Putting It All Together: Being More Assertive Worksheet Template Page 8
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10--------------------------------------------------------------------------------------------------------------ASSERT YOURSELF!
Are you More Assertive?
Congratulations! You have now completed all the modules in the programme “Assert
Yourself”. You can now redo the exercise from module 1 where you rated your
assertiveness in different situations and see if you have become more assertive!
Exercise. Rating your assertiveness in different situations
Fill in each cell using a scale from 0 to 5.
A rating of 0 means you can assert yourself with no problem.
A rating of 5 means that you cannot assert yourself at all in this situation.
Friends
Friends of
Authority
Strangers
Work
Intimate
Shop
of the
different
figures
colleagues
relations
assistants
same
gender
or spouse
gender
Saying No
Giving
compliments
Expressing
your opinion
Asking for help
Expressing
anger
Expressing
affection
Stating your
right and
needs
Giving
criticism
Being criticised
Starting and
keeping a
conversation
going
C
entre for
C I
linical
Module 10: Putting it all Together: Being More Assertive
Page 8
nterventions
• Psychotherapy • Research • Training
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