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Children's Voice Article, March/April, 2005

Managing Anger

By William Atkinson

Helping kids control their anger can prevent violence and move treatment forward

Having spent 10 years working in public schools, Jerry Wilde knows a thing or two about anger and young people.

"Most violence that students became involved in was a direct result of anger," says Wilde, now Associate Professor at Indiana University East in Richmond, Indiana, and author of Anger Management in Schools: Alternatives to Student Violence. "If you can teach kids to manage anger, you can cut down on a significant amount of violence."

Anger is not a disorder or medical condition. It's a normal human emotion, often brought on by stress. Unchecked, however, anger can lead to violence and other hurtful behaviors. Researching the causes of anger, and adopting proven strategies to prevent and manage it, is an important part of working with children and youth with histories of violence and other behaviors related to anger. Successful anger management strategies range from multistepped approaches, to dealing with kids one-on-one, to working with youth in structured group settings. Once their anger is managed, children can move toward achieving other developmental skills.

Andy Reitz, Associate Director of CWLA's Walker Treischman Center in Quincy, Massachusetts, adds, "The goal is not to eliminate anger, since it can provide motivation for a range of appropriate behavior. The goal is to learn to manage it." Stressful events, Reitz says, combined with negative thoughts, can lead to angry feelings, which can lead to angry behavior.

The Arise Foundation in Miami works with at-risk youth in more than 40 juvenile facilities in Florida. One facet of its work is anger management. "One thing we have found is that the youth think they were born angry," says cofounder Edmund F. Benson. "We explain that someone taught them how to be angry and lose their tempers, and we teach them they can hit the off switch when thing get out of control."

"You can't assume kids already know anger management skills," Reitz elaborates. They have to be taught the skills. And because of the abuse and other forms of trauma many have experienced, learning anger management skills can be more difficult for them than for other people. "Early trauma," Reitz explains, "especially from abuse and neglect, can result in changes in brain development that create biological barriers that make it difficult to learn anger management skills."

Different Strategies, Common Elements

Different experts have different strategies for helping children cope with anger, but most of these strategies have common elements that focus on multiple steps that teach the skills of managing anger, including identifying triggers and signals of anger and refocusing kids toward alternate behavior that redirects their energy and emotions to something more positive and calming.

"The best way to teach anger management is in a direct, structured way, in a series of steps," Reitz explains. He also emphasizes the need to program the environment where kids are all day so they are encouraged to use the skills once they've been taught. "They need to use these skills during the most stressful times of their lives, when they're angry, which are the times when it is most difficult to use them."

Reitz advocates a six-step program:
  • Identify external triggers. What situations cause kids to become angry, and what specific events produce anger? You can then teach them to avoid these situations, or prepare for them if they can't avoid them.

  • Identify internal triggers. Sometimes it's not only an external event that produces anger, it's also the child's interpretation of that event--for example, "He bumped into me on purpose." Reitz explains, "An anger management program can teach kids how to talk to themselves in more effective ways."

  • Recognize angry feelings and behaviors. The earlier kids recognize these feelings and behaviors, the easier they can manage anger. They can recognize these in three ways: physiologically (they may feel their heart pounding, feel knots in their stomach, or start to perspire); cognitively, which involves monitoring their thoughts; or behaviorally (they may find themselves pacing or making a fist).

  • Teach strategies to reduce anger. These can include such activities as deep breathing, pleasant imagery, going for a walk, or listening to music. "It's important to identify the strategies that work best for each individual," Reitz emphasizes. It also has to be easy for the child to use.

  • Plan and execute alternate behavior. Once they calm down, youth need a repertoire to deal with anger--what to do instead of being aggressive.

  • Self-evaluation. This involves teaching kids how to evaluate their own performance.
Wilde agrees that learning to manage anger is a skill--and as with any other skill, it has to be learned and practiced. He teaches distraction techniques: When children get angry, they learn how to change their thoughts to happy or funny memories. He also suggests, "To help a child cope with anger, let them work off some steam physically. Go shoot baskets with the child for a while. If you try to talk about the problem right away, it won't work, because they're too emotional."

Randolph Ecton is Treatment Team Leader at Sagamore Children's Psychiatric Center at Brennan High School, North Babylon, New York, and coauthor of Adolescent Anger Control: Cognitive Behavioral Techniques. He teaches children a five-step self-control program:
  • Stop and freeze. Pay attention to anger triggers.

  • Calm down. Use relaxation techniques, such as deep breathing.

  • Think positive. Seek calming thoughts, then engage in consequential thinking, assertive thinking, and rational thinking.

  • Listen for understanding. Use basic and active listening skills.

  • Act positively. Act more assertively, and be more pro-social.

Combined Efforts

When Erik Laursen started in the field 25 years ago, the most common way of dealing with anger in youth was to wrestle them to the ground and restrain them. But the Director of Residential Services at United Methodist Family Services in Richmond, Virginia, admits, "I never liked this approach, especially when the kids got hurt when they were restrained."

Researching other options in the early 1990s, he learned about aggression replacement training, developed by Arnold Goldstein at Syracuse University's Center for Research on Aggression. The program focused on anger management skills, social skills, and a moral education component that helped kids understand they might have been raised in an environment where it was okay to hurt other people.

Two years later, he added another program, Equip, which focused on training the entire peer group. Combined, aggression replacement training and Equip allowed Laursen's facility to reduce restraints to about 25% of what it had been doing before.

In the late 1990s, Laursen added a third program, Life Space Crisis Intervention (LSCI), a structured approach that helps kids gain insight into the patterns of their own crisis situations. LSCI has six steps:
  • Crisis. Drain off the student's intense emotions by acknowledging feelings.

  • Timeline. Use affirming and listening skills to discover the student's point of view.

  • Central issues. Identify what originally triggered the event.

  • Insight. Help students recognize and change their own self-defeating behavior patterns.

  • New skills. Teach them new ways to cope with similar situations.

  • Transfer of learning. Prepare students to reenter the ongoing activity and setting.
The combination of all three programs has allowed the facility to get a handle on dealing with anger. "We would occasionally have to put kids in a special hospital when they became destructive," Laursen says. "Since adding LSCI, we haven't had to do this even once."

Individual Approach

Millicent H. Kellner is Director of Project Development at CPC Behavioral Healthcare, High Point Schools, in Morganville, New Jersey, and author of In Control and Staying in Control. CPC uses Kellner's In Control program, which teaches kids they can control themselves, manage their anger, and have fun doing it. They learn anger management skills and how to evaluate themselves, and role-play to practice the skills. "The main key is to create an anger management culture in the organization that involves the staff," Kellner explains.

In Control teaches youth that anger is a signal they need to acknowledge and then learn from it. "We teach them to acknowledge their anger, interrupt the arousal cycle, stay calm, and then use a number of options, such as walking away and regrouping," Kellner says. The results: CPC is seeing a reduction in injuries, and children are cooperating better with teachers, even in unexpected ways, such as volunteering.

"We used to run anger management programs," reports Judy Vreeland, Director of Walden School, The Learning Center for Deaf Children, in Framingham, Massachusetts. Unfortunately, the training didn't carry over much into real-life situations. The goal wasn't to reduce anger specifically, but rather reduce the use of physical restraints. "However, we realized anger management was a key component," she says.

Now, Walden uses a skills-building program to help kids manage anger. The key has been to make the program individual. Each youth's plan is developed with the youth's two advocates-one from the school program and one from the residential program.

One segment focuses on helping the child develop coping strategies:
  • Identify things that get you angry in the first place.

  • Ask how you know when you're getting angry, then identify what kinds of things happen so you can catch yourself before you become assaultive.

  • Identify some things you can do to calm down.
For one boy, bouncing a basketball reduces the agitation, so when the staff sees him getting agitated, they remind him to bounce a basketball. For others, it may be something as simple as going for a walk.

A second segment focuses on increasing natural options, such as a weekly yoga class, a drumming circle, or using relaxation rooms, which contain weighted blankets and balls.

"We also have debriefings with them after they get angry," Vreeland says. Staff help kids look back on what they could have done differently, as well as what the staff could have done differently. "We also have training programs for the staff on how to build relationships, how to avoid power struggles, and recognizing their roles as teachers."

As a result of its efforts, Walden School has seen its use of physical restraints drop more than 60%.

Group Learning, Staff Support

Although anger management can be done individually, it's often more effective in structured group sessions of five to eight children with two or three instructors. "It should rely heavily on role-playing," Reitz notes. Typically, sessions run 30 - 50 minutes each and take place two or three times a week for eight to ten weeks.

Although most children can learn skills during the sessions, they don't always transfer these skills into real-life situations, so it's important to provide training for staff so they know what the kids are supposed to do and they are able to help them do it on the spot once they get angry. "The staff must be trained to encourage the children to use these skills, help them when they're angry to implement the skills, and then provide positive feedback when they do use them," Reitz says.

The Real Key--Anger Prevention

At one time, experts assumed stress was inevitable and that the only thing people could do was decompress from the experience afterward. Research now shows that stress is an individual response to an event. In other words, there is no such thing as a stressful event, only reactions to events, and those reactions are caused not just by preexisting attitudes, but by the state of one's physical health, which is largely regulated by sleep, exercise, and diet.

And research is showing that, just as people can take steps to prevent heart disease, stroke, diabetes, cancer, and other illnesses, they can also take steps to prevent stress by getting enough sleep, exercising, and eating healthy foods.

Similar research in the field of anger management is providing scientific evidence that adequate sleep, a good exercise program, and a healthy, balanced diet can help youth--and adults--from getting angry in the first place. The view of anger as a normal human emotion is changing with the understanding that anger is an explosive reaction to a stressful or threatening event, and that by improving one's physical health, the need to experience anger can be diminished and, in some cases, almost completely extinguished. Anger may not be natural at all.

"A lot of factors can lead to kids getting angry when they might not otherwise," Reitz notes. "One is lack of sleep. Another is nutritional deficiencies." He says if children aren't getting the proper nutrition, it can trigger anger. "For example, they may be hypoglycemic. If they have breakfast at 6:30 in the morning, but don't get lunch until 12:30 at school, they may have a drop in blood sugar by late morning, which is when they have most of their anger problems." He has also found that, for many kids, too much sugar can trigger anger.

"A good anger management program," he says, "will look at all of these issues, all of these precursors to anger."

Moving Forward

Managed properly, anger doesn't have to be an obstacle for children. Anger management is a difficult skill to master, but proven approaches abound. The process of managing anger requires structured teaching, a lot of practice, and frequent feedback that's both positive and corrective. Managing anger can take months, even years, to achieve, and slip-ups are inevitable, so it's important for staff and parents to focus on children's successes and encourage them to view the rough spots not as failures, but as opportunities to learn and grow.

"Anger management is not a panacea for all the issues children face," Reitz notes. "It's an important skill to master in its own right, but for most children it's only the first step. The most important outcome of a successful anger management program is that it opens the way for children, parents, and staff to turn their focus to mastering other critical developmental tasks."

"Once a child's anger management skills have improved," Reitz adds, "huge amounts of time and energy no longer need to be spent addressing all the problems created by serious anger outbursts. Instead, everyone can begin to focus on the real goal of treatment--to help the child build a satisfying, productive life, filled with positive relationships, meaning, and purpose."

William Atkinson is a full-time business writer and former regional reporter for TIME.

Resources

Anger Management Programs Books

Adolescent Anger Control: Cognitive Behavioral Techniques (1986)
By Eva L Feindler and Randolph Ecton, Pergamon Press

Anger Management in Schools: Alternatives to Student Violence (1997)
By Jerry Wilde (Technomic)

In Control: A Skill-Building Program for Teaching Young Adolescents to Manage Anger (2001)
Staying in Control: Anger Management Skills for Parents of Young Adolescents (2003)
By Millicent H. Kellner (Research Press)

Books and other resources

by Arnold Goldstein
Published by Research Press




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