PubMed · 15224525
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Susanne Gaddis. Positive, assertive "pushback" for nurses.. https://pubmed.ncbi.nlm.nih.gov/15224525/
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This study's objective was to evaluate the effect of an assertiveness training program on nursing and medical students' assertiveness, self-esteem, and interpersonal communication satisfaction. Using a longitudinal research design, 69 participants whose scores on the Assertive Scale were < or = 50% (i.e., low assertiveness) and who were willing to participate were included and assigned to an experimental group (33 subjects) or comparison group (36 participants; participants were matched with the experimental group by grade and sex). Participants in the experimental group received eight 2-h sessions of assertiveness training once a week. Data were collected before and after training and again one month after the end of the training using the Rotter's Internal versus External Control of Reinforcement Scale, Sex Role Inventory, Assertive Scale, Esteem Scale, and Interpersonal Communication Satisfaction Inventory. The generalized estimated equation (GEE) method was used for statistical analysis. The assertiveness and self-esteem of the experimental group were significantly improved in nursing and medical students after assertiveness training, although interpersonal communication satisfaction of the experimental group was not significantly improved after the training program.
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Cognitive-behavioral therapy (CBT) has a proven role as an adjunct to antipsychotic medication and remediative approaches such as social skills training in the management of residual symptoms of chronic schizophrenia. Positive symptoms, depression, and overall symptoms appear to be viable treatment targets for CBT with a less pronounced effect on negative symptoms. The effect size at end of therapy is strong, with durability at short-term follow up. CBT can be used safely in patients with schizophrenia, and caregivers can help with homework exercises. There is also evidence that psychiatric nurses in the community can use CBT effectively with this patient group under supervision. CBT can be combined with family therapy and assertive community treatment programs targeted to reduce relapse. CBT improves the coping of patients with schizophrenia through improved adherence and symptom management. CBT techniques include development of trust, normalizing, coping strategy enhancement, reality testing, and work with dysfunctional affective and behavioral reactions to psychotic symptoms. An enhanced response to CBT would be expected when given with low dose cognitively enhancing atypical antipsychotic medication.