Important note about this tool. This questionnaire is not a psychometrically validated diagnostic instrument. The questions were constructed based on the structure of recognised screening scales (HITS, ISA, WAST), however the score thresholds are clinical, not psychometric — they were established on the basis of clinical knowledge, not normative research. The tool serves solely as a pointer and a starting point for reflection for people who find it difficult to assess whether they are experiencing abuse. The result does not replace a consultation with a specialist.
Piotr Nowak · Psychologist & Psychotherapist

Relationship Safety Questionnaire

Many behaviours in relationships can be difficult to evaluate — especially when they happen gradually and boundaries become blurred over time. This questionnaire will help you look at what is happening in your relationship — without judgement and without pressure. The results are for you alone and can be a starting point for a conversation with a therapist.

Confidentiality: Your answers are not sent anywhere or saved. Everything happens solely in your browser. If you feel unsafe right now — call 112 or 116 123 (24-hour helpline for adults).

20 questions · approx. 5–8 minutes · scale: Never → Always

Relationship Safety Questionnaire
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Questionnaire results
0 / 80 pts
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Results by area

Which areas of the relationship require attention — to discuss with a therapist.

What next?

The results of this questionnaire are a pointer, not a diagnosis. Whatever the score — if anything in your relationship concerns you, it is worth discussing with a specialist.

The Blue Card (Niebieska Karta) is a formal protection procedure for victims of domestic violence in Poland. On the brainLab.center website you will find information on how to initiate it, what your rights are and where to turn.
Book a session Blue Card — how it works
About this tool. Questionnaire constructed based on the HITS, ISA and WAST screening instruments. Score thresholds are clinical, not psychometric — they were not derived from normative research and have not been validated on a Polish population. The tool serves solely as a pointer and starting point for reflection — it does not replace a clinical consultation or specialist assessment. No data is sent or saved.