The Questionnaire: Table of Contents

Many couples wonder if the Relationship Checkup will address the issues occurring in their relationship. Here are the topics that are covered in the questionnaire.

  1. Section 1: Assessment of Friendship and Intimacy
    1. Relationship Satisfaction Scale
    2. Assessment of Relationship Commitment
    3. How well do you know your partner?
    4. Fondness and Admiration
    5. Turning Towards or Away
    6. Romance in Your Relationship
    7. The Quality of Your Sex Life
    8. Frequency of Sex in Your Relationship
    9. Do you Feel Lonely or Disengaged?
  2. Section 2: The Detour Scales
    1. Is your relationship chaotic?
    2. Trust in Your Relationship
    3. Commitment to the Relationship
    4. Your Thoughts about Emotions
  3. Section 3: The Conflict Scales
    1. When You have Conflict
    2. When Issues Come Up
    3. Flooding
    4. Accepting Influence
    5. Compromise
    6. Negative Feelings
    7. Repair Attempts
    8. Your Family History
    9. Emotional Connection
    10. Stress
    11. Relatives and Extended Family
    12. Jealousy
    13. Emotional and Sexual Affairs
    14. Basic Values and Goals
    15. Housework and Childcare
    16. Financial Issues
    17. Having Fun Together
    18. Spirituality, Religion, Ethics
    19. Children
    20. Distressing Events
    21. Difficulty with Perpetual Issues
  4. Section 4: Shared Meaning
    1. Rituals of Connection
    2. Roles in Life
    3. Goals
    4. Symbols
  5. Section 5: Individual Areas of Concern
    1. Drug and Alcohol Abuse
    2. Frequency of Drug and Alcohol Use
    3. Thoughts of Suicide
    4. How Safe is Your Relationship?
    5. Safety in Your Relationship
    6. Feeling Isolated
    7. Degradation and Humiliation
    8. Sex
    9. Property Damage
    10. Physical Symptoms
    11. Feelings and Thoughts
    12. How You Think Others View You
    13. Sadness and Depression
    14. Anxiety and Panic
    15. Do You Feel Angry?
    16. Fears and Phobias
    17. Do You Worry about What Others Think?
    18. Your Thoughts
    19. Appetite
    20. Falling Asleep
    21. Waking in the morning
    22. Sleep
    23. Death and Dying
    24. Overeating
    25. Guilt