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?

Rows	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?

Rows	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?

Rows	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