Choosing Memento Vivere

Assertiveness Inventory

A 35-item situational reflection by Alberti & Emmons. Responses are organized into conversation themes; no total score, severity band, or diagnosis is calculated.

Rate how often each statement applies to you. After submitting, your responses will be organized into neutral conversation themes for reflection with your clinician.

Your Name Client Code (provided by your therapist)

Question 1 of 35

When a person is highly unfair, do you call it to attention?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 2 of 35

Do you find it difficult to make decisions?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 3 of 35

Are you openly critical of others' ideas, opinions, behavior?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 4 of 35

Do you speak out in protest when someone takes your place in line?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 5 of 35

Do you often avoid people or situations for fear of embarrassment?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 6 of 35

Do you usually have confidence in your own judgment?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 7 of 35

Do you insist that your spouse or roommate take on a fair share of household chores?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 8 of 35

Are you prone to fly off the handle?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 9 of 35

When a salesperson makes an effort, do you find it hard to say No even though the merchandise is not what you want?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 10 of 35

When a latecomer is waited on before you, do you call attention to the situation?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 11 of 35

Are you reluctant to speak up in a discussion or debate?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 12 of 35

If a person has borrowed something and is overdue in returning it, do you mention it?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 13 of 35

Do you continue to pursue an argument after the other person has had enough?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 14 of 35

Do you generally express what you feel?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 15 of 35

Are you disturbed if someone watches you at work?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 16 of 35

If someone keeps kicking your chair in a movie, do you ask them to stop?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 17 of 35

Do you find it difficult to keep eye contact when talking to another person?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 18 of 35

In a restaurant, when your meal is improperly prepared, do you ask the waiter to correct it?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 19 of 35

When you discover faulty merchandise, do you return it for adjustment?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 20 of 35

Do you show your anger by name-calling or obscenities?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 21 of 35

Do you try to be a wallflower in social situations?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 22 of 35

Do you insist that your property manager make repairs that are their responsibility?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 23 of 35

Do you often step in and make decisions for others?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 24 of 35

Are you able to express love and affection openly?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 25 of 35

Are you able to ask your friends for small favors or help?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 26 of 35

Do you think you always have the right answer?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 27 of 35

When you differ with someone you respect, are you able to speak up for your viewpoint?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 28 of 35

Are you able to refuse unreasonable requests made by friends?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 29 of 35

Do you have difficulty complimenting or praising others?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 30 of 35

If disturbed by someone smoking near you, can you say so?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 31 of 35

Do you shout or use bullying tactics to get others to do as you wish?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 32 of 35

Do you finish other people's sentences for them?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 33 of 35

Do you get into physical fights with others, especially strangers?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 34 of 35

At family meals, do you control the conversation?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Question 35 of 35

When you meet a stranger, are you the first to introduce yourself and begin a conversation?

Never/No Sometimes/Somewhat Usually/A Good Deal Almost Always/Entirely

Your responses are confidential.

Thank you

Your assessment has been recorded.

You may close this page.

© 2026 Jonathan Procter, Ph.D., LMHC — Choosing Memento Vivere

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