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The Cundill Centre for Child and Youth Depression
CARIBOU by CAMH: A treatment pathway for youth with depression

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  • The CARIBOU Pathway by CAMH
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  • The CARIBOU Pathway by CAMH

Depression in youth is common and a significant risk factor for suicide, the second leading cause of death for young people in Canada. To address the need for effective treatment, a team of researchers at the Cundill Centre for Child and Youth Depression and youth advisors developed the CARIBOU Pathway by CAMH. CARIBOU stands for Care for Adolescents who Receive Information 'Bout Outcomes. 

The CARIBOU Pathway provides an evidence-based approach to treating depression in youth and uses a measurement-based care framework for assessing and monitoring their progress. As an integrated care pathway (ICP) for outpatient youth ages 13-18 (with potential for use up to age 24) with depression, a structured treatment plan for the youth maps the treatment process from start to finish. The treatment is also collaborative, so youth are involved in decision-making, as are other people who support them, such as family members and their care team.  The pathway includes seven core components.

Related links

CARIBOU CBT Training for Facilitators: Enhance Your Skills in Youth Mental Health
March 31 to May 16, 2025

The Cundill Centre for Child and Youth Depression

The Cundill Centre Innovations in Clinical Care 

Sharing Knowledge from The Cundill Centre

CARIBOU Pathway: 1. Assessment | 2. Psychoeducation | 3. Psychotherapy options | 4. Caregiver support | 5. Medication recommendations | 6. Team Reviews | 7. Completion of Pathway
Access the PDF or the full PNG image file of the pathways graphic.

The Caribou Pathway

 

CARIBOU: Flexible Care for Youth with Depression
Watch this brief video that summarizes the pathway from the youth perspective.


 The CARIBOU Integrated Care Pathway for
Adolescents with Depression Manual

This manual outlines the seven steps of the CARIBOU pathway and includes the materials required to deliver the pathway, such as assessment forms and worksheets for youth. The manual is meant for health care providers who work with adolescents with depressive symptoms and who are interested in learning about or delivering the pathway, administrators and implementation science researchers.


1. Assessment
   
 

This initial step uses an assessment guide to support clinicians in determining whether a youth presenting to care is appropriate for the CARIBOU pathway and how the pathway might be further personalized to meet their treatment needs and wants, including risk management.
 

 

Resources:

Image of Cover of Guide
CARIBOU: Initial Assessment Guide

 

2. Psychoeducation

 

A session for youth and their caregivers that provides information about depression, how sleep, eating, and exercise can impact mood and what treatment may look like for youth with depression.

 

Youth Guides


CARIBOU Mood Foundations Youth Handouts

  

Clinician Guides

Cover of CARIBOU Mood Foundation Guide
CARIBOU Mood Foundations Facilitator Guide

 

 

Videos:

Cundill video screenshot depression Mood Matters: Describing Depression

Cundill video mood matters food screenshotMood Matters: How Food, Movement & Sleep Can Have an Impact on You

 

3. Psychotherapy Options 

Up to 16 sessions of cognitive behavioural therapy (CBT) or 12 sessions of a manualized brief psychosocial intervention tailored for youth with depression.

 

Psychotherapy and YOUth Worksheet and Decision Aid

Image of training manual cover
This handout explains psychotherapy options, in simple language, when youth might see the benefits, if any, can occur. This resource is meant for youth. It can also be used by clinicians or other supports in young people's lives to help explain psychotherapy options to youth. The tool was developed by youth from the Youth Engagement Initiative in partnership with a psychiatrist.

 

 

 

Youth Guides

Cover of SITB Youth Guide

CARIBOU Youth Handout for the Management of Self-Injurious Thoughts and Behaviours
 

  

Clinician Guides

Cover of SITB Therapist Guide
CARIBOU Clinicians Guide for the Management of Self-Injurious Thoughts and Behaviours

 


CARIBOU CBT Group Manual for Youth
 

 


CARIBOU CBT Group Manual for Facilitators
 

 

Caribou CBT Individual Manual for Youth
 

 


CARIBOU CBT Individual Manual for Therapists
 

 

Problem Solving Worksheets for Youth

This three-page package helps youth think through their problems by prompting them to describe the situation, as well as their emotions and needs. It takes youth through steps that help them explore solutions, evaluate those solutions, and make a plan of action. This resource is meant for youth and can be used by clinicians to support youth through the problem-solving process. It was co-developed by youth from the Youth Engagement Initiative at the McCain Centre as part of the CARIBOU project.


Cognitive Restructuring Worksheets for Youth


This three-page package helps youth examine thoughts that may not be helpful to them. It teaches youth how to change their thoughts by considering alternative ways of interpreting situations. This resource is meant for youth and can be used by clinicians to support youth through cognitive restructuring. It was co-developed by youth from the Youth Engagement Initiative at the McCain Centre as part of the CARIBOU project.

 

4. Caregiver Support (if desired) 

 

Up to eight support sessions for caregivers of youth who are experiencing depression.

 

Caregiver Resources

Cover page for guide

Information for Parents/Caregivers of Adolescents with Depression or Anxiety

 

Cover page for guide

Validation with Youth who have Mental Health Conditions

 
5. Medication Recommendations (if desired)

 

Medication options provided that follow a plan based on what researchers have found most effective for young people.

Youth Guide:

 

Medication and YOUth: A Resource for Youth by Youth

Thumbnail image of a training manual
Research has shown that a type of antidepressants, called selective serotonin reuptake inhibitors (SSRIs), can help reduce the symptoms of depression in young people. This handout explains, in simple language, what SSRIs are, when youth might see the benefits and what side effects, if any, can occur. It also provides tips on how to take the medication. This resource is meant for youth. It can also be used by health care providers, pharmacists or other supports in young people’s lives to help explain SSRIs to youth. The tool was developed by youth from the Youth Engagement Initiative in partnership with a psychiatrist and a pharmacist as part of the CARIBOU project.

 
6. Team Reviews

 

Meetings every four weeks with youth, their care team, and other important people to the young person to track progress and personalize treatment further. 

Video

  Cundill Centre Video: Monitoring Mental Health: Using measurement tools to inform care for youth
Monitoring Mental Health: Using measurement tools to inform care for youth
 

 
7. Completion of Pathway

Illustration of person with their arms up celebrating

 Youth and team discuss a relapse prevention plan and engage in planning of next steps, depending on the youth's needs.

Become certified in the CARIBOU Pathway by CAMH

The Cundill Centre is gradually rolling out a certification in delivering the CARIBOU Pathway. Clinicians will have the opportunity to complete individual courses in CARIBOU components or work towards a full CARIBOU Pathway certificate. 

By year 2026, the Cundill Centre will offer:

  • multi-staged certification in delivering the CARIBOU Pathway
  • tailored packages based on the priorities of your setting
  • options to complete courses in specific CARIBOU components or obtain a full CARIBOU Pathway Certificate which will prepare participants to implement the entire CARIBOU Pathway in their setting
  • complete training and individualized implementation support (e.g., longitudinal coaching and fidelity monitoring) for each course
  • access to a developing community of practice to deepen your learning and obtain ongoing support.

If you have further questions about the pathway or its materials, please contact Cundill.Centre@camh.ca

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