print this page    

NHES SKILLS

Interpersonal Communication

Interpersonal communication "means showing appropriate ways to exchange your ideas and needs." A student demonstrates appropriate application of this skill when he / she can do a good job of presenting both sides of an issue, showing how both sides feel and interact, showing respect, using appropriate language, not using "put downs", and using strategies such as "I messages" and refusal techniques. Some examples of activities that help to build this skills include skills, role plays, dialogue, and puppet shows. (from: Assessing Health Literacy: A Guide to Portfolios).

Interpersonal Communication Primer
Most people want to be understood and accepted more than anything else in the world. Knowing this is the first step toward good communication. Good communication has two basic components:

• You listen to and acknowledge other people's thoughts and feelings: Rather than showing that you only care about broadcasting your feelings and insisting that others agree with you, you encourage others to express what they are thinking and feeling. You listen and try to understand.
• You express your own thoughts and feelings openly and directly: If you only listen to what other people are thinking or feeling and you don't express your own thoughts or feelings, you end up feeling shortchanged or "dumped on."
  

To communicate effectively, practice using these interpersonal communication skills.

• I-statements help you express the way you feel and what you want with great clarity. Sometimes people use "you" statements, such as "You never call when you are going to be late." This type of statement can make others feel angry and defensive immediately. When you use I-statements, such as, "I really need to know when you're going to be here so I can make plans," you express your the concern in terms of you.
• A respectful tone of voice conveys that you are taking others seriously and that you also expect to be taken seriously. In addition, people with good communication skills are assertive without being aggressive or manipulative.
• Eye contact is vital for good communication. For example, how would you feel if the person you were talking to kept looking around the hallway or out the window?
• Appropriate body language encourages conversation. Nodding your head, smiling, laughing, using words such as "uh-huh" and "yeah" and asking questions at appropriate times assure the person that you are really listening.
• Clear, organized ideas help you accurately and honestly describe your feelings and contribute to conversations and to decisions that need to be made. Good communicators are also specific. For example, a good communicator would say, "I need to use the computer from 7-9," as opposed to "I'll need the computer tonight."

Refusal Techniques

Saying No!
Skill Practice
Young people may find themselves in a variety of pressure situations, so no single refusal strategy can be adequate for safeguarding their health. Students must be equipped with a repertoire of strategies to choose from, depending on the setting. Effective skill practice has the following components.
1. Introduce the skill.
2. Present steps for developing the skill (if applicable).
3. Model the skill correctly.
4. Allow learners to practice and rehearse the skill.
5. Provide feedback and reinforcement.

Ways to Say No

1. Say no firmly.
When you are asked or pressured to do something you don't want to do, say no firmly and convincingly. Sometimes it's best to say no and physically turn away.

2. Repeat the word no over and over.
If teased or called a name, don't counter with your own "put downs"; just continue to repeat the word no. Usually, the other person eventually gets tired and leaves.

3. Give an excuse (a believable one).
Examples:

• I tried it once, and when I got home, my folks could smell smoke on my clothes, and I was grounded for a week.
• I tried smoking a couple of times and always got sick. The doctor said I'm probably allergic to tobacco smoke.
• I gotta go home and babysit my kid sister.
• I've got a cold sore in my mouth, and everything hurts.

4. Give reasons.
Similar to the "Give an excuse" refusal strategy, this technique stresses the use of a rationale to explain why one is not participating in a certain behavior. Knowing the facts about tobacco can help. Examples:

• Tobacco would be one more thing to worry about. Besides, I need the money for other things.
• Diabetes runs in my family, so I don't want to risk my health with nicotine.
• My dad just quit smoking, so he could smell cigarette smoke on me a mile away.

5. Avoid or leave the situation.
When in an unfamiliar setting such as a party, scan the room to see what different people are doing. Many times the tobacco users hang out by themselves. Avoid these people while looking for those who share your values to talk to. If you find yourself getting pressured or just feel uncomfortable with what is going on around you, say that you have to meet someone (or will be back later) and then leave immediately.

6. Change the subject.
If the conversation begins to drift to the topic of drug use, subtly change the subject. Example:
"Hey, let me tell you how wasted I got last week."
"Speaking of wasted, did you see how Stone Cold Steve Austin 'wasted' the Undertaker on WWF last night?"

7. Suggest an alternative activity.
Invite your friends to do something else, which leaves the door to the friendship open. Examples:

• I'm going to my house to play Nintendo, want to come?
• No thanks, Dude, let's go to the video arcade.
• I'm starving; I want to get a taco. Who wants to go with me?

8. Ignore the problem/act dumb.
Remind students of the tone of voice they employ when they try to convince you that they just can't remember that you said they were going to have a quiz today.
Examples:

• Huh?
• Yeah, right?
• Say what?
• Duh, I don't know what you're talking about.

9. Find friends who feel the same way you do.
There really is safety in numbers, especially if the "numbers" (your friends) share your beliefs and values about not smoking or not using drugs. For example, at a party, you and your friends can watch out for each other. If pressured to use a drug by someone, you could turn to your friends and say, "Do the rest of you go along with this?" or "Are they crazy or what?"

10. Reverse the pressure.
Shift the focus away from the tobacco and onto your friendship. People who are really your friend will usually back off at this point. If friends keep pressuring you, rather than argue with them, simply say, "Why are you hassling me on this?" or "Why are you on my case so much today?" People who are really your friends will usually back off at this point. This skill is effective only if a friendship already exists. A person who doesn't really care for the other isn't going to be put off by these questions.

Another version of this if the Fairness Argument. For example, you could say, "Look, I'm not telling you not to smoke, so why are you telling me I have to smoke?" or "I'm not telling you what to do with your life…so why are you trying to tell me what to do with mine?"

11. Delay your decision.
If you're being pressured, this skill buys you time and temporarily, at least, gets you off the hook. Responses include: In a minute; catch me later; not yet.
Another version is to combine this strategy with Number 6, Change the Subject. For example, you could say, "Not now, I'm getting ready to dance/talk to, check out that person over there."

Be aware that using this strategy may give the impression that you are a person who sometimes uses tobacco. If you want to get the word out that you are tobacco free, this strategy may send mixed messages. It may be more appropriate to use when you are with a group of people you don't expect to see again.

12. Tell your friends, "I have made a decision."
The best decision for your health is to be tobacco free. If you're clear about your decision, your friends may stop pressuring you.

Web-Links

• Resisting Peer Pressure. DHHS.

"I" Statements/ Assertiveness Skills

Communication Styles
Without adequate communication skills, adolescents may be unable to release their feelings. This lack of communication can increase stress and lower self-esteem.
There are three styles of communication:

• passive
• assertive
• aggressive

Passive communication involves the inability or unwillingness to express thoughts and feelings. Passive people will do something they don't want to do or make up an excuse rather than say how they feel.

Assertive behavior involves standing up for oneself. Assertive people will say what they think and stand up for their beliefs without hurting others.
The aggressive style of communication involves overreaction, blaming and criticizing. Aggressive people try to get their way through bullying, intimidating or even physical violence. They do not or will not consider the rights of others.

Types of Messages
There are two types of messages that accompany each style of communication: nonverbal and verbal. Signs, symbols, posture, body movements, dress, facial expressions and gestures are examples of nonverbal messages. The nonverbal messages reinforce what the speaker is saying. For example, passive communicators often have slumped posture and a lack of eye contact. Assertive people exhibit erect posture and direct eye contact. Forward-leaning posture, pointing and a glaring look are nonverbal signals of aggressive communication.

The verbal messages for each communication style are very different. People who are passive will often ask questions to determine what others want, or they may say, "I don't care." Assertive communicators use I-messages to say what they want or need. They use refusal skills to say no while maintaining important relationships. People who are aggressive often use you-statements to blame or criticize.

Components of Assertive Communication
The components of verbal messages for assertive communication include I-messages and refusals. I-messages state what the sender thinks, feels, needs, wants or believes. They begin with the word I.

Examples of I-messages:

• I want to see Star Wars.
• I feel angry about the game.

There are a variety of refusal strategies, including:

• Say the word no firmly.
• Repeat no (if needed).
• Let the other person know you want to stay friends.

Examples of refusals:

• No, I can't sleep over on Friday, but I would like to another time.
• No, thanks. I'm allergic to peanuts. The cookies look really delicious, and I'm sorry I can't have one.

Assertiveness Skills

What is the difference between assertiveness (confrontation) and aggressiveness?
Assertiveness, or confrontation, means taking the initiative or first steps to deal with a problem in a constructive, self-protective manner. Assertiveness attacks the problem, not the person.

Aggressiveness attacks the other person rather than the problem. It is a destructive desire to dominate another person or to force a position or viewpoint on another person; it starts fights or quarrels.

When do you use assertiveness skills?
These skills can be used when another's behavior is not acceptable or when continued "listening and accepting" isn't appropriate. People often avoid confronting others about their behavior because they don't want to hurt the relationship. However, avoiding problems may cause bad feelings to build and may result in an explosion or withdrawal from the relationship. Using I-messages to be assertive is constructive, rather than destructive. It helps people deal with problem behavior in a way that allows the other person to agree to change while not damaging the relationship.

How do you use this skill?
The goal is to get other people to change their behavior without putting them down or making them feel badly toward you. You may like the person; it's a particular behavior of the person that you don't like. Your purpose is to address the behavior, not to "dress down" the person.

The Importance of I-messages
I-messages are designed to deal with problems. The purpose of an I-message is to express your needs. It expresses the attitude "I am not going to give up my needs and I'm willing to help you meet your needs," creating a win-win situation.
I-messages attempt to deal with the problem situation by talking about it in terms of what is happening to me-I've got a problem. An I-message is disarming. It's hard for someone to say something nasty in response to a good I-message. On the other hand, a "you" message blames others and puts them on the defensive. Then they want to retaliate, to get even.

Steps in Using I-Messages
There are three parts to delivering an I-message, although sometimes not all three parts are used.

A description of the behavior. What is it the other person is doing that gives you a problem? You are describing something to the other person, not blaming her or him for something. I-messages tell others that their behavior is interfering with something you need (not just something that you want). Give the other person a clear idea of what he has done without extra blame or guilt added.

A description of the feeling this behavior causes you. How does what the other person is doing affect you?

A description of the effects produced by the behavior. What concrete problem is the behavior causing you? If you can help other people see how their behavior effects you, then they are more likely to change the behavior.

Examples
Mother to teenage son:

• "You" message: You just tracked mud all over my clean floor! I just mopped that floor! You are such a slob.
• I-message: When I see mud tracked into my clean kitchen, I get irritated, because I have to clean it up again.

One friend to another:

• "You" message: You don't care about anyone but your own fat self!
• I-message: I feel hurt when you only call me to come over to visit when none of your other friends are available. I get left out.

Dad yelling at child.

• "You" message: You're late again! I told you to be home by 9:00 and it's 10:00. You have no consideration at all and care for no one but yourself."
• I-message: When you come home late, I get really upset because I worry that something bad has happened to you.

Hints for Successful I-messages

• Be specific in describing the problem behavior
• Make eye contact
• Use a respectful tone of voice, not an aggressive or confrontational tone
• Be aware of what your body language is saying-that it is reinforcing what your words say.

When an I-message Doesn't Work
If an I-message isn't working, it may be a lousy message. Yes, the words may be OK, but the tone may be full of blame or rage or disrespect. Pay attention to the non-verbal message. Is your face red; are your eyes bulging; are you yelling to the top of your voice? Or are you cool, calm and collected?

There is little to be gained by sending an anger message. Try to stop and think about why you are so angry. You will likely find other feelings underneath the anger: frustration, embarrassment, rejection, fear, hurt and loneliness.

Sometimes, an I-message may not work if the other person has a strong need to continue her or his behavior. If the other person is upset and out of control, shift gears. Try active listening, change the environment, or let him or her blow off steam.

I-messages also may not work if the other person doesn't agree that the "effect" on you is a real problem. This is a values collision, which occurs often in families.

If there is a conflict of needs, an I-message won't be enough. You'll need to give up on the I-message and work out the conflict with some other techniques.