Spring Creek School

Questionnaire

      If you, or someone you know is experiencing difficulty with a teen, take a few moments and answer the following questionnaire. This can serve as a point of reference in understanding the severity of the problems your teen is facing. Sometimes the problems are so severe that they can only be properly addressed by getting professional 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 click on the Calculate button, which will offer suggestions and recommendations based on the results of your own responses.

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Question

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. Has your teen ever been 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 Does your teen, at times, seem depressed/withdrawn?

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11. Is your teen's appearance or personal hygiene outside your family standards?

12. Has your teen ever displayed violent behavior?

13. Is your teen manipulative or deceitful?

14. Does your teen seem to lack motivation?

15. Do you suspect that your teen lies or is dishonest with you?

16. Are you concerned that your teen may be sexually promiscuous?

17. Any evidence of suicidal intentions?

18. Do you suspect at times you have had money or other valuables missing from your home?

19. Does your teen's behavior concern you for their safety?

20. Is your teen angry or displaying temper outbursts?

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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 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 be in constant opposition to your family values?

28. No matter what rules and consequences are established, does your teen defy them?

29. Are you exhausted and worn out from your teen's defiant or destructive behaviors and choices?

30. When dealing with your teen, do you often feel that you are powerless?

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