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*Marriage Questionnaire*

This questionnaire is meant to draw out information on the status of a marriage relationship in the context of counselling. As a counsellor I can get back to you for further discussions and hopefully help you to come out of problem situations. Please answer the questions truthfully, because that is the only way you can get an appropriate feedback. Remember that there is no need to impress me, and you don't get anything by fooling me.

Please be assured that as a counsellor I give you guarantee of keeping things confidential.

Questionnaire (Copyright 2008, Jacob Ninan, http://www.c-n-c.org)

Your name
Your email address
Your faith Christian  Other
Your gender Male  Female
Your country
Your age (years completed)
Your age at the time of marriage
Present marital status Married  SeparatedDivorced  Widowed
If remarried, number of marriages
If remarried, number of years between marriages
Number of children
Income level of the family Poor  Lower middleUpper middle  Rich
Type of husband’s work Own business  Employed  Unemployed  
Husband’s qualifications School  GraduateMasters  Doctorate  
Husband’s income Nil  Low  MediumHigh  
Husband’s working hours Normal  LongExtra long  
Husband’s work pattern Regular  Shifts  
Type of wife’s work Housewife  Working from home  Working outside  
Wife’s qualifications School  GraduateMasters  Doctorate  
Wife’s income Nil  Low  MediumHigh  
Wife’s working hours Normal  LongExtra long  
Wife’s work pattern Regular  Shifts  
Are you staying together with your spouse? Yes  No  
If ‘No’, is it because your spouse is working in another place? Yes  No  
Number of hours per day when husband and wife are together at home
Number of waking hours per day husband and wife spend together
Do you share the same religious faith as your spouse? Yes  No  
Do you eat together? Rarely  Now and then  Often  
Do you watch TV together? Rarely  Now and then  Often  
Do you work together in the kitchen? Rarely  Now and then  Often  
Do you go out together for walks? Rarely  Now and then  Often  
Do you go out together for social/cultural events? Rarely  Now and then  Often  
How much do you talk together per day? Up to 15 min  30 min  1 hour  2 hours  More than 2 hours  
Do you get upset with each other? Very little  Now and then  Often  Very often  
Do you quarrel with each other? Very little  Now and then  Often  Very often  
Is there physical violence between both of you? Never  Sometimes  Often  Very often  
When you get upset with your spouse do you wish to do something violent? Never  Sometimes  Often  Very often  
What happens after a quarrel? Make up quickly  Stop talking for a long time  Talk to others about it  Ignore it and carry on  Discuss and settle it  
Do you discuss problem issues together? Rarely  Sometimes  Often  Very often  
Are you afraid to address problem issues with spouse? Yes  No  Sometimes  Very often  
Do you think your spouse is the major cause of your problems? Yes  No  
If you made a mistake, do you apologise to your spouse? Yes  No  Sometimes  Very often  
Do you share with your spouse about things that bother you? Rarely  Now and then  Often  
Do you think your spouse has time to listen to you? Rarely  Now and then  Often  
Do you think you have time to listen to your spouse when he/she comes to talk about his/her problems? Rarely  Now and then  Often  
Do you tell your spouse about the things you appreciate about him/her? Rarely  Now and then  Often  
How long ago did you express your appreciation about your spouse in front of others? Days  Weeks  Long ago  
How long ago did you express your unhappiness about your spouse in front of others? Days  Weeks  Long ago  
Do you have fun or share jokes with your spouse? Rarely  Now and then  Often  
Do you make fun of your spouse in private? Rarely  Now and then  Often  
Do you make fun of your spouse in front of others? Rarely  Now and then  Often  
Do you talk together before making major decisions? Rarely  Now and then  Often  
Do you feel your spouse does not really understand you? Rarely  Sometimes  Often  
Do you think you understand your spouse well? To a large extent  Moderately  To a small extent  
Can you anticipate what your spouse will say or do? Rarely  Sometimes  Often  
Do you try to correct/train/teach your spouse? Rarely  Sometimes  Often  
Does your spouse appreciate the way you try to correct/train/teach him/her? Rarely  Sometimes  Often  
Do/Did you and your spouse agree on the number of children you would like to have? Yes  No  
Do/Did you or your spouse think that children are burdens on your life? Yes  No  
Do/Did you or your spouse think that children are a drain on your income? Yes  No  
Do/Did you and your spouse agree on the way to discipline/train your children? Yes  No  
Do/Did you share the responsibility of bringing up your children? Yes  No  
Does/Did your spouse share the responsibility of bringing up your children? Yes  No  
Do/Did you both depend to a major extent on others to bring up your children? Yes  No  
Do you think your children are generally doing well? Yes  No  
Do you have a well-adjusted sex life? Yes  No  
How often did you have sexual relations immediately after you got married? Rarely  Often  Very often  
How often do you have sexual relations now? Rarely  Often  Very often  
Do you think your spouse is asking for too much sex? Yes  No  
Do you think your spouse is not cooperating with you enough in sexual relationships? Yes  No  
Do you think your spouse is asking you to do things you don't like? Yes  No  
If you are a wife, are you afraid of childbirth? Yes  No  
Are you happy that your spouse is also earning? Yes  No  
How do you manage your incomes? Separately  As one income  Separately, with mutual understanding  
Do you and your spouse know how much you are both earning? Yes  No  
Do you and your spouse know how much you are spending? Yes  No  
Do you discuss expenditure/savings/strategies? Yes  No  
Are you able to manage within your income? Yes  No  
Do you wish you could have more happiness even at the cost of less income? Yes  No  
What would you rate as the best point in your wife? Attractive looking  Good cook  Takes care of home  Takes care of children  Sexual relationship  Good friend to talk to  Careful with money  Your best fan  A good balance for you  A good partner in life  Nothing special  
What would you rate as the second best point in your wife? Attractive looking  Good cook  Takes care of home  Takes care of children  Sexual relationship  Good friend to talk to  Careful with money  Your best fan  A good balance for you  A good partner in life  Nothing special  
What would you rate as the third best point in your wife? Attractive looking  Good cook  Takes care of home  Takes care of children  Sexual relationship  Good friend to talk to  Careful with money  Your best fan  A good balance for you  A good partner in life  Nothing special  
What would you rate as the worst point in your wife? Does not cooperate in sex  Spends too much  Wants to talk all the time  Complaining  Quarrelling  Nagging  Domineering  Negligent in appearance  Disinterested cook  Not taking care of the home  Too tired all the time  Nothing special  
What would you rate as the second worst point in your wife? Does not cooperate in sex  Spends too much  Wants to talk all the time  Complaining  Quarrelling  Nagging  Domineering  Negligent in appearance  Disinterested cook  Not taking care of the home  Too tired all the time  Nothing special  
What would you rate as the third worst point in your wife? Does not cooperate in sex  Spends too much  Wants to talk all the time  Complaining  Quarrelling  Nagging  Domineering  Negligent in appearance  Disinterested cook  Not taking care of the home  Too tired all the time  Nothing special  
What would you rate as the best point in your husband? Understanding  Affectionate  Considerate  Listens to me  Earns well  Helps at home  Helps with the children  A good friend  Handsome  Respected in society  Nothing special  
What would you rate as the second best point in your husband? Understanding  Affectionate  Considerate  Listens to me  Earns well  Helps at home  Helps with the children  A good friend  Handsome  Respected in society  Nothing special  
What would you rate as the third best point in your husband? Understanding  Affectionate  Considerate  Listens to me  Earns well  Helps at home  Helps with the children  A good friend  Handsome  Respected in society  Nothing special  
What would you rate as the worst point in your husband? Too much sex  No time for conversation  Not interested in the home  No time for children  No respect for me  Does not understand my problems  I don’t know if he loves me  Too lazy to work  Abusive  Womanising  Nothing special  
What would you rate as the second worst point in your husband? Too much sex  No time for conversation  Not interested in the home  No time for children  No respect for me  Does not understand my problems  I don’t know if he loves me  Too lazy to work  Abusive  Womanising  Nothing special  
What would you rate as the third worst point in your husband? Too much sex  No time for conversation  Not interested in the home  No time for children  No respect for me  Does not understand my problems  I don’t know if he loves me  Too lazy to work  Abusive  Womanising  Nothing special  
Overall: how would you rate your marriage? (1-Hopeless 10-Excellent)
What are you willing to do for enhancing your relationship"
For husbands only
Will you show your affection to your wife often through kind words, words of appreciation, hugs, kisses, gifts, treating her in a special way on her birthday and your anniversary day? Rarely  Often  Very often  
Will you give her a listening ear when your wife tries to share her feelings, thoughts, challenges, frustrations, etc.? Rarely  Often  Very often  
Will you be open with your wife about your activities, friendships, transactions, plans, etc.? Rarely  Often  Very often  
Will you share with your wife about your financial status and make her feel comfortable about the provisions you have made for her? Rarely  Often  Very often  
Will you take interest and share responsibility with your wife for raising up your children? Rarely  Often  Very often  
Will you let your wife know and feel that she is the most important person in your life? Rarely  Often  Very often  
How often will you pray to God to help you to love and stay faithful to your wife? Rarely  Often  Very often  
For wives only
Will you recognise your husband's strong sexual need and cooperate with him when he comes to you? Rarely  Often  Very often  
Will you be a supporting companion to your husband when he tries to enjoy his hobby or recreation? Rarely  Often  Very often  
Will you encourage your husband by showing him appreciation and admiration? Rarely  Often  Very often  
Will you try to make yourself look attractive to your husband in your appearance? Rarely  Often  Very often  
Will you take responsibility for managing the household so that your husband will love to come home? Rarely  Often  Very often  
Will you let your husband know and feel that he is the most important person in your life? Rarely  Often  Very often  
How often will you pray to God to help you to love and stay faithful to your husband? Rarely  Often  Very often  
 

Any other comments you would like to offer

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If you would like to receive some marriage counselling, for men and women, go to my Marriage Column, where you can also read some articles that can enhance your marriaage.