Abuse Questionnaire Part One

Part One – Criminally Abusive Behaviour

Have you, or has the other person, ever done any of the following things?

 1. Punched, pinched, kicked, headbutted, bitten, choked, strangled or burned the other person regardless of whether it was done on purpose, by accident, or for a good reason.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points.

Score for You _______    Score for the Other Person _______

 2. Used any kind of object or weapon to hurt the other person, or threatened to use such an item to hurt them, regardless of the circumstances.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points.

Score for You _______    Score for the Other Person _______

 3. Persuaded, or forced, the other person to participate in any type of unwanted sexual activity including foreplay, pornography, rough sex, BDSM, masturbation or sex with other people regardless of whether you were able to overcome their initial objections and get them to agree to the activity.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points.

Score for You _______    Score for the Other Person _______

 4. Grabbed, held down, pinned against the wall, locked the other person in the house, a room in the house, or any other place or physically restrained the other person in any way for any reason no matter how good that reason may have been.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points.

Score for You _______    Score for the Other Person _______

 5. Pulled the other persons hair, poked, pushed, shoved, smacked or slapped them regardless of whether it was done on purpose, by accident, or for a good reason.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points.

Score for You _______    Score for the Other Person _______

 6. Denied the other person basic needs such as food, water, sleep or hygiene, even if this was only for a very short period of time, and regardless of whether you had a good reason for doing it; or forced the other person to eat, drink, stay in bed, get out of bed, bathe, shower etc. against their will regardless of any reason you may have had for doing it.

NOTE
Special Conditions apply to people who are using this questionnaire to find out if they are being an abusive parent.  If this describes you then read on.  If this does not describe you then you may skip down to the scoring section for this question.

PARENTS
Deliberately depriving a child of basic needs, for any reason, is abusive.  Basic needs for children include food, water, air, hygeine, sleep, an education, physical and emotional safety, appropriate love, protection from harmful things or people, communication and appropriate discipline.

It is appropriate discipline, for example, to refuse to give a child soft drink in place of water or alternative food if he has rejected the food you offered provided that food was not inedible.  Food that is mouldy, dirty, has gone off or is rotten, has been under or over cooked, or has too much salt, pepper, or other seasoning is not edible and a child has a right to reject it.

A child has the right to decide he is full or she does not want good food you have offered but, if they are “fussy eaters”, it is important to teach them the decisions they make in life have consequences.  This means you should not offer food to them again before the next scheduled meal is due if they have refused edible food offered at meal time.

Depriving a child of privileges and non-essentials such as television or dessert is acceptable discipline.  Depriving them of essentials, such as their next meal, is not discipline.  It is abuse and should be counted in this question.

Insisting a child eat his dinner, take a bath, get up in the morning or go to bed at night should not be counted in this question either as long as you did not use undue force.

Physically forcing food into the childs mouth, handling them roughly to get them up, forcing them into bath water that is too hot or too cold, throwing them on the bed or using abusive threats designed to frighten the child into submission are all examples of undue force.

It is not abusive parenting if you do not have food, water, access to schools and so on to give your child because you live in a country that does not make it possible for you to provide these things.  You cannot give what you do not have and the abuse is, in such cases, the fault of government or society not the parent.  It is abusive parenting, however, if your child goes hungry because you spent money on alcohol or drugs when you could have used it to buy food or they don’t go to school because you can’t be bothered to make them go.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour resulted in any kind of physical reaction or injury such as a rash or bedsore, fainting or passing out, vomiting or diarrhoea, bruising, soap in the eyes, scalding or shivering, or being targeted by teachers or bullies at school for things such as dirty clothes, poor hygiene, nits etc. add 5 points.

Score for You _______    Score for the Other Person _______

 7. Hurt, harmed, or killed a pet the other person cared about.

Never: 0      Once or twice: 10    More than twice: 20

Score for You _______    Score for the Other Person _______

 8. Invaded the other persons personal space, stood over them, blocked a doorway or other escape route, took away a mobility device such as a wheelchair or crutches, made threatening gestures such as a clenched fist in the face or handled, displayed, or used any kind of weapon in a way that, if asked, they would say frightened them such as pointing a gun at them, stabbing a knife into something, or hitting tables, walls, or other objects with something that could be viewed as a weapon.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points even if the damage occurred because they did something in response to your behaviour that caused them to hurt themselves.

(For example they climbed through a window when you blocked the door and fell, they pulled their head away from your fist and banged it on the wall, they tried to move without their wheelchair and pulled something down on themselves.)

Score for You _______    Score for the Other Person _______

 9. Made threats to kill, hurt or harm the other person, their children, a friend, a family member or a pet regardless of whether you were serious or not.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points even if the other person caused the damage by reacting badly to the threats.

(For example they grabbed the pet to protect it from you and the pet was startled and bit them.)

Score for You _______    Score for the Other Person _______

10. Broken furniture, smashed glass, thrown things, torn clothing, punched holes in doors or walls, pulled the phone out of the wall, damaged a car or ruined things during arguments or when angry with the other person.

Never: 0      Once or twice: 5    More than twice: 10

If you are bigger, stronger, or in a position of power over the other person AND you did NOT answer “Never” add 5 points.

If the behaviour left a mark or bruise, drew blood, broke or loosened teeth, broke or fractured a bone, led to a loss of consciousness, caused internal injuries or created a need for any kind of medical attention add 5 points even if the damage was wholly accidental.

(For example the other person had bare feet and cut them on the glass you broke.)

Score for You _______    Score for the Other Person _______

Add up all the scores for yourself then add up all the scores you gave the other person.  You should each have a score somewhere between 0 and 200.

Total score for You ________     Total score for the Other Person ________

Minimum score is 0 and maximum score is 200

When you are ready you may move on to Part Two of the questionnaire.

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