Assertive training

Seminar of Assertive Training

1. ASSERTIVE TRAINING Mr. Kekal Kenneth Vinitkumar Mental Health Nursing 1 St Year MSc Nursing Symbiosis College of Nursing

2. Specific Objectives At the end of the Seminar students will be able to understand, Define the term Assertive Communication. Define the term Assertive Behavior. Enumerate the Characteristics of Assertive Communication. Enlist the Advantages of Assertive Communication. Enlist the Disadvantages of Assertive Communication. Describe the behavioral components of Assertive. Explain the techniques that promote Assertive Behavior. Describe the thought stopping techniques. Discuss the role of the Nurse.

3. Assertive Communication Definition Assertive communication is the straightforward and open expression of your needs, desires, thoughts and feelings. Assertive communication involves advocating for your needs while still considering and respecting the needs of others.

4. Assertive Behavior Definition Assertive behavior is “Behavior which enables a person to act in his own best interests, to stand up for himself without undue anxiety, to express his honest feelings comfortably, or to exercise his own rights without denying the rights of the others.” ( Alberti and Emmons, 1974 ). Assertive individuals stand up for own rights while protecting the rights of others. Feelings are expressed openly and honestly.

5. Characteristics of Assertive Communication There are S ix main characteristics of Assertive Communication. These are, Eye Contact : Demonstrates interest and shows sincerity. Body posture : Congruent body language will improve the significance of the message. Gestures : Appropriate gesture help to add emphasis. Voice : A level, well modulated tone is more convincing and acceptable. Timing : Use of judgement to maximize receptivity and impact. Content : How, where and when you choose to comment is probably more important than what you say.

6. Advantages of Assertive Communication There are many advantages of assertive communication, but some of the important advantages are, It helps us feel good about ourselves and others. It leads to the development of mutual respect with others. It increases our self esteem. It helps us achieve our goals. It minimizes hurting other people. It also 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.

7. Disadvantages of Assertive Communication Others may not approve of this style of communication, or may not approve of the views you express. Also having a healthy regard for another person’s rights means that you won’t always get what you want. You may also find out that you were wrong about a viewpoint you held. But, most importantly. It involves the risk that others may not understand and therefore not accept this style of communication.

8. Behavioral Components of Assertive Alberti and Emmons (2001) have identified several defining characteristics of assertive behavior. Eye Contact : Eye contact is considered appropriate when it is intermittent ( i.e looking directly at a person to whom one is speaking but looking away now and then). Individuals feel uncomfortable when someone stares at them continuously and intently. Intermittent eye contact conveys the message that one is interested in what is being said. Body Posture : Sitting and leaning slightly towards the other person in a conversation suggest an active interest in what is being said. A slumped posture conveys passivity or non assertiveness. Distance/Physical Contact : The distance between two individuals in interaction or the physical contact between has a strong cultural influence.

9. Behavioral Components of Assertive Gesture : Nonverbal gestures may also be culturally related. Gesturing can add emphasis, warmth, depth or power to a spoken word. Facial Expression : Various facial expression coveys different messages. (Smile, anger, surprise, fear). It is difficult to fake this expression/messages. In assertive communication, the facial expression is congruent with the verbal messages. Voice : The voice conveys a message by its loudness, softness, degree and placement of emphasis and evidence of emotional tone. Fluency : Being able to discuss a subject with ease with obvious knowledge conveys assertiveness and self-confidence. This message is important by numerous pauses or filler words such as “ and, uh…..?” or “You know……”.

10. Behavioral Components of Assertive Timing : Assertive response are most effective when they are spontaneous and immediate. However, the people have experienced times when it was not appropriate to respond. 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 time to understand what is being said before giving a response. Content : Many times individuals do not respond to an unpleasant situation. Emotions should be expressed when they are experienced. It is also important to accept ownership of those emotions and not devalue the worth of another individual to assert oneself.

11. Techniques that promote Assertive Behavior The following techniques have been shown to be effective in responding to criticism and avoiding manipulation by others: Standing up for one’s basic human rights : For Eg. I have the right to express my opinion. Assuming responsibility for one’s own statements: For Eg. I don’t want to go out with you tonight, instead of “I can’t go out with you tonight”. The latter implies a lack of power or ability. Responding as a “Broken record” : Persistently repeating in a calm voice what is wanted. Agreeing assertively : Assertively accepting negative aspects about oneself; admitting when an error has been made.

12. Techniques that promote Assertive Behavior Inquiring assertively : Seeking additional information about critical statements. Shifting from content to Process : Changing focus of the communication from discussing topic at hand to analyzing what is actually going on in the interaction. Clouding/fogging : Concurring with critic’s argument without becoming defensive and without agreeing to change. Defusing : Putting off further discussion with an angry individual until he/she is calm. Delaying assertively : Putting off further discussion with another individual until he/she is calm. Responding assertively with irony .

13. Thought Stopping Techniques Thought stopping technique as described here were developed by psychiatrist Joseph Wolpe (1990) and are intended to eliminate intrusive and unwanted thoughts. Method : In the practice setting, With the 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 is actually removed from one’s awareness. The individual then immediately shifts his or her thoughts to one that is considered pleasant and desirable.

14. Thought Stopping Techniques It is possible that the unwanted thoughts may soon recur, but with practice, the length of time between recurrences will increase until the unwanted thought is no longer instructive. Obviously, one cannot go shout his or her daily life shouting. “STOP” in public places. After a number of practice sessions, the technique is equally effective if the word “STOP” is used silently in the mind.

15. Role of Nurse It is important for the nurses to become aware of and recognize their own behavioral responses. The ability to respond assertively is especially important to nurses who are committed to further development of the profession. Assertive skills facilitate the implementation of change which leads to up gradation of the level of professionalism. Nurse to understand and use assertiveness skills themselves can in turn assist clients who wish to effect behavioral change in an effort to increase self-esteem and improve interpersonal relationships. The nursing process is useful tool for nurses who are involved in helping clients increase their assertiveness.

16. Role of Nurse Assessment Nurses can help clients 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 because it is so difficult to generalize when attempting to measure assertive behavior.

17. Role of Nurse Diagnosis Possible nursing diagnosis for individuals needing assistance with assertiveness include. Coping, defensive Coping, ineffective Decisional conflict Denial, ineffective Personal identity, disturbed Powerlessness Rape-trauma syndrome Self-esteem, low Social interaction impaired Social isolation

18. Role of Nurse Outcome/Implementation The goal of nurses working with individuals needing assistance is to help them develop more satisfying interpersonal relationships. Outcome criteria would be derived from specific nursing diagnosis. Some examples might include: The client verbalizes and accepts responsibility for his or her own behavior. The client is able to express opinions and disagree with the opinions of others in a socially acceptable manner and without feeling guilty. The client is able to verbalize positive aspects about self. The client verbalizes choices made in a plan to maintain control over his or her life situation. The client approaches others in an appropriate manner for one-to-one interaction.

19. Role of Nurse Evaluation Evaluation requires that the nurse and the 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 situation.

20. Bibliography Debr’s Mental health (Psychiatry) Nursing, D. Elakkuvana Bhaskara Raj, EMMESS Medical publishers, New-Delhi. (Page no- 117-124) Mary C. Townsend, Psychiatry Mental health Nursing, 6 th Edition. Pawan Sharma, Essentials of Mental health Nursing, JAYPEE BROTHERS, 1 St Edition 2013. Anbu . T; Textbook of Psychiatry Nursing; EMMESS, 1 St Edition 2010. R. Sreevani , A guide mental health Nursing, 4 th Edition, Jaypee Publications. www.google.com/Assertivetraining .