Assertiveness Training
· Assertive behavior
o Promotes equality in human relationships and enables us
o To act in our own best interests
o To stand up for ourselves without undue anxiety
o To express honest feelings comfortably
o To exercise personal rights without denying the rights of others
· Basic Human Rights
o The right to be treated with respect
o The right to express feelings, opinions, and beliefs
o The right to say “no” without feeling guilty
o The right to make mistakes and accept responsibility for them
o The right to be listened to and taken seriously
o The right to change your mind
o The right to ask for what you want
o The right to put yourself first, sometimes
o The right to set your own priorities
o The right to refuse justification for your feelings or behavior
· Response Patterns
o Individuals develop patterns of responding to others by:
o Watching other people (role-modeling)
o Being positively reinforced or punished for a certain response
o Inventing a response
o Not thinking of a better way to respond
o Not developing the proper skills for a better response
o Consciously choosing a response style
· Types of response Patterns
o Nonassertive behavior
o Assertive behavior
o Aggressive behavior
o Passive-aggressive behavior
· Two patients disagree on what movie to watch during free activity time. One patient says to the other, “I would like to watch the comedy instead of the murder mystery.” The nurse recognizes this as which form of communication response pattern?
o Nonassertive
o Assertive
o Aggressive
o Passive-Aggressive
· Behavioral Components of Assertive Behavior
o Characteristics of assertive behavior:
o Intermittent eye contact
o Body posture
o Distance/physical contact
o Gestures
o Facial expression
o Voice
o Fluency
o Timing
o Listening
o Thoughts
o Content
o Persistence
· A nurse is conducting an assertiveness training class. Which of the following characteristics of assertive behavior should the nurse include?
o Eye contact should be steady and continuous.
o Invasion of intimate space can be interpreted as assertive behavior.
o While interacting, individuals should turn slightly away from the other person.
o The facial expression is congruent with the verbal message.
· Techniques that Promote Assertive Behavior
o Standing up for one’s basic human rights
o Assuming responsibility for own statements
o Responding as a “broken record”
o Agreeing assertively
o Inquiring assertively
o Shifting from content to process
o Clouding or fogging
o Defusing
o Delaying assertively
o Responding assertively with irony
o Using “I” statements
· Thought-Stopping Techniques
o Developed by psychiatrist Joseph Wolpe
o Intended to eliminate intrusive, unwanted thoughts
· Role of the Nurse
o Nurses must understand and use assertive skills to effect change that will improve the status of nursing and the system of health-care provision.
o Nurses who understand and use assertiveness skills can assist patients who wish to effect behavioral change in an effort to increase self-esteem and improve interpersonal relationships.
o Assertive communication is part of a larger set of competencies called emotional intelligence (EI):
o Four sets of competencies:
§ Self-awareness
§ Social awareness
§ Self-management
§ Relationship management
· Clinical pearl
o An important part of this type of intervention is to ensure that clients are aware of the differences among assertive, nonassertive, aggressive, and passive-aggressive behaviors in the same situation.
o When discussion is held about what the best (assertive) response would be, it is also important to discuss the other types of responses as well, so that clients can begin to recognize their pattern of response and make changes accordingly.