Category: RAAPS Questions


RAAPS versus GAPS and other homegrown risk screening tools

People pose the “why?” question every day. Why should I invest the time, energy and resources into an adolescent risk screening and counseling technology? We may be biased, but our answer is simple: why not?

Before we dive into the several reasons why thousands of sites nationwide find tremendous value of integrating RAAPS into their practice or program, here is the 140-character, tweet-friendly definition of RAAPS: a standardized, validated risk assessment and behavior change counseling tool to support health professionals working with adolescents.

In simplified language, we make it easy for health professionals to do their job. We partner with clinicians, counselors and other providers who are passionate about improving adolescent health. Our partners—like school-based health centers, pediatric offices, sexual health clinics, schools, etc.—operate within a preventative-oriented culture (not crisis-oriented) and genuinely care about identifying risks, improving outcomes and changing lives. It’s not for the faint of heart.

RAAPS can make you money

“Say what?!” (Please excuse our language. Sometimes we find the way teens speak kind of catchy.) Yes, our leading risk assessments can save you money. How?

  • RAAPS dramatically improves the productivity of your existing staff and the effectiveness of your operations. You will no longer have to sit face-to-face with your patient, ask the sometimes-awkward questions, record the data, then figure out how to best counsel the patient to promote positive behavior change. RAAPS saves a provider’s time by flagging potential risk behaviors and offering health message talking points to guide the conversation.
  • By using a standardized, validated tool (RAAPS) to screen adolescents each month, the cloud-based system may be able to pay for itself. Assuming an average insurance reimbursement rate of $5 per administration, your sites would need to use the system with only 10 patients per month in order to recover the cost of using the system. #winning

RAAPS’ real-time tracking and easy to use reporting measures outcomes

Can your risk screening tool do this? If it’s not RAAPS, the answer is likely no. Access to individual and population data allows you to identify trends and assess your intervention effectiveness. Plus, data gathered can be helpful when applying for grants and gaining additional funding.

RAAPS asks the right questions

The risk landscape is always changing and unfortunately widening, which is why we continue to update or modify our questions to elicit honest responses from teens. Other risk screening tools, such as GAPS, hasn’t been updated since the early 2000’s. The way teens speak and the risks they’re involved in have changed drastically since the era of Boy Meets World and Backstreet Boys. At Possibilities for Change, we continue to identify issues and areas that are harmful to a teen’s health and well-being. One of the many beautiful things about RAAPS is that all questions are scientifically validated—and we used teens to help us refine the actual questions so that they were more understandable and relevant! Unlike most homegrown tools, the RAAPS youth-friendly patient portal includes audio and bilingual health messages features to increase health literacy.

The 21-question RAAPS assessment falls within seven risk categories identified by the CDC as contributing to adolescent morbidity and mortality. The Society for Adolescent Health and Medicine has our back, citing RAAPS as one of their important resources, handouts, toolkits and treatment protocols for healthcare providers to use in their practices.

In our fast-paced, technology-driven world, the manner and method of how we ask is just as important as what we ask. When it comes to discussions around things like sexual behavior and alcohol use, teens are more honest and comfortable answering to a tablet or other technology than an adult. The assessment takes about 5 minutes to complete—a better alternative to other assessments out there that take more than a half hour. Ain’t nobody got time for that! (We warned you.)

Learn more about RAAPS at or drop us a line at

Research Behind the RAAPS Questions (Question #21)

Do you have at least one adult family member or other adult that you can talk to about anything?

A key to successful adjustment in adolescence is to have supportive relationships that protect adolescents from the effects of stressors.  Social support from parents plays a protective role for adolescents, mitigating the effects of stress and other risk factors. Adolescents may seem distant or preoccupied with peer groups, however; the family is still home base in the changing world of middle adolescence, and core family values continue to exert a significant and stabilizing influence.

Did you know?

Youth who reported non-parents (romantic partners or peers) as their primary support system, were more likely than those who reported parents as their primary social support to show behavioral and emotional problems.

Try these messages with youth:

  • –  Not everyone has a strong relationship with family members or another adult.  This does not mean you are alone and it does not mean you should keep your problems and worries to yourself.  Talking to a trusted adult about your problems can be very helpful.  They may have good advice or resources to help you work through your problems.
  • –  Don’t be afraid to reach out to a neighbor, teacher, coach, health professional or school counselor.  If you can’t talk face to face, there is always the phone and email to stay in contact.  Everyone needs a trusted adult to talk to.  There are adults out there who care about you and want to help however they can.




Research Behind the RAAPS Questions (Question #20)

Have you ever seriously thought about killing yourself, tried to kill yourself, or have you purposely cut, burned or otherwise hurt yourself?

Suicide among young people continues to be a serious problem. Suicide is the third leading cause of death among U.S. youth and accounts for 7% of all deaths among youth ages 10-14 and 12% of all deaths among youth ages 15-19.

Did you know?

  • –  Females are disproportionately affected, and attempt to commit suicide more often than males, however; males complete suicide attempts at a rate more than five times that of females.
  • –  Four out of five teens that attempt suicide give clear warnings to parents, friends, and other trusted individuals.
  • –  American Indians/Alaskan Natives are also disproportionately affected by suicide. This group has the highest suicide rates for adolescents (33.3/100,000), followed by Non-Hispanic Caucasian youth (14.6/100,000), Non-Hispanic African American (10.0/100,000), Hispanics (9.7/100,000), and Asian Pacific Islanders (8.9/100,000).

Self-injury appears to have become more popular lately, especially in adolescents. Adolescents may self-mutilate to take risks, rebel, reject their parents’ values, state their individuality, or to be accepted. Others do so out of desperation or anger, to seek attention, or to show their desperation or suicidal thoughts. In the U.S., it is estimated that one in every 200 girls between the ages 13-19 cut themselves regularly. Those who cut comprise about 70% of teen girls who self-injure.

Try these messages with youth:

“Not everyone has a strong relationship with family members or another adult.  This does not mean you are alone and it does not mean you should keep your problems and worries to yourself.  Talking to a trusted adult about your problems can be very helpful.  They may have good advice or resources to help you work through your problems.”

“Don’t be afraid!  Everyone needs a trusted adult to talk to.  Think about reaching out to a neighbor, teacher, coach, health professional or school counselor.  If you can’t talk face to face, there is always the phone and email to stay in contact.  There are adults out there who care about you and want to help however they can.”

Resources for youth:

–  Teen Central is an anonymous help-line web site for teens.  It has been developed by experts in teen counseling and psychology.

–  The Substance Abuse and Mental Health Services Administration (SAMHSA) launched the Mental Health Campaign for Mental Health Recovery to encourage, educate, and inspire people between 18 and 25 to support their friends who are experiencing mental health problems.  The What a Difference a Friend Makes is a site designed for those with mental illness and their friends.

Research Behind the RAAPS Questions (Question #19)

Do you have any serious issues or worries at home or at school?

The period of adolescence is often filled with increased stress over school, friends, or family.  As youth struggle to cope with social, emotional, and physiological stressors they may easily become overwhelmed. If this happens, inadequately managed stress can lead to anxiety, withdrawal, aggression, or other mental health disorders.

Did you know?

  • –  One in five youth ages 9-17 are estimated to experience serious emotional disturbances or other mental health problems.

Without appropriate guidance or treatment, these emotional and mental health problems could lead to poor academic behavior, family problems, substance use, unintentional injuries, juvenile incarceration, or suicide.

Family and societal stress may cause adolescents to act out in a delinquent manner. Adolescent ethnic minority groups often receive poorer quality of mental health treatment and are less likely to access services. Furthermore, African American youth, especially males, are more likely than other ethnic/racial youth groups to be referred to the juvenile justice system as opposed to mental health treatment.

Try these messages with youth:

  • – Everyone feels nervous, anxious or worried at times. It is common for new or challenging situations to make you feel this way.  However, these feelings should not stop you from doing the things you want to do. Talking to a trusted adult can help you to work through your worries and find solutions. Remember that you are not alone and that there are people that care and want to help you.
  • –  Learning how to relax and deal with stress can help you feel more like yourself.  Try some of the following: deep breathing exercises or yoga to relax your mind and body, get enough sleep and exercise, eat well, take a walk or squeeze something (like a stress ball).
  • –  Spend time with people close to you who accept you and make you feel safe, sometimes the people around you may not be giving you the support you need or deserve.
  • –  Remember to focus on the positive things in your life and work through issues one at a time.
  • –  Manage your time with a planner and with achievable to-do lists to not feel overwhelmed.


Research Behind the RAAPS Questions (Question #18)

During the past month, did you often feel very sad or down as though you had nothing to look forward to?

Research has indicated that the decline in mental health and increase in behavioral problems during adolescence are occurring partly because youth experience massive life changes during the period of adolescence. These problems include negative images of self, depression, delinquency, and substance use. Depression or depression-like symptoms are serious problems that impact every aspects of an adolescent’s life. Left untreated, depression can lead to problems at home and school, drug or alcohol abuse, and even irreversible tragedy such as homicidal violence or suicide.

Symptoms of depression often go unnoticed, and adolescents with major depression are likely to identify themselves as depressed before their parents suspect a problem. Adolescent depression is fairly common. Population studies show that at any point in time, 10-15% of children and adolescents have some symptoms of depression. Depression is treatable and while some depression-like symptoms are expected as teenagers adapt to the challenges of growing older, dramatic long-lasting changes in personality, mood, and behavior are signs of a deeper problem.

Try these messages with youth:

– “It is completely normal to feel sad, down, or lonely. We all feel this way from time to time.  However, sometimes you may need a little help to feel better. Depression is more than sometimes feeling blue or sad. It often lasts for weeks, months or even longer. If you feel sad or down for longer than 2 weeks, tell an adult you trust. Never be ashamed of how you are feeling or afraid to ask for help. Depression doesn’t always go away by itself.”

–  Here are some ways to help you begin to feel more like yourself:

  • – Talk with a mental health care professional
  • – Exercise
  • – Eat healthy
  • – Listen to music
  • – Journal to help you express your feelings
  • – Talk with a trusted adult or friend
  • – Go out and do activities you enjoy
  • – Sometimes medications are needed to help you feel better

– “Don’t get discouraged; it takes time to work through depressed feelings but you can get through it. Remember that you are not alone.  There are people out there who care about you and want to help!”

Resources for youth:

– CopeCareDeal is a mental health website for teens.

– TeensHealth is a safe, private place for teens who need honest, accurate information and advice about health, emotions and life.  View TeensHealth’s depression information for teens.