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Assertiveness Training with Outpatients: The Effectiveness of Skill and Cognitive Procedures

Forty-four community mental health outpatients participated in an assertiveness training program in which three treatment methods were compared. Skill training aimed at training specific assertive responses by means of instruction, modeling, behavioral rehearsal, feedback, and homework assignments. Cognitive training focused on altering the irrational cognitions which theoretically inhibit the expression of assertive responses. A third group (Cognitive–Skill) received both forms of training simultaneously, and a fourth group (Waiting List) was included as a control. A behavioral roleplaying test (B.R.P.T.) and the Social Fear Scale were administered prior to and immediately following four individual training sessions occurring at one week intervals for all three treatment groups. Analyses of covariance of assertive content ratings made by independent judges for B.R.P.T. responses revealed that all three treatment groups evidenced significantly more assertive and effective responses on both refusal and behavior change situations when compared to the Waiting List control. Analyses of paralinguistic dimensions of the B.R.P.T. revealed training generally to be more successful for the Skill group.