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3 OCTOBER 2008
NO 1355
Cognitive-behavioral interventions and anger
The use of cognitive-behavioral therapy (CBT) with aggressive adolescents has been documented in a review of the literature by Kendall and Panichelli-Mindel (1995). The CBT strategies used were awareness of feelings, relaxation training, positive imagery, increased problem solving, recognition and alteration of self-talk, new coping strategies such as self-control and self-monitoring through modeling of behavioral cuing, establishment of peer feedback and role playing, and new behaviors and social skills through cognitive restructuring. CBT is most effective in replacing or eliminating cognitive distortions by mediating negative thoughts and feelings (self-distortions) that hinder positive outcomes. The results of these studies indicated significant improvements in anger control and reduction as observed in acting-out and aggressive behaviors maintained after the interventions were terminated.
Etscheidt (1991) conducted a study of 30 adolescents displaying aggression and acting-out behaviors to determine if a cognitive-behavioral training program would be effective in diminishing these behaviors and increasing self-control. CBT interventions, which were offered in group counseling, were supposed to help the youth alter their thoughts and responses during anger-provoking situations. The results indicated that external reinforcers did not increase the significant positive treatment effects. The youth did display fewer incidences of aggressive behaviors after treatment.
Goldstein (1988) demonstrated the effectiveness of using cognitive-behavioral modification to replace antisocial behaviors with prosocial ones in adolescents. He worked with one group that displayed chronic aggressiveness and antisocial behaviors and a second group that displayed withdrawal, asocial behavior, and social isolation. The participants were taught to stop and think when they encountered a problem rather than react immediately. They learned consideration of another person's point of view, decision-making skills, and how to examine alternative behaviors. Once they examined a number of behavioral alternatives and considered the consequences of each, they selected a behavior to use in the future.
Cognitive-behavioral interventions have been of value to public school and correctional personnel in helping them teach young persons how to interact with their environment through the use of functional methods other than anger (Larson,1992). When used with "angry" youth, such interventions should help them:
1. To scrutinize their past anger-induced behaviors to determine (a) the antecedents that lead to anger, (b) how they are reacting behaviorally and cognitively, and (c) the consequences of their behavior. Videotaping and role playing are helpful.
2. To recognize internal physiological reactions that anger produces. Biofeedback, relaxation training, and imagery are good techniques to decrease anger reactions.
3. To replace irrational anger-instigating thoughts with rational thoughts through:
(a) Self-instruction on monitoring internal and
external cues;
(b) Self-management strategies teaching dependence on self-control
rather than external, "controlling" forces;
(c) Monitoring of irrational private speech;
(d) Recognition that thought, affect, and behavior are all
interrelated-if they learn to change one, the other areas will also be
affected.
(e) Replacement of negative private speech with reality-based positive
thoughts.
4. To use alternate ways to interact, replacing anger with problem-solving efforts such as consequential thinking, causal thinking, interpersonal sensitivity, means-ends thinking, and perspective taking.
5. To learn new behaviors by watching the practitioner model appropriate strategies so that they will have a guide as to how to behave. (The practitioner will need to provide frequent feedback on improvement and give the youth a chance to experience reinforcing ways of interacting with others so that they can feel good about themselves.)
It cannot be stressed enough that practice of these strategies is necessary so that the learned behaviors will be generalized to other environments.
DAVID A. SABATINO
Sabatino, David A. (1997). Replacing anger with trust.
Reclaiming Children and Youth, 6, 3. pp. 169-170.
REFERENCES
Etscheidt, S. (1991). Reducing aggressive behavior and improving self-control: A cognitive-behavioral training program for behaviorally disordered adolescents. Behavioral Disorders, 16. pp. 107-115.
Goldstein, A. P (1988). The prepare curriculum: Teaching prosocial competencies. Champaign, IL: Research Press.
Kendall, P C. and Panichelli-Mendel, S. M. (1995). Cognitive-behavioral treatments. Journal of Abnormal Child Psychology, 23. pp. 107-121.
Larson, J. D. (1992). Anger and aggression management techniques through the think first curriculum. Journal of Offender Rehabilitation, 18. pp. 101-117.
