BreakThrough Wrap Up

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We would like to ask you to now take the time to take impact quiz again to compare your results, nd complete a feedback survey so that we can improve the course.

Impact Quiz

Step 1 of 11

Part I
Thinking about your relationship in the past week (if it wasn't a typical week, answer in terms of a typical week in the past month)...
1. How would you rate your personal contentment in your relationship?*
Very Discontented Discontented Neutral Contented Very Contented

2. How often did you think that things were going well between you?*
Never or rarely Sometimes Mostly Always
3. How safe and at ease did you feel in your relationship?*
Never or rarely Sometimes Mostly Always

4. How often did you feel hurt or disappointed in your relationship?*
Never Once or twice Almost daily Lost Count
5. How often did you connect on a significant level?*
Never Once or twice Almost daily Lost Count
6. How often did you laugh or have fun together?*
Never Once or twice Almost Daily Lost Count

7. How often did you have time together (of 10+ mins) for just the two of you?*
Never Once or twice Almost daily Lost Count
8. How equitable do you think your relationship is (ie both are contributing)?*
None A Little Acceptable Good
9. How often did you argue or disagree?*
None Once or twice 3-4 Times Every day Lost Count

10. How many positive to negative interactions did you have?*
Only Negative Mostly Negative About Even Mostly Positive Only Positive
11. How often were you physically intimate (sex, kissing, caressing, other non-genital touch etc)?*
Never Once Twice Three times Four times Lost Count

Part 2
Thinking about yourself in the past week…
12. How often did you make a gesture of kindness or service towards the other?*
None Once Twice 3-4 Times Every day More than Daily

13. How often did you express affection towards the other?*
None Once Twice 3-4 Times Every day More than Daily
14. How often did you express gratitude and appreciation to the other?*
None Once Twice 3-4 Times Every day More than Daily

15. How often did you speak or act in anger towards the other?*
None Once Twice 3-4 Times Every day More than daily
16. How often did you criticise or negatively judge the other?*
None Once Twice 3-4 Times Every day More than daily
17. How often were you dishonest with the other (withheld information, kept a secret, misled or lied)?*
None Once Twice 3-4 Times Every day More than Daily

18. How much did you grow or develop as a person?*
Went Backwards No Growth Grew a Little Grew a Lot
19. How committed are you to becoming a better husband/wife?*
Not at all Somewhat A little Totally
20. How hopeful are you with regards to the future of your relationshiip?*
Total Despair Despair Cautiously Hopeful Extremely Hopeful

Your Sex*
- Male
- Female
Relationship Status*
- Dating
- Cohabitating/Defacto
- Engaged
- Married
- Remarried
- Separated
- Divorced
Sexual Status*
Please select the one that best describes your relationship.
- Pre-sexual - some physical intimacy but no intercourse
- Sexual - includes genital intercourse
- Post-sexual - were previously sexual but are not currently so.
What SmartLoving course did you do?
- Discern
- Engaged
- Fertility
- Sponsor
- Newlywed
- Marriage Kit
- Breakthrough
- Theology
- Other

Name*
First
Email*

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Feedback

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1Impact

2Rate

3Comment

4Promotion

5Demographics

Impact

How did you engage with the BreakThrough material?*

Enrolled in the Online course

Did the course on my own

Did the course with my spouse

I did the course with a friend

I had a BreakThrough Companion

I had a SL Coach

I attended an in-person event

I attended an Online group event

Other

How did you use the Participant notes?

I had a print copy and pen

I used the interactive PDF

I used a notebook to answer the questions

What participant notes? I didn't know it existed

Do you plan to do the 40-day Gratitude Challenge?

Do you plan to use the TaNGo tool?

Time out | Needs | Gratitude

Do you plan to use the Daily Prayer for My Marriage?

How would you describe your emotions about your marriage before BreakThrough?

How would you describe your emotions about your marriage after BreakThrough?

How has BreakThrough benefited you and your marriage

Are you interested in... (check all that apply)

Having a SL Coaching session?

Doing other SL online courses?

Attending a SL Marriage Weekend Seminar?

Attending a live Workshop?

Hosting a SL event or course in your community?

Training to be a BreakThrough companion?

Rate BreakThrough on the following:

1. Information presented about relationships and arguments

2. Video presentation style

3. Reflection points and activities

4. Practical Strategies

5. Prayer

6. Being able to complete the course without your spouse

Comments/Suggestions

Do you have any suggestions to improve BreakThrough and/or suggestions for topics?

Promotion

1. How did you hear about BreakThrough? Tick all that apply and give details below.

Spouse

Recommendation by SmartLoving participant

Other person

Parish bulletin/website

Internet Search

Social Media (which one)

SmartLoving eNews

Brochure/Flyer/Poster (where did you get it)

Other (give details below)

Extra details

2. What factors were most influential in your decision to participate? (tick all that apply)

Encouragement from priest/deacon/minister

Recommendation of past attendee

Recommendation of counsellor

Endorsement of the workshop by the diocese/Bishop

Our marriage needed the support

Looked like something I/we would benefit from

Have already tried counselling

On-demand - available immediately

Live event in my local area

Privacy from the community

Privacy from my spouse

Minimal cost

Gift certificate/subsidised access

Other/extra details

Demographic Information

Your Name

First Last

Sex*

Age*

State of Life/Marital Status*

Years Married

Number of Children

Religion

How often do you attend Church?

We would like to ask you to now take the time to take impact quiz again to compare your results, nd complete a feedback survey so that we can improve the course.

Impact Quiz

Step 1 of 11

Part I

Part 2

Feedback

Impact

Rate BreakThrough on the following:

Comments/Suggestions

Promotion

Demographic Information

SmartLoving

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