Appendix - RonaldMah

APPENDIX

ABUSIVE BEHAVIOR INVENTORY (developed by Albert Dytch)

Client #1   Client #2

Past  Now  Past  Now   PHYSICAL ABUSE

____ ____ ____ ____ Block the way, stand in doorway

____ ____ ____ ____ Hold captive, keep from leaving the house

____ ____ ____ ____ Lock out of shared home

____ ____ ____ ____ Refuse to help sick, injured, or pregnant partner

____ ____ ____ ____ Abandon partner in a dangerous place

____ ____ ____ ____ Push or shove

____ ____ ____ ____ Grab or hold

____ ____ ____ ____ Pin to floor, bed, wall

____ ____ ____ ____ Throw down or knock down

____ ____ ____ ____ Slap

____ ____ ____ ____ Hit with fist

____ ____ ____ ____ Twist arm

____ ____ ____ ____ Pull hair

____ ____ ____ ____ Kick

____ ____ ____ ____ Bite

____ ____ ____ ____ Pinch

____ ____ ____ ____ Pull hair

____ ____ ____ ____ Butt heads

____ ____ ____ ____ Choke, put hands to throat

____ ____ ____ ____ Throw objects at partner

____ ____ ____ ____ Hit with an object

____ ____ ____ ____ Hit, shove, or kick pregnant partner

____ ____ ____ ____ Use a weapon to hurt or threaten

____ ____ ____ ____ Cause bruises, cuts, black eyes

____ ____ ____ ____ Cause broken bones

____ ____ ____ ____ Cause impaired vision or hearing

____ ____ ____ ____ Burn or scald

____ ____ ____ ____ Cause hospitalization

____ ____ ____ ____ Injure or disfigure permanently

____ ____ ____ ____ Prevent from receiving medical care

____ ____ ____ ____ Kill or attempt to kill

VERBAL ABUSE

____ ____ ____ ____ Scream or holler

____ ____ ____ ____ Use foul language

____ ____ ____ ____ Call names

____ ____ ____ ____ Put partner down, say demeaning things

____ ____ ____ ____ Criticize frequently or continually

____ ____ ____ ____ Make fun of a disability or shortcoming

____ ____ ____ ____ Make jokes at partner's expense

____ ____ ____ ____ Ridicule or insult partner

____ ____ ____ ____ Create fear with your voice

____ ____ ____ ____ Yell in partner's face ("nose to nose")

____ ____ ____ ____ Manipulate with lies and contradictions

____ ____ ____ ____ Insult or drive away partner's family or friends

____ ____ ____ ____ Ridicule or insult partner's religion, heritage, race, class, beliefs

EMOTIONAL ABUSE

Domination

____ ____ ____ ____ Act like the boss

____ ____ ____ ____ Try to tell partner what he/she can or can't do

____ ____ ____ ____ Force partner to do things against his or her will

____ ____ ____ ____ Treat partner as less than your equal

____ ____ ____ ____ Make important decisions without consulting partner

____ ____ ____ ____ Refuse to do your share of chores

Intimidation

____ ____ ____ ____ Prevent or impede movement

____ ____ ____ ____ Use physical size to frighten

____ ____ ____ ____ Create fear with actions, gestures, and facial expressions

____ ____ ____ ____ Remind partner of ability to hurt him/her

____ ____ ____ ____ Drive recklessly to frighten

____ ____ ____ ____ Have weapons your partner is afraid of

____ ____ ____ ____ Threaten regularly to leave or to make partner leave the relationship

____ ____ ____ ____ Threaten to hurt partner's family or friends

____ ____ ____ ____ Threaten to take away children

____ ____ ____ ____ Threaten to hit, hurt, or abuse children

____ ____ ____ ____ Threaten to hit, hurt, or abuse partner

____ ____ ____ ____ Threaten to kill partner

____ ____ ____ ____ Threaten to hurt or kill yourself

Humiliation

____ ____ ____ ____ Ridicule or ignore feelings

____ ____ ____ ____ Ridicule or embarrass in public

____ ____ ____ ____ Ridicule or embarrass in private

____ ____ ____ ____ Force to do demeaning or degrading things

____ ____ ____ ____ Talk about an affair (real or invented) to hurt partner

Harassment

____ ____ ____ ____ Refuse to leave partner alone

____ ____ ____ ____ Follow around the house

____ ____ ____ ____ Stalk partner

____ ____ ____ ____ Accuse partner of being unfaithful

Isolation

____ ____ ____ ____ Prevent or discourage partner from seeing family or friends

____ ____ ____ ____ Refuse to let partner leave the house

____ ____ ____ ____ Refuse to let partner go to work or school

____ ____ ____ ____ Take away car keys or money

____ ____ ____ ____ Refuse to socialize with partner

____ ____ ____ ____ Refuse to let partner be alone in public

____ ____ ____ ____ Monitor partner, interrogate about where he/she has been

Withdrawal

____ ____ ____ ____ Withhold approval, appreciation, or affection to punish

____ ____ ____ ____ Withhold sex to punish

____ ____ ____ ____ Sulk angrily to get even

Self-destruction

____ ____ ____ ____ Hit or injure yourself

____ ____ ____ ____ Place yourself in dangerous situations

____ ____ ____ ____ Attempt suicide

Using the children

____ ____ ____ ____ Turn children against partner

____ ____ ____ ____ Use visitation to harass partner

____ ____ ____ ____ Punish or deprive children when angry at partner

Destruction of property and pets

____ ____ ____ ____ Threaten to destroy property

____ ____ ____ ____ Drop plants or dishes

____ ____ ____ ____ Break a window

____ ____ ____ ____ Punch or kick a wall, door, doorjamb, etc.

____ ____ ____ ____ Slam doors

____ ____ ____ ____ Smash objects (TV, stereo, phone, remote control)

____ ____ ____ ____ Destroy something of emotional significance

____ ____ ____ ____ Threaten to harm a pet

____ ____ ____ ____ Neglect, harm, or kill a pet

SEXUAL ABUSE

____ ____ ____ ____ Express intense jealousy

____ ____ ____ ____ Tell demeaning sexual jokes

____ ____ ____ ____ Treat others as sex objects

____ ____ ____ ____ Show sexual interest in others when with partner

____ ____ ____ ____ Have an affair when you agreed to be monogamous

____ ____ ____ ____ Minimize importance of partner's feelings about sex

____ ____ ____ ____ Criticize sexual performance or frequency

____ ____ ____ ____ Insist that partner dress more seductively or less seductively

____ ____ ____ ____ Insist on unwanted touching or other sexual activity

____ ____ ____ ____ Threaten to retaliate if partner isn't interested in sex

____ ____ ____ ____ Force partner to watch pornography

____ ____ ____ ____ Force your partner into sexual activity

FINANCIAL ABUSE

____ ____ ____ ____ Completely control the finances

____ ____ ____ ____ Refuse to let partner have his or her own checkbook

____ ____ ____ ____ Make partner ask for money

____ ____ ____ ____ Threaten to hurt partner financially

____ ____ ____ ____ Take money or steal property

____ ____ ____ ____ Threaten to withdraw financial support

____ ____ ____ ____ Refuse to pay your share of bills as agreed

LEGAL SYSTEM ABUSE

____ ____ ____ ____ Violate a restraining order

____ ____ ____ ____ Violate a child custody agreement

____ ____ ____ ____ Lie about partner to police or in court