3, range = 1 8 – 2 7) Parent mean satisfaction was higher than y

3, range = 1.8 – 2.7). Parent mean satisfaction was higher than youth counterparts across all components: global satisfaction (M = 4.8, range = 4.3 – 5), individual therapy (M = 4, range = 4 – 5), web-based coaching (M = 4.8, range = 4.6 – 4.9), skills group (M = 4.3, range = 3.7 – 5). Feasibility and Acceptability of WBC The two families who completed treatment attended 36 and 41 WBC sessions. Families averaged 1.97 (SD = 1.7) sessions per week (range: 0 – 5). WBC sessions averaged 16.6

minutes (SD = 8.9) and ranged check details from 4.0 to 43.0 minutes in length. All WBC sessions began between 6:30 a.m. and 9:30 a.m., with 83.8% of WBC sessions beginning between 6:30 a.m. and 6:59 a.m. When asked how WBC sessions helped, participants commonly noted that WBC provided the youth “real-time” support and encouragement when the youth needed it most (“[The most helpful part of WBC was] having someone to talk Everolimus supplier to when I felt my worst”), improved routine or sleep regulation by providing structure in the mornings (“My son would get up in the morning specifically for WBC where he may not have gotten up otherwise”), helped parents feel confident that therapists were seeing real examples of the dysfunction (“It gave [the therapist] un-edited, real-time view of the challenges we have been living with”), and helped parents/youth practice DBT skills with active coaching (“[WBC helped my son] practice the skills learned in group at

a difficult time (early in the morning) when he felt tired and unable to get up.”). Of 77 WBC sessions, therapists noted a total of 49 technical problems in 37 sessions (49.3%)Audio or video lags were the most common and took place in 17.3% of sessions. Other technical problems included the program cutting out or CYTH4 freezing, broken up audio or video, and Internet problems. Despite the frequency of technology problems, participants reported that WBC video and audio quality was high. Clients reported that WBC video and audio quality were high, with means of 4.06 (SD = 1.23) and 4.10 (SD = 1.22) on a scale of 0 (“Coaching could not be done”) to 5 (“Flawless-

like in person”), respectively. Illustrative Case Examples Youth 1 Ricky1 was a 16-year-old, Caucasian boy in the 11th grade at a public high school who lived with both parents. At intake, Ricky was diagnosed with MDD (CSR = 5) and GAD (CSR = 4), with overall functioning in the “markedly ill” range (CGI-S = 5). SR behavior was endorsed with severe impairment (CSR = 6). Interviewers also gave Ricky a 53 on the CDRS-R, indicating symptoms in the 98th percentile of same-aged peers for depression. Ricky was taking an anti-depressant medication. See Table 2 for pre- and posttreatment diagnostic profile. At intake (mid-December), Ricky had missed 26 school days (41% of possible days) of the current school year and 13 days (50% of possible) in the past month. His long history of SR was related to gastro-intestinal distress secondary to contracting a bacterial infection in the 7th grade.

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