TECHNIQUES THAT PROMOTE

ASSERTIVE BEHAVIOR

By:- Firoz Qureshi Dept. Psychiatric Nursing

DEFINITIONS OF ASSERTIVENESS Assertiveness is the ability to express your

emotions and needs without violating the rights of others and without being aggressive.

Assertiveness is the act of asking for what you want in a confident way that harms no one but in the same time preserves your rights.

TECHNIQUES THAT PRAMOTE ASSERTIVE BEHAVIOR

The following techniques have been shown to be effective in responding to criticism and avoiding manipulation by others.

1- Standing up for one’s basic human rightsEXAMPLE:

“I have the right to express my opinion.”

2- Assuming responsibility for one’s own statements.

EXAMPLE:“ I don’t want to go out without you tonight”, instead

of “ I can’t go out with you tonight.” The latter implies a lack of power or ability.

3- Responding as a “broken record.” Persistently repeating in a calm voice what is wanted.

EXAMPLE:Telephone salesperson: “I want to help you to save

money by changing long-distance services.”

Assertive response: “I don’t want to change my long-distance service.”

Telephone salesperson: “I cant believe you don’t want to save your money.”

Assertive response: “I don’t want to change my long-distance service.”

4- Agreeing assertively. Assertively accepting negative aspects about oneself; admitting when an error has been made.

EXAMPLE:Ms. Jones: “You sure let the meeting get out of the

hand. What a waste of time.”

Ms. Smith: “Yes, I didn’t do a very good job of conducting the meeting today.”

5- Inquiring assertively. Seeking additional information about critical statements.

EXAMPLE:Male board member: “You made me real fool of

yourself at the board meeting last night.”Female board member: “Oh really? Just what about

my behaviour offended you?”Male board member: “You were so damned pushy”Female board member: “Were you offended that I

spoke up for my beliefs, or was it because my beliefs are in direct opposition to yours?”

6- Shifting from content to process. Changing the focus of the communication from discussion the topic at hand to analyzing what is actually going on in the interaction.

EXAMPLE:Wife: “Would you please call me if you will be late

for dinner?”Husband: “Why don’t you just get off my back! I

always have to account for every minute off my time with you!”

Wife: “Sounds to me like we need to discuss some other things here. What are you really angry about?”

7- Clouding/fogging. Concurring with the critic’s argument without becoming defensive and without agreeing to change.

EXAMPLE:Nurse- 1: “You never come to the nurse’s

association meetings. I don’t know why you even belong!”

Nurse- 2: “You’re right. I haven’t attended very many of the meetings.”

8- Defusing. Putting off further discussion with an angry individual until he or she is calmer.

EXAMPLE:“You are very angry right now. I don’t want to

discuss this matter with you while you are so upset. I will discuss it with you in my office at 3 o’clock this afternoon.”

9- Delaying assertively. Putting off further discussion with another individual until one calmer.

EXAMPLE: “That’s a very challenging position you have taken, Mr. Brown. I’ll need time to give it some thought. I’ll call you later this afternoon.”

10- responding assertively with irony.EXAMPLE:Man: “I bet you’re one of them so called ‘women’s

libbers,’ aren’t you?”Woman: “Why, yes. Thank you for noticing.”

BEHAVIORAL COMPONENTS OF

ASSERTIVE BEHAVIOR

Alberti and Emmons (2001) have identified several defining characteristics of assertive behavior:

1- Eye contact. Eye contact is considered appropriate when it is intermittent (i.e., looking directly at the person to whom one is speaking but looking away now and then). Individual feel uncomfortable when someone stares at them continuously and intently.

2- Body posture. Sitting and leaning slightly towards the other person in a conversation suggest an active interest in what is being said. Emphasis on an assertive stance can be achieved by standing with an erect posture, squarely facing the other person.

3- Distance/physical contact. The distance between two individual in an interaction or the physical contact between them has a strong cultural influence.

4- Gestures. Nonverbal gesture may also be culturally related. Gesturing can add emphasis, warmth, depth, or power to the spoken word.

5- Facial expression. Various facial expression convey different messages (e.g., frown, smile, surprise, anger, fear). It is difficult to “Fake” these messages.

6- Voice. The voice conveys a message by its loudness, softness, degree and placement of emphasis, and evidence of emotional tone.

7- Fluency. Being able to discuss a subject a subject with ease and with obvious knowledge conveys assertiveness and self-confidence.

8- Timing. Assertive responses are most effective when they are spontaneous and immediate. However, most people have experienced time when it was not appropriate to respond.

9- Listening. Assertive listening means giving the other individual full attention, by making eye contact, nodding to indicate acceptance of what is being said, and taking to understand what is being said before giving a response.

10- Thoughts. Cognitive processes affect one’s assertive behavior. Two such process are

i. An individual’s attitudes about the appropriateness of assertive behavior in general and

ii. the appropriateness of assertive behavior for himself or herself specially.

11- Content. Many times individuals do not respond to an unpleasant situation because “I just didn’t know what to say.” Perhaps what is being said is not as important as how it is said. Emotions should be expressed when they are experienced.

THOUGHT-STOPPING TECHNIQUES

Assertive thinking is sometimes inhibited by repetitive, negative thoughts of which the mind refuses to let go. Individuals with low self-worth may be obsessed with thought such as, “I know he’d never want to go out with me. I’m too ugly” or “I just know I’ll never be able to do this job well” or “I just can’t seem to do anything right.” this type of thinking fosters the belief that one’s individual rights do not deserve the same considration as those of others, and reflects non-assertive communication and behavioral response patterns.

METHODIn a practice setting, with eye closed the individual

concentrates on an unwanted recurring thought. Once the thought is clearly established in the mind, he or she shouts aloud: “STOP!” This action will interrupt the thought, and it is actually removed from one’s awareness. The individual then immediately shifts his or her thoughts to one that is considered pleasant and desirable.

After a number of practice session, the technique is equally effective if the word “STOP!” is used silently mind.

ROLE OF THE NURSE

It is important for nurses to become aware of and recognize their own behavioral responses. The nursing process is a useful tool for nurses who are involved in helping clients increase their assertiveness.

ASSESSMENTNurses can help client become more aware of

their behavioral responses. Many tools for assessing the level of assertiveness have been attempted over the years. None have been very effective. Perhaps this is because it is so difficult to generalize when attempting to measure assertive behaviors.

DIAGNOSISPossible nursing diagnoses for individuals needing

assistance with assertiveness includes:1. Coping, defensive 2. Coping, ineffective 3. Decisional conflict 4. Denial ineffective 5. Personal identity, disturbed 6. Powerlessness 7. Rape-trauma syndrome8. Self esteem, low9. Social interaction, impaired10. Social isolation

OUTCOME IDENTIFICATION/IMPLEENTATIONThe goal for nurses working with individuals

needing assistance with assertiveness is to help them develop more satisfying interpersonal relationships. Out come criteria would be derived from specific nursing diagnosis.

In the clinical setting nurse can teach clients the techniques to use to increase their assertive responses. This can be done on a one-to-one basis or in group situations.

EVALUATIONEvaluation requires that the nurse and client assess

whether or not these techniques are achieving the desired outcomes. Assertiveness training serves to extend and create more flexibility in an individual’s communication style so that he or she has a greater choice of responses in various situations.

THANK YOU