feat: add interactive administration guidance

Author: rhavekost

README.md

@@ -187,19 +187,25 @@ Skills can be invoked in multiple ways:
    → Uses depression-screening and anxiety-screening skills
    ```
 
-2. **Risk Assessment:**
+2. **Interactive Administration:**
+   ```
+   "Let's start a PHQ-9 assessment"
+   → Uses depression-screening skill in item-by-item mode
+   ```
+
+3. **Risk Assessment:**
    ```
    "The PHQ-9 Item 9 was positive - help me assess suicide risk"
    → Uses suicide-screening skill with C-SSRS or ASQ
    ```
 
-3. **Treatment Planning:**
+4. **Treatment Planning:**
    ```
    "Based on these assessment results, help me create a treatment plan"
    → Uses treatment-planning skill for goals and level of care
    ```
 
-4. **Documentation:**
+5. **Documentation:**
    ```
    "Help me write a SOAP note for this intake session"
    → Uses documentation skill

skills/anxiety-screening/SKILL.md

@@ -35,6 +35,18 @@ This skill helps administer and interpret validated anxiety screening instrument
 
 **For treatment recommendations:** See [references/clinical-decision-trees.md](references/clinical-decision-trees.md)
 
+## Interactive Administration (Optional)
+
+Use this mode when the clinician says "start" or "administer" the GAD-2/GAD-7.
+
+1. Confirm readiness and explain the past 2 weeks time frame plus the 0-3 response scale.
+2. Ask one item at a time (verbatim from the asset file) and wait for a response before continuing.
+3. Accept numeric or verbal responses; if unclear or out of range, ask for clarification.
+4. Record each response and keep a running total.
+5. If responses indicate severe anxiety or there is any safety concern, pause and assess safety (see Safety Considerations).
+6. After the final item, calculate the total score, interpret severity, and provide next-step guidance.
+7. Offer a brief documentation summary if requested.
+
 ## Assessment Tools
 
 ### GAD-7 (Generalized Anxiety Disorder-7)

skills/bipolar-risk-interview/SKILL.md

@@ -15,6 +15,16 @@ This is an **original, non‑validated** interview guide for exploring bipolar r
 - When antidepressant response has been atypical or poor
 - When family history suggests bipolar disorder
 
+## Interactive Mode (Lightweight)
+
+Use this mode when the clinician asks to go step-by-step.
+
+1. Confirm this is a non-validated interview guide and check readiness.
+2. Ask one prompt at a time from the interview guide and wait for a response.
+3. Summarize key points and confirm accuracy before moving on.
+4. At the end, synthesize risk factors, red flags, and functional impact with suggested next steps.
+5. If safety concerns arise, pause and follow appropriate safety protocols.
+
 ## Interview Guide
 
 See: [assets/interview-guide.md](assets/interview-guide.md)

skills/cognitive-concerns-intake/SKILL.md

@@ -9,6 +9,16 @@ description: "Use when you need a structured, non-validated intake for cognitive
 
 This is an **original, non‑validated** intake guide for cognitive complaints. It does **not** replace validated cognitive instruments.
 
+## Interactive Mode (Lightweight)
+
+Use this mode when the clinician asks to go step-by-step.
+
+1. Confirm this is a non-validated intake guide and check readiness.
+2. Ask one prompt at a time from the intake guide and wait for a response.
+3. Summarize key points and confirm accuracy before moving on.
+4. At the end, synthesize cognitive concerns, functional impact, and suggested next steps.
+5. If safety concerns arise, pause and follow appropriate safety protocols.
+
 ## Intake Guide
 
 See: [assets/history-template.md](assets/history-template.md)

skills/depression-screening/SKILL.md

@@ -85,6 +85,18 @@ digraph item9_protocol {
 
 **Universal crisis protocols:** [../../docs/references/crisis-protocols.md](../../docs/references/crisis-protocols.md)
 
+## Interactive Administration (Optional)
+
+Use this mode when the clinician says "start" or "administer" the PHQ-2/PHQ-9.
+
+1. Confirm readiness and explain the past 2 weeks time frame plus the 0-3 response scale.
+2. Ask one item at a time (verbatim from the asset file) and wait for a response before continuing.
+3. Accept numeric or verbal responses; if unclear or out of range, ask for clarification.
+4. Record each response and keep a running total.
+5. **Item 9 safety rule:** If Item 9 > 0, STOP and follow the Item 9 safety protocol before continuing.
+6. After the final item, calculate the total score, interpret severity, and provide next-step guidance.
+7. Offer a brief documentation summary if requested.
+
 ## Assessment Tools
 
 ### PHQ-9 (Patient Health Questionnaire-9)

skills/distress-screening/SKILL.md

@@ -23,11 +23,16 @@ This skill provides the K6 and K10 psychological distress scales. Use K6 for bri
 - **K6**: [assets/k6.md](assets/k6.md)
 - **K10**: [assets/k10.md](assets/k10.md)
 
-## Interactive Administration (Item-by-Item)
+## Interactive Administration (Optional)
 
-1. Read each item verbatim with the past 30 days time frame.
-2. Record responses using the five-category frequency scale.
-3. Recode responses to 0-4 scoring and sum.
+Use this mode when the clinician says "start" or "administer" the K6/K10.
+
+1. Confirm readiness and explain the past 30 days time frame plus the 5-point response scale.
+2. Ask one item at a time (verbatim from the asset file) and wait for a response before continuing.
+3. Accept numeric or verbal responses; if unclear or out of range, ask for clarification.
+4. Recode responses to 0-4 scoring and keep a running total.
+5. After the final item, calculate the total score, interpret severity, and provide next-step guidance.
+6. Offer a brief documentation summary if requested.
 
 ## Documentation
 

skills/documentation/SKILL.md

@@ -32,6 +32,16 @@ This skill provides templates and guidance for standard clinical documentation f
 | Treatment plan | Treatment Plan Template |
 | Safety issue | Safety Documentation Protocols |
 
+## Interactive Mode (Lightweight)
+
+Use this mode when the clinician asks to build a note step-by-step.
+
+1. Confirm the note type (SOAP, DAP/BIRP/GIRP, or treatment plan) and setting.
+2. Ask for required inputs one section at a time and wait for responses.
+3. If information is missing or unclear, ask targeted follow-ups.
+4. Draft the note and ask for confirmation or edits before finalizing.
+5. If safety issues are described, prioritize safety documentation protocols.
+
 ## Usage
 
 This skill can be invoked when you need to:

skills/eating-risk-checklist/SKILL.md

@@ -9,6 +9,16 @@ description: "Use when you need a structured, non-validated checklist for eating
 
 This is an **original, non‑validated** checklist for eating disorder risk factors and medical red flags. It is **not** a validated screener and does not diagnose.
 
+## Interactive Mode (Lightweight)
+
+Use this mode when the clinician asks to go step-by-step.
+
+1. Confirm this is a non-validated checklist and check readiness.
+2. Ask one item at a time from the checklist and wait for a response.
+3. Summarize key risks and confirm accuracy before moving on.
+4. At the end, synthesize red flags and recommended next steps.
+5. If immediate medical or safety concerns arise, pause and follow appropriate protocols.
+
 ## Checklist
 
 See: [assets/red-flags.md](assets/red-flags.md)

skills/functional-impairment-interview/SKILL.md

@@ -9,6 +9,16 @@ description: "Use when you need a structured, non-validated interview for functi
 
 This is an **original, non‑validated** interview guide for functional impact. It does **not** replace validated disability instruments.
 
+## Interactive Mode (Lightweight)
+
+Use this mode when the clinician asks to go step-by-step.
+
+1. Confirm this is a non-validated interview guide and check readiness.
+2. Ask one domain at a time from the interview guide and wait for a response.
+3. Summarize functional impacts and confirm accuracy before moving on.
+4. At the end, synthesize impairment patterns and suggested next steps.
+5. If safety concerns arise, pause and follow appropriate safety protocols.
+
 ## Interview Guide
 
 See: [assets/domain-checklist.md](assets/domain-checklist.md)

skills/intake-interview/SKILL.md

@@ -33,6 +33,16 @@ This skill provides structured interview guides and frameworks for comprehensive
 | 3 | Run HEADSS or Biopsychosocial |
 | 4 | Summarize 4Ps formulation and level of care |
 
+## Interactive Mode (Lightweight)
+
+Use this mode when the clinician asks to go step-by-step.
+
+1. Confirm readiness and explain confidentiality/limits before starting.
+2. Screen safety early (SI/HI/abuse) and pause if urgent concerns arise.
+3. Ask one domain at a time from the selected framework and wait for responses.
+4. Summarize key findings and confirm accuracy before moving on.
+5. At the end, synthesize 4Ps and suggested next steps.
+
 ## Usage
 
 This skill can be invoked when you need to: