H E EADSSS

Table 1 The HEEADSSS psychosocial interview for adolescents

Home Who lives with you? Where do you live? Have you moved recently?
What are relationships like at home? Have you ever had to live away from home? (Why?)
Can you talk to anyone at home about stress? (Who?) Have you ever run away? (Why?)
Is there anyone new at home? Has someone left recently? Is there any physical violence at home?
Do you have a smart phone or computer at home? In
your room? What do you use it for? (May ask this in the
activities section.)

Education Tell me about school. How many days have you missed from school this month/
and Is your school a safe place? (Why?) Have you been quarter/semester?
employment bullied at school? Have you changed schools in the past few years?
Do you feel connected to your school? Do you feel as if Tell me about your friends at school.
you belong? Have you ever had to repeat a class/grade?
Are there adults at school you feel you could talk to Have you ever been suspended? Expelled? Have you ever
about something important? (Who?) considered dropping out?
Do you have any failing grades? Any recent changes? How well do you get along with the people at school? Work?
What are your future education/employment plans/ Have your responsibilities at work increased?
goals? What are your favorite subjects at school? Your least favorite
Are you working? Where? How much? subjects?

Eating Does your weight or body shape cause you any stress? If What do you like and not like about your body?
so, tell me about it. Have you done anything else to try to manage your
Have there been any recent changes in your weight? weight?
Have you dieted in the last year? How? How often? Tell me about your exercise routine.
What do you think would be a healthy diet? How does that
compare to your current eating patterns?
What would it be like if you gained (lost) 10 lb?
Does it ever seem as though your eating is out of control?
Have you ever taken diet pills?

Activities What do you do for fun? How do you spend time with Do you participate in any sports?
friends? Family? (With whom, where, when?) Do you regularly attend religious or spiritual activities?
Some teenagers tell me that they spend much of their Have you messaged photos or texts that you have later
free time online. What types of things do you use the regretted?
Internet for? Can you think of a friend who was harmed by spending time
How many hours do you spend on any given day in online?
front of a screen, such as a computer, TV, or phone? Do How often do you view pornography (or nude images or
you wish you spent less time on these things? videos) online?
What types of books do you read for fun?
How do you feel after playing video games?
What music do you like to listen to?

Drugs Do any of your friends or family members use Is there any history of alcohol or drug problems in your
tobacco? Alcohol? Other drugs? family?
Do you use tobacco or electronic cigarettes? Does anyone at home use tobacco?
Alcohol? Other drugs, energy drinks, steroids, or Do you ever drink or use drugs when you’re alone?
medications not prescribed to you? (Assess frequency, intensity, patterns of use or abuse,
and how patient obtains or pays for drugs, alcohol, or
tobacco.)
(Ask the CRAFFT questions in Table 5, page 25.)

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Questions if time permits or

Sexuality Have you ever been in a romantic relationship? Tell Are your sexual activities enjoyable?
me about the people that you’ve dated. Have any of your relationships been violent?
Have any of your relationships ever been sexual What does the term “safer sex” mean to you?
relationships (such as involving kissing or Have you ever sent unclothed pictures of yourself on
touching)? e-mail or the Internet?
Are you attracted to anyone now? OR: Tell me Have you ever been forced or pressured into doing
about your sexual life. something sexual that you didn’t want to do?
Are you interested in boys? Girls? Both? Not yet Have you ever been touched sexually in a way that you
sure? didn’t want?
Have you ever been raped, on a date or any other time?
How many sexual partners have you had altogether?
(Girls) Have you ever been pregnant or worried that you
may be pregnant?
(Boys) Have you ever gotten someone pregnant or
worried that might have happened?
What are you using for birth control? Are you satisfied
with your method?
Do you use condoms every time you have intercourse?
What gets in the way?
Have you ever had a sexually transmitted infection or
worried that you had an infection?

Suicide/ Do you feel “stressed” or anxious more than usual Tell me about a time when you felt sad while using
depression (or more than you prefer to feel)? social media sites like Facebook.
Do you feel sad or down more than usual? Does it seem that you’ve lost interest in things that you
Are you “bored” much of the time? used to really enjoy?
Are you having trouble getting to sleep? Do you find yourself spending less time with friends?
Have you thought a lot about hurting yourself or Would you rather just be by yourself most of the time?
someone else? Have you ever tried to kill yourself?
Tell me about a time when someone picked on you Have you ever had to hurt yourself (by cutting yourself,
or made you feel uncomfortable online. for example) to calm down or feel better?
(Consider the PHQ-2 screening tool [Table 6, page Have you started using alcohol or drugs to help you
26] to supplement.) relax, calm down, or feel better?

Safety Have you ever been seriously injured? (How?) How Do you use safety equipment for sports and/or other
about anyone else you know? physical activities (for example, helmets for biking or
Do you always wear a seatbelt in the car? skateboarding)?
Have you ever met in person (or plan to meet) with Have you ever been in a car or motorcycle accident?
anyone whom you first encountered online? (What happened?)
When was the last time you sent a text message Have you ever been picked on or bullied? Is that still a
while driving? problem?
Tell me about a time when you have ridden with a Have you gotten into physical fights in school or your
driver who was drunk or high. When? How often? neighborhood? Are you still getting into fights?
Is there a lot of violence at your home or school? In Have you ever felt that you had to carry a knife, gun, or
your neighborhood? Among your friends? other weapon to protect yourself? Do you still feel that
way?
Have you ever been incarcerated?

Abbreviations: CRAFFT, Car, Relax, Alone, Forget, Friends, Trouble; HEEADSSS, Home, Education and employment, Eating, Activities,
Drugs, Sexuality, Suicide/depression, Safety; PHQ-2, Patient Health Questionnaire 2.
Adapted from Goldenring JM, et al1; Goldenring JM, et al.2

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