Couples Intake Questionnaire

1. The problem that led us to couples therapy is frequent arguments about financial issues and lack of communication. 2. We have been together for 5 years, and we are married. 3. I was initially attracted to my partner's sense of humor and kindness. 4. The beginning of our relationship was exciting and full of adventure, and this phase lasted for about a year. 5. I first felt disillusioned with my partner when they started working long hours, which led to less time spent together and increased tension. 6. It has been about 2 years since things were good between us. The stress of buying a house and managing finances caused things to go downhill. 7. We are similar in our love for travel and adventure, but different in our communication styles; I am more expressive, while my partner is more reserved. 8. When there is conflict, I tend to withdraw, while my partner becomes more confrontational. 9. When I am angry, I prefer to take a walk to cool down, whereas my partner tends to raise their voice. 10. My strength in resolving conflict is my patience, but I struggle with expressing my feelings. My partner is good at initiating discussions but can be overly critical. 11. I enjoy activities like yoga and reading separately from my partner. 12. I am comfortable with my partner spending free time away from me, as it gives us both space to recharge. 13. I have a close friendship with a colleague that sometimes creates jealousy in my partner. 14. I rate myself a 7 in being aware of my emotions because I am generally in tune with how I feel but sometimes struggle to articulate it. 15. I rate myself a 6 in openness with my partner, as I find it hard to share my deepest fears. 16. It is most difficult for me to open up about financial stress because I fear judgment. 17. When I need support, my partner often provides it by listening and offering advice. I try to support my partner by being present and attentive. 18. Our sexual relationship is satisfying, but I miss the spontaneity we had initially. It has become more routine over time. 19. I feel most content when we are traveling together and most frustrated during financial discussions. 20. I rate my commitment to the relationship as a 9 because I am dedicated to making it work. 21. I rate my love for my partner as an 8, as I still deeply care for them despite our challenges. 22. I rate my respect for my partner as a 7, as I admire their work ethic but wish they were more emotionally available. 23. I have contributed to our problems by avoiding difficult conversations and not expressing my needs clearly. 24. If our relationship was a book, it would be titled 'The Balancing Act,' and I hope it ends with us finding harmony and understanding.