Name______________________________________ Date: ___________________

Instructions: Below you will find a list of goals you may consider important for the two of you to work toward at this time. Please read each item. Select the one most important goal for you at this time.

1. I would like to get some relief from the constant arguing and unpleasantness between us.

2. I would at least like things to be a bit more peaceful and pleasant.

3. I would like to see more politeness in our day-to-day relationship.

4. I would like to avoid violent quarrels.

5. I would like us to be more civil and respectful toward each other.

6. I would like to be able to work together better as a team, to take better care of the daily chores.

7. I would like to know that if I do something positive it will count and mean something to my spouse.

8. I would like to be able to come to agreements better in which there is give and take on both sides.

9. I would like there to be more exchange of affection between us.

10. I would like my spouse to share more in the responsibilities we both must meet.

11. I would like my spouse to accept me more and to express more liking for me.

12. I wish we could be better at being each other's friend.

13. I would like my spouse to find me more attractive.

14 I would like to have more influence in making decisions.

15 I would like to have my spouse be more interested in me.

16. I would like to be better able to get my messages across to my spouse.

17. I want my spouse to be better at discussing problems and helping to solve them.

18. I want my spouse to improve at listening to me

19. I wish my spouse were more understanding and considerate of my feelings.

20. I would like to better understand my spouse's feelings and reactions.

21. Other (please specify) ' __________________________________________

Source: John Gottman, Behavioral Interviewing with Couples ( guidebook accompanying the film)(Champaign Illinois: Research Press, 1976), p 34.