J. Behav. Ther. & Exp. Psychiat.

57 (2017) 1e5

Contents lists available at ScienceDirect

Journal of Behavior Therapy and

Experimental Psychiatry
journal homepage: www.elsevier.com/locate/jbtep

Training the social skill “being able to demand” vs. training the social
skill “being able to say no”. A randomized controlled trial with healthy
individuals
Thomas Probst a, b, *, Corinna Geib a, Erika Güroff c, Andreas Mühlberger a
a
Department of Psychology, Regensburg University, Germany
b €ttingen, Go
Georg-Elias-Müller Institute for Psychology, Georg-August University Go €ttingen, Germany
c
Arbeitsgemeinschaft für Verhaltensmodifikation, Munich, Germany

a r t i c l e i n f o a b s t r a c t

Article history: Background and objectives: This randomized controlled trial evaluated whether training one of two social
Received 13 October 2016 skills (“being able to say no” and “being able to demand”) belonging to the domain “asserting one's
Received in revised form rights” improves specifically the trained skill or the “asserting one's rights” domain in general.
27 January 2017
Methods: Ten social skills training groups comprising three weekly sessions and four healthy participants
Accepted 30 January 2017
Available online 2 February 2017
each were conducted. In each group, the participants were randomized either to the condition which
practiced the social skill of “saying no” or to the condition which practiced the social skill of
“demanding”.
Keywords:
Social skills training
Results: From pre-training to 3-month follow-up, participants of the “demanding” condition improved
Role-plays significantly on the “being able to demand” scale of the “Short Version of the Insecurity Questionnaire”
Social skills (p ¼ 0.047) but not on the “incapacity in saying no” scale of the “Short Version of the Insecurity
Questionnaire” (p ¼ 0.645), whereas participants of the “saying no” condition improved significantly on
the “incapacity in saying no” scale of the “Short Version of the Insecurity Questionnaire” (p ¼ 0.015) but
not on the “being able to demand” scale of the “Short Version of the Insecurity Questionnaire”
(p ¼ 0.484).
Limitations: Further studies are needed to evaluate whether the results of the present study can be
generalized to clinical samples.
Conclusions: This trial provides very preliminary evidence that training a specific social skill has specific,
not generalized, effects.
© 2017 Elsevier Ltd. All rights reserved.

1. Introduction
Social skills trainings (e. g., Güroff, 2016; Hinsch & Pfingsten,
2015; Ullrich & de Muynck, 2001, 2002, 2004, 2006) belong to
the standard repertoire of behavior therapists. The effectiveness of
social skills trainings has been demonstrated for various psychiatric
disorders (Barth et al., 2013; Mayo-Wilson et al., 2014; Turner, van
der Gaag, Karyotaki, & Cuijpers, 2014). Moreover, social skills can
prevent healthy individuals from developing psychological prob-
lems (Durlak & Wells, 1997; Segrin & Flora, 2000; Segrin, McNelis,
& Swiatkowski, 2016).
While several social skills exist, the two social skills “being able
to say no” and “being able to demand” are both basic social skills
practiced at an early stage in several social skills trainings (Güroff,
2016; Hinsch & Pfingsten, 2015; Ullrich & de Muynck, 2006).
Both skills belong to the domain “asserting one's rights” (Hinsch &
Pfingsten, 2015) and training one of these skills might improve
either specifically the trained skill or the “asserting one's rights”
domain in general (including the untrained skill). To explore this
question, the study at hand investigated, whether the specific
training of “being able to say no”/“being able to demand” leads to
specific progress in the trained skill or to progress in the trained
skill as well in the not actively trained skill.

* Corresponding author. Department of Psychology, Regensburg University,

93053 Regensburg, Germany.
E-mail address: Thomas.Probst@ur.de (T. Probst).

http://dx.doi.org/10.1016/j.jbtep.2017.01.006
0005-7916/© 2017 Elsevier Ltd. All rights reserved.
2 T. Probst et al. / J. Behav. Ther. & Exp. Psychiat. 57 (2017) 1e5
2. Material and method
2.1. Sample
Participants were recruited through notices at the Regensburg
University and the study was announced at webpages of the Chair
for Clinical Psychology and Psychotherapy of the Regensburg Uni-
versity. Exclusion criteria were self-reported mental illness,
participation in any previous social skills training, current psy-
chotherapeutic as well as psychopharmacological treatment.
Written informed consent was obtained from all participants. The
patient flow is depicted in Fig. 1. The final sample consisted of
N ¼ 40 healthy volunteers. The study participants were M ¼ 23.90
(SD ¼ 7.15) years old and the majority of the individuals were fe-
male (n ¼ 33; 83%). N ¼ 39 (98%) were Bachelor, Master or doctorial
students and most of the participants (n ¼ 34; 85%) studied psy-
chology. The psychology students received research credits. There
was no drop-out during the social skills trainings, all N ¼ 40 par-
ticipants attended all training sessions. N ¼ 31 (78% of N ¼ 40)
individuals took part in the 3-month follow-up: 80% (n ¼ 16 of
n ¼ 20) of the “demanding” condition and 75% (n ¼ 15 of n ¼ 20) of
the “saying no” condition participated.
Fig. 1. CONSORT flow diagram.
2.2. Randomization and training
The N ¼ 40 participants were allocated (depending on their time
availability) into ten social skills training groups. The research
questions of this study were not revealed to the participants. Each
group consisted of n ¼ 4 participants and comprised three weekly
training sessions (first session 90min, second session 60min, third
session 60min). At the beginning of the first training session, the
n ¼ 4 members of each group were randomly assigned either into
the “saying no” condition or in the “demanding” condition: the
participants of each group picked one of four numbers (1e4) and,
subsequently, the trainer allocated the two participants with the
numbers 1 and 2 to one training condition, whereas the trainer
allocated the two participants with the numbers 3 and 4 to the
other training condition. Participants of the “saying no” condition
practiced saying no in each role-play and participants of the
“demanding” condition practiced demanding in each role-play. In
each of the three training sessions, two different role-plays were
performed and consequently the participants performed six
different role-plays during the entire training phase. Each of the six
role-plays was repeated three times within a training session to
give the participants enough possibilities to practice saying no or
 T. Probst et al. / J. Behav. Ther. & Exp. Psychiat. 57 (2017) 1e5
demanding in the respective role-play. The following six role-plays
of the “Assertiveness Training Programme” (ATP; Ullrich & de
Muynck, 2001, 2002, 2004, 2006) were chosen for this study,
because they are dyadic role-plays and one part has to practice
saying no and the other part has to practice demanding.
 Role-play 1 (ATP 4): A person (“saying no”) who is in a hurry
refuses to give information to another person (“demanding”)
who asks for directions. In this role-play, the participant of the
“saying no” condition succeeded.
 Role-play 2 (ATP 22): A person (“demanding”) claims a booked
seat in a train that is taken by another person (“saying no”) who
reluctantly vacates the seat. The participant of the “demanding”
condition was successful in this role-play.
 Role-play 3 (ATP 34): A person (“saying no”) tries to avoid the
consulting of an insistent shop assistant (“demanding”). The
participant of the “saying no” condition succeeded in this role-
play.
 Role-play 4 (ATP 37): A person (“demanding”) wants to return
an item and the shop assistant (“saying no”) unwillingly accepts
the return. The “demanding” condition succeeded in this role-
play.
 Role-play 5 (ATP 40): A person (“saying no”) tries to stop an
obtrusive solicitor (“demanding”) who wants to enter her/his
apartment. In this role-play, the participant of the “saying no”
condition succeeded.
 Role-play 6 (ATP 57): A person (“demanding”) wants to return a
meal in a restaurant and the waiter (“saying no”) reluctantly
accepts the return. The participant of the “demanding” condi-
tion succeeded in this role-play.
The description of the six role-plays indicates that the partici-
pants of the condition “saying no” and the participants of the
condition “demanding” both succeeded in 50% of the role-plays.
This rate was standardized for this study in order to balance the
positive consequences for successfully practicing the social skill
between the conditions. Moreover, we standardized that an indi-
vidual performed the three repetitions of one role-play within a
training session with one and the same person X of the other
training condition. Finally, we standardized that half of the six
different role-plays across all training sessions were played with
person X of the other training condition and the other half with
person Y of the other training condition.
In the first session, a general introduction to social skills was
given before the participants performed the first role-play. More-
over, video demonstrations (Hellauer, De Muynck, & Ullrich, 1998)
were presented before each of the six role-plays to give the group
members an idea how the role-play can be performed. However, it
was stressed that the video demonstrates only an example and the
participants were motivated to choose and to practice their indi-
vidual training goals. Although it was standardized that partici-
pants of the “saying no” condition practiced the social skill “being
able to say no” in each role play and participants of the
“demanding” condition practiced the social skill “being able to
demand” in each role play, the participants could set individual
behavioral goals before each role play regarding how they want to
perform the standardized task (e. g. to stay relaxed or to speak
loudly and clearly; this procedure is in accordance with Güroff,
2016). At the end of each session, homework was assigned to all
participants. The homework consisted of performing each of the
two role-plays of the session two times, whereby participants of the
“demanding” condition were instructed to train the skill “to be able
to demand” and participants of the “saying no” condition were
instructed to train the skill “to be able to say no”. In the homework
role-plays, it was not standardized which of the role-play partners
3
should succeed, since the participants had to perform the home-
work tasks with other persons than the group members and the
study team had no contact with these other persons and could
therefore not give them instructions. Fig. 2 illustrates the structure
of the trainings.
2.3. Measures
Outcome measures were the “incapacity in saying no” and the
“being able to demand” scales of the “Short Version of the Inse-
curity Questionnaire” (U-24; Albani et al., 2006). Both scales were
assessed at pre-treatment and 3-month follow-up. The two scales
consist of 6 items, which are rated on a 6-point Likert scale. Higher
values indicate more fear of saying no on the “incapacity in saying
no” scale. On the “being able to demand” scale, however, higher
values indicate less fear of demanding. In the present sample,
Cronbach's Alpha (pre-training) for the “incapacity in saying no”
scale was a ¼ 0.75 and for the “being able to demand” scale
a ¼ 0.82.
Goal attainment scaling: Participants rated how much they
achieved their individual behavioral goals during the role-play
directly after each role-play on a visual analogue scale (VAS; 1e10).
Group atmosphere: At the end of each session, participants gave
a rating on how negatively or positively they perceived the group
atmosphere of this session in general (VAS; 0e6).
Motivation to train social skills: Participants were asked about
their motivation to train social skills at pre-training (VAS; 1e5).
Homework compliance: Adherence to homework was assessed
at the beginning of the next session. The adherence to the home-
work assigned at session 3 was not recorded, since session 3 was
the last training session and the participants were not contacted
after the training except for the 3-month follow-up assessment.
Participants who reported that they performed the two role-plays
of the session two times with a person not involved in the study
were categorized as being compliant.
2.4. Statistics
The statistical analyses were performed with SPSS 23. T-tests for
dependent samples were performed to investigate whether
training specific social skills leads to specific effects. For each
treatment condition, the pre-training scores were compared with
the 3-month follow-up scores on the “incapacity in saying no” scale
as well as on the “being able to demand” scale. Moreover, Hedges g
effect sizes (formula 1 of the appendix in Durlak, 2009) were
calculated to quantify the difference of the two training conditions
at follow-up on the “incapacity in saying no” scale as well as on the
“being able to demand” scale. To perform an intent-to-treat anal-
ysis (ITT), the missing values of the drop-outs at the 3-month
follow-up on the “incapacity in saying no” and the “being able to
demand” scales were replaced by the drop-outs’ pre-training
scores.
All statistical tests were performed two-tailed and the signifi-
cance value was set to p < 0.05.
3. Results
The two training conditions did not significantly differ in gender,
age, motivation to train social skills at pre-training, U-24 “being
able to demand” pre-training score, U-24 “incapacity in saying no”
pre-training score, goal attainment score after each role-play, and
group atmosphere score after each session. Moreover, the two
conditions did not differ in self-reported homework compliance:
The homework assigned at session 1 was completed by n ¼ 14
(70%) participants of the “demanding” condition and by n ¼ 15
4 T. Probst et al. / J. Behav. Ther. & Exp. Psychiat. 57 (2017) 1e5

Fig. 2. Structure of a social skills training group.

(75%) participants of the “saying no” condition”. The homework
assigned at session 2 was completed by n ¼ 11 participants (55%) of
both conditions. The patients who took part in the 3-month follow-
up did not significantly differ from the drop-outs in the investi-
gated baseline variables.
The results for the outcome measures (see Table 1) indicate that
training one of the two social skills belonging to the domain
“asserting one's rights” improved specifically the actively trained
skill at 3-month follow-up and not the “asserting one's rights”
domain in general. At follow-up, participants of the “demanding”
condition had more positive scores on the “being able to demand”
scale with an effect size of g ¼ 0.45 and participants of the “saying
no” condition had more positive values on the “incapacity in saying
no” scale with an effect size of g ¼ 0.46.
4. Discussion
This randomized controlled trial revealed that training one of
the two social skills belonging to the domain “asserting one's
rights” improves specifically the trained skill and not the “asserting
one's rights” domain in general. This result might be attributed to
the fact that both skills differ in the type of behavior they “request”
from an individual, e. g. “saying no” is always a reciprocal interac-
tion behavior; it can only be shown upon a social activity of an

Table 1
Change in the outcome measures for each training condition from pre-training to 3-month follow-up.

Pre-training 3-month follow-up Statistics

M (SD) M (SD)

“Demanding” condition U-24 “being able to demand” scale 14.10 (5.11) 16.40 (5.69) T(19) ¼ -2.13; p ¼ 0.047
U-24 “incapacity in saying no” scale 11.45 (4.57) 11.10 (5.01) T(19) ¼ 0.47; p ¼ 0.645
“Saying no” condition U-24 “being able to demand” scale 14.69 (6.70) 13.39 (7.14) T(19) ¼ 0.71; p ¼ 0.484
U-24 “incapacity in saying no” scale 10.45 (5.62) 8.55 (5.56) T(19) ¼ 2.69; p ¼ 0.015

Note: U-24 ¼ Short Version of the Insecurity Questionnaire.

 T. Probst et al. / J. Behav. Ther. & Exp. Psychiat. 57 (2017) 1e5
interaction partner who initiated/directed the interaction.
Demanding something may be considered a more active, inde-
pendent skill because this skill can be shown unconditionally from
a social behavior of an interaction partner. And this difference may
be associated with other important aspects, such as levels of social
anxiety because responding to someone may be easier than initi-
ating a demanding situation (which in turn is eliciting social
behavior from the interaction partner to which the person subse-
quently needs to respond again).
A major limitation of the current study is its rather low external
validity: First, the social skills training used for this experimental
study is not representative for a complete social skills training
under the conditions of routine practice; second, the study sample
was very homogenous (it consisted mainly of female psychology
students). Compared to the U-24 scores of the general population
(Albani et al., 2006), our sample had slightly less fear of saying no
but was less able to demand. In comparison to the U-24 scores of
psychotherapy patients (Albani et al., 2006), the training partici-
pants of the current study were less afraid of saying no and more
able to demand. Future studies are needed to investigate whether
the results found in the study at hand can be replicated in more
representative samples. These further studies should also use
behavioral measures as outcome criteria, since we only used self-
reports. Another limitation is that, although only one social skill
was actively trained in one training condition, the not actively
practiced skill could have been learned by observation and
modeling (by the demonstration videos and by the training partner
who actively practiced the other skill). This problem appears to be
related to the fact that one social skills training group contained
participants of both training conditions in the present study. Yet,
even if future studies randomize participants to a group consisting
solely of participants belonging to one training condition (e. g. one
group, whose participants all belong to the “being able to demand”
condition), the participants will have to train the skill in an inter-
action with a counterpart. In the saying no group/condition, this
counterpart would have to make demands to enable the partici-
pants to train the skill “being able to say no”, whereas, in the
demanding group/condition, this counterpart would have to show
resistance and to say no to allow the participants to train the skill
“being able to demand”. Thus, the participants might learn the not
actively trained skill also from observation and modeling even if the
training group consists only of participants belonging to one
training condition. A further shortcoming is that we investigated
the specificity of social skills trainings only for two skills.
If these results of the current study can be replicated for various
social skills (including “confident behavior in relationships” or
“gaining sympathy”) in future more refined studies with clinical
samples, they might have implications for the delivery of social
skills trainings. For patients with deficits in several social skills, it
might not be sufficient to train only one skill and to expect a
generalization of the training effect to another not actively trained
skill. For patients with a specific social skill deficit, however,
5
personalizing the role-plays to train the specific skill deficit could
be as beneficial(and more time- and cost-effective) as providing a
complete social skills program.
5. Conclusion
In summary, we provide very preliminary evidence that training
a specific social skill of the “asserting one's rights” domain im-
proves specifically the trained skill but not the “asserting one's
rights” domain in general.
Declaration of interest
The authors declare that there is no conflict of interest relevant
to the content of the article.
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