ASSESSMENTS OF PERSONALITY AND INTERVENTIONS IN CLINICAL

PSYCHOLOGY

ASSERTIVENESS TRAINING

Demo no.: Smruti Sivakumar

Date:

INTRODUCTION:

Communication where one can express themselves directly and honestly in interpersonal
situations, while also respecting the dignity and rights of others is what makes up
assertiveness. Assertive behavior is defined as any action that shows an individual’s own best
interest, including standing up for oneself without significant anxiety, expressing one’s
feeling comfortable or exercising one’s own rights without denying right of others (Alberty
and Emmons, 1970)

Assertiveness training is based on the principle that everyone has a right to express their
thoughts, feeling, opinions and needs to others, and to do so in a way that is respectful to all.
Not being able to express ourselves can lead to a lot of resentment, and can lead to anger,
anxiety or depression. Assertiveness training is also based on the fact that assertiveness is
something learned and not something one is born with. Hence anyone can learn to be
assertive. It involves expressing one’s own way of expressing things, but being respectful of
others while doing it.

The concept of assertiveness was explained in 1949 by Salter as a need to learn how to
express themselves more openly for people who have inhibitory personalities. Wolpe later
conceptualized assertiveness training as a way to reduce anxiety. He later collaborated with
Lazarus to develop the assertiveness questionnaire and defined four abilities possessed by the
assertive individual: ability to communicate openly about own desires, ability to say no,
ability to openly communicate about own positive and negative feelings, to establish contact
and to begin, maintain and end conversations.

Assertiveness could be considered to be on a continuum, where assertiveness can manifest as

excessive agreeableness (passive) or excessive hostility (aggressive). Behavior or language
that may be assertive for once person in a situation may not be so for others, being too
passive or too aggressive for others. Hence assertiveness is not defined by a set of hard rules.

Assertiveness training which used a variety of cognitive behavioral techniques, can be

conceptualized as a component of social skills training, broadly aimed at helping individuals
reduce anxiety-based inhibitions and learn specific skills to develop more competent social
functioning. Training people to be assertive can be beneficial and an effective treatment for
certain conditions like depression, social anxiety and expressing anger and emotions. It is
also beneficial for those who want to improve their general interpersonal skills.

A study by Lin and colleagues tried to evaluate the effect of an assertiveness training
program on nursing and medical students using a longitudinal research design and an
experimental and control group. The results shows that self-esteem and assertiveness
considerably improved in the nursing and medical students who did receive the training.
Another study by Wu and Yang and colleagues tried to ascertain the effectiveness of
assertiveness training on psychiatric patients. This study was also conducted through an
experimental and control group and effects were measured before, after and one month after
assertiveness training. In these patients who had a mixed diagnoses of psychiatric illnesses,
assertiveness training seemed to show an increase in assertiveness in both an immediate
follow-up and one month follow up. Through this study we found that there is change in how
these psychiatric patients view themselves. (Wu et.al, 2008)

Avsar and Alkaya’s study wanted to determine the effectiveness of assertive training for
school children affected by peer bullying and was studied through a quasi-experimental
design with pre- and post-testing. The results revealed that the assertiveness training
increased the assertiveness of the students and reduced the victim mindset, but it had no
effect on the state of being bullies. (Avsar and Alkaya, 2017)

A study aimed to study the effects of assertiveness training in women’s responses to assault
and attacks and the results found that women were less scared and consistent with teachings
of self-defense and being assertive when they received the assertiveness training. (Brecklin
et.al, 2005). Eslami and colleagues study aimed to study the effectiveness of assertiveness
training on high school students’ levels of stress, anxiety and depression through a quasi-
experimental method. The results showed that 2 months after the assertiveness training, a
significant decrease in anxiety and depression was seen in the experimental group who
received assertiveness training (Eslami et.al, 2016)
CONTENTS:

Assertiveness training is done to help clients understand which interpersonal situations are
problems for them and which behaviors and cognitions need the most attention. The clients
cultural context is also taken into account and through a combination of interviews, tests,
techniques and role-playing exercises. Assertiveness also focuses on both verbal and non-
verbal behavior, which includes communication and expressing requests, opinions, feelings
and drawing boundaries, non-verbal behavior including body language like eye contact,
posture, distance etc.

Assertiveness training has typically been divided into two specialties: behavioral skills
training which talks about the skills we lack and exposing us to the stressor to reduce anxiety
and cognitive restructuring training that targets the anxious thoughts that potentially lead to
avoidance behavior. (Speed, 2018)

The DESC model provides a useful framework to help express our feelings and thoughts. The
DESC model script was given by Sharon and Gordon Bower.

- Describe: Describe the behavior which is affecting individual in a negative way,

specifically and stick to the facts. To be objective in describing this behavior.
- Express: Elaborate how the behavior makes you feel and take ownership of your
feelings
- Specify - To be clear about the outcome individual wants, what change they want to
se
- Consequences – Explain to client what will happen if the behavior does not or does
change.

For this model to work effectively, it is also important to remember to use body language
effectively to keep voice controlled and make eye contact etc. Being brief and sticking to the
point and not getting distracted by other person’s defenses or excuses is also important for
this model to be effective in communication. Some other tips for this model to work
effectively are:

- Using “I” statements – to take ownership and responsibility of the concern and deal
with it by effectively communication
- Using non-judgmental descriptions of behavior and be neutral.
 - To avoid ascribing motivations to behavior as we never know why a person acts the
way they do
- Avoid statements involving absolutes and exaggerations

Other ways to improve communication process and being assertive, because assertiveness is
not only a matter of what we say but how we say it too: Active listening and reflecting to the
other person both their words and feelings expressed. Identifying your position and exploring
alternative solutions by brainstorming other possibilities, rating the pros and cons etc.

Learning how to say “No” is also extremely essential when being assertive. This can be
practiced by asking oneself if the request made is reasonable. The feeling of being cornered,
nervousness and hesitating are signs that you want to say “No” or be more assured of the
information before giving your response. Understand that one has the right to ask for more
information and clarification before giving an answer and to say “No” firmly and calmly once
you do decide and not to apologize while saying it. Other assertiveness techniques include:

- Broken record: To be persistent in communicating what we want without getting

angry or loud and sticking to the point
- Self-disclosure: To assertively disclose information about self and our feelings and
thoughts and reach to the other person’s information.
- Fogging: A coping skill to deal with criticism by not denying it and not counter-
attacking with our own criticism
- Agree with the truth and odds: Find a statement within criticism that is truthful and
agree to that and agree with any possible truth in the criticism
- Negative assertion: Assertively accepting things negative about yourself and coping
with one’s errors
- Workable compromise: To offer a workable compromise when your self-respect isn’t
in question.

PROCESS:

Assertiveness Training was conducted on a 18 year old college student who had concerns
with her friends and peer group. The client mentioned always feeling pressured and
uncomfortable with her peers and had concerns with teachers too. She noted primary
concerns of how small instances of not wanting to join friends in clubbing or going to a
restaurant but still having to go; being forced to do tasks given by teacher and parents. Client
says that usually she unwillingly ends up doing what she is told do and there have also been
instances where she has gotten snappy with her friends or parents due to irritation. In the end,
either way it has left her feeling drained, uncomfortable and stressed she says. She also
reported starting to feel anxious whenever around her large group of friends outside college
settings in fear of being pressured to do something she does not want to do, like approach
new people, drink, smoke etc.

The client was first psycho-educated about assertiveness and what it entails. She was told
about how different assertiveness expresses itself as either passive or aggressive to other
people by explaining the characteristics of the two. The client was then asked to identify
instances where she felt she was being passive, aggressive or assertive and then ascertain
which communication style she could notice more in herself.

Once identified, the client was asked to pick one incident of the top of her head where she felt
the distress she described as a result of such interactions with peers, parents or teachers. With
this incident, the DESC model was framed.

 Describe: Describe behavior negatively affecting the client. Peers telling client to
consume alcohol when she wasn’t feeling like it and telling her she is often not fun to
hang out with and making passing comments about her being a prude casually
 Express: Asked to elaborate how client felt as a result of this using “I” statements. “I
felt belittled, not enough. I felt not worthy enough and like I’m not a good friend”
 Specify: Specify the outcomes the client wants to see. “I want my friends to hear out
my ideas and preferences for when we hang out and respect my decision if I don’t
want to join and not act in a way to make me feel excluded and that I’m not enough”
 Consequences: Client was asked what would be the result if the peers listen to her and
choose to change/ not change. “If they listen and accept my opinion and preference, I
think our dynamics would be much better as friends with better understanding. That
we can have more fun together and make nice memories. I feel a positive
consequence would be that we’ll just be much more understanding of each other as
friends and have fun. If they choose to not change after hearing how it makes me feel,
then I feel like I’d want to be honest with them about the actions of theirs that do
negatively affect people and that we would maybe have to stop being friends and that
I cannot help them with their tasks or club works anymore”
The client was then asked to imitate this in a role-play scenario to ensure she is able to
express these emotions and thoughts. Through this, the client’s body language was also noted
and commented on to help her improve her posture, eye contact and modulation of voice to
help her be more assertive and confident in what she means to say. Client was also taught to
actively listen to what friends had to say to such feeling expressed by her and practice
negative assertion if any negative of the client is pointed out.

Overall the client was urged to be persistent and modulated in communication their wishes
and to try and accept shortcomings as they are and not let emotions take over when talking
with parents, peers and teachers, by ensuring to communicate the specific behavior causing
distress, how it makes them feel and what needs to change and its consequence. She was also
noted to be neutral and non-judgmental in the language she used.

OUTCOME:

The assertiveness skills acquired in assertiveness training are valuable for both our personal
and academic life for the client, by finding ways to:

 Communicate feelings and thoughts effectively

 Allowing these thoughts to be expressed lead to lesser distress on the client’s part as
she wasn’t passively agreeing to others’ wishes
 To get what client wanted without being too aggressive and letting anger pile up and
also by not being complacent
 Helping her reduce stress and gain clarity in the interactions with friends
 Knowing one’s own boundaries of comfort and when to say no and effectively
communicate it
 Allows emotions to be regulated and in check without getting too out of hand due to
distress. Become our own master and avoid being trampled on.

In general, being more assertive we can improve our sense of identity, our confidence and our
self-esteem. A snowball effect is created: the more confident we feel, the more assertive we
are and so on. By stating more clearly what our needs are, we increase the chances that these
needs will be met. Being assertive leads to a saving in energy and a reduction in tension. We
are no longer preoccupied with avoiding upsetting others, and no longer overly concerned
with making gains in an aggressive way. Being assertive increases our resilience. The more
we practice it the easier it gets and our resilience develops as a result.

Contra-indicators:

 People who have concerns with impulsivity or managing anger must first need
training in emotional regulation before taking in assertiveness training to ensure the
they’re assertive in a controlled and constructive manner (Armheim, 2013)
 People going through trauma, emotional distress, significant life changes etc. would
not benefit much from assertiveness training as they may first need immediate support
and stabilization.
 A lack of motivation to make a change and showing resistance to implement
assertiveness techniques may also be seen and underlying factors that cause the
resistance must be identified in these cases and the client’s readiness to take this on
must be respected and worked on (Prochaska, 1983)
 Severe psychological disorders like personality disorders and other psychiatric
disorders may first require more specialized therapeutic techniques to address
underlying mental health condition before engaging in assertiveness training
(Amrhein et al., 2003)

INTROSPECTION:

Working on the client’s case, learning to identify if client has an awareness of what the cause
of the concern is from their presenting concern is also important to be gauged as it determines
what level of psycho-education is required and what may be to the client’s level of
incorporating techniques. It also helped to identify specific techniques and areas that client
may need to work on as part of assertiveness training from the concerns she described, like
learning to say “no”, regulating emotion when communicating and using neutral language.
Important aspect of assertiveness seemed to also be self-esteem as clients may need to be
reassured and informed that their feelings, preferences and opinions are also of importance
and need to be heard and given way.

CRITICISM:

 For people shy or self-conscious the training may invoke anxiety to speak up or to
even change their behaviors.
  Degree of assertiveness is situation specific and what may be assertive enough in one
situation may not be so in another
 Some people going through assertiveness training may also be prone to going the
extreme end and become aggressive in their communication too.
 Cultural context is often overlooked with assertiveness training, with collectivistic
cultures possible finding it difficult to incorporate something like being assertive and
forefront is a community that prioritizes harmony. So it is not admissible to various
diverse populations
 It addresses short-term behavioral shortcomings and forms changes in them but the
deep-rooted underlying concerns and psychological factors that communicate to the
issue are overlooked.

CONCLUSION:

Assertiveness training is an approach to help individuals communicate effectively to express

one’s thoughts, feelings, opinions and needs through both verbal and non-verbal
communications methods and to establish healthy boundaries. The training usually involves
psycho-education, role-play, assertiveness and communication strategies and techniques. The
DESC (Describe-Explain-Specify-Consequence) model is the most frequently applied
method to help client’s framework their concerns specifically and structure how they can try
and communicate in an effective way. Other techniques in assertiveness training include
learning to say no, setting boundaries, accepting criticisms, regulating your emotions and
body language when communicating. This technique can be effectively used in improving
self-esteem, reducing symptoms of anxiety and distress and improving overall well-being.
This serves as an essential took for personal and professional development and express one’s
needs, evaluate their strengths and limitations.

REFERENCES:

Lin, Y.-R., Shiah, I.-S., Chang, Y.-C., Lai, T.-J., Wang, K.-Y., & Chou, K.-R. (2004).
Evaluation of an assertiveness training program on nursing and medical students’
assertiveness, self-esteem, and interpersonal communication satisfaction. Nurse
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Speed, B. C., Goldstein, B. L., & Goldfried, M. R. (2018). Assertiveness training: A forgotten
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Avşar, F., & Ayaz Alkaya, S. (2017). The effectiveness of assertiveness training for school-
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Brecklin, L. R., & Ullman, S. E. (2005). Self-defense or assertiveness training and women’s
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https://doi.org/10.1177/0886260504272894

Eslami, A. A., Rabiei, L., Afzali, S. M., Hamidizadeh, S., & Masoudi, R. (2016). The
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The DESC model, a framework for improving assertiveness. In Equilibrium. (2020, June 19).
https://www.in-equilibrium.co.uk/the-desc-model-for-assertiveness/

Bower, S. A., & Bower, G. H. (1980). Asserting yourself: A practical guide for positive
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