Safety and Sobriety Manual
Best Practices in Domestic Violence and Substance Abuse
Sample Screening Questions
(Note: The form can be found on page 15 of the Appendix Resource (pdf))
Answer YES or NO for each question as it applies.
- Within the past few years, have you been hit, slapped, kicked, pushed, shoved, or otherwise physically hurt by a family member, a person with whom you were in a relationship, or a care giver?
- Within the past year, has anyone in your family, or anyone you have been in a relationship with forced you to participate in sexual activities against your will?
- (If yes to either above): Are you afraid that the person who harmed you may do it again?
- Within the past few years, have you hit, slapped, kicked, pushed, shoved, or otherwise physically hurt a family member, a person with whom you were in a relationship, or a person to whom you were a care giver?
- Within the past year, have you forced anyone in your family, or anyone with whom you have been in a relationship, to participate in sexual activities against their will?
- (If yes to either above): Do you think that you may do it again?
NOTE: A YES to any of the questions would indicate that a more formal assessment be completed by a qualified professional.
Red Flags of Abusive Partners
A list of warning signs to indicate a possible abuser:
(Note: The list can be found on page 16 of the Appendix Resource(pdf))
- Watching the amount of time you are away
- Wanting to keep you away from friends
- Asks "Who are you talking to?" when you are on the phone
- Asks too many questions
- Sulks when he doesn't get his way
- Seems childish and/or insecure
- When something is important to you, he tunes you out
- He talks louder until he gets your undivided attention
- He physically restrains you until you listen to him
- Yells in your ear (sometimes until it is painful)
- He follows you around endlessly, repeating things over and over again
- Makes you repeat what he said back to him to be sure you were listening
- Makes you stop what you are doing to listen to him
- He makes all the rules. There is no flexibility
- What you think and feel are not important
- What he thinks and feels is very important
- He says, "We will get along fine as long as it goes my way."
- He won't admit it when he's wrong
- He pesters you about it until you admit it
- He tells you what your feelings are and then punishes you with the silent treatment or violence
- He acts as if he found a clue and makes a big issue of it
- He makes frequent accusations
- He acts as if any attention to another human being is flirting
- He says things like, "You belong to me", I got papers on you", and "You're my wife."
- He tells you how to dress or whether or not to wear make-up.
- He criticizes frequently
- He uses what you have told him against you
- He doesn't like anybody you like or he criticizes your friends
- He is controlling
- He is possessive of you
- He is bossy
- He is jobless
- He is a drug/alcohol user and uses that as an excuse for his behavior
- He was abusive in a previous relationship
- He has to know about your business but is secretive about his own
- He smiles too much (sneaky)
- He is always argumentative
- He has an uncontrollable temper