Communication Styles – Extended

A detailed handout describing four key communication styles (assertive, passive, aggressive, and passive-aggressive) to support psychoeduction and communication skills development.

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Professional version

Offers theory, guidance, and prompts for mental health professionals. Downloads are in Fillable PDF format where appropriate.

Client version

Includes client-friendly guidance. Downloads are in Fillable PDF format where appropriate.

Overview

Assertive communication can lead to improvements in mental health symptoms, relationships, workplace performance, and personal safety. A key component of assertiveness training is recognizing different ‘styles’ of communication and correcting misconceptions about assertiveness. This information handout provides a detailed overview of assertive and non-assertive styles of communication (i.e., passive, aggressive, and passive-aggressive), outlining the thoughts, feelings, behaviors, intentions, and typical consequences associated with each style.

Why Use This Resource?

Communication styles influence how individuals interact, express their needs, and manage conflict. Understanding and developing effective communication skills is essential for mental health and healthy relationships.

  • Builds awareness of communication patterns.
  • Distinguishes between assertive and non-assertive behavior.
  • Highlights the benefits of assertive communication.
  • Supports interpersonal effectiveness.

Key Benefits

Clear

Differentiates between communication styles using easy-to-understand descriptions.

Educational

Helps clients understand the emotional and relational consequences of different styles.

Versatile

Suitable for psychoeducation, assertiveness training, and CBT-related interventions.

Engaging

Accessible and relatable.

Who is this for?

Social anxiety disorder (SAD)

For clients who fear judgment and avoid speaking up.

Generalized anxiety disorder (GAD)

For individuals who struggle with expressing concerns or saying no.

Depression

For clients who find it difficult to advocate for themselves.

Borderline personality disorder (BPD)

As part of dialectical behavior therapy (DBT) skills training for interpersonal effectiveness.

Low self-esteem

Helps clients confidently express their thoughts, feelings, and needs.

Relationship problems

For clients struggling with patterns of avoidance, conflict, or submission.

Workplace stress

For difficulties with boundaries, conflict, or assertiveness at work.

Integrating it into your practice

01

Introduce

Use the handout to introduce the concept of communication styles.

02

Review

Discuss examples of each style and identify which are most familiar to the client.

03

Reflect

Encourage clients to reflect on the outcomes of different communication patterns in their own life.

04

Explore

Discuss more effective ways of communicating (e.g., assertiveness).

05

Train

Model, practice, and fine-tune assertive communication.

Theoretical Background & Therapist Guidance

This Communication Styles – Extended resource draws on research exploring interpersonal behavior and assertiveness training. Assertive communication is considered an adaptive form of self-expression that emphasizes clarity, respect, and responsibility.

Assertiveness deficits have been conceptualized through various lenses, including skills deficits, response inhibition, and difficulties knowing when to communicate in this way (Linehan, 1979). Conversely, assertive communication is associated with positive psychological and social outcomes, such as improved self-esteem, reduced anxiety, and enhanced relational functioning.

Assertiveness training typically involves self-monitoring, cognitive restructuring, behavioral skills training, and real-world practice. This detailed handout supports these therapeutic components by providing key psychoeducation regarding different communication styles.

What's inside

  • Definitions and descriptions of passive, aggressive, passive-aggressive, and assertive communication.
  • A visual, side-by-side comparison table of thoughts, feelings, behaviors, and consequences associated with each style.
  • Summary of the impact of each style on the individual, others, and relationships.
  • Therapist guidance for introducing the material in-session.
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FAQs

Communication styles are groups of conversational behaviors that form recognizable patterns.
Assertive communication is a clear, honest, and respectful way of communicating that is effective in many situations.
Assertiveness supports healthy relationships, improves confidence, promotes fairness in interactions, and can help improve mood-related difficulties.

How This Resource Improves Clinical Outcomes

  • Describes unhelpful communication patterns.
  • Provides key psychoeducation within assertiveness training or work around interpersonal effectiveness.
  • Supports reflection and self-monitoring between sessions.
  • Offers a shared vocabulary for discussing communication difficulties.
  • Reinforces skills development.

References And Further Reading

  • Alberti, R. E., & Emmons, M. L. (2017). Your perfect right: Assertiveness and equality in your life and relationships (10th ed.). Impact Publishers.
  • Alden, L., & Cappe, R. (1981). Nonassertiveness: Skill deficit or selective self-evaluation? Behavior Therapy, 12, 107-114. DOI: 10.1016/S0005-7894(81)80111-6.
  • Ames, D. R., & Flynn, F. J. (2007). What breaks a leader: The curvilinear relation between assertiveness and leadership. Journal of Personality and Social Psychology, 92, 307-324.
  • Birtchnell, J. (1996). How humans relate: A new interpersonal theory. Psychology Press.
  • Birtchnell, J. (2002). Relating in psychotherapy: The application of a new theory. Brunner Routledge. DOI: 10.1002/cpp.615.
  • Blood, L., Adams, G., Turner, H., & Waller, G. (2020). Group dialectical behavioral therapy for binge‐eating disorder: Outcomes from a community case series. International Journal of Eating Disorders, 53, 1863-1877.
  • Bonham-Carter, D. (2012). Assertiveness: A practical guide. Icon Books.
  • Chłopicki, W. (2017). Communication styles: an overview. Styles of Communication, 9 (2).
  • Duckworth, M. P. (2009). Assertiveness skills and the management of related factors. In W. T. O’Donohue & J. E. Fisher (Eds.), General principles and empirically supported techniques of cognitive behavior therapy (pp. 124–132). John Wiley and Sons.
  • Duckworth, M. P., & Mercer, V. (2006). Assertiveness training. In J. E. Fisher & W. T. O’Donohue (Eds.), Practitioner’s guide to evidence-based psychotherapy (pp. 80-92). Springer.
  • Eisler, R. M., Hersen, M., Miller, P. M., & Blanchard, E. B. (1975). Situational determinants of assertive behaviors. Journal of Consulting and Clinical Psychology, 43, 330–340.
  • Epstein, N., Degiovanni, I. S., & Jayne-Lazarus, C. (1978). Assertion training for couples. Journal of Behavior Therapy and Experimental Psychiatry, 9, 149-155.
  • Gerber, L. (2023). From middle-class American women to French managers: The transatlantic trajectory of assertiveness training, c. 1950s–1980s. History of Psychology, 26, 187–209.  
    Gilbert, P., & Allan, S. (1994). Assertiveness, submissive behaviour and social comparison. British Journal of Clinical Psychology, 33, 295-306.
  • Goldfried, M. R., & Davison, G. C. (1976). Clinical behavior therapy. Holt, Rinehart, and Winston.  
    Hagberg, T., Manhem, P., Oscarsson, M., Michel, F., Andersson, G., & Carlbring, P. (2023). Efficacy of transdiagnostic cognitive-behavioral therapy for assertiveness: A randomized controlled trial. Internet Interventions, 32, 100629.
  • Hansford, B. C., & Hattie, J. A. (1987). Perceptions of communicator style and self-concept. Communication Research, 14, 189-203.
  • Hayward, M., Strauss, C., & Kingdon, D. (2012). Overcoming distress voices: A self-help guide using cognitive behavioral techniques. Robinson.
  • Jakubowski, P., & Lange, A. J. (1978). The assertive option: Your rights and responsibilities. Research Press Company.
  • Karatuna, I., Jönsson, S., & Muhonen, T. (2020). Workplace bullying in the nursing profession: A cross-cultural scoping review. International Journal of Nursing Studies, 111, 103628.
  • Lee, S., & Crockett, M. S. (1994). Effect of assertiveness training on levels of stress and assertiveness experienced by nurses in Taiwan, Republic of China. Issues in Mental Health Nursing, 15, 419-432.
  • Linehan, M. M. (1978). Behavioral treatment of assertiveness problems: A clinical study. Journal of Behavior Therapy and Experimental Psychiatry, 9(3), 183–189.
  • Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.
  • McKay, M., Davis, M., & Fanning, P. (2018). Messages: The communication skills workbook (4th ed.). New Harbinger Publications.
  • Paterson, R. J. (2022). The assertiveness workbook: How to express your ideas and stand up for yourself at work and in relationships (2nd ed.). New Harbinger Publications.
  • Pfafman, T. M., & McEwan, B. (2014). Polite women at work: Negotiating professional identity through strategic assertiveness. Women’s Studies in Communication, 37, 202-219.  
    Rakos, R. F. (1991). Assertive behavior: Theory, research, and training. Routledge.
  • Simpson Rowe, L., Jouriles, E. N., McDonald, R., Platt, C. G., & Gomez, G. S. (2012). Enhancing women’s resistance to sexual coercion: A randomized controlled trial of the DATE program. Journal of American College Health, 60, 211-218.
  • Speed, B. C., Goldstein, B. L., & Goldfried, M. R. (2018). Assertiveness training: A forgotten evidence-based treatment. Clinical Psychology: Science and Practice, 25, e12216.
  • Suzuki, E., et al. (2009). Relationship between assertiveness and burnout among nurse managers. Japan Journal of Nursing Science, 6, 71-81.
  • Vagos, P., & Pereira, A. (2016). A cognitive perspective for understanding and training assertiveness. European Psychologist, 21, 109–121.
  • Williams, M. J., & Tiedens, L. Z. (2016). The subtle suspension of backlash: A meta-analysis of penalties for women’s implicit and explicit dominance behavior. Psychological Bulletin, 142, 165–197.
  • Wolpe, J. (1954). Reciprocal inhibition as the main basis of psychotherapeutic effects. Archives of Neurology and Psychiatry, 72, 205–226.