A.R.E. Questionnaire

Name*

First NameLast Name

Email*

example@example.com

Who is your therapist?*

This questionnaire will help you begin to see your relationship through the lens of emotional responsiveness.

Read each statement and rate on a scale between 1-10 where 1 = not at all true and 10 = completely true.

From your view point, how ACCESSIBLE is your partner to you?*

	Never True	Rarely True	Sometimes True	Usually True	Always True
I can get my partner's attention easily.
My partner is easy to connect with emotionally.
My partner shows me that I come first with them.
I am not feeling lonely or shut out in this relationship.
I can share my deepest feelings with my partner and they will listen.

Total Accessibility Score

From your view point, how RESPONSIVE is your partner to you?*

	Never True	Rarely True	Sometimes True	Usually True	Always True
If I need connection and comfort, they will be there for me.
My partner responds to signals that I need them to come close.
I find I can lean on my partner when I am anxious or unsure.
Even when we fight or disagree, I know that I am important to my partner and we will find a way to come together.
If I need reassurance about how important I am to my partner, I can get it.

Total Reliability Score

Are you positively emotionally ENGAGED with each other?*

	Never True	Rarely True	Sometimes True	Usually True	Always True
I feel comfortable being close to and trusting my partner.
I can confide in my partner about almost anything.
I feel confident, even when we are apart, that we are connected to each other.
I know that my partner cares about my joys, hurts, and fears.
I feel safe enough to take emotional risks with my partner.

Total Engagement Score

TOTAL SCORE