The major cause of morbidity and mortality in adolescents is unintentional injuries, including motor vehicle
accidents, more than half related to drug or alcohol use. Next in importance are other causes of morbidity
including unwanted pregnancy, sexually transmitted disease (STD), eating disorders, and mood disorders. All
of these situations are not easily amenable to the intervention of a physiologically-oriented health care
provider. In fact, they may not even show up on the standard interview that health care providers are taught to
perform.
The health care provider who sees adolescents must be willing to take a developmentally-appropriate
psychosocial history. While a fellow at Los Angeles Children’s Hospital, Dr. Cohen refined a system for
organizing the psychosocial history that was developed in 1972 by Dr. Harvey Berman of Seattle. The
system has been used successfully around the world, in the adolescent health care field. This method
structures questions so as to facilitate communication and to create a sympathetic, confidential, respectful
environment where youth may be able to attain adequate health care. The approach is known as the
acronym HEADSS (Home, Education/employment, peer group Activities, Drugs, Sexuallity, and
Suicide/depression).