6.3 Interpersonal Communication and Skills That Promote Healthy Interactions

Key Takeaways

  • The four communication styles -- passive, aggressive, passive-aggressive, and assertive -- are distinguished by whether a person expresses their own needs and whether they respect the other person's; assertive communication does both.
  • A complete I-statement names the feeling, the specific behavior, the impact, and the requested change, which keeps the focus on the behavior rather than attacking the person.
  • Nonverbal communication -- posture, eye contact, tone, volume, and proximity -- must match the verbal message, because a mismatched delivery undermines even a well-worded refusal.
  • Effective refusal skills combine a clear no, a reason or alternative, matching nonverbal assertiveness, and persistence when pressure is repeated -- the single most commonly omitted element is repeating the refusal.
  • Collaborative conflict resolution seeks a solution meeting both parties' underlying interests, and is distinguished from compromise, in which both parties give something up.
Last updated: August 2026

Two Standards in One Section

National Health Education Standard 4 requires students to demonstrate effective interpersonal communication skills to enhance health. Because it is a demonstration standard, communication must be taught the way a motor skill is taught: modeled, broken into components, rehearsed, and given feedback. Explaining assertiveness produces students who can define assertiveness.


The Four Communication Styles

Two questions define the grid: does the person express their own needs, and does the person respect the other's?

StyleOwn needs expressedOther respectedSignature behaviorTypical result
PassiveNoYesYielding, apologizing, silence, avoidingNeeds unmet; resentment accumulates
AggressiveYesNoBlaming, insulting, threatening, dominatingShort-term compliance; relationship damage
Passive-aggressiveIndirectlyNoSarcasm, the silent treatment, deliberate delay, subtle sabotageConflict persists unaddressed
AssertiveYesYesDirect, honest, respectful statement of feelings, needs, and limitsNeeds stated; relationship preserved

Assertiveness is the instructional target across every health topic -- refusing a substance, telling a friend a joke was hurtful, asking a partner to use protection, telling a coach about pain, asking a teacher for help.

Distinguishing assertive from aggressive

Students commonly confuse the two, since both are direct. The difference is respect for the other person's rights. "I'm not going to do that, and I'd rather stay" is assertive. "That's the stupidest thing you've ever said" is aggressive. Both are direct; only one preserves the relationship.


I-Statements

The I-statement is the workhorse assertive structure. A complete one has four parts:

I feel [emotion] when [specific, observable behavior] because [impact on me]. I would like [specific requested change].

Example: "I feel frustrated when practice plans change the morning of, because I've already arranged my ride. I'd like to know by the night before when we can."

Why it works: it reports the speaker's experience, which cannot be argued with, rather than asserting a claim about the other person's character, which will be defended. Two failure modes appear as exam distractors:

  • The disguised you-statement: "I feel like you are being selfish." The word I appears, but the content is an accusation.
  • The vague behavior: "I feel upset when you disrespect me." Disrespect is an interpretation; the statement needs an observable behavior.

Active Listening in Peer Interaction

Communication is bidirectional, and Standard 4 includes receiving. Components students should demonstrate: attending nonverbally, allowing the speaker to finish, paraphrasing content, reflecting feeling, asking open clarifying questions, and summarizing. Blockers to name and avoid: interrupting, advising before understanding, minimizing, judging, and topic-hijacking to one's own experience.


Nonverbal Communication

Delivery carries much of a message's force, and a mismatch between words and delivery undermines the words.

ChannelAssertive deliveryUndermining delivery
PostureUpright, squared, groundedSlumped, turned away, shifting
Eye contactSteady and appropriate to the cultural contextAvoided entirely, or used as a stare-down
VoiceFirm, even volume, steady paceTrailing off, rising into a question, shouting
Facial expressionMatching the messageSmiling or laughing while refusing
Proximity and gestureComfortable distance, open handsCrowding, pointing, arms rigidly crossed

A refusal delivered while laughing and stepping closer reads as flirtation or negotiation, not a no. This is why refusal practice must be observed, not written.

Cultural note: norms for eye contact, personal distance, volume, and directness vary substantially, and instruction should acknowledge that rather than presenting one cultural style as universally correct.


Conflict Resolution

Five standard approaches, each appropriate somewhere:

ApproachConcern for own goalConcern for relationshipWhen appropriate
AvoidingLowLowTrivial issue; unsafe moment; need to cool down first
AccommodatingLowHighThe issue matters far more to the other person
CompetingHighLowSafety emergency; a nonnegotiable boundary
CompromisingMediumMediumTime-limited; both can give something up
CollaboratingHighHighThe relationship and the outcome both matter; time exists

Collaboration versus compromise is a favorite distinction. In compromise both sides give something up and neither is fully satisfied. In collaboration the parties look behind their stated positions to underlying interests and search for an option that meets both. Two students both wanting the last basketball court can compromise by splitting the hour, or collaborate by discovering one wants shooting practice and the other wants a game, and running a shooting game together.

The collaborative sequence

  1. Cool down enough to talk
  2. Each states their view using I-statements; the other paraphrases before responding
  3. Identify the shared interest and define the problem jointly
  4. Brainstorm options without evaluating
  5. Evaluate against agreed criteria and choose
  6. Agree on specifics and a check-in

Refusal Skills

Refusal is the most heavily assessed skill in adolescent health education. Its components:

  1. A clear, unambiguous no. Not "I don't think I should" -- "No, I'm not doing that."
  2. A reason or alternative -- brief; a long justification invites negotiation. "I've got a game tomorrow. Let's get food instead."
  3. Matching nonverbal delivery -- steady voice, upright posture, no laughing.
  4. Repetition. Pressure is rarely single. The broken record technique repeats the same refusal without new arguments, because each new reason gives the other person something to counter.
  5. Leaving. If pressure continues, exit. Naming this in advance -- an exit plan, a code word to a parent, a ride arranged -- makes it usable.

The repetition component is the one students most often omit and the one exam items most often test. A student who says no once and then argues is being drawn into negotiation.

Teaching sequence

Model with think-aloud, break into the components above, rehearse in low-pressure pairs, add realistic persistence, score with a rubric whose criteria are the components, then debrief and re-run.


Common Praxis Traps

  • Trap 1: Confusing assertive with aggressive. Both are direct; only assertive respects the other person.
  • Trap 2: Accepting a disguised you-statement. "I feel like you are..." is an accusation.
  • Trap 3: Assessing communication with a written test. Delivery must be observed.
  • Trap 4: Omitting repetition from refusal instruction. Real pressure repeats.
  • Trap 5: Equating collaboration with compromise. Compromise splits; collaboration finds an option meeting both interests.
Test Your Knowledge

A student says to a teammate, 'I feel like you don't care about this team at all.' Why does this statement fail as an I-statement?

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Test Your Knowledge

During a refusal role-play, a student clearly says 'No, I'm not going to do that,' but does so while laughing and stepping closer to the person applying pressure. What feedback should the teacher give?

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Test Your Knowledge

Two students both want the single available gymnasium court. One wants shooting practice; the other wants to play a game. They design a shooting-based game they can run together. This resolution approach is best described as:

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Test Your Knowledge

A student practicing refusal skills says no once, then begins explaining in detail why the activity is a bad idea when the peer keeps pressing. Which refusal component is the student failing to apply?

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