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Using Group Therapy to Reduce Anger in Middle School Boys. Josie Boehlert. Problems Associated with Anger Issues. Academic failure Truancy Dropout Peer rejection Tobacco, alcohol and drug use Suicidal behavior Often becomes worse over time ( Sutcu , Aydin , & Sorias , 2010). - PowerPoint PPT Presentation
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Using Group Therapy to Reduce Anger in Middle School BoysJosie Boehlert
Problems Associated with Anger Issues
Academic failureTruancyDropoutPeer rejectionTobacco, alcohol and drug useSuicidal behaviorOften becomes worse over time(Sutcu, Aydin, & Sorias, 2010)
Reasons Group Therapy Should be Used
Access to multiple students (Burt, Patel, & Lewis, 2012)Students’ behaviors are shaped by peer perception – presence of others might affect behaviorSupport inside and outside of group“Naturally occurring community of reinforcers”Minimize stress of unfamiliarMembers might feel more open to share with people that they can relate to(Dwivedi & Gupta, 2000)
Role of School Counselors
Support academic achievementSupport social developmentImprove functioning of whole school
Application of CBTBehavior is learned and can be changedAllows member to try out new behaviorsPromote understanding of anger as a processIdentifies clear goalsHelps students identify triggersProvides coping strategies
CBT TechniquesModelingBehavior rehearsalCoachingHomeworkFeedbackReinforcementCognitive restructuring
Pre-group Measures
ScreeningInitial pool from teacher referralResearch conduct reports (Burt, Patel, & Lewis, 2012)ObservationBrief interview (Dwivedi & Gupta, 2000)
Assess potential for changeConsider group dynamicsAbility to gain parental consentChoose 5-7 students in same grade
Logistical PlanningScheduling – 30 minutesLocationParental permissionCreate plansObtain necessary materials
Group Process
Initial SessionExplain purpose Positive framing (Burt, Patel, & Lewis, 2012)Informed consent/confidentialityIdentify goalsCreate rules & consequencesPre-intervention questionnaire (Burt, Patel, & Lewis, 2012)
Session 2Summarize previous session/review goalsIntroduce topic Psychoeducation:
Talk about situations that cause angerDiscuss how anger feels for students
Activity: Create an “anger-log.” Students may decorate. On first page, include goals and note signs of anger to watch for
Assign Homework:Instruct students to pay attention to triggers, physiological reactions, and behaviors and log
Session 3Review previous session/ review goalsShare notes in anger log homework and discussPsychoeducation:
Talk about acceptable reactions to anger
Activity:Play the “Anger Solution Game”
Assign homework:Students should record their acceptable and unacceptable reactions to anger
Session 4Review previous session/ review goalsShare notes in anger log homework and discussFocus on strengthsPsychoeducation:
Coping skills: Thought stopping, breathing exercises, Progressive Muscle Relaxation (PMR)
Activity:Engage in PMT and breathing exercise. Discuss.Inform students that they will be responsible for teaching classmates PMR and/or breathing exercise as a final project
Homework:Instruct students to use coping strategies in anger situations and log
Session 5Review previous session/ review goalsShare notes in anger log homework and discussPsychoeducation:
Talk about problem solving skills and communication
Activity:Role play anger situationsPractice breathing and PMR
Homework:Log anger reactions and successful use of problem solving skills, communication skills, breathing exercises and PMR
Session 6Review previous session/ review goalsShare notes in anger log homework and discussAddress terminationActivity:
Remind students that they will be instructing their classmates in PMR or breathing in the coming weekWork together to create a script and assign rolesPractice presentationDiscuss feelings about presentation
Homework:Practice presentationLog anger and coping strategies
PresentationArrange with teacherIntroduce purpose to classIntroduce studentsObserve while students teach classmates
Session 7: TerminationReview previous session/ review goalsDiscuss presentation and associated feelingsShare notes in anger log homework and discussActivity:
Review goals. Discuss how they have been achieved.Ask students to write the “autobiography” of their futures
Address strengthsAddress feelings associated with terminationGive certificate of achievement (Dwivedi & Gupta, 2000)
Post-group Measures/EvaluationPost-intervention questionnaireCompare results to originalRecord increase in positive responses to anger as reported in students’ logs6 month follow up (Sutcu, Aydin, & Sorias, 2010)
Possible Issues
Forming: Issues that may ariseMay be difficult to establish trust if members see counselor as disciplinarianAll members have issues with social skills = may be difficult to form bondsInvoluntary members may be unwilling to follow rules or engage
Make goals of the group clearSet ground rulesDeal openly with issuesEncourage members to express themselves in constructive ways
Storming: Issues that may arise
Members may feel defensiveConflict may ariseMembers may have conflict with leaderMembers may become annoyed with a difficult member
Counselor should openly address conflictCounselor should teach members constructive ways of expressing feelingsCounselor should have another adult that she can call on in the case of physical aggression
Norming/Performing: Issues that may arise
Members may show improvement inside of group but not outside
Make sure to revisit goalsGive practical homework and activities
Issues that may arise in termination
Strong feelingsMembers may not apply new skills outside of group
Address termination earlyEncourage members to express feelingsDiscuss ways members will apply new skills
Skills that will be needed
Group managementAssertivenessCrisis managementKnowledge of anger and coping strategiesKnowledge of CBTAbility to confrontBasic skills: listening, summarizing, reflecting, supporting, empathizing, goal setting, linking, blocking, etc.
Therapeutic FactorsTrust – Members must build trust or be able to express lack of trustEmpathy – members will benefit from empathy received from leader and other members. Members will work on the cultivation of empathy
Intimacy – members will benefit from learning that they are like othersHope – CBT provides hope that change is possibleFreedom to Experiment – Role play, relaxation
Therapeutic Factors Cont.
Cognitive Restructuring –CBT helps spark change. Adopt more constructive beliefs Commitment to Change – Leader should attempt to elicit by stressing goalsSelf-Disclosure – Members with share with group
Confrontation – Members will be encouraged to take responsibility for actionsFeedback – Members and leaders will comment on strengths
Ethical/Multicultural Considerations
Confidentiality (giving parents info)Attempt to ensure that no students feel isolatedIncorporate diversityProtect members from harmInvoluntary members - help them understand
ReferencesBurt, I., Patel, S. H., & Lewis, S. V. (2012). Anger management leadership groups: A creative intervention for increasing relational and social competencies aith aggressive youth. Journal Of Creativity In Mental Health, 7(3), 249-261. doi:10.1080/15401383.2012.710168Dwivedi, K., & Gupta, A. (2000). 'Keeping cool': Anger management through group work. Support For Learning, 15(2), 76.Gaines, T., & Barry, L. M. (2008). The effect of a self-monitored relaxation breathing exercise on male adolescent aggressive behavior. Adolescence, 43(170), 291-302. Sportsman, E. L., Carlson, J. S., & Guthrie, K. M. (2010). Lesson learned from leading an anger management group using the 'Seeing Red’ curriculum within an elementary school. Journal Of Applied School Psychology, 26(4), 339-350. doi:10.1080/15377903.2010.518823Sütcü, S., Aydın, A., & Sorias, O. (2010). Effectiveness of a cognitive behavioral group therapy program for reducing anger and aggression in adolescents. Turk Psikoloji Dergisi, 25(66), 68-72.