This questionnaire can serve as a point of reference for you and the current situations you and your teen are facing. Sometimes the problems are so severe that they can only be properly addressed by getting profession help in a controlled environment, such as a residential center, treatment program or specialty school. Other times problems can be resolved right in the home by setting better limits and tightening up the basic family rules and structure. After completing the questionnaire, any relevant suggestions or recommendations based on the results of your own responses will be displayed.
| Yes | No | |
|---|---|---|
| Does your teen struggle with basic family rules and expectations? | ||
| Has your teen ever been suspended, expelled, truant or had a drop in school grades? | ||
| Is your teen verbally abusive? | ||
| Does your teen associate with a bad peer group? | ||
| Has your teen lost interest in former productive activities, hobbies or sports? | ||
| Do you have difficulty getting your teen to do simple household chores or homework? | ||
| Has your teen had problems with the law? | ||
| Do you find your self picking your words carefully when speaking to your teen, so as not to elicit a verbal attack or rage from them? | ||
| Are you worried that your teen may not finish high school? | ||
| Does your teen seem depressed/withdrawn? | ||
| Has your teen's appearance and/or personal hygiene changed? | ||
| Does your teen ever display violent behavior? | ||
| Is your teen manipulative and/or deceitful? | ||
| Does your teen seem to demonstrate a lack of motivation? | ||
| Do you suspect that your teen sometimes lies or is dishonest with you? | ||
| Are you concerned that your teen may be sexually promiscuous? | ||
| Has your teen ever displayed any evidence of suicide ideation? | ||
| Do you suspect at times you have had money or other valuables taken from your home? | ||
| Does your teen's behavior concern you for their safety? | ||
| Is your teen angry or display temper outbursts? | ||
| Does your teen seem to lack self-esteem and self-worth? | ||
| Do you have a lack of trust with your teen? | ||
| Does your teen have problems with authority? | ||
| Does your teen engage in activities you do not approve of? | ||
| Do you think your teen is possibly using or experimenting with drugs/ alcohol? | ||
| Are you concerned about your child's well being and their future? | ||
| Does your teen seem to constantly be in opposition to your family values? | ||
| No matter what rules and consequences are established, do you feel that you teen will defy them? | ||
| Are you exhausted and worn out from your teen's defiant and /destructive behavior and choices? | ||
| When dealing with your teen, do you often feel that you are powerless? |
Your Teen is at High Risk!
Get help! A residential center, treatment program, or specialty school is strongly recommended.
Your Teen is at Borderline Risk
The problems may be resolved by tightening up family rules and structure. However, a residential center, treatment program, or specialty school may need to be considered.
Your Teen is at Moderate Risk
Tighten up family rules / understanding, be consistent with your monitoring, and follow through.
