assertiveness training of health care workers and dealing with patients

assertiveness training of health care workers and dealing with patients

1. ASSERTIVENESSASSERTIVENESS

2. 1-HISTORY OF ASSERTIVENESS1-HISTORY OF ASSERTIVENESS

SocratesSocrates

Smith-1975Smith-1975

TodayToday

3. 2-WHAT IS ASSERTIVENESS?2-WHAT IS ASSERTIVENESS?

Assertiveness is about self Assertiveness is about self
confidence which means having confidence which means having
a positive attitude towards a positive attitude towards
yourself and others. yourself and others.

4. Ten Points about Assertive Ten Points about Assertive
BehavioursBehaviours
1-It depends on expressing yourself1-It depends on expressing yourself
2-Showing respects to others rights2-Showing respects to others rights
3-Being honest3-Being honest
4-Indirect and certain 4-Indirect and certain
5-Mutual equilibrim and benefit is important in 5-Mutual equilibrim and benefit is important in
a relationshipa relationship
6-It is expressing emotions, rights, realities, 6-It is expressing emotions, rights, realities,
thoughts and boundaries by wordsthoughts and boundaries by words
7-Using non-verbal comminication for sending 7-Using non-verbal comminication for sending
the messagethe message
8-It is not universal, it depends on the position 8-It is not universal, it depends on the position
and the individualand the individual
9-It is getting social responsibility9-It is getting social responsibility
10-It is not the nature of the hunamkind, it can 10-It is not the nature of the hunamkind, it can
be learned be learned

5. Being AssertiveBeing Assertive
1-Being assertive is focusing on your 1-Being assertive is focusing on your
goalgoal
2-Being assertive is being self-aware2-Being assertive is being self-aware
3-Being assertive is being true to 3-Being assertive is being true to
yourselfyourself
4-Being assertive is building self 4-Being assertive is building self
esteemesteem
5-Being assertive is nurturing yourself.5-Being assertive is nurturing yourself.

6. 3-TYPES OF 3-TYPES OF
ASSERTIVENESSASSERTIVENESS

Non-assertive behaviourNon-assertive behaviour
I am not ok,you are okI am not ok,you are ok

Assertive behaviourAssertive behaviour
I am ok,you are okI am ok,you are ok

Aggresive behaviourAggresive behaviour
I am ok,you are not okI am ok,you are not ok

Manipulative behaviour Manipulative behaviour
I am not ok,you are not okI am not ok,you are not ok

7. Agressive ---AgressiveAgressive ---Agressive

8. Aggresive---PassiveAggresive---Passive

9. Assertive---PassiveAssertive---Passive

11. Negative attitude and Negative attitude and
passive behaviourpassive behaviour

Lack of self confidence and low self Lack of self confidence and low self
esteemesteem

Lack of self respectLack of self respect

Self putdownsSelf putdowns

Negative feelings and thoughts about Negative feelings and thoughts about
yourselfyourself

Feeliings of inferiority compared to othersFeeliings of inferiority compared to others

Like others to be in control of people and Like others to be in control of people and
situationssituations

Feel guilty towards othersFeel guilty towards others

demotivateddemotivated

12. Negative attitude and Negative attitude and
manipulative behaviourmanipulative behaviour

Lack of self confidence and low self esteemLack of self confidence and low self esteem

Lack of self respect and lack of respect for Lack of self respect and lack of respect for
othersothers

Mistrustful and suspicious of others’ motivesMistrustful and suspicious of others’ motives

Negative feelings and thoughts about self Negative feelings and thoughts about self
and othersand others

Feel very wary towards othersFeel very wary towards others

Dishonest and indirectDishonest and indirect

Twist what others have saidTwist what others have said

Undermine others’ self esteemUndermine others’ self esteem

Depressed and demotivatedDepressed and demotivated

13. Negative attitude and Negative attitude and
aggressive behaviouraggressive behaviour

Lack of self confidence and low self esteemLack of self confidence and low self esteem

Lack of respect towards othersLack of respect towards others

Put others downPut others down

Feelings of superiorityFeelings of superiority

Like to be in control of people and situationsLike to be in control of people and situations

Disinterested in others’ thoughts and feelingsDisinterested in others’ thoughts and feelings

Feel angry towards others and are quick to blame Feel angry towards others and are quick to blame
themthem

Don’t listen to or ask questionsDon’t listen to or ask questions

Dismissive of feedbackDismissive of feedback

14. Positive attitude and Positive attitude and
assertive behaviourassertive behaviour

Self confidence and high self esteemSelf confidence and high self esteem

Respect for self and towards othersRespect for self and towards others

Take responsibility for selfTake responsibility for self

Motivated to do a good jobMotivated to do a good job

İnterested in others’ feelings and İnterested in others’ feelings and
thoughtsthoughts

Ask questionsAsk questions

Honest and directHonest and direct

Listen to othersListen to others

Ask others for feedbackAsk others for feedback

15. SKILLS OF SKILLS OF
ASSERTIVENESSASSERTIVENESS
a) Broken recorda) Broken record
b) Foggingb) Fogging
c) Negative assertionc) Negative assertion
d) Negative inquiryd) Negative inquiry
e) Free informatione) Free information
f) Self disclosuref) Self disclosure
g)Workable compromiseg)Workable compromise

16. ASSERTIVENESS BY VERBAL ASSERTIVENESS BY VERBAL
AND NONVERBAL AND NONVERBAL
COMMUNICATIONCOMMUNICATION
““It ain’t what you say, it is the way that you say it”It ain’t what you say, it is the way that you say it”

TonationTonation
‘‘II will phone you’ – It will be me not any other person will phone you’ – It will be me not any other person
‘‘I I willwill phone you’ – I will not forget! phone you’ – I will not forget!
‘‘I will I will phonephone you’ – I will not write or visit. you’ – I will not write or visit.
‘‘I will phone I will phone youyou’ – It will be you,not any other person.’ – It will be you,not any other person.

Faces and the looksFaces and the looks

Eye signalEye signal

Body imageBody image

Personal spacePersonal space

The gestureThe gesture

18. ASSERTIVENESS IN ASSERTIVENESS IN
CULTURESCULTURES

ASIANASIAN
LowLow degree of individualism , degree of individualism ,
nonassertive.nonassertive.

EUROPEAN,AMERICANEUROPEAN,AMERICAN
HighHigh degree of individualism , degree of individualism ,
assertive.assertive.

19. HUMAN ASSERTIVE RIGHTSHUMAN ASSERTIVE RIGHTS

The right to express The right to express
sexualitysexuality

The right to have The right to have
needs and desiresneeds and desires

The right to have The right to have
informationinformation

The right to have The right to have
goods or services goods or services
which have been which have been
paid paid

The right to be The right to be
independent and to independent and to
be left alonebe left alone

The right to say noThe right to say no

The right to be The right to be
treated with respecttreated with respect

The right to do anything which The right to do anything which
does not violate the rights of does not violate the rights of
othersothers

The right to be assertive or The right to be assertive or
non-assertivenon-assertive

The right to make choicesThe right to make choices

The right to change The right to change

The right to control over The right to control over
body,time and possesionsbody,time and possesions

The right to express opinions The right to express opinions
and beliefsand beliefs

The right to think well of The right to think well of
oneselfoneself

The right to make requestsThe right to make requests

20. SAYING ‘YES’ OR ‘NO’SAYING ‘YES’ OR ‘NO’

21. Why is it difficult to say no?Why is it difficult to say no?


If I say no,they may feel hurt or injectedIf I say no,they may feel hurt or injected

If I say no this time, they may not like me If I say no this time, they may not like me
anymoreanymore

If I say no this time,they may never ask againIf I say no this time,they may never ask again

They won’t take any notice if I say noThey won’t take any notice if I say no

They would say ‘yes’ to me (and so I will feel They would say ‘yes’ to me (and so I will feel
guilty if I refuse them)guilty if I refuse them)

I can’t say no, because I feel sorry for themI can’t say no, because I feel sorry for them

22. How to say ‘no’ assertively?How to say ‘no’ assertively?

Start your reply with a Start your reply with a
clear,firm,audible ‘no’clear,firm,audible ‘no’

Do not justify or make excuses.Giving Do not justify or make excuses.Giving
a reason is different from over-a reason is different from over-
appologizingappologizing

Feel that you have a right to say noFeel that you have a right to say no

Once you have said ‘no’ , do not stay Once you have said ‘no’ , do not stay
around waiting to be persuaded to around waiting to be persuaded to
change your mind.Make a definite change your mind.Make a definite
closure by changing the closure by changing the
subject,walking away, continiuing subject,walking away, continiuing
with what you are doing-whatever is with what you are doing-whatever is
appropriateappropriate

23. How to say ‘no’ assertively?How to say ‘no’ assertively?

Remember you are saying ‘no’ to that Remember you are saying ‘no’ to that
particular request,not rejecting the particular request,not rejecting the
personperson

If the request takes you unawares or If the request takes you unawares or
you have not sufficent time to think you have not sufficent time to think
when asked,you can always say, ‘I will when asked,you can always say, ‘I will
let you know’ in order to give yourself let you know’ in order to give yourself
time to think about what you want to time to think about what you want to
saysay

Take responsibility for saying no-do not Take responsibility for saying no-do not
blame the other person for asking youblame the other person for asking you

Ask for more information if you need it Ask for more information if you need it
in order to decide whether you want to in order to decide whether you want to
say ‘yes’ or ‘no’say ‘yes’ or ‘no’

24. Why is it difficult to say ‘yes’?Why is it difficult to say ‘yes’?

I don’t deserve itI don’t deserve it

They might not really mean itThey might not really mean it

I am not really sure that is what I wantI am not really sure that is what I want

I don’t have enough informationI don’t have enough information

25. How to say ‘yes’ assertivelyHow to say ‘yes’ assertively

Say ‘yes’ clearly and definitelySay ‘yes’ clearly and definitely

Identify why you would find it difficultIdentify why you would find it difficult

Examine thoughts realistically and ask Examine thoughts realistically and ask
yourselfyourself

Having calarified thughts for yourself Having calarified thughts for yourself
then reaffirm your desire to say ‘yes’then reaffirm your desire to say ‘yes’

26. Combining ‘yes’ and ‘no’Combining ‘yes’ and ‘no’

‘‘yes’ and ‘no’ may be combined assertively to yes’ and ‘no’ may be combined assertively to
define what we want or what our limits are in a define what we want or what our limits are in a
particular situation.particular situation.

27. THE IMPORTANCE OF THE IMPORTANCE OF
ASSERTIVENESS IN ASSERTIVENESS IN
ORGANISATIONSORGANISATIONS
AssertivenessAssertiveness

Personal identityPersonal identity

Wages or salaryWages or salary

Satisfaction from Satisfaction from
exercising skillsexercising skills

Satisfaction from Satisfaction from
helping peoplehelping people

Social Social
environmentenvironment
Need to dealing withNeed to dealing with

TheirselvesTheirselves

The manager to The manager to
whom they reportwhom they report

Their colleaguesTheir colleagues

Their subordinatesTheir subordinates

Clients or customersClients or customers

29. ASSERTIVENESS TRAINING ASSERTIVENESS TRAINING
IN WORK PLACEIN WORK PLACE

Body-language awareness leading Body-language awareness leading
to work body oriented therapiesto work body oriented therapies

Role-plays and then work in Role-plays and then work in
psyhcodrama psyhcodrama

Awareness of other people’s Awareness of other people’s
perceptions and so work in perceptions and so work in
sensitivity groups and encountersensitivity groups and encounter

Looking at situations in the past Looking at situations in the past
where one was, or was not where one was, or was not
assertive and hence traditional assertive and hence traditional
psychoteraphypsychoteraphy

30. Techniques in Assertiveness Techniques in Assertiveness
TrainingTraining

Verbal communicationVerbal communication

Non-verbal communicationNon-verbal communication

Anxiety reduction and control Anxiety reduction and control

Anger reduction and control, and Anger reduction and control, and
redirection of this energyredirection of this energy

Increase in self esteemIncrease in self esteem

Awareness of self and others in Awareness of self and others in
interpersonnal situationsinterpersonnal situations

Awareness of social and cultural Awareness of social and cultural
rules of behaviourrules of behaviour

31. Problems in Assertiveness Problems in Assertiveness
TrainingTraining

The first major problem for assertion The first major problem for assertion
training involves negative evaluations of training involves negative evaluations of
assertive people by othersassertive people by others

Confusion between assertion and Confusion between assertion and
aggressionaggression

Problem involves transfer of training,the Problem involves transfer of training,the
difficulty experienced by trainees in difficulty experienced by trainees in
generalising assertive from the training generalising assertive from the training
context to real-life situationscontext to real-life situations

Finally some of the difficulties in applying Finally some of the difficulties in applying
assertion training outside the training assertion training outside the training
context may be due to intuitive training context may be due to intuitive training
procedures that are inadequately based in procedures that are inadequately based in
researchresearch

32. The skills of helping the person to commit to The skills of helping the person to commit to
changing his/her behaviour from non-changing his/her behaviour from non-
assertive to assertive.assertive to assertive.
You will need action planning skills at You will need action planning skills at
this stage of the counselling process.In this stage of the counselling process.In
particular, you need to help the person particular, you need to help the person
set clear objectives;a mnemonic which set clear objectives;a mnemonic which
can be useful is SMART.can be useful is SMART.
This stands for:This stands for:

SSpecificpecific

MMeasurableeasurable

AAchievablechievable

RRealisticealistic

TTime orientedime oriented

33. TO DECİDE WHEN TO BE TO DECİDE WHEN TO BE
ASSERTİVEASSERTİVE

Do you know really what is the situation?Do you know really what is the situation?

How much importance it has for you?How much importance it has for you?

Will you get what you want?Will you get what you want?

Do you want to just express yourself?Do you want to just express yourself?

What is your options?What is your options?

Do you want an optimistic result?Do you want an optimistic result?

Are you ready to be assertive?Are you ready to be assertive?

Did you count to the 10?Did you count to the 10?

Is it beter to wait?Is it beter to wait?

Will you get anger to yourself, ,f you don’t do Will you get anger to yourself, ,f you don’t do
anything?anything?

Have you done your best?Have you done your best?

What are the possible results and risks?What are the possible results and risks?

Will assertiveness cause a change?Will assertiveness cause a change?