HEADSS Assessment

Understanding the HEADSS Framework

The HEADSS assessment is designed to explore key domains of an adolescent’s life, each critical to their physical, emotional, and social health:

• Home: Questions like “Who do you live with?” and “How are relationships at home?” reveal family dynamics, housing stability, and potential stressors (Goldenring & Rosen, 2004).
• Education/Employment: Asking about school performance or work—“How are your grades?” or “Do you have a job?”—uncovers academic challenges or career aspirations (AAP, 2019).
• Activities: Inquiries such as “What do you do for fun?” or “Are you involved in sports or clubs?” highlight social engagement and lifestyle.
• Drugs: Questions like “Do you or your friends use alcohol or drugs?” assess substance use risks without judgment.
• Sexuality/Suicide/Depression: Sensitive topics—“Are you in a relationship?” or “Have you ever felt depressed?”—probe romantic experiences and mental health (Goldenring & Rosen, 2004).
• Safety: Queries about seat belt use or online activities ensure a holistic view of risk behaviors (AAP, 2019).

This conversational approach builds trust, allowing adolescents to share openly while guiding clinicians to tailor interventions.

How to Use the HEADSS Assessment

1. Create a Safe Environment: Begin by ensuring privacy and explaining confidentiality, as adolescents may hesitate to disclose sensitive information. For example, assure them that discussions are private unless there’s a risk of harm (AAP, 2019).
2. Start with Neutral Topics: Open with less invasive domains like Home or Activities to build rapport. For instance, “What do you like to do for fun?” eases teens into the conversation.
3. Use Open-Ended Questions: Encourage dialogue with questions like “Can you tell me about your school?” rather than yes/no prompts. This fosters deeper responses and reveals nuances.
4. Be Nonjudgmental: When discussing Drugs or Sexuality, maintain a neutral tone. Phrases like “I’m here to help, not judge” can reduce defensiveness (Goldenring & Rosen, 2004).
5. Adapt to the Individual: Tailor questions to the adolescent’s age, culture, and context. For younger teens, simplify language; for older ones, explore complex goals like career plans.
6. Follow Up on Red Flags: If an adolescent mentions suicidal thoughts or substance use, gently probe further and connect them to resources like counseling or social services.