Ask questions in HEADSSS format to perform a psychosocial history on adolescents.
(Originally just HEADSS, now it is HEEADSSS.)
- Home: Who lives with you? What are your relationships like at home? Who are you closest to at home?
- Education: What classes do you like best? Least? Grades? Tell me about your friends at school.
- Activities: What do you and your friends/family do for fun? What sorts of hobbies do you have? How much TV/video games do you do in a week?
- Drinking/Drugs: Do any of your friends smoke? Drink alcohol? Do you? Have you tried other drugs?
- Sex: Are you attracted to boys? Girls? Do you have a boyfriend or girlfriend? How long? Do you get along well? Do you have sex? Does it go OK? Do you know how to say “no”? Do you know how to protect yourself from STDs and pregnancy?
- Suicide/depression: Are you “bored” a lot of the time? Have you lost interest in things you used to enjoy? Have you started hanging out with your friends less and less? Have you ever thought of hurting yourself or suicide?
- Safety: Do you feel unsafe? When? At school? At home? In your neighborhood? Have you ever been hurt by someone?
Start the conversation with light banter to make them feel at ease and possibly open up with something personal after a nice compliment about their clothing or something that reflects their personality.
Accentuate and praise positive behaviors that suggest maturity and resilience.
Use open-ended questions and do not make assumptions during the interview.
Ask questions about friends first -- youngsters are willing to divulge their friends' behavior more readily than their own.
A good way to wrap things up is by asking teens to sum up their life in a word.
Alternately, ask for a " weather report" for the week.
Goldenring, J.M. Contemporary Pediatrics. "Getting into adolescent heads: an essential update" Jan 1, 2004.