CRAFFT Screening Tool Template

Key Takeaways

CRAFFT is a validated six-question screening tool for adolescent substance use aged 12-21.

Scores of 2 or higher indicate need for further assessment or brief intervention.

The CRAFFT 2.1 version includes updated questions for contemporary substance patterns.

Screening results support clinical documentation and referral decision-making.

Free downloadable template designed for rapid administration in clinical settings.

The CRAFFT Screening Tool Template is a clinically validated instrument designed to identify substance use disorders and risky behaviours in adolescents and young adults. This evidence-based assessment asks six targeted questions that help clinicians quickly evaluate potential alcohol and drug-related problems, enabling early intervention and appropriate referral pathways. The CRAFFT Screening Tool Template has become an essential tool in mental health practices, paediatric clinics, and primary care settings for systematically identifying at-risk youth.

Developed by researchers at the Boston Children’s Hospital, the CRAFFT Screening Tool is endorsed by the American Academy of Pediatrics and widely used across NHS and private practice settings. For practices managing adolescent mental health workflows, secure client portals enable adolescents to complete screening forms before appointments, streamlining data collection. The latest version, CRAFFT 2.1, incorporates updated screening items reflecting contemporary substance use patterns, improving sensitivity for modern risk profiles. This guide explains how to administer the screening tool, interpret scores, and integrate results into clinical workflows.

Download Your Free CRAFFT Screening Tool Template

What is a CRAFFT Screening Tool?

The CRAFFT Screening Tool is a brief, evidence-based clinical assessment instrument consisting of six yes-or-no questions designed to identify substance use disorders in adolescents and young adults aged 12-21. The acronym CRAFFT represents the key screening domains: Car, Relax, Alone, Forget, Friends, and Trouble-each addressing different dimensions of substance use behaviour and consequences.

The tool emerged from research at Boston Children’s Hospital as a response to the need for a rapid, validated screening method that could be administered in busy clinical settings. Unlike lengthy diagnostic interviews, the CRAFFT requires only 2-3 minutes to complete and score, making it practical for paediatric practices, adolescent mental health clinics, and primary care environments. Mental health practices use standardised screening tools to ensure systematic identification of at-risk youth before problems escalate.

Clinically, the CRAFFT serves two core purposes: identifying adolescents requiring further assessment for substance use disorders and documenting baseline risk status in the clinical record. A score of 2 or higher on the CRAFFT indicates clinically significant substance use risk, prompting more comprehensive evaluation. The tool is designed for adolescents who report any substance use; clinicians administer it selectively after an initial brief substance use history.

From a documentation and compliance perspective, the CRAFFT Screening Tool Template creates a standardised record that satisfies regulatory requirements for adolescent screening. Recording screening results in the patient record demonstrates adherence to American Academy of Pediatrics screening guidelines and supports quality reporting to regulatory bodies like Joint Commission and SAMHSA.

How to Use the CRAFFT Screening Tool Template

Administering the CRAFFT Screening Tool Template follows a straightforward five-step clinical workflow. Digital form capture tools can automate scoring and route high-risk results directly to the clinician dashboard, supporting rapid clinical decision-making.

1. Establish screening context: Begin by explaining to the adolescent that you ask all young patients about substance use as part of routine care. Frame screening as a standard health assessment, not a judgment-based interrogation. Use neutral, non-judgmental language to create psychological safety for honest responses.
2. Administer the six CRAFFT questions: Read each of the six yes-or-no questions aloud, or allow the adolescent to self-complete the form. Record responses clearly. Avoid explaining the acronym during administration-keep questioning straightforward and paced naturally within conversation flow.
3. Score the responses: Count the total number of “yes” answers. A score of 0-1 suggests low substance use risk; a score of 2 or higher indicates clinical concern requiring further assessment. CRAFFT 2.1 includes updated scoring guidance for contemporary substance patterns (e.g., vaping, synthetic cannabinoids).
4. Interpret the result: Communicate findings to the adolescent and, if appropriate, caregivers (respecting confidentiality laws). Scores of 2+ warrant a more comprehensive substance use assessment and discussion of brief intervention or referral options. Document your clinical decision-making rationale in the patient record.
5. Document and refer: File the completed CRAFFT Screening Tool Template in the patient record with date, time, clinician name, score, and recommended next steps. If further assessment or intervention is indicated, document referral information using digital intake forms to streamline the referral workflow.

Client records that integrate screening templates allow clinicians to track multiple assessments over time, showing patterns of substance use risk and intervention responses.

Many mental health clinics streamline screening administration and scoring using integrated digital forms and client portals. Book a demo to see how clinical assessment workflows can simplify your practice’s substance use screening processes.

Who is the CRAFFT Screening Tool Helpful For?

The CRAFFT Screening Tool Template is designed for clinicians working with adolescents and young adults in multiple healthcare settings. Paediatricians use it during routine adolescent visits to screen for substance use disorder risk as part of anticipatory guidance. Mental health clinicians-including psychologists, counsellors, psychiatrists, and therapists-administer it as a standard component of adolescent intake assessments.

School nurses benefit from the tool’s brevity and ease of administration in educational health services. Substance abuse treatment programmes use the CRAFFT both for intake screening and to monitor intervention responses over time. Primary care nurses and nurse practitioners apply the tool in general practice settings to identify adolescents requiring onward referral to specialist mental health or addiction services.

Private practice psychologists working with teenagers integrate the CRAFFT Screening Tool Template into their initial assessment batteries. Integrated care practices serving adolescents with complex health and social needs use it alongside other screening tools to comprehensively evaluate risk. The tool’s evidence base and brevity make it suitable for high-volume clinical settings where time pressures are significant.

Benefits of Using the CRAFFT Screening Tool Template

Systematic risk identification: The CRAFFT standardises substance use screening across your clinic. Workflow automation ensures all adolescents receive consistent assessment rather than ad-hoc questioning, reducing clinician bias and improving early detection of at-risk youth before problems escalate to crisis.

Evidence-based accuracy: The CRAFFT is validated in peer-reviewed research with sensitivity and specificity demonstrated across diverse adolescent populations. Using validated screening tools strengthens the clinical and legal defensibility of your risk assessment decisions. Regulatory bodies like the American Academy of Pediatrics explicitly recommend CRAFFT screening for all adolescent patients.

Time efficiency: The six-question format takes 2-3 minutes to administer and score, fitting easily into typical clinical appointments. This efficiency enables broad population screening rather than selective questioning only of adolescents who appear to use substances-a practice known to introduce clinician bias.

Structured documentation: The CRAFFT Screening Tool Template creates a dated, scoreable clinical record that demonstrates adherence to screening standards. This documentation supports quality audits, regulatory compliance reporting, and defence against allegations of missed assessment. Clinicians can easily track screening completion rates across the practice.

Referral clarity: Standardised scoring thresholds (2+) remove ambiguity about whether further assessment is warranted. Clinicians have clear decision rules, and automated workflows can trigger referral letters and appointment booking based on screening results, ensuring no at-risk adolescent falls through gaps.

CRAFFT 2.1 vs Original Version: What Changed

The original CRAFFT, validated in the early 2000s, remains highly effective. However, CRAFFT 2.1 incorporates updated items reflecting contemporary adolescent substance use patterns. The updated version adds screening for vaping, electronic nicotine delivery systems, and synthetic cannabinoids-substances that were less prevalent when the original tool was developed.

Research from the Center for Adolescent Substance Abuse Research (CAsAR) at Boston Children’s Hospital confirms that CRAFFT 2.1 maintains the same sensitivity and specificity as the original while capturing modern risk profiles more accurately. Clinicians can confidently use either version; CRAFFT 2.1 is recommended for new screening programmes due to improved relevance to current adolescent substance use.

Both versions screen the same domains (car, relax, alone, forget, friends, trouble). The substantive change is in question wording and response options to align with current vocabulary adolescents use when discussing drug and nicotine use.

Expert Picks

Looking for a structured approach to adolescent mental health assessment? Psychiatric Evaluation Template provides a comprehensive framework for documenting full mental health histories alongside substance use screening.

Need to streamline how you store and retrieve screening forms? Mental Health EMR Software centralises all adolescent assessments in a searchable, HIPAA-compliant system.

Want to automate referral pathways after screening results? Automated Workflows can trigger referral letters and appointment booking when a CRAFFT score exceeds the threshold.

Conclusion: Making Adolescent Screening Part of Routine Care

The CRAFFT Screening Tool Template represents a practical, evidence-based method for identifying substance use disorders in adolescents before they progress to serious consequences. Implementing systematic CRAFFT screening across your clinic-whether paediatrics, mental health, primary care, or school health-ensures all young patients receive consistent risk assessment as part of routine practice.

Success depends on integrating screening into standard workflows, training all staff on consistent administration and scoring, and documenting results systematically. The free downloadable template is a starting point; combining the CRAFFT with digital forms and organised client records transforms screening from a one-off checklist into a cornerstone of adolescent preventive care.

Frequently Asked Questions