Toronto Psychological Services is located in west Toronto and offers professional services 6-days a week to adults, couples, adolescents and children. The TPS Anger Management Program for all clients is based on individual rather than group counselling. Clients may be self-referred, counsel referred and/or court mandated. We favour an anger management model delineated by Steve Duncan:
A useful approach is the AREA approach. AREA is an acronym to help people remember a better way to resolve anger. The A stands for “Admitting your anger;” R refers to “Restraining your anger,” E stands for “Expressing your anger;” and the last A refers to “Action planning”.
Prior to beginning a set of counselling sessions the client participates in an Intake Interview, which includes careful documentation of any specific incident/s leading to treatment. TPS clients are welcome to pay for individual sessions to address anger management or complete a 10-session or 15-session program or a court specified number of counselling sessions. If necessary, an evidence letter showing the client’s commitment to counselling or a customized follow-up letter could be prepared for the court that refers to a specific incident, client attendance, and subsequent treatment and, should they be necessary, recommendations.
In counselling at TPS, clients work with an individual counselor using a Cognitive Behaviour Therapy framework. Clients are asked to purchase an Anger Management Workbook and to complete homework exercises from the book.
1. Initial Assessment
In the first counselling session the client is asked to describe the events and their role in situations that led to their out-of-control behaviour. Emphasis is placed on taking ownership of their culpability in each situation including an altercation with their spouse or partner or friend or workplace colleague. A psychologist or therapist will explore with the client whether there have been past acts of violence, intimidation, humiliation and verbal abuse in the past. Factors that contribute to power imbalances in their relationships are explored, such as finances, physical stature, age and intellectual functioning.
2. Recognizing the negative role anger plays in one’s life and identifying payoffs that perpetuate destructive displays of anger
Clients are encouraged to explore all the areas of their life that have been affected by their anger. By completing the Personal Cost of Anger Worksheet, clients are obligated to look at the ways anger has affected not only their marriage or romantic relationships, but their work relationships, family relationships, children, friendships, health and involvement with the law.
Clients explore the “payoffs” that perpetuate their anger. They learn that there are a number of reasons why individuals continue to act in inappropriate ways. For some the payoff may be the reduction of stress, the need to hide emotional pain, the desire for attention or the urge to punish and seek revenge.
3. Identifying some misperceptions about anger
Clients are assisted to identify some of the distorted ways of thinking they have adopted that perpetuates anger outbursts. Blaming, magnifying situations, using negative words to label others, jumping to conclusions, over-generalizing and demanding expectations are all distorted ways of thinking that can contribute to exaggerated anger responses. Clients are asked to complete a worksheet, Identifying Distortions to understand the thoughts they hold that contribute to their anger outbursts.
4. Identification of Anger Triggers
Each client explores with their therapist their own family background and role anger played in their past. Often the scars of being shamed, criticized, ignored or controlled in younger years are significant triggers for adults struggling with anger problems. When the actions of others in the present remind clients of situations from their past, anger becomes a knee jerk reaction. Clients are encouraged to talk about the pain from their past and understand the role these unresolved issues are having in their present life.
5. Learn New Ways to Cope and Develop Alternative Behaviours
Clients are taught to challenge and replace distorted thoughts with more balanced and objective thoughts using Anger Logs. They are taught coping strategies such as relaxation and deep breathing techniques, removing themselves from situations when they feel overwhelmed, developing new coping thoughts and learning to use assertive communication. With these new resources clients are given the tools to interact with others in more effective ways.
Some anger management issues that may be addressed in counselling at TPS:
Physical Abuse: hitting; choking; slapping; burning; shoving; threatening; physically restraining
Isolation: attempting/controlling another’s contact with friends and family, access to information; attempting to restrict mobility; monitoring telephone calls
Psychological & Emotional Abuse: constantly criticizing, ridiculing (partner, family, friends/co-worker); trying to humiliate or degrade; lying; undermining self-esteem
Stalking/Harassing Behaviour: following; turning up at workplace or house; parking outside; repeated phone calls or mail to victim and/or family, friends, colleagues
Threats & Intimidation: threatening to harm partner/self/others or; threatening to make reports to authorities that jeopardize child custody, immigration or legal status
Sexual Abuse/Harassment: pressuring someone into unwanted sexual behaviour, criticizing performance
Property Destruction: destroying mementos, breaking furniture or windows, throwing or smashing objects possessions
Other: road rage, workplace