Reducing Parental Conflict pre-questionnaire PT – Strengthening Families, Strengthening Communities

The information below helps us understand what impact this course has, if it helps parents, and what things we need to improve.

We will keep this information anonymously (without your personal details) and will not share it.

We can tell you more about privacy and how we manage data here.

Initials *

Postcode *

Date of birth *

Parent focus

The following are a number of statements about you and your child. Please say how much you agree or disagree with each one.

I am able to communicate respectfully with my co-parent or other carer of my child/ren *

I am able to cooperate with my co-parent or child/ren’s carer *

I am able to resolve a disagreement with my co-parent or child/ren’s carer *

In most situations, I listen to what my co-parent has to say without interrupting *

I trust my co-parent *

Mental well-being

Below are some statements about feelings and thoughts. Please tick the box that best describes your experience of each over the last 12 months.

I've been feeling optimistic about the future *

I've been feeling useful *

I've been feeling relaxed *

I've been dealing with problems well *

I've been thinking clearly *

I've been feeling close to other people *

I've been able to make up my own mind about things *

Your child

Below are some statements about feelings and thoughts. Please tick the box that best describes your experience of each over the last 12 months.

How often does your child hear or see the arguments (including silences/an inability to communicate) between you and your co-parent/other carer? *

How often does your child appear withdrawn, angry, aggressive, hostile? *

How often does your child refuse to comply with requests at home or school? *

How often does your child tell you they feel scared or worried about the future because you and your co-parent/carer are arguing? *

How often does your child feel to blame for the arguments you have with your co-parent/carer? *

About the course

Can you tell us how you heard about this course? *

Please specify how you heard from us

Has a child/children's co-parent (by this we mean the other parent, or a step parent, or key adult playing a major part in bringing up your child) already attended this course? *

Yes
No

Will a child/children's co-parent (by this we mean the other parent, or a step parent, or key adult playing a major part in bringing up your child) be attending at the same time as you? *

Yes
No