ANAMNESE

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ANAMNESE ADOLESCENTE
1. IDENTIFICAÇÃO DO ADOLESCENTE
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2. QUEIXA INICIAL
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3. DINÂMICA FAMILIAR 
a) Quem são as pessoas que moram com você? 
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b) Como é o relacionamento com seus irmãos? 
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c) Como é o relacionamento com os seus pais?
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d) Quando você faz algo que desagrada os seus pais, o que eles fazem? 
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e) Com quem você gosta mais de conversar e resolver seus problemas? Por quê?
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f) Você identifica alguém na sua família com quem tenha dificuldade de relacionamento? Por quê?
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g) Como você percebe o clima em sua casa? 
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4. RESUMO DA SITUAÇÃO ESCOLAR DO ADOLESCENTE
a) Qual o nome da sua escola?
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 b) Você frequenta normalmente a escola? 
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c) Como está o seu desempenho escolar?
d) Cite o que você gosta e o que não gosta na sua escola?
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e) Fale sobre o relacionamento com seus colegas e professores.
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f) Qual o profissional de referência para você na escola? Por quê?
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g) Você realiza alguma atividade extraescolar? Qual?
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5. SEXUALIDADE
a) Você tem namorado (a)?
b) Você já recebeu alguma orientação sexual em sua casa ou na escola? Quem orientou?
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6. RELACIONAMENTOS
a) Com os amigos quais as suas facilidade e dificuldade de estabelecer relações de amizade, onde conhece, há quanto tempo, frequenta a casa, como é a relação de seus pais com o dos colegas? 
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b) Quais os lugares que gosta de frequentar? Por quê?
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c) Você faz ou já fez uso de alguma substanciam lícitas ou ilícitas? Qual?
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d) O que faz no tempo livre?
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f) Que mudanças aconteceram na sua vida que foram positivas, e quais foram negativas?
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g) Como é sua casa é tranquila ou agitada? É um lugar seguro? É triste ou alegre? Quem dá as ordens em casa? O que acontece com quem não segue as regras da casa? 
 
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h) O que as pessoas dizem de você? Você concorda com o que elas dizem? 
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i) O que você mais gosta em você e o que menos gosta? 
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7. EXPECTATIVAS EM RELAÇÃO AO FUTURO
a) O que você espera do futuro?
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b) Que atividade profissional gostaria de exercer? Por quê?
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c) Como você espera realizar esse desejo? 
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Observações do Terapeuta:
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Data: ___/___/_____ Ass. Terapeuta: _____________________________________