Partner Advocacy Survey

Your written responses will be LIMITED to 500 characters.

'SA' will be used throughout the survey as an abbreviation for sex addiction or to refer to the person struggling with the addiction. 'Partner' will be used to refer to the spouse or significant other.

Q.1

Name:

This question is completely optional. Feel free to answer what is comfortable.

Q.2

Age range: *

18-30
31-40
41-50
51-60
61-70a
71-80
80+

Please share your specific age if you wish.

Q.3

State:

Q.4

Country:

Q.5

May we contact you for further information? If yes, what is the best way for us to contact you? *

This question is completely optional. Feel free to answer what is comfortable.

Email:
Cell:
Other:

Contact information:

Q.6

What type of program did your SA attend? *

Residential program (30-45 days)
Intensive Outpatient Program (1-2 weeks)
Intensive (less than 1 week)
Other:

How long was the actual stay? When did it occur?

Q.7

Who recommended this program to your significant other? *

Q.8

Who made the decision about the program choice? SA? Partner? Joint choice? *

Q.9

What was the deciding factor in choosing this particular program? *

Recommendation from your therapist?
Recommendation from your SA’s therapist?
Location?
Length of stay?
Recommendation from other partners/SA’s?
Other:

Q.10

Was the future of the marriage contingent upon this treatment selection? *

Yes
No
Other:

Please help us understand why you selected this answer

Q.11

Were you working with an individual therapist at the time? *

Yes
No
Other:

If yes, how long had you been in individual therapy?

Q.12

If you answered 'yes' to the previous question, did your therapist have a specialized training or certification in any of the following: *

	Yes	No	I do not know	Not applicable
Sex Addiction
Addictions
Betrayal Trauma
Trauma

Sex Addiction

Yes No I do not know Not applicable

Addictions

Yes No I do not know Not applicable

Betrayal Trauma

Yes No I do not know Not applicable

Trauma

Yes No I do not know Not applicable

Q.13

Were you working with a couples therapist at that time? *

Yes
No
Other:

Q.14

Did your couples therapist have specialized training/certification in any of the following: *

	Yes	No	I do not know	Not applicable
Sex Addiction
Addictions
Betrayal Trauma
Trauma

Sex Addiction

Yes No I do not know Not applicable

Addictions

Yes No I do not know Not applicable

Betrayal Trauma

Yes No I do not know Not applicable

Trauma

Yes No I do not know Not applicable

Q.15

Was your couples therapist involved with the treatment program during the: *

	Yes	No	I do not know	Not applicable
Intake process
Treatment
After discharge

Intake process

Yes No I do not know Not applicable

Treatment

Yes No I do not know Not applicable

After discharge

Yes No I do not know Not applicable

Q.16

At the time your significant other attended this program, how long was it following discovery? Weeks? Months? Years? (please specify) *

Q.17

Did your SA have other addictions as well as sex addiction? *

Yes
No
Other:

If yes, were those adequately addressed in the program? Please explain.

Q.18

Were you part of the formal intake process prior to his/her admission? *

Yes
No
Other:

If yes, was this a phone interview? Questionnaire? Please describe.

Q.19

Did anyone from the program reach out to you and communicate with you prior to his/her arrival at the program? *

Yes
No
Other:

Please describe

Q.20

Was there a family liaison/therapist assigned to communicate with you during his/her stay? *

Yes
No
I do not know
Other:

If yes, please describe.

Q.21

Was there regular feedback from the program or liaison throughout his/her stay? *

Yes
No
Other:

If there was, please indicate how often? Was it helpful? If not, please describe.

Q.22

Were your questions answered to your satisfaction when they came up? *

Yes
No
Not applicable
Other:

If not, describe.

Q.23

Were your needs addressed to your satsifaction? *

Yes
No
Other:

If no, please describe.

Q.24

During the program, was there the opportunity to discuss the needs of or impact on the children? *

Yes
No
Not applicable
Other:

Please describe

Q.25

Were you given help with what to say to your children about your SA’s admission to treatment? *

Yes
No
Not applicable
Other:

Please help us understand why you selected this answer

Q.26

Were you given suggestions about local help with regard to speaking to your children about his/her admission? *

Yes
No
Not applicable
Other:

Please help us understand why you selected this answer

Q.27

Were the children’s needs addressed appropriately? *

Yes
No
Not applicable
Other:

If no, please describe.

Q.28

What support, if any, was offered to the children?

Q.29

Was your individual therapist included in the treatment process? *

Yes
No
Not applicable
Other:

If yes, did you participate in joint clinical meetings? (each of you with your therapists)

Q.30

Was the individual therapist involved with the treatment program during the: *

	Yes	No	I do not know	Not applicable
Intake process
Treatment
After discharge

Intake process

Yes No I do not know Not applicable

Treatment

Yes No I do not know Not applicable

After discharge

Yes No I do not know Not applicable

Q.31

Did the treatment staff request your input about your SA's history, behavior, etc.? *

Yes
No
Other:

If yes, did they ask for your feedback about him/her early on in the process?

Q.32

If your input was requested, how was it obtained?

Q.33

Was there any type formal disclosure done while your SA was at the program? *

Yes
No
Not applicable
Other:

Please help us understand why you selected this answer

Q.34

If a disclosure was done, what type? Please check all that apply: *

Formal Therapeutic Disclosure?
Emergency Disclosure for health/safety reasons?
Disclosure for financial reasons?
Not applicable
Other:

Please help us understand why you selected this answer

Q.35

If there was a disclosure, did you receive any preparation and support? *

Yes
No
Not applicable
Other:

Please describe.

Q.36

If a formal disclosure occurred, was any kind of new information disclosed? *

Yes
No
Not applicable
Other:

Q.37

If there was any type of formal disclosure of new information during this treatment program, at what point in the treatment did that occur? *

Beginning
Middle
Toward End
Not applicable
Other:

Please specify.

Q.38

Were you encouraged to write and present an Impact Statement/Letter? *

Yes
No
I'm not sure
Not applicable
Other:

If yes, were you assisted in this process?

Q.39

Did you receive any Emotional Restitution or Amends Letter from your SA? *

Yes
No
I'm not sure
Not applicable
Other:

Comments:

Q.40

Did you attend Family Week or program? *

Yes
No
Not applicable
Other:

If yes, how were you prepared?

Q.41

Was the Family program helpful to you? *

Yes
No
Not applicable
Other:

What was helpful?

Q.42

Were there aspects of the Family program that were NOT helpful to you? *

Yes
No
Not applicable
Other:

What was NOT helpful?

Q.43

Were you included in the Discharge process prior to your SA being released? *

Yes
No
I'm not sure
Not applicable
Other:

If yes, did you have the opportunity to provide input? Please describe.

Q.44

If you disagreed with any of the recommendations, was your opinion taken into account? *

Yes
No
Not applicable
Other:

Please describe

Q.45

How did the program help him/her re-integrate into the family? *

Q.46

What was the best aspect of the treatment process for you? *

Q.47

What was the worst aspect of the treatment process? *

Q.48

Your Story: Here you can elaborate and tell us your personal story of what happened, how you were treated, how you felt.

Q.49

What recommendations would you make to improve this program? *

Q.50

What wisdom would you share with other partners whose SAs are attending a program? *