Sex & Love Therapy® Partner(s) Questionnaire
This form is an optional tool for providing your therapist with additional information. Each partner completes this form.
Email *
Full Name *
Partner(s) Name *
Phone
What is the problem that led you to decide to come to therapy? *
How long have you and your partner been together? In what form? (i.e,.dating, living together, married)? *
How was the decision to live together or marry made? *
What was the very beginning of your relationship like? *
How long did this phase last? *
What was your first disillusionment? *
What happened and how did you resolve it? *
Did this lead to any changes in your relationship? *
When did you first become aware of significant differences between the two of you? *
How are the two of you similar? *
How are you different? *
What do you do when there is conflict between the two of you? *
What does your partner do? *
What do you do when you are angry? *
What does your partner do when angry? *
What strengths do you have that support resolving differences? *
What strengths does your partner have? *
Do you spend time alone? *
Do you enjoy your free time? *
Does planning how to spend it create anxiety for you? *
Do you have separate friendships with people who are not mutual friends? *
Does this create conflict in your relationship? *
Are you comfortable doing activities away from your partner? *
What do you like to do? *
How comfortable are you with your partner spending time away from you? *
On a scale of 1 to 10, how open are you in expressing your innermost wants, thoughts, desires, and feelings to your partner? *
Totally Closed
Totally Open
When you feel like you want support or encouragement from your partner, do you get it? *
How? *
When your partner wants support or encouragement from you, do you feel that you give it? *
How?
Do you support your partner's development as an individual? (Give an example) *
Do you support your partner's development as an individual? *
What do you find most satisfying about it? *
What do you find least satisfying about it? *
How has your sexual relationship changed since you were first together? *
What is one thing that you wish was different about your sexual relationship? *
When do you feel most gratified in your relationship? *
Do the two of you have joint commitments to goals, projects, work, or social causes? *
Does this add or detract from the bond between you? *
If your relationship was a movie, drama, or book, what would it be titled? *
How would it end? *
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