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Rm Suicidal Ideation Date Targets 0-5 0-5 0-5 0-5 0-5 0-5 0-5 SUICIDAL IDEATION: 0 = No thoughts 1 = Fleeting thoughts 2 = More intense 3 = Very Intense 4 = Developing specific plan 5 = Acting on plan INTENSITY: 0 = Not at all 1 = A bit 2 = Somewhat 3 = Rather Strong 4 = VERY Strong 5 = EXTREMELY STRONG How often did you fill in your diary card? _____ DAILY ______ 2 / 3 X’S WK ______ 1X WK Urge to quit therapy? _______ Notes for the Week: Mon Agenda Items: Tue Wed Thurs Fri Sat Su.

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