Assertiveness

PRESENTER: MAYANK DABRAL (Msc 1st year)

MODERATOR: RAJRATAN GUPTA

Moderator : Mr. RajrataGupta

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OBJECTIVES:

GENERAL: At the end of the seminar, group will understand and apply
this knowledge in clinical as well as in educational settings

SPECIFIC:
On completion of seminar, students will be able to:
•Introduce the topic
•Define Assertiveness.
•Discuss the Assertiveness rights and responsibilities.
•Explain about normal Assertiveness communication
•Describe the aggressiveness response.

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•Explain the behaviour complication of assertiveness
behaviour.
•Discuss the advantages and disadvantages of
Assertiveness behaviour.
•Enumerate the techniques of assertiveness therapy.
•Explain research findings.
•Elaborate assertiveness training.
•Discuss the conclusions.
•Explain the nursing implications in assertiveness
therapy.
•Summarize the topic.

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 Doyou say “Yes” when you mean
“no” ?

 Doyou keep your opinions to

yourself for fear of upsetting or
having an arguement with others?

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 Find out if you stand up for

yourself as much as you should ?

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Introduction
 Assertiveness is a behavioral skill taught by
many personal development experts, behavior
therapists, and cognitive behavioral therapists

 Assertiveness is a particular mode

of communication and is often linked to self-
esteem

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Definition
 Assertiveness is the ability to communicate
your needs, feelings, opinions, and beliefs in
an open and honest manner without violating
the rights of others
 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.

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Definition (cont…)

 A form of behavior characterized by a confident

declaration or affirmation of a statement without need
of proof; this affirms the person's rights or point of
view without either aggressively threatening the
rights of another (assuming a position of dominance)
or submissively permitting another to ignore or deny
one's rights or point of view
(Dorland's Medical Dictionary)

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Definition
 Aiberti and Emmons(1990) defines assertive
behaviour as “Behaviour that enables
individuals to act in their own best
interests,to stand up for themselves without
undue anxiety,to express their honest
feelings comfortably,or to exercise their own
rights without denying the rights of others.”

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AsstAssertiveness is…
 Respect for yourself and others.
 Honestly expressing your thoughts, feelings,
and beliefs.
 Effectively influencing, listening, and
negotiating with others
 Saying “yes” when you want to and “no” when
you mean no
 Being confident in handling conflict when it
occurs

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AsstAssertiveness is…
 Being able to talk openly about yourself and
being able to listen to others
 Having confident,open body language
 Being able to receive positive and negative

feedback
 Positive ,optimistic outlook and expressing

positive and negative emotions

 Being firm so that your rights are respected
 Refusing others request if they are too

demanding

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Ass Assertiveness is not ….
 It is important to remember that
assertiveness is not aggressiveness or
selfishness.
 Being assertive does not involve
humiliating or abusing other people and
their rights.
 Being assertive does not mean violating
the rights of others or gaining at the
expense of some one else’s loss

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 Assertive rights Assertive responsibilities

To be treated with respect To treat others in away that

recognizes their human dignity

To say no Others have the right to say no too

To express feelings ,opinions To accept ownership of our feelings

and beliefs and show respect for those that differ
from our own

To be listened to To listen to others

To make mistakes to accept responsibilities for own

mistakes and to try to correct them
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 Assertive rights Assertive responsibilities
To ask for what you want to accept other’s right to refuse your
request

To set your own priorities To consider one’s limitations and

strengths in directing independent
activities

To put yourself To put others first ,sometimes

first ,sometimes

To refuse to justify feeling or to accept ownership of own

behaviors feelings/behaviors and to others
without justification

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 Why Assertiveness Is Important
 Effective communication brings about the
achievement of individual and/or shared goals.
 Assertiveness increases your ability to reach
these goals while maintaining your rights and
dignity

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Consequence of not being
assertive
 Depression
 Resentment
 Frustration
 Temper /violence
 Anxiety which lead to avoidance
 Poor relationship of all kind
 Physical complaints
 Parenting problem

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Unassertive communication
 One problem most people have is the
"disease to please", which makes them feel so
concerned about others' feelings, and they
violate their own rights. it comes from fear of
rejection

 The underlying communication position is

"Others are OK, but I am not, and if I say what
I think, I will be rejected". It comes form low
self-esteem

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Different behavioral response

Passive Assertive Aggressive

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Passive response
 Act in an indirect or passive manner.

 Permitting others to take advantage of you by

violating your rights.

 Thinking that you and your needs are inferior to

others and their needs

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Passive response
-Speak softly and hesitantly.
-Use fillers like “uh” and “um.”
-Avoid eye contact.
-Allow other people in their personal space.

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Ask yourself ?????
 Do you feel guilty standing up for your rights or
expressing your feelings?
 Do you have trouble saying “no” to people?
 Are you uncomfortable with starting or carrying
on a conversation?
• Do you rarely stand up for yourself?
A “yes” answer to any of the questions may indicate
unassertive behavior

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 Assertive behavior
-Asserts his or her own rights in a positive, open,
honest, and self-confident manner
-Speak calmly and confidently.
-Notify other people of their feelings with statements
starting with “I think” and “I feel.”
-Maintain eye contact, have good posture and are
poised and in control

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 Assertive communication
 Assertive communication is the ability to
express positive and negative ideas and
feelings in an open, honest and direct
way
 The underlying communication position

is "I am OK, and others are OK, and I am

free to express myself, as is everybody
else
 It allows us to take responsibility for

ourselves and our actions without

judging or blaming other people.
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Assertive communication
 It allows us to constructively confront
and find a mutually satisfying solution
where conflict exists.
 Both people have a better chance of

getting what they want

 Both People feel understood
 Both people feel respected
 Both people feel in control of

their thoughts and feelings

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Assertive communication
 Bothpeople enhance their self-
esteem and their confidence

 Bothpeople get a chance to

express themselves

 Both people improve the

relationship

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Aggressive behavior

-Raise their voices when they lose control.

-Shout and use accusatory language like
“You should” and “You must.”
-Stare people down and may invade other
people’s personal space physically
-Infringes on others’ rights, using fear and
intimidation to get what he or she wants

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Aggressive behavior
 Inappropriately expressing your thoughts,
feelings, and beliefs in a way that violates other
people’s rights.
 Achieving your goal by not allowing others the
freedom to choose.
 Completely disrespecting others whether it be in
an active or passive method

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Aggressive response
 We have people who feel upset they cannot
express themselves properly and use
aggressive words and behavior in their
communication

 The underlying communication position is "I

am OK, but others are not, and I need to
make them do the right thing". It also comes
from low self-esteem

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Are You Aggressive?
 Do you ignore the rights and feelings of other
people?
 Do you aim to get your way at all costs?
 Do you often dominate conversations with
others?
 Do you purposely make others feel like they are
incompetent or unimportant?
 A “yes” answer to any of the questions may indicate
aggressive behavior

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Examples of Aggressive response
 "You are crazy!"
* "Do it my way!"
* "You make me sick!"
* "That is just about enough out of you!"
* Others include sarcasm, name-calling,
threatening, blaming, insulting.

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 Passive Assertive Aggressive

Language Sorry to I That won’t

bother you … believe/need/I’d work
I can’t seem to like You can’t be
… No (when serious
It’s only my appropriate) Your problem /
opinion Open questions fault

Attitude I lose, you win I win ,you win I win ,you lose

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Behavioral component of
assertive behavior
 Eye contact
 Body posture
 Facial expression
 Voice
 Fluency
 Timing
 Listening

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Advantages of assertiveness
 Helps you become self-confident

 Increases self-esteem

 Gain respect of others

 Improve communication skills

 Improve decision-making ability

 Better time management skills

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Advantages of assertiveness
 It helps us feel good about ourselves and others

 It leads to the development of mutual respect with

others

 It helps us achieve our goals

 It minimizes hurting other people

 Manage the stress better

 They succeed more since they are not afraid of

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Advantages of assertiveness
 It reduces anxiety

 It protects us from being taken advantage of by

others

 It enables us to make decisions and free choices in

life

 It enables us to express, both verbally and non-

verbally, a wide range of feelings and thoughts,
both positive and negative

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Disadvantages of assertiveness
 If not properly conveyed ,can be considers to
be rudeness

 It can reflect overconfidence

 It involves the risk that others may not

understand and therefore not accept this
style of communication.

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 Research Input
 Undergraduate nursing students’
level of assertiveness in Greece: A
questionnaire survey
Anna Deltsidou; Nurse Education
in Practice (2009) 9, 322–330
 School of Nursing Studies,

Technological Educational
Institution, Lamia, Greece
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 Background
 A number of studies of nursing and
midwifery have found stress and
bullying to be frequent problems. Those
suffering from bullying and stress need
to have high levels of assertiveness to
resist and to cope successfully. Hence, it
was considered vital to assess the
assertiveness level of nursing students
throughout their curriculum.

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 Methods
study population- nursing students in different
semesters at one school in Central Greece (n =
298) who agreed to complete a questionnaire
on assertiveness level assessment, which had
been translated into Greek and adapted to this
population.
 Mean assertiveness scores between semesters

were compared by ANOVA and comparisons

between the responses of the first semester
students and responses of advanced
semester students were done by Pearson’s chi
square.
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 Results
 The main finding of this study was that the
assertiveness levels displayed
by students increase slightly in advanced
semesters by comparison to those displayed
by first-semester students.
 Conclusions: Assertive behavior should be

encouraged through learning methods.

Nurses should preferably obtain this training
throughout their studies. Instructors
have an essential role in the improvement and
achievement of assertiveness training
curriculums for undergraduate nursing students.
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Reasons for lack of
assertiveness
 Many of us are taught that we should
please others or that we shouldnot “make
waves”.
 If someone says or does something that

we don’t like,we should be quite and

remain away from that person in the
future
 Traditional assumptions learned in

childhood
 Low self esteem;looking others for

validation and guidance

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 Reasons for lack of
assertiveness
 From childhood females are taught to be
passive rather than assertive
 For nurses,passive female characteristics have

been reinforced over the years by the male

physician-dominated health care system.
(Ashley 1976)
 Lack of clarity about the task
 Inability to say sorry inspite of being wrong
 Lack of empathy/Low level of empathy
 Blaming others and suspiciousness

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Fears Which Block Assertive
Behavior
1. Fear of making mistakes.
2. Fear of displeasing others.
3. Fear of disapproval.
4. Fear of appearing too masculine

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Types of assertions
 Basic Assertion
This is a simple, straight forward expression
of your beliefs, feelings, or opinions. It's
usually a simple "I want" or "I feel" statement.

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Types of assertions
 Empathic Assertion
This conveys some sensitivity to the other
person. It usually contains two parts- a
recognition of the other person's situation or
feelings, followed by a statement in which you
stand up for your rights.

"I know you've really been busy, but I want to feel

that our relationship is important to you. I want
you to make time for me and for us."
.

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Types of assertions
 Escalating Assertion
This occurs when the other person fails to
respond to your basic assertion and continues to
violate your rights. You gradually escalate the
assertion and become increasingly firm. It may
even include the mention of some type of
resulting action on your part, made only after
several basic assertive statements.
"If you don't complete the work on my car by
5:00 tomorrow, I'll be forced to call the Better
Business Bureau.

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Types of assertions
 I-Language Assertion
 This is especially useful for expressing
negative feelings.
 The real focus in I-Language Assertion is

on the "I feel," "I want" part of the statement

 It involves a 3-part statement
◦ When you do . . . (describe the behavior).
◦ The effects are . . . (describe how the behavior
concretely affects you).
◦ I'd prefer. . . (describe what you want)

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I-Language Assertion
 For example:
"When you didn't buy the groceries, I couldn't
cook dinner for my parents.
I feel hurt and angry with you.
Next time, I'd like you to follow through
when you agree to do something.“
 I-Language Assertion can help you
constructively focus anger and be
clear about your own feelings

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Importance of ‘I’ statements
 These "I" statements indicate ownership
 Do not attribute blame
 It focuses on behavior, identifies the

effect of behavior
 It is direct and honest,
 It contributes to the growth of your

relationship with each other

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Assertiveness Training ("AT")
Introduced by Andrew Salter (1961) , belief was that
a person could not be both assertive and anxious at
the same time, and thus being assertive would
inhibit anxiety. The goals of assertiveness training
include:
 increased awareness of personal rights
 differentiation between non-assertiveness and

assertiveness
 differentiation

between assertiveness and aggressiveness
 learning both verbal and non-verbal assertive skills.

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Techniques that
promote assertiveness

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Techniques that promote
assertiveness
 Standing for one’s basic rights

“I have the right to express my opinion”

 Assuming responsibility for ones own

statement

“I don’t want to go out for shopping”

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Techniques that promote
assertiveness
 Agreeing assertively –
assertively accepting ones negative
aspects
admitting when an error occur
A: “you sure let that meeting get out of
hand”
B: “yes, I didn’t do a good job of
conducting the meeting today”

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Techniques that promote
assertiveness
Responding as a- broken record
To most effectively use this technique use
calm repetition, and say what you want and stay
focused on the issue
Example:
"I would like to show you some of our
products" 
"No thank you, I'm not interested" 
"I really have a great range to offer you" 
"That may be true, but I'm not interested”

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Techniques that promote
assertiveness
 Clouding /fogging –concurring with the
critic argument without becoming defensive
and without agreeing to change
 Example:

A: “you never come to the nurses’

association meetings .I don’t know why you
even belong” ?
B: “you are right ,I haven’t attended very
many of the meetings” .

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Techniques that promote
assertiveness
 Negative assertion
this technique lets you look more
comfortably at negatives in your own
behavior or personality without feeling
defensive or anxious, this also reduces your
critics' hostility.
 Agreeing with valid criticism

An example would be, "Yes, you're right. I

don't always listen closely to what you have
to say."

  56
Techniques that promote
assertiveness
 Defusing –putting off further discussion
with an angry individual until he or she is
calmer
Example : I can see that you are upset and I
can even understand part of your
reaction.Lets talk about this later.

 Behavior Rehearsal: which is literally

practicing how you want to look and
sound.

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ASSERTING YOURSELF IN IMPORTANT
SITUATIONS
 Everyone has rights, some of which are
protected by law, others that are basic
courtesy.
 Asserting your rights is important,

especially when they may affect your health,

career, or relationships
You have the right to:
 ask and receive a full explanation
 to refuse 
 to be informed 

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WORK AND COLLEGE
 Right to equal opportunity
You cannot be denied the same
opportunities available to others.

 Equal rewards
If you perform as well as others at
work or at school, you deserve the
same compensation

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FAMILY AND FRIENDS
 Just as you expect fair treatment from your
boss, coworkers, or teachers, you should
expect the same from those who care for you.
 You deserve to be treated the same as other

family members and friends when it comes to

responsibilities and rewards
 While family members and friends may be

casual around each other , if their actions or

behaviors offend you or hurt your feelings,
you have the right to tell them and ask them
to change those behaviors.
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 LADDER script
 Look at your rights and goal in the situation
 Arrange a time and place to discuss the situation
 Define the problem specifically
 Describe your feelings using “I” statements
 Express your request simply and firmly
 Reinforce the other person to give you what you
want

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Assertiveness Formula

 I feel … When you … because … . I want/need …

.
Examples:
 I feel disappointed when you read the paper

while I am talking, because it is hard to

communicate like this. I want you to look at me
when I am talking.
 I feel angry when you watch TV instead of doing

your homework, because we have agreed that

homework comes first. I want you to respect the
agreement we have made.

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Learn to accept criticism

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Tackle with criticism
 If true
:agree with criticism
:if possible add some disclosures
 If partly true

:agree and give reason

 If unfounded

:disagree
:clear it out

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Giving and receiving constructive
criticism
 Talk
about the behavior, not
about the person.

 Be as specific as possible.

 Couple
the criticism with a
compliment.

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In Dealing With Conflicts
 Ask questions.

 Compliment the individual/group for

having the courage to bring this to your
attention.

 Respond calmly and clearly.

 Offer alternatives

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ACTIVE LISTENING
 Be sure to listen to what others have to say,
especially after you send an I-message

 Assertiveness means expressing your

wants/needs while you also listen to the
other's wants/needs.

 In this way conflictual situations can be

solved in a win-win manner

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What To Do When Confronted
With a Problem
 Geta Grip
Controlling your emotions is the first
step to helping solve, rather than
magnify, this problem.

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What To Do When Confronted
With a Problem
 Reach for Logic

Examine the situation carefully and make

sure you have a handle on all the facts.
Look to see if you are in fact also
contributing to the situation

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What To Do When Confronted
With a Problem?
 Don’t Keep a Lid On It

Procrastination will only make it worse.

Pent-up frustrations could lead to unwanted
explosions that may be more problematic
than the original situation

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SETTING BOUNDARIES
 Inform the other of their unacceptable
behavior
 Request that they stop that unacceptable

behavior
 Instruct them on the behavior you would like

them to do instead
 Warn them the action you will take if they do

not stop the unacceptable behavior

 Act on the action you said you would take if

they continue with the unacceptable behavior.

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No” is Not a Dirty Word
 If something makes you feel uncomfortable
or if you feel the request is unreasonable,
then it is your right to refuse
Remember:
 You are not saying “no” to the whole
person, but only to part of the relationship
which makes you feel uncomfortable.
 “No” does not require an explanation

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BUT DO NOT DENY YOUR RESPONSIBILITIES

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TAKING CONTROL of your life:
 Set goals and take the actions you need to
meet them
 Accept that You choose your actions; take
responsibility for your own behaviors be
accountable
 Ask for what you want.
  Make an assessment: what level of control do
you have in the following areas of your life:
Home, Work, Family, Friends, Significant Other,
Children, Community, Finances, Environment.

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Control yourself rather than
controlling others

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 How to take a compliment?
 A surprisingly large number of people do not
know how to take a compliment.

 There’s something in our mind-set that says we

cannot possibly deserve positive feedback and
therefore anyone who pays us a compliment
must be either lying, misguided, or feeling sorry
for us.

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Stop doing this
 Putting yourself down:   “I don’t deserve
it” and list reasons why.
 Assuming the other person

doesn’t really mean it.
 Pointing out your weaknesses: A

compliment isn’t about your weaknesses,

it’s about your strengths.

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Stop doing this
 Deflecting compliments to others: . Others
may be deserving, but so are you.
 Claiming it was all “luck”: Another way of

deflecting embarrassing attention from

yourself,
 Making them work for it: Cut the long

stream of “no, it was nothings” and “I just

did what I had to do” and let people give
you the compliment..

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Start doing this…..
 Own your accomplishments

 Be appreciative: a compliment is a gift. You

wouldn’t put down or reject a gift from a friend;
take compliments the same way.

 Be honest and optimistic about the future. Not

pointing out your weaknesses doesn’t mean you
can’t be honest about what lays ahead. But a
simple “We still have to do x, y, and z but it’s
good to see we’re on the right track”
.
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 Recognize your contribution. You may not be the
only one who deserves to be complimented on a
job well-done, and it’s fine to say so, but
remember that you’re a part of your group’s
success
 Follow up. If applicable, offer to involve the person

giving you a compliment in your success. “Thanks,

Maria. I wonder if you’d like to help us out by
offering some feedback on…”
 Be gracious. Giving a compliment isn’t always easy.

When someone does offer you one, accept it easily

and gracefully. Pay one back, if merited. Let people
know that you appreciate them for appreciating
you 80
TOP TEN TIPS for BECOMING MORE
ASSERTIVE
  Teach others how to treat You.
 Act As If
   Stand Up! Speak Up! Talk Back! 
 Be Authentic with an Assertive Attitude
 Ask for what you want

81
TIPS
  Raise your Standards 
 Change the Environment
 Use the Assertive Skills; Set Boundaries - Say
NO
 Take the Right Risks 
 Accept what you cannot change!! 

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 Why assertiveness is
essential for nurses?
 It enables
 To express the ideas while respecting the
ideas of others
 To overcome burnout and to reduce
distress
 To solve problems diplomatically and
tactfully
 To negotiate healthily
83
Why assertiveness is
essential for nurses?
 To tackle verbal abuse and
violence in work environment
 Effective nurse patient
communication
 Aid the confidence of the
profession
 Increase job satisfaction

84
 Research input
 Assertiveness in nursing practice: an action
research and reflection project.

• Taylor B, Edwards P, Holroyd B, Unwin

A, Rowley j

• Southern Cross University - Lismore

campus, Lismore, New South Wales.

Contemp Nurse. 2005 Dec;20(2):234-47

85
 Research input
 -This article describes an action
research project that highlighted
reflective processes, so hospital
nurses could work systematically
through problem solving processes to
uncover constraints against effective
nursing care; and to improve the
quality of their care in light of the
identified constraints and possibilities

86
 Research input
 Four Registered Nurses (RNs) co-researched
their practice with the facilitator and over
the research period identified the thematic
concern of the need for assertiveness in
their work. The RNs planned, implemented
and evaluated an action plan and, as a
direct result of their reflections and
collaborative action, they improved their
nursing practice in relation to becoming
more effective in assertiveness in work
situations.
Contemp Nurse. 2005 Dec;20(2):234-47
87
Remember

Assertiveness =
Personal Authority
+ Confidence in Your
Skills
+ Sense of Purpose
+ Commitment to Goals

88
summary
 Assertiveness –definition
 Assertive communication
 Different types of behavior
 Advantages of assertiveness
 Components of assertive behavior
 Techniques to promote assertive behavior
 Assertive quiz

89
Conclusion
 "Nothing on earth can stop the individual with the
right mental attitude from achieving their goal;
nothing on earth can help the individual with the
wrong mental attitude“

W.W. Ziege

 "I just said 'no' and I don't feel guilty!"

90
References
 Mary C. Townsend; Psychiatric Mental health
Nursing; concepts of care. Third edition,page
no.220-225
 http://www.livestrong.com/article/14699-
improving-assertive-behavior
 http://en.wikipedia.org/wiki/Assertiveness
 http://www.2knowmyself.com/self_confidence/
assertiveness_definition
 http://www.mtstcil.org/skills/assert-3.html
 http://www.mindtools.com/stress/pp/
Assertiveness.html

91
ASSERTIVENESS QUIZ…..
 Assertiveness Quiz:
 1= Not much.

 2= Sometimes…
 3= Always.

 Mark your questions with 1, 2 or 3, depending

on your answer. Total up your points at the end

and read your score!
 1: _____ If I disagree with a friend, I say so, even

if it means he or she might get mad at me.

 

92
ASSERTIVENESS QUIZ…..
 2: _____ I ask for help when I am hurt or
confused.
 3: _____ I tell my friends what I honestly think

about drugs, alcohol or premarital sex, even if

they don’t like my answers.
 4: _____ I let people know when they disappoint

me.
 5: _____ If a friend borrows money and is late

paying it back, I remind her or him.

 6: _____ I say no when classmates want to copy

my homework or test answers.

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ASSERTIVENESS QUIZ…..
 7: _____ If a friend is talking, texting or making
noise in a movie, I ask him or her to be quiet.
 8: _____ If a friend is always showing up late, I
tell him or her how I feel about it.
 9: _____ I ask my friends for a favor when I need
one.
 10: _____ When someone asks me to do
something against my beliefs, I refuse.
 11: _____ I express my views on things that
matter to me, even if others disagree.

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ASSERTIVENESS QUIZ…..
 12: _____ I don’t do dangerous things with my
friends.
 13: _____ When I don’t understand something

in class, or directions, I ask questions.

 14: _____ When I disagree with someone, I try

not to hurt that person’s feelings.

 15: _____ When people upset me, I let them

know how I feel.

TOTAL: ________
Flip your sheet over to see your score!

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ASSERTIVENESS QUIZ…..
 45-35: People might not agree with you,
but they’ll respect you for your self-esteem
and your willingness to stand up for what
you believe in.
 35-25: You’ve got some work ahead of you.

Remember, you can’t make everyone happy

all the time.
 25-15: It’s time for you to speak up. If you

don’t tell people how you feel about things,

you’ll never see any changes.
 
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