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.

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