Troubled Teen Questionnaire

Are you the parent of a troubled teen? Many times as parents, we wonder whether or not our teenager is in need of help. The following document is a list that we have put together in order to give you an idea of the seriousness of your teenager's at-risk behaviors. This will help you start the process of making the decision whether your child is a candidate for the Turning Winds boarding school for troubled teens.

Does your troubled teen fail to complete tasks that require effort regardless of the future importance of the task?
(e.g. school work)
Yes No
Does your troubled teen attempt to negotiate and/or manipulate in order to avoid consequences and problems?
Yes No
Does your troubled teen justify negative behaviors by blaming others?
Yes No
Is your troubled teen unwilling to recognize the impact of his/her behavior on family and friends?
Yes No
Does your troubled teen use manipulation and deception in order to change others' points of view?
Yes No
Does your troubled teen have weekly outbursts or mood swings?
Yes No
Does your troubled teen avoid participating in family activities and social events?
Yes No
Does your troubled teen become impatient or easily agitated with others?
Yes No
Does your teen have an intense fear of gaining weight or becoming fat?
Yes No
Has there been a recent drop in your teen's performance at school?
Yes No
Is it difficult for your teen to relate with others or make friends?
Yes No
Does your teen frequently fail to finish schoolwork, projects or chores?
Yes No
Does your teen fail to follow through with responsibilities or instructions?
Yes No
Is your teen forgetful or often viewed as lazy?
Yes No
Does your teen argue with adults and authority figures?
Yes No
Is your teen failing one or more courses in school?
Yes No
Has your teen undergone therapy and/or counseling without results?
Yes No
Does your teen do dangerous things without considering the consequences, "a daredevil?"
Yes No
Has your teen been physically abusive to animals?
Yes No
Is your teen extremely self-conscious?
Yes No
Does your teen appear depressed, sad, tearful or irritable nearly every day?
Yes No
Has your teen run away from home? (More than twice)
Yes No
Is your teen sexually active?
Yes No
Does your teen engage in self-injurious behaviors and/or threaten to inflict self-harm?
Yes No
Does your teen use illegal drugs and/or alcohol?
Yes No

*Note: Once personal information is submitted your teens score will be automatically tallied below and a counselor will contact you within 24 hours.

Parent Name:
Address:
City:
State:
Zip:
Phone Number:
Email Address:
Child's Name:
Child's Gender:
Child's Age:
Are you looking at enrolling your child:
Method of Contact:
How did you hear about us?
Reffered by:
Comments: