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Assertiveness: A Practical Approach

by Stephanie Holland, Speech Therapist and Clare Ward, Occupational Therapist

This resource takes the reader throught the principales and practices of using assertiveness, the authors have created a highly practical working manual which will help everyone to develop new interpersonal skills and become more effective in their daily lives.

Full Description:   

This resource will take the reader through the principals and practices of using assertiveness. The authors have created a highly practical working manual which will help everyone to develop new interpersonal skills and become more effective in their daily lives.

Each chapter looks at a specific aspect of assertion and encourages an experimental learning approach, for example, through brainstorming, group exercises and role-play.

Accompanying each chapter is a session plan which includes worksheets (with no photocopying restrictions!), exercises and a list of the equipment required. Each plan is adaptable for use with individuals or groups and can be adjusted according to time available.

Sample Activity

People Who Feel Depressed and Anxious

Those readers working in the mental health field will appreciate that an individual's problems may often encompass many different aspects of their lives. Feelings of depression and anxiety are often an expression of unresolved issues from past experiences or present circumstances. It is therefore necessary to give space within a group or individual session for people to look at such issues as and when they arise. This means that you need to be flexible in the way you run the group or facilitate the individual session.

Another factor to consider is the style in which you, as a therapist, generally work. Assertiveness, as who have said, is predominantly a behavioural approach, rather than psychodynamic, so you may need to make it clear both to clients and referring agents that the work will be taking on a behavioural slant.

Working with clients with acute difficulties may be a long-term process; a client will not necessarily be enabled to make changes in their life after an initial course in assertiveness. Progress in this area will naturally be determined by the client's motivation to change, and the pace at which they can work with the material. Working with a client on an out-patient basis will often be far more effective than struggling to help them during their acute crisis. Providing follow-up work can also be helpful in facilitating the client towards further change and progress after their initial course of treatment.

Assertiveness is also relevant to clients with long-term needs, but the material may have to be adapted, with shorter sessions being used to allow for reduced concentration levels. Role-plays need to be specific to clients' needs and experiences, especially if they are institutionalised. Much of the information in the above section on those with learning difficulties is also relevant for this group of clients.

Most of us recognise that our own self-esteem is lowered when we feel anxious or depressed, so strategies for building self-esteem are especially relevant for this group. It is important to acknowledge that the lowered level of their self-esteem is directly linked to the depth of their depression.

People need an insight into their own problems and behaviour patterns before they can apply any of the learning from an assertiveness program. Those who are in acute crisis, or who have expressed suicidal thoughts, may possibly benefit more in the first instance from direct support and care, then from participating in a full program. Learning to be more assertive is often a goal cited by many who wish to overcome their difficulties, but the introduction of this needs to be well timed.

Advantages for this client group are:

  • becoming more in touch with their feelings;
  • overcoming fears;
  • working on presenting issues with new insight;
  • developing positive thinking patterns;
  • learning to take control of their lives.

Case History

Tom was 28 when he was admitted to the acute ward of a psychiatric hospital. He had attempted suicide on two occasions prior to his admission, and was very depressed and anxious. He was referred for individual assertiveness training, as it was felt he was particularly unassertive in his behaviour, and had a severe loss of self-esteem.

After an initial assessment it was agreed to commence individual therapy and review his progress at 12-week intervals. Tom was seen twice weekly for six weeks, during which time he was discharged from the hospital. He then attended weekly out-patient sessions for a further year. It was explained to him that, whilst assertiveness training would form part of his therapy, time would also be given for him to work on current unresolved issues. A weekly assertiveness program was not followed; instead the information was given throughout the year's therapy. Tom used the sessions to resolve current issues by working out assertive strategies for coping.

In the first two months he began to acknowledge his passivity and how his suicide attempts related to that behaviour, but had difficulty at this stage in acknowleding his aggression. The next five months' work centered on enabling Tom to become more in touch with his feelings and looked at his difficulty with self-disclosure and stating his needs. He felt pressurised and conditioned by society not to express his feelings openly because he was a man.

During the year's therapy, Tom attempted suicide twice. The first occasion was approximately two weeks after his discharge, the second after eight months of therapy. Tom recognised that the first attempt was a demonstration of his passivity in an extreme sense, and he acknowledged his responsibility for his behaviour. The second attempt was a spontaneous reaction to the enormous despair he felt at the depth of his feelings, and was a much more serious attempt. In the months that followed, Tom began to challenge his depressive feelings with great vigour. The most significant change was his recognition of his passivity, the result of which was a reduction in the frequency of is depressive bouts, and a considered decision not to attempt suicide again.

During therapy Tom attended college and took up various hobbies. He began to build friendships with women, something he had prviously been scared of doing.

In the last session Tom described how he felt it was not up to him to make something of his life and that when he became depressed he would need to deal with it, rather than 'wallow' in it. With this attitude he decided to terminate the therapy.

104 pages; 8 X 9;spiral bound

Foreward

About Ourselves

Preface

Acknowledgements

Introduction

  1. Introduction to Assertiveness
    Assertiveness and You/Change/Personal Change/Defining Assertiveness
  2. Behaviour Types
    Introduction/Learning to Accept our Behaviour/Passivity/Direct Aggression/Indirect Aggression/Assertion
  3. Being Assertive
    Introduction/Body Language/Setting the Scene/Disclosing Feelings/Being Clear/Staying with it and Empathising/Working for a Compromise
  4. Our Right to be Assertive
    Introduction/The Rights Charter/assertive Thought
  5. Owning our Feelings
    Introduction/What are Feelings?/Denial and Repression/Acknowledgement/Disclosure/Physical Release/Cognitive Release
  6. Refusing and Requesting
    Introduction/The Belief Beneath the Feeling/Challenging the Belief/Setting Limits/Ways of Saying 'No'/Making Requests
  7. Self-respect
    Introduction/Building Self-esteem/Compliments
  8. Criticism and Conflict
    Receiving Criticism/Why does it Hurt?/How to Handle it/Giving Criticism
  9. Sexuality
    Introduction/Society's Messages/Body Image/Sexism/Sexuality versus Sensuality/Working with Clients
  10. The Assertive Option
    Introduction/What is Power?/Inappropriate Use of Power/Assertive Power/Where do we go from Here?
  11. Clinical Application
    Introduction/Timing/Selection and Referral/Group Dynamics/Facilitator's Role/Client Groups/An Account of a Group/Using Assertiveness in the Working Environment

Appendix I -- Session Plans

Appendix II -- Resources for Facilitators

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