Assertiveness Training LECTURE (slides only).pptx

Assertiveness Training LECTURE (slides only).pptx

1. Assertiveness training Dr Maria Livanou

2. Aims These notes aim at introducing Assertiveness Training to you and highlight: What assertiveness is about What assertiveness exercises involve Communication techniques associated with assertiveness (e.g., behavioural rehearsal, the ‘broken record’, fogging, negative enquiry) Information about its effectiveness

3. What is ‘assertive behaviour’? Behaviour which is in line with the person's best interest e.g., standing up for oneself without significant anxiety, saying ‘ no’ when others are pushing them to do things that they don’t really want to do, or setting boundaries to people who behave in undesirable ways towards them and expressing one's feelings comfortably Exercising one's own rights without denying the rights of others ( Alberti & Emmons, 1970).

4. What is ‘assertive behaviour’? If you think of a continuum, where submissive (passive or self-sacrificing) behaviour is on one end, and hostile (aggressive or selfish) behaviour is on the other end, assertive behaviour is in the middle . Assertiveness training aims at helping people express their needs clearly using mainly behavioural exercises (which help them build the skills needed to overcome anxiety‐based inhibitions and be more competent socially. ( see Speed et al, 2018)

5. Assertiveness increases your chances of being heard Reduces resentment, anger, isolation, depression Helps build Respect (mutual) Helps us have better relationships Helps us achieve our goals Helps us express our feelings and thoughts Boosts confidence …improves your chances of psychological wellbeing

6. Being Assertive means… BUT remember… It may not be socially acceptable in all contexts (e.g., some professional environments, some cultural settings). Safeguarding – assertiveness in the context of an abusive relationship could trigger violence and put someone at risk Stereotypes : assertive men may be perceived more positively compared to assertive women (violation of stereotypes has been associated with rejection, aggression, exclusion, punishment) Stating your feelings and your needs (or desires) confidently and clearly you need to be aware of these parameters and make careful decisions.

7. Assertiveness training as a brief therapeutic intervention can form part of psychological treatment (usually CBT) For example it can be used in the context therapy for diagnosable disorders, including depression, anxiety disorders or personality difficulties (see Speed et al., 2018; Hayakawa, 2009; Gilbert , 2007: pp. 291-305 ) or as part of therapy for self-esteem or relationship difficulties (Speed et al., 2018)

8. The process Assertiveness training is self-therapy, in that it is conducted by the client, in the context of real-life situations It involves carefully planned exercises that the person does in their daily life and which are then discussed / reviewed / analysed when the client meets with the therapist in the session A Diary can be used to make the training easier

9. What do the exercises involve? (a) They involve changing one’s own behaviour, especially when confronted with the selfish or inconsiderate behaviour of others, and ensuring that they have communicated clearly their own wishes, needs or preferences Example: You feel frustrated because you had an appointment with a friend at 8pm and they arrived 45 minutes late. An assertiveness exercise would involve you communicating appropriately your feelings and asking that this does not happen again. Example: Jenny feels bad because her partner criticises her (e.g., makes jokes about her bad driving or her hopeless cooking). An assertiveness exercise would involve her communicating appropriately her feelings to her partner and asking them to stop putting her down.

10. What do the exercises involve? (b) Listening carefully – being appropriate in your response even if you disagree Behaving as an equal Maintaining self-control Taking responsibility Negotiating / Compromising

11. Being assertive can be difficult… It can be stressful It involves you changing your way of communicating with others; others also have to change their way of communicating with you If you change your behaviour (and you start being assertive) others may be surprised or confused or may become incompatible with you. It could involve confrontation.

12. Why would someone not be assertive? Fear of confrontation / counterattack / shame Lack of clarity about own rights Fear of loss of control Disliking ‘assertive’ people; viewing them as competitive or selfish (Gilbert , 2007: pp. 291-305) Fear of rejection Need to be liked (external validation) Past assertiveness was not rewarded

13. Communication: Interpretation of messages is influenced by… Prior learning or past experiences Personal sensitivities / vulnerabilities (e.g., fatigue, pain, etc.) Overgeneralisations Non-verbal communication

14. Assertiveness Exercises D escription / describe the undesirable or hurtful behaviour are objectively as possible E motion / express your feelings about it without blaming others S uggestion / suggest what you want the other person to do C onsequences / explain what will change if they act as you want them to act

15. How to be assertive D escription / we said we’d meet at 8 and it is 8.45 E motion / I feel frustrated and angry S uggestion / I would like you to be on time when we meet again, or call me as soon as you know that you will be late, to let me know C onsequences / if you do that, I will feel respected and considered.

16. How to be assertive: Eye contact – sincerity, directedness (not aggressive) Body posture – confidence, straight back, ‘ownership’ (not threatening) Gestures – ok to give emphasis (but make sure you are not overwhelming) Voice – confident and convincing (not whispering or shouting or with intimidating tone) Timing – ‘at the best time’ Context –be wise about how, where and when you chose to be assertive; the underlying message is “This is important”, “This deserves your full attention”, “This is not a joke”.

17. T echniques for assertiveness in communication Behaviour Rehearsal Practice how you want to look and sound. Practice your "I" statements; this reduces anxiety and allows you to become clearer about the other person’s behaviour that you wish to confront.

18. Keep repeat your point, without being manipulated into side issues, arguments that are not directly related to the point you are making, and irrelevant logic. 'calm persistence' Need to be calm and stay focused on the issue. T echniques for assertiveness in communication Broken Record

19. Example Situation - Stuck Record (a): Assertive friend " I’m wondering whether I could have a word with you. I need some advice about how to handle my problems with Tom.“ "I'm sorry. I was on my way out . Let’s do this some other time . I’ll text you and we’ll set a time for this.” “I don’t really know whether I should be so hard on him… He has apologised several times but I’m not sure whether I should give him another chance. I wanted to see what you think…” “I’m sorry. This is not a good time. We’ll have to do this some other time .” “It won’t take too long. I’m just worrying that I might be a little too strict here. After all, we all make mistakes..” “We’ll have to do this some other time ”. “Are you sure?” “Yes. Sorry. I’ll text you later and we’ll do this some other time . I am in a hurry now.”

20. Example Situation - Stuck Record (b): Assertive flat-mate “ This week, it’s your turn to do the cleaning but the sink is full of dishes. Our agreement was that the person who does the cleaning each week washes the dishes every day and leaves the sink clean. Can you please clean the kitchen as we agreed ? ” "I'm sorry. I was very busy. I had an assignment to submit and I completely forgot about it ”. “I understand, but the sink is full of dirty dishes and there are no clean ones left in the cupboard. C an you please clean the kitchen as we agreed ? ” “I was going to do it yesterday but then , to be honest, I got into this assignment and I forgot.… ” “That’s OK. It can happen to anyone ” “I am very busy though. I can’t do it today. I’ll do it tomorrow.” “ I would prefer it if you would please clean the kitchen today, as we agreed . If you did this, I would feel that you respect my needs as I respect yours. ”

21. A ct like a 'wall of fog‘ into which arguments are thrown, but not returned . This is u seful if people are behaving in a manipulative or aggressive way . Instead of becoming defensive or arguing back, give a minimal, calm and appeasing response. Agree with any truth in the criticism that you are receiving. When the atmosphere is less heated, it will be possible to discuss the issues more reasonably . T echniques for assertiveness in communication Fogging

22. Example – Fogging (a) ‘You’ve completely ruined my jumper!' ‘I know – the jumper is ruined.' ‘I can’t believe this. You first take my clothes and then you ruin them.' ‘OK. You are angry with me.’ ‘You never read the washing instructions on the label. It’s not your jumper so why should you care?' ‘It’s true, I sometimes forget to read the washing instructions on the labels.' 'It's so annoying.' ‘ I can see how annoyed you are.'

23. Example – Fogging (b) “ What time do you call this? You're nearly half an hour late, I'm fed up with you letting me down all the time .” “ Yes, I am later than I hoped to be and I can see this has annoyed you.” “ Annoyed? Of course I'm annoyed, I've been waiting for ages. You really should try to think about other people a bit more .” “ Yes, I was concerned that you would be left waiting for almost half an hour.” “ Well... why were you late?”

24. Encourage the honest expression of the other person’s negative feelings to improve communication. Listen for critical comments and seek clarifications. Use the information if it will be helpful or ignore it if it is manipulative. Example “You don’t care about my feelings.” “What makes you feel that I don’t care about your feelings?” T echniques for assertiveness in communication Negative Enquiry

25. Example – Negative Enquiry CRITIC : " You are so unprofessional“ GP: "What is about me that makes you think I'm unprofessional?" CRITIC: " The way you dress. You're always so scruffy“ GP: "You say I'm dressed scruffily. What is it about how I'm dressed that makes me look scruffy?" CRITIC: " Well, you shoes, for one thing“ GP: "What is it about my shoes that's scruffy?" CRITIC: " Just look at them. You haven't shined them in a month“ GP: " Then it's my shoes not being shined that makes me look unprofessional" CRITIC: " Yes... that's one thing." Retrieved on the 28/01/19 from http://www.gp-training.net/training/leadership/assertiveness/negenquiry.htm.

26. Be open to the negative aspects in your own behaviour (or personality) without defensiveness, anger or anxiety. This reduces your critics' hostility. "Yes, you're right. I don't always listen closely to what you have to say." T echniques for assertiveness in communication Negative Assertion

27. C onsider a compromise - bargain for material goals (unless the compromise affects your self-respect). If the end goal involves a matter of your self-worth and self-respect → do not compromise. EXAMPLE "I understand that you have a need to talk and I need to finish what I'm doing. So what about meeting in half-an-hour?" T echniques for assertiveness in communication Workable compromise

28. Effectiveness - Usefulness It often forms part of a broader approach, which may contain other therapeutic components (e.g., cognitive restructuring, exposure, etc.) so it is difficult to evaluate is effectiveness independently (whilst controlling for the effect of the other components) Still, there is enough evidence to support its usefulness in the psychological treatment of anxiety, depression, poor self-esteem and relationship difficulties (Speed et al ., 2018; Gilbert, 2007). Some preliminary evidence that it can be useful in people with borderline personality disorder and wrist-cutting (Hayakawa, 2009). A small scale study involving short biweekly assertiveness therapy sessions over a course of one to four years reported that 69% of outpatients experienced significant reduction in wrist-cutting behaviours. Assertiveness is associated with increased autonomy (Rutten et al., 2016)

29. Summary & Directions for Further Study What is Assertiveness training? What does it involve and how can it be incorporated into a treatment plan? What communication strategies or techniques does it involve? Consider the existing evidence for its usefulness.

30. Recommended Reading Alberti , R., & Emmons, M. (1970).  Your perfect right: A guide to assertive behavior . San Luis Obispo, CA: Impact Press. Gilbert, P. (2007). Working with specific difficulties i: approval, achievement, assertiveness and rebellion. In  Psychotherapy and counselling for depression  (pp. 291-305). London: SAGE Publications Ltd doi : 10.4135/9781446279830.n13 Hayakawa , M. (2009). How repeated 15-minute assertiveness training sessions reduce wrist cutting in patients with borderline personality disorder.  American Journal of Psychotherapy, 63 (1), 41-51. doi:10.1176/appi.psychotherapy.2009.63.1.41 Rutten, E. A. P., Bachrach , N., van Balkom , A. J. L. M., Braeken , J., Ouwens , M., & Bekker , M. H. J. (2016). Anxiety, depression and autonomy–connectedness: The mediating role of alexithymia and assertiveness.  Psychology and Psychotherapy, 89 (4), 385-401. doi:10.1111/papt.12083 Speed BC, Goldstein BL, Goldfried MR (2018) Assertiveness Training: A Forgotten Evidence‐Based Treatment Clin Psychol Sci Prac  25: 1– 20,  2018