Practice Assertiveness Questionnaire


By: Eary,Sydney
Instance of:  Assertiveness Questionnaire (7-12)
To Print this page: Click Here

For help with printing (margins, paper size, etc): Click Here

Assertiveness is the ability to express your wants, needs, and thoughts while respecting others, even when it is difficult.

The first section shows your students' self-rated behaviors on the two components of assertiveness:
1. Express Myself
2. Respect Others

The graph provides average ratings for all items within a component, and the table displays the number of students that selected each rating for individual items. Some items, such as "I often have a hard time saying 'No,'" are reverse scored. Selecting a rating of '1 - not very like me' means that students are demonstrating the ability to say no when there is pressure to do something that they do not want to do, whereas if they selected a rating of '5 - very like me,' they currently may need to focus on the express myself component of assertiveness.

NOT Like Me
VERY Like Me
Question Topic Reversed? Average Reverse Corrected Average #1 Cnt #2 Cnt #3 Cnt #4 Cnt #5 Cnt
1. I stand up to my friends if they are doing something I don't feel comfortable doing.Express MyselfNO5500002
2. I speak up when someone is not respecting my personal boundaries like 'no cheating off my homework' or 'I don't let friends borrow money.'Express MyselfNO5500002
3. I often have a hard time saying 'No.'Express MyselfYES4200020
4. I express my opinions, even if others disagree with me. Express MyselfNO3300200
5. When an argument is over, I often wish I would have said what was really on my mind.Express MyselfYES4200020
6. I tend to just go along with what everyone else wants instead of stating my own thoughts.Express MyselfYES1520000
7. I sometimes avoid asking questions for fear of sounding stupid.Express MyselfYES3300200
8. I tend to bottle up my emotions rather than talk about my feelings.Express MyselfYES2402000
9. If I disagree with my teacher, I talk to him or her about it.Express MyselfNO4400020
10. If a person has borrowed money (or a game, clothes, or something else of value) and is overdue in returning it, I talk to the person about it.Express MyselfNO1120000
11. I'm usually able to tell people how I'm feeling.Express MyselfNO3300200
12. If I don't like the way someone is being treated, I speak up about it.Express MyselfNO4400020
13. I speak up about things I really care about.Express MyselfNO3300200
14. I am careful to avoid hurting other people's feelings, even when I feel that I have been wronged.Respect OthersNO2202000
15. I have a hard time controlling my emotions when I disagree with someone.Respect OthersYES2402000
16. I avoid attacking someone's intelligence when I disagree with their ideas.Respect OthersNO4400020
17. I listen to other people's opinions, even if I disagree with them.Respect OthersNO3300200
18. In disagreements, I make sure that I understand other points of view.Respect OthersNO2202000
19. In discussions, I communicate that I am listening through body language (nodding my head, avoiding rolling my eyes). Respect OthersNO5500002
20. Even in an argument, I don't interrupt the other person.Respect OthersNO4400020
Total Average With Reverse Questions Flipped 3.4 OR (60%)