WOMAN ABUSE COUNCIL OF TORONTO
CREATING SAFETY
The purpose of this self-assessment questionnaire is to outline the seriousness of domestic violence and woman abuse. This questionnaire is intended to help you become aware of some of the indicators of domestic violence/woman abuse. It is intended as an assessment tool, designed to provide an opportunity for women to consider their safety options by means of risk assessment
There are a variety of issues associated with abuse situations and this questionnaire presents some of the key behavioural indicators/situations that may be of help to you.
WHAT IS ABUSE?
There are many forms of domestic abuse/woman abuse. These include physical, financial, cultural, verbal, and emotional. None of these are acceptable in any way.
Domestic violence/woman abuse involves situations of power and control. When women find themselves in situations of abuse, it does not mean that they are weak, but it is an indication that they definitely should consider their safety and the safety of their children.
SELF-ASSESSMENT/SAFETY AUDIT TOOL
Begin by answering these questions as openly and honestly as possible.
1.Has your partner ever threatened to harm you? YESNO
2.Has your partner ever threatened to harm himself?YESNO
3.Does your partner throw or break things to scare you?YESNO
4.Does your partner make excuses for his violent and/or abusive behaviour?YESNO
5.Does your partner blame you and say that you provoke his violent
Behaviour?YESNO
6.Do you continually apologize in order to “not upset him?”YESNO
7.Does your partner often insult you or your children by calling you
names, etc?YESNO
8.Does your partner use your children against you in order to hurt you?YESNO
9.Does your partner make decisions in the home without your imput?Y ESNO
10.Do you have to let your partner know where you are at all times?YESNO
11.Do you feel comfortable/safe asking your partner for money?YESNO
12.Do you feel you can turn to your partner when you are upset?YESNO
13.Has your partner ever tried to prevent you from leaving your/his home?YESNO
14.Has your partner stopped you from seeing your friends and family?YESNO
15.Is your partner jealous of time spent with family or friends?YESNO
16.Does your partner get overly jealous when you are in the presence of
other men?YESNO
17.Does your partner tell you how to dress or does he get upset at the kind
of clothes that you wear?YESNO
18.Does your partner force or pressure you to have sexual relations against
your will?YESNO
19.To the best of your knowledge, has your partner ever abused/assaulted
any previous spouses/partners or children from another relationship?YESNO
20.Do you feel trapped in your relationship?YESNO
21.Have you ever called the Police because you were afraid of your partner?YESNO
22.Have you ever called anyone because you were afraid of your partner?YESNO
22.Do you have any fears for your safety or the safety of your family?YESNO
23.Has your partner every hit your children or his children?YESNO
24.Has your partner ever hit you?YESNO
WHERE TO GET HELP
If you answered yes to any of these questions you may be involved in or at risk of becoming involved in an abusive situation.
This is designed to help you become aware of abusive behaviour or high-risk behaviour that may put you or your family at risk
If you want or need help, there ARE places you can go and people you can talk to.
The following information may be of help to you:
The Assaulted Women’s Helpline: 416-863-0511
Parkdale Legal Clinic: 416-531-2411
Sexual Assault/Domestic Violence Care
Centre of Women’s College Ambulatory Care Centre: 416-323-6040
Women’s Health in Women’s Hands: 416-593-7655, TTY: 416-593-5835
Education Wife Assault: 416-968-3422
Central Intake for Shelter:416-397-5651
THERE IS NO EXCUSE FOR ABUSE
This project received a grant from the Canadian Women’s Foundation, in partnership with The Body Shop STOP Violence Against Women Fund, The Canadian Pacific Violence Prevention Fund, the Royal LePage Shelter Foundation Fund, the Traders Challenge Fund, the White Ribbon Campaign Fund, the Zellers Friends of the Family Fund, and the CWF Violence Prevention Fund.