Adquest is an adolescent self-assessment questionnaire which was designed by practitioners at Mount Sinai’s Adolescent Health Center (AHC) in New York City to serve as a bridge to engagement, a device to keep the clinical dialogue open. It attempts to standardize and broaden clinical assessment, identifying treatment objectives, and framing psycho-educational interventions. This article describes how AHC clinicians use Adquest in planned and unplanned ways. It describes a practitioner-led inquiry into the impact of a formal assessment instrument on their practice and that of colleagues. Practitioners report that this practitioner-designed, indigenous instrument enhances their ability to engage high-risk urban adolescents. Clinicians have been able to use it creatively despite some concerns that, by offering a different perspective from interviewing alone, Adquest might at times leave them somewhat exposed. In order to more clearly understand how to better serve vulnerable populations, more needs to be heard from practitioners about their own experiences in integrating innovations into practice. References