Les troubles psychiatriques sévères entravent le développement de la socialisation durant l’adolescence. Toutefois, l’entraînement aux habiletés sociales (EHS) permet d’améliorer le fonctionnement interpersonnel.

Tester l’effet sur l’assertivité des participants et spécifier pour quel type de population le programme d’EHS semble être le plus bénéfique.

L’assertivité de 38 adolescents (19 souffrant de troubles anxieux/dépressifs et 19 souffrant de troubles psychotiques) a été mesurée à l’aide de l’échelle d’assertivité Rathus (permettant de différencier les adolescents : inhibés, assertifs et assertifs-agressifs) avant et après un programme d’EHS.

Nous observons une augmentation des scores à l’échelle Rathus (amélioration à l’échelle Rathus de 5,46, partial eta square (η2)=0,131 : taille d’effet modéré). Par ailleurs, les adolescents souffrant de troubles anxieux/dépressifs présentent une amélioration importante à l’échelle Rathus (amélioration à l’échelle Rathus de 9,36, partial eta square (η2)=0,206 : taille d’effet modérée) ainsi que ceux « inhibés » (amélioration à l’échelle Rathus de 9,81, η2=0,311 : taille d’effet forte).

Nous avons observé une amélioration générale de l’assertivité après l’EHS. Plus spécifiquement, ce sont les adolescents souffrant de troubles anxieux/dépressifs ainsi que les adolescents « inhibés » qui bénéficient le plus du programme d’EHS utilisé. Les facteurs pouvant rendre compte de ces résultats sont discutés.

Adolescence is a crucial period involving numerous acquisitions of social skills. These skills were experienced in peer relationships. In this context, assertivity is a fundamental ability allowing individuals to act in function of their own interests and defend their point of view without denying the rights of others. However, for some adolescents such acquisition is not easy. Thus, anxiety, social withdraw or emotion regulation difficulties impaired the socialization process. More specifically, psychiatric illness (such as mood disorder, anxiety or psychosis disorder) during this period interferes dramatically with such acquisition. However, training targeting social skills improvement, in a population presenting psychiatric disorders may help to enhance interpersonal functioning. In this perspective, the present study aimed (1) to assess the effect on assertivity of the training and (2) to specify the patient's type which reports the most benefit of such training.

Thirty-eight adolescents (19 suffering from anxiety/mood disorders and 19 suffering from psychotic disorders) participated in a social skill training. Their assertivity was assessed with the Rathus assertivity scale which is a 30-item self-report questionnaire. The participant respond on a Likert scale composed of 6 points (from “totally true” to “totally false”). The Rathus assertivity scale allows to differentiate adolescents in: Inhibited, assertive, assertive-aggressive. The scale was administered before and after the social skills training.

A general improvement on assertivity after the social skills training (partial eta square (η2)=0.131: moderate effect size) was observed. More specifically, adolescents suffering from anxiety/mood disorder (partial eta square (η2)=0.206, moderate effect size) and the “inhibited” adolescents (η2=0.311, strong effect size) showed the higher benefit from the social skills training.

The social skill training was reported by the adolescents to be an effective treatment allowing enhancing the assertivity of these population. Furthermore, the patients with anxiety/mood disorders reported the highest benefit compared to the patients with psychosis. This result raised the question about the usefulness of self-report questionnaire, as the patients with psychosis were observed, at a clinical level, to have better social abilities after the treatment, but did not report such effect on the self-assessment. In addition, the inhibited patients reported the highest benefits of such treatment. Three main factors could help us to interpret the results: (a) the composition of the groups, (b) the therapeutic approach, and (c) the team giving the social skill training. Firstly, the composition of the groups is heterogeneous like in the social reality of the youths. Thus, the heterogeneity of the psychopathologies composing the groups involved that the youths experienced a wide variety of social interactions with peers. Furthermore, some adolescents could experiment to be a model for others. However, related to our results, we could assume that adolescents with anxious/mood disorders benefit the most from the heterogeneity of the groups and the fact to be a model for others. Secondly, the therapeutic tools used seem also to be an important factor. Indeed, the training is based on cognitive and behavioral approach (using tools like psycho-education, cognitive restructuration, etc.) and social learning which are frequently used in this type of training. Thus, psycho-education allows acquiring new knowledge about their difficulties, for example. In particular, we could understand the most important increase in adolescents with anxiety/mood disorders by the fact that relaxation exercises could reduce their symptoms and so increase their assertivity. In contrast, for adolescent with psychosis disorders, this is not sufficient. Perhaps, their dysfunctional believes had to be reduced before they could benefit from the social skills training. Thirdly, the team giving the social skill training is also important. They all receive a complete training and have a lot of experience in working with such population. More generally, learning new social abilities in protected context, through experiencing positive social interaction may be beneficial for interpersonal function of the patients.