psychotropic medication and has been redirected to do so.The client identified side effects of the psychotropic medications and was directed to consult with the prescribing clinician if the side effects persist or worsen.18 Assign an Anger Journal (18)The client was assigned to keep a daily journal in which to document persons or situations that cause anger, irritation, and disappointment and to record the depth of anger, rating on a scale of 1 to 100.The client was assigned “Anger Journal” from the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client has kept a journal of anger-producing situations and this material was processed within the session.It was noted that the client has become more aware of the causes for targets of their anger, as a result of journaling these experiences on a daily basis.The client has not kept an anger journal and was redirected to do so.
19 List Targets of/Causes for Anger (19)The client was assisted in listing as many of the causes for and targets of their anger that they are aware of.The client was assigned “Is This Anger Due to Feeling Threatened?” or “Is My Anger Due to Unmet Expectations?” in the Addiction Treatment Homework Planner (Lenz, Finley, & Jongsma).The client's list of targets of and causes for anger was processed in order to increase awareness of anger management issues.The client has indicated a greater sensitivity to angry feelings and the causes for them as a result of the focus on these issues.The client has not been able to develop a comprehensive list of causes for and targets of anger and was provided with tentative examples in this area.
20 Convey Model of Anger (20)The client was assisted in understanding a model of anger as involving different components that go through predictable phases.The client was taught about the different components of anger, including cognitive, physiological, affective, and behavioral components.The client was taught how to better discriminate between relaxation and tension.The client was taught about the predictable phases of anger, including demanding expectations that are not met, leading to increased arousal and anger, which lead to acting out.The client displayed a clear understanding of this model of anger and was provided with positive reinforcement.The client has struggled to understand this model of anger and was provided with remedial feedback in this area.
21 Process Anger Triggers (21)The client was assisted in processing the list of anger triggers and other relevant journal information.The client was assisted in understanding how cognitive, physiological, and effective factors interplay to produce anger.The client was reinforced for their insight into anger triggers and the cognitive, physiological, and effective factors.The client struggled to connect anger triggers with cognitive, physiological, and effective factors and was provided with remedial information in this area.
22 Discuss Rationale for Treatment (22)The client was engaged in a discussion about the rationale for treatment.Emphasis was placed on how functioning can be improved through change in various dimensions of anger management.The concept of rationale for treatment and how functioning can be improved through change in the various dimensions of anger management was revisited.
23 Assign Reading Material (23)The client was assigned to read material that educates about anger and its management.The client was directed to read Overcoming Situational and General Anger: Client Manual (Deffenbacher & McKay).The client was directed to read Of Course You're Angry (Rosselini & Worden).The client was directed to read The Anger Control Workbook (McKay & Rogers).The client was assigned to read Anger Management for Everyone (Kassinove & Tafrate).The client has read the assigned material on anger management and key concepts were reviewed.The client has not read the assigned material on anger management and was redirected to do so.
24 Teach Calming Techniques (24)The client was taught deep-muscle relaxation, rhythmic breathing, and positive imagery as ways to reduce muscle tension when feelings of anger are experienced.The client has implemented the relaxation techniques and reported decreased reactivity when experiencing anger; the benefits of these techniques were underscored.The client has not implemented the relaxation techniques and continues to feel quite stressed in the face of anger; the client was encouraged to use the techniques.
25 Explore Self-Talk (25)The client's self-talk that mediates angry feelings was explored.The client was assessed for self-talk, such as demanding expectations reflected in “should,” “must,” or “have to” statements.The client was assisted in identifying and challenging biases and in generating alternative self-talk that corrects for the biases.The client was taught about how to use correcting self-talk to facilitate a more flexible and temperate response to frustration.
26 Assign Self-Talk Homework (26)The client was assigned a homework exercise in which they identify angry self-talk and generate alternatives that help moderate angry reactions.The client was assigned the exercise “Journal and Replace Self-Defeating Thoughts” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client's use of self-talk alternatives was reviewed within the session.The client was reinforced for success in changing angry self-talk to more moderate alternatives.The client was provided with corrective feedback to help improve use of alternative self-talk to moderate angry reactions.
27 Role-Play Relaxation and Cognitive Coping (27)The client was assisted in visualizing anger-provoking scenes and then using relaxation and cognitive coping skills.The client engaged in role-plays regarding the use of relaxation and cognitive coping in anger-provoking scenes.The client was gradually moved from low to high anger-inducing scenes.The client was assigned to implement calming techniques in daily life and when facing anger-triggering situations.The client's experience of using relaxation and cognitive coping in daily life was processed, with reinforcement for success and problem-solving for obstacles identified.
28 Assign Thought-Stopping Technique (28)The client was directed to implement a thought-stopping technique on a daily basis between sessions.The client was assigned “Making Use of the Thought-Stopping Technique” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client's use of the thought-stopping technique was reviewed.The client was provided with positive feedback for helpful use of the thought-stopping technique.The client was provided with corrective feedback to help improve use of the thought-stopping technique.
29 Teach Assertive Communication (29)The client was taught assertive communication through instruction, modeling, role-playing, rehearsal, and practice.The client was referred to an assertiveness training class.The client was assigned Your Perfect Right (Alberti & Emmons) or “Assertive Communication of Anger” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client displayed increased assertiveness and was provided with positive feedback in this area.The client has not increased level of assertiveness and was provided with additional feedback in this area.
30 Teach Problem-Solving Skills (30)The client was taught problem-solving skills through the use of instruction, modeling, role-playing, rehearsal, and practice.The client was taught about defining the problem clearly, brainstorming multiple solutions, listing the pros and cons of each solution, seeking input from others, selecting and implementing a plan of action, and evaluating and readjusting the outcome.The client was assigned “Problem Solving: An Alternative to Impulsive Action” in the Adult Psychotherapy Homework Planner (Jongsma & Bruce).The client displayed a clear understanding of the use of the problem-solving skills and displayed this through examples.The client struggled to understand the use of problem-solving skills and was provided with remedial feedback in this area.
31 Teach Conflict Resolution Skills (31)The client was taught conflict resolution skills through instruction, modeling, role-playing, rehearsal, and practice.The client was taught about empathy and active listening.The client was taught about “I messages,” respectful communication, assertiveness without aggression, and compromise.The client was reinforced for clear understanding of the conflict resolution skills.The client displayed a poor understanding of the conflict resolution skills and was provided with remedial feedback.
32 Conduct Conjoint Session for Skill Generalizations (32)The client was asked to invite their significant other for a conjoint session.The client and significant other were seen together in order
