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Client Assignment Submission

INSTRUCTIONS

Use the form below to submit your assignment for this week.  Incomplete assignments cannot be submitted:  ALL fields on the form are required and if you close this window, you will lose your work.
 

If you have any questions, please contact us:  941.250.0124

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Assignment Form

I am submitting this assignment for the following TOPIC:

select only one

Topic for This Assignment:

For your selected topic, answer ALL the following questions:

Q1 - YOUR ACTIONS *

Briefly describe the situation and the actions you took to control your partner.  
Include abusive statements, intimidating gestures, tone of voice, physical contact, facial expressions, names you called her.  BE SPECIFIC

Q2 - YOUR INTENTS *

What did you want to make happen in this situation? 
For example:  I wanted her to ____, I wanted her to stop ____, I wanted her to know ____,
I wanted her to feel ____.

Q3 - YOUR BELIEFS *

What beliefs do you have that support your actions and intents? 
For example:  Women should ____, Men have the right to ____, Wives are supposed to ____,
Women shouldn't ____, I have the right to ____, Women are ____, Men are ____.

Q4 - YOUR FEELINGS *

What feelings were you having - besides anger?  Anger is a cover for other emotions, identify those other emotions.  For example:  frustrated, hurt, disappointed, insecure, scared, lonely, jealous, threatened, embarrassed, annoyed, etc.

Q5 - THE EFFECTS *

What were the impacts of your actions?  For example:  On YOU, on HER, on OTHERS.

Q6 - SHORT-TERM GAINS *

What were the short-term gains for you?  For example:  I made her shut up, I got my way, etc.

Q7 - LONG-TERM COSTS *

What were the long-term costs for you?  For example:  hurt the relationship, made her love me less, made her not trust me, got arrested, etc.

Q8 - MINIMIZATION, DENIAL & BLAME *

What did you say to yourself or to her to get out of taking full responsibility for your actions?  
For example:  it was her fault, she pushed me, she provoked me, it was only a push, I don't remember, it was the alcohol, she pushes my buttons, she knows how I am, she made a big deal out of nothing, etc.

Q9 - PAST VIOLENCE *

How did your past use of violence affect his situation? Is there anything you did in the past that affected how she reacted to you this time?  For example:  Did she give into you this time because she was afraid of what might happen if she didn't.

Q10 - NONCONTROLLING BEHAVIORS *

What could you have done diffirently? 

Got it! Thank you.

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