Professional Relationships (Arnold & Boggs)

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Therapeutic Relationships

Back 1

A professional, interpersonal alliance in which the nurse and client join together for a defined period to achieve health-related treatment goals.

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Characteristics of Therapeutic Relationships

Back 2

Client-centered, from mutuality to partnership, professional boundaries

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Goal of Therapeutic Relationships

Back 3

Health promotion and well-being

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Key Concepts of Therapeutic Relationships

Back 4

Purpose, collaboration, client as expert, Interdependence

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Characteristics of a Nurse in a Therapeutic Relationship

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Therapeutic, intimate, collaborative, respectful, self-aware

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Therapeutic Use of Self

Back 6

Not simply about what the nurse does, who the nurse is in relation to clients and families. Done through self-disclosure, authenticity, healing presence

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Phases of Therapeutic Relationships

Back 7

Pre-interaction, orientation, working, termination

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Pre-interaction

Back 8

Begins prior to meeting a client; done in preparation for meeting a client; check of client's chart; purpose of client presence; considers appropriate approach to client, proper addressing; attempt to put them at ease, also preparing them for the environment

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Orientation

Back 9

Nurse and client meet and get to know each other; Important to show caring to validate the uniqueness of the relationship; assesses perception of health, expectations of health care, reasons for seeking treatment; requires observation of behaviour, mental status, anxiety levels, characteristics that might help/hinder the healing process (through open-ended questions, verbal cues, leads)

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Working

Back 10

Nurse and client work together to accomplish goals and solve problems; uses therapeutic communication skills (explaining alternatives and options, influencing, attending and listening, feedback); uses appropriate self-disclosure and confrontation

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Termination

Back 11

End of relationship; evaluation takes place ( result of influencing, feedback, validation); helps with separation of nurse and client

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Social Relationships

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Both parties have equal responsibilities; may or may not have specific purpose of goal; relationship can last or terminate at any time; focus on needs of both partners; relationship is entered spontaneously, accompanied by feelings of liking; companions are chosen; self-disclosure is expected from both parties; understanding is not required to be put into words

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Professional (Therapeutic/Helping) Relationships

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Helper/nurse takes responsibility for conduct and maintenance of appropriate boundaries; specific purpose or health-related goal; termination occurs when the identified goal is met; focuses on the needs of the client; relationship is entered through necessity; no choice regarding who is in relationship; self-disclosure is limited for the helper/nurse, encouraged for the client; understanding should always be put into words

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Concepts that Enhance Professional (Therapeutic/Helping) Relationships

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Respect, caring, empowerment, trust, empathy, mutuality, veracity (meaning habitual truthfulness), confidentiality

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''Respect'' in Professional (Therapeutic/Helping) Relationships

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Values and opinions; How client wants to be addressed

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''Caring'' in Professional (Therapeutic/Helping) Relationships

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Demonstrated throughout therapeutic relationship (holism, primary health care, etc); intentional and may involve family

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''Empowerment'' in Professional (Therapeutic/Helping) Relationships

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Assisting the client to take full charge of their own life; providing client with tools and resources; identify and build on existing strengths; leads to better health outcomes

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''Trust'' in Professional (Therapeutic/Helping) Relationships

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essential in a therapeutic relationship; allows client to feel safe; demonstrated through respect, honesty, consistency, faith, caring, and hope

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''Empathy'' in Professional (Therapeutic/Helping) Relationships

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Ability to be sensitive and accurately communicate understanding the client's situation; ability to put oneself in the client's position; conveyed through the utilization of communication skills

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''Mutuality'' in Professional (Therapeutic/Helping) Relationships

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An agreement/collaboration; both the nurse and the client commit to enhance the client's well-being; characterized by mutual respect for autonomy and value systems

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''Veracity'' in Professional (Therapeutic/Helping) Relationships

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Based on professional nursing values that stem from ethical principles (truth-telling, confidentiality, privacy, etc); contributes to the establishment of a therapeutic relationship

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''Confidentiality'' in Professional (Therapeutic/Helping) Relationships

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Disclosing information only to those that the client has expressed permission to share with; providing information only to those healthcare providers directly involved in the client's care; directly relates to professional behaviour (professional conduct); misconduct violates various nursing ethical and legal codes, as well as standards of practice; nurses must ensure clients are protected against invasion of privacy

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Barriers to Therapeutic Relationships

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Lack of respect, caring; failure to provide support and appropriate resources; mistrust; lack of empathy; sympathy; violations of confidentiality; anxiety; stereotyping or bias; over-involvement; violation of personal space; culture; gender

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Zones of Personal Space

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Intimate (~0.5 m), Personal (~1.2 m), Social (~3.0 m), Public (more than 3.0 m)

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Professional Boundaries

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Invisible structures imposed by legal, moral and professional standards of nursing that respect nurse and patient rights (e.g. confidentiality, defining length of contact, providing an appropriate setting, etc.)

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Professional Guidelines for Professional Boundaries

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RNAO Best Practice Guidelines on ''Client-centered care'', and ''Establishing Therapeutic Relationships''; CNO Professional Practice Standards

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RNAO Best Practice Guideline - ''Client-centered Care''

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An approach in which clients are viewed as whole; it is not merely about delivering client services where the client is located. Client centered care involves advocacy, empowerment, and respecting the client’s autonomy, voice, self-determination, and participation in decision-making; Nurses provide decision support by partnering with clients as experts in their own lives, and providing structured decision support

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RNAO Best Practice Guideline - ''Establishing Therapeutic Relationships''

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Nurses must acquire the necessary knowledge to participate effectively in therapeutic relationships; reflective practice includes capacities of self-awareness, self-knowledge, empathy, awareness of ethics, boundaries and limits of the professional role; understand the process and be able to recognize the current phase of relationship

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CNO Professional Practice Standards

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Each nurse establishes and maintains respectful, collaborative, therapeutic and professional relationships; professional relationships are based on trust and respect and result in improved client care; indicators for each identified

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Communication

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Combination of verbal and nonverbal behaviours integrated for the purpose of sharing information; leads to better health outcomes, greater client satisfaction, increased client understanding;

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Communication Assumptions

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1- It is impossible not to communicate.
2- Every communication has a content and a relationship (metacommunication) aspect.
3- We only know about ourselves and others through communication.
4- Faulty communication results in flawed feeling and acting.
5- Feedback is the only way we know our perceptions about meanings are valid.
6- Silence is a form of communication.

7- All parts of a communication system are interrelated and affect one another.
8- People communicate through words (digital communication) and through non-verbal behaviours and analog-verbal modalities, which are equally necessary to interpret the message appropriately.
9- Interpersonal communication processes are either symmetric or complementary, and can reflect differences in the equality of the relationship.

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Linear Theory of Communication

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Sender (Initiates the message, encoding it into verbal or nonverbal symbols that the receiver can understand) -> Message (transmitted verbal or nonverbal expression of thoughts and feelings) -> Receiver (receives and decodes or translates the message and interprets the meaning)

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Circular Transaction Models (''Circular Theory of Communication'')

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Sender -> Referent (not always; environment influences/starts conversation; can appear at any time in cycle) -> Message -> Receiver -> Feedback -> Sender

Summary: sender and receiver construct a picture of the message sent; Information (input) is also received from the environment and interpreted or reacted to (throughput) and new information or behaviour is produced (output)

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Communication Roles

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Symmetrical role (equal nurse-client relationship) and Complementary role (one person above the other in relationship); **NURSES PLAY BOTH ROLES IN A THERAPEUTIC RELATIONSHIP**

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Factors that influence Communication

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Verbal factors: Vocabulary, clarity and brevity (shortness of time), denotative and connotative meanings, pace, pitch and tone, timing and relevance

Nonverbal factors: Personal appearance, posture and gait, facial expression, eye contact, gestures and touch, sounds, territoriality and personal space

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Symbolic Communication

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Verbal and nonverbal symbolism used by others to convey meaning; art and music are forms of symbolic communication that a nurse can use to enhance understanding and promote healing; dreams, child’s play, drawing and symptoms of illness are all forms of symbolic communication

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Metacommunication

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All of the factors that influence how the message is perceived; includes verbal and nonverbal communication and how the message should be interpreted

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Active Listening

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A dynamic interactive process in which the nurse hears the client’s message (verbal and nonverbal), decodes its meaning, asks questions for clarification, and provides feedback to the client; facilitates trust and communication,
demonstrates acceptance and respect

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SOLER

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Active Listening Procedure:

Sit facing the client

Observe and open posture

Lean toward the client

Establish and maintain intermittent eye contact

Relax

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Client Barriers to Active Listening

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Preoccupation with pain, discomfort, worry or contradictory beliefs; unable to understand the nurse; struggling with emotions; feeling defensive, insecure, or judged; confused by the message; deprived of privacy; hearing or cognitive deficits; preoccupation with personal agendas; being in a hurry to complete physical care; making assumptions about client motivations; cultural stereotypes; defensiveness or personal insecurity about being able to help the client; thinking ahead to the next question; client emotionality or aggressiveness

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Levels of Communication

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Intrapersonal, Interpersonal, Transpersonal, Small Group, Public

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Professional Communication

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Communicated through: appearance, courtesy, use of names, privacy and confidentiality, trustworthiness, autonomy and responsibility,
assertiveness

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Barriers to Communication

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Lack of Respect, lack of caring, paternalistic (''I know what's best for you'') attitudes, mistrust, lack of empathy, violations of confidentiality, anxiety, stereotyping and bias, over-involvement, violation of personal space,

cultural and gender differences

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Contextual Factors Influencing Communication

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Physical and emotional factors, developmental factors, socio-cultural factors, gender

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Physical and Emotional Factors Influencing Communication

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Altered health states (deficits, strokes, etc), emotion, stress, attitudes

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Developmental Factors Influencing Communication

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Language, psycho-social and intellectual development change throughout the lifespan
(e.g. may need to speak slowly very old/very young); knowledge of a person’s developmental level will help a nurse to modify messages accordingly

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Socio-cultural Factors Influencing Communication

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Social norms and rules of interpersonal engagement: expression of emotions, gestures, language/vocabulary, tone, personal space

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Gender Factors Influencing Communication

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Females: use language to seek confirmation, minimize differences, and establish intimacy

Males: use language to establish independence, and negotiate status within a group

Front 49

Therapeutic Communication

Back 49

An interactive dynamic process entered into by nurse and client for the purpose of achieving identified health –related goals. It takes place within the context of a healing conversation, and encompasses both verbal and nonverbal components

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Therapeutic Listening Response

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Minimal Cues and Leads, clarification, restatement, paraphrasing, reflection, summarization, silence, touch

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Types of Question in Therapeutic Communication

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Open-ended questions (cannot be answered with yes or no)

Close-ended questions (can answer with yes or no)

Focused questions (requires more than yes or no but focuses on a specific issue or problem)

Circular questions (focused questions but focus on interpersonal context of the illness)

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What to listen for in Therapeutic Communication

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Content themes, communication patterns,
discrepancies in content, body language & vocalization, feelings revealed in a person’s voice, body movements and facial expressions,
what is not being said as well as what is being said, client’s preferred representational system (auditory, visual, tactile), nurse’s own inner responses, the effect communication produces in others involved with the client

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Therapeutic Verbal Response Strategies

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Matching Responses (match client message in level of depth, meaning and language)

Using Understandable Language (use simple, clear cut words appropriate to level of education and development)

Focusing (focus on most pressing needs)

Presenting Reality (clients may be misinterpreting reality)

Giving Feedback (message given by nurse in response to a message or observed behaviour)

Honest, clear and reflective

Asking for Validation (ensures both parties have the same understanding)

Touch (a powerful listening response and can be used when words fail; stimulates comfort, security and a sense of feeling valued)

Humor (a powerful communication technique;
laughter increases endorphins; positively influences the immune system; has incredible psychological benefit; cultural considerations)

Metaphors (non-threatening mental picture similar to what the client is facing)

Reframing (changing the frame in which a person perceives events in order to change the meaning)

Cognitive Behavioural Strategies (negative thinking creates emotional responses that influence behaviour)

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Non-therapeutic Communication

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Asking personal questions, giving personal opinions, changing the subject, automatic response, false reassurance, sympathy, asking for explanations, approval or disapproval,
defensive responses, passive or aggressive responses, arguing

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Communication Across the Lifespan

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Infants: be gentle, cuddle, pat, and/or rock the infant during interactions, hold the infant facing the parents, talk softly to the infant

Toddlers and preschoolers: Interact with parents first, make sure you are at eye-level with the child, allow children time to touch and examine equipment, use language that they can understand – short simple sentences, communicate through dolls, puppets, or stuffed animals before questioning child directly

Children: Allow time for child to feel comfortable, avoid sudden moves and/or threatening gestures, talk with parents and children, be mindful of HOW you are speaking to the child, explain what you’re doing and what the child can expect, allow children to state their fears and ask questions, drawing or play can be helpful

Adolescents: Give undivided attention - listen,
be courteous, calm and open-minded, avoid judging or criticizing, make expectations clear,
respect their privacy and views, praise good points and tolerate differences, encourage expressions of ideas and feelings

Older Adults: Be mindful of communication barriers (hearing, visual impairments), make sure you have your client’s attention before starting, minimize distractions, ensure that the environment is conducive to communication with the client, ensure that your verbal and non-verbal communication match, summarize the most important parts of the conversation, allow for plenty of time to ask questions,
allow them to make errors, do not constantly correct them, be a good listener & don’t keep your eye on the time, stick to one topic at a time, when possible have family members present during communication

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True Colours Personality Testing

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Attempt to identify various personality styles and label them with colors. It draws heavily on the work of Isabel Briggs-Myers, Katherine Briggs, and David Keirsey. Don Lowry, a student of Keirsey, developed the system which uses four primary colors to designate personality types and behavioral styles. Lowry hoped it would result in positive self- worth and self-esteem. The program was designed to maximize the application of psychological style in the workplace, in the family and in education and in other types of communities. The ease of understanding and use in all human relationships and interactions make this model very functional.

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Self-Concept

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An acquired set of thoughts, feelings, attitudes, and beliefs that individuals have about the nature and organization of their personality; response to the question “Who am I?”; creates and reflects our personal reality and worldview; helps people experience who they are and what they are capable of becoming physically, emotionally, intellectually, socially and spiritually in relationship or community with others

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Components of Self-Concept

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Physical (body image); cognitive / perceptual (personal identity); emotional (self esteem);
spiritual (connectivity with a higher purpose or God)

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Theoretical Models of Self-Concept

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William James – distinction between “I” & “me”

George Mead – self concept through interpersonal interactions

Sigmund Freud – protection against threats à ego defense mechanism

Carl Rogers – spoke about the “self” & values

Harry Stack Sullivan – development of the self concept

Erickson’s Psycho-social Theory of Development – personality evolves with developmental challenges

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Erikson's Stages of Psycho-social Development

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1. Trust vs. Mistrust
2. Autonomy vs. Shame & doubt
3. Initiative vs. Guilt
4. Industry vs. Inferiority
5. Identity vs. Identity confusion
6. Identity vs. Isolation
7. Intimacy vs. Isolation
8. Generativity vs. Stagnation
9. Integrity vs. Despair

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Features and Functions of Self-Perception

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An active source of information about the self explains our behaviours; becomes more unique as we age; often consists of multiple images of self – e.g. Athlete, student, etc; helps people make sense of their past as it relates to their present and future.

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Possible Selves

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Thoughts of future expectations that may be positive or negative

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Influencing Factors of Self-Concept

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Reflective Appraisals (personalized messages received from others that help shape the self concept and contribute to self evaluation)

Environmental (can be positive or negative)

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Healthy Self-Concept

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Reflects attitudes, emotions and values that are realistically consistent with meaningful purposes in life and satisfying to the individual

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Characteristic of Self-Concept

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Congruence between real and ideal self; realistic life goals; distinct sense of identity; high self-esteem; satisfaction with role performance; emotional stability; satisfaction with body image; spiritual well-being

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Self-Esteem

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Sense of self-worth/self judgment – how one feels about one’s self; stems from self concept; develops from individual’s perception of person and achievements

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Positive Self-Esteem

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Value self as capable, worthwhile, valuable, competent; have a personal conviction that they are unique and useful to society; expect people to value them; strong social support system; satisfaction with life

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Negative Self-Esteem

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Sensitive to criticism; defensive in relationships and seek constant reassurance from others due to self doubt; devaluing by others; dissatisfied with themselves, with life; expect people to be critical; weak social support system

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Body Image

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Physical aspect of self-concept; how people perceive their physical characteristics (e.g. people with eating disorders, amputations, hair loss due to chemotherapy, etc.); often intertwined with personal identity

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Personal Identity

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Cognitive perceptual aspect of self-concept;
a person’s perceptions or images of personal abilities, characteristics and potential growth; often culturally supported

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Spirituality

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Connection with a higher purpose or God; linked to person’s worldview; gives meaning and purpose to life and supports wholeness

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Self-Awareness

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Nurses need to “understand own personal values, feelings, attitudes, motivations, strengths and limitations and how these affect practice and client relationships.”; need to honestly and critically examine own behaviours as well as those of clients in order to create a caring and trustworthy climate for clients

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Self-Awareness Effects

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Allows nurses to be accountable for actions ( aware of what own actions are and whether or not they are acceptable or not); assertive with colleagues (''I know who I am and can share my needs with my colleagues''); an advocate for clients (understands where patients are coming from as nurses learn to better understand themselves)

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Johari Window

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Open Self: known to self, known to others

Hidden Self: known to self, not known to others

Blind Self: not known to self, known to others

Unknown Self: not known to self, not known to others

Summary: As we become more self aware, the open area increases and we know more about ourselves –the blind, hidden and unknown areas decrease and this allows the Open area to increase.
We do however, need to be aware that we do not disclose inappropriate information to our clients but rather self-disclose to people who are safe for us

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Reflection

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Seeks to understand one’s personal values, feelings, attitudes, motivations, strengths and limitations and how these affect practice and client relationships; need to simultaneously examine behaviours of client and nurse and what is going on in the relationship; allows nurse to meet client’s needs rather than personal ones; allows the nurse to treat client with respect even if cannot understand behaviour and create a safe, trustworthy and caring relationship

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Perception

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Cognitive process, not an emotional one; depending where your eyes focus, you can draw different conclusions about an image; the same applies about life

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Group

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Two or more individuals who are connected by and within social relationships

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Primary Group

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Usually spontaneous; linked to the values of the individual; informal structure and social process; membership automatic or voluntary; important to self-concept and personal development
(i.e. Church group, soccer team)

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Secondary Group

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Have a planned association; have structure and purpose; time limited; designated leader; designated goals and specific purpose; group disbands when goals are met (i.e. focus group, therapy group, education group)

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Therapeutic Group

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A group with the purpose to increase knowledge of oneself and others, helping to clarify the changes that are wanted and to develop the tools needed to make changes

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11 Therapeutic Process Factors

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1. Installation of hope
2. Universality
3. Imparting information
4. Altruism
5. The corrective recapitulation of the primary family group
6. Development of socializing techniques
7. Imitative behaviour
8. Interpersonal learning
9. Group cohesiveness
10. Catharsis (moving toward positive attitude)
11. Existential factors

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Types of Therapeutic Groups

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Therapeutic activity groups, Community support groups, Educational groups, Focus groups

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Group Dynamics

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Communication processes and behaviours that occur during the life of a group; includes individual and group characteristics; influence successfulness of group; communication variables, clarifying, reflecting, linking, paraphrasing, summarizing

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Factors Affecting Group Dynamics

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Member variables: motivation, function similarity, previous experience

Group Variables: purpose, norms, role function, cohesiveness, decision-making

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Group Member Roles

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Group Task Roles: affect a group’s ability to achieve it’s common goal by focusing on getting the job done

Group Maintenance Roles: affect how group members get along while pursuing a shared goal; concerned with building relationships and cooperation

Self-Centered Roles: Put individual’s needs ahead of the group’s

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Group Task Roles

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Initiator, information seeker, coordinator chairperson, information giver, opinion seeker, opinion giver, clarifier-summarizer, implementer-complementer, evaluator-critic, energizer, procedural technician, recorder-secretary

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Group Maintenance Roles

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Encourager-supporter, harmonizer, compromiser, tension releaser, gatekeeper, observer-interpreter, teamworker-follower

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Self-Centered Roles

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Aggressor, blocker, dominator, recognition seeker, clown, deserter, confessor, special interest pleader

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Factors Affecting Group Dynamics

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Verbal communication, nonverbal communication, social climate

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Social Climate

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Acceptance, respect, understanding, privacy, freedom from Interruptions, consistent Venue, comfortable Environment, established length and convenient time

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Group Leadership

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Leaders can be designated or emergent; characteristics include: commitment to group purpose, self-awareness of personal values, biases, and limitations; open attitude, good listener, supportive, ability to convey warmth and understanding; ability to adapt to meet the needs of the group

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Leadership Styles

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Authoritarian: Take full responsibility for group direction and control; all decision-making is done by the leader on behalf of the entire group; suggestions and ideas from subordinates are not entertained

Democratic: The leader shares decision-making power with group members and encourages ideas while providing support and encouragement; promotes the interests of the group; goal-directed, but flexible and leads to high member satisfaction

Laissez-faire: Every man/woman for themselves; person in a leadership position, not providing leadership; this leader provides little to no structure; members are given free-reign regarding decision-making and less productive

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Tuckman’s Stages of Group Development

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Forming, Storming, Norming, Performing, Adjourning

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Forming

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Desire to be accepted by others, avoid conflict and controversy; serious issues and feelings are avoided; team members behave as individuals;

important because team members get to know each other, exchange some personal information, and make new friends

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Storming

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Different ideas compete for consideration

can be uncomfortable; necessary for team growth; important because upon resolving their issues, group members are able to participate with each other more comfortably

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Norming

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Setting goals and mutual plans; cohesiveness develops; individual goals have become aligned with group goals; important because all team members take responsibility and have ambition to work towards the group’s success

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Performing

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Some high performing teams reach this stage; members function as a unit as they get the job done smoothly and effectively; important because team members are competent, autonomous and not in need of supervision

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Adjourning

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Reviewing what has been accomplished, and reflecting on the meaning of the group’s work together; involves completing the task and breaking up the team.

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Characteristics of Effective Groups

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Goals are clearly identified and collaboratively developed; open, goal-directed communication of feelings and ideas is encouraged; power is equally shared and rotates among members, depending on ability and group needs; decision-making is flexible and adaptable to group needs; controversy is viewed as healthy because it builds member involvement and creates stronger solutions; there is a healthy balance between task and maintenance role functioning; individual contributions are acknowledged and respected; diversity is encouraged; interpersonal effectiveness, innovation, and problem-solving adequacy are evident

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Conflict

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Tension arising from incompatible needs, in which the actions of one frustrate the ability of the other to achieve a goal

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Causes of Conflict

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Misunderstanding, poor communication, differences in values and goals, personality clashes, stress; may occur between two clients, between nurse and client and between colleagues and within groups

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Types of Conflict

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Intrapersonal (internal), interpersonal (2 or more people), overt (observable), covert (hidden)

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Functional Conflict

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Helpful, serves a purpose; provides opportunity for growth; can be normal part of team development (e.g. Storming Phase); can provide opportunities for growth (learn more about self);
can be healthy

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Dysfunctional Conflict

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Emotions distort the content issue (e.g. Information is withheld so one of the participants has to guess what is going on in the mind of the other); Emotions are expressed too strongly; there are double messages; emotions can distort/cloud issues; listener feels attacked; conflicts not resolved so issues build up

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Styles of Conflict Management

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Avoidance, Accommodation, Competition,

Collaboration

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Avoidance

Back 106

Withdrawal from uncomfortable situations;
appropriate when the other individual is more powerful or the cost of addressing the conflict is higher than the benefit of resolution (e.g. can not fight City Hall); sometimes you need to “pick your battles”; barely an appropriate strategy as it usually postpones the conflict; usually a lose-lose situation

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Accomodance

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Maintains peace and smoothes things over; co-operative but non-assertive; often involves quick compromise and false reassurance; by giving in, person maintains peace but does not deal with the issue so it will likely re-surface in the future; appropriate when the issue is more important to the other person than it is to you; lose-win situation

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Competition

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Authority is exerted and may be utilized to suppress conflict in a dictatorial manner; characterized by domination, aggression and lack of compromise; exercises power to gain his or her own personal goals regardless of the needs of the other & can increase stress; effective when there is a need for quick decisions but leads to problems in the long-term; lose-lose situation

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Factors Influencing Conflict

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Gender (differences in handling conflict; differences in expression of emotion)

Culture (responses typically reflect cultural socialization/behaviours)

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Principles of Conflict Resolution

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1. Identify conflict issues
2. Know your own response to conflict-triggers
3. Separate the problem from the people involved
4. Stay focused on the issues
5. Identify available options
6. Try to identify established standards for decision-making (fair, objective criteria)

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Nursing Strategies to Enhance Conflict Resolution

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Prepare for the encounter; organize information manage your own anxiety or fear; time the encounter; put the situation in perspective; use therapeutic communication skills; use clear congruent & therapeutic communication; take one issue at a time; mutually generate options for resolution; make a request for behaviour change; understand cultural implications; evaluate conflict resolution; Identify client intrapersonal conflict situations; talk about it; use tension reducing actions; defuse intrapersonal conflict; evaluate

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CNO: Conflict Prevention and Management

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Nurse-client conflict; conflict with colleagues; workplace conflict; nursing leadership roles; preventing and managing conflicts among staff

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Assertiveness

Back 113

Setting goals, acting on those goals in a clear & consistent manner, & taking responsibility for the consequences of those actions

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Goal of Assertiveness

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To stand up for your rights without infringing on the rights of others; to reduce anxiety, which prevents us from acting assertively

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Components of Assertiveness

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Being able to: say no; ask for what you want; appropriately express positive & negative thoughts & feelings; initiate, continue & terminate the interaction; Demonstrate respect; use “I” statements; make clear statements; use proper pitch and tone; analyze personal feelings; focus on the present

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Types of Responses

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Assertive: “I” statements (“I am feeling upset about what you just said. Can we talk about it?”)

Aggressive: “You” statements (“It’s your fault that this has happened.” or “You are impossible to work with.”)

Non-assertive: “Giving in” (“Sure, we can do that if you want.”)