assertiveness

ASSERTIVENESS ASSERTIVENESS

ASSERTIVENESASSERTIVENES

PROMOTIG SELF ESTEEM PROMOTIG SELF ESTEEM

WITHOUT DIMINISHING THE WITHOUT DIMINISHING THE

ESTEEM OF OTHERSESTEEM OF OTHERS

What is Assertiveness?What is Assertiveness? It’s the ability to

honestly express your opinions, feelings, attitudes, and rights -- without undue anxiety -- in a way that doesn’t infringe on the rights of others.

It’s not aggressiveness,

Assertiveness……………..Assertiveness……………..

A form of behavior characterized by a A form of behavior characterized by a confident declaration or affirmation of a confident declaration or affirmation of a statement without need of proof; this affirms statement without need of proof; this affirms the person's rights or point of view without the person's rights or point of view without either aggressively threatening the rights of either aggressively threatening the rights of another or submissively permitting another to another or submissively permitting another to ignore or deny one's rights or point of view.ignore or deny one's rights or point of view.

ASSERTIVE BEHAVIOURASSERTIVE BEHAVIOUR(ALBERTI & EMMONS, 2001)(ALBERTI & EMMONS, 2001)

PROMOTES EQUALITY IN PROMOTES EQUALITY IN RELATIONHIPSRELATIONHIPS

ENABLING US TO ACT IN OUR OWN ENABLING US TO ACT IN OUR OWN BEST INTERESTSBEST INTERESTS

STAND UP FOR OURSELFSTAND UP FOR OURSELF TO EXPRESS HONEST FEELINGSTO EXPRESS HONEST FEELINGS EO EXCERCISE PERSONAL RIGHTS EO EXCERCISE PERSONAL RIGHTS

WITHOUT DENYING THE RIGHTS OF WITHOUT DENYING THE RIGHTS OF OTHERSOTHERS

ASSERTIVE PEOPLE………..ASSERTIVE PEOPLE………..

They feel free to express their feelings, thoughts, and They feel free to express their feelings, thoughts, and desires.desires.

They are "also able to initiate and maintain They are "also able to initiate and maintain comfortable relationships with people"comfortable relationships with people"

They know their rights.They know their rights. They have control over their anger. They have control over their anger. ““Willing to compromise with others ... and tend to Willing to compromise with others ... and tend to

have good self-esteem".have good self-esteem". "Assertive people enter friendships from an 'I count "Assertive people enter friendships from an 'I count

my needs. I count your needs' position".my needs. I count your needs' position".

Why is Assertiveness Important?Why is Assertiveness Important? If you don’t know how If you don’t know how

to be assertive, you to be assertive, you might experience the might experience the following:following:

DepressionDepression. This comes . This comes from anger turned from anger turned inward. It can give you inward. It can give you a sense of being a sense of being helpless, hopeless, with helpless, hopeless, with no control over your no control over your life.life.

Resentment. Anger at others for manipulating or taking advantage of me.

Frustration. Why did I let someone victimize me?

Temper/Violence. If you can’t express anger appropriately, it builds up until it blows.

Anxiety. Which leads to avoidance. If you begin to avoid situations or people that you know will make you uncomfortable, you may miss out on fun activities, job opportunities, relationships, and lots of other good stuff.

Poor relationships of all kinds. Non-assertive people are often unable to express emotions, positive or negative.

Physical complaints. Headaches, ulcers, high blood pressure. We all know what stress does to our bodies.

How to be Effectively AssertiveHow to be Effectively Assertive Use “I” statements. Use “I” statements. ExampleExample: “I’d” like to be able to : “I’d” like to be able to

tell my stories without interruption.” instead of tell my stories without interruption.” instead of “You’re always interrupting my stories!”“You’re always interrupting my stories!”

Use facts, not judgments. Use facts, not judgments. ExampleExample: “Your : “Your punctuation needs work and your formatting is punctuation needs work and your formatting is inconsistent.” instead of “This is sloppy work.” or inconsistent.” instead of “This is sloppy work.” or “Did you know that shirt has some spots?” instead of “Did you know that shirt has some spots?” instead of “You’re not going out looking like THAT, are you?”“You’re not going out looking like THAT, are you?”

Express ownership of your thoughts, feeling, Express ownership of your thoughts, feeling, and opinions. and opinions. ExampleExample: “I get angry when he : “I get angry when he breaks his promises.” instead of “He makes me breaks his promises.” instead of “He makes me angry.” or “ I believe the best policy is to…” angry.” or “ I believe the best policy is to…” instead of “The only sensible thing is to…”instead of “The only sensible thing is to…”

Make clear, direct, requests. Don’t invite the Make clear, direct, requests. Don’t invite the person to say no. Example: “Will you person to say no. Example: “Will you please…? Instead of “Would you mind…?” or please…? Instead of “Would you mind…?” or “Why don’t you…?”“Why don’t you…?”

Assertiveness among professional Assertiveness among professional nurses (1993)nurses (1993)

determine assertiveness levels of a population determine assertiveness levels of a population of professional nurses. The results revealed of professional nurses. The results revealed that this group of nurses was more assertive. that this group of nurses was more assertive. The oldest group of nurses (60-76 years) was The oldest group of nurses (60-76 years) was significantly less assertive than any of the significantly less assertive than any of the younger groups of nurses. Nurses practising younger groups of nurses. Nurses practising with a diploma as the highest level of with a diploma as the highest level of education were significantly less assertive than education were significantly less assertive than nurses having a baccalaureate or above. nurses having a baccalaureate or above.

Nurses' and midwives' assertive behaviour in the Nurses' and midwives' assertive behaviour in the workplace.(2005)workplace.(2005)

they were less accomplished at expressing their they were less accomplished at expressing their own opinions or making requests. Assertive own opinions or making requests. Assertive behaviours were used more frequently with behaviours were used more frequently with nursing/midwifery colleagues than with nursing/midwifery colleagues than with management/medical colleagues. Most used management/medical colleagues. Most used assertiveness skills with other grades of staff in assertiveness skills with other grades of staff in their own profession. Responsibility to their own profession. Responsibility to patients/clients emerged as a supporting factor for patients/clients emerged as a supporting factor for using assertive behaviour. Managers, the work using assertive behaviour. Managers, the work atmosphere and fear were viewed as obstacles.atmosphere and fear were viewed as obstacles.

What are the assertive rightsWhat are the assertive rights

You have the right to...You have the right to...1. 1. be treated with respectbe treated with respect2. express feelings, opinions2. express feelings, opinions3. put yourself first , for sometime3. put yourself first , for sometime4. determine your own priorities4. determine your own priorities5. ask for what you want5. ask for what you want

6. refuse without making excuses or 6. refuse without making excuses or feeling guiltyfeeling guilty7. make mistakes and be responsible for 7. make mistakes and be responsible for them.them.8. give and receive information as a 8. give and receive information as a professionalprofessional9. act in the best interest of the patient9. act in the best interest of the patient10. be human10. be human

Barriers to assertive skills in Barriers to assertive skills in nurses (1995)nurses (1995)

The results indicated that the 152 nurses The results indicated that the 152 nurses sampled considered themselves to have sampled considered themselves to have moderate to low assertiveness skills, and a moderate to low assertiveness skills, and a significant negative correlation was found significant negative correlation was found between the level of assertiveness and the between the level of assertiveness and the perception of barriers inhibiting assertive perception of barriers inhibiting assertive behaviour. The study concluded that behaviour. The study concluded that assertiveness training is needed for qualified assertiveness training is needed for qualified nurses nurses

RESPONSE PATTERNSRESPONSE PATTERNS ROLE MODELINGROLE MODELING REINFORCEMENTREINFORCEMENT INVENTING A RESPONSEINVENTING A RESPONSE NOT BEING ABLE TO THINKNOT BEING ABLE TO THINK NO PROPER SKILLNO PROPER SKILL CONSCIOUSLY CHOOSING RESPONSE CONSCIOUSLY CHOOSING RESPONSE

STYLESTYLE

Three Patterns of CommunicationThree Patterns of Communication

AggressiveAggressive

Nonassertive (Passive)Nonassertive (Passive)

AssertiveAssertive

Aggressive BehaviorAggressive Behavior

Directly standing up for personal rights and expressing thoughts and beliefs in a way which is often dishonest, usually inappropriate, and always violates the rights of the other person


Goals of Aggressive BehaviorGoals of Aggressive Behavior:: domination and winningdomination and winning forcing the other to loseforcing the other to lose

Winning is insured by humiliating, degrading, Winning is insured by humiliating, degrading, belittling, or overpowering other people so that they belittling, or overpowering other people so that they become weaker and less able to express and defend become weaker and less able to express and defend their needs and rightstheir needs and rights


Nonverbal intend to dominate other Eye contact that tries to stare down,

dominate the other Sarcastic, loud tone of voice Parental body gestures such as excessive

finger pointing

Reasons People Act AggressivelyReasons People Act Aggressively To get your point acrossTo get your point across Don’t know another way to get your point acrossDon’t know another way to get your point across For personal gain, controlFor personal gain, control To avoid your own personal responsibilityTo avoid your own personal responsibility Low self esteemLow self esteem Anger related to previous nonassertionAnger related to previous nonassertion Don’t have other coping mechanismsDon’t have other coping mechanisms Reacting to another’s aggressionReacting to another’s aggression

Consequences of AggressionConsequences of Aggression The other person gets defensive Get rid of anger or other emotions Lose friendships, other intimate

relationships, damage relationships Affect work, lose job Lose respect

Nonassertive BehaviorNonassertive Behavior

Violating your own rights by failing to express honest feelings, thoughts, and beliefs and consequently permitting others to violate you

Nonassertive BehaviorNonassertive Behavior Goals of nonassertive behavior:Goals of nonassertive behavior:

to appease othersto appease others to avoid conflict at any costto avoid conflict at any cost

Message communicated:Message communicated: My thoughts aren’t important; I don’t countMy thoughts aren’t important; I don’t count I’m nothing; you are superiorI’m nothing; you are superior I don’t respect your ability to take I don’t respect your ability to take

disappointments, handle your own problems. . .disappointments, handle your own problems. . .

Nonassertive BehaviorNonassertive Behavior

Evasive eye contact Body gestures such as stepping back from the

other, hunching shoulders, covering the mouth, nervous gestures

Voice tone may be singsong or overly soft Hesitant speech pattern, nervous laughter Gestures which convey weakness, anxiety

Reasons People Act NonassertivelyReasons People Act Nonassertively

Avoid confrontation Personality Fear of hurting the other person Fear of rejection, losing the other person Avoid aggression Self esteem Lack of skills Cultural differences

Consequences of NonassertionConsequences of Nonassertion Not getting your point across Nothing changes, problems can get worse Damages self esteem Can lead to aggressive behavior Other people can take advantage of you

Passiveness may involve…• Flight• Possibly respecting others’ rights while

ignoring your own rights.• Not communicating directly when the

situation warrants it.• Allowing others to “walk on” or control

you.• Allowing your boundaries to be violated.

Passive-Aggressiveness • Fight-Flight pattern.• Either respecting ONLY your rights

OR other’s rights.• Not addressing the problem or

behavior.• Talking about people behind their

back/Gossip• Fluctuating between violating others’

boundaries or having your boundaries violated.

Assertive BehaviorAssertive Behavior

Standing up for personal rights and expressing thoughts, feelings and beliefs in direct, honest, and appropriate ways which do not violate another person’s rights

Assertive BehaviorAssertive Behavior Goals of Assertive Behavior--

to get and give respect to ask for fair play to leave room for compromise when the

needs and rights of two people conflict to communicate and develop mutuality

in relationships


Involves respect, not deference Two types of respect:

respect for oneself respect for the other person’s needs and

rights


Basic Message:This is what I thinkThis is what I feelThis is how I see the situation

This message expresses who the person is and is said without dominating, humiliating, or degrading


Assertive Behavior is NOT:

simply a way to get what you wantmanipulativeaggressive irresponsible

Assertive Behavior Assertive Behavior

Nonverbals are congruent with verbals Voice is appropriately loud to the situation Eye contact is firm but not a stare down Body gestures denote strength Speech pattern is fluent, expressive, clear,

and emphasizes key words

Behavioral components…..Behavioral components….. Eye contact Body posture Physical contact Gestures Facial expression Voice

Continues…..Continues….. Fluency Timing Listening Thoughts Content

Special Techniques for Difficult Special Techniques for Difficult SituationsSituations

Broken recordBroken record. Keep repeating your . Keep repeating your point, using a low-level, pleasant point, using a low-level, pleasant voice. Don’t get pulled into arguing voice. Don’t get pulled into arguing or trying to explain yourself.or trying to explain yourself.

Eg: repeatingEg: repeating

Fogging. This is a way to deflect negative criticism. You agree with some of the fact, but you retain the right to choose your behavior.

Eg: agreeing but not changing

Standing up for one’s basic human right

Eg: I have the right Assuming responsibility for one’s

own statements Agreeing assertively Enquiring assertively

Content to Process Shift. When someone is trying to confuse the issue. Stop talking about the problem and bring up how the person is behaving right now. Example: “You’re getting off the point. I’m starting to feel frustrated because I feel like you’re not listening.

Defusing. Letting someone cool down before discussing an issue. Example: “I can see that you’re upset. Let’s talk about this later.” Also, if they try to stay with it, you have the right to walk away..

Summarization. This helps to make sure you’re understanding the other person. Example: “So what you’re trying to tell me is …”

Specificity. It’s really important to be very clear about what you want done. This helps prevent distractions

Thought stopping tehniquesThought stopping tehniques

Negative thoughts Shout loud: STOP

As people practice assertive communication, As people practice assertive communication, you can almost see that little spark of self-you can almost see that little spark of self-respect glimmer, flicker, take hold, and burst respect glimmer, flicker, take hold, and burst into flame.into flame.

People can sense it when you respect yourself, People can sense it when you respect yourself, and they will treat you with respect. And that and they will treat you with respect. And that is the ultimate goal of assertive is the ultimate goal of assertive communication.communication.

What is the behavior of an What is the behavior of an assertive nurseassertive nurse

-appears self-confident and composed-maintains eye contact-uses clear, concise speech-speaks firmly and positively-speaks genuinely, without sarcasm-is non-apologetic-takes initiative to guide situations-gives the same message verbally and nonverbally

What are the advantages of What are the advantages of assertive communication? assertive communication?

-get what you want when you clearly ask for it-get what you want when you clearly ask for it-people respect clear, open, honest, communication-people respect clear, open, honest, communication-stand up for your own rights and feel self-respect-stand up for your own rights and feel self-respect-avoid the invitation of aggression when the rights -avoid the invitation of aggression when the rights of others are violated.of others are violated.-more independent-more independent-you become a decision-maker-you become a decision-maker-you feel more peaceful and comfortable with -you feel more peaceful and comfortable with yourselfyourself

What constitutes responsible What constitutes responsible communication for a nurse?communication for a nurse?

-focus on the nursing process and problem--focus on the nursing process and problem-solving processsolving process-considers the world of the client and the -considers the world of the client and the client's familyclient's family-is a client advocate-is a client advocate-open to trusting intuition-open to trusting intuition-treats each person as an individual-treats each person as an individual

APPLICATION…….APPLICATION…….Several research studies have identified assertiveness Several research studies have identified assertiveness

training as a useful tool in the prevention of alcohol-use training as a useful tool in the prevention of alcohol-use disorders.disorders.[16][16]Psychological skills in general including Psychological skills in general including assertiveness and social skills have been posed as assertiveness and social skills have been posed as intervention for a variety of disorders with some intervention for a variety of disorders with some empirical support.empirical support.[17][17]

In connection with gender theory, "Tannen argues that In connection with gender theory, "Tannen argues that men and women would both benefit from learning to men and women would both benefit from learning to use the others' style. ... So, women would benefit from use the others' style. ... So, women would benefit from assertiveness training just as men might benefit from assertiveness training just as men might benefit from sensitivity training".sensitivity training".[18][18]

Evaluating the effect of self-awareness and Evaluating the effect of self-awareness and communication techniques on communication techniques on

nurses'assertiveness and self-esteem (2012)nurses'assertiveness and self-esteem (2012) A significant difference A significant difference

between assertiveness and self-esteem scores. between assertiveness and self-esteem scores. There was a positive relationship between There was a positive relationship between assertiveness and self-esteem. The course assertiveness and self-esteem. The course lasted 14 weeks for a total of 3 h per week. The lasted 14 weeks for a total of 3 h per week. The teaching methods focused mostly on active teaching methods focused mostly on active student participation, demonstration, role play, student participation, demonstration, role play, experience and experience sharing, homework, experience and experience sharing, homework, constructive feedback, and watching films. constructive feedback, and watching films.

The effects of assertiveness training in patients with The effects of assertiveness training in patients with schizophrenia (2013)schizophrenia (2013)

(1) assertiveness significantly improved from (1) assertiveness significantly improved from pre- to post intervention and was maintained pre- to post intervention and was maintained until the follow-up; (2) anxiety regarding until the follow-up; (2) anxiety regarding social interactions significantly decreased social interactions significantly decreased after assertiveness training; and (3) satisfaction after assertiveness training; and (3) satisfaction with interpersonal communication slightly with interpersonal communication slightly improved after the 12-session intervention and improved after the 12-session intervention and at the 3-month follow-up.at the 3-month follow-up.

Criticism…………..Criticism…………..

Some authors stress that assertiveness is not always Some authors stress that assertiveness is not always practiced in a balanced way, especially by those new to practiced in a balanced way, especially by those new to the process: "[One] problem with the concept of the process: "[One] problem with the concept of assertiveness is that it is both complex and situation-assertiveness is that it is both complex and situation-specific. ... Behaviors that are assertive in one specific. ... Behaviors that are assertive in one circumstance may not be so in another".circumstance may not be so in another".[19][19] More More particularly, while "unassertiveness courts one set of particularly, while "unassertiveness courts one set of problems, over-assertiveness creates problems, over-assertiveness creates another."another."[20][20] Assertiveness manuals recognize that Assertiveness manuals recognize that "many people, when trying out assertive behaviour for "many people, when trying out assertive behaviour for the first time, find that they go too far and become the first time, find that they go too far and become aggressive."aggressive."[21][21]

assertiveness

Healthcare