Screening Teens
Read Ethics and Privacy. It is especially important for teens to understand the limits of confidentiality up front, so that they don’t feel "betrayed" if you need to report.
Goals during interview
- screen for abuse in the home
- screen for abuse in relationships
- educate about healthy relationships
- establish rapport
Framing the question
- “I don’t know if this is a concern for you, but many teens I see are dealing with violence or bullying issues, so I’ve started asking questions about this routinely.”
- “Sometimes when I see an injury like yours, it’s because somebody got hit. How did you get this injury/bruise?”
Asking indirectly – sample questions
- How are your parents getting along?
- How would you describe your parent's relationship?
- How are disagreements handled in your family?
- Are you in a relationship with someone? How are things going with that? What happens when you disagree?
Teen family and relationship abuse screening
(3:20 min.)
Video clip courtesy of Family Violence Prevention Fund ©2003, all rights reserved. For a free 30 minute CD of 5 clinical interactions titled "Screen to End Abuse" contact FVPF.
In response to abuse, teens in particular may be prone to:
- eating disorders
- dressing younger or older for age
- poor school performance
- self cutting
- depression
- substance abuse
- promiscuity
- suicidality
- running away
Asking directly – sample questions
- Have you seen anyone get hurt in your home?
- Have you ever been hurt or threatened by anyone?
- Have you ever been forced to do something sexual that you didn’t want to do?
- Do you ever feel afraid of your boy/girl friend?
- Does it seem like your boy/girl friend tries to control what you do?
- Does your boy/girl friend put you down or make fun of you, or tell you any problems are all your fault?
- Does your boy/girl friend threaten to hurt your or him/herself if you break up?
Responding
If the teen reveals past or present abuse:
- how you respond is very important - see “Responding” from domestic abuse website
- ask about details – who, what, when, where, how – do not ask why, as it may imply the teen somehow caused the abuse
- ask about the impact of the abuse on emotional or physical symptoms – anxiety, depression, eating or sleeping difficulties, etc.
- ask about impact of abuse on school functioning
- ask about suicidality
- ask about safety going home
- ask about presence of a supportive adult in the teen’s life
- ask about situational cultural issues
- inform about reporting requirements and procedures; ask if teen wants to sit in on your call to CPS or police
- make follow up appointment
If no abuse is revealed:
- reply “I just want you to know that if anything like that does come up, this is a safe place to talk about it and get help.”
- educate about healthy relationships
[Adapted from Family Violence Prevention Fund's Identifying and Responding to Domestic violence: Consensus Recommendations for Child and Adolescent Health]