Teen Health Supervision

Psychosocial Interview

The HEADS mnemonic is widely used to help remember the important aspects of the psychosocial history. HEADS moves from the least to the most personal areas while building rapport.

Source: Goldenring JM, Cohen E. Getting into adolescents' heads. Contemp Pediatr 1988; 5: 75-9

H: Home

How are things going where you live? Have you had any recent moves/changes/losses/ stresses in your home environment? Who lives with you/ how do you get on with them? What does the family do together/ eat/ vacation/ go to church? What are your parent's expectations for you? What are the "rules?" What do you get in trouble for? What kinds of restrictions or punishments are given?

E: Education, Employment, Eating and Exercise


Are you doing any study or work at the moment? How's it going? Do you like it? How are your grades/work performance -any recent changes? Any special classes? Do you have any future education/employment plans? Where do you get your spending money and the things that you need? How do you get on with your teachers/boss/school or work mates? Do you miss much work/ school?

Eating/ Exercise

Are you satisfied with your weight? Is there anything you would change about your body? What is your usual breakfast/ lunch/ dinner? Do you diet and/or exercise? How much/ how often/ what type? Do you use other methods to control weight (laxatives/ purging)? Have you had any recent and past weight gain/ losses?

A: Activities

What do you like to do for fun or in spare time (e.g. hobbies/ sports/ youth clubs/ parties / church)? Where do you hang out? Do you have any close friends you spend time with, trust or can talk to? How old are your friends? What are they like? What do you do most days? How much time do you spend with the TV or computer?

D: Drugs and Alcohol

Many young people experiment with substances (i.e., alcohol, cigarettes, prescription/ illicit drugs). Do any of your friends? How about you? How much and how often? Have you ever had any treatment/ sought help? Have you ever ridden in a car when the driver was under the influence?

S: Sexuality, Suicide, and Safety


Have you ever had a sexual/romantic relationship with a girl or a boy? If never been sexually active, when do you feel it is the right time? If sexually active, do you protect yourself against STIs/ pregnancy? Have you ever been tested for STIs? Do you have any children? Has anyone ever touched you in a way that has made you feel uncomfortable or forced you into a sexual relationship?

Suicide and Depression

Compared to other people, do you think you are happier, sadder or about the same? People sometimes feel down or sad. How about you? Do you feel guilty about things or cry a lot? Have you ever thought about suicide or attempted suicide in the past? What is your sleep like? What is your energy level like?


Do you wear seat belts/ helmets/ eye protection? Do you know how to swim and avoid water hazards? Do you feel safe at home/ school/ neighborhood? Have you carried a weapon? Do you have access to a gun? Have you ever been bullied or bullied other people? Have you ever been shaken down?