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Relationship Distress Self-Assessment

This brief self-assessment is designed to help you reflect on the current state of your relationship. It may help clarify whether support could be beneficial.

Over the past 3 months, how often have the following been true?

0 = Never1 = Rarely2 = Sometimes3 = Often4 = Almost Always

This is a self-screening tool only, not a clinical diagnosis. Results are not saved or stored.

Emotional Connection

1I feel emotionally close to my partner.(reverse scored)

2I feel lonely even when we are together.

3We share openly about our thoughts and feelings.(reverse scored)

4I feel misunderstood by my partner.

Communication

5Our conversations frequently turn into arguments.

6We struggle to resolve disagreements.

7I feel heard and respected during discussions.(reverse scored)

8Difficult topics are avoided rather than addressed.

Conflict & Safety

9Arguments escalate quickly.

10I feel criticised, dismissed, or blamed.

11I feel emotionally safe expressing vulnerability.(reverse scored)

12We repair after conflict and reconnect.(reverse scored)

Trust & Commitment

13I question my partner's commitment to the relationship.

14Trust has been damaged and remains unresolved.

15We feel like a team facing life together.(reverse scored)

Intimacy & Satisfaction

16I feel satisfied with our level of affection and intimacy.(reverse scored)

17Physical or emotional intimacy has significantly declined.

18I feel hopeful about our future together.(reverse scored)

Please answer all 18 questions to continue.