| Friendship & Intimacy |
| Overall, our relationship operates smoothly, comfortably, and cohesively. | | |
| I feel genuinely happy, satisfied, and emotionally fulfilled in this relationship. | | |
| I feel completely secure in our future together and have no desire to separate or divorce. | | |
| I know and understand my partner's inner world, daily stresses, fears, and aspirations. | | |
| I feel deeply respected, loved, appreciated, and valued by my partner. | | |
| When I reach out to my partner, they pay attention and respond rather than ignoring or denying me. | | |
| We have plenty of romance, courtship, and physical affection in our relationship. | | |
| I am satisfied with the emotional closeness and physical quality of our sex life. | | |
| We are well-matched and satisfied with how often we are sexually intimate. | | |
| I feel emotionally close, connected, and prioritized by my partner. | | |
| Total | 0 | |
| Average | 0.00 | |
| Preparedness for Couples Therapy |
| Our domestic and relational life feels calm, orderly, and predictable. | | |
| I completely trust my partner and feel safe from deception, lies, or betrayal. | | |
| I am deeply committed to staying in this relationship and making it last for life. | | |
| We comfortably discuss and explore difficult or vulnerable emotions together. | | |
| Total | 0 | |
| Average | 0.00 | |
| Conflict |
| Discussions of disagreements usually begin calmly and gently, without blaming attacks. | | |
| Our conflicts remain respectful, without criticism, defensiveness, contempt, or stonewalling. | | |
| During arguments, I remain calm, regulated, and able to think clearly. | | |
| My partner is genuinely open to my opinions and shares decision-making power. | | |
| When we disagree, we are able to meet halfway and find workable compromises. | | |
| I give my partner the benefit of the doubt and assume positive intent during our interactions. | | |
| When conflict escalates, we can successfully de-escalate, apologize, or laugh it off. | | |
| Our relationship is free from the impact of our childhood wounds or past family-of-origin experiences. | | |
| Total | 0 | |
| Average | 0.00 | |
| Navigating Shared Life |
| We effectively manage outside stressors like work or health without straining our connection. | | |
| We maintain healthy, peaceful, and respectful boundaries with in-laws and extended family. | | |
| We feel secure with each other,with no issues around jealousy or outside attractions. | | |
| Our relationship is completely faithful and free from unhealed affairs or betrayals. | | |
| We are in strong agreement regarding our core values, life philosophy, and lifestyle. | | |
| The division of household chores and child responsibilities feels fair and balanced. | | |
| We are united and aligned in how we manage money, spending, debt, and financial planning. | | |
| We regularly enjoy shared fun, playfulness, laughter, and relaxing recreational time together. | | |
| We share a comfortable connection and alignment regarding spiritual, religious, or moral values. | | |
| We are in strong agreement regarding parenting philosophy, child discipline, and family goals. | | |
| Our relationship is free from unresolved crises or major breaches of trust that have happened between us. | | |
| We discuss recurring differences constructively without feeling stuck, hostile, or gridlocked. | | |
| Total | 0 | |
| Average | 0.00 | |
| Shared Meaning |
| We have reliable, predictable routines for connecting daily, weekly, and on vacations. | | |
| My partner respects and supports the primary personal and career roles I play in life. | | |
| We actively support each other's individual life goals and future aspirations. | | |
| We share similar meanings regarding what home, marriage, and family represent. | | |
| My partner knows, honors, and actively champions my deepest life dreams. | | |
| Total | 0 | |
| Average | 0.00 | |
| Individual Concerns |
| My alcohol or substance use does not cause any problems in my life or relationship. | | |
| My partner's alcohol or substance use is healthy and not a source of concern for us. | | |
| I generally feel hopeful, energetic, emotionally stable, and interested in life. | | |
| I feel calm and grounded, and I rarely struggle with anxiety, panic, or feeling constantly on edge. | | |
| I feel hopeful about my life and am completely free from thoughts of suicide or self-harm. | | |
| Total | 0 | |
| Average | 0.00 | |
| Safety |
| Our arguments remain completely non-physical, with no pushing, shoving, or grabbing. | | |
| I feel physically and emotionally safe with my partner and never fear retaliation or harm. | | |
| My partner fully respects my independence and encourages my outside friendships. | | |
| My partner treats me with dignity and never insults, demeans, or gaslights me. | | |
| Our sexual intimacy is always fully consensual, safe, and free from pressure or coercion. | | |
| My partner completely respects our property, home, and personal belongings. | | |
| Total | 0 | |
| Average | 0.00 | |
