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Free Questionnaire

This guide is designed to help you in determine what type of program would best help your struggling teen. This guide will ask a variety of questions that will help assess your teen and his or her needs and how urgent they need help.

After completing the questionnaire refer to the scoring guide which will offer suggestions, and recommendations based on the results of your own responses.

Answer Yes or No to each question.	Yes	No
1. Does your teen struggle with basic family rules and expectations?
2. Has your teen ever been suspended, expelled, truant, or had a drop in school grades?
3. Is your teen verbally abusive?
4. Does your teen associate with a bad peer group?
5. Has your teen lost interest in former productive activities, hobbies or sports?
6. Do you have difficulty getting your teen to do simple household chores or homework?
7. Has your teen had problems with the law?
8. Do you find yourself picking your words carefully when speaking to your teen, so as not to elicit a verbal attack or rage from them?
9. Are you worried that your teen may not finish high school?
10. Does your teen seem depressed/withdrawn?
11. Has your teen's appearance and/or personal hygiene changed?
12. Does your teen ever display violent behavior?
13. Is your teen manipulative and/or deceitful?
14. Does your teen seem to demonstrate a lack of motivation?
15. Do you suspect that your teen sometimes lies or is dishonest with you?
16. Are you concerned that your teen may be sexually promiscuous?
17. Has your teen ever displayed any evidence of suicide ideation?
18. Do you suspect at times you have had money or other valuables from your home?
19. Does your teen's behavior concern you for their safety?
20. Is your teen angry or display temper outbursts?
21. Does your teen seem to lack self-esteem and self-worth?
22. Do you have a lack of trust with your teen?
23. Does your teen have problems with authority?
24. Does your teen engage in activities you don't approve of?
25. Do you think your teen is possibly using or experimenting with drugs/alcohol?
26. Are you concerned about your child's well being and their future?
27. Does your teen seem to constantly be in opposition to your family values?
28. No matter what rules and consequences are established, do you feel that your teen will defy them?
29. Are you exhausted and worn out from your teen's defiant and/or destructive behavior and choices?
30. When dealing with your teen, do you often feel that you are powerless?

ATTENTION: This is not a clinical test. This is designed as a guideline for parents with troubled teens. If you feel that your teen needs a clinical evaluation see a licensed psychologist.

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