Self-Regulation CAP Fall 17 [Student ID: 1039983]

Instance of: Assertiveness (Old Version)
Administered By: Shaw, Olivia
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Grade: 9Gender: male Date Taken: 1/10/17
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This assessment measures two important components of assertiveness:
1. Express Myself: Do you express your own opinions, needs, and preferences?

2. Respect Others: Do you show respect to others, even if you disagree?

The graph highlights your strengths.



QuestionReversed?TopicVERY
like me		54321NOT
like me
1. I stand up to my friends if they are doing something I don't feel comfortable doing.Boundaries
2. To be honest, people often take advantage of me.YESBoundaries
3. I have personal boundaries like 'no cheating off my homework' or 'I won't let friends borrow money"Boundaries
4. If someone was upsetting me, I would keep my feelings to myself rather than politely remove myself from the situation.YESBoundaries
5. I often have a hard time saying 'No"YESExpress Myself
6. I express my opinions, even if others disagree with me.Express Myself
7. When an argument is over, I often wish I would have said what was really on my mind.YESExpress Myself
8. I tend to just go along with what everyone else wants, instead of stating my own thoughts.YESExpress Myself
9. I sometimes avoid asking questions for fear of sounding stupid.YESExpress Myself
10. I tend to bottle up my emotions rather than talk about my feelings.YESExpress Myself
11. If I disagree with my teacher, I talk to him or her about it.Express Myself
12. 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 Myself
13. I generally express how I feel.Express Myself
14. If my food order is wrong, I will return it.Express Myself
15. I tend to lose my temper and swear at people.YESRespect Others
16. I tend to yell at people when I don't get my way.YESRespect Others
17. I am careful to avoid hurting other people's feelings, even when I feel that I have been wronged.Respect Others
18. I am very careful to avoid attacking someone's intelligence when I disagree with their ideas.Respect Others
19. I appreciate other people's opinions, even if I disagree with them.Respect Others
20. In discussions, I restate what others said to make sure I understood them correctly.Respect Others
21. In discussions, I communicate that I am listening through body language (nodding my head, eye contact).Respect Others
22. Even in an argument, I don't interrupt the other person.Respect Others