When would you seek help for your relationship?
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If you realized that you and your spouse/partner had a relationship problem, how likely would you be to seek professional help?
If you realized that you and your spouse/partner had a relationship problem, how likely would you be to seek professional help?
Very unlikely
Unlikely
Neutral
Likely
Very likely
Other (please specify)
What kind of help would you seek first?
What kind of help would you seek first?
Couple retreat
Couple retreat
Pastoral counseling
Help from friends and/or family
Marriage counseling
Relationship coaching
Single gender group
Couples group
Relationship workshop
Self-help book(s)
Other (please specify)
How bad would things have to get between you and your spouse/partner for you to consider seeking help for your relationship? Would you seek help for...
How bad would things have to get between you and your spouse/partner for you to consider seeking help for your relationship? Would you seek help for...
A minor problem?
A few minor problems?
A major problem (like infidelity, domestic violence, or substance abuse)?
Constant arguing?
Loss of passion?
Loss of attraction?
Difficulties with parenting?
Financial struggles?
Other (please specify)
Have you sought help for a relationship problem? If yes, what kind of help did you seek?
Have you sought help for a relationship problem? If yes, what kind of help did you seek?
Couple retreat
Pastoral counseling
Help from friends and/or family
Marriage counseling
Relationship coaching
Single gender group
Couples group
Relationship workshop
Self-help book(s)
I have not done any of these things
Other (please specify)
If you had to pick only one quality for a happy relationship, which would be the most important to you?
If you had to pick only one quality for a happy relationship, which would be the most important to you?
Freedom from conflict
Monogamy and fidelity
Compatibility
Shared values
Harmony
Agreeing with each other
Great communication
Equality
Quality time together
Emotional awareness and intelligence
Other (please specify)
What would be the second most important quality to have to consider yours a happy relationship?
What would be the second most important quality to have to consider yours a happy relationship?
Freedom from conflict
Monogamy and fidelity
Compatibility
Shared values
Harmony
Agreeing with each other
Great communication
Equality
Quality time together
Emotional awareness and intelligence
Other (please specify)
What motivates you most strongly to make changes?
What motivates you most strongly to make changes?
Pain gets bad enough
Desire to improve myself
Fear of losing my relationship
Always want things to be better
Other (please specify)
How long have you been married/in a long-term, committed relationship?
How long have you been married/in a long-term, committed relationship?
Newlywed
1-2 years
3-10 years
11-20 years
21 or more years
Would you be willing to provide as much information as you feel comfortable giving below? Your answers will be kept in strict confidence.
Would you be willing to provide as much information as you feel comfortable giving below? Your answers will be kept in strict confidence.
Name:
Company:
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RI Rhode Island
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WA Washington
WV West Virginia
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