M09 — Screening · Inner EDGE Navigator · T1 + T2

Tier 1 Module Cover Sheet Faculty & Student Reference · Regulatory Anchor

Phase 3 — Clinical & Practical Applications Phase 3

Module 09: Screening

If M08 is knowing what to look for across the three spaces, M09 is knowing how to have the conversation that surfaces it. This module teaches the architecture of the screening interview — how to open, how to sequence the three-space inquiry, how to ask questions that invite rather than lead, how to apply thresholds transparently, and how to communicate a recommendation that the participant can genuinely act on. The screening interview is where eligibility knowledge becomes eligibility practice.

5 hrs total 3.5 sync / 1.5 async Phase 3 · v1.0

M08 → M09 Distinction

M08 built the knowledge: what to look for across healthspace, mindspace, and lifespace. M09 builds the skill: how to structure and conduct the conversation that surfaces that information professionally, neutrally, and transparently. The three-space framework from M08 is now the organizing architecture of the screening interview.

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Learning Objectives By module completion

PC3 — Clinical Readiness & Participant Assessment

1

Outline the sections and sequence of a structured screening interview — opening, three-space inquiry, threshold application, recommendation, and documentation — and explain the purpose and scope boundaries of each phase. Understand CO I.2 · I.3
2

Demonstrate neutral questioning technique — distinguishing leading questions from open, non-directive questions — and conduct the first 8 minutes of a screening interview in a scope-appropriate, participant-centered manner. Apply CO I.1 · I.3
3

Apply exclusion and cautionary threshold criteria to sample screening scenarios — distinguishing between conditions that require referral, conditions that require a hold with pathway, and conditions that allow proceeding with appropriate preparation. Analyze CO I.1 · I.4 · I.5
4

Communicate a transparent screening recommendation — including proceed, hold with specific pathway, refer, or connect with a different facilitator — in language that is specific, scope-compliant, autonomy-preserving, and clearly actionable. Apply CO I.1 · I.4 · J.12

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Regulatory Crosswalk CO NMTP Section I · 5 hrs

Source	Code	Standard	Lesson Coverage
CO NMTP	I.1	Discussion of participant's reasons for seeking natural medicine services — eliciting intentions, goals, and expectations in a neutral, non-directive manner	L1 — primary · L2 — supporting
CO NMTP	I.2	Completion of the mandated screening form — understanding the structure, sequence, and required elements of the CO NMTP screening instrument	L1 — primary
CO NMTP	I.3	How to conduct screening for pertinent physical and mental health concerns — applying M08 knowledge within the structured interview format	L1 — primary · L2 — primary
CO NMTP	I.4	Helping participants connect with different facilitators if needed — recognizing fit and scope mismatch, communicating transparently, facilitating warm handoffs without abandonment	L2 — primary
CO NMTP	I.5	Role play scenarios of screening sessions — applying the full interview architecture in live practice	L1 exercise + L2 exercise + OSCE
CO NMTP	J.12	Documentation standards — producing a scope-compliant screening summary note	L2 — primary
iETA	A.3	Applied DISC communication style awareness in the screening interview — self-awareness of style-driven risks in questioning and recommendation delivery; real-time participant style observation and adaptive communication. Extends CO A.3 (personal bias and communication awareness) into live applied practice. iETA addition beyond CO minimum.	L1 — DISC tool · L2 — style-adaptive delivery · Debrief integration

Prerequisites & Forward Connections

Direct prerequisites: M08 (Participant Readiness — all four sub-modules must be completed). Students must have their three-space intake instrument and go/hold/refer documentation template from M08 in hand. M09 applies those tools within a structured interview format — students who have not completed M08 will not have the clinical knowledge base that M09's interview architecture requires. Forward connections: The screening interview structure built in M09 is the direct foundation for M10 (Preparation — the first post-eligibility phase). Once a participant has been screened and cleared, the preparation phase begins. M09 is the gate between eligibility and preparation.

Colorado NMTP — Section I Compliance Note & iETA Addition

Module 09 satisfies the full Section I requirement (5 hrs) for screening competency in the Colorado Natural Medicine Treatment Program. The mandated screening form (I.2) is addressed in L1 — students must understand both the Colorado NMTP mandated screening form structure and how to complete the M08-developed three-space intake instrument within that context. Role play requirements (I.5) are satisfied through the L1 and L2 exercises plus the OSCE. OSCE passage (≥70%) constitutes the documented competency evidence for Section I. All OSCE rubrics must be retained with assessor signatures. iETA addition: The DISC communication style integration (A.3) is an iETA-specific contribution that extends CO communication awareness requirements into applied screening practice — both self-knowledge of style-driven risks and real-time participant style reading and adaptation. This content is not required by CO NMTP but significantly deepens screening competency.

── T1 ends · T2 begins ──

Tier 2 Instructor Guide Facilitator Copy · Not for Distribution · All Tools Included

Module 09 — Phase 3: Clinical & Practical Applications Phase 3

Screening — Instructor Guide

Two lessons covering interview architecture and neutral questioning (L1), threshold application and transparent recommendations (L2), plus full OSCE assessor package. All tools included.

5 hrs total 2 Lessons + OSCE

Tier 2 What This Module Asks of You

Module 09 · Screening

The Conversation Is the Competency

Students who know everything in M08 but can't conduct a screening conversation are not ready to screen.

M09 is a skills module. The content is not complex — students already know the clinical framework from M08. What they are learning here is the architecture of a professional screening conversation: how to open it, how to sequence it, how to ask questions that get honest answers rather than the answers participants think you want, how to apply thresholds transparently, and how to communicate a recommendation that serves the participant rather than managing their disappointment.

The most important thing you will do in this module is model the conversation before you ask students to practice it. A lecture about neutral questioning is far less valuable than watching you conduct eight minutes of a screening interview in front of the class and then deconstructing what you did and why. If you have done real screening conversations, this is the module to bring that experience forward. If you haven't, practice the interview architecture with a colleague before you teach it.

Before You Begin

Students must bring their completed three-space intake instruments from M08. M09 assumes they have that tool and are learning to use it in a structured conversation — not learning the content of it again. If students arrive without their M08 portfolios, their screening practice will lack the clinical grounding that makes M09 meaningful. Check in on this before L1 begins.

Materials Needed

Students' own M08 three-space intake instruments (required — bring from M08)
Interview architecture reference cards (T3 version in SG)
Neutral questioning guide (T3 version in SG)
DISC screening application guide — self + participant reading (T3 version in SG)
Threshold matrix reference card (T3 version in SG)
Transparent recommendation language template (T3 version in SG)
Screening practice scenario cards — 6 cases + key (L2 exercise)
OSCE assessor packets (2 per station)

Pre-Session Instructor Prep

Review CO NMTP Section I requirements in the Alignment Matrix
Prepare or practice a demonstration screening interview (8 min) to model before L1 exercise
Prepare the L2 practice scenario cards before the session
Prepare 2 OSCE scenario versions before the assessment window
Know the CO mandated screening form requirements for I.2 — students need to know both the CO instrument and how their M08 three-space intake maps to it
Confirm all students have their M08 portfolio materials

Lesson 1 Interview Architecture & Neutral Questioning · 2.0 hr sync + 0.5 hr async

Lesson 1: Interview Architecture & Neutral Questioning

2.5 hrs total · 2.0 hr sync / 0.5 hr async · CO I.2 · I.3

This lesson teaches the structure of the screening conversation — what phases it moves through, what each phase accomplishes, and how to ask questions that get accurate disclosures rather than socially acceptable answers. The interview architecture is the scaffold; neutral questioning is the technique that makes it work. The CO mandated screening form (I.2) is introduced here in the context of how students' M08 three-space intake maps onto it.

Sync Time 2.0 hours — warm-up (10 min) + lecture (40 min) + model demonstration (15 min) + practice pairs (40 min) + debrief (15 min)

Materials Interview architecture reference cards · Neutral questioning guide · Students' M08 intake instruments

Warm-Up · 10 min

Prompt "Think about a time you were on the receiving end of an interview — job interview, medical intake, anything. What did the interviewer do that made you want to be honest? What made you want to give them the answer you thought they wanted?" Collect 4–5 responses. Students typically name: unhurried pace, non-reactive responses to surprising answers, genuinely curious tone, not leading with assumptions. Then: "Everything you just described is what neutral questioning looks like in practice. And the things that closed you down — rushed pace, visible expectations, leading questions — are exactly what we're training out of. The screening conversation's quality is determined before you ask a single clinical question."

The warm-up reframes screening from a clinical data-collection exercise to a relational skill. Students often arrive with a "checklist" mental model from M08; this opens them to the idea that the conversation architecture is its own competency.

Lecture · 40 min

"The screening interview has a job: to create the conditions in which a participant will tell you what you actually need to know. Not what they think will get them approved. Not what they've rehearsed. Not the sanitized version. The actual picture. And the only way to do that is with a conversation structure that feels safe enough to be honest in — and questioning technique that invites disclosure rather than managing it."

The screening interview has five phases. Understanding the purpose of each phase matters as much as knowing the questions to ask in it, because the purpose shapes the tone.

Phase 1 — Opening and relationship establishment (3–5 min): Before any clinical content, the facilitator establishes the nature of the conversation. This is not small talk — it is intentional context-setting. What is this conversation for? What will the facilitator do with what they hear? What does the participant have the right to know about the process? The opening also establishes therapeutic presence: the quality of attention the participant will experience throughout. A rushed, distracted, or clipboard-focused opening communicates that the interview is a transaction. A grounded, genuinely attentive opening communicates that this is a professional conversation that matters. Most participants arrive with some anxiety about the screening. The opening either settles that or compounds it.

Phase 2 — Reasons for seeking and intentions (5–8 min): This is I.1 — discussing the participant's reasons for seeking natural medicine services. The purpose here is twofold: to understand the participant's intentions and expectations (which will inform the preparation phase if they proceed), and to assess whether those intentions reflect any distorted expectations that need addressing. A participant who says "I want to completely heal my trauma in one session" needs honest psychoeducation before proceeding — not because this disqualifies them, but because unmet expectations cause harm. The key technique here is open, non-directive questioning. Not "are you coming to work on depression?" but "what brings you here?" Not "what do you hope to heal?" but "what are you hoping for from this process?"

Phase 3 — Three-space inquiry (15–20 min): This is the core clinical content of the screening — working through healthspace, mindspace, and lifespace in a structured but conversational way. The interview architecture is: healthspace first (medications and physical health), then mindspace (current psychological state and history), then lifespace (support structure and logistics). The sequencing matters: starting with the least emotionally loaded domain (physical health) and building toward the more personal domains (mindspace, lifespace) mirrors good interviewing practice across clinical contexts. The three-space intake instrument from M08 is the question bank; the interview architecture is how you move through it.

Phase 4 — Threshold application and deliberation (5 min): After the three-space inquiry, the facilitator takes a brief moment — sometimes literally, sometimes by saying "let me just take a moment to think about what we've covered" — to synthesize what they've heard before delivering a recommendation. This deliberative pause communicates that the recommendation is considered, not reflexive. It also gives the participant a moment to add anything they may have held back. Sometimes the most important disclosure comes in this pause, when the participant realizes the facilitator is about to decide and chooses to be more candid.

Phase 5 — Recommendation and next steps (5–8 min): The recommendation must be specific, transparent, and actionable. The participant should leave knowing exactly what the recommendation is, exactly why it is what it is (in scope-compliant language), and exactly what their next step is. Vague recommendations — "I have some concerns" without specifics, "let's think about this more" without a timeline — serve the facilitator's discomfort, not the participant's need for clarity. This phase also includes the I.4 content: if the facilitator determines they are not the right fit for this participant — due to scope mismatch, specialization needs, or any other reason — the recommendation includes a warm handoff, not a referral-by-abandonment.

The CO mandated screening form (I.2): CO NMTP requires a specific screening instrument. Students need to know both the form structure and how their M08 three-space intake instrument maps onto it. In practice, the M08 intake instrument typically captures all or most of the CO mandated content — the difference is how it is organized and sequenced. The important point is that "completing the mandated screening form" is not a separate exercise from the screening conversation; it is the documentation that happens within and after that conversation. The form is never completed instead of the conversation — it is the record of it.

Watch For in This Lecture

"Can I just ask the questions from my intake form?": Yes, the intake instrument is the question bank — but reading questions off a form is not a screening conversation. The architecture is about how the facilitator inhabits the form, not whether they have one.
Treating the deliberative pause as unnecessary: Some students will see Phase 4 as padding. Clarify that the pause serves two functions — synthesis and participant disclosure — and is a professional practice marker, not empty time.
Scope creep in the "reasons for seeking" phase: When participants describe their intentions, facilitators are sometimes tempted to begin clinical assessment or provide therapeutic responses. The purpose of Phase 2 is to listen and understand — not to begin treatment or validate clinical hypotheses.

T2 Tool · T3 Version in Student Guide Screening Interview Architecture — Five-Phase Structure

Phase 1 Opening & Relationship Establishment 3–5 min

Purpose: establish context, set expectations, create the conditions for honest disclosure.

"Before we start, I want to tell you a little about what this conversation is for and how I'll use what you share with me."
"This is a screening conversation — my goal is to understand your situation and help us figure out whether and how I can best support you. Nothing you share here will be used against you, but it will inform my recommendation."
"Do you have any questions about the process before we start?"

Scope boundary: this is not a therapy session, intake counseling, or a commitment to services. It is a professional assessment conversation.

Phase 2 Reasons for Seeking & Intentions 5–8 min · CO I.1

Purpose: understand what brings the participant here and what they're hoping for — without leading their answer or beginning clinical assessment.

"What brings you here — what made you decide to look into natural medicine services?"
"What are you hoping for from this process?"
"Have you had any previous experiences with psilocybin or other psychedelics? If so, what was that like?"
"Is there anything specific you're hoping to work on or explore?"

Listen for: unrealistic outcome expectations ("cure," "fix," "one session"); signs of acute distress driving the decision; intentions that suggest misalignment with facilitation scope. Do not begin assessment or validation in this phase — listen and note.

Phase 3 Three-Space Inquiry 15–20 min · CO I.3 · Uses M08 Intake Instrument

Purpose: gather the healthspace, mindspace, and lifespace information needed to apply eligibility thresholds. Sequence: healthspace → mindspace → lifespace.

Healthspace transition: "Let me ask you some questions about your health and any medications you're taking — this is an important part of how we make sure this is safe for you."
Mindspace transition: "Now I'd like to ask some questions about your mental health and emotional life — this is just as important as the physical side."
Lifespace transition: "And finally, I want to understand your life context a bit — things like your support system, schedule, and logistics."

Use your M08 three-space intake instrument as the question bank. The transitions above introduce each space; your intake questions fill it out. Sequence — healthspace first — moves from least to most personally sensitive, which mirrors good interviewing practice.

Phase 4 Deliberative Pause 1–3 min

Purpose: synthesize what you've heard before delivering a recommendation; create space for any final disclosures.

"Let me just take a moment to think about everything you've shared with me."
"Before I share my thoughts — is there anything else you'd want me to know about your situation?"

This pause is not procedural filler. It communicates that your recommendation is considered. It also reliably elicits late disclosures — participants often share something important when they realize you are about to decide.

Phase 5 Recommendation & Next Steps 5–8 min · CO I.1 · I.4 · J.12

Purpose: communicate a specific, transparent, actionable recommendation — proceed, hold with pathway, refer, or connect with a different facilitator.

"Based on everything we've discussed, here's where I am..."
"My recommendation is [specific outcome] because [specific, non-diagnostic rationale]."
"Your next step is [specific, concrete action]. I'll [what the facilitator will do next]."
If connecting with another facilitator: "I don't think I'm the best fit for you for [specific reason]. I want to help you find someone who is. Here's what that could look like..."

The recommendation must include: what (proceed / hold / refer / connect), why (specific, scope-compliant rationale), and what next (concrete step for participant, concrete step for facilitator). Vague recommendations serve the facilitator's discomfort. Specific recommendations serve the participant.

T2 Tool · T3 Version in Student Guide Neutral Questioning Guide — Leading vs. Open Questions

Leading questions embed the expected answer in the question itself. Neutral questions open the space without directing it. The difference is often subtle — one word can shift a question from open to leading. Study these pairs, then practice the revisions with your intake instrument questions.

Leading — Avoid

"You're not having any thoughts of hurting yourself, are you?"

The phrasing signals the expected answer ("no") and gives the participant an easy way to avoid the disclosure.

Neutral — Use

"I want to ask you directly — are you having any thoughts of harming yourself or others?"

Direct, non-leading, and signals that the facilitator can handle the answer whatever it is.

Leading — Avoid

"You're in a good place emotionally right now, right?"

Confirms the expected "yes" before the participant has answered. Participants often agree rather than contradict.

Neutral — Use

"How would you describe your current emotional state? What's contributing to that?"

Opens the question genuinely and asks for the participant's own framing.

Leading — Avoid

"You don't have any family history of schizophrenia or anything like that, do you?"

"Or anything like that" is vague and the phrasing signals the expected "no." Easy to miss a disclosure.

Neutral — Use

"I'd like to ask about family history. Do you or any first-degree relatives — parents, siblings, children — have a history of schizophrenia, schizoaffective disorder, or other primary psychotic conditions?"

Specific, direct, explains what "first-degree" means, doesn't embed the expected answer.

Leading — Avoid

"You're hoping this will help with your depression, I assume?"

Assumes the reason and the condition. Participant may agree to a narrative that isn't quite theirs.

Neutral — Use

"What brings you here? What made you decide to look into natural medicine services?"

Genuinely open — the participant defines their reason in their own words.

Leading — Avoid

"Your support system is solid, right? You have people around you?"

Invites "yes" and glosses over a potentially significant lifespace gap.

Neutral — Use

"Tell me about your support system — is there at least one person in your life who knows you're considering this, who you could reach after the session?"

Specific enough to surface the actual gap without signaling the expected answer.

T2 Tool · T3 Version in Student Guide · Activates M01 DISC Work DISC in the Screening Interview — Know Yourself, Read Your Participant

DISC was introduced in M01 as self-awareness. M09 is where it becomes applied — in two directions simultaneously. You need to know your own style-driven risks in the screening conversation, and you need to be able to read the participant's style in real time to adapt how you ask questions and how you deliver your recommendation.

Part 1 — Know Your Style-Driven Risk in the Screening Interview

Every DISC style has a predictable failure pattern in the screening interview. Name yours before you practice — so you can watch for it.

D — Dominance

Style-driven risk: Drives toward the recommendation before the full picture is in — skips the deliberative pause, rushes Phase 3
Leading question risk: Asks closed questions to move faster ("You don't have a family history of psychosis, right?")
Watch for: Any time you feel impatient with the pace — slow down, that's the signal

I — Influence

Style-driven risk: Over-talks in Phase 2, shares own experiences, lets rapport-building crowd out clinical inquiry
Leading question risk: Softens questions with warmth in ways that lead ("You're in a pretty good place overall, yeah?")
Watch for: Any time you're talking more than the participant in the three-space inquiry

S — Steadiness

Style-driven risk: Avoids difficult questions to preserve harmony — softens Phase 3 clinical questions, hesitates on hard disclosures
Leading question risk: Softens to the point of leading ("You're not having any dark thoughts or anything like that, are you?")
Watch for: Any question you reworded to feel less confrontational

C — Conscientiousness

Style-driven risk: Over-processes in Phase 4, delays the recommendation, gives the participant too much technical rationale
Leading question risk: Asks compound questions that overwhelm ("So thinking about your medication history and also any family history, can you tell me about...?")
Watch for: Any recommendation preamble longer than 30 seconds

Part 2 — Read the Participant's Style in Real Time and Adapt

You can observe a participant's likely style in the first few minutes of Phase 1 — how they respond to the opening, how much they talk, what they prioritize, how they frame their answers. Use that reading to adapt how you conduct the interview and deliver the recommendation. You don't need certainty — you need calibration.

Participant reads as D

Signals: Cuts to the point quickly, asks what this is going to take, may seem impatient with process explanation
How to ask questions: Be direct and efficient. Skip long context-setting. Ask one question at a time.
How to deliver the recommendation: Bottom line first, then rationale. "My recommendation is X. Here's why."

Participant reads as I

Signals: Enthusiastic, shares a lot, makes personal connections, may jump between topics
How to ask questions: Honor the rapport; gently redirect to the question when they range. "That's really helpful — and I also want to ask about..."
How to deliver the recommendation: Acknowledge what you heard before the recommendation. Frame the pathway as a shared next chapter.

Participant reads as S

Signals: Warm but reserved, waits to be asked, answers carefully, may minimize their own needs
How to ask questions: Give extra reassurance that honest answers are welcome. Slow the pace. Check in: "Is there anything you want to add about that?"
How to deliver the recommendation: Warm and relational. Reassure that the relationship continues regardless of the outcome. Name the pathway clearly.

Participant reads as C

Signals: Asks clarifying questions, wants to understand why you're asking, gives precise, detailed answers
How to ask questions: Briefly explain the purpose of each phase. Precision is welcomed. Don't skip the "why" behind clinical questions.
How to deliver the recommendation: Give the rationale in full. They want to understand the logic, not just the conclusion. Specific documentation language lands well.

Important reminder: DISC is a communication style framework, not a clinical assessment tool. You are observing how this participant communicates and adapting your approach accordingly — you are not diagnosing their personality or making eligibility judgments based on their style. A high-D participant who seems impatient is not a red flag. A high-S participant who takes time to answer is not withholding. Style observation is in service of better communication, not clinical interpretation.

Demonstration · 15 min

Instructor Models Conduct a live demonstration screening interview (first 8 minutes) with a volunteer student as participant. Use a prepared scenario — the participant has one mild healthspace flag (controlled anxiety on medication, prescriber aware but no written clearance) and a solid lifespace. Conduct the interview using the five-phase architecture and neutral questioning throughout. After the demonstration, debrief specifically: "What did you notice about how I transitioned between phases? Where did you see neutral questioning vs. a moment when I might have led?" This deconstruction is as valuable as the demonstration itself.

If no volunteer is available, the instructor can demonstrate with a co-facilitator or describe the interview aloud while narrating the decision-making. The demonstration is essential — students need a model before they practice.

Practice Exercise · 40 min

First 8 Minutes — Interview Architecture Practice · Pairs

Pairs take turns as facilitator and participant. The facilitator conducts the first 8 minutes of a screening interview using the five-phase architecture and their M08 intake instrument. The participant uses a provided scenario card (one mild healthspace flag, clear mindspace, solid lifespace). Observer partner notes: which phase was in play at each point; any leading questions that appeared; whether the facilitator used transitions between spaces. Switch roles. Debrief on specific moments.

Round 1: Facilitator conducts interview, observer notes. 8 min + 5 min notes
Partner debrief — observer shares specific observations. 5 min
Round 2: Switch roles. 8 min + 5 min notes
Partner debrief. 5 min
Full group share: one leading question each person caught in themselves. 4 min

Debrief · 15 min

Debrief Questions

Which phase felt most unnatural to you — and what does that tell you about your default conversational style?

Where did the Phase 3 three-space inquiry start to feel like a checklist rather than a conversation? What would you do differently to maintain the relational quality while covering the clinical content?

What is the hardest neutral question to ask? Why — and is your DISC style part of that answer?

When you played participant, what did it feel like when the facilitator asked a leading question? What did it feel like when they read your style and adapted? What's the difference in what you were willing to disclose?

Async Assignment — Due Before Lesson 2

Interview architecture self-assessment: Record yourself conducting the first 8 minutes of a screening interview with a friend, family member, or study partner as a practice participant. Watch it back and note: (1) at least one moment where you led a question — write the leading version and your revised neutral version; (2) which phase felt least natural and one specific thing you'll do differently; (3) whether your three-space transitions felt smooth or abrupt — revise the transition language to feel more natural in your voice. This is not submitted; bring your notes to L2.

Lesson 2 Thresholds & Transparent Recommendations · 1.5 hr sync + 1.0 hr async

Lesson 2: Thresholds & Transparent Recommendations

2.5 hrs total · 1.5 hr sync / 1.0 hr async · CO I.1 · I.4 · I.5 · J.12

This lesson teaches how to apply thresholds to what a screening interview surfaces — distinguishing exclusion criteria from cautionary criteria — and how to communicate the resulting recommendation in a way that is transparent, specific, autonomy-preserving, and scope-compliant. It also addresses the I.4 content: what to do when the facilitator is not the right fit, including how to offer a warm handoff rather than a referral-by-abandonment.

Sync Time 1.5 hours — lecture (25 min) + threshold case exercise (35 min) + recommendation roleplay (25 min) + debrief (5 min)

Materials Threshold matrix reference card · Transparent recommendation language template · Practice scenario cards (6 cases)

Lecture · 25 min

"The screening interview surfaces information. The threshold matrix tells you what to do with it. And the recommendation is how you communicate that decision in a way that actually serves the participant. All three are required. A facilitator who can conduct a beautiful screening interview but gives a vague recommendation at the end hasn't completed the job."

Exclusion criteria vs. cautionary criteria: Exclusion criteria are the absolute and relative contraindications from M08 — conditions that require either a hard stop or a hold pending medical clearance. These are non-negotiable within facilitator scope. Cautionary criteria are conditions that don't prevent proceeding but require specific additional preparation, monitoring, or support structure. The practical difference: exclusion criteria drive a hold or refer recommendation; cautionary criteria drive a "proceed with additional preparation" recommendation with specific named additions. A facilitator who treats cautionary criteria as exclusion criteria is over-gatekeeping; a facilitator who treats exclusion criteria as cautionary is under-gatekeeping. The threshold matrix builds the clear distinction between these two categories.

Applying thresholds after a live screening: In a real screening, threshold application is not done with a reference card in hand. It is done from internalized knowledge — which is why the M08 content must be solid before M09 is meaningful. The reference card is a training tool and a memory aid, not a real-time decision support system. The OSCE will test whether students can apply thresholds in a live conversation without external references.

Transparent recommendations (I.1, J.12): The recommendation phase of the screening interview must accomplish four things: state the recommendation clearly (what), explain the rationale in scope-compliant language (why), provide the participant with their next action (what they do), and document the conversation accurately. "I have some concerns" is not a recommendation. "I'd like to think about this more" is not a recommendation. A recommendation is specific: "Based on what you've shared, I recommend we proceed to preparation — your healthspace and mindspace are clear, and your support structure is solid. Here's what preparation looks like and when we'd schedule our first session." Or: "Based on what you've shared, I'm recommending we hold for now — specifically because your current medication requires written clearance from your prescribing physician before we can proceed. Here is the service description document to take to your next appointment."

Connecting with a different facilitator (I.4): Sometimes the right recommendation is "I'm not the right facilitator for you." This is not a failure — it is professional integrity. Reasons a facilitator might not be the right fit: scope mismatch (participant needs clinical mental health support that exceeds facilitation scope), specialization mismatch (participant has complex trauma that requires specialized trauma-informed training the facilitator hasn't completed), relational mismatch (dual relationship concerns, significant cultural or language barriers the facilitator cannot adequately bridge), or genuine therapeutic contraindication (prior relationship that creates transference risk). When connecting a participant with a different facilitator, the conversation must be: honest about why, non-shaming (the participant is not deficient), and warm (a specific referral, not "go find someone else"). I.4 language: "I want to be honest with you — based on what you've shared, I think you'd be better served by a facilitator with specialized experience in [X]. That's not a reflection on you; it's me wanting to make sure you have the best possible support. I have someone I can connect you to..."

Watch For

Vague recommendations as conflict avoidance: Students often soften recommendations to manage the participant's anticipated disappointment. "I have some concerns" instead of "I recommend we hold because of X." Practice direct delivery until it no longer feels unkind.
"Connecting with a different facilitator" as rejection framing: Students sometimes struggle to deliver I.4 language without it sounding like "you're too much for me." The frame is professional judgment about optimal fit, not participant deficiency.
Documentation after recommendation: Some students forget that the recommendation is what gets documented — not just the screening content. The documentation note should reflect the actual recommendation made and the specific rationale.

Use Your M08 Reference Cards for Threshold Application

M09 does not duplicate the threshold content from M08 — it applies it. When working through the exercise cases, use the reference cards students already have from M08:

Healthspace Physical Reference Card — absolute and relative contraindications
Healthspace Medications Reference Card — medication classes and clearance requirements
Mindspace Stability Reference Card — hold indicators, cautionary criteria, proceed criteria
Lifespace Readiness Mapping Worksheet — the five lifespace domains and flag criteria
M08D Threshold reminder: the determination is always the whole three-space picture. A cautionary criterion in all three spaces simultaneously may constitute a combined hold recommendation even if no single criterion is exclusionary.

Students who have not consolidated their M08 reference cards will struggle with the L2 exercise. Check in before beginning.

Use Your M08 Recommendation Tools + New I.4 Language Below

For proceed, hold, and refer recommendation language, use the tools students already have from M08:

Go/Hold/Refer Documentation Template (M08D) — proceed, hold, and refer language with scope notes
Hold Conversation Language Template (M08B) — three-part hold structure and model language

What M09 adds is the I.4 content below — connecting a participant with a different facilitator. This is the one recommendation type not addressed in M08, and it is genuinely new here.

M09 Tool · T3 Version in Student Guide · New Content — Not in M08 Connecting with a Different Facilitator — I.4 Language Template

I.4 requires facilitators to know how to help a participant connect with a different facilitator when the current facilitator is not the right fit. This is not a rejection — it is professional integrity. The participant should leave with a specific person to contact, not a vague "go find someone else."

When the Facilitator Is Not the Right Fit

Reasons: scope mismatch, specialization gap, dual relationship concern, significant unmitigable cultural/language barrier.

"I want to be honest with you about something. Based on what you've shared, I think you'd be better served by a facilitator with [specific specialization — e.g., 'specialized training in complex trauma' / 'experience working with participants from your cultural background' / 'Portuguese language fluency']. That's not a reflection on you — it's me wanting to make sure you have the best possible support for what you're bringing. I have someone I can connect you to. Their name is [name], they specialize in [X], and here's how to reach them. Would you like me to make that introduction?"

This is a warm handoff. The participant leaves with a specific person, a specific reason that person is a better fit, and the facilitator actively facilitating the connection — not just redirecting.

What a Warm Handoff Includes

A Warm Handoff Includes

Specific name or practice of the other facilitator
Specific reason they are a better fit
Concrete contact information
Facilitator actively facilitating the introduction if possible

A Warm Handoff Is Not

"I don't think I'm the right fit for you" with no next step
"You should look for someone who specializes in that"
A referral framed as a participant deficiency
Abandonment disguised as professional judgment

Style-Adaptive Recommendation Delivery — Activates M01 DISC

The recommendation is the same regardless of style — what changes is the sequence and framing. Use your reading of the participant's DISC style from the interview to adapt delivery.

D Participant

Bottom line first. "My recommendation is X." Then rationale. Keep it efficient — they'll ask questions if they want more.

I Participant

Acknowledge what you heard first. Frame the recommendation as a shared next step. Keep the relational tone warm throughout.

S Participant

Lead with warmth and reassurance that the relationship continues. Name the pathway clearly — ambiguity creates anxiety. Check in: "How does that feel?"

C Participant

Give the full rationale. They want to understand the logic. Specific documentation language ("here's what I noted") lands well. Welcome their questions.

Exercise · 60 min · Threshold Application + Full Recommendation Roleplay

Screening Practice — 6 Scenario Cards + Recommendation Roleplay · Pairs

Part 1: Pairs receive 6 screening summary cards (simulated end-of-Phase-3 pictures). For each: apply the threshold criteria from their M08 reference cards, name the recommendation type (proceed / hold / refer / connect), and draft the spoken recommendation using the M08 GHR template or hold conversation template — plus the new I.4 language template for any "connect" scenarios. Part 2: Pairs conduct a full 10-minute screening simulation using the most complex scenario — facilitator conducts all five phases; partner plays participant; observer notes leading questions, threshold application, and recommendation quality.

Threshold matrix application — 6 cases, classify and draft recommendation. 20 min
Group comparison and debrief on contested cases. 10 min
Full 10-minute screening simulation — most complex scenario. 10 min + 5 min debrief

Scenario 01 — Proceed

Healthspace: No contraindications, no medications. Mindspace: History of mild anxiety, well-managed, current therapist aware and supportive of pursuing this. Stable baseline. Lifespace: Spouse aware and available, no obligations day-after, works remotely. Intentions: Personal growth and curiosity. Realistic expectations.

Key: Proceed to preparation. All spaces clear. Recommendation: "Based on everything we've covered, I'm ready to move forward. Your health picture is clear, you're in a stable place emotionally with good support in place, and your logistics are solid. I'd like to move into preparation. Here's what that looks like..."

Scenario 02 — Hold (Healthspace)

Healthspace: Taking venlafaxine 75mg/day; prescriber aware participant is interested in natural medicine services but no written clearance provided. Mindspace: Stable; good support. Lifespace: Clear. Intentions: Managing treatment-resistant depression; realistic about outcomes.

Key: Hold pending healthspace clearance. Recommendation: "My recommendation is to hold for now — not because of who you are or what you're hoping for, but because your venlafaxine needs written clearance from your prescribing physician before we can proceed. Here is the service description document to bring to your next appointment. Once you have that in writing, reach out and we'll move forward."

Scenario 03 — Hold (Mindspace)

Healthspace: No medications, no physical flags. Mindspace: Discloses a significant loss (parent died 6 weeks ago); sleep severely disrupted; "I feel like this is what I need to get through this." No current therapeutic support. Lifespace: Adequate support. Intentions: Processing grief; driven by acute pain.

Key: Hold (mindspace — acute grief <90 days, no clinical support). Recommendation includes the pathway: active therapeutic work for at least 60 days + grief stabilization before reassessment. Also name: microdosing may be worth exploring as a bridge if they don't want to wait entirely. Warm, specific, pathway-focused.

Scenario 04 — Refer

Healthspace: No medications. Mindspace: During Phase 2, participant discloses they've been having "thoughts of not being here anymore" on and off for several months. They minimize: "It's not serious, I just think about it sometimes." Lifespace: Relatively isolated. Intentions: "I need something to help because nothing else has worked."

Key: M05 protocol activates. This is a safety situation, not a screening threshold decision. Do not continue the screening. Facilitate connection to mental health support immediately. The facilitator's warmth and non-alarmist tone is critical here — this person needs to feel heard, not processed.

Scenario 05 — Connect with Different Facilitator

Healthspace: No flags. Mindspace: History of complex developmental trauma; currently working with a trauma therapist who is supportive; stable but brings very intense material. Lifespace: Solid. Facilitator assessment: The facilitator is new to practice and has not completed specialized complex trauma training. The participant is eligible — but this facilitator is not the right fit.

Key: I.4 — connect with a different facilitator. Participant is eligible from a three-space perspective. The concern is facilitator fit and scope of competency — not participant eligibility. Recommendation must be honest, non-shaming, and result in a warm connection to a more specialized facilitator. Do not frame as a participant problem.

Scenario 06 — Complex / Discuss (Multiple Spaces)

Healthspace: ADHD, taking low-dose methylphenidate; prescriber general support letter (not specific to the combination question). Mindspace: History of anxiety, currently well-managed; also discloses their partner does not know they are doing this and "would not approve." Lifespace: The undisclosed status to partner = support gap; logistics otherwise solid.

Key: Hold on two items. Healthspace: clearance letter needs to specifically address the stimulant combination question. Lifespace: the partner not knowing creates a support gap — the facilitator should not require disclosure (that is prescriptive) but should name the gap and co-plan around it. This case should generate discussion — neither hold item is obvious, and the I.4 question (is this a fit issue?) may come up too.

Debrief · 5 min (embedded)

Debrief Questions

Scenario 03 — the acute grief case. The participant said "this is exactly what I need." How did you hold that compassionately while delivering a hold recommendation with a pathway?

Scenario 05 — connecting with a different facilitator. What was hardest about that recommendation? What would make it feel like professional judgment rather than rejection?

Scenario 06 — the partner doesn't know. Did you feel pulled toward requiring the participant to tell their partner? Where is the scope line?

When you delivered your recommendation in the full simulation — did you adapt your delivery to the participant's apparent style? What did you notice about their response when you did (or didn't)?

Async Assignment — Due Before OSCE Window

Interview architecture refinement + I.4 language (portfolio artifact): Finalize your interview architecture reference card with your own transition language written between the phases — the words you will actually use to move from healthspace to mindspace to lifespace in a real conversation. Also write your personalized version of the I.4 warm handoff language from today's template — in your own voice, practiced out loud until it sounds natural and not like a rejection. Bring both to the OSCE window. Your M08 GHR template and hold conversation template are your recommendation language — make sure those are in your portfolio and ready to use.

Full OSCE Summative performance assessment · Scheduled within M09 window · Assessor copy — not for distribution

M09 OSCE — Screening Interview Station

10-minute performance station · 4 domains × 25 pts · Cut score: 70 overall / min 15 per domain · One retake permitted

Station Overview

The candidate conducts the first 8 minutes of a structured screening interview with a prospective participant, then delivers a clear summary and recommendation. The participant profile contains one mild healthspace flag (medication requiring medical clearance), one cautionary mindspace item (processed trauma history with active therapeutic support), and one lifespace item that surfaces during conversation (undisclosed complex childcare logistics). The candidate must cover all three spaces, apply the threshold matrix, and deliver a specific, scope-compliant recommendation with documented rationale.

Scenario Brief — Candidate Copy (Given at Station Start)

Participant Profile — Presented to Candidate

Background: 44-year-old prospective participant. Has scheduled this screening after reading about psilocybin-assisted therapy for depression. Currently taking bupropion (Wellbutrin) 150mg/day prescribed for depression. No other medications disclosed on intake form. Described mood as "much better than it was two years ago." No psychiatric hospitalizations. No family history of psychotic disorders.

Candidate instruction: Conduct the first 8 minutes of a structured screening interview covering all three spaces. Use good interview architecture and neutral questioning. Deliver your recommendation at the end. You may use your intake instrument.

Scenario Script — Assessor and Actor

Actor Setup — Warm, Motivated, Initially Incomplete

Actor plays participant: warm, engaged, somewhat eager to be approved. Answers all questions honestly but doesn't volunteer information not directly asked for. Two key disclosures actor holds until specifically asked:

Childcare logistics (if asked about lifespace obligations): "Oh — I have two kids, 5 and 7. My husband works evenings so I'm usually solo for the evening. I'd need to figure something out for the session day." If asked about backup: "I haven't really thought about that — I guess my sister could help? She lives 40 minutes away."

Trauma history (if asked about mindspace history): "I had a pretty rough childhood — I've been in therapy for the last three years working through it. My therapist actually suggested looking into psilocybin. She thinks I'm ready."

Bupropion Disclosure — If Not Caught by Candidate

Bupropion is listed on the intake form. If the candidate does not address it in the healthspace phase, assessor notes this as a Domain 2 gap. Actor does not volunteer it again — the candidate is responsible for following up on what's in the form.

Scoring Rubric — 4 Domains × 25 Points Each

Domain	Exemplary (23–25)	Meets Standard (17–22)	Below Standard (0–16)
1 · Interview Architecture Five phases present · Transitions clear · Sequence correct	All five phases present in correct sequence. Transitions between phases and spaces are explicit and smooth. Opening establishes context and presence. Deliberative pause used before recommendation. Conversation feels structured but not mechanical.	Four of five phases present. Transitions between spaces occur but may be abrupt or implicit. Sequence is mostly correct. Deliberative pause may be brief or absent.	Fewer than four phases identifiable. No transitions between spaces — conversation jumps between domains. Recommendation appears without deliberation. Conversation feels like a checklist rather than an interview.
2 · Neutral Questioning & Three-Space Coverage All three spaces covered · No leading questions · Bupropion addressed	All three spaces covered with specific, non-leading questions. Bupropion identified and addressed as requiring medical clearance. Childcare logistics surfaced through lifespace questioning. Trauma history surfaced through mindspace history questions. No leading questions observed.	All three spaces covered but one space may be shallow. Bupropion identified but response may be vague. Childcare or trauma history may not be fully surfaced. 1–2 mildly leading questions present.	One or more spaces not meaningfully covered. Bupropion not addressed or minimized. Leading questions multiple or significant. Participant's disclosures not followed up adequately.
3 · Threshold Application Correct classification · Exclusion vs. cautionary clear · Recommendation type appropriate	Correctly identifies bupropion as requiring medical clearance (hold item) and addresses the childcare logistics gap (lifespace hold or planning item). Trauma history with active therapist support correctly classified as cautionary/proceed with preparation — not as a hold. Recommendation type (hold on healthspace, proceed with prep note on mindspace) is appropriate to the picture.	Bupropion correctly identified as a hold item. Trauma history classification may be overly cautious (treated as exclusion when it is cautionary). Childcare logistics may not be classified. Recommendation type mostly appropriate with minor gaps.	Bupropion not identified or treated as no-flag. Trauma history misclassified as exclusionary. Childcare logistics not surfaced or classified. Recommendation type does not match the three-space picture.
4 · Recommendation Quality What + why + what next · Specific · Scope-compliant · Actionable	Recommendation states: hold on healthspace pending written medical clearance for bupropion use; proceed with preparation note regarding trauma history (therapist support is a positive factor, not a hold driver); address childcare logistics before session scheduling. Rationale is specific and scope-compliant. Next steps are concrete for both participant and facilitator. Language maintains participant agency.	Recommendation covers the bupropion hold but may be vague on rationale ("we need clearance" without specifics). Trauma history may not be addressed in the recommendation. Childcare logistics may not appear. Next steps present but incomplete.	Recommendation is vague ("I have some concerns"), missing ("let me think about this"), or incorrect (proceed without addressing bupropion; hold on trauma history without pathway). No next steps. Language is disempowering or scope-violating.
Total Score (max 100)

Cut score: 70 overall · No domain below 15/25 · Retake: One retake permitted within M09 assessment window

Alternate OSCE Scenario — For Retake Use Only

Alternate — Lifespace-Driven Hold + I.4 Element

Participant profile: 38-year-old, no medications, no physical flags. History of alcohol use disorder, 18 months sober, active in AA, sponsor aware. Good support structure. Clear intentions around personal growth.

Mid-interview disclosure (when lifespace is asked): "I should mention — I'm going through a custody dispute right now. It's been going on for six months. My lawyer says it could go to trial in about three months."

Additional late disclosure (if asked about fit/facilitator experience): Participant mentions their primary issue is complex addiction history with childhood abuse roots — "I've heard this can help with addiction specifically."

Candidate challenge: The lifespace item (active legal proceeding, high-stakes stressor) may be a cautionary item or a hold item depending on the picture. The addiction/trauma history needs to be properly classified (cautionary, with solid recovery support — not exclusionary). The I.4 element: if the facilitator doesn't have specialization in addiction, the recommendation should include a note about fit. Correct recommendation: likely proceed with cautionary preparation focus on the legal stressor + fit check for addiction specialization.

Assessor Calibration Notes

Domain 1: The most common Domain 1 failure is missing the deliberative pause — candidates move directly from Phase 3 to Phase 5 without a moment of synthesis. This is worth noting specifically in feedback, as it's a professional practice marker, not just procedural compliance.

Domain 2: Bupropion is an SNRI — serotonin-norepinephrine reuptake inhibitor. Candidates who don't flag it have either forgotten the M08 medication content or failed to connect the intake form to the screening conversation. Domain 2 failure on this item is a marker of M08 content not being consolidated.

Domain 3: The most common Domain 3 error is over-pathologizing the trauma history — classifying "history of childhood trauma, actively in therapy for 3 years, therapist recommends" as an exclusion criterion. This inverts the threshold matrix. Active therapeutic support is a positive factor. Candidates who hold on trauma history with active support need specific coaching on cautionary vs. exclusionary.

Domain 4: The recommendation must include the bupropion hold AND address what happens next with the trauma history AND the childcare logistics. A recommendation that only addresses one of the three items is incomplete. Watch also for language that is technically correct but disempowering — "I can't work with you until you get clearance" versus "I'd like to move forward with you — here's the one thing that needs to be in place first."

Remediation Protocol

For Candidates Below Cut Score

Written domain-specific feedback from assessor delivered within 48 hours
30-minute coaching session: for Domain 2 failures (medication recognition) — M08 content review and targeted medication practice; for Domain 3 failures (threshold application) — threshold matrix practice with 6 additional cases; for Domain 4 failures (recommendation quality) — written recommendation drafting with feedback
One retake using the alternate scenario within the M09 assessment window
Candidates who do not pass on retake may not begin M10 (Preparation) until a remediation plan approved by the program director is completed
All OSCE attempts must be documented with assessor rubrics retained in the student's program file

Bridge to Module 10

M09 completes the eligibility phase — the participant has been screened and cleared. Module 10 — Preparation opens the next phase: co-designing the preparation plan with a participant who has been determined eligible to proceed. Where M08 and M09 asked "can this person take the journey?", M10 asks "how do we prepare them for it?" The preparation phase is where intention-setting, psychoeducation, environmental design, and logistics planning happen — building directly on the three-space foundation the screening established.

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