalProblem":"Pain/somatic","summary":"Source-grounded workflow assembled from therapies indexed to Pain/somatic. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"exposure-and-response-prevention-for-tics-erp-for-tics","label":"Initial option","description":"Best used for Tourette syndrome and persistent motor or vocal tic disorder when tics are distressing, impairing, painful, socially disruptive, or functionally limiting. European guidance and recent reviews treat ERP as one of the main evidence-based behavioural therapies alongside HRT and CBIT."}]},{"slug":"personality-interpersonal-pathway","name":"Personality/interpersonal pathway","clinicalProblem":"Personality/interpersonal","summary":"Source-grounded workflow assembled from therapies indexed to Personality/interpersonal. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"supportive-psychotherapy","label":"Initial option","description":"High-yield in ED, inpatient psychiatry, consultation-liaison psychiatry, older-adult psychiatry, severe comorbidity, adjustment reactions, and bridging phases before or between more specific therapies. Also useful when a patient is too unwell, overwhelmed, ambivalent, or cognitively overloaded for a manualised therapy."},{"therapySlug":"interpersonal-and-social-rhythm-therapy-ipsrt","label":"Alternative option","description":"Best used as an adjunctive psychotherapy for bipolar disorder, especially in patients whose episodes are clearly linked to sleep/routine disruption or interpersonal stress. NICE does not name IPSRT specifically, but recommends a structured psychological intervention designed for bipolar disorder with an evidence-based manual for relapse prevention or persisting symptoms; IPSRT fits that definition."},{"therapySlug":"phase-oriented-trauma-therapy","label":"Alternative option","description":"Most defensible for complex trauma / complex PTSD-type presentations where there is marked instability, chronic interpersonal trauma history, and major deficits in regulation or safety. This is a common clinical model and is supported as an evidence-informed way of working, but it does not have the same direct first-line guideline status as adult PTSD treatments such as TF-CBT, CT, CPT, PE, or EMDR."},{"therapySlug":"trauma-informed-skills-work","label":"Follow-up option","description":"Most useful when trauma exposure has left the patient with major emotion-regulation or interpersonal difficulties, especially in complex trauma presentations. It is also useful as a bridge into more definitive trauma-focused treatment or as an adjunct alongside broader care."},{"therapySlug":"seeking-safety","label":"Follow-up option","description":"Best viewed as a stabilisation-oriented integrated treatment when the patient needs a present-focused approach, is not ready for trauma processing, or when a service cannot yet deliver trauma-focused integrated treatment. It is also widely implemented and generally acceptable to patients and clinicians."},{"therapySlug":"social-cognition-training","label":"Follow-up option","description":"Best used as a selective rehabilitation adjunct in psychosis or schizophrenia when social-cognitive deficits are clearly contributing to poor relationships, poor community functioning, or difficulty using rehabilitation opportunities. It does not currently have the same mainstream first-line guideline status as CBTp or family intervention."}]},{"slug":"psychosis-pathway","name":"Psychosis pathway","clinicalProblem":"Psychosis","summary":"Source-grounded workflow assembled from therapies indexed to Psychosis. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"supportive-psychotherapy","label":"Initial option","description":"High-yield in ED, inpatient psychiatry, consultation-liaison psychiatry, older-adult psychiatry, severe comorbidity, adjustment reactions, and bridging phases before or between more specific therapies. Also useful when a patient is too unwell, overwhelmed, ambivalent, or cognitively overloaded for a manualised therapy."},{"therapySlug":"motivational-interviewing","label":"Alternative option","description":"Highest-yield in substance use disorders, harmful use, medication ambivalence, health-behaviour change, early engagement, and situations where the patient is not yet ready for direct action treatment. Also useful as a bridge into broader psychiatric care."},{"therapySlug":"motivational-enhancement-therapy-met","label":"Alternative option","description":"Highest-yield for substance use disorders, harmful alcohol or drug use, treatment engagement problems, and early behaviour-change work when ambivalence is the main barrier. It is strongest when the patient is not yet fully ready for more action-focused treatment."},{"therapySlug":"problem-solving-therapy-pst","label":"Follow-up option","description":"Most useful for less severe depression, stress-linked depression, adjustment-related difficulty, executive overload, and patients whose distress is closely tied to unresolved current-life problems. It is especially high-yield when the person needs structure more than deep cognitive restructuring."},{"therapySlug":"relapse-prevention-psychotherapy","label":"Follow-up option","description":"Strongest guideline-backed use is recurrent depression, especially after remission or partial remission in people at higher relapse risk. It is most clearly used either by continuing the same psychological therapy adapted for relapse prevention or by using group CBT or mindfulness-based cognitive therapy for relapse prevention."},{"therapySlug":"self-management-interventions","label":"Follow-up option","description":"Strongest formal guideline support is in psychosis and schizophrenia, where NICE recommends considering a manualised self-management programme as part of treatment and management. Self-management principles are also highly relevant in mood disorders, chronic severe mental illness, rehabilitation, and relapse-prevention work, but the most explicit guideline-backed programme language is in psychosis."}]},{"slug":"sleep-pathway","name":"Sleep pathway","clinicalProblem":"Sleep","summary":"Source-grounded workflow assembled from therapies indexed to Sleep. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"cognitive-behavioural-therapy-for-bipolar-depression-bipolar-relapse-prevention","label":"Initial option","description":"Best used as an adjunctive psychotherapy in bipolar disorder, especially for bipolar depression, residual symptoms, and relapse prevention in people who are not acutely manic. NICE specifically names CBT among therapies that can be offered for bipolar depression, and systematic reviews show CBT has beneficial effects, though not unequivocal superiority over other specialist psychotherapies."},{"therapySlug":"family-focused-psychoeducation-for-bipolar-disorder","label":"Alternative option","description":"Best used for relapse prevention in bipolar disorder, especially when relatives/carers are closely involved in day-to-day life or episode detection. Systematic reviews report that family psychoeducation is associated with reductions in illness recurrence and hospitalisation, while NICE places family intervention and bipolar-specific structured psychological intervention in longer-term management."},{"therapySlug":"behavioural-parent-training","label":"Alternative option","description":"Best for oppositional defiant disorder, conduct disorder, disruptive behaviour, and children at high risk of conduct disorder. NICE states that parents or carers of children aged 3–11 years with conduct disorder should be offered referral for evidence-based group or individual parent/carer training programmes. (NICE)"},{"therapySlug":"social-communication-parent-mediated-autism-interventions","label":"Follow-up option","description":"Best supported for children and young people with autism, especially preschool children where NICE says to consider parent, carer or teacher mediation, and for school-aged children where NICE says to consider peer mediation. This is the most direct current mainstream guideline recommendation for treating the core features of autism in children."},{"therapySlug":"group-psychoeducation-for-bipolar-disorder","label":"Follow-up option","description":"Best used for maintenance / relapse prevention in bipolar disorder, especially when the patient is not in an acute episode and can engage in a structured group format."},{"therapySlug":"group-relapse-prevention-programmes","label":"Follow-up option","description":"Strongest guideline support is for adults with depression at higher risk of relapse, where NICE recommends relapse-prevention interventions including group CBT or MBCT. Similar programme logic is also used in bipolar disorder and addiction care, but evidence and programme standardisation are more diagnosis-specific and uneven. (NICE)"}]},{"slug":"substance-use-pathway","name":"Substance use pathway","clinicalProblem":"Substance use","summary":"Source-grounded workflow assembled from therapies indexed to Substance use. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"motivational-interviewing","label":"Initial option","description":"Highest-yield in substance use disorders, harmful use, medication ambivalence, health-behaviour change, early engagement, and situations where the patient is not yet ready for direct action treatment. Also useful as a bridge into broader psychiatric care."},{"therapySlug":"motivational-enhancement-therapy-met","label":"Alternative option","description":"Highest-yield for substance use disorders, harmful alcohol or drug use, treatment engagement problems, and early behaviour-change work when ambivalence is the main barrier. It is strongest when the patient is not yet fully ready for more action-focused treatment."},{"therapySlug":"interoceptive-exposure","label":"Alternative option","description":"Strongest use is panic disorder, with or without agoraphobic avoidance, especially when the patient fears bodily sensations such as dizziness, tachycardia, breathlessness, chest tightness, depersonalisation, or feeling faint. It can also be helpful when panic-spectrum anxiety is heavily driven by internal sensation monitoring rather than only by external situations."},{"therapySlug":"integrated-cbt-for-ptsd-and-substance-use-disorders","label":"Follow-up option","description":"Best used for co-occurring PTSD and SUD when the patient is stable enough for structured treatment and is willing to address trauma directly. VA/DoD-linked guidance states that patients with PTSD and SUD can tolerate and benefit from evidence-based trauma-focused PTSD treatment, and that having one disorder should not block evidence-based treatment for the other."},{"therapySlug":"family-intervention-for-psychosis","label":"Follow-up option","description":"Best supported for adults with psychosis or schizophrenia who live with or are in close contact with family members or carers. NICE quality standards state that family members of adults with psychosis or schizophrenia should be offered family intervention because it improves coping skills and relapse rates."},{"therapySlug":"cognitive-remediation-therapy-crt","label":"Follow-up option","description":"Best supported in rehabilitation for adults with complex psychosis, particularly when cognitive impairment is contributing to poor everyday function, educational difficulty, or problems engaging in vocational recovery. NICE specifically recommends considering cognitive remediation alongside vocational rehabilitation services."}]},{"slug":"trauma-pathway","name":"Trauma pathway","clinicalProblem":"Trauma","summary":"Source-grounded workflow assembled from therapies indexed to Trauma. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"psychoeducation","label":"Initial option","description":"Broadly useful across most psychiatric disorders. Highest-yield in psychosis, bipolar disorder, depression, anxiety disorders, OCD, eating disorders, and relapse-prevention work. It is especially important early in treatment, after diagnosis clarification, at discharge planning, and after relapse."},{"therapySlug":"supportive-psychotherapy","label":"Alternative option","description":"High-yield in ED, inpatient psychiatry, consultation-liaison psychiatry, older-adult psychiatry, severe comorbidity, adjustment reactions, and bridging phases before or between more specific therapies. Also useful when a patient is too unwell, overwhelmed, ambivalent, or cognitively overloaded for a manualised therapy."},{"therapySlug":"brief-supportive-psychotherapy","label":"Alternative option","description":"Best as a pragmatic short-term intervention in inpatient psychiatry, CL psychiatry, ED/crisis recovery, early engagement, post-discharge follow-up, adjustment to diagnosis, medical illness, grief/stress reactions, and bridging while waiting for more specific therapy. RANZCP identifies supportive psychotherapy as one of the forms of psychotherapy practised by psychiatrists, within psychotherapy as a core component of psychiatric treatment."},{"therapySlug":"crisis-intervention-crisis-oriented-brief-therapy","label":"Follow-up option","description":"Best for acute crisis presentations where the person needs immediate containment and a short practical intervention. Common settings include ED, crisis team, inpatient admission, CL psychiatry, urgent community review, post-self-harm follow-up, post-discharge vulnerability, and acute psychosocial crisis."},{"therapySlug":"cbt-informed-psychological-intervention-for-self-harm","label":"Follow-up option","description":"Best for adults who self-harm and are receiving continuing support after an episode or repeated episodes. Especially high-yield in ED follow-up, community mental health, post-discharge planning, personality vulnerability, recurrent crisis presentations, mixed depression/anxiety/self-harm presentations, and patients where self-harm is linked to identifiable triggers or problem states."},{"therapySlug":"motivational-interviewing","label":"Follow-up option","description":"Highest-yield in substance use disorders, harmful use, medication ambivalence, health-behaviour change, early engagement, and situations where the patient is not yet ready for direct action treatment. Also useful as a bridge into broader psychiatric care."}]}]
\ No newline at end of file
+[{"slug":"anxiety-pathway","name":"Anxiety pathway","clinicalProblem":"Anxiety","summary":"Source-grounded workflow assembled from therapies indexed to Anxiety. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"cognitive-behavioural-therapy-cbt","label":"Initial option","description":"Strongest broad evidence-backed uses are depression and anxiety disorders. It is also a major umbrella treatment family for disorder-specific variants such as panic-focused CBT, social-anxiety CBT, CBT for insomnia, trauma-focused CBT, CBT for psychosis, and CBT-based interventions in substance use, eating disorders, and severe mental illness."},{"therapySlug":"graded-exposure","label":"Alternative option","description":"Most useful for phobic avoidance, panic disorder with avoidance, social anxiety disorder, and broader anxiety presentations where the main perpetuating factor is avoidance of feared situations rather than compulsions or trauma re-experiencing. NICE social-anxiety guidance specifically supports exposure to feared or avoided social situations within individual CBT."},{"therapySlug":"applied-relaxation-relaxation-based-therapy","label":"Alternative option","description":"Strongest formal guideline support is for generalised anxiety disorder, where NICE includes applied relaxation as a high-intensity psychological treatment option alongside CBT. It can also be a useful adjunct in broader anxiety care when body tension and rapid arousal are prominent."},{"therapySlug":"worry-focused-cbt","label":"Follow-up option","description":"Best for GAD or transdiagnostic presentations where worry is the dominant maintaining process rather than panic attacks, compulsions, trauma re-experiencing, or social evaluative fear. NICE recommends high-intensity CBT or applied relaxation for GAD when low-intensity options are insufficient or impairment is marked. (NICE)"},{"therapySlug":"panic-focused-cbt","label":"Follow-up option","description":"Best for panic disorder with or without agoraphobia, especially when recurrent panic attacks, bodily-sensation fear, anticipatory anxiety, and avoidance are central. NICE recommends low-intensity self-help for mild to moderate panic disorder and CBT for moderate to severe panic disorder. (NICE)"},{"therapySlug":"social-anxiety-focused-cbt","label":"Follow-up option","description":"Best for social anxiety disorder in adults, and developmentally adapted CBT for children and young people. NICE recommends individual CBT specifically developed for social anxiety disorder as the first intervention for adults, using Clark and Wells or Heimberg models. (NICE)"}]},{"slug":"crisis-risk-pathway","name":"Crisis/risk pathway","clinicalProblem":"Crisis/risk","summary":"Source-grounded workflow assembled from therapies indexed to Crisis/risk. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"crisis-intervention-crisis-oriented-brief-therapy","label":"Initial option","description":"Best for acute crisis presentations where the person needs immediate containment and a short practical intervention. Common settings include ED, crisis team, inpatient admission, CL psychiatry, urgent community review, post-self-harm follow-up, post-discharge vulnerability, and acute psychosocial crisis."},{"therapySlug":"cbt-informed-psychological-intervention-for-self-harm","label":"Alternative option","description":"Best for adults who self-harm and are receiving continuing support after an episode or repeated episodes. Especially high-yield in ED follow-up, community mental health, post-discharge planning, personality vulnerability, recurrent crisis presentations, mixed depression/anxiety/self-harm presentations, and patients where self-harm is linked to identifiable triggers or problem states."},{"therapySlug":"problem-solving-therapy-pst","label":"Alternative option","description":"Most useful for less severe depression, stress-linked depression, adjustment-related difficulty, executive overload, and patients whose distress is closely tied to unresolved current-life problems. It is especially high-yield when the person needs structure more than deep cognitive restructuring."},{"therapySlug":"dialectical-behaviour-therapy-dbt","label":"Follow-up option","description":"Best supported for borderline personality disorder / borderline personality symptoms, especially when recurrent self-harm is a major treatment priority. In current NICE guidance, for women with borderline personality disorder in whom reducing recurrent self-harm is a priority, clinicians should consider a comprehensive DBT programme. In broader contemporary practice, DBT is widely used across genders for comparable borderline-pathology and dysregulation presentations."},{"therapySlug":"coping-skills-interventions","label":"Follow-up option","description":"Best used as a low-intensity or adjunctive intervention for common mental health problems, subthreshold or mixed distress states, adjustment-related difficulty, stress-related functional decline, and as a bridge while waiting for or building toward more specific treatment. Particularly useful where the main task is teaching practical skills rather than deep formulation or disorder-specific exposure or processing work."},{"therapySlug":"brief-supportive-psychotherapy","label":"Follow-up option","description":"Best as a pragmatic short-term intervention in inpatient psychiatry, CL psychiatry, ED/crisis recovery, early engagement, post-discharge follow-up, adjustment to diagnosis, medical illness, grief/stress reactions, and bridging while waiting for more specific therapy. RANZCP identifies supportive psychotherapy as one of the forms of psychotherapy practised by psychiatrists, within psychotherapy as a core component of psychiatric treatment."}]},{"slug":"eating-body-image-pathway","name":"Eating/body image pathway","clinicalProblem":"Eating/body image","summary":"Source-grounded workflow assembled from therapies indexed to Eating/body image. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"eating-disorder-focused-cognitive-behavioural-therapy-cbt-ed-cbt-e","label":"Initial option","description":"Strongest current guideline-backed use is in adults with bulimia nervosa, adults with binge eating disorder, and as one of the main options for adults with anorexia nervosa. NICE recommends individual CBT-ED for adults with bulimia nervosa when guided self-help is unacceptable, contraindicated, or ineffective after 4 weeks; group CBT-ED as the main treatment for adults with binge eating disorder, with individual CBT-ED if group CBT-ED is unavailable or declined; and individual CBT-ED as one of the treatment options for adults with anorexia nervosa alongside MANTRA and SSCM."},{"therapySlug":"family-based-treatment-for-adolescent-anorexia-nervosa-ft-an","label":"Alternative option","description":"Best used for children and young people with anorexia nervosa. NICE recommends anorexia-nervosa-focused family therapy (FT-AN) as the main first-line psychological treatment in this group."},{"therapySlug":"guided-self-help-for-binge-eating-disorder","label":"Alternative option","description":"Best used for adults with binge eating disorder as the initial psychological treatment step. NICE makes this a clear first-line recommendation."},{"therapySlug":"maudsley-anorexia-nervosa-treatment-for-adults-mantra","label":"Follow-up option","description":"Best supported for adults with anorexia nervosa. NICE recommends offering adults with anorexia one of CBT-ED, MANTRA, or SSCM, and explaining the options so the person can help choose their preferred treatment."},{"therapySlug":"specialist-supportive-clinical-management-sscm","label":"Follow-up option","description":"Best supported for adults with anorexia nervosa. NICE recommends offering adults one of CBT-ED, MANTRA, or SSCM and helping them choose by explaining what each involves."},{"therapySlug":"guided-self-help-for-bulimia-nervosa","label":"Follow-up option","description":"Best used for adults with bulimia nervosa as the first psychological treatment step to consider. NICE says to consider bulimia-nervosa-focused guided self-help for adults with bulimia nervosa."}]},{"slug":"grief-loss-pathway","name":"Grief/loss pathway","clinicalProblem":"Grief/loss","summary":"Source-grounded workflow assembled from therapies indexed to Grief/loss. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"interpersonal-psychotherapy-ipt","label":"Initial option","description":"Strongest routine use is depression, especially when symptoms are closely linked to bereavement, changing roles, interpersonal conflict, or isolation. NICE includes IPT as a treatment option for both less severe and more severe depression."},{"therapySlug":"meaning-centred-psychotherapy","label":"Alternative option","description":"Best-supported use is advanced cancer, serious illness, and palliative care, where RCTs and reviews suggest benefit for meaning, spiritual well-being, and existential distress. It is not a broadly guideline-dominant first-line psychotherapy across general psychiatric syndromes. (PubMed)"},{"therapySlug":"brief-supportive-psychotherapy","label":"Alternative option","description":"Best as a pragmatic short-term intervention in inpatient psychiatry, CL psychiatry, ED/crisis recovery, early engagement, post-discharge follow-up, adjustment to diagnosis, medical illness, grief/stress reactions, and bridging while waiting for more specific therapy. RANZCP identifies supportive psychotherapy as one of the forms of psychotherapy practised by psychiatrists, within psychotherapy as a core component of psychiatric treatment."},{"therapySlug":"life-review-therapy-reminiscence-therapy","label":"Follow-up option","description":"Best for older adults with depression/loneliness, dementia-care settings, aged care, palliative/CL psychiatry, and patients needing meaning, identity, continuity or life-story work. Reminiscence therapy has specific evidence in dementia, but effects vary by format and setting."},{"therapySlug":"dignity-therapy","label":"Follow-up option","description":"Best in palliative care, psycho-oncology, advanced illness, neurodegenerative disease, and CL psychiatry where existential distress, dignity, meaning, and legacy are central."},{"therapySlug":"emotion-focused-therapy","label":"Follow-up option","description":"Best for emotionally driven distress where maladaptive emotion processing is central, and especially for couple distress in the couples form. Meta-analyses support emotionally focused couples therapy for reducing couple distress and improving relationship satisfaction, with some maintenance of gains at follow-up. The broader individual EFT evidence base is more supportive than definitive, and much less guideline-prominent in psychiatry than CBT-family therapies. (PubMed)"}]},{"slug":"mood-pathway","name":"Mood pathway","clinicalProblem":"Mood","summary":"Source-grounded workflow assembled from therapies indexed to Mood. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"cognitive-behavioural-therapy-cbt","label":"Initial option","description":"Strongest broad evidence-backed uses are depression and anxiety disorders. It is also a major umbrella treatment family for disorder-specific variants such as panic-focused CBT, social-anxiety CBT, CBT for insomnia, trauma-focused CBT, CBT for psychosis, and CBT-based interventions in substance use, eating disorders, and severe mental illness."},{"therapySlug":"behavioural-activation-ba","label":"Alternative option","description":"Strongly indicated for depression, especially when inactivity, withdrawal, reduced routine, and loss of reinforcement are prominent. It may be particularly useful for patients who struggle with more cognitively demanding therapy models or who need a simpler, action-focused treatment."},{"therapySlug":"interpersonal-psychotherapy-ipt","label":"Alternative option","description":"Strongest routine use is depression, especially when symptoms are closely linked to bereavement, changing roles, interpersonal conflict, or isolation. NICE includes IPT as a treatment option for both less severe and more severe depression."},{"therapySlug":"problem-solving-therapy-pst","label":"Follow-up option","description":"Most useful for less severe depression, stress-linked depression, adjustment-related difficulty, executive overload, and patients whose distress is closely tied to unresolved current-life problems. It is especially high-yield when the person needs structure more than deep cognitive restructuring."},{"therapySlug":"mindfulness-based-cognitive-therapy-mbct","label":"Follow-up option","description":"Strongest guideline-backed use is relapse prevention in recurrent depression. NICE recommends group CBT or MBCT for people at higher risk of relapse, and also lists a mindfulness-based cognitive therapy programme specifically designed for depression as a treatment option in less severe depression."},{"therapySlug":"short-term-psychodynamic-psychotherapy-for-depression-stpp","label":"Follow-up option","description":"Best used for adult depression when relational-emotional patterns and developmental difficulties in close relationships are central. NICE includes STPP in first-line treatment options for adult depression, and the 2023 meta-analysis found STPP superior to no intervention and to usual unstructured treatments for depressive disorders."}]},{"slug":"neurodevelopmental-pathway","name":"Neurodevelopmental pathway","clinicalProblem":"Neurodevelopmental","summary":"Source-grounded workflow assembled from therapies indexed to Neurodevelopmental. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"behavioural-parent-training","label":"Initial option","description":"Best for oppositional defiant disorder, conduct disorder, disruptive behaviour, and children at high risk of conduct disorder. NICE states that parents or carers of children aged 3–11 years with conduct disorder should be offered referral for evidence-based group or individual parent/carer training programmes. (NICE)"},{"therapySlug":"parent-management-training-pmt","label":"Alternative option","description":"Best supported for children with clinical levels of disruptive behaviour, especially oppositional and conduct-type presentations in younger children. It overlaps heavily with NICE’s recommended parent training programmes because those are also built on a social learning model."},{"therapySlug":"social-communication-parent-mediated-autism-interventions","label":"Alternative option","description":"Best supported for children and young people with autism, especially preschool children where NICE says to consider parent, carer or teacher mediation, and for school-aged children where NICE says to consider peer mediation. This is the most direct current mainstream guideline recommendation for treating the core features of autism in children."},{"therapySlug":"developmental-social-skills-interventions","label":"Follow-up option","description":"Best for autistic children/young people and other developmental presentations where social communication is a clear functional target. In autism, NICE specifically supports social-communication interventions adjusted to developmental level and involving parents, carers, teachers, or peers. For adults, NICE supports group-based or individually delivered social learning programmes where social interaction problems are identified. (NICE)"},{"therapySlug":"neurodevelopmentally-adapted-psychosocial-interventions","label":"Follow-up option","description":"Best whenever a standard psychosocial therapy is clinically indicated but the person’s neurodevelopmental profile makes usual delivery ineffective or inaccessible. Core examples include adapted CBT for anxiety/depression, adapted ERP for OCD, adapted DBT skills, behavioural parent work, social-communication interventions, structured life-skills programmes, and functional behaviour support. NICE specifically recommends social-communication interventions for autistic children and young people and social learning or structured life-skills programmes for autistic adults where indicated. (NICE)"},{"therapySlug":"parent-child-interaction-therapy-pcit","label":"Follow-up option","description":"Best supported for young children with clinically significant disruptive behaviour problems. Meta-analysis found PCIT outperformed waitlist for parent-rated disruptive behaviour, with larger effects than PMT in the included comparisons, and a recent systematic review concluded PCIT reduces disruptive behaviours and improves parent–child relationships across diverse settings."}]},{"slug":"pain-somatic-pathway","name":"Pain/somatic pathway","clinicalProblem":"Pain/somatic","summary":"Source-grounded workflow assembled from therapies indexed to Pain/somatic. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"acceptance-and-commitment-therapy-act","label":"Initial option","description":"Most defensible routine psychiatric uses are depression, anxiety-spectrum distress, and broader transdiagnostic emotional disorders when avoidance and fusion are prominent. It also has a formal NICE recommendation for chronic primary pain. In Australian psychiatry, it is best understood as an accepted structured psychotherapy, but not one with as broad a first-line guideline footprint across disorders as standard CBT."},{"therapySlug":"cognitive-behavioural-therapy-cbt","label":"Alternative option","description":"Strongest broad evidence-backed uses are depression and anxiety disorders. It is also a major umbrella treatment family for disorder-specific variants such as panic-focused CBT, social-anxiety CBT, CBT for insomnia, trauma-focused CBT, CBT for psychosis, and CBT-based interventions in substance use, eating disorders, and severe mental illness."},{"therapySlug":"health-anxiety-focused-cbt","label":"Alternative option","description":"Best for persistent health anxiety where adequate medical assessment has not found an explanatory serious disease and the main maintaining mechanism is anxiety-driven misinterpretation and reassurance-seeking. A meta-analysis of 13 RCTs found CBT outperformed control conditions for hypochondriasis/health anxiety at post-treatment and follow-up. (PubMed)"},{"therapySlug":"mindfulness-based-stress-reduction","label":"Follow-up option","description":"Best as a structured mindfulness intervention for stress, depressive symptoms, and broader distress where mindfulness practice is acceptable and safe. Recent meta-analyses suggest benefit for depressive symptoms across mental disorders and for depression/PTSD in veteran samples, but MBSR is not generally a first-line substitute for more specific psychiatric psychotherapies such as ERP, TF-CBT, or comprehensive DBT. (PubMed)"},{"therapySlug":"applied-relaxation-relaxation-based-therapy","label":"Follow-up option","description":"Strongest formal guideline support is for generalised anxiety disorder, where NICE includes applied relaxation as a high-intensity psychological treatment option alongside CBT. It can also be a useful adjunct in broader anxiety care when body tension and rapid arousal are prominent."},{"therapySlug":"mindfulness-based-cognitive-therapy-mbct","label":"Follow-up option","description":"Strongest guideline-backed use is relapse prevention in recurrent depression. NICE recommends group CBT or MBCT for people at higher risk of relapse, and also lists a mindfulness-based cognitive therapy programme specifically designed for depression as a treatment option in less severe depression."}]},{"slug":"personality-interpersonal-pathway","name":"Personality/interpersonal pathway","clinicalProblem":"Personality/interpersonal","summary":"Source-grounded workflow assembled from therapies indexed to Personality/interpersonal. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"dialectical-behaviour-therapy-dbt","label":"Initial option","description":"Best supported for borderline personality disorder / borderline personality symptoms, especially when recurrent self-harm is a major treatment priority. In current NICE guidance, for women with borderline personality disorder in whom reducing recurrent self-harm is a priority, clinicians should consider a comprehensive DBT programme. In broader contemporary practice, DBT is widely used across genders for comparable borderline-pathology and dysregulation presentations."},{"therapySlug":"mentalisation-based-therapy-mbt","label":"Alternative option","description":"Best supported for borderline personality disorder and related severe personality dysfunction where attachment stress and relational misinterpretation are central. Unlike DBT, MBT is not specifically singled out in NICE BPD recommendations, but it is a recognised structured psychotherapy and has supportive trial and review evidence."},{"therapySlug":"schema-therapy","label":"Alternative option","description":"Strongest and clearest use is personality disorder, especially borderline personality disorder (BPD) and other chronic personality pathology. Current evidence suggests schema therapy is an effective specialist treatment for BPD, but NICE BPD guidance does not single it out by name in the way it mentions DBT for recurrent self-harm."},{"therapySlug":"structured-clinical-management","label":"Follow-up option","description":"Best for BPD/personality disorder in public-sector or general mental health settings where a structured, consistent, manualised clinical model is needed and specialist therapies may not be available. SCM has been used as a comparator in trials against MBT, with one trial describing it as protocol-driven best current clinical practice delivered by non-specialist practitioners in a publicly funded service. (SpringerLink)"},{"therapySlug":"good-psychiatric-management","label":"Follow-up option","description":"Best for borderline personality disorder or clinically significant borderline traits, especially in general psychiatric, community, outpatient, ED follow-up, CL, and public-sector settings where full DBT, MBT, schema therapy, or TFP is unavailable or not required. Recent literature describes GPM as “good enough,” easier to implement, principle-based, and adaptable for stepped care. (PubMed)"},{"therapySlug":"transference-focused-psychotherapy-tfp","label":"Follow-up option","description":"Best supported for borderline personality disorder and closely related severe personality organisation. It is a specialist treatment option with supportive evidence from trials and reviews, but it is not specifically privileged by NICE in the way that DBT is mentioned for recurrent self-harm in women with BPD."}]},{"slug":"psychosis-pathway","name":"Psychosis pathway","clinicalProblem":"Psychosis","summary":"Source-grounded workflow assembled from therapies indexed to Psychosis. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"cognitive-behavioural-therapy-for-psychosis-cbtp","label":"Initial option","description":"Best supported for psychosis and schizophrenia, including people at increased risk of psychosis, first and subsequent acute episodes, and the recovery phase when positive or negative symptoms continue to affect distress or function. It is particularly useful when the clinical goal is to reduce distress and improve functioning rather than to “argue away” psychotic experiences."},{"therapySlug":"family-intervention-for-psychosis","label":"Alternative option","description":"Best supported for adults with psychosis or schizophrenia who live with or are in close contact with family members or carers. NICE quality standards state that family members of adults with psychosis or schizophrenia should be offered family intervention because it improves coping skills and relapse rates."},{"therapySlug":"psychoeducation-for-psychosis","label":"Alternative option","description":"Broadly useful across first-episode psychosis, established schizophrenia-spectrum illness, relapse prevention, discharge planning, rehabilitation, and self-management work. It is especially high-yield when the person needs a clearer model of symptoms, treatment, relapse risk, and what to do if symptoms worsen."},{"therapySlug":"cognitive-remediation-therapy-crt","label":"Follow-up option","description":"Best supported in rehabilitation for adults with complex psychosis, particularly when cognitive impairment is contributing to poor everyday function, educational difficulty, or problems engaging in vocational recovery. NICE specifically recommends considering cognitive remediation alongside vocational rehabilitation services."},{"therapySlug":"illness-management-and-recovery-style-interventions-imr-style-interventions","label":"Follow-up option","description":"Most useful in severe mental illness, especially schizophrenia-spectrum disorders and other long-term psychotic illnesses, when the clinical task is ongoing recovery and self-management rather than acute symptom containment alone. It fits best in rehabilitation and continuing community care."},{"therapySlug":"supported-employment-individual-placement-and-support-ips","label":"Follow-up option","description":"Best supported for psychosis / schizophrenia and complex psychosis rehabilitation when the person wants mainstream employment. NICE says that for people who want to work towards mainstream employment, clinicians should consider referral to supported employment using the IPS approach."}]},{"slug":"sleep-pathway","name":"Sleep pathway","clinicalProblem":"Sleep","summary":"Source-grounded workflow assembled from therapies indexed to Sleep. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"cognitive-behavioural-therapy-for-insomnia-cbt-i","label":"Initial option","description":"Best used for chronic insomnia disorder in adults of any age, including people with comorbid conditions. Current European and AASM guidance place CBT-I as first-line treatment, and Australian Sleep Health Foundation material states CBT-I is the recommended best first treatment in Australian practice."},{"therapySlug":"sleep-compression-therapy-for-insomnia","label":"Alternative option","description":"Best used for chronic insomnia disorder when the clinician wants the core logic of sleep restriction but in a more tolerable, gradual format. Current high-quality evidence suggests it may be a practical alternative when standard sleep restriction feels too harsh or is poorly tolerated."},{"therapySlug":"mindfulness-based-therapy-for-insomnia-mbti","label":"Alternative option","description":"Best viewed as an evidence-supported option for chronic insomnia, especially when arousal, worry, and reactive struggle with sleep are prominent. Current insomnia guidelines still place full CBT-I first-line, so MBTI should not be described as guideline-superior to CBT-I."},{"therapySlug":"imagery-rehearsal-therapy-irt-for-nightmare-disorder","label":"Follow-up option","description":"Best used for nightmare disorder in adults and for persistent distressing nightmares in broader psychiatric populations. The 2018 AASM position paper states IRT is the only treatment strategy recommended for all patients with nightmare disorder."},{"therapySlug":"bright-light-therapy","label":"Follow-up option","description":"Best as an adjunctive treatment for depressive disorders when a low-burden somatic option is attractive, especially where circadian disruption or preference for non-drug augmentation is relevant. The 2024 JAMA Psychiatry meta-analysis found significantly better remission and response rates with BLT in nonseasonal depressive disorders, but this is not the same as saying BLT should replace established first-line psychotherapy or pharmacotherapy. (JAMA Network)"},{"therapySlug":"circadian-rhythm-based-interventions","label":"Follow-up option","description":"Best-supported psychiatric uses are 2 main groups. First, bipolar disorder, where IPSRT has evidence as an adjunctive acute and prophylactic intervention addressing rhythm dysregulation. Second, depression, where circadian realignment and chronotherapeutic approaches, including wake-therapy-type interventions, show antidepressant potential, though the depression evidence is more heterogeneous and implementation-sensitive than for major established psychotherapies. (PubMed)"}]},{"slug":"substance-use-pathway","name":"Substance use pathway","clinicalProblem":"Substance use","summary":"Source-grounded workflow assembled from therapies indexed to Substance use. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"motivational-interviewing-mi-for-substance-use-disorders","label":"Initial option","description":"Best used at engagement, assessment, early treatment, and whenever motivation is unstable. It is especially useful for alcohol misuse, broader substance use disorders, and patients who are reluctant, unsure, or inconsistent in change efforts. NICE alcohol guidance makes motivational intervention universal at intake, and SAMHSA TIP 35 positions MI as a core SUD treatment approach for enhancing participation and retention."},{"therapySlug":"relapse-prevention-therapy-for-substance-use-disorders","label":"Alternative option","description":"Best used after initial motivation has improved and the patient is actively trying to reduce, stop, or maintain abstinence, especially in alcohol use disorder and broader substance use disorders. NICE alcohol guidance recommends offering community-based interventions to promote abstinence or moderate drinking and prevent relapse, and recommends CBT/behavioural therapies focused on alcohol-related problems."},{"therapySlug":"contingency-management-cm","label":"Alternative option","description":"Best used for stimulant use disorder, for illicit drug use in methadone maintenance, and for engagement / abstinence targets in drug services. NICE explicitly recommends introducing CM to reduce illicit drug use and/or promote engagement for people on methadone maintenance and for people who primarily misuse stimulants."},{"therapySlug":"community-reinforcement-approach","label":"Follow-up option","description":"Best for alcohol and other drug use disorders where lifestyle, reinforcement, social context, and recovery capital are central. Evidence is strongest historically for alcohol, cocaine, and opioid-related disorders, but it should be framed as one structured addiction therapy rather than a universal replacement for pharmacotherapy, withdrawal care, or contingency management. A systematic review found limited-to-moderate evidence for CRA, with or without medication or contingency management, across alcohol and substance-related disorders. (NCBI)"},{"therapySlug":"mindfulness-based-relapse-prevention-mbrp","label":"Follow-up option","description":"Best viewed as an adjunctive or selective relapse-prevention treatment for SUDs rather than a clearly dominant stand-alone first-line therapy. The 2025 systematic review and meta-analysis found small benefits for withdrawal/craving symptoms and negative consequences of substance use, but no statistically significant differences versus comparators for relapse, frequency of use, treatment dropout, depressive symptoms, anxiety symptoms, or mindfulness scores overall."},{"therapySlug":"twelve-step-facilitation-tsf","label":"Follow-up option","description":"The strongest evidence is for alcohol use disorder (AUD). A 2020 Cochrane review found AA/TSF was at least as effective as other established treatments and often better for continuous abstinence and remission over follow-up, with evidence of healthcare cost savings. It is more accurate to present TSF as especially evidence-supported for AUD than as equally established across all SUDs. (cochrane.org)"}]},{"slug":"trauma-pathway","name":"Trauma pathway","clinicalProblem":"Trauma","summary":"Source-grounded workflow assembled from therapies indexed to Trauma. Marked incomplete until clinician review confirms sequencing.","cautions":"Use as decision support only. Confirm acuity, risk, patient preference, and local service capability.","incomplete":true,"reviewStatus":"needs_review","steps":[{"therapySlug":"trauma-focused-cognitive-behavioural-therapy-tf-cbt","label":"Initial option","description":"Strongest use is PTSD. It is also appropriate for clinically important post-traumatic symptoms after trauma, depending on timing, severity, and readiness. In Australian guidelines, TF-CBT, CPT, CT, and PE are all recommended adult PTSD treatments."},{"therapySlug":"eye-movement-desensitisation-and-reprocessing-emdr","label":"Alternative option","description":"For adults with PTSD, Phoenix Australia gives EMDR a strong recommendation. NICE recommends EMDR for adults with PTSD or clinically important PTSD symptoms more than 3 months after non-combat-related trauma, and suggests considering it between 1 and 3 months after non-combat trauma if the person prefers EMDR."},{"therapySlug":"cognitive-processing-therapy-cpt","label":"Alternative option","description":"Strongest use is PTSD. Australian guidelines give a strong recommendation for CPT in adults with PTSD. It is especially useful when maladaptive trauma meanings, guilt, shame, and self-blame are central."},{"therapySlug":"prolonged-exposure-pe","label":"Follow-up option","description":"Strongest use is PTSD in adults. Phoenix Australia gives a strong recommendation for PE in adult PTSD. NICE also includes prolonged exposure therapy within recommended adult trauma-focused CBT interventions."},{"therapySlug":"narrative-exposure-therapy-net","label":"Follow-up option","description":"In Australian PTSD guidelines, NET has a conditional recommendation for adults with PTSD where trauma is linked to genocide, civil conflict, torture, political detention, or displacement. It is best understood as a selective trauma therapy, not a universal first-line PTSD treatment alongside TF-CBT, CT, CPT, PE, or EMDR."},{"therapySlug":"written-exposure-therapy","label":"Follow-up option","description":"Best as a brief trauma-focused PTSD treatment option when a concise, lower-burden exposure-based therapy is needed. Current VA/DoD guidance places WET as a second-line PTSD psychotherapy, not above PE, CPT, or EMDR. It is not currently included in NICE or Phoenix Australia PTSD guideline recommendations, so in Australian practice it should be framed as promising and evidence-supported internationally, but not yet an Australian first-line guideline therapy."}]}]
\ No newline at end of file
diff --git a/src/components/clinical-dashboard/ClinicalSidebar.tsx b/src/components/clinical-dashboard/ClinicalSidebar.tsx
index c346758af..98118eff0 100644
--- a/src/components/clinical-dashboard/ClinicalSidebar.tsx
+++ b/src/components/clinical-dashboard/ClinicalSidebar.tsx
@@ -41,7 +41,7 @@ function useClientMounted() {
);
}
import { Sheet } from "@/components/ui/sheet";
-import { type AppModeId } from "@/lib/app-modes";
+import { type AppModeId, isAppModeId, isAppModeVisible } from "@/lib/app-modes";
import { type ResolvedTheme } from "@/lib/theme";
export type SidebarIdentity = {
@@ -85,6 +85,12 @@ const sidebarToolItems = [
{ id: "therapy-compass", label: "Therapy Compass", icon: appModeIcons["therapy-compass"], href: "/therapy-compass" },
] as const;
+// Drop any tool whose id is a dev-only app mode from the production nav. Non-mode
+// entries (answer, documents, prescribing, tools) are query-param destinations,
+// not app modes, so they always stay. NODE_ENV is inlined into the client bundle,
+// so this resolves at build time.
+const visibleSidebarToolItems = sidebarToolItems.filter((item) => !isAppModeId(item.id) || isAppModeVisible(item.id));
+
function sidebarItemBadge(item: (typeof sidebarToolItems)[number]): string | undefined {
return "badge" in item ? item.badge : undefined;
}
@@ -236,7 +242,7 @@ export function ClinicalSidebarContent({