The HEEADSSS psychosocial interview for adolescents Home Education and employment Eating Activities Drugs Potential first-line questions ‘Who ves with you? Where do youlive? ‘What are relationships ke at home? ‘Canyoutalkto anyone at home about stress? (Who?) lcthere anyone new at home Has someone lft recent? Do you havea smart phone or computer athome? In your room? What do you use it for (May sk this inthe {ctvties section) Tellme about school. Is your school a safe place? (Why?) Have you been bullied atschool? Do you feel connected to your school? Do you Feel as if youbelong? ‘Are there adults at school you feel you could talk to about something important? (Who?) Do you have any falling grades? Any recent changes? ‘Whatare your future education/empoyment plans! ols? ‘Are you working? Where? How much? Does your weight or body shape cause you any stress2f so, tellme about. Have there ben any recent changes in your weight? Have you deted inthe last year? How? How often? ‘What do you dofor fun? How do you spend time with {tiend Family? (With whom, where, when?) Some teenagers tell me that they spend much of thelr {ree time online. What types of things do you use the Internet for? How many hoursdo you spend on any given day in {ont of a screen, such asa computer, TV, or phone? Do {YU wish you spent less time on these things? Do any of your friends o family members use ‘tobacco? Alcohol? Other drugs? Do youuse tobacco or electronic cigarettes? Alcoho? Other drugs, energy drinks, steroid, oF medications not prescribed to you? Questions iftime permits or ifsituation warrants exploration Have you moved recent? Have you ever hat ive away from home? (Why?) Have you evecrun away? (Why?) \sthere any physical violence at home? How mary days have you mised from school this month? quartersemester? Have you changed schoolsnthe pas few yeas? Tellme about your friends t school Have you ever had torepeata classigrade? Have you ever been suspended? Expelled? Have you ever considered dropping out? How well do youget along the pecpleat school Work? Have our responsibilities at workincreased? What are you favorite subjects at school? Your least favorite subjects? What doyou like and not ik about your boy? Have you done anything else to try to manage your weight? Tell me about your exercise routine. What do you think would be aealthy diet” How does that compare to your current eating patterns? What wouldit belie Ifyou gained ost) 1010? Doesit ever seem as though your eating s out of contol? Hove you evertaken cet pil? Do you participate in any sports? Do youreguiaryattendreigious or spiritual activities? Have you messaged photos or texts that you have later regretted? CCenyouthinkofa frend who was harmed by spending time online? How often do you view pornography (or nude images or videos online? What types of books do you read for fur? How do you feel aftr playing video games? What music do you ike to listen? Is there any history of alcohol or drug problems in your family? Does anyone at home use tobacco? Do you ever drink or use drugs when you're alone? (Assess frequency intensity, patterns of use or abuse, and how patient abtains or pays for drugs alcohol, or tobacco) (Ask the CRAFFT questions in Table 5, page 25)Potential first-line questions Questions iftime permits or ‘situation warrants exploration Sewality Hoveyoueverbeen naromantcrelaionship? Tel Areyoursoqal acts enjoyable? ‘me about the people that you've dated. Have any of your relationships been violent? Have any of yout lationshps everbeenexial what does the term safe Sex’ mean 0 you? ae cmlorheincne ‘re youttracted to anyone now!ORTEHMe ave you ever been forced or pressured in dong a something sexual that you didn’t want to do? Ae youinterested in bey Gtk? Both? Notyet_——_ aye yoy everbeen touched Sexual/in away that You =“ didn’t want? Haveyou ever been raped, ona date or any other time? How many sexual partners have you had atogethe? (irs Hove you ever been pregnantor word that you may be pregnant (Boys Have youve gotten someone pregnantor word thotmight have happened? Whetare you using fr bith conto? Areyousatsied with yeurmethod? Do you use condoms everytime you have inercouse? Wat getsinthe way? Haveyou ever had a sexually ansmitted infection o ‘wotied tht youtad aninfeton? Suicide/ _Doyouteet“sesseoransiousmotethan usual Tel me about atime when you fltsnd while wing depression (ormorethan you preferto feel? Soca meta sts ke Facebook Do yofed sad ordown more than sua Does t seem that youve lostinterst in things that you Are you "bored" much of the time? used to really enjoy? ‘Ae youhaving wouble geting to sleep? Doyou ind yoursel spending less time with ends? Have you thoughta lot about hurting yourselfor Would yourather just be by yourself ost ofthe time? someeneeter Have you ever vied til yousel? Tellme about atimewhen someone pckedon you Haveyou everhad to hurt yourself (by cuting yousel, or made you feluncomforable online. for example) to calm down or fee! Bete?” (Consider the PHO-2 screening tel (Table 6,page Have youstated using alcohol or drgstohep you 2sitosupplement) relax cam down orfel beter? Safety Hove youeverbeen seriously injured? How”) How Do you usesafety equipment for sports andor other about anyone else you know? Dp you always weara seatbelt in the ca?” Have you ever met in person (or plan to meet) with anyone whom you fist encountered online? ‘When was the last time you senta text message while driving? Tell me about a time when you have ridden with a driver who was drunk or high, When? How often? Istherea lot of violence at your home or school? In your neighborhood? Among your fiends? physical activities for example, helmets fr biking oF skateboarding)? Have you ever been ina car or motorcycle accident? (What happened?) Have you ever been picked on or bullied? Is that stil a problem? Have you gotten into physical fights in school or your neighborhood? Are you sil geting into fights? Have you ever felt that you had to carry knife, gun, or ‘other weapon to protect yourself? Do you stil feel that way? Have you ever been incarcerated? Areviaton:CRAFF, car, Rees, Aone, Forge, Frnt, rouble; HEEADSS, Home, EOwatn aod employment, Eating Actin, Drugs, Senay, Sucide/ depression, Safty, PHO, Ptient Heath Quastionare 2 Adopted rom Goldonring IM, a; Glésring JM et al?Characteristics of resilient teenagers Home Education and employment Drugs Sexuality Suicidality Safety Connected, caring parents or family members Acceptance of responsibility Chores Care of siblings or other relatives Better than average school performance Feelings of connection to school Limited employment (<20 hr/wk) Strong participation in extracurricular, school-related activities, including sports Leadership among peers Religious affiliation Pledge to abstain Refusal skills Pledge to abstain Refusal skills Consistently responsible sexual behavior No personal history of attempted suicide No family history of attempted or accomplished suicide Access to a confidant Successful coping skills Substance free Seat belt and helmet use Conflict resolution skills Substance free Refusal to ride in cars with potentially intoxicated driver Goldenring JM, et al’; Ginsburg KR™; Resnick MD, et al.Opening lines, poor and better Category Poor tone Donut Education “Howarevou dingin Exting “What do you eat?” Aetiies susie cho” Drugs “Doyouusedrugs?” Sexuality ‘Have you everhad sex?" From Goldenrng JM, ea? Better “Where do you live and who lives there wth you? (No assumptions made.) “Tell me about school’ OR: "What do you enjoy about school? What do you dislike? (Open-ended; harder to answer‘OK") “Tell me what you think about your weight and shape! OR: "Tell me about ‘what you ike and dont lke about your body” (Open-ended; can't answer "OK") “What do you and your friends lke to do fr fun?" (Open-ended) "What kind of drugs have youseen around your school or at parties?" OR:"Do any of your fiends use drugs or alcohol?" (Less personal eases nto acficult discussion) *You told me you've been going out wit Steve for the past 3 months. Has your relationship become sexual” (Context makes question seemless intrusive) OR:‘Are you attracted to anyone curently? (Nonjudgmental)