Assertiveness Training

B. I'm so sorry. I only have enough to pay for my own lunch today

A fellow worker often borrows small amounts of money from you with the promise that she will pay you back "tomorrow." She currently owes you 15$ and has not yet paid back any that she has borrowed. She asks if she can borrow a couple of dollars for lunch. Which of the following is an example of a nonassertive response? A. I've decided not to loan you any more money until you pay me back what you already borrowed B. I'm so sorry. I only have enough to pay for my own lunch today C. Get a life will you? I'm tired of you sponging off me all the time! D. Sure, here's 2$ (then to the other workers in the office, you say "Be sure you never lend Cindy any money. She never pays her debts. I'd be sure never to go to lunch with her if I were you!")

C. You've got to be kidding! What kind of a fool do you take me for anyway?!

A typewritten report for your psychiatric nursing class is due tomorrow at 8am. The assignment was made 4 weeks ago, and yours is ready to turn in. Your roommate says, "I finally finished writing my report, but now I have to go to work, and I don't have time to type it. Please be a dear and type it for me. Otherwise, I'll fail!" You have a date with your boyfriend. Which of the following is an example of an aggressive response? A. Okay, I'll call Ken and cancel our date B. I don't want to stay here and type your report. I'm going out with Ken C. You've got to be kidding! What kind of a fool do you take me for anyway?! D. Okay, I'll do it. (however, when your roommate returns from work at midnight, you are asleep and the report has not been typed.

C. Excuse me. I would like to finish my statement

At a hospital committee meeting, a fellow nurse who is the chairperson has interrupted you each time you have tried to make a statement. The next time it happens, you intend to respond assertively. Which of the following is an example of an assertive response? A. You make a lousy leader. You won't even let me finish what I'm trying to say! B. You say nothing C. Excuse me. I would like to finish my statement D. You say nothing, but you fail to complete your assignment and do not show up for the next meeting

Passive-Aggressive Behavior

Characteristics of ____ Behavior: · Passive aggressive (covert or indirect aggression) behavior is shows when individuals respond to others by appearing passive and accepting of other's demands while behaving in ways the suggest anger and resentment of their true feelings. · Indirect · Dishonest · Manipulative · Sly · Undermines others with behavior that expresses the opposite of what they are feeling · Allow others to make choices for them then resist by procrastinating or "forgetting" · Respond to others by appearing passive · Behave in ways that suggest anger or resentment · Associated with low self-confidence

Assertive Behavior

Characteristics of _____ Behavior · Stand up for own rights · Protect the rights of others and their own rights · Assume accountability for their own choices and allow others to choose for themselves · Maintain self-respect and respect for others by treating everyone equally · Tactful in approaching/communicating with people · Communicate effectively, using "I" statements · Voices are warm and expressive · Eye contact is direct · Self-confident · Satisfactory relationships with friends, coworkers, significant others, etc.

Aggressive Behavior

Characteristics of _____ Behavior: · Defend own basic rights (what they want, when they want) by violating rights of others · May be dishonest or inappropriate (can be very manipulative) · Devalue the self-worth of others (tear others down, making their problems a priority) · Superior, voices are loud, demanding, angry, cold, or emotionless · Use eye contact and posture to intimidate · Increase feelings of power by dominating/humiliating others · Hinders interpersonal relationships (changing significant others frequently, few friends)

Passive (Nonassertive) Behavior

Characteristics of ________ Behavior : · Individuals who are ____ seek to please others at the expense of their own basic rights. · Seldom show true feelings (often in fear of angering/upsetting others) · May not achieve goals · Apologetic, saying "sorry" a lot · Uncomfortable in interpersonal interactions · Avoid confrontation although they harbor feelings of anger/resentment · Use actions instead of words and hope someone will "guess" what they want · Voices are hesitant, weak, and monotone

· Teach clients to increase assertive response · Compose a list of personal examples of situations that create difficulties for them · Role play the situations in a therapy setting so the client can practice assertive responding · Ensure the client is aware of the different among assertive, aggressive, passive, and passive aggressive behavior. Discuss the different types of responses and why the assertive response is best Provide emotional support

Nursing Interventions to Promote Assertive Behavior:

Know your own response patterns. · The nurse who is competent in assertive behavior can assist clients in mastering the behavior. · Assertiveness skills have proven beneficial in reducing depression and improves self-esteem.

Role of the Nurse in Assertiveness Training:

Assertive Behavior

Techniques That Promote ______: · Standing up for one's basic human rights · Assuming responsibility for one's own statements · Responding as a broken record: persistently repeating in a calm voice · Agreeing assertively: accepting negative aspects about oneself and admitting when errors are made · Inquiring assertively: seeking additional information about critical statements · Shifting from content to process: changing the focus of the communication from discussing the topic at hand to analyzing what is actually going on in the interaction · Clouding or fogging: concurring with the critic's argument without becoming defensive and without agreeing to change. · Defusing: putting off further discussion with an angry person until the other person is calmer · Delaying assertively: putting off further discussion with another person until one is calmer · Responding assertively with irony · Using "I" statements

· The right to be treated with respect. · The right to express feelings, opinions, and beliefs (not be fearful of bad treatment due to their beliefs) · The right to say "no" without guilt · The right to make and accept responsibility for mistakes · The right to be heard and taken seriously · The right to change your mind · The right to ask for what is wanted (can be difficult for women) · The right to put self first (can be difficult for women) · The right to set priorities · The right to refuse justification for feelings/behavior

Ten Basic Human Rights Related to Assertiveness (Assertive Rights):

A. I'm very disappointed and very angry. I'd like to talk to you about this later. I'll call you

You and your best friend, Jill, have had plans for 6 months to go on vacation together to Hawaii. You have saved your money and have plane tickets to leave in 3 weeks. She has just called you and reported that she is not going. She has a new boyfriend, they are moving in together, and she does not want to leave him. You are very angry with Jill for changing your plans. Which of the following is an example of an assertive response? A. I'm very disappointed and very angry. I'd like to talk to you about this later. I'll call you B. I'm very happy for you Jill. I think its wonderful that you and Jack are moving in together. C. You tell Jill that you are very happy for her, but then say to a friend, "Well, that's the end of my friendship with Jill!" D. What? You can't do that to me! We've had plans! You're acting like a real slut!

D. Okay, if I'm really needed, I'll serve

You are asked to serve on a committee on which you do not wish to serve. Which of the following is an example of a non-assertive response? A. Thank you but I do not wish to be a member of that committee B. I'll be happy to serve. (but then you don't show up for any meetings) C. I'd rather have my teeth pulled D. Okay, if I'm really needed, I'll serve

A. "I don't do windows!" And slam the door in his face

You are having company for dinner, and they are due to arrive in 20 minutes. You are about to finish cooking and still have to shower and dress. The doorbell rings and it is a man selling a new product for cleaning windows. Which of the following is an example of an aggressive response? A. "I don't do windows!" And slam the door in his face B. "I'll take a case." And write him a check C. "Sure, I'll take three bottles." Then to yourself think "I'm calling this company tomorrow and complaining to the manager about their salespeople coming around dinnertime! D. "I'm very busy at the moment. I don't wish to purchase any of your product. Thank you."

B. Pease put your cigarette out. Smoking is prohibited

You are in a movie theater that prohibits smoking. The person in the seat next to you just lit a cigarette and the smoke is very irritating. Which of the following is an example of an assertive response? A. You say nothing B. Pease put your cigarette out. Smoking is prohibited C. You say nothing but begin to frantically fan the air in front of you and cough loudly and convulsively D. Put your cigarette out, you slob! Can't you read the 'no smoking' sign?

A. "I'm sorry. I'll have it done in no time, honey." But then you move very slowly and take a long time to cook the meal

You have been studying for a nursing exam all afternoon and lost track of time. Your husband expects dinner on the table when he gets home from work. You have not started cooking yet when he walks in the door and shouts, "Why the heck isn't dinner ready yet?" Which of the following is an example of a passive-aggressive response? A. "I'm sorry. I'll have it done in no time, honey." But then you move very slowly and take a long time to cook the meal B. I'm tired from studying all afternoon. Make your own dinner, you bum! I'm tired of being your slave! C. I haven't started dinner yet. I'd like some help from you. D. I'm so sorry. I know you're tired and hungry. It's all my fault. I'm such a terrible wife!

A. I'm on my way to the Celtics game. Where do you think I'm going?

You're on your way to the laundry room when you encounter a fellow dorm tenant who often asks you "to throw a few of my things in with yours." You view this as an imposition. He asks you where you're going. Which of the following is an example of a passive-aggressive response? A. I'm on my way to the Celtics game. Where do you think I'm going? B. I'm on my way to do some laundry. Do you have anything you want me to wash with mine? C. Its none of your dang business! D. I'm going to the laundry room. Please don't ask me to do some of yours. I resent being taken advantage of in this way.

C. You're probably right. Maybe I should reconsider.

Your husband says, "You're crazy to think about going to college! You're not smart enough to handle the studies and the housework, too." Which of the following is an example of a nonassertive response? A. I will do what I can and the best that I can B. (Thinking to yourself): We'll see how he likes cooking dinner for a change C. You're probably right. Maybe I should reconsider. D. I'm going to do what I want to do, when I want to do it, and you can't stop me!

Assertive behavior

___ : this behavior promotes equality in human relationships, enabling us to act in our own best interests, to stand up for ourselves without undue anxiety, to express honest feelings comfortably, and to exercise personal rights without denying the rights of others

Distance

___: Invading personal space can be interpreted as aggressive and should be avoided; this is a concept of assertive behavior

Fluency

___: the ability to discuss a subject with ease and obvious knowledge conveys assertiveness and self-confidence. This is conveyed by pauses or fillers, like "and, uh"; this is a concept of assertive behavior

Facial Expression

___: the facial expression should be congruent with verbal message; this is a concept of assertive behavior

Voice

___: the voice should convey an acceptable volume to communicate confidence without being too loud or forceful (should be level, calm) this is a concept of assertive behavior

Gestures

___: these add emphasis, warmth, depth, or power to the spoken word; this is a concept of assertive behavior;

Posture

___: this is a concept of assertive behavior; sitting, leaning slightly toward the individual suggests interest in the interaction. Emphasis on assertive stance can be achieved by standing with an erect posture squarely facing the other person. -If the client is leaning back, away from you, it can indicate that you are too close and they are uncomfortable

Eye contact

___: this is a concept of assertive behavior; this is appropriate when intermittent because continuous staring can make someone uncomfortable

Content

____: "I" statements to describe feelings and needs. Defensive (nonassertive) statements tend to use "you" more ("You don't respect me"); this is a concept of assertive behavior;

Thoughts

____: assertive communication is supported by a belief that being assertive is a reasonable, appropriate, and healthy way to communicate

Listening

____: giving the other individual full attention by making eye contact, nodding to indicate acceptance of what is said, and taking time to understand the message before responding; this is a concept of assertive behavior

Persistence

____: this involves maintaining confidence and commitment to one's needs and feelings even when someone is pressuring the individual to cave in to demands. It often means repeating a stated feeling or need in an effort to be heard and respected. this is a concept of assertive behavior

Timing

_____: assertive responses are most effective when spontaneous and immediate. "It is never too late to be assertive."; this is a concept of assertive behavior

Thought stopping techniques

· Individuals with mental health issues frequently have negative thoughts of self. EX: "I just can't seem to do anything right!" · ____ are techniques are meant to eliminate/minimize intrusive and unwanted thoughts: -Client closes eyes. -Focuses on negative thought. -Shouts, "Stop!" (After some time, the client can do this silently in their mind). -This interrupts the thought. -The client immediately replaces with a positive thought.