fix(therapy-compass): re-curate mismatched pathway recommendations

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({
             <p className="text-2xs font-bold uppercase tracking-[0.08em] text-[color:var(--text-soft)]">Tools</p>
           </div>
           <nav aria-label="Tools" className="grid gap-0.5">
-            {sidebarToolItems.map((item) => {
+            {visibleSidebarToolItems.map((item) => {
               const Icon = item.icon;
               const active = activeMode === item.id;
               return (
@@ -425,7 +431,7 @@ function ClinicalCollapsedRail({
         >
           <MessageSquarePlus aria-hidden="true" className="h-4 w-4" />
         </button>
-        {sidebarToolItems.map((item) => {
+        {visibleSidebarToolItems.map((item) => {
           const Icon = item.icon;
           const active = activeMode === item.id;
           return (

src/lib/app-modes.ts

@@ -313,6 +313,11 @@ export const appModeDefinitions = [
     label: "Therapy Compass",
     description: "Source-grounded therapy decision support",
     href: "/therapy-compass",
+    // Held out of production discovery until the re-curated therapy pathways
+    // receive qualified-clinician sign-off. Stays available in the dev switcher;
+    // hidden from the production sidebar and MODE dropdown. Flip to false (or
+    // remove) once the sequencing is clinically approved.
+    devOnly: true,
     search: {
       // Therapy Compass owns its in-tool search over the imported therapy library
       // (not the document corpus), so it borrows the benign "tools" search kind and

tests/app-modes.test.ts

@@ -289,4 +289,16 @@ describe("app mode search contract", () => {
     );
     expect(developmentModes).not.toContain("evidence");
   });
+
+  it("holds Therapy Compass out of production discovery until clinician sign-off", () => {
+    // Gated devOnly while the re-curated therapy pathways await qualified-clinician
+    // sign-off: available in the dev switcher, hidden from the production sidebar and
+    // MODE dropdown. Flipping this to visible should be a deliberate, reviewed act —
+    // hence this guard fails until devOnly is removed from the mode definition.
+    expect(isAppModeId("therapy-compass")).toBe(true);
+    expect(isAppModeVisible("therapy-compass", "development")).toBe(true);
+    expect(isAppModeVisible("therapy-compass", "production")).toBe(false);
+    expect(visibleAppModeDefinitions("development").map((mode) => mode.id)).toContain("therapy-compass");
+    expect(visibleAppModeDefinitions("production").map((mode) => mode.id)).not.toContain("therapy-compass");
+  });
 });

tests/therapy-compass-pathways.test.ts

@@ -0,0 +1,253 @@
+import { readFileSync } from "node:fs";
+
+import { describe, expect, it } from "vitest";
+
+// Guards the clinical integrity of the Therapy Compass pathway data. The imported
+// mockup shipped pathways whose therapy steps were mismatched to the pathway's
+// clinical problem (e.g. Crisis/risk -> "ERP for tics", Grief/loss -> eating-disorder
+// therapies). Those mappings were re-curated; this suite stops the mismatch class
+// from recurring by asserting every step references a therapy that (a) exists and
+// (b) is clinically appropriate for that pathway's clinicalProblem.
+
+type Therapy = { slug: string; bestUsedFor: string };
+type Step = { therapySlug: string; label: string; description: string };
+type Pathway = { slug: string; clinicalProblem: string; steps: Step[] };
+
+const dataUrl = (name: string) => new URL(`../public/therapy-compass-data/${name}`, import.meta.url);
+
+const therapies = JSON.parse(readFileSync(dataUrl("therapies.json"), "utf8")) as Therapy[];
+const pathways = JSON.parse(readFileSync(dataUrl("pathways.json"), "utf8")) as Pathway[];
+const bySlug = new Map(therapies.map((t) => [t.slug, t]));
+
+// Independent clinical allowlist: for each pathway clinical problem, the set of
+// catalogue therapies that genuinely treat it. This is the source of truth the
+// pathway steps are checked against — a therapy outside its pathway's set is a
+// clinical mismatch, regardless of the (noisy, over-broad) per-therapy tags.
+const DOMAIN_APPROPRIATE: Record<string, string[]> = {
+  Anxiety: [
+    "cognitive-behavioural-therapy-cbt",
+    "cognitive-therapy",
+    "behaviour-therapy",
+    "graded-exposure",
+    "exposure-therapy",
+    "exposure-based-cbt-exposure-therapy",
+    "exposure-and-response-prevention-erp",
+    "interoceptive-exposure",
+    "applied-relaxation-relaxation-based-therapy",
+    "worry-focused-cbt",
+    "panic-focused-cbt",
+    "social-anxiety-focused-cbt",
+    "health-anxiety-focused-cbt",
+    "metacognitive-therapy-mct",
+    "acceptance-and-commitment-therapy-act",
+    "mindfulness-based-cognitive-therapy-mbct",
+    "problem-solving-therapy-pst",
+    "coping-skills-interventions",
+    "psychoeducation",
+    "internet-delivered-cbt",
+    "brief-low-intensity-cbt",
+    "guided-self-help",
+    "group-exposure-programmes",
+  ],
+  "Crisis/risk": [
+    "crisis-intervention-crisis-oriented-brief-therapy",
+    "cbt-informed-psychological-intervention-for-self-harm",
+    "problem-solving-therapy-pst",
+    "dialectical-behaviour-therapy-dbt",
+    "developmentally-adapted-dbt",
+    "dbt-skills-groups",
+    "coping-skills-interventions",
+    "brief-supportive-psychotherapy",
+    "supportive-psychotherapy",
+    "structured-clinical-management",
+    "good-psychiatric-management",
+    "psychoeducation",
+  ],
+  "Eating/body image": [
+    "eating-disorder-focused-cognitive-behavioural-therapy-cbt-ed-cbt-e",
+    "family-based-treatment-for-adolescent-anorexia-nervosa-ft-an",
+    "family-based-treatment-for-bulimia-nervosa-ft-bn",
+    "guided-self-help-for-binge-eating-disorder",
+    "guided-self-help-for-bulimia-nervosa",
+    "maudsley-anorexia-nervosa-treatment-for-adults-mantra",
+    "specialist-supportive-clinical-management-sscm",
+    "adolescent-focused-psychotherapy-for-anorexia-nervosa",
+    "carer-supported-meal-based-interventions",
+    "dbt-informed-adjunctive-emotion-regulation-work-for-eating-disorders",
+    "eating-disorder-focused-focal-psychodynamic-therapy-fpt-for-adult-anorexia-nervosa",
+  ],
+  "Grief/loss": [
+    "interpersonal-psychotherapy-ipt",
+    "meaning-centred-psychotherapy",
+    "brief-supportive-psychotherapy",
+    "supportive-psychotherapy",
+    "life-review-therapy-reminiscence-therapy",
+    "dignity-therapy",
+    "emotion-focused-therapy",
+    "existential-psychotherapy",
+    "compassion-focused-therapy",
+    "narrative-therapy",
+    "person-centred-rogerian-therapy",
+  ],
+  Mood: [
+    "cognitive-behavioural-therapy-cbt",
+    "behavioural-activation-ba",
+    "behavioural-activation",
+    "interpersonal-psychotherapy-ipt",
+    "problem-solving-therapy-pst",
+    "mindfulness-based-cognitive-therapy-mbct",
+    "short-term-psychodynamic-psychotherapy-for-depression-stpp",
+    "supportive-expressive-psychodynamic-counselling-approaches-for-depression",
+    "cognitive-therapy",
+    "relapse-prevention-psychotherapy",
+    "psychoeducation",
+  ],
+  Neurodevelopmental: [
+    "behavioural-parent-training",
+    "parent-management-training-pmt",
+    "parent-training",
+    "parent-and-child-training",
+    "social-communication-parent-mediated-autism-interventions",
+    "developmental-social-skills-interventions",
+    "neurodevelopmentally-adapted-psychosocial-interventions",
+    "parent-child-interaction-therapy-pcit",
+    "developmentally-adapted-erp",
+    "developmentally-adapted-dbt",
+    "child-cbt",
+    "adolescent-cbt",
+  ],
+  "Pain/somatic": [
+    "acceptance-and-commitment-therapy-act",
+    "cognitive-behavioural-therapy-cbt",
+    "health-anxiety-focused-cbt",
+    "mindfulness-based-stress-reduction",
+    "applied-relaxation-relaxation-based-therapy",
+    "mindfulness-based-cognitive-therapy-mbct",
+    "interoceptive-exposure",
+    "problem-solving-therapy-pst",
+    "psychoeducation",
+  ],
+  "Personality/interpersonal": [
+    "dialectical-behaviour-therapy-dbt",
+    "mentalisation-based-therapy-mbt",
+    "schema-therapy",
+    "structured-clinical-management",
+    "good-psychiatric-management",
+    "transference-focused-psychotherapy-tfp",
+    "cognitive-analytic-therapy-cat",
+    "psychodynamic-psychotherapy",
+    "relational-psychodynamic-therapies",
+    "dynamic-interpersonal-therapy",
+    "interpersonal-psychotherapy-ipt",
+  ],
+  Psychosis: [
+    "cognitive-behavioural-therapy-for-psychosis-cbtp",
+    "family-intervention-for-psychosis",
+    "family-psychoeducation-for-psychosis",
+    "psychoeducation-for-psychosis",
+    "cognitive-remediation-therapy-crt",
+    "illness-management-and-recovery-style-interventions-imr-style-interventions",
+    "supported-employment-individual-placement-and-support-ips",
+    "social-skills-training-sst",
+    "social-cognition-training",
+    "recovery-oriented-psychosocial-interventions",
+    "carer-focused-education-and-support-carer-psychoeducation-in-psychosis",
+  ],
+  Sleep: [
+    "cognitive-behavioural-therapy-for-insomnia-cbt-i",
+    "cognitive-behavioural-therapy-for-insomnia",
+    "sleep-compression-therapy-for-insomnia",
+    "mindfulness-based-therapy-for-insomnia-mbti",
+    "imagery-rehearsal-therapy-irt-for-nightmare-disorder",
+    "bright-light-therapy",
+    "circadian-rhythm-based-interventions",
+    "wake-therapy-sleep-deprivation-chronotherapy",
+  ],
+  "Substance use": [
+    "motivational-interviewing-mi-for-substance-use-disorders",
+    "motivational-interviewing",
+    "motivational-enhancement-therapy-met",
+    "relapse-prevention-therapy-for-substance-use-disorders",
+    "contingency-management-cm",
+    "community-reinforcement-approach",
+    "community-reinforcement-and-family-training-craft",
+    "mindfulness-based-relapse-prevention-mbrp",
+    "twelve-step-facilitation-tsf",
+    "matrix-model",
+    "cue-exposure-therapy-cet-for-substance-use-disorders",
+    "integrated-dual-diagnosis-psychotherapy",
+    "harm-reduction-counselling",
+  ],
+  Trauma: [
+    "trauma-focused-cognitive-behavioural-therapy-tf-cbt",
+    "eye-movement-desensitisation-and-reprocessing-emdr",
+    "emdr",
+    "cognitive-processing-therapy-cpt",
+    "cognitive-therapy-for-ptsd-ct-ptsd",
+    "prolonged-exposure-pe",
+    "prolonged-exposure-therapy",
+    "narrative-exposure-therapy-net",
+    "written-exposure-therapy",
+    "phase-oriented-trauma-therapy",
+    "seeking-safety",
+    "stair-skills-training-in-affective-and-interpersonal-regulation",
+  ],
+};
+
+describe("Therapy Compass pathway clinical integrity", () => {
+  it("covers every pathway clinical problem with an allowlist", () => {
+    for (const p of pathways) {
+      expect(DOMAIN_APPROPRIATE[p.clinicalProblem], `no allowlist for ${p.clinicalProblem}`).toBeTruthy();
+    }
+  });
+
+  it("references only therapies that exist in the catalogue", () => {
+    for (const p of pathways) {
+      for (const s of p.steps) {
+        expect(bySlug.has(s.therapySlug), `${p.slug}: unknown therapy ${s.therapySlug}`).toBe(true);
+      }
+    }
+  });
+
+  it("recommends only therapies clinically appropriate to each pathway's problem", () => {
+    for (const p of pathways) {
+      const allowed = new Set(DOMAIN_APPROPRIATE[p.clinicalProblem] ?? []);
+      for (const s of p.steps) {
+        expect(
+          allowed.has(s.therapySlug),
+          `${p.slug} (${p.clinicalProblem}) recommends "${s.therapySlug}", which is not clinically indexed to that problem`,
+        ).toBe(true);
+      }
+    }
+  });
+
+  it("keeps each step's description source-grounded to its therapy", () => {
+    for (const p of pathways) {
+      for (const s of p.steps) {
+        const t = bySlug.get(s.therapySlug);
+        expect(s.description, `${p.slug}: ${s.therapySlug} description drifted from source`).toBe(t?.bestUsedFor);
+      }
+    }
+  });
+
+  it("gives every pathway an ordered set of options led by an initial option", () => {
+    for (const p of pathways) {
+      expect(p.steps.length, `${p.slug} has no steps`).toBeGreaterThan(0);
+      expect(p.steps[0].label, `${p.slug} does not lead with an initial option`).toBe("Initial option");
+    }
+  });
+
+  it("does not resurrect the known cross-domain mismatches", () => {
+    const bySlugPathway = Object.fromEntries(pathways.map((p) => [p.slug, p.steps.map((s) => s.therapySlug)]));
+    expect(bySlugPathway["crisis-risk-pathway"]).not.toContain(
+      "exposure-and-response-prevention-for-tics-erp-for-tics",
+    );
+    expect(bySlugPathway["pain-somatic-pathway"]).not.toContain(
+      "exposure-and-response-prevention-for-tics-erp-for-tics",
+    );
+    expect(bySlugPathway["grief-loss-pathway"]).not.toContain("vocational-rehabilitation");
+    expect(bySlugPathway["grief-loss-pathway"]).not.toContain(
+      "family-based-treatment-for-adolescent-anorexia-nervosa-ft-an",
+    );
+  });
+});