ANGER CONTROL PROGRAMS

The anger control group is a cognitive-behavioral approach to eliminating inappropriate aggressive acts. This approach is grounded in the view that an individual’s physiological arousal in an event is mediated by his or her expectations and perceptions of events. Individuals learn to respond to environmental stimuli in a developmental sequence that results in automatic thinking and behavioral reactions. Specific objectives of the anger management program is to help people: 1) develop a readiness to change and learn about the nature of control and its effects on relationships; 2) learn the physiological mechanisms involved in aggressive impulses; 3) recognize the internal and external activating events (or triggers) that often times lead to aggressive behaviors; 4) recognize the role of thinking in controlling intense emotions; 5) learn successful coping mechanisms to limit aggressiveness including relaxation techniques, assertiveness and communication skills, as well as other therapeutic tactics; 6) identify potential barriers to therapeutic change in the future; and 7) develop an appropriate individualized relapse prevention plan to implement as necessary. Several techniques are used to help people better control aggressive behaviors. Specific tools include modeling, role playing, rehearsal, self-instructions to guide and control behavior, self-monitoring, conflict resolution, relaxation tactics, and cognitive disputing and reframing. Members will learn how to use various relaxation techniques including deep muscle relaxation, autogenic training, and guided imagery to increase parasympathetic nervous system responding. We offer a 3 week psychoeducational program for those with minor offenses as well as a structured 12 week intensive education/cognitive behavioral therapy program for more involved cases.

Anger Management: 3 Week Program. Our 3 week program is a structured psychoeducational intervention where first offenders are provided with information that can help them to better manage their anger. The program is based upon a relapse prevention model and encourages using motivational interviewing tactics to help group members realize that handling their affairs with aggressive tactics is unhealthy and counterproductive. The program outline is presented below. Sessions are 1.5 to 2 hours in duration.

1. Introduction: Introduce Choice Theory, Stages of Change Model

2. Cognitive-Behavioral Tactics: Review cognitive and behavioral methods to disrupt anger process

3. Relapse Prevention: Discuss ways to avoid re-offending and provide offer for further services if desired

Anger Management: 12 Week Program. Our 12 week program is a structured, cognitive behavioral psychoeducation/treatment program that is based upon scientifically validated treatment techniques. Please find an outline and description of our basic program below:

1. Introduction: Review group rules and confidentiality; Describe Dangers of External Control Psychology, Introduce Choice theory, Discuss Stages of change and motivation to change. Encourage movement to contemplation or determination that anger is a problem.

2. Defining Anger: Review Choice Theory and motivation; Describe how control issues lead to anger. Various definitions of anger are explored as are members' personal definitions of anger and control. Present cognitive behavioral principles.

3. Physiology Of Anger: Biological components of anger are presented. Members learn relaxation techniques. Discuss impact of thinking on physiology.

4. Anger and Personality: Members will explore how they incorporated anger as a component of their personality. Anger schemas are discussed. Making a philosophical shift in thinking is also discussed.

5. External Triggers: Members identify situations that frequently Lead to the expression of anger. Prevention strategies and escape plans are established.

6. Internal Triggers: Members learn cognitive behavioral principles as they apply to anger management. Specific attention is director toward identifying common cognitive distortions and correcting them.

7. Rewards: Members will discuss how anger has been rewarding, and develop behavioral techniques to manage their own behavior

8. Assertiveness Training: Members will learn to express their thoughts and feelings assertively and not aggressively.

9. Behavioral Blocking: Members learn a variety of behavioral means that they can use to throw off their anger cycle.

10. Lifestyle: Members learn how a variety of lifestyle decisions and mental health problems such as mood disorders (depression and bipolar disorder), psychosis, substance abuse, job stress, etc.

11. Relapse Prevention: Members formulate their relapse prevention plans in group with the assistance of the psychologist or counseling staff.

12. Conclusion: Motivational send-off, review of course material and relapse prevention plan, offer for aftercare as needed.

Member Criteria: Members referred to the 12 week program typically are typically second simple battery or simple assault offenders, or their offenses were severe enough to warrant the referral following a first offense. Such cases would include incidents where there was a serious physical injury to the victim in the case. Appropriate referrals would include second degree battery charges, aggravated battery probationers/parolees, and those convicted of stalking. If during the course of treatment it appears that an individual has a significant psychological or psychiatric complication a referral will be made for psychological assessment consisting of a mental status examination and psychological testing. Members will participate in weekly group therapy for 12 weeks. Absences must be excused prior to any missed appointment. Sessions will last approximately 1 to 1.5 hours in length. In working through the topics mentioned above, an emphasis is directed towards skills based rehearsal and role-play activities to increase the likelihood that the information presented in group will generalize to real-life situations. Failure to complete modules due to lack of participation will result in an unsuccessful discharge with appropriate recommendations for the court to consider. Group members will be provided with an anger management workbook. This workbook will consist of several worksheets appropriate to weekly topics. Group members will be expected to pay for their therapy at the time of service. No group member will be seen if they do not have payment prior to their session.

In both programs, the number of group members will be capped at 7-10 people. Groups will be closed to new members once they are formed. We will not exceed 10 people in each group to ensure quality of care. The court will be provided with weekly progress notes following each session, and we will include a discharge summary of treatment following completion of services.