Your Perfect Right

Your Perfect Right

Always wondered if you could use assertiveness and equality in your relationships and in your life? Here are some great information on how to be more assertive! Do you want to improve your career and the amount of money that you bring home? Do you want to break all the sales records in your office? Do you want to bring home more money? Do you feel as though you are just short of reaching all of your goals?

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Over time she became significantly more engaged and developed a bold and articulate, yet still nice way of being. In one instance she bravely shared her sense of discomfort about a peer's crass language and promiscuous behavior, saying that she believed that this young woman was destroying her much-stated desire for a relationship. The other group members were clearly relieved that someone had spoken up, but the following week the young woman announced that she had decided to terminate group treatment, and that this was the first of her last four group sessions.2 Although this event could have been experienced as proof of the original injunction regarding the horrible risks of not being nice, the group framework provided the time for her and others to explore and clarify feelings, resulting in the young woman's increased self-awareness, her subsequent decision to stay in group, and the practicing patient's reassurance of the positive outcomes of her assertiveness. Her interactions...

Issues of questionnaires and rating scales

Chart review, elicitation by a standardized survey questionnaire or interview, and patients' spontaneous reports are three methods to recognize symptoms in clinical practice or research (Kroenke 2001). Each method can provide a different perspective of CRF. Reliance only on chart review may underestimate the burden of CRF. Fatigue is a subjective sensation best measured by self-report. Self-report questionnaires or structured interviews can capture the unrecognized problems, but may prompt over-endorsement bias from the tendency of patients to generously claim the symptoms on a symptom checklist (Kroenke 2001). Patients' complaints are directly relevant to clinical practice but their presence and level of detail may reflect factors unrelated to fatigue (for example opportunity, assertiveness, verbal fluency) as well as CRF symptoms and consequences.

Drug Tapering and Discontinuation

The patient, a 44-year-old man who works as a county clerk, has a major depressive disorder of recent onset. He had two previous episodes 1 and 3 years earlier that were treated by his primary care physician with fluvoxa-mine (100 mg per day) for 4 months each time. Although in this case his physician has prescribed fluvoxamine (100 mg per day), he wonders whether a different treatment may be justified. Careful assessment discloses only partial remission after each episode. The psychiatrist confirms treatment with fluvoxamine, but introduces the need of a sequential approach. After 3 months of drug treatment, the patient is given the combined treatment, CT + WBT. The CT part of treatment yields important insights and modification of some of his maladaptive attitudes. WBT allows him to realize how his lack of autonomy leads his workmates consistently to take advantage of him. This results in workloads that, because of their diverse nature, undermine the patient's environmental mastery,...

Kay E Segal Sarah E Altman Jessica A Weissman Debra L Safer and Eunice Y Chen

Like standard DBT for BPD, group skills training in standard DBT for BED targets the acquisition of new behavioral skills in a structured psycho-educational format and is divided into four modules mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. Mindfulness skills involve observation and description of thoughts and emotions, including taking control of where attention is focused. Acquisition of emotion regulation skills increases identification of emotions and how they operate, reduces vulnerability to negative emotions, and alters negative emotional states. The distress tolerance module provides skills to tolerate painful emotions or difficult situations without making them worse. Finally, interpersonal skills focus on validation, effective communication, maintaining positive relationships, and assertiveness.

The Social and Cultural Domain

Differences has been incorporated into feminist theories in various ways. This is an area in which politics and values intermingle with the science of personality. Some researchers prefer to minimize the differences between men and women, emphasizing that sex differences are small and that the variability within sex (e.g., between women) far exceeds the variability between the sexes (e.g., between men and women). Other researchers focus on the dif ferences between the sexes and emphasize that some are rather large and are found in different cultures. For example, women tend to have slightly higher verbal ability than men, and men tend to have somewhat better spatial visual ability than women. In terms of personality, men tend to score higher on measures of assertiveness and aggressiveness, whereas women tend to score higher on measures of trust and nurturance. Where do such dif fer-ences come from

Hostility The Lethal Component of the Type A Behavior Pattern

What do researchers mean by the trait of hostility People high in hostility are not necessarily violent or outwardly aggressive. They are not necessarily even assertive or demanding of others. Instead, such people are likely to react disagreeably to disappointments, frustrations, and inconveniences. Frustration can be understood as the subjective feeling that comes when you are blocked from an important goal. For example, you want a cold drink from the vending machine and it takes your money but does not give you the drink you request. This is frustrating. A hostile person reacts to such frustrations with disagreeable behavior, attacking the machine or swearing and kicking the garbage can as he or she sulks away . Hostile people are easily irritated, even by small frustrations, such as when they misplace their car keys or have to wait in line at the grocery store. In such situations, hostile people can become visibly upset, sometimes even becoming rude and uncooperative or even...

Closer Look The Six Myths of Self Esteem

Self-disclosure, being assertive when necessary, providing emotional support to their friends, and managing interpersonal conflict. The researchers also had the subject's roommates report what the subject was like on each of the above interpersonal skill domains. While the subject's self-esteem scores correlated with all of the self-reported interpersonal skill domains, the correlations between self-esteem and the roommates' ratings were essentially zero for four out of five of the interpersonal skills. The only interpersonal skill area that the roommates noticed that was associated with self-esteem was the subject's ability to initiate new social contacts and friendships. This does seem to be the one area in which the confidence associated with self-esteem really matters. People who think that they are desirable and attractive should be good at striking up conversations with strangers. Persons with low self-esteem may shy away from trying to make new friends, perhaps fearing...

Psychosocial Influences On Painrelated Limitations In Cancer Survivors

Cognitive-behavioral approaches have dominated psychological intervention research on cancer pain management. Cognitive-behavioral perspectives proceed from the view that an individual's interpretation, evaluation and beliefs about their health condition, and their coping repertoire with respect to pain and disability will impact on the degree of emotional and physical disability that will be associated with cancer.25,28 It is important to note that the term cognitive-behavioral does not refer to a specific intervention but, rather, to a class of intervention strategies. The strategies included under the heading of cognitive-behavioral interventions vary widely and may include self-instruction (e.g., motivational self-talk), relaxation or biofeedback, developing coping strategies (e.g., distraction, imagery), increasing assertiveness, minimizing negative or self-defeating thoughts, changing maladaptive beliefs about pain, and goal setting.67 A client referred for cognitive-behavioral...

The Polite And The Not So Polite

I have the fortune or misfortune, depending on your perspective, to work with primarily very nice and gracious clients. However, that is not always an enviable position when trying to facilitate a group of highly passive and respectful adults in a psychodynamic psychotherapeutic group. The issues arise on how to encourage them to confront one another with honest feedback how to ask for honest feedback and expect to get it how to practice new behaviors like assertiveness or even some of their lifelorigforbidden emotions like anger or how to get them to become fully integrated personalities that encompass the polite and the not so polite.

Three Common Elements of Temperament Characteristics

The third component of all definitions of temperament is that behavioral styles are relatively stable across development. Temperament characteristics can and will change in response to parenting and other social forces. The idea is that the early roots of adult personality can be seen from the beginning. Several studies have included groups of individuals who were followed from birth to adulthood. The findings from these studies regarding stability are mixed. Children's temperament traits do appear to be quite stable through infancy and into childhood. Jerome Kagan and his colleagues studied two extreme groups of children from infancy to adolescence. Members of the first group, behaviorally inhibited children, were very shy and fearful in unfamiliar situations. Members of the second group, behaviorally uninhibited children, were very gregarious and assertive in novel settings. The researchers found that the inhibited children were at greater risk for later social and emo

Self Schemata Possible Selves Ought Selves and Undesired Selves

So far, we have considered some of the main steps in the development of a self-concept. Once formed, the self-concept provides a person with a sense of continuity and a framework for understanding the past and present and for guiding future behavior. In adults, the self-concept is a structure made up of building blocks of knowledge about the self, a multidimensional collection of knowledge about the self Am I responsible, athletic, cooperative, attractive, caring, and assertive The self-concept is like a network of information in memory , which or ganizes and provides coherence to the ways in which we experience the self (Markus, 1983). The self-concept also guides how each person processes information about him- or herself (Markus & Nurius, 1986). For example, people more easily process information that is consistent with their self-concepts if you see yourself as highly masculine, then you will quickly agree with statements such as the following I am assertive and I am strong. The...

Family Income and Early Child Care

The effects of center-based care on children's social behavior are more mixed. In the NICHD study and in some other studies, there is evidence that children with center-care experience, particularly in infancy, show more behavior problems at ages 4.5 and kindergarten (NICHD ECRN, 2003 in press). Among low-income children, however, one observational study found no positive or negative effects of center care on problem behavior (Loeb et al., 2004). Our experimental analyses in the Next Generation study indicated that, once selection factors are controlled, children with center care experience in preschool are rated by elementary school teachers as having fewer behavior problems than those with other types of prior experience. It seems likely that children can learn aggressive and assertive behaviors when they spend a large amount of time with peers on the other hand, centers can vary considerably in the ways in which social behavior and social conflicts among children are handled.

Identifying Anger Guilt and Self Punishment Embedded in Character

Some depressed patients can seem, even to their therapists, to experience recurrences out of the blue, apparently related to a biological susceptibility to that mood state. In such patients, reductions in medication can be a contributing factor to recurrences of their depressions. However, in our clinical experience, certain personality traits and vulnerabilities are also clearly implicated in a susceptibility to recurrences for most dysthymic and depressed patients. Even for patients who relapse as they are weaned off their medications, some predisposing features of their psychology may make them additionally vulnerable. The presence of a severe superego that limits pleasure and harshly judges or punishes anger, assertiveness, or sexuality is a major predisposing factor to chronic depression and to depressive relapses. It is thus important to recognize and to treat the kinds of self-punishing character adaptations that occur within patients in response.

Referral for services

Children with a history of chemotherapy and or radiation to the brain require thorough neuropsychological testing, which is best administered by psychologists experienced in testing children with cancer. Most large children's hospitals have such personnel, but it sometimes takes very assertive parents to get the school system to use these experts. Your written consent is required prior to your child's evaluation, and you have the right to obtain an independent evaluation if you believe that the schools evaluation is biased or flawed in any way. However, you may be responsible for this cost.

Masculinity Femininity Androgyny and Sex Roles

Women and men dif fer in a few dimensions assertiveness, tender -mindedness, and anxiety, as well as in aggression, sexuality , and depression. But do these dif ferences mean that there is such a thing as a masculine or feminine personality This section explores the conceptions of masculinity and femininity and how the treatment of these topics has changed over time.

Summary And Evaluation

The domains that show large and small sex differences are now fairly clear. Men score consistently higher on the personality attributes of assertiveness, aggressiveness (especially physical aggressiveness), and casual sexuality . Women consistently score higher on measures of anxiety, trust, and tender-mindedness (nurturance). Women are more likely than men to experience both positive emotions (e.g., af fection, joy) and negative emotions (e.g., fear, sadness), although the magnitude of these dif ferences is not large. Men are more likely to be sexually aggressive, trying to force women to have sex, although these findings appear to be limited to a subset of men those wh are narcissistic, lack empathy , and show hostile masculinity . Although no sex dif fer-ences are reported in depression rates prior to puberty , at around age 13 women tend to show higher rates of depression than do men. This sex dif ference has been tied to theories of suggesting that women ruminate more than men...

Equality In Human Relations

For many individuals, group therapy provides special skills to deal with problems in social situations. Among the difficulties experienced by clients is the inability to ask for acknowledgment of their personal rights and needs. The foundation of this problem may be a resistance to express both positive and negative feelings, a lack of confidence to be direct, and a judgment that their requests are unreasonable and unacceptable to others. Alberti and Emmons (1990) suggest that Assertive behavior promotes equality in human relationships, enabling us to act in our own interests, and to stand up for ourselves without undue anxiety, to express honest feelings comfortably and to exercise personal rights without denying the rights of others (p. 7).

Dealing with Teasing and Bullying

There are several other techniques that have shown promise in reducing the likelihood that teasing or bullying will occur. Many approaches involve similar ingredients to those used in peer mediation programs, including providing information about autism to classmates and creating regular opportunities for interaction between children with AS-HFA and typical peers. Other programs involve assertiveness training and teaching the child specific techniques for standing up to bullies asking for help, seeking out a safe teacher or place, walking away, using humor, and the like. If you have reason to suspect that your child is being bullied, contact your child's teacher and principal immediately. It is of the utmost importance that your child be protected, which means outlining specific plans to deal with different situations, establishing safe zones around the school, and better monitoring less-structured activities and situations where the harassment may take place. The resource list in the...

Birth Order and Personality

The results of research regarding the associations between birth order and personality are varied. In general, meta-analyses of systematic studies indicate that firstborn children are achievement-oriented, ambitious, conforming, anxious, assertive, and less em-pathetic than latterborns. Frank J. Sulloway, using a Darwinian perspective, argued that children assume different personalities or niches within the family to gain favor with parents. Firstborns do this by identifying with their parents and by conforming to parental standards. Because firstborn children are older, wiser, and more powerful, latterborns become diverse in their interests and they become more open to experience. Sulloway's treatise stemmed from his study of 3,890 career histories of scientists. Even though many firstborns were scientists (e.g., Isaac Newton, Albert Einstein, Sigmund Freud), supporters of the scientists were predominantly latterborns. Sulloway interpreted this finding as indicative of the...

Overview And Structure Of

Broad-spectrum cognitive-behavioral approaches such as that described by Monti and colleagues (1989), and adapted for use in Project MATCH (Kadden et al., 1992), expand to include interventions directed to other problems in the individual's life that are seen as functionally related to substance use. These may include general problem-solving skills, assertiveness training, strategies

The Early Onset Persistent Pattern

Pended and or expelled, begin to fail academically, and eventually develop adversarial relationships with the school system. By the time they enter high school, these children have had a lifetime of training and preparation for delinquent behavior in adolescence and quickly find peers who reinforce their patterns of behavior. In fact, one of the strongest findings is that delinquent children associate with and commit many of their offenses in the company of delinquent peers. Other vicious cycles can be found in the homes of most EOP youth. Power-assertive discipline strategies are more likely to be used, which in turn reinforce aggressive habits. Moreover, groundbreaking work by Gerald Patterson in 1982 showed that parents of EOP youth tend to use parenting strategies marked by an escalation of conflict, which also reinforces aggressive behaviors.

Cognitive Therapy For Depression In Patients With Comorbid Pds

Once the core and active schemas have been identified, the corollary schema can be investigated and tested. For example, the schema might be, The world is a dangerous place, and the corollary schema might be, The most dangerous thing in the world are relationships. Relationships can injure you, or Avoid relationships. The decision can then be made as to the therapeutic interventions. Schemas can be constructed, reconstructed, modified, reinterpreted, or camouflaged. If the individual has no schema for dealing with a particular experience, the schema may have to be built or constructed within the therapy (e.g., a patient is aggressive but has no schema for assertive behavior). Rules for being assertive may have to be constructed within the therapeutic collaboration.

Case Illustration

L., a 32-year-old, single, African American woman employed as a temporary office assistant, sought help for extreme anxiety in a variety of social situations. When describing her difficulties, J. L. reported that she had had problems with people ever since she was teased and taunted in junior high school. She reported that she had had few friends and felt continuously uneasy, alone, and terrified in school. In addition, she feared parties public speaking participating in meetings and classes speaking with unfamiliar people and authority figures being assertive maintaining a conversation entering public places, such as restaurants, coffee shops, and stores and dating. She reported that she never had a serious romantic relationship. J. L. stated that she feared all of these situations because she was worried that people were evaluating her negatively. She noted, I just have a huge fear of people. I always think that I will not be liked. She further stated, Initiating

Contraindica Tions

This intervention may have contraindications if the client is not fully educated about the purpose of the skills training from the start. The client must understand that assertive communication is for the sake of the client and not for the sake of changing others. Clients must recognize that standing up for their rights and expressing their views will provide them with a greater sense of freedom, enhanced self-esteem and self-worth, and assist him or her in eliminating self-destructive behaviors by uncovering some of those pent-up thoughts, feelings, and desires. They will feel more empowered to overcome obstacles, which in the past they were too fragile to overcome, simply by getting it off their chest rather then consciously suppressing their thoughts and feelings. Another contraindication to learning this type of skill is a possible loss of a current relationship. It is sad but true. For example, in the case of a marriage or other intimate partner relationship, the more dominating...

Self Help Behavioral Therapies

These self-help therapies provide guidance through the process of quitting as well as teaching strategies of relapse prevention. The therapies can range from brief, unstructured motivational pamphlets to comprehensive, step-by-step instructional manuals encompassing all components implemented in therapist-directed cognitive-behavioral treatment groups. Typical components include self-monitoring, cigarette brand switching, nicotine fading, the identification of situational and affective triggers or cues to smoke, cognitive strategies such as self-talk, problem-solving methods in dealing with cravings, social support, stress management techniques, and assertiveness training. However, the structure, depth, and comprehensiveness of these treatment materials vary widely.

Joes seventh weekly review

Joe's weight had increased to 38.9 kg from 37.8 kg , so he was well within his target weight of 38 kg to 40 kg . In eight weeks Joe had gained just under 8 kg , which was a fantastic achievement. Joe desperately wanted to leave The Great Barn and come home, but there was still a long way to go. The care team were still concerned about his ritualistic tendencies. Staff still suspected Joe was exercising in secret and Joe had been observed doing discreet exercises during the community meeting and hopping and skipping on the walk to the day centre. It had also been noted that Joe was becoming much more assertive and that he had requested shorter rest periods. It was clear that the care team felt that Joe was fighting against them rather than working with them.

Establishing Maintaining And Ending Therapeutic Relationships

Alongside this awareness of beginning interpersonal relationships with adults with learning disabilities, consideration needs to be given to how to maintain these relationships, using everyday opportunities to engage in valued conversation. Often, as carers, our interaction with people is associated with personal care (Ambalu, in O'Hara & Sperlinger 1997). The demands of time and perhaps staffing levels can limit opportunities care must be taken to guard against this and to be conscious of developing opportunities for 'real' conversations. We need to accept and value times at which people may choose not to interact with us, hence supporting people to be assertive and enabled to indicate to carers when they wish to disengage or be left alone, which is equally important (Ferris-Taylor, in Gates 2003).

Inter Vention A Ttention A Ttention Now Hear This

Among the most salient of challenges was my fear of venturing out of my comfort zone to self-actualize in an area outside my home-making duties and find a job in the workplace. One of the difficulties of achieving and living a more psychologically healthy existence is the resistence of family members who prefer to remain unchanged by a new lifestyle of one of its pivotal members. Comments such as I have not had a good meal in many weeks to There is no orange juice were expressed on a regular basis. Success in this arena meant my own acceptance and value of these achievements and my assertion that things have changed and that others in the household were now responsible for their daily living conditions. Being assertive at home and in the workplace required a skill that demanded practice and rehearsal, which the group experience supplied.

Second Stage Developing An Interpersonal Relationship With The Horse

Which demanded more precise handling of the horse. Handling and taking care of the horse included brushing and washing of the horse, and putting on the saddle. The group members also cleaned the stables. Greater emphasis was placed on group work, which involved rubbing shoulders with one another and addressing interpersonal situations. At this stage attention was paid to feelings of trust, readiness for devotion, and assertive behavior. Intimacy in the group increased and it appeared that this was facilitated by the decrease in the level of anxiety.

Treatment Strategies for Each Class of Targets

N. also reported that her drug use was often motivated by her desire to hurt herself to make her boyfriend feel bad and thereby punish him. Therefore, individual therapy also focused on C. N.'s use of the assertiveness skills she was learning in the Interpersonal Effectiveness module of the DBT skills group, to express better her needs and her feelings of disappointment or anger when these were not met. Cognitive restructuring work also focused on whether hurting her boyfriend actually led to any substantive positive outcomes for her, even if it might have felt satisfying momentarily, or whether, as in the previous example, it simply resulted in C. N. feeling bad about herself and further damaging the relationship.

CT for Residual Symptoms

Cognitive restructuring follows the classic format of Beck et al. (1979 Beck & Emery, 1985) and is based on introduction of the concept of automatic thoughts (Session 2) and of observer's interpretation (Session 3 and subsequent sessions). The problems that may be the object of cognitive restructuring strictly depend on the material offered by the patient. They may encompass insomnia (sleep hygiene instructions are added), hyper-somnia, diminished energy and concentration, residual hopelessness, reentry problems (diminished functioning at work, avoidance and procrastination), lack of assertiveness and self-care, perfectionism, and unrealistic self-expectations.

The Final Phase of Treatment

If the patient remains committed to change after the discussion of the implications of changing core beliefs, then a number of techniques can be adopted, including public declarations of the intent to change, clarifying the old and new ways to think and act (or even to dress and talk), or changing relationships and the personal environment so that they are more consistent with the new schema that is being cultivated. One particularly powerful change method, the as if technique, involves discussing how a patient would think and act if he she had truly internalized the new belief, then structuring behavioral homework as if the patient had actually done so. This technique potentially allows the patient to discover that he she can live life using the new beliefs. It also has a reasonable probability of engendering negative reactions from others in the social environment, so these reactions must be anticipated. Part of this planning may include discussion of assertive ways for the patient...

Medical Illness as a Target of Treatment

They help patients with both medical problem solving and decision making, and with the assertiveness and communication skills needed to interact with health care providers, third-party payers, employers, and assistance agencies. Also, the targets of treatment in CT for depression in medical patients often include health behavior problems such as smoking, lack of exercise, or medication nonadherence. Thus, therapists often play an important role in their patients' medical care.

Interpersonal Problems in Bipolar Disorder and Their Psychotherapeutic Treatment

But the problems between patient and partner have only just begun. Assuming the patient is stabilized on medication, there comes the necessity for maintenance psychotropic drug treatment, and monitoring of this treatment. Since noncompliance is not unusual in bipolar patients, clinicians sometimes ask the partner to provide information regarding the patient's medication-taking behaviour. As illustrated in the reference, the patient may come to believe that the clinician and marital partner are then in collusion against him her. If the patient is a woman and the clinician a man, there is the additional accusation that both men are trying to control the woman, suppress her assertiveness and creativity, and interfere with her drive towards independence and autonomy 1 . Female bipolar patients, while hypomanic, may leave their husbands and therapy declaring freedom at last from male domination. Unfortunately these flights into freedom are often short-lived as the patient's manic behaviour...

Considering consequences C

I want more responsibility and the pay and recognition that go along with it. I've been here for six years, and I'm still doing the same things I was when I got here. I don't think the problem is a lack of skills I'm pretty confident about my talent. One of the books I've read suggests that maybe I haven't been assertive enough and made myself known around here. This issue keeps me up at night, so it's quite important. I can work on my assertiveness skills maybe take a Dale Carnegie class and go to Toastmasters. It took me a while to realize this, but learning assertiveness and speaking skills may help a lot. The people who've done well here are a lot more sociable than I am. This fits in with my other idea about assertiveness. I think it actually has a pretty darn good chance of working. I won't particularly like doing it, and I'll feel uncomfortable, but it's likely to pay off.

Gender And Substance Abuse Treatment

Substance-abuse treatment programs have been geared more to the problems and needs of male clients. Some contend that only sex-segregated treatment can meet the unique needs of female clients. Even those advocating integrated programs acknowledge the need for greater attention to women's issues. In addition to parenting responsibilities, it is urged that treatment programs address women's histories of physical and sexual abuse, domestic violence, and relationships with substance-abusing partners. Burman (1994) also suggests that treatment programs for women should emphasize skills such as problem solving, assertive-ness, self-advocacy, and Life Skills (including parenting and job seeking).

Davis Adelle 190474

O ne of the early twentieth-century diet authorities who had a professional background in nutrition. Trained in dietetics and nutrition at the University of California at Berkeley, she received her M.S. degree in biochemistry from the University of Southern California in 1938. Her work piggybacked on that of Gayelord Hauser in that she was an early advocate of nutritional supplements as well as natural foods in specific combinations. In i935, Stationers' Hall of London, England published her Optimum Health, and in 1939 her second book, You Can Stay Well. In i942, the Macmillan Company published the most assertive of Davis's works of the period, Vitality through Planned Nutrition.

Job Performance

Crawley, Pinder, and Herriot (1990) showed that g was predictive of task-related dimensions in an assessment-center context. The lowest and highest uncor-rected correlations for g were with the assertiveness dimension and the task-based problem-solving dimension, respectively.


Schmidt and Miller (1983) conducted one of the earliest studies on the efficacy of bibliotherapy for depression as compared to a wait-list control group, group therapy in a small group, group therapy in a large group, and individual therapy. The authors created a multidimensional program that consisted of cognitive restructuring, assertiveness training, and behavior management. Results indicated that participants in all treatment conditions improved significantly on all depression measures, and gains were maintained at an 18-week follow-up. There were no differences across treatment groups. However, none of the therapists in the study were professionals, which may affect the generalizability of the results. One study evaluated a version of self-help in which bibliotherapy was supplemented with a videotape and periodic telephone contact (Osgood-Hynes, Greist, & Marks, 1998). This 12-week treatment, known as COPE , was used in an uncontrolled open trial with a general adult population....

Group Therapy

In hospital settings, educational groups are an essential part of the early treatment process, and the subjects covered in these groups are quite similar to those in educational family groups (described in the first section of this article). The major difference of emphasis in patient educational groups is on the physiological aspects and risk factors of drugs and alcohol. Other important didactic groups cover in detail issues such as (1) Assertiveness Training (2) other compulsive behaviors, such as sexuality, eating, working, and Gambling (3) Relapse Prevention (4) the prolonged abstinence syndrome (5) leisure skills and (6) cross addiction. All educational groups include appropriate coping strategies, some of which are developed from the experiences of recovering members. combined with empathy for others, and has scaled down inordinate demands on others for superego reassurance. He or she has become effectively assertive rather than destructively aggressive and has developed a...


In a longitudinal study of women from Mills College in the San Francisco bay area, Helson and Wink (1992) examined changes in personality between the early forties and early fifties. They used the California Psychological Inventory at both time periods. The most dramatic change occurred on the femininity scale (now called the femininity masculinity scale). High scorers on femininity tend to be described by observers as dependent, emotional, feminine, gentle, high-strung, mild, nervous, sensitive, sentimental, submissive, sympathetic, and worrying (Gough, 1996). Low scorers (i.e., those who score in the masculine direction), in contrast, tend to be described as aggressive, assertive, boastful, confident, determined, forceful, independent masculine, self-confident, strong, and tough. In terms of acts performed (recall th Act Frequency Approach from Chapter 3), as reported by the spouses of these women,

Who Dates When

Even while chaperoned dating has virtually disappeared, the median age at which dating begins decreased from sixteen in 1924 to thirteen in 1990. Most females begin dating by fourteen years of age, while males begin between fourteen and fifteen. Initially, dating takes the form of mixed-gender groups involved in common activities, with dating as a couple delayed until approximately fifteen or sixteen years of age. By sixteen, more than 90 percent of all adolescents report having had at least one date, and by their senior year in high school, 50 percent of adolescents report dating more than once a week. The majority of teens report having had at least one exclusive relationship during middle adolescence, lasting several months to perhaps a year. And even though females tend to be more assertive, males continue to initiate most dating encounters.


Mental health professionals can play an important role in the prevention of HIV by providing information about safer sex, drug use, and other means of transmission. School programs focused on self-esteem building and assertiveness training have been shown to help teenagers navigate the complex interpersonal situations that can place them at risk for acquiring HIV. Mental health professionals can also work with parents, encouraging them to foster an environment of open communication in the home.

Function Basic

Although advocate roles and titles differ slightly from one cooperative group to another depending on the structure and specific needs of the group, their function is comparable from group to group. In all the cooperative groups patient advocates sit on and participate in disease committee activities, including discussion and comment on ideas and concepts presented to a committee, protocol development, conference calls, reviewing informed consent documents and committee decision making regarding prioritization of studies. Advocates are also part of administrative and modality committee activities, playing an active role in education, ethics, quality of life, cancer control prevention and diversity committees among others. The degree of participation among advocates varies according to the experience and assertiveness of the advocate, the culture of the committee and the committee chair's comfort level with advocate participation.

Irritability Anger

These emotions are often a response to events that are perceived to be physically or psychologically threatening. They can be brought on by overindulgence, overwork, or exhaustion, or they may be associated with digestive ailments and, in men, premature ejaculation or impotence. Such feelings may lead to depression. Physical manifestations include an increased pulse rate, fluttering feelings in the stomach, and tense muscles. SELF-HELP Get more exercise and practice relaxation techniques, meditation, or movement therapy such as tai chi (see page 217). Assertiveness training may help to overcome feelings of insecurity.

Social Phobia

Young people with social phobia are often overly sensitive to criticism, have trouble being assertive, and have low self-esteem. Social phobia may be limited to certain situations so that the adolescent may experience a sense of dread in relation to dating or recreational events but may be confident in school and work situations.


All too frequently 'shortage' is used in an assertive way by people having a vested interest of some sort in the entity asserted to be in short supply. The way economists would address any question of the adequacy of the supply of an entity relates to the value to be attached to the increase (and by whom it is attached) compared to the cost of creating the increase. If the value exceeds the cost, there is a shortage in the sense that (ceteris paribus, and given a few other assumptions) more ought to be consumed. More crudely, if demand exceeds supply at the going price there is said to be a shortage. However it does not follow that this shortage ought to be eliminated (for example, by allowing price to rise, supply to increase or demand to fall, or any combination of these three) unless there are grounds for believing that the efficient (or equitable) allocation of resources would be enhanced thereby. Likewise, in comparing the marginal value with the marginal cost, the interpretation...

Patient Education

Lives and how it affects their family and friendships. To manage their disorder, they must learn to be more assertive in declining extra tasks and invitations. For example, a holiday tradition that includes eight extra family members visiting as house guests may need to be changed a better plan may be meeting daily for a few hours at a restaurant or other location outside the home over two to four days. In well-managed FM, fatigue control becomes an important strategy. This means on occasion limiting chores to those that are most essential or deciding on just one of several possible fun activities. Energy-saving techniques can include simple changes such as sitting during showering or while brushing teeth. Many with FM have great difficulty with activities that require them to hold their arms at shoulder height or higher for long periods. Therefore, a woman with FM might need to opt for a hairstyle that doesn't require a great deal of hair drying and styling.

Social development

Sex typing refers to gaining the general characteristics that a particular culture regards as appropriate to being male or female. This is not the same as gender identity. So, for example, I might have a strong sense of myself as male but, nevertheless, not mind expressing attitudes and behaviours that are considered to be more typical of females in my culture. Think of people that you know where there might be an apparent discrepancy between gender identity and sex typing. Perhaps the most interesting aspect of gender identity is that it is not fixed but can be changed or modified. Such changes have been seen developing in Western culture during the past few decades in which some women have taken on more male characteristics and some men have taken on more female characteristics. For example, some women are more assertive in the workplace than they once were and some men are more socially and emotionally sensitive than once they were.

Case Example 1D

T began to realize how much his difficulties in competing were linked with angry feelings that triggered guilt and a need for punishment. Thus, Mr. T did not take advantage of certain opportunities to expand his territories and be promoted when younger because he feared creating a conflict and felt guilty about his efforts to outdo his rivals. For similar reasons, he did not bring up certain creative ideas he had with his boss. Understanding these issues led to his feeling increased freedom to be assertive in his office as he felt safer with his competitive wishes. He had a dream in which his rival at work was having difficulty and he felt very happy about it.

Case Example 1E

T wanted to confront his wife about her infrequent desire for sex but was inhibited by fears of disrupting their relationship further and by his feeling that he did not deserve more from her. Mr. T also experienced inadequacy with his therapist, fearing that the clinician wanted him to be more assertive with his wife and that he wasn't getting a good grade and was disappointing him. The therapist explored Mr. T's need to be the good patient and submit to what he felt the therapist required of him, just as he had with his mother to be the good little boy. Mr. T's case followed the core dynamic of depression in which narcissistic injuries experienced in childhood led to anger and vengeful fantasies of retaliating against loved ones to get what he needed. He felt guilty about these fantasies, further lowering his self-esteem, and feared punishment via castration or some other retaliation. Understanding these dynamics helped to reduce his guilt and allow for a...

Case Example 4

Mired in his conflicts about confronting others with his anger, Mr. W generally directed anger toward himself via self-destructive behavior. For instance, he would not exercise and he chain-smoked cigarettes. In addition, he would not be assertive in his career, and his law practice suffered.

Individual Alone

Individual CT may be used to target depressive symptoms and behaviors that have an impact on the family. Behavioral interventions may focus on increasing the patient's assertiveness and setting limits, decreasing criticism, expression of both positive and negative feelings in a constructive manner, increasing social activities, and completing family-related responsibilities. Cognitive interventions may focus on changing the way an individual interprets his her family member's behavior, and modifying dysfunctional beliefs about relationships. For example, a depressed individual may


N. had marked decreases in self-injurious behaviors (overdosing, cutting, and hitting herself) moderate increases in attendance and timeliness for therapy and completion of self-monitoring forms moderate increases in work attendance, interpersonal assertiveness, and involvement in hobbies and moderate decreases in drug and alcohol use, self-blame and guilt, anger, and depressive symptoms. Progress across the year of treatment was far from linear, however. C. N. experienced several relapses in which she overdosed, engaged in other self-injury, or was physically violent toward her boyfriend. Indeed, arguments with and physical violence toward her boyfriend continued relatively unchanged. There were several discussions about the wisdom of continuing in what was clearly a very problematic relationship, especially because her boyfriend continued to sell drugs. On one level, C. N. was aware that it was a huge problem, but she remained very ambivalent and not ready to end the...

Course of Treatment

Over the course of 20 A-CT sessions, Mr. Turner was taught the cognitive model. His forte was identifying and reevaluating logical errors in cognition, such as all-or-none thinking, overuse of should statements, perfectionism, and personalization. Because he was able to distance himself from his depression, he viewed himself as having a recurrent illness that could be treated rather than as weak and incompetent. The therapist used role plays and homework assignments to help Mr. Turner increase his assertive behavior and respond effectively when choir members criticized him. He also learned to prioritize and schedule his major responsibilities, to have time for himself and his family. During the fourth session of C-CT, Mr. Turner was distressed about his relationship with his oldest daughter. On the one hand, he feared that she would not comply with any limits he tried to place on her behavior, so their difficulties would intensify. On the other hand, he was upset with himselffor being...


But introspection cannot be a form of perceiving. Perception invariably involves sensory qualities, and no qualities ever occur in introspection other than those of the sensations and perceptions we introspect the introspecting itself produces no additional qualities. Moreover, speech acts generally express not perceptions, but thoughts and other intentional states (see intentionality). So introspective reports express intentional states about the mental states we introspect, and introspective representations of concurrent mental states involve assertive intentional states, or thoughts. introspection is deliberate and attentive because these higher-order intentional states are themselves attentive and deliberate. And our introspecting seems spontaneous and unmediated presumably because we remain unaware of any mental processes that might lead to these higher-order intentional states. Introspection consists in conscious, attentively focused, higher-order thoughts about our concurrent...

Why Am I Doing This

Other researchers (e.g., Ford, 1992 Wentzel, 1991) have adopted a more complex perspective on goals and motivation, arguing that there are many different kinds of goals individuals can have in achievement settings. For example, Ford (e.g., Ford, 1992 Ford & Nichols, 1987) defined goals as desired end states people try to attain through the cognitive, affective and biochemical regulation of their behavior. Similar to Rokeach's (1979) human values and Eccles' attainment value (Eccles, 1983), Fords' set of goals included affective goals (e.g., happiness, physical well-being), cognitive goals (e.g., exploration, intellectual creativity), and subjective organization goals (e.g., unity, transcendence). Like Deci and Ryan's self-determination theory, his list of important goals also included self-assertive goals such as self-determination and individuality, integrative social relationship goals such as belonging-ness and social responsibility, and task goals such as mastery, material gain,...

Sizing things up S

I want more responsibility and the pay and recognition that go along with it. I've been here for six years, and I'm still doing the same things I was when I got here. I don't think the problem is a lack of skills I'm pretty confident about my talent. One of the books I've read suggests that maybe I haven't been assertive enough and made myself known around here. This issue keeps me up at night, so it's quite important.

Treatment Options

Social-skills training includes techniques for improving communication skills, forming and maintaining interpersonal relationships, resisting peer pressure for drinking, and becoming more assertive. Research on its effectiveness has been encouraging.