Assist the client in generating a list of anger triggers (or supplement with “Is My Anger Due to Feeling Threatened?” or “Is My Anger Due to Unmet Expectations?” in the Addiction Treatment Homework Planner by Lenz, Finley, & Jongsma); process the list toward helping the client understand the causes and expressions of his/her/their anger.
Verbalize increased awareness of anger expression patterns, their causes, and their consequences. (20, 21)
Convey a model of anger that involves different dimensions (cognitive, physiological, affective, and behavioral) that interact predictably (e.g. demanding expectations not being met leading to increased arousal and anger leading to aggression), and that can be understood and changed (see Anger Management by Kassinove & Tafrate; Overcoming Situational and General Anger by Deffenbacher & McKay).
Process the client's list of anger triggers and other relevant journal information toward helping the client understand how cognitive, physiological, and affective factors interplay to produce anger and lead to increased risk of maladaptive behavioral consequences (e.g. verbal and/or physical aggression, unassertiveness and resentment, or passive aggression).
Verbalize an understanding of how the treatment is designed to prevent or manage anger, enhance functioning, and improve quality of life. (22)
Discuss the rationale for treatment, emphasizing how functioning can be improved through change in the various dimensions of anger; revisit relevant themes throughout therapy to help the client consolidate his/her/their understanding (see Overcoming Situational and General Anger: Therapist Protocol by Deffenbacher & McKay; Anger Management by Kassinove & Tafrate; Understanding Anger and Anger Disorders by DiGiuseppe & Tafrate).
Read a book or treatment manual that supplements the therapy by improving understanding of anger and anger control problems. (23)
Assign the client to read material that educates him/her/them about anger and its management (e.g. Overcoming Situational and General Anger: Client Manual by Deffenbacher & McKay, Of Course You're Angry by Rosselini & Worden, The Anger Control Workbook by McKay & Rogers, or Anger Management for Everyone by Kassinove & Tafrate); process and revisit relevant themes throughout therapy to help the client consolidate his/her/their understanding of relevant concepts.
Learn and implement calming and coping strategies as part of an overall approach to managing anger. (24)
As part of a larger personal and interpersonal skill set, teach the client tailored calming techniques (e.g. progressive muscle relaxation, breathing induced relaxation, calming imagery, cue-controlled relaxation, applied relaxation, mindful breathing) for reducing chronic and acute arousal that accompanies his/her/their anger expression (or supplement with “Deep Breathing Exercise” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce).
Identify, challenge, and replace anger-inducing self-talk with self-talk that facilitates a more measured response. (25, 26, 27)
Use cognitive therapy techniques to explore the client's self-talk that mediates his/her/their angry feelings and actions (e.g. demanding expectations reflected in should, must, or have-to statements); identify, challenge, and change biased self-talk, assist him/her/them in generating appraisals that correct for the biases and facilitate a more flexible and temperate response to frustration; explore underlying assumptions and schema if needed. Combine new self-talk with calming skills as part of a coping skills set for managing anger.
Assign the client a homework exercise in which he/she/they identify angry self-talk and generate alternatives that help regulate angry reactions; review; reinforce success, problem-solve obstacles toward sustained and effective implementation (or supplement with “Journal and Replace Self-Defeating Thoughts” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce).
Role-play the use of calming and cognitive coping skills to visualized anger-provoking scenes, moving from low- to high-anger scenes. Assign the implementation of calming and cognitive techniques in his/her/their daily life and when facing anger-triggering situations; process the results, reinforcing success, and problem-solving obstacles.
Learn and implement thought-stopping as part of a new approach to managing angry feelings when they arise. (28)
As the initial part of a multicomponent coping strategy for controlling impulverbalsivity (e.g. “stop, calm, think, and act” approach), teach a thought-stopping technique in which the client silently “shouts” the word STOP upon recognizing the first signs of anger and then proceeds to the other management steps (i.e. calming, thinking) toward responding in an adaptive, effective manner (or supplement with “Making Use of the Thought-Stopping Technique” in the Adult Psychotherapy Homework Planner by Jongsma & Bruce); review implementation, reinforcing success, and problem-solving obstacles.
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