THREAT ASSESSMENT 60 QUESTIONS

  1. Who do you live with?
  1. Do you get along with who you live with?
  1. What is your room situation?
  1. What kind of music do you listen to?
  1. Do you play violent video games?
  1. Is your video game playing restricted at all?
  1. How long have you lived in this house?
  1. Have you ever been bullied?
  1. What has been done about it?
  1. Do you have a girlfriend/boyfriend?
  1. How is that relationship?
  1. Have you had previous relationships?
  1. How did those end?
  1. Do you look at or own any pornography?
  1. Do you often feel anger or depression?
  1. What has been done about this?
  1. Are you on any medication?
  1. What for?
  1. Do you feel like the medication works?
  1. Do you feel that you need to be on medication?
  1. Do you see a therapist or counselor?
  1. What for?
  1. Do you take any illegal drugs (marijuana, pills, etc)?
  1. How often do you take illegal drugs or last time?
  1. Do you drink alcohol?
  1. How often or last time?
  1. Are you in a gang or do you associate with gang members?
  1. Do you have any weapons in your house?
  1. Do you have access to those weapons, or any other weapons elsewhere?
  1. Are you knowledgeable about weapons?
  1. Are you under peer pressure for anything?
  1. What kind of area do you live in (low, middle, high income)?
  1. Have you ever been arrested or involved with criminal activity whether caught or not?
  1. What was the outcome?
  1. Are you a part of any church or religious organization (name of church)?
  1. Do you attend regularly?
  1. Other than school, what kind of discipline is common with you?
  1. Do you have any enemies?
  1. How is that dealt with?
  1. Do you have any friends?
  1. Do have any friends that you are with outside of school?
  1. Are you in any sports?
  1. How are you doing in that sport?
  1. Do you have any pets?
  1. Do you like those pets?
  1. Have you ever threatened to harm anyone before?
  1. How did that turn out?
  1. How is your school attendance?
  1. How is your school discipline history?
  1. What was most serious discipline offense?
  1. What was the outcome?
  1. How are your grades (Poor, Average, or Very good)?
  1. Do you feel like anyone: students, teachers, or others are out to get you?
  1. How do you deal with that?
  1. What are your goals, interests, or aspirations?
  1. Do you have any role models or someone you look up to?
  1. Do you have a job or make your own money?
  1. Do you draw, write poetry, or short stories? May I see?
  1. Have you ever had a traumatic experience happen to you?
  1. Did that experience change you? If so was the change good or bad?

Person Assessed:

Name:______

DOB:______

SSN:______

Address:______

______

Reason for threat Assessment: ______

______

Phone: ______

Date:______

Time: ______

Case#: ______

Threat Level: Low Medium High

Phil Chalmers Ten Causes of Teen Murder:

10: Metal illness and Personality Disorder

9: Lack of spiritual guidance and proper discipline

8: Fascination with the criminal lifestyle and poverty

7: Peer pressure

6: Fascination with deadly weapons and easy access to guns

5: Cults, Gangs, and Hate groups

4: Drugs and Alcohol

3: Anger and depression-suicidal

2: Obsession with violent media and violent pornography

1: Unstable family and bullying at school