White County Community Counseling Moto

Relationship Assessment

Relationship Assessment

I seek my partner’s opinion *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner and I agree on how we handle our finances *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I respect my partner’s actions *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I feel nurtured by my partner *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I know and understand my partner’s dreams and long-term aspirations *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
Home is where I go to receive support *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I can easily remember romantic, special times in my marriage *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner seeks out my opinion *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I feel respected and loved everyday *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner understands my fears *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
When I fail, I turn to my partner for understanding and support *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I am satisfied with the amount of affection my partner gives me *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I feel comfortable sharing my dreams and aspirations with my partner *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I have a positive attitude about myself *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner is my best friend *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
During disagreements, I feel safe sharing my thoughts and feeling with my partner *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I feel protected by my partner *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I respect my partner’s decisions *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
Home is a safe place to receive forgiveness and encouragement *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I am pleased with how my partner and I express affection and relate sexually *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner understands my dreams and long-term aspirations *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner and I agree on our spiritual beliefs *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I find relief from stress at home *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
I have a positive attitude about my partner *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner makes me feel like my thoughts and feelings matter *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
My partner has a positive attitude about themselves *
 Never  
 Seldom 
 Occasionally 
 Often 
 Almost Always 
Marriage is lonelier than I thought it would be *
 True  
 False 
My partner should be perfect for me *
 True  
 False 
I have to be careful what I say when discussing certain issues with my partner *
 True  
 False 
I feel like we are two ships passing in the night *
 True  
 False 
My partner should make me happy *
 True  
 False 
I will avoid conflict with my partner by not saying what I really think and feel *
 True  
 False 
When my partner voices an opinion or a complaint I think they are being too self-centered *
 True  
 False 
In a healthy marriage, I believe it is important to determine who is at fault *
 True  
 False 
My partner and I should never fight *
 True  
 False 
I feel misunderstood by my partner *
 True  
 False 
I find it difficult or uncomfortable to be in conflict with my partner’s opinion *
 True  
 False 
In healthy communication, speaking one’s mind is most important *
 True  
 False 

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 Female 
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