ANGER MANAGEMENT for Substance Abuse and Mental Health Clients Participant

ANGER
MANAGEMENT
for Substance Abuse and
Mental Health Clients
Participant
Workbook
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
www.samhsa.gov

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Anger Management
for Substance Abuse and
Mental Health Clients
Participant Workbook
Patrick M. Reilly, Ph.D.
Michael S. Shopshire, Ph.D.
Timothy C. Durazzo, Ph.D.
Torri A. Campbell, Ph.D.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Center for Substance Abuse Treatment
Rockwall II
5600 Fishers Lane
Rockville, MD 20857

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Anger Management for Substance Abuse and Mental Health Clients
Acknowledgments
This workbook was developed for use in conjunction with Anger Management for Substance
Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual. Numerous people
contributed to the development of that manual (see appendix). The manual was written by
Patrick M. Reilly, Ph.D., and Michael S. Shopshire, Ph.D., of the San Francisco Treatment
Research Center. Sharon Hall, Ph.D., was the Treatment Research Center’s Principal
Investigator.
Disclaimer
This document is, in part, a product of research conducted with support from the National
Institute on Drug Abuse, Grant DA 09253, and the Department of Veterans Affairs to the San
Francisco VA Medical Center, San Francisco Treatment Research Center, Department of
Psychiatry, University of California, San Francisco. The document was produced by Johnson,
Bassin & Shaw, Inc., under Contract No. 270-99-7072 with the Substance Abuse and Mental
Health Services Administration (SAMHSA), U.S. Department of Health and Human Services
(DHHS). Karl White, Ed.D., served as the Center for Substance Abuse Treatment (CSAT)
Knowledge Application Program (KAP) Project Officer. The content of this publication does not
necessarily reflect the views or policies of CSAT, SAMHSA, or DHHS.
Public Domain Notice
All material appearing in this report is in the public domain and may be reproduced or copied
without permission from SAMHSA or CSAT. Citation of the source is appreciated. However, this
publication may not be reproduced or distributed for a fee without the specific, written authori-
zation of the Office of Communications, SAMHSA, DHHS.
Electronic Access and Copies of Publication
This publication can be accessed electronically through the following Internet World Wide Web
connection: www.samhsa.gov/. For additional free copies of this document, please call
SAMHSA’s National Clearinghouse for Alcohol and Drug Information at 1-800-729-6686 or
1-800-487-4889 (TDD).
Recommended Citation
Reilly PM, Shopshire MS, Durazzo TC, and Campbell TA. Anger Management for Substance
Abuse and Mental Health Clients: Participant Workbook. DHHS Pub. No. (SMA) 02-3662.
Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health
Services Administration, 2002.
Originating Office
Office of Evaluation, Scientific Analysis and Synthesis, Center for Substance Abuse Treatment,
Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Rockville,
MD 20857.
DHHS Publication No. (SMA) 02-3662
Printed 2002

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Contents
Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Session 1
Overview of Anger Management Treatment . . . . . . . . . . . . . . . . . . . . . . . . 3
Session 2
Events and Cues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Session 3
Anger Control Plans . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
Session 4
The Aggression Cycle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Session 5
Cognitive Restructuring. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Session 6
Review Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31
Sessions 7 & 8
Assertiveness and the Conflict Resolution Model . . . . . . . . . . . . . . . . . . 33
Sessions 9 & 10
Anger and the Family . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39
Session 11
Review Session . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Session 12
Closing and Graduation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45
Appendix
Authors’ Acknowledgments. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
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Introduction
This workbook is designed to be used by participants in an anger management group treat-
ment curriculum for substance abuse and mental health clients. It provides individuals partici-
pating in the 12-week anger management group treatment with a summary of core concepts,
worksheets to complete homework assignments, and space to take notes for each of the ses-
sions. The concepts and skills presented in the anger management treatment are best learned
by practice and review and by completing the homework assignments given in this workbook.
Using this workbook as an adjunct to your participation in the 12-week anger management
group treatment will help you develop the skills that are necessary to successfully manage
anger.
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Session 1:
Overview of Anger Management Treatment
In this first session, you will get a general overview of the anger management treatment. This
includes the purpose of the group, group rules, definitions of anger and aggression, myths
about anger, anger as a habitual response, and the introduction of the anger meter used to
monitor anger.
I. Purpose of the Group
1) Learn to manage anger effectively.
2) Stop violence or the threat of violence.
3) Develop self-control over thoughts and actions.
4) Receive support from others.
II. Group Rules
1) Group Safety: No violence or threats of violence toward staff or other group members are
permitted. It is very important that you view the group as a safe place to share your experi-
ences and feelings without threats or fear of physical harm.
2) Confidentiality: Group members should not discuss outside of the group what other mem-
bers say. (The group leader should determine the limits of the laws or rules pertaining to
confidentiality in his or her State.)
3) Homework Assignments: Brief homework assignments will be given each week. Doing the
homework assignments will improve your anger management skills and allow you to get the
most from the group experience.
4) Absences and Cancellations: You should call or notify the group leader in advance if you
cannot attend a group session. Because of the amount of material presented in each ses-
sion, you may not miss more than 3 of the 12 sessions.
If you miss more than three sessions, you may continue attending the weekly sessions, but
you will not receive a certificate of completion.
5) Timeouts: The group leader reserves the right to call a timeout at any time. Eventually, you
will learn to call a timeout yourself if you feel that you may be losing control because your
anger is escalating.
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Anger Management for Substance Abuse and Mental Health Clients
III. Definitions
In the most general sense, anger is a feeling or emotion that ranges from mild irritation to
intense fury and rage. Many people often confuse anger with aggression. Aggression is
behavior that is intended to cause harm or injury to another person or damage to property.
Hostility, on the other hand, refers to a set of attitudes and judgments that motivate aggressive
behaviors.
• Before you learned these definitions, did you ever confuse anger with aggression?
Please explain how.
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IV. When Does Anger Become a Problem?
Anger becomes a problem when it is felt too intensely, is felt too frequently, or is expressed
inappropriately. Feeling anger too intensely or frequently places extreme physical strain on the
body.
• List some ways anger may be affecting you physically.
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V. Payoffs and Consequences
The inappropriate expression of anger initially has apparent payoffs (e.g., releasing tension,
controlling people). In the long-term, however, these payoffs lead to negative consequences.
That is why they are called “apparent” payoffs; the long-term negative consequences far out-
weigh the short-term gains.
• List some payoffs to using anger that you are familiar with.
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Participant Workbook
• List the negative consequences that you have experienced as a result of expressing your
anger inappropriately.
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VI. Myths About Anger
Myth #1: Anger Is Inherited. One misconception or myth about anger is that the way people
express anger is inherited and cannot be changed. Evidence from research studies, however,
indicates that people are not born with set and specific ways of expressing anger. Rather,
these studies show that the expression of anger is learned behavior and that more appropriate
ways of expressing anger can also be learned.
Myth #2: Anger Automatically Leads to Aggression. A related myth involves the misconception
that the only effective way to express anger is through aggression. There are other more con-
structive and assertive ways, however, to express anger. Effective anger management involves
controlling the escalation of anger by learning assertiveness skills, changing negative and hos-
tile “self-talk,” challenging irrational beliefs, and employing a variety of behavioral strategies.
These skills, techniques, and strategies will be discussed in later sessions.
Myth #3: You Must Be Aggressive To Get What You Want. Many people confuse assertiveness
with aggression. The goal of aggression is to dominate, intimidate, harm, or injure another per-
son—to win at any cost. Conversely, the goal of assertiveness is to express feelings of anger in
a way that is respectful of other people. Expressing yourself in an assertive manner does not
blame or threaten other people and minimizes the chance of emotional harm. You will learn
about the topic of assertiveness skills in more detail in sessions 7 and 8.
Myth #4: Venting Anger Is Always Desirable. For many years, there was a popular belief that
the aggressive expression of anger, such as screaming or beating on pillows, was therapeutic
and healthy. Research studies have found, however, that people who vent their anger aggres-
sively simply get better at being angry. In other words, venting anger in an aggressive manner
reinforces aggressive behavior.
• Before our discussion, did you believe any of these myths about anger to be true?
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