The goal is not to make the client sound like the therapist.
In this simulation, you will work with a client who struggles to communicate
limits at work and at home. Your task is not to find the most assertive sentence.
It is to determine what makes communication difficult, what the client wants to
accomplish, and what happens when other people respond.
You’ll practice
Formulating before scripting
Clarifying what the client is trying to communicate
Distinguishing warmth from appeasement
Rehearsing pushback rather than only opening lines
Separating clarity from persuasion
Working with guilt and relational friction
Incorporating hierarchy and realistic interpersonal risk
Adapting assertiveness to client voice, relationship and culture
Approx. 25–35 minutes
What do I want?
↓
What stops me from saying it?
↓
What does expression risk?
↓
What language fits me?
↓
What happens after the response?
Case orientation
Meet Elena
Elena is 32 and works as a project coordinator at a university.
Her manager, Martin, frequently sends requests late in the afternoon.
Most are not emergencies. Elena usually responds immediately anyway.
She stays late, rearranges plans, and then feels angry.
Friday · 4:37 PM · Martin
“Can you clean up the enrollment spreadsheet before Monday? Shouldn't take too long.”
Elena stays until 7:15 and misses dinner with a friend.
Monday · Martin
“Thanks for taking care of that.”
The problem may not be knowing what to say.
Decision 1 · Formulate before scripting
Elena
“I was furious.”
“But obviously I said, ‘No problem.’”
“I shouldn't have to tell a grown man not to send me work at 4:37 on a Friday.”
What do you need to understand first?
“What were you predicting would happen if you didn't stay?”
“Did you know what you wanted to say?”
“What were you trying to protect?”
Clinical Support
Assertiveness training starts before the sentence.
4:37 PM request
↓
“If I don't do it, he'll think I'm difficult.”
↓
Stay late
↓
Avoid possible disapproval
↓
Resentment
↓
Manager receives no information that the timing is a problem
Decision 2 · What is the goal?
Elena
“I want him to stop doing it.”
Is that the communication goal?
Clinical Support
Assertiveness is not control.
Outcome you cannot guarantee
“Make Martin stop.”
Communication goal
Communicate availability and clarify urgency without automatically accepting the implied deadline.
Decision 3 · “Assertive” according to whom?
Elena
“I don't want to march into his office and say, ‘You need to respect my boundaries.’”
“That is not how I talk.”
“I hate those therapy scripts.”
What do you do?
Clinical Support
Teach function, not one communication dialect.
Relevant information
Preference / limit
Request
Openness to response
These are communication functions, not mandatory sentence structures.
Decision 4 · What does assertiveness cost?
Elena
“I could technically say that.”
“The problem is what happens after.”
What do you ask?
Clinical Support
Identify what assertiveness is expected to cost.
“I don't know what to say.”
↓
“He'll think I'm not a team player.”
↓
Possible loss of professional standing
Clients often know the words. The obstacle may be what they believe will happen after they use them.
Decision 5 · Warmth or appeasement?
“I'm really sorry, but I have plans tonight and
I know this is probably inconvenient and
I don't want you to think I'm not willing to help,
but maybe if it's okay I could possibly do this Monday?”
Elena
“That's embarrassing.”
What do you modify?
Clinical Support
Do not confuse warmth with appeasement.
Chosen courtesy
“I can take a look Monday morning.”
Useful clarification
“If you need it sooner, what's time-sensitive?”
Possible disapproval management
“I'm really sorry…”
“I don't want you to think…”
Clinical question
What function is each phrase serving?
Decision 6 · Role-play failure
Elena
“I can get to this Monday morning. If it needs to be done before then, can you let me know what's urgent?”
Therapist as Martin
“I was hoping to have it done tonight.”
Elena
“Okay, I can stay.”
Where did the skill break down?
Clinical Support
Rehearse the difficult turn—not only the opening line.
Weak rehearsal
Client says boundary ↓ Therapist congratulates ↓ End
Full rehearsal
Client communicates ↓ Other person reacts ↓ Client feels discomfort ↓ Client responds again
The hardest part may begin after the first sentence.
Decision 7 · The rule underneath
Elena
“I can get to this Monday morning. If you need it sooner, what's the urgent piece?”
Therapist as Martin
“I'd really prefer it done tonight.”
Elena
“Is tonight required for something happening this weekend?”
Martin
“No. I just wanted to clear it off my list.”
Elena
“Then Monday morning works for me.”
Elena
“That felt rude.”
What do you work on?
Clinical Support
Assertiveness often reveals the rule underneath.
A preference is not legitimate unless I can prove necessity.
Possible next move
Cognitive restructuring
Possible next move
Behavioral experiment
Possible next move
Continued rehearsal
Real-world practice plan
Next late-day nonurgent request
□ Pause before answering
□ Clarify timing if necessary
□ State realistic availability
□ Do not invent an excuse
□ Remain in the interaction after pushback
□ Record what actually happens
Prediction: Martin will think I'm less committed.
70%
Decision 8 · Genuine urgency
Wednesday · 4:42 PM · Martin
“Could you update the student-contact list today?”
Elena
“I can do it first thing tomorrow. Is there a reason you need it tonight?”
Martin
“I was going to send it to the dean this evening.”
What should Elena do?
Clinical Support
Assertiveness is responsive, not rigid.
Decline
Deliberate choice
Agree
Assertiveness can include counteroffering, narrowing scope, agreeing, asking for time, or declining.
The question is whether the client remains part of the decision.
Outcome 1
Elena asks what part the dean actually needs that evening.
Martin
“Just the updated phone numbers. The rest can wait.”
Elena
“I can update that piece before I leave. I'll finish the full list tomorrow.”
Elena leaves at 5:20.
Martin
“Perfect, thanks.”
Elena
“That one barely counts. He had a reason.”
Decision 9 · Ambiguous outcome
Friday · 4:31 PM · Martin
“Any chance you can format the committee slides before you sign off?”
Elena
“I can do them Monday morning.”
Martin
“Okay.”
Elena
“He definitely thinks I'm difficult now.”
How do you process the outcome?
Clinical Support
Successful assertiveness does not mean the other person approves.
Observed
Elena stated Monday availability. Martin accepted it. No overt conflict occurred.
Unknown
Martin's private evaluation.
Original prediction
Elena's professional standing will be damaged.
Decision 10 · Actual pushback
Two weeks later, Elena declines an additional event because she is already covering two vacancies.
Martin
“Everyone is stretched right now.”
Martin
“I need people who can be flexible.”
What is the clinical task now?
Clinical Support
Direct communication happens inside power.
Martin
Assigns workload
Evaluates performance
Influences promotion
Controls scheduling
Elena
Currently covering vacancies
Needs continued employment
Has limited workload authority
A feared consequence can be cognitively amplified and structurally plausible at the same time.
Decision 11 · “Assertive enough?”
Elena
“I understand everyone is stretched. I'm currently covering the orientation project and Nadia's portfolio,
so taking on the event would mean delaying one of those. Which priority would you like me to move?”
Elena
“But is it assertive enough?”
How do you answer?
Clinical Support
“More assertive” is not always “better.”
Position
Was Elena's position clear?
Request
Was the ask or limit understandable?
Congruence
Did it sound like Elena?
Context
Did it fit the relationship and risk?
Negotiation
Did it preserve the flexibility she wanted?
Work → Family
Same skill. Different relationship.
Does the form need to remain the same?
Decision 12 · Transfer across relationships
Elena's younger sister frequently calls when distressed.
Elena often answers even when exhausted.
Elena's text
“I love you. I don't have the bandwidth to talk tonight. Can we check in tomorrow?”
Sister
“Wow. Okay.”
Elena immediately calls her.
What should you explore?
Clinical Support
Same skill, different relational language.
COMMUNICATE CAPACITY
Workplace
“Which priority should move?”
Sister
“I want to talk. I can't do it well tonight.”
Friend
“Can we make this another night?”
Clinical team
“I have a different read of the case.”
The function travels. The sentence may not.
Decision 13 · Negative reaction
Elena
“I care about you, and I don't have the capacity for a call tonight. I can talk tomorrow after six.”
Sister
“Forget it. I won't bother you anymore.”
Elena
“See?”
“This is why people say boundaries destroy relationships.”
How do you respond?
Clinical Support
Assertiveness does not prevent relational consequences.
Direct communication cannot guarantee that another person responds maturely,
agrees, remains comfortable, or preserves the relationship exactly as it was.
The skill is not: “Say this and get a good response.”
It is: Communicate more deliberately, then learn from the response.
Decision 14 · Guilt after the limit
Elena clarifies that she still wants to talk the next day.
Her sister later reconnects, though both remain somewhat hurt.
Elena
“I keep expecting the boundary to feel clean.”
What learning do you emphasize?
Clinical Support
Do not use emotion as the sole communication metric.
Communication fit
Emotional comfort
These dimensions do not have to move together.
Clarity
Was the meaning understandable?
Congruence
Did it sound like Elena?
Agency
Did Elena remain part of the decision?
Flexibility
Could she respond to new information?
Outcome
What actually happened?
Aftermath
What guilt, fear, anger or relief emerged?
Context complication
“Sometimes in my family, saying something indirectly is how you preserve dignity.”
Decision 15 · Directness and cultural fit
Elena
“Direct. Individual. Clear. Efficient.”
“Sometimes that sounds like a very particular kind of professional person.”
How do you respond?
Clinical Support
Adaptation is precision.
“What does respect sound like here?”
“When does indirectness preserve dignity?”
“When does it leave you unable to be known?”
“Which parts of the framework fit?”
“Which parts need translation?”
Cultural responsiveness does not mean assuming Elena prefers indirect communication.
It means making the preference itself discussable.
Final integration · Ten minutes remain
Elena
“I thought assertiveness meant becoming someone who doesn't care what other people think.”
“I care a lot what people think.”
“I just don't want that to make every decision for me.”
Where would you go next?
Pattern synthesis
Your clinical attention tended to foreground…
This is not a clinical competence score.
It describes what your decisions tended to emphasize in this simulation.
Completed assertiveness formulation
Request / need / disagreement
↓
“If I express what I want, they'll think badly of me.”
↓
Comply · apologize · overexplain · stay silent
↓
Reduced overt disapproval
↓
Needs remain invisible · resentment increases · little corrective information
Before scripting, ask what the communication needs to do.
Need, preference, limit, disagreement, request, information or repair?
No language? Fear? Shame? Status difference? Trauma response? Cultural mismatch? Uncertainty? Realistic retaliation?
Be understood? Negotiate? Decline? Ask? Repair? Clarify?
What performs the needed function while still sounding like this client in this relationship?
Include that response in rehearsal rather than stopping after the opening sentence.
Can the client remain engaged, clarify, negotiate, pause or repeat their position deliberately?
Not necessarily agreement. Consider clearer expression, agency, usable information, deliberate compromise and contextual fit.
Adjacent interventions
Assertiveness training
How can the client express the need, preference, limit or disagreement?
Cognitive restructuring
What belief makes expression feel dangerous or illegitimate?
Behavioral experiment
What happens when communication changes?
Exposure
What can be learned by approaching disagreement or possible disapproval?
Problem-solving
What practical arrangement needs to change?
Debrief
Reflect on the intervention process.
Formulation
What did you need to understand before scripting?
What was Elena predicting?
Where did the first rehearsal actually fail?
Communication
What made a sentence congruent rather than merely “assertive”?
When was negotiation more appropriate than refusal?
What did pushback add to rehearsal?
Context
How did hierarchy change the formulation?
When was Elena's fear realistic?
What assumptions about communication style needed examination?
Integration
When would you move into cognitive restructuring?
When would you use a behavioral experiment?
When is this primarily an organizational problem?
Take this question with you
If the client can say the “perfect assertive sentence”
but only in a communication style that does not feel like theirs,
whose voice has therapy strengthened?
Continue with The CBT Dive
See what CBT sounds like when the formulation has to happen in conversation.
The transcripts extend these teaching modules into longer clinical conversations,
including hesitations, pivots, incomplete answers, relational moments, and formulation
decisions that are difficult to capture in a technique summary.
Transcripts, Notes and Reflections from The CBT Dive Video Podcast
