Relationship Assessment | Couples Counselling Sevenoaks Kent | London Bridge SE1

Couples Conflict Questionnaire

You can respond anonymously, and no data will be retained from this assessment. If you choose to include your initials and an email address, your results will be automatically sent to the email address provided. Please check that the email address has been entered correctly before submitting this form. All client information is managed on a strictly confidential basis. Please Note: Whilst every effort is made to ensure that our system is securely encrypted, email is not a completely secure means of communication. Think CBT does not accept liability for loss or theft of personal data where any individual chooses to transmit or receive information via email.

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Couples Conflict Questionnaire

This questionnaire has been designed to identify the key interpersonal factors that maintain behavioural conflict in relationships. The results can be used to identify perceived differences and highlight important targets for behavioural change. The questionnaire can be completed independently by both partners and results can be used to explore differences in perception and behaviour. Please rate each statement as honestly as possible using the following rating scale:

1. Attacking the other person's personality or character.

Never Sometimes More often than not Almost always

2. Blaming the other person when things go wrong.

Never Sometimes More often than not Almost always

3. Using overgeneralisations during disagreements "you always, you never."

Never Sometimes More often than not Almost always

4. Striking at an emotional vulnerability or weakness to hurt the other person.

Never Sometimes More often than not Almost always

5. Pointing out mistakes and inadequacies.

Never Sometimes More often than not Almost always

6. Using insults and Name calling.

Never Sometimes More often than not Almost always

7. Using Hostile humour, sarcasm or mockery.

Never Sometimes More often than not Almost always

8. Showing negative body language and using a negative tone of voice.

Never Sometimes More often than not Almost always

9. Demeaning the other person in front of other people.

Never Sometimes More often than not Almost always

10. Making decisions without concern for the other person's feelings.

Never Sometimes More often than not Almost always

11. Playing the victim or innocent party.

Never Sometimes More often than not Almost always

12. Yes butting - starting by agreeing and then disagreeing.

Never Sometimes More often than not Almost always

13. Making excuses or deflecting the causes to circumstances beyond ones control.

Never Sometimes More often than not Almost always

14. Matching a criticism or complaint with a criticism or complaint of one's own.

Never Sometimes More often than not Almost always

15. Repeating one's self without paying attention to what the other person is saying.

Never Sometimes More often than not Almost always

16. Using stony silence during conflict.

Never Sometimes More often than not Almost always

17. Avoiding eye-contact after disagreements.

Never Sometimes More often than not Almost always

18. Using monosyllabic mutterings or speaking under one's breath.

Never Sometimes More often than not Almost always

19. Changing the subject in an attempt to avoid the issue.

Never Sometimes More often than not Almost always

20. Leaving the room or walking away from conflict.

Never Sometimes More often than not Almost always

There are many psychotherapists and counsellors offering cognitive behavioural therapy. Always ensure that your therapist is professionally accredited with the British Association of Behavioural and Cognitive Psychotherapy (BABCP).

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