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©
LDS Family Services and used by Mental Health Resource Foundation with permission
July 2003. “He that is slow to anger is better than the mighty; and he that ruleth his spirit than he that taketh a city.”
Proverbs 16:30

OVERVIEW
PURPOSE
 | To present a coherent clinical model for assessing and treating anger. |
 | To learn how to use anger management training. |
OBJECTIVES
To be able to:
 | Discuss the nature of anger. |
 | Differentiate between “bad” anger and “good” anger. |
 | Track anger; recognize anger patterns and anger cycles. |
 | Implement the Meichenbaum Model to assist in anger management. |
 | Apply relapse prevention measures. |

IMPORTANT CONCEPTS FOR WORKERS
 | Anger is a human emotion. |
 | Anger, like all emotions, is not inherently unhealthy. |
 | Anger is often secondary. |
 | Anger may be addictive. |
 | Anger may be related to frustration or the lack of problem-solving skills. |
 | Anger may be suppressed, only to be expressed while under the influence of
drugs or alcohol. |
 | Successful management of anger can remove significant barriers to individual, family and community progress. |

AGENDA
I. Introduction
A. Anger Management Training.
B. Aggressiveness and assertiveness.
II. Differentiate between “good anger” and “bad anger.”
A. “Good anger”
1. Anger can give you energy.
2. Anger can help you talk with
others.
3. Anger can give you information.
4. Anger can motivate.
B. “Bad anger”
1. Anger stops you from thinking,
feeling and acting clearly.
2. Anger occurs more frequently than
necessary.
3. Anger is the energy that directs
aggression.
III. Track anger; recognizing anger patterns and anger cycles.
A. Tracking anger.
B. Recognizing anger patterns.
C. Recognizing anger cycles.
IV. Present and Demonstrate the Meichenbaum Model
A. Cognitive Preparation.
B. Confronting and coping.
C. Dealing with temporary difficulties.
D. Assessing and self-reinforcement.
V. Describe Relapse Prevention
 | Anger is a common response. It may be overt or covert, expressed openly,
misdirected or disguised as depression or aggression. |
 | Anger may be a symptom of an underlying psychological disorder. |
 | Anger may be constructive if it leads to positive change. |
 | Anger is destructive if it leads to violence or aggression. |

ANGER'S GOOD AND BAD EFFECTS
Anger, like other emotions, is neutral. It may be uncomfortable or
undesirable. However, it is the effects of anger that may be problematic.
Good Effects:
1. Anger gives energy. If there is danger, anger can provide
an extra boost to move you away from a situation.
2. Anger can motivate individuals to talk. If there is a
problem and you are willing to talk about issues, much
good can be done for you and others.
3. Anger can provide information. Anger indicates that
something is wrong.
4. Anger can motivate individuals to take control of their
lives. Self-control is a sign of good mental health.
5. Anger can signal the need to problem-solve. Taking
constructive action to resolve problems makes individuals
feel competent.
Bad Effects:
1. Anger can stop individuals from thinking, feeling and
acting clearly.
2. Anger has an addictive quality resulting in greater
frequency than is needed.
3. Anger may lead to aggression. Anger can build up and
result in violence to self or others. When anger leads to aggression both
suicide and homicide become real possibilities.
4. Anger affects relationships. Anger is incompatible with
intimacy, a necessary ingredient in all good relationships.

MANAGING ANGER THROUGH TRACKS, PATTERNS AND CYCLES
Managing
anger is not magic, but is a skill. Tracking anger, understanding patterns and
cycles can help in managing anger.
Tracking steps include:
A. Cognitions (knowing what angers you)
B. Affect (feelings when you become angry)
C. Behavior (how you act and what you do when angry)
The tracking model

Anger patterns include:
A. Withdrawal/isolation
B. Yelling and shouting
C. Threats
D. Shoving/slapping/punching
E. Violence
Anger cycles include:
A. Pretends to be normal phase
B. Building up phase
C. Acting out phase
D. Downward spiral phase
E. Pretends to be normal phase

MEICHENBAUM MODEL OF ANGER MANAGEMENT INOCULATION TRAINING
An analogue of biological immunization, Anger Inoculation Training prepares
clients to deal with anger by teaching self-control strategies and then exposing
the individual to the stressful situations either in vivo or vicariously.
The four phases of Anger Inoculation Training include:
1. Cognitive Preparation. Clients are provided
with an adaptive way to view and understand their negative reactions. Clients
are told that they can learn coping skills that will allow them to
reconceptualize and deal with such situations without becoming emotionally
upset.
2. Confronting and Coping. The client
learns coping skills, primarily restructuring. Clients are taught to monitor
their negative, maladaptive thoughts when faced with angry situations and to
replace them with coping self-statements. When clients have mastered a number of
coping skills, they are ready to be exposed to angry situations where they can
use their newly acquired skills.
3. Dealing with Temporary Difficulties.
Temporary difficulties in coping are noted and replaced with other strategies.
4. Assessing and self-reinforcement. Assessment
alternatives are: partially successful coping and successful coping.

STRESS INOCULATION FOR FEAR OR ANXIETY, ANGER, AND PAIN
Examples of Coping Self-Statements
|
STAGE OF COPING |
ANGER |
| 1. Preparing |
What do I have to do? This is going to upset me, but I know
how to deal with it. I can manage the situation. I know how to regulate my
anger. Easy does it.
Remember to keep your sense of humor. |
| 2. Confronting & Coping |
Think of what you want to get out of this.
There is no point in getting mad.
I’m not going to let him (or her) get to me.
Look for the positives.
Don’t assume the worst or jump to conclusions. |
3. Dealing with Temporary
Difficulties
|
My muscles are starting to feel tight.
Time to relax and slow things down.
I have a right to be annoyed, but let’s keep the lid on.
My anger is a signal of what I need to do.
Time to instruct myself.
Try to reason it out.
Treat each other with respect. |
4. and 5. Assessing
Self-Reinforcement |
Partially Successful Coping
These are difficult
situations and they take time to straighten out.
I’ll get better at this as I get more practice.
Can I laugh about this?
It’s probably not so serious.
Successful Coping
I handled the one pretty well. It worked.
I actually got through that without getting angry.
That wasn’t as hard as I thought. |

RELAPSE PREVENTION
Relapse prevention is a process for emotional (feelings),
cognitive (thoughts) and behavioral (actions) self-management of a problem
behavior. The relapse processes happens in the first two parts of the anger
cycle (the Pretends To Be Normal Phase and the Build-Up Phase). When individuals
work on Relapse Prevention Skills, they are less likely to get to the Acting Out
Phase. Instead they get into the Anger Action and Resolution Phases.
Relapse Prevention Procedures
1. Client and therapist discuss the commitment and make
preparation for the individual’s journey to freedom from “Bad Anger.”
2. Identify High Risk Factors (defined as circumstances,
situations, triggering events, thoughts, feelings, and behavior that occur in
your life just before you act in an angry manner).
3. Identify perceived level of self-efficacy (client
confidence) in facing each high risk situation.
4. Educate the client regarding covert set-ups.
5. Focus on successful coping and partially successful coping
and provide reinforcement according.

BIBLIOGRAPHY
Bums, David. (1980) Feeling Good. New York: William Morrow.
Cullen, M. And Freeman-Longo, R.E. (1995) Men to Anger. Vermont: The Safer
Society Press.
Lerner, H.G. (1985) The Dance of Anger. New York: Harper & Row.
Meichenbaum, D. (1990) Stress Inoculation Training New York: Pergamon Press.
Nyc, B. (1995) Understanding and Managing Your Anger and Aggression. Washington:
BCA Publishing.
Sonkin, D.J. (1990) The Wounded Man: Healing from Childhood Abuse. California:
Jeremy P. Tarcher, Inc.
Sonkin, D.J. & Durphy, M. (1989) Learning to Live Without Violence. California:
Volcano Press.
‘Weisinger, H. (1985) Anger Workout Book New York: Quill.

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