Relationship Assessment

1. What is the problem that led you to decider to come to therapy?
How long have you and your partner been together? In which capacity
2. dating, living together married?
3. What initially attracted you to each other? How did you decide to get married or live
together?
4. What do you find most fulfilling about your relationship?
5. What was the very beginning of your relationship like? How long did this last?
6. What was your first disillusionment? What happened and how did you resolve it?
7. What do you feel least fulfilled in your relationship?
8. In what significant ways are the two of you similar?
9. Do you spend time in activities away from your partner?
10. How comfortable are you doing activities away from your partner? How comfortable are
you with your partner doing things away from you?
11. How safe do you feel expressing your innermost thoughts and feelings to your partner?
How do you ask for emotional support from your partner when you are feeling
vulnerable? Do you expect to get it?
12. Would your partner say that you are emotionally responsive to his/her vulnerability?
Explain.
13. Do you take an active energetic role in nourishing the relationship? Does your partner
do the same? How?
14. Do you support your partner’s development as an individual? How(give example) Do
you support his/her growth as an individual even when you don’t agree (example)
15. Do you believe that your partner is giving at least 50% to the relationship?
16. Do the two of you have joint commitment to projects, work activities, or social causes?
If so what?
17. Did you deliberately decide to create something together in one of these areas?
18. Does this project seem to add or distract from the bond between you?
19. If your marriage were a drama, a movie, or a book, what would it be titled? How would
it end?

You've come to the right place. We can help, CALL US!

LOCATION

OFFICE HOURS

Primary

Monday:

9:00 am-5:00 pm

Tuesday:

9:00 am-5:00 pm

Wednesday:

9:00 am-5:00 pm

Thursday:

9:00 am-5:00 pm

Friday:

9:00 am-5:00 pm

Saturday:

Closed

Sunday:

Closed