Domestic Abuse Assessment Tool - The Rainbow House

RELATIONSHIP LETHALITY CHECKLlST

This questionnaire is designed to help to help you decide if you are living in an abusive situation. There are different forms of abuse, and not every person experiences all of them. Below are various questions about your relationship. As you can see, each possible answer has points assigned to it. By answering each question, and then totaling these points as directed, you can compare your score with the abuse index. You will know if you are living in a potentially violent situation; and if abuse is occurring, you will have an estimate of how lethal the abuse is.

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Step 1 of 2

Frequently-3 Sometimes-2 Rarely-1 Never-0

Directions: Please number your response to each question according to the chart below. Be honest, this checklist is for you.

1. Does your partner continually monitor your time and make you account for every minute (when you run errands, visit with friends, commute to work, etc.)?

Please enter a number less than or equal to 3.

2. Does your partner ever accuse you of having affairs?

Please enter a number less than or equal to 3.

3. Is your partner ever rude to your friends?

Please enter a number less than or equal to 3.

4. Does your partner ever- discourage you from starting friendships P

Please enter a number less than or equal to 3.

5. Do you ever feel isolated and alone, as if there is no one close to you to confide in?

Please enter a number less than or equal to 3.

6. Is your partner overly critical of daily tliings, such as your cooking, your clotl1es, your housework, or your appearance?

Please enter a number less than or equal to 3.

7. Does your partner demand a strict amount of how you spend money?

Please enter a number less than or equal to 3.

8. Do you quarrel much over financial matters?

Please enter a number less than or equal to 3.

9. Does your partner's mood change radically, from very calm to very angry, or vice versa?

Please enter a number less than or equal to 3.

10. Is your partner disturbed by you working or by the thought of you working or attending school?

Please enter a number less than or equal to 3.

11. Does your partner become angry more easily if he/she drinks or uses drugs?

Please enter a number less than or equal to 3.

12. Does your partner pressure you for sex more often than you are comfortable with or when you are ill?

Please enter a number less than or equal to 3.

13. Does your partner become angry if you don't want to go along with his requests for sex?

Please enter a number less than or equal to 3.

14. Do you argue about having children or how to raise them?

Please enter a number less than or equal to 3.