Assertiveness

Define Assertiveness:

• A direct, honest expression of ideas, opinions, and desires.
• The intent of assertive behaviour is to show an atmosphere of trust
• Assertive individuals initiate communication in a way that shows respect toward others
• You cannot simply force others to change you have to change yourself/ how you react
• Skills needed in assertive communication
  • Initiating and maintaining a conversation
  • Responding appropriately to negative criticism
  • Give negative feedback gracefully
  • Express appreciation
  • Make requests
  • Refuse requests
  • Convey confidence
  • Express opinions appropriately

Passive Behavior

• Avoiding conflict at all cost
• Passive people may not share their opinions if they disagree with someone else
• Are not the ones to initiate conversation
• Passive-aggressive
  • When they show a happy/ encouraging front but when they turn around are angry and resentful

Aggressive Behavior

• People who have to “win” conversations
• They work to intimidate others
• Such have a short fuse and a long tolerance for frustration
• They bully their way into getting what they want

Theoretical Foundations

• Cognitive Theories show that people respond because they have irrational beliefs that interfere with assertiveness

  • Fear of rejection or anger from others and need for approval (everyone should

  and approve of what I do)

  • Overconcern for the needs and rights of others (I should always try to help o

  be nice to them)

  • Beliefs that problems with assertiveness are due to unalterable personality chara and are, therefore, unchangeable (this is just who I am)
  • Perfectionist standards (I must be perfectly competent. If I am not, then I am a failure)

• These fears are irrational and lead to unnecessary conflicts and anxiety

• Cognitive restructuring teaches people to identify self-defeating thoughts and change them to more reasonable thoughts

Assertiveness Techniques

Providing Feedback

• Feedback focuses on a person's behavior rather than personality.
  • Focus on what the person can change
• Feedback is descriptive rather than evaluative.
  • Describing what was said or done is less threatening than judging why it was done.
• Feedback focuses on your own reactions rather than the other person's intentions.
• Assigning "blame" is not part of constructive feedback.
• Feedback uses "I" statements to show how you feel instead of pointing out and making accusations
• Feedback is specific rather than general.
  • It focuses on behavior that has just occurred and avoids dragging in past behavior.
• Feedback focuses on problem-solving.
• The intent is to solve a problem in a relationship so that the relationship can be improved.
• Feedback is provided in a private setting.

Inviting feedback from Others

• Be able to admit to your mistakes
• Do not act negatively to feedback
• Encourage constructive criticism
• Two common beliefs
  • Everyone has to like us
  • We can never make mistakes
• Since it is impossible not to make mistakes and for everyone not to like us we see ourselves as failures we get defensive and take it personally

Make Request

• If we can say no so can they
• Try not to overreact

Setting Limits

• Learn to say no
• Know how much you can handle and stop there
• Be persistent
  • If you say no do not be coaxed into changing your mind
• Stay calm

Assertiveness and Patients

• Most important assertive skill in relating to patients is YOUR WILLINGESS TO INITIATE COMMUNICATION.
• Encouraging patients to be more assertive is also important to improve your communication with them.
• Responding to an angry or critical patient
  • Keep in mind that their feelings of hostility may be greatly magnified by the life stressors they are experiencing.
  • Try to understand what it is like for them and respond empathically.
• Another skill useful in responding to patient criticism is to get the patient to turn criticism into useful feedback.
• If a patient persists in aggressive behavior in spite of your efforts to focus on understanding and problem-solving, you will want to set limits without becoming aggressive.

Assertiveness and other Health Care Professionals

• If you determine you need to speak directly with a doctor, you will be most effective if you are persistent with the receptionist or nurse.
• Need to show respect towards other healthcare professionals but you need to be persistent in stating your request.
• When you are identifying potential problems, you should be prepared to identify alternatives to resolve the problem.
• Your duty to the patients’ best interests always comes first

Assertiveness and Employers

• Sometimes you will need to be assertive with your supervisor/boss.
• Sometimes your supervisor will not share the professional identity or ethical standards we hold for patient care.
• For some of us the first response to criticism is to counterattack.
• Neither a passive nor aggressive response is helpful in this situation.
  • Assertiveness will allow for problem-solving.
  • When you are being criticized, it is important to distinguish between:
• The truths people tell you about your behavior,
  • The judgment that they attach to your behavior.
• When you are being criticized filter through the truth and the opinions
  • Use the truth to improve yourself
• How to respond to criticism
  • Getting useful feedback,
  • Find out exactly what lead to the criticism. This may be useful to you improving your performance.
  • Agreeing with criticism: Acknowledge the mistake.
• Disagreeing with criticism: If you consider the criticism unreasonable, it is important to state your disagreement and why.
• Fogging: Acknowledging the truth or possible truth in what people tell you about yourself while ignoring completely any judgments they might have implied.
• Delaying a response: If the criticism takes you by surprise and you are confused about how to respond, give yourself time to think about the problem before you respond.