Mr. Kekal Kenneth Vinitkumar provides an overview of assertive training and communication. He defines assertive communication and behavior, lists the characteristics and advantages. The document also describes behavioral components of assertiveness including eye contact and voice, techniques to promote assertive behavior such as thought stopping, and the role of nurses in helping patients develop more assertive skills.

1. ASSERTIVE
TRAINING
Mr. Kekal Kenneth Vinitkumar
Mental Health Nursing
1St 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 Six 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, 6th Edition.
 Pawan Sharma, Essentials of Mental health Nursing, JAYPEE
BROTHERS, 1St Edition 2013.
 Anbu. T; Textbook of Psychiatry Nursing; EMMESS, 1St Edition 2010.
 R. Sreevani, A guide mental health Nursing, 4th Edition, Jaypee
Publications.
 www.google.com/Assertivetraining.