Anger Anger Management - Family Therapy
angerAnger managementDennis Neill works in CAMHS with under-16s. Here, he focuses on his systemic work with youngpeople who have difficulty with impulse control and in handling their angry feelingsReferrals for anger management have soaredover the past few years. In my experience,outcomes are best when individual angertherapy is combined with family therapy andcollaboration with the school. This is becausea systemic approach searches for meaning andcontext and therefore attributes less blame to theyoung person. It also engages parents and otherindividuals in the therapy process. However, wherethere is a history of family violence and/or severeattachment difficulties, a more intensive approachwill be called for than the one offered here. Thatsaid, my hope is that this article will add to yourstrategies for working with children and familieswhere there are angry relationships.My initial task with the parents and youngperson is to deconstruct the label ‘anger’. Thisraises awareness of the issues and elementsunderlying the so-called anger, and effectivelybroadens the remit of therapy by highlightingimportant family relationships and areas ofconflict in the young person’s life. It also givesinsight into issues of self-esteem.Exploring anger as a theme can elicit usefulinformation from parents about their ownexperiences with anger. Many parents havedescribed improvements in their own impulsecontrol when attending anger managementsessions with their children. In practice, parentalinvolvement in anger management therapy willdepend on the age of the child, their willingnessFigure 12 CCYP March 2010to work together, and the intensity of feelings inthe family.Contextual assessmentIt is important, at the start, to consider thecontext in which the anger occurs. When assessingcontext, I cover the following areas: Family We draw up a genogram, which includesall important family members and events such asseparations, divorces, deaths etc. School We explore issues of bullying,relationships with teachers and peers, academicabilities, special needs and school history. Community Environmental factors such ashousing, family relationships in the community,contact with other social institutions such aschurch, youth groups etc. Other professional involvement Who elseis involved with the family and young person?Perhaps social workers, counsellors, teachers anddoctors. Beliefs Reflect on cultural beliefs, experiencesand family scripts. Events Consider the impact of family andindividual life events, including violence. Physical health Ask about any healthconditions in the young person and their family.This should include illnesses in the past as well asin the present. Mental health Determine any mental healthconditions in the young person and their family.Check for depression and deliberate self-harm inthe young person. Developmental issues Enquire aboutdevelopmental factors in the child and family, suchas specific or general learning difficulties, ADHDand autistic spectrum disorders. The problem over time Identify when theangry behaviour began, when it is worse and if itever goes away. Motivation for change Does the young personactually want to do any work on their anger? Ifnot, engagement will be difficult.This assessment identifies events and situationsthat have impacted on the development of angryfeelings in the young person. It places theiranger within the context of family and otherrelationships. It should highlight any risk factorsin the young person’s life and in the family. Ifthese are serious, they should be addressed beforethe anger therapy begins. With agreement, the
angeryoung person is seen individually for five to sevensessions of 45 minutes. Some children and parentsask to do this work together, and I welcome this.The individual sessions are followed by familytherapy.Individual workThe individual needs and interests of the childdetermine the order and time spent on theexercises below. I try to balance talk and activityin sessions. The externalising process of story workand drawing (a therapeutic practice developed byMichael White1) makes it easier for young peopleto engage and to explore difficult feelings andevents.I begin by asking the young person to drawan AngerGram (Figure 1). This becomes a mapof anger-inducing situations and events. It helpsyoung people understand the components ofanger and where their strong feelings are comingfrom. It covers areas such as: What feeling elements are in anger? Perhaps‘upset’, ‘hurt’ and ‘failure’. Who do you get angry with? Where do you get angry and when? What happens when you become angry andhow do you show it? How do you feel about your anger?understanding and changing behaviour can lead tohealthier and more fulfilling relationships.Exercises to explore physiological effectsBody-map exercise (Figure 2)In this exercise, I ask the young person to draw anoutline of their body on a large piece of paper. Wediscuss the physical effects of anger in the bodyand then add them to the drawing. For instance,they might draw a heart to symbolise increasedheart rate, and clenched fists to indicate an angryresponse. Talk can focus around a recent angryevent, linking it to the physiological changesidentified in their drawing. Other talk exploreshow to recognise these changes in their body atan early stage. Most young people enjoy doingthis. Many children report that their thinkingis affected when they are stressed, upset andangry. This useful insight is developed in cognitiveexercises later in the therapy. The notion of angeris expanded to include ‘energy’, ‘tension’, ‘a buildup of feelings’, ‘upset’, ‘hurt’ etc. This increasesthe young person’s descriptive repertoire aroundfeelings and mood, and increases their potentialfor change.Tracking angryevents is usefulfor parents, too.It highlightshow things buildup, and theinteractionalnature of familybehaviourMany young people have already found somestrategies for dealing with their angry and upsetfeelings. It’s important to acknowledge these andto incorporate them into the work. This validatesthe young person and provides a collaborativebasis for our work. It’s useful to explore how theydeveloped these strategies and to hear who hasadvised them. Examples I have been given are: Counting to 10. Avoiding stressful situations (in functional anddysfunctional ways). For instance, using a schooltime-out room or avoiding school completelybecause it engenders negative feelings. Talking to a trusted person eg a grandma,boyfriend or girlfriend. Having a private space to calm down in. Some kind of physical distraction/stimulus suchas tapping, pinching, thumping a bed or pillow,and, in extreme cases, self-harm. Using mind-altering substances such ascannabis and alcohol.Because anger and strong emotional impulsespowerfully affect the body and mind, I helpthe young person identify the physical andpsychological effects of anger by using a numberof exercises and stories. I incorporate aspects ofcommunication theory and issues of identity andself-esteem in the work. We explore how powerfulfeelings can be functional and informative ifunderstood and managed. We reflect on howFigure 2CCYP March 2010 3
angerFigure 3The caveman story (Figure 3)The young person imagines they are a caveman (orwoman). They live alone in a cave on a hill. Theydraw the scene on a piece of paper and we discussthe caveman’s basic needs for life – heat, food,water and companionship.The caveman’s world is a dangerous place,full of wild animals. Despite this, he has to huntand gather food. A situation arises where afierce animal, a sabre-toothed tiger, confrontsthe caveman. What should he do? Mostchildren identify fighting or running away as anappropriate response. The fight or flight responseto threat and danger is discussed. We re-examinethe body map, done previously, highlighting theidentified physiological responses to danger andthreat.Over time, the caveman becomes lonely andseeks contact with a distant group of cavedwellers. The young person explores ways ofachieving this. For instance, they might make agift to the other tribe in order to win their favour.We explore the need for social skills and why theydeveloped. Social skills are a way of getting whatyou want without having to fight for everything.explore how social reformers used their powerfulfeelings to right social injustice, or how angryfeelings can express the iniquity of domesticviolence. If powerful feelings can be harnessedand directed, they can become a force for good.On the other hand, negative aspects of angercan lead to a loss of control and violence. Wesearch for events in the young person’s life thatreflect their recognition and good managementof these powerful feelings. For instance, the urgeto win and score goals in a football match hasto be managed within the rules of the game andbalanced against the needs of the team. We mightexplore an occasion within the family when theyoung person chose not to react in an angry way,but chose instead to go to their bedroom to calmdown.Cognitive techniques to manage angerAfter the focus on the body physical, we turnto the mind. Children are usually very goodat generating ideas and stories and I activelyincorporate these into therapy. I use a variety ofthought-stopping techniques and exercises to helpchildren recognise and manage their feelings. Thefollowing exercise works well with many youngpeople.The special boxI ask the young person to create a special box intheir mind. I ask them to describe how it looks ingreat detail. Some children like to draw it. The boxis put in a very safe place, which they can easilyfind again.Next, we prepare some ‘special’ imaginaryphotographs to put into the box. Thesephotographs only contain good feelings andsensations. I begin by suggesting some images: A plate of their favourite food (Figure 4).A changed world but the same body responsesIn this exercise, we contrast the caveman’s worldwith the modern world, exploring how the modernworld has changed. Despite that change, theprimitive impulses and feelings we had as cavemenremain. We explore issues of entrapment (egbeing shouted at by a teacher in a classroom), ofpower inequality, of social behavioural norms andexpectations, and the importance of context (egit’s OK to shout in the playground, but not in theclassroom). We focus on the importance of socialskills and the understanding and management ofprimitive feelings when threatened or stressed.Positive and negative aspects of angerThis exercise explores positive and negativeaspects of anger. Anger is reframed as a powerfulindicator that something is wrong. We might4 CCYP March 2010Figure 4
angerCase study 1: Integrative/CBTWork with Stefan by Dennis LinesStefan was a Year 7 pupil of African ethnicity who hadbeen excluded from his previous school for punching theheadteacher. His father and older brothers had served timefor violence and physical assault and Stefan had witnessedmuch violence. Stefan was again at risk of exclusion afterthree serious fights. We worked integratively, combiningfeatures of CBT, the Egan three-stage model and NarrativeTherapy, and identified an early vital goal: stop fighting.We first engaged in a shared analysis of why he becameimpulsively aggressive.1. Had there been a recent event? Was he carrying anger as aresult of loss or bereavement, or a family situation, whichfound expression through violent outburst?2. Had he poor social skills, leaving him vulnerable toteasing and humiliation. Were his strategies to cope withfrustration limited?3. Did he think he might have unconsciously internaliseda male-dominant, aggressive persona from a significantfamily member, or an idealised figure from the street?Although I felt the third was the central cause, we neededto ‘hold the situation’ and help Stefan develop a measure ofself-control through identifying his triggers to fight. I askedhim to complete a journal of events that enraged him, andto identify the triggers that led to loss of control. Followinga CBT methodology, he listed the triggers on a chart, andwe tried to identify what assumptions might account forimpulsivity. Three typical triggers were:TriggerKids in class cuss meI get told offA kid stares at meAssumptionOther pupils put me down,as if I’m stupidTeacher thinks I’m no goodHe thinks he’s harder than meand wants a fightTherapy firstly involved working on what he was saying tohimself when corrected or threatened. We planned selfcoaching strategies to ease tension, and ‘self-talk’ to remaincalm. The face of a person who loves them. A special place.A child might describe the smell of their favouritefood, or the warm, safe feeling when huggedby their mother etc. The therapist aims to elicitas much descriptive, sensory and emotionalinformation about the image as possible. Somechildren like to draw the image and take it homeand put it in a drawer.Using their imagination, I ask them to create aspecial photograph that contains all the feelings,smells, colours and experiences associated withthat event. Once this is done, they place it in thebox. Then we do another picture. After completingWhenever a fight brewed, he was to use his angermanagement pass and visit me to practise the skills andgradually fine-tune his responses.We then moved into the next phase and looked at theunconscious assumptions he was making. These were disputed,and more realistic ones superimposed. His first assumption wasrephrased as: pupils might cuss me to wind me up, just as Iwind up other kids. It doesn’t mean they think I’m stupid. Thesecond was reframed as: the teacher thinks I could improveand so takes the trouble to correct me. If he thought I was nogood, he would let me do as I liked. The third assumption wasaltered to: the kid might be scared of me and stare becausehe’s nervous I’ll beat him up – there’s no obvious connectionbetween staring and wanting a fight. Showing him a diagramof the amygdala, and how it responds to perceived threat,helped him to account for his rage when reacting impulsively.A second and more long-term goal was becoming a focus forcontinued work. Underlying Stefan’s violent outbursts werethe powerful role models and unconscious expectations of himin his social environment. An effective counter-role model wasidentified in the self-controlled calmness of Stefan’s friends.One pupil made light of intimidation by using humour todesensitise tension; and since Stefan had a sense of humour,we agreed this was a technique he might try.However, incidental factors for Stefan’s aggression werenot as significant as his perceived need to maintain the‘tough guy’ persona. Moving towards a narrative model ofworking, we examined the attitudes he’d been brought upwith and which had been regularly reinforced. This processbrought to light a ‘sub-plot’ in his general ‘might is right’narrative – in one unprompted disclosure, he said: ‘When Iwas younger, I watched old people struggling with shoppingand digging the garden. I used to help them but Mum didn’talways like it.’ Clearly, there was a caring side to Stefan’scustomary persona of a fighter, and I was keen to explorethe ambivalence. Developing this ‘sub-plot’ brought positivelong-term effect. Dennis Lines is a school counsellor and trainer at Shenley CourtSpecialist Art College (Academy) in Birmingham. This case ismore extensively written up in Brief counselling in schools (SagePublications, 2006, 2nd edition).it, they put this in the box too. At this point, Iask them to ‘take out’ the first picture and toremember all the special things in that picture,such as the smells, the colours, sounds and goodfeelings.The box becomes a container of happy feelingsand memories and a place they can return towhen they are feeling tense, sad or angry. Theycan add any special pictures they like, providedthey contain good feelings.Other cognitive workOther work develops protective strategies tocounteract future negative feelings. Some childrenfind writing positive poems, supportive lettersCCYP March 2010 5
angerCase study 2: Non-Directive Play TherapyWork with Shirley by Nina RyeSix-year-old Shirley’s1 25 sessions of Non-Directive PlayTherapy (NDPT) were full of drama and intense emotions– she was a very angry little girl. Two years earlier, she hadwitnessed a violent event that led to a former step-parentbeing jailed. When I first met her mother and stepfather,there were already a number of interventions in progress,with individuals and the family as a whole, from mentalhealth, community and social care agencies. Shirley was thefourth child in a large family. She was referred because ofher aggressive and non-compliant behaviour at home andschool. The first few sessions were quiet, as Shirley showeda surprising (to her parents) liking for peace and orderliness.Then toward the end of the fifth session, she initiatedher first role play, a teacher giving orders to a child, thenreversing our roles after a few minutes. This short ‘taster’was the beginning of a string of stories in which Shirleyexpressed rage, hate, and plain irritation toward father andmother and, to a lesser extent, toward her stepfather and herteachers. She also expressed hurt, confusion, and a longingfor reconciliation and forgiveness.Shirley’s story characters had a thirst for power to blowup and cause disaster or, conversely, ‘make everything comeright’. The assumed persona would often change withoutwarning from domineering to genial, or from a false ‘nice’ tobeing fierce and mean. These feelings were so intense that shecould not express them herself even in role play at first. Soshe directed me to be the big bad king who treated her – inrole as ‘good little Molly’ – unfairly. After a few weeks of this,‘Molly’ began to fight back, eventually consigning the kingto a dungeon without food or drink. The king spent weeks inthat dank place, trying to figure out how to get himself outof this impasse. Of course, it was actually Shirley’s problem wewere trying to solve: what strategy could replace her currentpattern of alternating ‘charming’ and ‘terrible’, and still get herattachment needs met in a rather chaotic and loud household?Shirley gradually allowed the king to become moregenuinely nice, and then she moved on to a different setof role-played stories about mothers, daughters and absentfathers. Again, huge anger was expressed in these imaginedscenes. I felt she was a little girl who just could not makesense of the adult world, yet desperately wanted the powerand control that adults seemed to have. So she switchedfrom being a grown-up daughter with babies of her own(this seemed to represent real power) to being a baby, or elsea very poorly teenager in hospital. These roles were painfullyaccurate in their depiction of existing family dynamics.True to the NDPT model, I did not make verbal reflectionsthat directly linked with real life. Only when Shirley talkedabout her mother, father or stepfather, could I use myhypotheses and insight about her feelings, based on our playtogether, to suggest, ‘Maybe you sometimes feel angry withX.’ Shirley would either accept or deny this, but clearly gaveme to understand that these verbal exchanges were notwhat Play Therapy was about for her. The agonising dramas,filled with twists and complications, were ‘larger than life’because her feelings were so immense they simply could notfit into daily existence. Shirley’s solution was to take controlby means of coercive strategies, the alternating Charmer/Monster pattern of some Type C (insecure-ambivalentattachment type) children, dictating to grown-ups howthings were going to be. Here, there was a very clear parallelbetween the playroom and real life.Play Therapy helped Shirley deal with many of her angryfeelings about events in her past, but the Type C pattern wasonly slightly modified, showing that Shirley still needed it. Reference1 ‘Shirley’ is based on two real girls, each with different names.Nina Rye is an accredited counsellor and a director of ConnectionsCounselling Ltd. She is a registered play therapist and play therapysupervisor with the British Association of Play Therapists, as well asbeing trained in filial therapy. ninarye@connections-c.comto themselves or drawing cartoon-strips to betherapeutic and calming. They can read theseat times of stress to counteract their negativefeelings.We record any strategies the young person hasdeveloped on their own to counter their upset andangry feelings, and label them as ‘resources’. Wediscuss how to connect with helpful people whenthey are feeling upset or depressed. Be open toincorporating their ideas and thoughts into anywork you undertake.Another exercise uses a graph to highlight howangry feelings build up. At what point along thegraph does it become hard to manage feelings?Where is the tipping point? Some children find ituseful to rate their feeling state. For example, ‘Ona scale of 1 to 10, where 10 is mega angry and1 is really calm, where would you be right now?’‘When you hit your mother last Monday, wherewere you on the scale then?’ Such exercises help6 CCYP March 2010children ‘measure’ how they are feeling and tomodify their mood before they lose control.Relaxation techniquesIt takes time to learn to relax. For this reason, Ilike to include parents in the relaxation sessions.This way, they can continue the work with theirchild away from the therapy room. Parents oftenbenefit from relaxation training too.I teach progressive relaxation techniques2 tohelp young people develop an awareness of theirbody and emotions. Some children enjoy learningabout and practising full relaxation from toe tohead.Most children prefer quick and easy ‘stressbusting’ techniques. The first is based on tensingand relaxing the shoulder muscles. Since stressoften results in muscle tension, checking thestiffness of shoulder muscles can indicate stresslevels. Children are taught to tense their shoulder
angermuscles and then to slowly release that tension.This can incorporate breathing techniques, suchas taking a deep breath and expiring slowly. I getparents to feel their children’s shoulder musclesas they relax and tense them up. This physicalcontact and feedback can be a useful way ofbuilding up relationships. Check that people arecomfortable using touch, particularly if there hasbeen violence in their relationships.Another technique requires the young personto carefully clench their hands into fists and thenslowly release the tension. This is repeated two orthree times. This gives time for them to re-focustheir thinking. This can be done invisibly, forinstance, within a classroom. It can be combinedwith the shoulder technique above. Some childrenlike using stress balls. Explore any other ideaschildren suggest and incorporate them into thework.We discuss the positive mental health benefits ofregular exercise. Research has shown that regularexercise can effectively reduce depression. It’s alsoan effective way to burn off or redirect energy.Integrating therapyThroughout therapy, I frequently reference thework we have already done. Asking questions thatmake a link between the work done and theirCase study 3: Solution Focused TherapyWork with Steven by John WheelerThe solution-focused approach establishes what apreferred future might be and identifies ways in whichthis is already happening1. Young people who do not managetheir anger are typically preoccupied with past failuresand a prevailing sense that nothing works, and, at worst, asense that nothing ever will. Solution-focused questions cantherefore provide young people with a novel opportunity toshape their future, take credit for past successes, notice selfagency and restore self-esteem. When asked about positivegoals for the work, they name whatever they want moreof in their lives. Sometimes anger isn’t mentioned at all atthis stage, though working on ‘getting on better with mymother’, ‘keeping my place in school’, or ‘keeping my friends’typically results in the generation of strategies to addressanger effectively along the way.When Steven2 (15) was asked how he would know thatcoming to this service had been useful, he directly referredto anger, saying: ‘I’d have some control over my temper,because at the minute I don’t have any.’ Amplifying thegoal can then help young people become more motivatedthrough recognising the useful consequences of succeeding.When asked what else would be different if he could controlhis temper, he replied: ‘Well, I wouldn’t get thrown out ofschool.’ And when asked to elaborate on why this matteredto him, he went on to say: ‘I want to get a good education,get qualifications, so I can get a decent job.’Scaling questions put the experience of anger inperspective, helping young people to realise, perhaps for thefirst time, that they have already exercised some self-agency.When Steven was asked to rate his anger on a scale of 0 to10, where 10 meant he had as much control over his temperas he would want, and 0 meant he was as out of control withhis temper as anyone could be, he replied: ‘About 3.’ Whenasked how he knew it was 3 and not lower, he explained:‘Well, at the weekend all the young people were cleared outof the shopping centre by the security men. I was furiousbecause I hadn’t done anything. I felt like arguing but didn’twant to get banned, so I just left. When I got home, mymother assumed I’d been in trouble because I was so workedup. I felt like hitting her but didn’t, and ran into the gardenand smashed the shed window.’ Steven said that he’d be at 4if he hadn’t smashed the shed window, but had no idea howto manage this.The Miracle Question offers another framework forconsidering alternative actions: ‘Suppose that while you areasleep tonight a miracle happens and you are given controlover your temper. When you wake in the morning, how wouldyou know this miracle had happened?’ Steven’s answer was,‘I’d wake up feeling relaxed. If my brother said something thatannoyed me, I wouldn’t react, I’d just carry on getting readyfor school. The friend I go to school with would be able totell a miracle had happened because I’d laugh at his jokes andprobably tell him I hadn’t lost it with my brother like I usuallydo.’ This helped Steven recognise that loss of temper typicallyhappens within an interaction, and that different actions onhis part could contribute to a different outcome.Subsequent meetings are an opportunity for young peopleto take stock of what has been better, what has worked.Steven reported that he hadn’t lost his temper at schooland was able to concentrate more on his work. I asked anexception question: ‘Were there times you might have lostyour temper but didn’t?’ Steven replied, ‘I can’t stand theFrench teacher. In the last lesson I hated her and wished shewas dead, but I just kept my thoughts to myself and got onwith the work.’Young people who have not managed anger well typicallyrequire someone to believe that they want life to be betterand trust that they can do something to achieve this. Thesolution-focused approached has provided an effective andefficient framework for me to help many young people tonotice the self-agency that is often already there, and movein the direction they prefer to go.References1 UK Association for Solution Focused Practice.See www.ukasfp.co.uk2 Steven is a constructed identity based on a number of youngpeople, in order to protect the identities of the specific clients Ihave worked with.John Wheeler works part time as a social worker and UKCPregistered systemic psychotherapist in CAMHS, and part time as afreelance trainer and supervisor. www.johnwheeler.co.ukCCYP March 2010 7
angerCase study 4: HumanisticWork with Zoe by Jacky DaviesZoe, 12, did not have a clear understanding of why she had beenreferred for counselling or what counselling was. But I believed Zoehad within her the internal resources for change and growth, and was thebest authority on her experiences, so we explored this in detail so thatshe could make an informed decision to take part. At our next meeting,she had forgotten our previous conversation and expressed confusion andanger with herself. I was unsure if Zoe’s struggle to understand was dueto learning difficulties or her overriding anger towards adults or both.Many times during our work, we needed to revisit conversations, andI felt that working creatively through art and play therapy techniqueswould best support Zoe to understand herself and her anger.As Zoe began to express her trauma, her emotional distress increased.She became increasingly angry at home, resulting in much conflict withparent and siblings. In her rage, she shouted, swore and threatened toharm herself. As our work continued, Zoe’s behaviour became even morechallenging at home. She experienced flashbacks and was often unableto separate past from present. During the flashbacks, she would return topast behaviours that had been a response to her environment and thosewithin it. This was extremely difficult for the family, and twice-weeklysessions became advisable.Zoe had no emotional boundaries and was physically hurting herself.She would frequently come skipping into the session, yet her face wascontorted with rage, further indicating her internal confusion. We workedat separating the past from the present, helping Zoe to differentiatebetween them and to begin to develop positive relationships with thosewho were around her now.We did this in many ways. In the first half of the session, we exploredthe past by painting her thoughts or making clay monsters and smashingthem. She said that her anger had ‘outgrown’ her, was bigger than her,she didn’t know what to do about it, and was often angry with herself fornot being able to stop her rage from exploding out of her. As a responseto this, we installed time boundaries in the session that were agreed atthe start, so that they were respectful of – and responsive to – Zoe’sneeds that day. Sometimes, Zoe asked for longer in the first half; at other
anger within the context of family and other relationships. It should highlight any risk factors in the young personÕs life and in the family. If these are serious, they should be addressed before the anger therapy begins. With agreement, the Anger management Dennis Neill works in CAMHS
worksheets to complete homework assignments, and space to take notes for each of the ses . about anger, anger as a habitual response, and the introduction of the anger meter used to monitor anger. I. Purpose of the Group . 1) Learn to manage anger effectively. 2) Stop violence or the threat of violence.
Recognise whether you may be experiencing anger problems. Understand what anger is, what causes it and what keeps it going. Find ways to understand, manage or overcome your anger. Contents of this self help guide . Strategies that you could use to overcome your anger problems: 1. Understanding more about anger
Muay Thai Championship between universities volunteered for the study. “The Trait Anger and Anger Expression Scales” by Spielberger was used to determine the trait anger and anger expression styles of participants. Kruskal Wallis H and Mann Whitney U tests were
in the history of family therapy. They include Bowen Natural Systems Theory, contex-tual therapy, Virginia Satir’s Growth Model, brief therapy of the Mental Research Insti-tute, strategic family therapy, Milan Systemic Family Therapy, structural family therapy, solution-focused brief therapy, and narrative therapy.
Occupational Therapy Occupational Therapy Information 29 Occupational Therapy Programs 30 Occupational Therapy Articulation Agreements 31 Occupational Therapy Prerequisites 33 Physical Therapy Physical Therapy Information 35 Physical Therapy Programs and Prerequisites 36 Physical Therapy Articulation Agreements 37 Physical Therapy vs .
5. Anger management skills are developed in the brain before you are born. True False 6. Acting out in anger can sometimes help you fix problems. True False 7. Venting is a healthy way to let out your anger. True False 8. Holding in your feelings of anger can be dangerous. True False 9. Anger management skills are best learned when you are not .
ANGER MANAGEMENT. for Substance Use Disorder and Mental Health Clients Overview of Group Anger Management Treatment. Definitions . In the most general sense, anger is a feeling or emotion that ranges from mild irritation to intense fury and rage. Many people often confuse anger with aggression. Aggression is behavior
2.1 ASTM Standards:2 C165 Test Method for Measuring Compressive Properties of Thermal Insulations C203 Test Methods for Breaking Load and Flexural Proper-ties of Block-Type Thermal Insulation C303 Test Method for Dimensions and Density of Pre-formed Block and Board–Type Thermal Insulation C390 Practice for Sampling and Acceptance of Thermal Insulation Lots C578 Specification for Rigid .
