Secrets to Successful Intimate Relationships - Toronto

Instruction: Please answer all of the questions in this questionnaire to the best of your ability.


Personal Information / 个人信息

Information in this section will be encrypted when stored on our server, but it is recommended that you submit this form over a private (e.g. home) network.

Family Assessment Instrument / 家庭評估量表

For each of the items describing your view of your current family, please select the response that best represents how you feel. Please answer every question.


Psychosocial Screen / 心理與社交健康的評估表

This questionnaire provides you with a means of reporting problems that you may be having as an individual or in your relationships with your family and others whom you know or work with. It is not a test, so there are no right or wrong answers. Answer each item as carefully and as accurately as you can.


Problem checklist / 问题询问表

Please check any of the following items that are currently problems for you. If none apply, check "None of the above" at the bottom of the list.


Experiences in Close Relationships / 親密關係體驗量表

Instruction: The statements below concern how you feel in emotionally intimate relationships. We are interested in how you generally experience relationships, not just in what is happening in a current relationship. Respond to each statement by selecting the option that best indicates how much you agree or disagree with the statement.


Relationship Satisfaction Scale / 關係滿足程度

Select the category that best describes the amount of satisfaction you feel in your relationship with your attachment figure. / 請選出你與你的依附對象的關係中所感到的滿足程度。 (0=extremely dissatisfied / 絕對不滿; 1=very dissatisfied / 非常不滿; 2=moderately dissatisfied / 相當不滿; 3=dissatisfied / 頗為不滿; 4=slightly dissatisfied / 有些不滿; 5=neutral / 中立; 6=slightly satisfied / 有些滿足; 7=satisfied / 頗為滿足; 8=moderately satisfied / 相當滿足; 9=very satisfied / 非常滿足; 10=extremely satisfied / 絕對滿足)

Note: Although this test assesses your marriage or most intimate relationship, you can also use it to evaluate your relationship with a friend, family member, or colleague. / 雖然這問卷是用來評估你的婚姻或最親密的關係,也可以用來評估你與朋友、家人、同學和同事之間的關係。

1. Communication and openness / 溝通與開放

2. Resolving conflicts and arguments / 處理衝突

3. Degree of affection and caring / 感情和關心

4. Intimacy and closeness / 親密與親近

5. Satisfaction with your role in the relationship / 你自己的角色

6. Satisfaction with the other person's role / 對方的角色

7. Overall satisfaction with your relationship / 普遍的關係滿足

8. Understand and acceptance of the relationship / 對關係的認識和了解

9. Understand and acceptance of yourself / 對自己的認識,了解和接納

10. Understand and acceptance of the other person / 對對方的認識,了解和接納

Brief Accessibility, Responsiveness, and Engagement (BARE) Scale (About)
精簡的可親,回應和投入程度的量表(BARE) (介紹)

A quick A.R.E. tune-up conversation can be prompted by the following brief 12-item questionnaire. Please take a few minutes to answer the questions, then discuss how you can improve as a couple. Remember, the peace, love, and joy that come from experiencing a safe haven and secure base is worth the effort.

通過下面簡單12項的問卷調查進行快速調整關係的A.R.E.對話。請你花幾分鐘時間來回答這些問題,然後討論如何改善你們的夫婦關係。請記住, 從經歷一個安全的避風港和安全的基地而來的和平,愛和喜樂是絕對值得努力爭取的。

Dyadic Adjustment Scale / 配對適應量表

Most persons have disagreements in their relationships. Please indicate below the approximate extent of agreement or disagreement between you and your partner for each item on the following list.


How often would you say the following events occur between you and your mate?

These are some things about which couples sometimes agree and sometime disagree. Indicate if either item below caused differences of opinions or were problems in your relationship during the past few weeks.
婦間在某些事情上會有時意見一致,但也有時會持不同的意見。請選出在過去數個星期內,以下的事情曾否引致你們夫婦間有不同的意見,或這些事情已經成為你們婚姻關係中的問題? (請指出是或否)