ANGER MANAGEMENT

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ANGER MANAGEMENT

-Prevalence

-For school-aged children, anger-related problems such as oppositional behavior, verbal and physical aggression, & violence are one of the most common referrals to mental health services (Blake & Hamrin, 2007)

-Need for early intervention

-Elementary school (4th or 5th grade)

-A high level of anger leads to crime, violence, low academic achievement, & physical and mental illness in later adolescence & adulthood (Currie, 2004)

-Intervention becomes more difficult after age 15 (Currie, 2004)

-More common among boys

-Avoid speaking about inner experience (Currie, 2004)

-Difficulty discussing emotions & feelings (Currie, 2004)

BENEFITS OF GROUP DRUMMING

-Community building

-via “rhythmic dialogue”

-Decreases stress

-Improved relaxation strategies

-Universality & applicability to diverse cultures & ages (multiculturalism)

-Breaks through cultural, racial, & religious differences

-Make connections & enhance camraderie and tolerance for others

-No “stigma” of therapy

-Empowering

(Camilleri, 2002)

WHY GROUP DRUMMING FOR ANGER?

Effective for this particular population:

-Non-verbal expression & noncompetitive (no “right or wrong”) (Camilleri, 2002)

-Percussion symbolizes inner experience

-Begin to bridge the difference between emotion and action (Currie, 2004)

-Emotional catharsis (Choi, Lee, & Lee, 2010)

-Express anger via percussion

-Enhances feelings of self-efficacy & self-control (Choi, Lee, & Lee, 2010)

-Fosters respect for others (Choi, Lee, & Lee, 2010)

-Listening; cooperation; teamwork

-Learn new ways of expressing emotions

-Use the drum to get out anger and frustration (Camilleri, 2002)

SUCCESSFUL PROGRAMS

-Doing Anger Differently (DAD) (Currie, 2004)

-10-week school-based intervention for young adolescent boys

-Percussion instruments used to represent the feeling of anger

-The non-verbal act of group drumming helps participants begin to think and speak about their experiences of anger

-Results maintained for 6 months: Reduction in anger levels, depression and misbehavior, and an increase in self-esteem

-Reduced aggressive behavior & improved self-esteem for 10-12 year olds (Choi, Lee, & Lee, 2010)

-Charter school in inner city, at-risk neighborhood in Manhattan (Camilleri, 2002)

-School-counselor-led group drumming improved social-emotional behavior of low income 5th grade students (Ho, Tsao, Bloch, & Zeltzer, 2011)

PURPOSE & GOALS OF GROUP

-To understand the meaning behind angry feelings

-To learn new relaxation and coping methods

-To enhance feelings of self-efficacy & self-control

-To promote group bonding and cohesiveness

PARTICIPANTS-4th or 5th grade

-All boys

-5-6 group members

THEORETICAL ORIENTATION

Adlerian Therapy:

-Focus on social context

-Creativity and choice – “we are self-determining beings”

-Focus on group members’ subjective perceptions of reality (how they interpret conflicts from their perspective)

-Focus on community & social interest (belonging, contribution, self-worth, cooperation)

-Confront inferiority feelings, and promote self-efficacy and self-control

-Serve as model to the group via my actions

Some cognitive-behavioral techniques:

-cognitive restructuring, relaxation techniques, problem-solving skills, social skills training, and conflict resolution (Blake & Hamrin, 2007)

ROLE OF THE SCHOOL COUNSELOR

-Needed Group Skills:

-interpreting: encourage deeper self-exploration & explanations for feelings and behavior

-Reflect feelings

-Supporting & emphasizing

-Facilitating: promote effective communication between members

-Set and evaluate goals

-Model desired behavior

-Linking & blocking

-Terminating & relapse prevention

-Time outs & “It’s hot” for conflicts (Currie, 2004)

-Setting limits

GROUP STAGES & CRITICAL INCIDENTS

-Forming:

-May be cautious, & reluctant to even try the drums at first

-Members might not open up out of fear of embarrassment or rejection

-Unwilling to discuss how they can improve their anger management at first

-Some members may be angry that they are even in the group

-Others may be trying to just play around the whole time without processing

-Group leader needs to be open, positive, and accepting

-Focus on the group members’ goals instead of teacher/parent goals

-Discuss group rules & set limits

-Allow time for exploration with the drums so members get comfortable

-Focus on joining, linking, & drawing out to get members participating

GROUP STAGES & CRITICAL INCIDENTS

-Storming

-Members may experience conflict and anxiety

-Members may compete with one another for “power” over the group

-Members may still be unwilling to discuss personal flaws or changes

-Members attempt to understand their individual role in the group

-Group leader should give feedback to members

-Allow natural process of group, while still maintaining control

-Don’t allow members to keep “one-upping” each other

GROUP STAGES & CRITICAL INCIDENTS

-Norming

-Group’s sense of belonging improves

-Group members begin to rely on each other more

-More enthusiasm and cooperation is present

-Members recognize commonalities, & collaborate with each other

-It is important for members to fully commit to the group

-As group leader, provide support, empathy, & perhaps self-disclosure

-Emphasize the process of team-building and group cohesion

GROUP STAGES & CRITICAL INCIDENTS

-Performing/Working

-Focus on achieving individual and group goals of anger management

-Group becomes more productive & actually works to make changes

-Members have genuine concern for one another, & learn more about each other

-Members are more willing to share personal information & examples

-Group leader must focus on group members’ maintaining their relationships while simultaneously working towards their goals

-This is a period of brainstorming, modeling, exercises, group processing, & psychoeducation

GROUP STAGES & CRITICAL INCIDENTS

-Mourning/Termination

-Members know themselves better

-Reflect on past group experiences & process memories

-Evaluate what was learned & prepare for future decision making

-Members have feelings of empathy & compassion for one another

-Group leader must acknowledge & process feelings of grief

-Discuss the positive outcomes & meaning of the group

-Prepare for a “new beginning” (relapse prevention)

-Group leader should summarize, provide rating sheets, & allow for individual reflection

(Gladding, 2011)

THERAPEUTIC FACTORS

-Universality

-Hope

-Self-understanding

-Catharsis

-Cohesiveness

-Imitative behavior

-Development of socializing techniques

(Yalom, 2005)

SESSION OUTLINE: PRE-SCREENING

Selection & Screening:

-Parent permission forms & informed consent

-Teacher and/or parent recommendations

-Individual meetings beforehand

-Ethical consideration: How to advertise group without “labeling” members

-Naming the group

-Inform parents about the goals and length of group

-Approximately 30 minute sessions

-6 sessions

-Ethical consideration: If parents do not agree child needs anger intervention

SESSION ONE

-Establish rules & standards for behavior

-ex: When I raise my hand, the drumming stops

-Introduce confidentiality & exceptions of confidentiality

-Introduce “temper-a-ture” scale

-Pre-test questions

-Build rapport

-If hand-making drums, take time to decorate paper

-Introductions to the beat of the drum

-Group listens and mirrors back (Camilleri, 2002)

-Learn rhythmic patterns and use of drums

-Discuss goals for the group – what the members want to get out of it

SESSION TWO

-Check “temper-a-ture”

-Establish group cohesiveness

-Team building exercises – “call and response” lead by group leader (Ho, et al., 2011)

-Focus and listening (Ho, et al., 2011)

-”Echo Game” – One person makes drum sound and the one person at a time around the circle copies the rhythm, creating a wave effect (Camilleri, 2002)

-Begin to discuss interpersonal conflicts & problem solving techniques

SESSION THREE

-Check “temper-a-ture”

-Sharing and understanding emotions

-Use anger scenarios as examples

-”Mapping Anger” – Use percussion to demonstrate the rise and fall of anger for different scenarios (soft to loud; loud to soft) (Currie, 2004)

-By performing the anger, understands anger is his (can’t blame others)

-Emotional catharsis – express inner anger

-Discussion: “What do you think of when you’re drumming? Listening?”

-Cognitive restructuring & thought-stopping in the moment of anger

SESSION FOUR

-Check “temper-a-ture”

-Control over anger – brainstorm ways to manage anger

-Emphasize personal choice and responsibility

-Self-efficacy – Speak and beat an affirmation: “I am responsible; I do the right thing”

-Match beat of the drum to the syllables (Ho et al., 2011)

-Learn spoken calm down mantra (Ho et al., 2011) & relaxation

-Leadership – person in center of the drum circle leads call and response

-Discuss how the leader may have felt – fosters empathy (Ho et al., 2011)

SESSION FIVE

-Check “temper-a-ture”

-Accept personal changes

-Pass drum or shaker around in circle faster and faster until it drops (Ho et al., 2011)

-Accept making mistakes

-Giving and receiving

-Relapse prevention

-Support of others – group identity and belonging

-More discussion of managing anger and stress

SESSION SIX

-Termination

-Review strategies for future

-Emphasis on sense of purpose, personal goals, and self-motivation

-Free drumming time

-Hand out booklets of anger management tips, calm down mantra, etc.

-All members sign each other’s booklets

FOLLOW UP

-Likert scale response from members

-Teacher report

-Parent feedback

-Individual follow-up meetings with members

CHALLENGES & LIMITATIONS

-Counselor may need additional training to prepare for group drumming facilitation

-Behavior management – aggressive drumming might get out of control

-Funding – may need to purchase instruments

-Lack of group cohesiveness and participation

-Different individuals may have different skill levels

REFERENCES

Camilleri, V. (2002). Community building though drumming. The Arts of Psychotherapy, 2002.

Choi, A., Lee, M.S., & Lee, J. (2010). Group music intervention reduces aggression and improves self-esteem in children with highly aggressive behavior: A pilot controlled trial. Evidence-based Complementary and Alternative Medicine, 7(2), 213-217.

Corey, G. (2012). Theory & Practice of Group Counseling.

Currie, M. (2004). Doing anger differently: A group percussion therapy for angry adolescent boys. International Journal of Group Psychotherapy, 54(3), 275-294.

Gladding, S. T. (2011). Groups: A Counseling Speciality, 6th ed.

Ho, P., Tsao, J. C. I., Bloch, L., & Zeltzer, L.K. (2011). The impact of group drumming on social-emotional behavior in low-income children. Evidence-Based Complementary and Alternative Medicine, 2011.

Yalom, I. D. (2005). The Theory and Practice of Group Psychotherapy, 5th ed.