Encourage the client to discuss his/her/their anger management goals with trusted persons who are likely to support his/her/their change.
Participate in Acceptance and Commitment Therapy (ACT) for learning a new approach to anger and anger management. (43, 44, 45, 46)
Use an ACT approach to help the client experience and accept the presence of anger-invoking thoughts and images without allowing them to change the client's commitment to value-driven action; reinforce the client's efforts toward engaging in activities that are consistent with identified, personally meaningful values (see Acceptance and Commitment Therapy by Hayes, Strosahl, & Wilson).
Teach mindfulness meditation to help the client recognize the negative thought processes associated with anger and change his/her/their relationship with these thoughts by accepting thoughts, images, and impulses that are reality-based while noticing but not reacting to non-reality-based mental phenomena (see Guided Mindfulness Meditation [Audio CD] by Kabat-Zinn).
Assign the client homework in which he/she/they practice lessons from mindfulness meditation and ACT in order to consolidate the approach into everyday life.
Assign the client reading consistent with the mindfulness and ACT approach to supplement work done in session (see Get out of Your Mind and into Your Life: The New Acceptance and Commitment Therapy by Hayes).
Gain insight into the origins of current anger control problems by discussing experiences that may be involved in their development. (47, 48)
Assist the client in identifying past relationship dynamics (e.g. with father, mother, others) that may have influenced the development of current anger control problems; discuss how these experiences have positively or negatively influenced the way he/she/they handle anger.
Verbalize an understanding of how anger has been reinforced as a coping mechanism for stress. (48)
Teach the client how anger blocks the awareness of pain, discharges uncomfortable feelings, erases guilt, and places the blame for problems on others.
Verbalize an understanding of the need for and process of forgiving others to reduce anger. (49)
Assist the client in identifying whom he/she/they need to forgive, and educate him/her/them as to the long-term process that is involved in forgiveness versus a magical single event; recommend reading books on forgiveness (e.g. Forgive and Forget by Smedes); review the client's progress, reinforce success, and assess its impact on anger reduction.
Verbalize an understanding of the concept of a higher power and the benefits of acceptance of such a concept. (50)
Teach the client about the 12-step recovery program concept of a higher power, and how to turn over perpetrators of pain to his/her/their higher power for judgment.
Implement regular physical exercise to reduce tension. (51)
Teach the client the benefits of regular physical exercise; assign a program of implementation.
Attend 12-step recovery group meetings regularly and share feelings with others there. (52)
Teach the client the importance of actively attending 12-step recovery meetings, getting a sponsor, reinforcing people around him/her/them, and sharing feelings.
Develop a long-term plan to recover from substance abuse and anger. (53)
Assist the client in developing a five-year personal recovery plan.
Complete a survey to assess the degree of satisfaction with treatment. (54)
Administer a survey to assess the client's degree of satisfaction with treatment.
DIAGNOSTIC SUGGESTIONS
ICD-10-CM
DSM-5 Disorder, Condition, or Problem
F43.21
Adjustment disorder, With depressed mood
F43.23
Adjustment disorder, With mixed anxiety and depressed mood
F34.1
Persistent depressive disorder
F34.0
Cyclothymic disorder
F63.81
Intermittent explosive disorder
F31.xx
Bipolar I disorder
F31.81
Bipolar II disorder
F91.x
Conduct disorder
F43.10
Posttraumatic stress disorder
Z69.12
Encounter for mental health services for perpetrator of spouse or partner violence, physical
Z69.82
Encounter for mental health services for perpetrator of nonspousal adult abuse
F60.3
Borderline personality disorder
F60.2
Antisocial personality disorder
F60.0
Paranoid personality disorder
F60.81
Narcissistic personality disorder
Note
1
Indicates that the Objective/Intervention is consistent with those found in evidence-based treatments.
ANTISOCIAL BEHAVIOR
BEHAVIORAL DEFINITIONS
1 Has a history of breaking the rules or the law (often under the influence of drugs or alcohol) to get his/her/their own way.
2 Exhibits a pervasive pattern of disregard for and violation of the rights of others.
3 Substance use exacerbates antisocial behavior patterns such as criminal activity, aggression and intimidation, thrill seeking, impulsivity, and self-centeredness.
skills. (42)
