Platform — How It Works Under the Hood

The engine under every session

Neurodex's trajectory model tracks each person's PHQ-9 and GAD-7 arc session by session — selecting CBT techniques, adjusting intensity, and escalating crisis signals to a licensed clinician before they become emergencies.

Request a Pilot Clinical Safety

Three user trajectories — weeks 1 to 8

Intake & Assessment

30 seconds to a baseline. A session in under 2 minutes.

Every Neurodex session begins with a 9-item PHQ-9 screener and a 7-item GAD-7 screener, delivered conversationally. The completion time is under 2 minutes for most members. Scores establish symptom severity (minimal / mild / moderate / severe) and map directly to opening module selection logic.

PHQ-9 for depression severity — 9-question Patient Health Questionnaire, scored 0–27

GAD-7 for anxiety severity — 7-question Generalized Anxiety Disorder scale, scored 0–21

PHQ-9 Item 9 monitored continuously — suicidal ideation signal triggers immediate escalation review

Over the last two weeks, how often have you had trouble falling or staying asleep, or sleeping too much?

Not at all

Several days

More than half the days

Nearly every day

3/9

Under 90 seconds remaining

Trajectory Engine

Every session updates the model. Every model changes the next session.

Unlike static CBT apps that assign everyone the same 8-week curriculum, Neurodex recalculates the care pathway after every session using 14 real-time signals.

What the trajectory engine tracks

PHQ-9 score delta session-over-session (improvement rate)

GAD-7 score trajectory and week-3 plateau detection

Session completion rate (abandonment clustering)

Between-session engagement (check-in responses)

Module efficacy signal (engagement quality per technique)

Suicidal ideation item 9 — always monitored independently

What changes based on trajectory

Session intensity — depth of cognitive challenge scales with readiness

Module sequencing — plateau triggers pivot to a complementary technique

Check-in frequency — rising distress increases between-session contact

Escalation threshold — worsening trend pre-arms the crisis monitoring window

Clinician notification — triggered at severity thresholds, not calendar dates

CBT Module Library

Seven validated CBT techniques. Auto-selected per symptom profile.

Neurodex doesn't assign one technique and stay with it. Each module is auto-selected based on the intake profile and can be swapped when trajectory signals indicate diminishing returns.

Thought Records

Structured written exercise identifying automatic thoughts, examining evidence, and reframing cognitive distortions. Primary module for moderate-to-severe depression with strong cognitive distortion signals.

Trigger conditions

PHQ-9 ≥ 10 + catastrophizing language in intake. Cognitive distortion cluster detected.

Behavioral Activation

Activity scheduling and engagement planning. Strongest evidence base for mild-to-moderate depression. Directly addresses social withdrawal and anhedonia patterns detected in intake.

Trigger conditions

PHQ-9 items 1/7 elevated (anhedonia + fatigue cluster). Inactivity signals from session content.

Cognitive Restructuring

Systematic challenging of distorted thought patterns using Socratic questioning. Builds metacognitive awareness and reduces rumination cycles. Complementary module after Thought Records.

Trigger conditions

Session 3+ with active rumination. Negative attribution style sustained across 2+ sessions.

Sleep Hygiene Protocol

CBT-I–informed sleep intervention addressing the depression-insomnia comorbidity. PHQ-9 item 3 is a leading predictor of treatment non-response when unaddressed.

Trigger conditions

PHQ-9 item 3 ≥ 2 (sleep disruption). Flagged at intake and re-evaluated each session.

Relaxation Training

Progressive muscle relaxation and diaphragmatic breathing for anxiety symptom management. Delivered as audio-guided exercises and in-session practice. High engagement, short-term outcome signal.

Trigger conditions

GAD-7 ≥ 8 + somatic anxiety indicators. Often delivered as Session 1 or 2 for high-anxiety presentations.

Problem-Solving Therapy + Mindfulness

PST for situational stressors and life problems driving distress. MBSR-informed mindfulness for chronic stress and generalized worry. Used in later sessions after foundational techniques.

Trigger conditions

Session 4+ with persistent GAD-7 plateau. Situational stressor clusters in session content analysis.

Crisis Escalation Protocol

When a signal appears, a human responds — within 3 minutes.

Neurodex's escalation protocol is not a chatbot safety message. It is a clinical handoff. When crisis signals are detected, the session pauses, a licensed clinician on our 24/7 team is paged, and the member receives direct human contact within 3 minutes.

PHQ-9 item 9 spike Direct crisis disclosure Session abandonment cluster Severity escalation pattern Hopelessness language detection

Signal detected in session

Crisis indicator identified from PHQ-9 item 9, direct statement, or session behavior pattern.

AI session paused — safety resources shown

Member immediately sees 988 Lifeline and local crisis resources. Session content preserved.

Licensed clinician paged — 3-minute SLA

On-call clinical staff receives alert with session context. Direct outreach to member within 3 minutes.

Incident documented in audit log

Full escalation record available in aggregate dashboard for health plan clinical reviewers.

See the platform in a 30-minute walkthrough

We'll walk through a live session, show you the trajectory dashboard, and demonstrate the escalation protocol end-to-end.

Request a Pilot Clinical Safety Page