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[null,null,null,null,null,null,null,null,null,null,"v5"]
[]
[null,"Reducing Parental Conflict Programme"]
[null,"Referral Stage Questionnaire "]
[null,"For parents who are  currently in a relationship"]
[]
[]
[null,"Please read the following instructions.",null,null,null,null,null,null,null,null,null,0]
[]
[null,"Please could you answer all questions in Part 1 asking for information relating to you ",null,null,null,null,null,null,null,null,null,"Values"]
[null,"and your family."]
[null,null,null,null,null,null,null,null,null,null,null,0]
[null,"Once you have provided your information please move on to Part 2. Please answer "]
[null,"all questions in this section."]
[]
[null,"Once completed please return the questionnaire to the person who gave it to "]
[null,"you"]
[null,null,null,null,null,null,null,null,null,null,null,0]
[null,"Additional Needs (including any needs for interpreters etc.)"]
[]
[null,"I have no additional needs that might make it difficult for me to take part"]
[]
[null,"I have additional needs that might make it difficult for me to take part. "]
[null,"I have given details of these below:"]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L25=1, \"No Additional Needs Identified\", IF(L25=2, \"Additional Needs Identified\", \"Must Complete\"))","v":"Must Complete"}]
[null,"Please give details"]
[]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(B27>0, B27, \"Additional Needs not entered\")","v":"Additional Needs not entered"},{"$f":"IF(B27>0, \"Additional Needs Entered\", \"Additional Needs not entered\")","v":"Additional Needs not entered"}]
[]
[null,"I have completed a separate Participation Agreement with the person who gave me the "]
[null,"questionnaire",null,null,null,null,null,null,null,null,null,false,{"$f":"IF(L31=TRUE, \"Participation Agreement Completed\", \"Must Complete\")","v":"Must Complete"}]
[]
[null,"If you are completing a paper copy of this questionnaire, please select just one answer "]
[null,"for multiple choice questions."]
[]
[null,"Is anyone within your household currently in work?"]
[null,"Yes"]
[null,"No",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L38=1, \"Yes\", IF(L38=2, \"No\", \"Must Complete\"))","v":"Must Complete"}]
[]
[]
[null,"PART 1"]
[]
[null,"Parent information"]
[]
[null,"This section collects important information about you and your family."]
[null,"Please complete all questions in this section."]
[]
[null,"About You"]
[]
[null,null,null,"Please complete below"]
[null,"Title",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D51>0, D51, \"Must Complete\")","v":"Must Complete"}]
[null,"Forenames",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Surname",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Date of birth\n(dd/mm/yyyy)",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Telephone\nnumber (mobile)",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D55>0, \"+44 \"& D55, \"Must Complete\")","v":"Must Complete"}]
[null,"Alternative\ntelephone \nnumber (e.g. landline)",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D56>0, \"+44 \"&D56, \"No alternative number supplied\")","v":"No alternative number supplied"}]
[null,"Address",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Post code",null,null,null,null,null,null,null,null,null,null,"Must Complete"]
[null,"Email",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D59>0, D59, \"No email address supplied\")","v":"No email address supplied"}]
[]
[null,"What is your gender identity? Please select below."]
[]
[]
[null,"Male"]
[null,"Female"]
[null,"Other"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L67=0,\"Must Complete\",IF(L67=1,\"Prefer not to say\",IF(L67=2,\"Other\",IF(L67=3,\"Female\",IF(L67=4,\"Male\",\"INCORRECT\")))))","v":"Must Complete"}]
[]
[null,"Disability:"]
[null,"Do you have a long-standing physical or mental impairment, illness or disability? By "]
[null,"long-standing' we mean anything that has troubled you over a period of at least 12 "]
[null,"months or that is likely to trouble you over a period of at least 12 months."]
[]
[]
[null,"Yes",null,"No ",null,"Prefer not to say",null,null,null,null,null,0,{"$f":"IF(L75=0, \"Must Complete\", IF(L75=1, \"Prefer not to say\", IF(L75=2, \"No\", IF(L75=3, \"Yes\",\"Incorrect\"))))","v":"Must Complete"}]
[]
[]
[]
[null,"What is your ethnic group? Select one option that best describes your ethnic group "]
[null,"or background."]
[]
[null,"White"]
[null,"    1.  English/Welsh/Scottish/Northern Irish/British"]
[null,"    2.  Irish"]
[null,"    3.  Gypsy or Irish Traveller"]
[null,"    4.  Any other white background. Please describe below:"]
[]
[null,"Mixed/ Multiple Ethnic Groups"]
[null,"    5.  White and Black Caribbean"]
[null,"    6.  White and Black African"]
[null,"    7.  White and Asian"]
[null,"    8.  Any other Mixed/Multiple ethnic background. Please \n         describe below:"]
[]
[null,"Asian/Asian British"]
[null,"    9.  Indian"]
[null,"    10. Pakistani"]
[null,"    11. Bangladeshi"]
[null,"    12. Chinese"]
[null,"    13. Any other Asian background. Please describe below:"]
[]
[null,"Black/African/Caribbean/Black British "]
[null,"    14. African"]
[null,"    15.  Caribbean"]
[null,"    16. Any other Black/African/Caribbean background. Please describe below:"]
[]
[null,"Other ethnic group "]
[null,"    17. Arab"]
[null,"    18. Any other ethnic group. Please describe below:"]
[null,null,null,null,null,null,null,null,null,null,null,0]
[null,"    19. Prefer not to say",null,null,null,null,null,null,null,null,null,{"$f":"IF(L109=4, B87, IF(L109=8, B93, IF(L109=13,B100,  IF(L109=16, B105, IF(L109=18, B109, \"None Selected\")))))","v":"None Selected"}]
[null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(L109>0,L109,\"Must Complete\")","v":"Must Complete"},{"$f":"IF(L109=0, \"None Selected\", IF(L110=\"None Selected\", \"Standard Ethnicity Type\",  IF(L110=0, \"Please Select/Enter Type\",L110)))","v":"None Selected"}]
[]
[null,"Please answer the following questions by selecting your answer."]
[]
[null,"What is your current marital status?"]
[]
[null,"Single (never married or been in a civil partnership)"]
[null,"Married or in a Civil Partnership and living with husband/wife"]
[null,"Living together"]
[null,"Steady relationship without living together "]
[null,"Separated"]
[null,"Divorced"]
[null,"Widowed"]
[null,"Prefer not to say"]
[null,"Other",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L125=1,\"Single\",IF(L125=2,\"Married or Civil Partnership\",IF(L125=3,\"Living Together\",IF(L125=4,\"Steady Relationship\",IF(L125=5,\"Separated\",IF(L125=6,\"Divorced\",IF(L125=7,\"Widowed\", IF(L125=8, \"Prefer not to say\", IF(L125=9, \"Other\", \"Must Complete\")))))))))","v":"Must Complete"}]
[]
[null,"How many children do you currently have  primary or shared care"]
[null," responsibility for?"]
[]
[null,"Expecting first child"]
[null,1]
[null,2]
[null,3]
[null,"4 or more"]
[null,"None",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L135=1,\"Expecting first child\",IF(L135=2,1,IF(L135=3,2,IF(L135=4,3,IF(L135=5,\"4 or more\",IF(L135=6,\"None\",\"Must Complete\"))))))","v":"Must Complete"}]
[]
[null,"Are you or your partner pregnant now?"]
[]
[null,"Yes"]
[null,"No"]
[null,"Don't know"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L142=1, \"Yes\", IF(L142=2,\"No\", IF(L142=3, \"Don't Know\", IF(L142=4, \"Prefer not to say\", \"Must Complete\"))))","v":"Must Complete"}]
[]
[]
[null,"Which of these best describes your current employment status?"]
[]
[null,"Please note: if you are on parental leave, you should tick the box of the category you"]
[null,"were in prior to this leave."]
[]
[null,"Self employed"]
[null,"In full time paid employment"]
[null,"In part time paid employment (less than 30 hours/week)"]
[null,"Unemployed"]
[null,"Retired"]
[null,"Looking after family or home (unpaid)"]
[null,"Full-time student"]
[null,"Long-term sick or disabled"]
[null,"On a government training scheme"]
[null,"Doing something else"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L160=1,\"Self employed\",IF(L160=2,\"Full time employment\",IF(L160=3,\"Part time employment\",IF(L160=4,\"Unemployed\",IF(L160=5,\"Retired\",IF(L160=6,\"Looking after family or home\",IF(L160=7,\"Full time student\",IF(L160=8,\"Long term sick/disabled\",(IF(L160=9,\"On a government training scheme\",IF(L160=10,\"Doing something else\",IF(L160=11,\"Prefer not to say\",\"Must Complete\"))))))))))))","v":"Must Complete"}]
[]
[]
[]
[null,"Are you presently or have you ever experienced mental health problems? "]
[]
[null,"No, and I have no mental health diagnosis"]
[null,"No, but I do have a mental health diagnosis"]
[null,"Yes, but I do not have a mental health diagnosis"]
[null,"Yes, and I have a mental health diagnosis"]
[null,"Don't know"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L171=1, \"No, No diagnosis\", IF(L171=2, \"No, Have diagnosis\", IF(L171=3, \"Yes, No diagnosis\", IF(L171=4, \"Yes, Have diagnosis\", IF(L171=5, \"Don't know\", IF(L171=6, \"Prefer not to say\", \"Must Complete\"))))))","v":"Must Complete"}]
[]
[]
[null,"What is your relationship with the person you are currently experiencing"]
[null,"conflict with? "]
[]
[null,"Married or in a Civil Partnership"]
[null,"Living together (but not married or in a civil partnership)"]
[null,"Steady relationship without living together"]
[null,"Separated"]
[null,"Divorced"]
[null,"Other"]
[null,"Prefer not to say",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L183=1, \"Married or Civil Partnership\", IF(L183=2, \"Living Together\", IF(L183=3, \"Steady Relationship\", IF(L183=4, \"Separated\", IF(L183=5, \"Divorced\", IF(L183=6, \"Other\", IF(L183=7, \"Prefer not to say\", \"Must Complete\")))))))","v":"Must Complete"}]
[]
[null,"I understand that the provision is most effective when both parents attend together.  I am "]
[null,"supplying the other parent’s details below so that we can be referred to provision together. I "]
[null,"understand that if both parents are unable to attend this provision, then I may not be able to"]
[null,"receive this support as some types are only able to proceed with both parents."]
[]
[null,"Their name",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D190>0, D190, \"Co-Parent details not supplied\")","v":"Co-Parent details not supplied"}]
[]
[null,"Their date of birth",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D192>0, D192, \"Co-parent details not supplied\")","v":"Co-parent details not supplied"}]
[null,"(dd/mm/yyyy)"]
[]
[null," "]
[]
[null,"There are three sections of questions in this part of the questionnaire. Please answer "]
[null,"all questions to the best of your ability, even if they do not seem entirely relevant to "]
[null,"you. "]
[]
[null,"Once you have finished these questions, please return the questionnaire to the "]
[null,"person who gave it to you. "]
[]
[]
[null,"Section 1:  You and your spouse/partner"]
[]
[null,"Please think about the times during the last 4 weeks when you and your spouse/partner"]
[null,"have spent time talking or doing things together."]
[]
[null,"With those times in mind, please indicate how often your spouse/partner acted in the "]
[null,"following ways towards you. During the past 4 weeks, how often did your "]
[null,"spouse/partner…"]
[]
[null,"1. Let you know they really care about you"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L218>0, L218, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"2. Was loving and / or affectionate towards you"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L224>0, L224, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"3. Let you know that they appreciate your ideas or the things you do"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L230>0, L230, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"4. Help you to do something that is important to you"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L236>0, L236, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"5. Be supportive and understanding towards you"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L242>0, L242, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"6. Criticise you"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L248>0, L248, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"7. Argue with you when you disagreed about something"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L254>0, L254, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"8. Get angry at you"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L260>0, L260, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"9. Shout at you because they were upset with you"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L266>0, L266, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[null,"Section 2:  Agreement between parents"]
[]
[null,"Most people have disagreements in their relationships. Please select how often you"]
[null,"and your spouse / partner agree or disagree about the following:"]
[]
[null,"1. Philosophy of life (Your approach to life)"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L278>0, L278-1, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"2. Aims, goals, and things you believe are important"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L284>0, L284-1, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"3. Amount of time spent together"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L290>0, L290-1, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Please circle how often you would say the following events occur between you and"]
[null,"your spouse / partner?"]
[]
[null,"4. Have a stimulating exchange of ideas (A meaningful discussion)"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L299>0, L299-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[]
[null,"5. Calmly discuss something together"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L307>0, L307-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[]
[null,"6. Plan something together"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L315>0, L315-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[]
[null,"7. The following represent different degrees of happiness in your relationship. "]
[null,"The middle point, “happy,” represents the degree of happiness of most relationships. "]
[null,"Please select the degree of happiness, all things considered, in your relationship."]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L324>0, L324-1, \"Must Complete\")","v":"Must Complete"}]
[]
[]
[]
[null,"Please tick below the approximate extent of agreement or disagreement between you "]
[null,"and your spouse / partner for each item on the following list."]
[]
[null,"8. How often do you discuss or have you considered divorce, separation "]
[null,"or ending your relationship?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L336=6,\"All the time\",IF(L336=5,\"Most of the time\",IF(L336=4,\"More often than not\",IF(L336=3,\"Occasionally\",IF(L336=2,\"Rarely\",IF(L336=1,\"Never\",\"Must Complete\"))))))","v":"Must Complete"}]
[]
[]
[null,"9. Do you ever regret that you married? (or lived together)"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L343=6,\"All the time\",IF(L343=5,\"Most of the time\",IF(L343=4,\"More often than not\",IF(L343=3,\"Occasionally\",IF(L343=2,\"Rarely\",IF(L343=1,\"Never\",\"Must Complete\"))))))","v":"Must Complete"}]
[]
[]
[null,"10. How often do you and your spouse / partner argue?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L350=6,\"All the time\",IF(L350=5,\"Most of the time\",IF(L350=4,\"More often than not\",IF(L350=3,\"Occasionally\",IF(L350=2,\"Rarely\",IF(L350=1,\"Never\",\"Must Complete\"))))))","v":"Must Complete"}]
[]
[]
[null,"11. How often do you and your spouse / partner “get on each other’s nerves”?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L357=6,\"All the time\",IF(L357=5,\"Most of the time\",IF(L357=4,\"More often than not\",IF(L357=3,\"Occasionally\",IF(L357=2,\"Rarely\",IF(L357=1,\"Never\",\"Must Complete\"))))))","v":"Must Complete"}]
[]
[]
[]
[]
[null,"Section 3: How you deal with relationship issues"]
[]
[null,"The following are a series of statements that describe things people sometimes do and feel when "]
[null,"disagreements arise. Please answer as best as you can. "]
[]
[null,"The questions refer to your child’s awareness of conflicts that occur between you and your spouse"]
[null,"/ partner. If you have more than one child, please consider the child you are most concerned about "]
[null,"when answering this set of questions. If you are not concerned about a child please consider"]
[null," your youngest child. "]
[]
[null,"Please indicate how often each statement applies to your family by ticking the relevant box for each "]
[null,"question. "]
[]
[null,"Child’s first name: ",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D375>0, D375, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"1. Sometimes it is difficult to keep financial discussions to specific times and places. How often would "]
[null,"you say you and your spouse/partner argue over money in front of this child?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L382=5,\"Very Often\",IF(L382=4,\"Often\",IF(L382=3,\"Occasionally\",IF(L382=2,\"Rarely\",IF(L382=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[null,"2. Children often go to one parent for money or permission to do something after having already been refused "]
[null,"by the other parent. How often would you say this child approaches you or your spouse/partner in this manner? "]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L390=5,\"Very Often\",IF(L390=4,\"Often\",IF(L390=3,\"Occasionally\",IF(L390=2,\"Rarely\",IF(L390=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[null,"3. Parents disagree on the subject of discipline. How often do you and your spouse/partner argue over"]
[null," disciplinary problems in front of this child?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L398=5,\"Very Often\",IF(L398=4,\"Often\",IF(L398=3,\"Occasionally\",IF(L398=2,\"Rarely\",IF(L398=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[null,"4. How often does your spouse/partner complain to you about your behaviour in the home (e.g. drinking "]
[null,"or smoking, nagging, sloppiness, etc.) in front of this child?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L406=5,\"Very Often\",IF(L406=4,\"Often\",IF(L406=3,\"Occasionally\",IF(L406=2,\"Rarely\",IF(L406=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[null,"5. In every normal relationship there are arguments. How often do you complain to your spouse/partner"]
[null,"about their behaviour in front of this child?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L414=5,\"Very Often\",IF(L414=4,\"Often\",IF(L414=3,\"Occasionally\",IF(L414=2,\"Rarely\",IF(L414=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[null,"6. How often do you and your spouse/partner argue in front of this child?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L421=5,\"Very Often\",IF(L421=4,\"Often\",IF(L421=3,\"Occasionally\",IF(L421=2,\"Rarely\",IF(L421=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[null,"7. How often do you and/or your spouse/partner display verbal hostility in front of this child?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L428=5,\"Very Often\",IF(L428=4,\"Often\",IF(L428=3,\"Occasionally\",IF(L428=2,\"Rarely\",IF(L428=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[null,"8. How often do you and your spouse/partner show affection for each other in front of this child?"]
[]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L435=5,\"Very Often\",IF(L435=4,\"Often\",IF(L435=3,\"Occasionally\",IF(L435=2,\"Rarely\",IF(L435=1,\"Never\",\"Must Complete\")))))","v":"Must Complete"}]
[]
[]
[]
[]
[null,null,{"$f":"IF(L440>0, \"You have not completed one or more questions, please complete them.\", \"\")","v":"You have not completed one or more questions, please complete them."},null,null,null,null,null,null,null,null,{"$f":"COUNTIF(M31:M445, \"Must Complete\")","v":47}]
[null,null,null,null,null,"END OF QUESTIONS"]
[]
[null,null,null,null,null,"Thank you for completing this questionnaire"]
[]
[]
[]
[]
[null,"For use by staff member"]
[null,"Why is this data being collected?"]
[null,"This information will be really valuable for providers and RPC Local Authorities and "]
[null,"gateways to work effectively with you to support parents on the Programme, as well as for "]
[null,"internal learning within the CPAs on the referral process."]
[]
[null,"The information is also being collected to contribute to DWP’s evaluation of the RPCP. DWP "]
[null,"have contracted two independent research companies to support the evaluation: IFF, and "]
[null,"Tavistock Institute of Human Relations (TIHR) who may contact you to seek your views on "]
[null,"your experiences of the referral process and of identifying and supporting parents in conflict. "]
[null,"The results of the evaluation will be published, though all results will be anonymised, so you "]
[null,"will not be identifiable in any way"]
[]
[null,"What happens to information collected about me?"]
[null,"Your contact details will be shared with the Provider and Local Authority CPA gateway to "]
[null,"help them to work effectively with parents on the Programme, as well as for the CPA Local "]
[null,"Authorities to understand locally the how the RPC Programme is working. "]
[]
[null,"For DWP’s evaluation, your professional contact information will be transferred securely from "]
[null,"DWP to IFF and TIHR who may contact you to take part in further research for the "]
[null,"evaluation of the RPCP. If contacted, you may decline to participate. Although we would "]
[null,"value your feedback on the programme. "]
[]
[null,"You can request a copy of the information DWP holds about you on the link below. "]
[null,"https://www.gov.uk/guidance/request-your-personal-information-from-the-department-for-work-and-pensions"]
[]
[null,"You can also change the information you have provided and or withdraw the information "]
[null,"DWP holds about you."]
[null,"https://www.gov.uk/government/organisations/department-for-work-pensions/about/personal-information-charter#dpo"]
[]
[null,"You can do this by contacting our Data Protection Officer at: "]
[null,"data.protectionofficer@dwp.gsi.gov.uk."]
[]
[null,"The legal basis for processing your data:"]
[null,"DWP have a public function to evaluate and assess their programmes. Data processing will "]
[null,"be carried out under Article 6 of the GDPR which states: the processing is necessary for the "]
[null,"performance of a task carried out in the public interest or in the exercise of official authority "]
[null,"vested in the controller Art 6(1)(e)"]
[]
[]
[null,"Your Name :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D488>0, D488, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Job Title :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D490>0, D490, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Team :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D492>0, D492, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Service  :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D494>0, D494, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Organisation  :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D496>0, D496, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Email :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D498>0, D498, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Phone Number :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D500>0, \"+44 \"&D500, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Date Completed :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D502>0, D502, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Local Authority :",null,null,null,null,null,null,null,null,null,null,{"$f":"IF(D504>0, D504, \"Must Complete\")","v":"Must Complete"}]
[]
[null,"Have you had any of the following training / awareness sessions?"]
[]
[null,"Process Training  / Awareness Overview"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L511=1,\"More than 2 Months ago\",IF(L511=2,\"Up to 3 months ago\",IF(L511=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Online)"]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L515=1,\"More than 2 Months ago\",IF(L515=2,\"Up to 3 months ago\",IF(L515=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Classroom Based)"]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L518=1,\"More than 2 Months ago\",IF(L518=2,\"Up to 3 months ago\",IF(L518=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[]
[]
[null,"Other (Please Specify)",null,null,null,null,null,null,null,null,null,{"$f":"E521","v":0},{"$f":"IF(L521>0, L521, \"Other Training not specified\")","v":"Other Training not specified"}]
[]
[]
[null,null,null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L524=1,\"More than 2 Months ago\",IF(L524=2,\"Up to 3 months ago\",IF(L524=3,\"Not received\",\"Please complete\")))","v":"Please complete"}]
[]
[]
[null,"Are the family already being supported by any of the following? "]
[]
[null,"No support"]
[null,"Children's Social Care"]
[null,"Early Help"]
[null,"Other (Please specify below)",null,null,null,null,null,null,null,null,null,0,{"$f":"IF(L532=1,\"No support\",IF(L532=2,\"Children's Social Care\",IF(L532=3,\"Early Help\",IF(L532=4,\"Other\",\"Must Complete\"))))","v":"Must Complete"}]
[null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(B533>0, B533, \"No Other Support Specified\")","v":"No Other Support Specified"}]
[]
[null,"Additional Information / Risk Assessment Details"]
[null,"Please give details"]
[null,null,null,null,null,null,null,null,null,null,null,{"$f":"IF(B537>0, B537, 0)","v":0},{"$f":"IF(L537>0, L537, \"Additional Information not entered\")","v":"Additional Information not entered"}]
[]
[]
[]
[null,null,{"$f":"IF(L541>0, \"One or more questions are incomplete, please complete them.\", \"\")","v":"One or more questions are incomplete, please complete them."},null,null,null,null,null,null,null,null,{"$f":"COUNTIF(M447:M505, \"Must Complete\")","v":9}]

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["***** FOR ADMINISTRATION USE ONLY ******"]
[]
["CPA Email"," rpcgateway@gateshead.gov.uk"]
[]
["DWP Email","RPC.REFERRALTEAM@DWP.GOV.UK"]
[]
["Provider Email","RPC@relate.org.uk"]
[]
[]
[]
[]
[]
[null,"Level Calculated"]
[null,{"$f":"IF(Questionnaire!L31,Scoring!H49, \"Participation Statement not Completed DO NOT FORWARD\")","v":"Participation Statement not Completed DO NOT FORWARD"}]
[]
[null,{"$f":"\"RSQ -  \"&B15","v":"RSQ -  Participation Statement not Completed DO NOT FORWARD"}]
[null,{"$f":"CPA!I9","v":"TEST"},null,null,null,null,null,null,null,{"$f":"CPA!I9","v":"TEST"}]

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["Scoring "]
[]
["Interaction",null,"From Questionnaire","Numeric Value",null,"Conflict Level"]
["IOWA",1,{"$f":"Questionnaire!M218","v":"Must Complete"},{"$f":"IF(C4<>\"Must Complete\", C4, 0)","v":0},null,{"$f":"IF(D9>=33,\"High\",IF(D9>=25,\"Moderate\",IF(D9>=0,\"None/Low\",\"Error\")))","v":"None/Low"},{"$f":"IF(F4=\"High\", 3, IF(F4=\"Moderate\", 2, IF(F4=\"None/Low\", 1, 0)))","v":1}]
["WARMTH",2,{"$f":"Questionnaire!M224","v":"Must Complete"},{"$f":"IF(C5<>\"Must Complete\", C5, 0)","v":0}]
[null,3,{"$f":"Questionnaire!M230","v":"Must Complete"},0]
[null,4,{"$f":"Questionnaire!M236","v":"Must Complete"},0]
[null,5,{"$f":"Questionnaire!M242","v":"Must Complete"},0]
[null,null,"Total",{"$f":"SUM(D4:D8)","v":0}]
[]
["IOWA ",6,{"$f":"Questionnaire!M248","v":"Must Complete"},{"$f":"IF(C11<>\"Must Complete\", C11, 0)","v":0},null,{"$f":"IF(D15>=25,\"None/Low\",IF(D15>=20,\"Moderate\",IF(D15>=0,\"High\",\"Error\")))","v":"High"},{"$f":"IF(F11=\"High\", 3, IF(F11=\"Moderate\", 2, IF(F11=\"None/Low\", 1, 0)))","v":3}]
["HOSTILITY",7,{"$f":"Questionnaire!M254","v":"Must Complete"},{"$f":"IF(C12<>\"Must Complete\", C12, 0)","v":0}]
[null,8,{"$f":"Questionnaire!M260","v":"Must Complete"},0]
[null,9,{"$f":"Questionnaire!M266","v":"Must Complete"},0]
[null,null,"Total",{"$f":"SUM(D11:D14)","v":0}]
[]
["Inter-parental conflict"]
["DYADIC "]
["ADJUSTMENT",1,{"$f":"Questionnaire!M278","v":"Must Complete"},{"$f":"IF(C19<>\"Must Complete\", C19, 0)","v":0},null,{"$f":"IF(D26<=13,\"High\",IF(D26<=18,\"Moderate\",IF(D26>=19,\"None/Low\",\"Error\")))","v":"High"},{"$f":"IF(F19=\"High\", 3, IF(F19=\"Moderate\", 2, IF(F19=\"None/Low\", 1, 0)))","v":3}]
["SCALE",2,{"$f":"Questionnaire!M284","v":"Must Complete"},{"$f":"IF(C20<>\"Must Complete\", C20, 0)","v":0}]
[null,3,{"$f":"Questionnaire!M290","v":"Must Complete"},0]
[null,4,{"$f":"Questionnaire!M299","v":"Must Complete"},0]
[null,5,{"$f":"Questionnaire!M307","v":"Must Complete"},0]
[null,6,{"$f":"Questionnaire!M315","v":"Must Complete"},0]
[null,7,{"$f":"Questionnaire!M324","v":"Must Complete"},0]
[null,null,"Total",{"$f":"SUM(D19:D25)","v":0}]
[]
["DAS Unscored",8,{"$f":"Questionnaire!M336","v":"Must Complete"},{"$f":"IF(C28<>\"Must Complete\", Questionnaire!L336, 0)","v":0}]
["SATISFACTION",9,{"$f":"Questionnaire!M343","v":"Must Complete"},{"$f":"IF(C29<>\"Must Complete\", Questionnaire!L343, 0)","v":0}]
[null,10,{"$f":"Questionnaire!M350","v":"Must Complete"},{"$f":"IF(C30<>\"Must Complete\", Questionnaire!L350, 0)","v":0}]
[null,11,{"$f":"Questionnaire!$M$357","v":"Must Complete"},{"$f":"IF(C31<>\"Must Complete\", Questionnaire!L357, 0)","v":0}]
[]
[]
["O'Leary Porter"]
[null,1,{"$f":"Questionnaire!$L$382","v":0},{"$f":"IF(C35<>\"INCOMPLETE\", C35, 0)","v":0}]
[null,2,{"$f":"Questionnaire!$L$390","v":0},0]
[null,3,{"$f":"Questionnaire!$L$398","v":0},0]
[null,4,{"$f":"Questionnaire!$L$406","v":0},0]
[null,5,{"$f":"Questionnaire!$L$414","v":0},0]
[null,6,{"$f":"Questionnaire!$L$421","v":0},0]
[null,7,{"$f":"Questionnaire!$L$428","v":0},0]
[null,8,{"$f":"Questionnaire!$L$435","v":0},0,null,{"$f":"IF(D43>=32,\"High\",IF(D43>=26,\"Moderate\",IF(D43<=25,\"None/Low\",\"Error\")))","v":"None/Low"},{"$f":"IF(F42=\"High\", 3, IF(F42=\"Moderate\", 2, IF(F42=\"None/Low\", 1, 0)))","v":1}]
[null,null,"Total",{"$f":"SUM(D35:D42)","v":0}]
["Scores"]
[null,"Iowa Warmth",{"$f":"G4","v":1}]
[null,"Iowa Hostility",{"$f":"G11","v":3}]
[null,"DAS",{"$f":"G19","v":3}]
[null,"O'Leary",{"$f":"G42","v":1}]
[null,"Highest Score",{"$f":"MAX(C45:C48)","v":3},null,"Amalgamated Score",{"$f":"C49","v":3},"Level of Conflict",{"$f":"IF(F49=3, \"High Intensity Support\", IF(F49=2, \"Moderate Intensity Support\", \"Other Support / None RPCP\"))","v":"High Intensity Support"}]

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[]
[" Tab for CPA Admin Use Only"]
[]
[]
["RSQ Completed","Parent Name","Date of Birth","Phone Number","Practitioner","Role","Team","Service","Organisation","Email","Phone","LA","Workless Household","Support Level","Main Carer"]
[{"$f":"Questionnaire!M502","v":"Must Complete"},{"$f":"Questionnaire!M51&\" \"&Questionnaire!M52&\" \"&Questionnaire!M53","v":"Must Complete Must Complete Must Complete"},{"$f":"Questionnaire!M54","v":"Must Complete"},{"$f":"Questionnaire!M55","v":"Must Complete"},{"$f":"Questionnaire!M488","v":"Must Complete"},{"$f":"Questionnaire!M490","v":"Must Complete"},{"$f":"Questionnaire!M492","v":"Must Complete"},{"$f":"Questionnaire!M494","v":"Must Complete"},{"$f":"Questionnaire!M496","v":"Must Complete"},{"$f":"Questionnaire!M498","v":"Must Complete"},{"$f":"Questionnaire!M500","v":"Must Complete"},{"$f":"Questionnaire!M504","v":"Must Complete"},{"$f":"IF(Questionnaire!M38=\"Yes\", \"No\", IF(Questionnaire!M38=\"No\", \"Yes\", \"Not Completed\"))","v":"Not Completed"},{"$f":"Admin!B15","v":"Participation Statement not Completed DO NOT FORWARD"},"N/A"]
[null,null,null,null,null,null,null,null,"Enter UIN Below"]
[null,"Linked Co-Parent"]
[null,{"$f":"Questionnaire!M190","v":"Co-Parent details not supplied"},{"$f":"Questionnaire!M192","v":"Co-parent details not supplied"},null,null,null,null,null,"TEST","*Copy and paste yellow cell data to UIN spreadsheet "]
[null,null,null,null,null,null,null,null,null,"to assign a UIN"]
[null,"Child",null,null," Use this button  to send the full RSQ to DWP"]
[null,{"$f":"Questionnaire!M375","v":"Must Complete"},null,null,null,null,null,null,"test2"]
[null,null,null,null," Use this button to send RSQ data to the Provider"]

{"sheet":"DWP","index":4,"n_rows":259,"n_cols":10,"rows_kept":259,"cut":false,"hidden":true,"merged":[[232,3,232,8],[234,3,234,8],[230,3,230,8],[75,3,75,6],[77,3,77,6],[184,3,184,6],[226,3,226,8],[228,3,228,8],[44,1,44,2],[44,3,44,8],[48,1,48,6],[48,7,48,8],[41,1,41,2],[41,3,41,8],[42,1,42,2],[42,3,42,8],[43,1,43,2],[43,3,43,8],[37,1,37,2],[37,3,37,8],[39,1,39,2],[39,3,39,8],[40,1,40,2],[40,3,40,8],[38,1,38,2],[38,3,38,8],[36,1,36,2],[36,3,36,8],[34,1,34,2],[34,3,34,8],[35,1,35,2],[35,3,35,8],[236,3,236,8],[238,3,238,8],[240,3,240,8],[242,3,242,8],[250,2,250,5],[254,1,254,5],[255,1,255,5],[256,1,256,5],[257,1,257,5],[258,1,258,5]]}
[null,"Level of Support Required = ",null,null,{"$f":"Admin!B15","v":"Participation Statement not Completed DO NOT FORWARD"}]
[null,"Workless Household",null,{"$f":"CPA!M6","v":"Not Completed"}]
[]
[null,"Reducing Parental Conflict Programme"]
[null,"Referral Stage Questionnaire "]
[null,"For parents who are  currently in a relationship together"]
[]
[]
[null,"Please read the following instructions."]
[]
[null,"Please could you answer all questions in Part 1 asking for information relating to you "]
[null,"and your family."]
[]
[null,"Once you have provided your information please move on to Part 2. Please answer "]
[null,"all questions in this section."]
[]
[null,"Once completed please return the questionnaire to the person who gave it to "]
[null,"you"]
[]
[null,"Additional Needs - "]
[null,{"$f":"Questionnaire!M25","v":"Must Complete"}]
[]
[null,"Participation Agreement"]
[null,{"$f":"Questionnaire!M31","v":"Must Complete"}]
[]
[null,"PART 1"]
[]
[null,"Parent information"]
[]
[null,"This section collects important information about you and your family."]
[null,"Please complete all questions in this section."]
[]
[null,"About You"]
[]
[null,null,null,"Please complete below"]
[null,"Title",null,{"$f":"Questionnaire!M51","v":"Must Complete"}]
[null,"Forenames",null,{"$f":"Questionnaire!M52","v":"Must Complete"}]
[null,"Surname",null,{"$f":"Questionnaire!M53","v":"Must Complete"}]
[null,"UIN",null,{"$f":"CPA!I9","v":"TEST"}]
[null,"Date of birth\n(dd/mm/yyyy)",null,{"$f":"Questionnaire!M54","v":"Must Complete"}]
[null,"Telephone\nnumber (mobile)",null,{"$f":"Questionnaire!M55","v":"Must Complete"}]
[null,"Alternative\ntelephone \nnumber (e.g. landline)",null,{"$f":"Questionnaire!M56","v":"No alternative number supplied"}]
[null,"Address",null,{"$f":"Questionnaire!M57","v":"Must Complete"}]
[null,"Post code",null,{"$f":"Questionnaire!M58","v":"Must Complete"}]
[null,"Email",null,{"$f":"Questionnaire!M59","v":"No email address supplied"}]
[]
[null,"What is your gender identity? Please select below."]
[null,{"$f":"Questionnaire!M75","v":"Must Complete"}]
[]
[null,"Disability:"]
[null,{"$f":"Questionnaire!M75","v":"Must Complete"}]
[]
[null,"What is your ethnic group? "]
[null,{"$f":"Questionnaire!M111","v":"Must Complete"}]
[null,{"$f":"Questionnaire!L110","v":"None Selected"}]
[]
[null,"What is your marital status?"]
[null,{"$f":"Questionnaire!M125","v":"Must Complete"}]
[]
[null,"How many children do you have primary or shared care responsibility for?"]
[null,{"$f":"Questionnaire!M135","v":"Must Complete"}]
[]
[null,"Are you or your partner pregnant now?"]
[null,{"$f":"Questionnaire!M142","v":"Must Complete"}]
[]
[null,"Which of these best describes your current employment status?"]
[null,{"$f":"Questionnaire!M160","v":"Must Complete"}]
[]
[null,"Are you presently or have you ever experienced mental health problems? "]
[null,{"$f":"Questionnaire!M171","v":"Must Complete"}]
[]
[null,"What is your relationship with the person you are currently experiencing"]
[null,"conflict with? "]
[null,{"$f":"Questionnaire!M183","v":"Must Complete"}]
[]
[null,"Their name",null,{"$f":"Questionnaire!M190","v":"Co-Parent details not supplied"}]
[]
[null,"Their UIN",null,{"$f":"CPA!I12","v":"test2"}]
[]
[]
[null,"PART 2 - About Your Circumstances"]
[]
[]
[null,"There are three sections of questions in this part of the questionnaire. Please answer "]
[null,"all questions to the best of your ability, even if they do not seem entirely relevant to "]
[null,"you. "]
[]
[null,"Once you have finished these questions, please return the questionnaire to the "]
[null,"person who gave it to you. "]
[]
[null,"Section 1:  You and your spouse/partner"]
[]
[null,"Please think about the times during the last 4 weeks when you and your spouse/partner"]
[null,"have spent time talking or doing things together."]
[]
[null,"With those times in mind, please indicate how often your spouse/partner acted in the "]
[null,"following ways towards you. During the past 4 weeks, how often did your "]
[null,"spouse/partner…",null,"Score from 1 (Always) to 7 (Never)"]
[]
[null,"1. Let you know they really care about you"]
[null,{"$f":"Questionnaire!M218","v":"Must Complete"}]
[]
[null,"2. Was loving and / or affectionate towards you"]
[null,{"$f":"Questionnaire!M224","v":"Must Complete"}]
[]
[null,"3. Let you know that they appreciate your ideas or the things you do"]
[null,{"$f":"Questionnaire!M230","v":"Must Complete"}]
[]
[null,"4. Help you to do something that is important to you"]
[null,{"$f":"Questionnaire!M236","v":"Must Complete"}]
[]
[null,"5. Be supportive and understanding towards you"]
[null,{"$f":"Questionnaire!M242","v":"Must Complete"}]
[]
[null,"6. Criticise you"]
[null,{"$f":"Questionnaire!M248","v":"Must Complete"}]
[]
[null,"7. Argue with you when you disagreed about something"]
[null,{"$f":"Questionnaire!M254","v":"Must Complete"}]
[]
[null,"8. Get angry at you"]
[null,{"$f":"Questionnaire!M260","v":"Must Complete"}]
[]
[null,"9. Shout at you because they were upset with you"]
[null,{"$f":"Questionnaire!M266","v":"Must Complete"}]
[]
[null,"Section 2:  Agreement in relationships"]
[]
[null,"Most people have disagreements in their relationships. Please select how often you"]
[null,"and your spouse / partner agree or disagree about the following:"]
[null,"Scoring from 5(Always Agree) to 0(Always Disagree)"]
[]
[null,"1. Philosophy of life (Your approach to life)"]
[null,{"$f":"Questionnaire!M278","v":"Must Complete"}]
[]
[null,"2. Aims, goals, and things you believe are important"]
[null,{"$f":"Questionnaire!M284","v":"Must Complete"}]
[]
[null,"3. Amount of time spent together"]
[null,{"$f":"Questionnaire!M290","v":"Must Complete"}]
[]
[null,"Please circle how often you would say the following events occur between you and"]
[null,"your spouse / partner?"]
[null,"Scoring from 5(More than once a day) to 0 (Never)"]
[]
[null,"4. Have a stimulating exchange of ideas (A meaningful discussion)"]
[null,{"$f":"Questionnaire!M299","v":"Must Complete"}]
[]
[null,"5. Calmly discuss something together"]
[null,{"$f":"Questionnaire!M307","v":"Must Complete"}]
[]
[null,"6. Plan something together"]
[null,{"$f":"Questionnaire!M315","v":"Must Complete"}]
[]
[null,"7. The following represent different degrees of happiness in your relationship. "]
[null,"The middle point, “happy,” represents the degree of happiness of most relationships. "]
[null,"Please select the degree of happiness, all things considered, in your relationship."]
[null,{"$f":"Questionnaire!M324","v":"Must Complete"}]
[]
[null,"8. How often do you discuss or have you considered divorce, separation "]
[null,"or ending your relationship?"]
[null,{"$f":"Questionnaire!M336","v":"Must Complete"}]
[]
[null,"9. Do you ever regret that you married? (or lived together)"]
[null,{"$f":"Questionnaire!M343","v":"Must Complete"}]
[]
[null,"10. How often do you and your spouse / partner argue?"]
[null,{"$f":"Questionnaire!M350","v":"Must Complete"}]
[]
[null,"11. How often do you and your spouse / partner “get on each other’s nerves”?"]
[null,{"$f":"Questionnaire!M357","v":"Must Complete"}]
[]
[null,"Section 3: How you deal with relationship issues"]
[]
[null,"The following are a series of statements that describe things people sometimes do and feel when "]
[null,"disagreements arise. Please answer as best as you can. "]
[]
[null,"The questions refer to your child’s awareness of conflicts that occur between you and your spouse"]
[null,"/ partner. If you have more than one child, please consider the child you are most concerned about "]
[null,"when answering this set of questions. If you are not concerned about a child "]
[]
[null,"Please indicate how often each statement applies to your family by ticking the relevant box for each "]
[null,"question. "]
[]
[null,"Child’s first name: ",null,{"$f":"CPA!B12","v":"Must Complete"}]
[]
[null,"1. Sometimes it is difficult to keep financial discussions to specific times and places. How often would "]
[null,"you say you and your spouse/partner argue over money in front of this child?"]
[null,{"$f":"Questionnaire!$M$382","v":"Must Complete"}]
[]
[null,"2. Children often go to one parent for money or permission to do something after having already been refused "]
[null,"by the other parent. How often would you say this child approaches you or your spouse/partner in this manner? "]
[null,{"$f":"Questionnaire!$M$390","v":"Must Complete"}]
[]
[null,"3. Parents disagree on the subject of discipline. How often do you and your spouse/partner argue over"]
[null," disciplinary problems in front of this child?"]
[null,{"$f":"Questionnaire!$M$398","v":"Must Complete"}]
[]
[null,"4. How often does your spouse/partner complain to you about your behaviour in the home (e.g. drinking "]
[null,"or smoking, nagging, sloppiness, etc.) in front of this child?"]
[null,{"$f":"Questionnaire!$M$406","v":"Must Complete"}]
[]
[null,"5. In every normal relationship there are arguments. How often do you complain to your spouse/partner"]
[null,"about their behaviour in front of this child?"]
[null,{"$f":"Questionnaire!$M$414","v":"Must Complete"}]
[]
[null,"6. How often do you and your spouse/partner argue in front of this child?"]
[null,{"$f":"Questionnaire!$M$421","v":"Must Complete"}]
[]
[null,"7. How often do you and/or your spouse/partner display verbal hostility in front of this child?"]
[null,{"$f":"Questionnaire!$M$428","v":"Must Complete"}]
[]
[null,"8. How often do you and your spouse/partner show affection for each other in front of this child?"]
[null,{"$f":"Questionnaire!$M$435","v":"Must Complete"}]
[]
[]
[null,null,null,null,null,"END OF QUESTIONS"]
[]
[null,null,null,null,null,"Thank you for completing this questionnaire"]
[]
[]
[]
[]
[]
[null,"For use by staff member"]
[]
[null,"Your Name :",null,{"$f":"Questionnaire!M488","v":"Must Complete"}]
[]
[null,"Job Title :",null,{"$f":"Questionnaire!M490","v":"Must Complete"}]
[]
[null,"Team",null,{"$f":"Questionnaire!M492","v":"Must Complete"}]
[]
[null,"Service",null,{"$f":"Questionnaire!M494","v":"Must Complete"}]
[]
[null,"Organisation",null,{"$f":"Questionnaire!M496","v":"Must Complete"}]
[]
[null,"Email :",null,{"$f":"Questionnaire!M498","v":"Must Complete"}]
[]
[null,"Phone Number :",null,{"$f":"Questionnaire!M500","v":"Must Complete"}]
[]
[null,"Date Completed :",null,{"$f":"Questionnaire!M502","v":"Must Complete"}]
[]
[null,"Local Authority :",null,{"$f":"Questionnaire!M504","v":"Must Complete"}]
[]
[null,"If you have received any of the following training to deliver this programme "]
[null,"please supply date completed"]
[]
[null,"Process Training  / Awareness Overview",null,null,null,null,null,null,null,{"$f":"Questionnaire!M511","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Online)",null,null,null,null,null,null,null,{"$f":"Questionnaire!M515","v":"Please complete"}]
[null,"Practitioner Training supplied by DWP/ Knowledgepool (Classroom Based)",null,null,null,null,null,null,null,{"$f":"Questionnaire!M518","v":"Please complete"}]
[null,"Other",{"$f":"Questionnaire!M521","v":"Other Training not specified"},null,null,null,null,null,null,{"$f":"Questionnaire!M524","v":"Please complete"}]
[]
[null,"Are the family already being supported by any of the following? "]
[]
[null,"No support",null,null,null,null,null,null,null,{"$f":"Questionnaire!M532","v":"Must Complete"}]
[null,"Children's Social Care"]
[null,"Early Help"]
[null,"Other (Please specify below)"]
[null,{"$f":"Questionnaire!M533","v":"No Other Support Specified"}]

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[null,"Level of Support Required = ",null,null,{"$f":"Admin!B15","v":"Participation Statement not Completed DO NOT FORWARD"}]
[null,"Workless Household",null,{"$f":"CPA!M6","v":"Not Completed"}]
[]
[null,"Reducing Parental Conflict Programme"]
[null,"Referral Stage Questionnaire "]
[null,"For parents who are  currently in a relationship together"]
[]
[null,"Please read the following instructions."]
[]
[null,"Please could you answer all questions in Part 1 asking for information relating to you "]
[null,"and your family."]
[]
[null,"Once you have provided your information please move on to Part 2. Please answer "]
[null,"all questions in this section."]
[]
[null,"Once completed please return the questionnaire to the person who gave it to "]
[null,"you"]
[]
[null,"Additional Needs - "]
[null,{"$f":"Questionnaire!M25","v":"Must Complete"}]
[]
[null,"Details"]
[null,{"$f":"Questionnaire!L28","v":"Additional Needs not entered"}]
[]
[]
[null,"Participation Agreement"]
[null,{"$f":"Questionnaire!M31","v":"Must Complete"}]
[]
[null,"PART 1"]
[]
[null,"Parent information"]
[]
[null,"This section collects important information about you and your family."]
[null,"Please complete all questions in this section."]
[]
[null,"About You"]
[]
[null,null,null,"Please complete below"]
[null,"Title",null,{"$f":"Questionnaire!M51","v":"Must Complete"}]
[null,"Forenames",null,{"$f":"Questionnaire!M52","v":"Must Complete"}]
[null,"Surname",null,{"$f":"Questionnaire!M53","v":"Must Complete"}]
[null,"UIN",null,{"$f":"CPA!I9","v":"TEST"}]
[null,"Telephone\nnumber (mobile)",null,{"$f":"Questionnaire!M55","v":"Must Complete"}]
[null,"Alternative\ntelephone \nnumber (e.g. landline)",null,{"$f":"Questionnaire!M56","v":"No alternative number supplied"}]
[null,"Address",null,{"$f":"Questionnaire!M57","v":"Must Complete"}]
[null,"Post code",null,{"$f":"Questionnaire!M58","v":"Must Complete"}]
[null,"Email",null,{"$f":"Questionnaire!M59","v":"No email address supplied"}]
[]
[]
[null,"How many children do you have primary or shared care responsibility for?"]
[null,{"$f":"Questionnaire!M135","v":"Must Complete"}]
[]
[null,"Are you or your partner pregnant now?"]
[null,{"$f":"Questionnaire!M142","v":"Must Complete"}]
[]
[null,"Which of these best describes your current employment status?"]
[null,{"$f":"Questionnaire!M160","v":"Must Complete"}]
[]
[null,"Are you presently or have you ever experienced mental health problems? "]
[null,{"$f":"Questionnaire!M171","v":"Must Complete"}]
[]
[null,"What is your relationship with the person you are currently experiencing"]
[null,"conflict with? "]
[null,{"$f":"Questionnaire!M183","v":"Must Complete"}]
[]
[null,"Their name",null,{"$f":"Questionnaire!M190","v":"Co-Parent details not supplied"}]
[]
[null,"Their UIN",null,{"$f":"CPA!I12","v":"test2"}]
[]
[]
[null,"Name of the child they are most concerned about",null,null,null,null,null,{"$f":"Questionnaire!$M$375","v":"Must Complete"}]
[]
[]
[null,"PART 2 - About Your Circumstances"]
[]
[null,"There are three sections of questions in this part of the questionnaire. Please answer "]
[null,"all questions to the best of your ability, even if they do not seem entirely relevant to "]
[null,"you. "]
[]
[null,"Once you have finished these questions, please return the questionnaire to the "]
[null,"person who gave it to you. "]
[]
[null,"Section 1:  You and your spouse/partner"]
[]
[null,"Please think about the times during the last 4 weeks when you and your spouse/partner"]
[null,"have spent time talking or doing things together."]
[]
[null,"With those times in mind, please indicate how often your spouse/partner acted in the "]
[null,"following ways towards you. During the past 4 weeks, how often did your "]
[null,"spouse/partner…",null,"Score from 1 (Always) to 7 (Never)"]
[]
[null,"1. Let you know they really care about you"]
[null,{"$f":"Questionnaire!M218","v":"Must Complete"}]
[]
[null,"2. Was loving and / or affectionate towards you"]
[null,{"$f":"Questionnaire!M224","v":"Must Complete"}]
[]
[null,"3. Let you know that they appreciate your ideas or the things you do"]
[null,{"$f":"Questionnaire!M230","v":"Must Complete"}]
[]
[null,"4. Help you to do something that is important to you"]
[null,{"$f":"Questionnaire!M236","v":"Must Complete"}]
[]
[null,"5. Be supportive and understanding towards you"]
[null,{"$f":"Questionnaire!M242","v":"Must Complete"}]
[]
[null,"6. Criticise you"]
[null,{"$f":"Questionnaire!M248","v":"Must Complete"}]
[]
[null,"7. Argue with you when you disagreed about something"]
[null,{"$f":"Questionnaire!M254","v":"Must Complete"}]
[]
[null,"8. Get angry at you"]
[null,{"$f":"Questionnaire!M260","v":"Must Complete"}]
[]
[null,"9. Shout at you because they were upset with you"]
[null,{"$f":"Questionnaire!M266","v":"Must Complete"}]
[]
[null,"Section 2:  Agreement in relationships"]
[]
[null,"Most people have disagreements in their relationships. Please select how often you"]
[null,"and your spouse / partner agree or disagree about the following:"]
[null,"Scoring from 5(Always Agree) to 0(Always Disagree)"]
[]
[null,"1. Philosophy of life (Your approach to life)"]
[null,{"$f":"Questionnaire!M278","v":"Must Complete"}]
[]
[null,"2. Aims, goals, and things you believe are important"]
[null,{"$f":"Questionnaire!M284","v":"Must Complete"}]
[]
[null,"3. Amount of time spent together"]
[null,{"$f":"Questionnaire!M290","v":"Must Complete"}]
[]
[null,"Please circle how often you would say the following events occur between you and"]
[null,"your spouse / partner?"]
[null,"Scoring from 5(More than once a day) to 0 (Never)"]
[]
[null,"4. Have a stimulating exchange of ideas (A meaningful discussion)"]
[null,{"$f":"Questionnaire!M299","v":"Must Complete"}]
[]
[null,"5. Calmly discuss something together"]
[null,{"$f":"Questionnaire!M307","v":"Must Complete"}]
[]
[null,"6. Plan something together"]
[null,{"$f":"Questionnaire!M315","v":"Must Complete"}]
[]
[null,"7. The following represent different degrees of happiness in your relationship. "]
[null,"The middle point, “happy,” represents the degree of happiness of most relationships. "]
[null,"Please select the degree of happiness, all things considered, in your relationship."]
[null,{"$f":"Questionnaire!M324","v":"Must Complete"}]
[]
[null,"8. How often do you discuss or have you considered divorce, separation "]
[null,"or ending your relationship?"]
[null,{"$f":"Questionnaire!M336","v":"Must Complete"}]
[]
[null,"9. Do you ever regret that you married? (or lived together)"]
[null,{"$f":"Questionnaire!M343","v":"Must Complete"}]
[]
[null,"10. How often do you and your spouse / partner argue?"]
[null,{"$f":"Questionnaire!M350","v":"Must Complete"}]
[]
[null,"11. How often do you and your spouse / partner “get on each other’s nerves”?"]
[null,{"$f":"Questionnaire!M357","v":"Must Complete"}]
[]
[null,"Section 3: How you deal with relationship issues"]
[]
[null,"The following are a series of statements that describe things people sometimes do and feel when "]
[null,"disagreements arise. Please answer as best as you can. "]
[]
[null,"The questions refer to your child’s awareness of conflicts that occur between you and your spouse"]
[null,"/ partner. If you have more than one child, please consider the child you are most concerned about "]
[null,"when answering this set of questions. If you are not concerned about a child "]
[]
[null,"Please indicate how often each statement applies to your family by ticking the relevant box for each "]
[null,"question. "]
[]
[null,"Child’s first name: ",null,{"$f":"Questionnaire!$M$375","v":"Must Complete"}]
[]
[null,"1. Sometimes it is difficult to keep financial discussions to specific times and places. How often would "]
[null,"you say you and your spouse/partner argue over money in front of this child?"]
[null,{"$f":"Questionnaire!$M$382","v":"Must Complete"}]
[]
[null,"2. Children often go to one parent for money or permission to do something after having already been refused "]
[null,"by the other parent. How often would you say this child approaches you or your spouse/partner in this manner? "]
[null,{"$f":"Questionnaire!$M$390","v":"Must Complete"}]
[]
[null,"3. Parents disagree on the subject of discipline. How often do you and your spouse/partner argue over"]
[null," disciplinary problems in front of this child?"]
[null,{"$f":"Questionnaire!$M$398","v":"Must Complete"}]
[]
[null,"4. How often does your spouse/partner complain to you about your behaviour in the home (e.g. drinking "]
[null,"or smoking, nagging, sloppiness, etc.) in front of this child?"]
[null,{"$f":"Questionnaire!$M$406","v":"Must Complete"}]
[]
[null,"5. In every normal relationship there are arguments. How often do you complain to your spouse/partner"]
[null,"about their behaviour in front of this child?"]
[null,{"$f":"Questionnaire!$M$414","v":"Must Complete"}]
[]
[null,"6. How often do you and your spouse/partner argue in front of this child?"]
[null,{"$f":"Questionnaire!$M$421","v":"Must Complete"}]
[]
[null,"7. How often do you and/or your spouse/partner display verbal hostility in front of this child?"]
[null,{"$f":"Questionnaire!$M$428","v":"Must Complete"}]
[]
[null,"8. How often do you and your spouse/partner show affection for each other in front of this child?"]
[null,{"$f":"Questionnaire!$M$435","v":"Must Complete"}]
[]
[]
[]
[null,null,null,null,null,"END OF QUESTIONS"]
[]
[null,null,null,null,null,"Thank you for completing this questionnaire"]
[]
[]
[]
[]
[null,"For use by staff member"]
[]
[null,"Your Name :",null,{"$f":"Questionnaire!M488","v":"Must Complete"}]
[]
[null,"Local Authority :",null,{"$f":"Questionnaire!M504","v":"Must Complete"}]
[]
[null,"Phone Number :",null,{"$f":"Questionnaire!M500","v":"Must Complete"}]
[]
[null,"Date Completed :",null,{"$f":"Questionnaire!M502","v":"Must Complete"}]
[]
[null,"Additional Information / Risk Assessment Details"]
[null,"Please give details"]
[null,{"$f":"Questionnaire!M537","v":"Additional Information not entered"}]