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«Participant Workbook Participant Workbook U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration ...»

-- [ Page 1 ] --

ANGER

management

for Substance Abuse and

Mental Health Clients

Participant

Workbook

Participant Workbook

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Center for Substance Abuse Treatment

1 Choke Cherry Road

Rockville, MD 20857

Anger Management for Substance Abuse and Mental Health Clients

This workbook was developed for use in conjunction with Anger Management for Substance Abuse and Mental Health Clients: A Cognitive Behavioral Therapy Manual.

This publication 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 publication was produced by JBS International, 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 (HHS). Karl White, Ed.D., served as the Center for Substance Abuse Treatment (CSAT) Knowledge Application Program (KAP) Project Officer.

Disclaimer The views, opinions, and content of this publication are those of the authors and do not necessarily reflect the views, opinions, or policies of SAMHSA or HHS.

Public Domain Notice All materials appearing in this publication except those taken from copyrighted sources are in the public domain and may be reproduced or copied without permission from SAMHSA or the authors.

Citation of the source is appreciated. However, this publication may not be reproduced or distributed for a fee without the specific, written authorization of the Office of Communications, SAMHSA, HHS.

Electronic Access and Printed Copies This publication may be ordered from SAMHSA’s Publications Ordering Web page at http://www.store.samhsa.gov. Or, please call SAMHSA at 1-877-SAMHSA-7 (1-877-726-4727) (English and Español). The document can be downloaded from the KAP Web site at http://www.kap.samhsa.gov.

Recommended Citation Reilly PM, Shopshire MS, Durazzo TC, and Campbell TA. Anger Management for Substance Abuse and Mental Health Clients: Participant Workbook. HHS Pub. No. (SMA) 12-4210.

Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 2002.

Originating Office Quality Improvement and Workforce Development Branch, Division of Services Improvement, Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857.

HHS Publication No. (SMA) 12-4210 First printed 2002 Revised 2003, 2005, 2006, 2007, 2008, 2009, 2010, 2011, and 2012

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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.

Participant Workbook

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.

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.

• efore you learned these definitions, did you ever confuse anger with aggression?

B 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.

• ist some ways anger may be affecting you physically.

L _______________________________________________________________________________

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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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• ist the negative consequences that you have experienced as a result of expressing your L 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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Anger Management for Substance Abuse and Mental Health Clients VII. Anger Is a Habit Anger can become a routine, familiar, and predictable response to a variety of situations. When anger is displayed frequently and aggressively, it can become a maladaptive habit. A habit, by definition, means performing behaviors automatically, over and over again, without think­ ing. The frequent and aggressive expression of anger can be viewed as a maladaptive habit because it results in negative consequences.

• Has anger become a habit for you? How?

_______________________________________________________________________________

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• In what ways has it been maladaptive?

_______________________________________________________________________________

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VIII. Breaking the Anger Habit You can break the anger habit by becoming aware of the events and circumstances that trigger your anger and the negative consequences that result from it. In addition, you need to develop a set of strategies to effectively manage your anger. You will learn more about strategies to manage anger in session 3.

• List some anger control strategies that you might know or that you may have used in the past.

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

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IX. Anger Meter A simple way to monitor your anger is to use a 1 to 10 scale called the anger meter. A score of 1 on the anger meter represents a complete lack of anger or a total state of calm, whereas 10 represents an angry and explosive loss of control that leads to negative consequences.

• each day of the upcoming week, monitor and record the highest number you reach on For the anger meter.

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