Assertive behaviour can help to create a more profitable therapy practice. Often confused with aggressiveness, which is concerned with winning, Assertiveness is stating clearly and directly what you want or how you feel about a situation. It is a both/and position rather than an either/or, and is based in mutuality of respect for ourselves and the other person.

In any given situation, behaving assertively helps ensure the needs of both parties are met, helps you to stay firm in negotiation, and helps recognise the position of the other without necessarily giving ground.

Why is assertiveness important for profitability? Without having to defend a position in order to win, any negotiations can be conducted easily and quickly.

Situations in which Assertiveness supports profitability in a practice include:

• Fee negotiations
  • Being clear in your own mind about your terms
  • Clearly expressing them to client
  • Following up when necessary, for example, by reminding the client of what you agreed
• Cash collections
  • Prompting the client to pay, if necessary
  • Addressing non-payment with the client, both in business and clinical terms
• Staff management, (if applicable) including
  • Work targets, expectations and consequences
  • Salary negotiation and
  • Performance review: Appreciating strengths and contributions, Addressing problem areas if they arise
• Having appropriate authority in the client work
• Cost monitoring and negotiation: Shopping around, requesting variations in service agreements, asking for better price
• Bank borrowing and negotiations

Assertive behaviour starts with being clear about what you want in any given situation, and being able to express it. Many people are focussed on what they won’t want, to the extent that they have never really clarified what it is they would like instead. For example, in your practice, perhaps you are concerned about having enough work. You may find yourself focussing on the reasons why you don’t have enough work, maybe the recession, the locality you’re working in, the facilities at your place at work, or the other health professionals in your area.

Becoming more assertive means shifting your focus to what you’d like instead. From there, you can more clearly see what is possible, what you can do for yourself, and what you’d like others to support you with.

So assertive skills start with being clear. The first and most important skill is to

Be specific

• Say what you want to say, clearly and firmly; and
• Avoid unnecessary padding or waffle

Let’s take the example of a client who is leaving the room without making any indication about your fee. Perhaps they have forgotten, become distracted by the session you’ve just had together, or maybe there’s something else going on. You would like them to pay you. So you say something like, “Before you go, you need to pay me.” The tone you use will convey how you feel about this, so if possible, keep it light, after all, you don’t know what’s happening for the client at this time.

If having been specific, you feel the other person has not heard or acknowledged what you’ve said, the next couple of skills may help you to get their attention more fully. Using the example above, let’s say that despite your direct reminder the client goes to leave the room without paying.

Repetition (Broken Record)

• Repeat where necessary: You might say, “I don’t know if you heard me, but before you go, my fee..?”

Fielding the Response

• Not getting caught in irrelevant deflection or argument: Depending on what happens next, this skill may or may not be appropriate. Let’s say the client hears you the second time, but introduces something new at this point, such as: “Do you think I should…?” Don’t get lost in this tantalising diversion. Indicate you’ve heard what they said, but return to your own agenda, which is getting paid. You might say something like, “Maybe we could have a look at that question next week? And now, my fee?”

Workable Compromise or Alternative

• Listen to and acknowledge the objections / comments raised and attempt to meet them if possible. Perhaps the client says they do not have enough money with them, or proposes some sort of payment schedule. Weigh up whether you want to agree to this or not, and say so. If you don’t like what they’re proposing, say so. You might say something like, “Okay, but I’d be grateful if you could pay me the balance at the next session.”

Additional skills include:

Self –disclosure

• Let them know how it is for you (if appropriate). For example: “I’d prefer if we stuck to our agreed arrangement, that you pay me each week for that week’s session.”

Negative assertion

• Own your part (if appropriate). For example: “I know we’ve had these situations before, and I haven’t said anything, but now I want to regularise the situation.”

Negative Inquiry

• Ask for feedback (if appropriate). For example: “How is it for you when I say that?”

There are lots of situations where being clear in your own mind, and then communicating that to others, can support you moving to a more profitable practice. Behaving assertively is like any skill, it takes time to learn and practice it. If you struggle with this in your practice, perhaps I can help you? Contact me here for your free 20 minute consultation, or leave your comment or question in the box below.