anger management protocol

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Anger Management:

A Cognitive Behavioral Group Intervention Protocolfor Students with Exceptional Learning Needs

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Table of Contents

1. Forward. ..32. Session 1: Introduction To Group. 43. Session 2 : Anger and Aggression.104. Session 3: Cognitive Triangle/Feeling Identification135. Session 4: Feeling Identification/Mask Activity...166. Session 5: Identification/Physical Reactions/anger Meter197. Session 6: Identification/Triggers..248. Session 7: Management/Deep Breathing...289. Session 8: Management/Progressive Muscle Relaxation..3410.Session 9: Management/distraction/imagery.3711.Session10: Management/Thoughts.4012.Session 11: Management/Problem solving..4413.Session 12: Review..4814.Session 13: Termination..56

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FOREWORD

This anger intervention group protocol was created by Monica Freedman through herwork with the Center for School Mental Health at the University of Maryland for use inthe public domain. It is assumed that those administering this protocol have training inthe mental health field, basic knowledge of cognitive behavioral intervention, andknowledge of group processes. Teachers and support staff may need to partner withanother party with this background knowledge in order to gain the most positiveoutcome.

Basic clinical skills are necessary to discern when to discuss group processes versuscontent and to decide when it is appropriate to process issues brought to group overpushing forward with items on the agenda. This protocol as created to be modified to fitvarious student skill levels and functionality. Therefore, sessions can be combined orextended to fit a groups level and natural progression. For example, sessions 11 and 12have been broken down into four sessions for students with lower functioning allowingfor a better grasp of the materials and more practice time. Additionally, the protocol waswritten in simple language to allow for the greatest access to the materials.

Facilitators will need to create a behavior modification system that works for their group.Token economies with frequent tangible and verbal rewards work well, and consequencesare best decided upon and agreed to by the group in the first session.

Pre and Post testing is helpful to document positive change.

Each session has an agenda at the beginning for quick review. It is recommended thatthis agenda be used to gather needed materials for each session. Most items are readilyavailable in schools, but a few need to be purchased ahead of time. Assume that paper,pencils, and chalk are needed for most sessions. Also, it may be helpful to create a folderfor each participant and place handouts of necessary activities and homework for thatdays session in these folders for quick access. The folders can be distributed to theparticipants at the beginning of each session.

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I. Introduction

ScheduleWelcome participants and reviewthe schedule. Discuss theimportance of coming to everysession in order to get what theyneed from this group.

ConfidentialityAsk the group if they know whatconfidentiality means. Define theterm and ask for reasons why it isimportant. Give an example ofbreaking confidentiality. It is OK toshare ones own information regardingthe group, but not any others membersinformation. Hand out folders anddiscuss the Confidentiality Promise.Have students sign the form and placetheir folders under their chairs.

Group Session 1

AgendaI. Introduction to the Group

ScheduleConfidentiality PromiseGroup RulesIce Breaker

II. Explanation of Group

III. Goals

IV. Homework

Materials NeededM&Ms

Index CardsIdentified Rewards

Group Rules

Discuss with the group why they thinkrules are Ask the group to givesuggestions for rules they think areneeded. You may want to list them onthe board and discuss each rulesimportance. Also, it may be helpful tohave a scribe write the list down if thereis a student able to do so. The Rulescan be transferred to a large poster boardand posted or written on the boardbefore each session.

Ask the group what consequences theythink are fair for breaking the groupsrules. List consequences along with therules.

Ice BreakerUse a game that will provide benigninformation about each member to helpthe group connect. An example is theSkittles Game. Buy a bag of Skittles.

Take some index cards and writequestions that all members are likely tofeel comfortable answering. Forexample, What is your favorite song?A question can be created for each colorSkittles. Draw cards out of a bag, orgive a card to each participant and havethem hold it so the writing is toward thecenter of the group if the group is smallenough. The facilitator pours someSkittles in each participants hand and

reads one card at a time. Tell them thatif they have a certain color Skittle theyneed to answer that question before theycan eat it. Facilitators can modelappropriate answers for the group.

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This is a good place to discuss

ongoing positive behavior recognition.

Explain how participants will be

rewarded for positive behavior and

participation in group activities by

praise and some tangible measure.Facilitators may choose a method that

works for their students. An example

would be to keep small candies, tickets

or prizes on hand and set expectations

for theirdistribution. Remember toidentify allergies to chocolate or any

sensitivities to sugar!

II. Explanation of GroupAsk members to share briefly what

brought them to group. Normalize thateveryone has reasons for being in thegroup and it often helps people feel morecomfortable to hear that others havesimilar issues. Reflect similaritiesbetween members reasons and praisemembers for their willingness to share.

Pose the question, What is anger? tothe group and listen to the responses.Define anger.

Anger is a normal feeling that comesnaturally when we think someone or

something will hurt us or someone we

care about. Also, we may become angrywhen we think that someone has

wronged us. Finally, it is normal to

become angry when our needs, wants,and goals are not being met.

III. GoalsDescribe the importance of the goalsetting activity. This is good place tobegin to reinforce that individual needsare important and obtainable.

Now we are going to pick what you

want to get out of group. This group is

for you and it is important that you get

what you need from it.

Have participants get their folders andturn to the Goals worksheet. Hold up anexample to ensure everyone understandswhich sheet to take out. Work with theparticipants to identify their goals.Remember to instruct them to choosegoals in the Do section that are thingsthat may be hard for them now and theywant to do those things better by the endof group.

IV. HomeworkHave the students pull out the CareGiver Goalsworksheet and ask theparticipants to take it home and havetheir caregiver fill it out before the nextsession. Let the participants know thatthere will be times they will be asked todiscuss things that we go over in groupwith their caregivers. This will helpthem reach their goals. Also, let themknow that they will have homework forgroup sometimes, and they willbe asked to practice what they learnin-between sessions. Explain that thehomework will help them reach theirgoals, and the more they practice thethings they learn, the easier it will be touse those tools when they really needthem. It is best to practice things whenthey are calm, because it is very hard totry new things when they are angry.

Praise participants for their attention andparticipation during group and let themknow that you are looking forward toworking with them to meet their goals.

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Activities -----Group Session 1

GOALSNAME:_________________________________________

BY THE END OF THIS GROUP

I want to feelLESS:

SAD ANGRY HURT

OUT OF CONTROL DEFENSIVE

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I want to feelMORE:

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CALM / RELAXED HAPPY

SUCCESSFUL UNDERSTOOD

CONFIDENT


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I want to change the way I think and do things so that I am

BETTERat:

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Calming myself down Not being aggressive

Asking for what Talking to my parents

I need and teachers

Getting along with others


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Homework -----Group Session 1

Caregiver Goals

What would you like to see changed in your child by the end of

the anger management group?

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

____________________________________________________

________________________

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Group Session 2

I. Review of Homework

Review each participants CaregiversGoals. Ask for volunteers to share andreflect commonalities in their caregiversgoals and their own. Express hope in theability to obtain these goals and reframegoals that may not be appropriate for thisgroup. Also, ask the group if they weresurprised by any of the goals their caregiverslisted or by anything their caregivers wrote.

For those who did not bring their goals back

or do not want to share, normalize thatthings can happen to make it difficult to gethomework finished, and discuss how toovercome some of those things with thegroup.

Its true that caregivers may be busy or it

may be difficult to ask them to fill things out.How about if those who didnt bring get

their Caregiver Goals share some goals you

think they might choose?

Ask participants to place their CaregiverGoals worksheet behind their Goalsworksheet in their folder.II. 3 Myths of AngerAsk participants to open to the All AboutAnger: True and False sheet in their folders.Explain that people have beliefs about anger

that may not be true. Read each statementto the group and ask group participants ifthey think the statement is true or false.

AgendaI. Review HomeworkII. Myths of Anger

III. Anger Vs. Aggression

IV. Homework

MaterialsIndentified Rewards

Comment on how many members report trueor false on each one to assist in buildingconnections between participants. Read theanswers and explanations.

Let participants know they are going to learnways to control their anger better, learn totalk about how they feel and what angersthem, and theyll learn how to check theirthoughts to see if they are right because weoften think very fast and sometimes havethoughts about a situation that are not true.Finally, they will learn healthy ways to getwhat they need or want.

III. Anger Vs. Aggression

Explain that the words anger andaggression are used together a lot, but theymean different things.

Anger is a feeling, and aggression isan action or something we do. Aggressionis something a person does that may harm

someone else. Ask participants for examples

and add to them. Acts of aggression mayinclude:

Fighting YellingPushing Kicking

Destroying Sexual Assault

Stealing Lying

Keeping information from someone

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Saying something hurtful on purpose.

Ask participants to discuss examples ofwhen they have been aggressive and whataggressive acts they do the most. Also, ask

the group to discuss what the consequencesof their aggression have been in the past.Universalize common threads of negativeconsequences for acts of aggression, andthen ask the participants to share how theyhave expressed their anger without usingaggressive acts. There may not be manyexamples, but praise participants for anynonaggressive examples given and expresshope that participants will learn other waysto deal with and express their anger during

this group that will lead to more positiveconsequences.

V. Homework

Ask participants take the Caregiver AllAbout Anger: True and False worksheethome, and share it with their caregiver.

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Caregiver SheetAll About Anger: True and False

1. False. You are born with your anger and you cant changethe way you deal with it.

True. You have learned how to show your anger overtime. You can learn other healthier ways to expressanger.

2. False. Aggression/fighting is the only way to deal withanger.

True. There are other ways to deal with anger like:

Learning how to control how much anger you have

Learning how to talk about what angers you

Learning to think about things differently and checkyour thought to see if they are right

Learn tools to handle and express your anger

3. False. You have to be aggressive to get what you needor want

True. You can get people to hear what you want or needwithout harming others or acting in a way you will feel

bad about later. This is called being assertive.

Adapted from: Reilly PM, Shopshine MS, Durazzo TC, and Cambell TA, AngerManagement for Substance Abuse and Mental Health Clients; Participant Workbook, DHHSPub. No (SMA) 02-3622.

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I. Review Homework

Ask participants to discuss their experienceswith sharing their Myths of Angerworksheets with their Caregivers. Askparticipants to place homework in theirfolders.

II. Cognitive TriangleAsk participants to pay close attention asyou read the following scenario and let themknow it will be used for discussionthroughout the group.

John has been waiting for weeks to watch a

new episode of his favorite TV show. He has

been talking about it at home and at school.The day has finally arrived. John comes

home from school does his homework and

turns on the TV. Just as he sits down on the

couch and the show begins, his mom comesin and says, Turn off the TV. I need you to

watch your brother and sister while I go to

thestore. John becomes very angry, yellsat his mother, pushes his sister to the

ground, and goes to his room and slams the

door.

Next, ask the group for Johns feelings,thoughts, and dos from the story.Although the story did not give Johns

thoughts, ask the group to guess what hemight have been thinking. Discuss thefeelings that the group brings up that are notfeelings of anger like used, upset, sad,etc. If the group does not bring them up,discuss the possibility that John may havebeen feeling other feelings besides anger,like disappointed, because he thought hewas not going to be able to see his show.

Group Session 3AgendaI. Review Homework

II. Cognitive Triangle

III. Identification

Feelings

Poster/Sheet ActivityIV. Homework

MaterialsFeelings Poster/Sheet

Index Cards

1 Die

Indentified Rewards

_____________________

Introduce thecognitive triangle by drawinga triangle on the board and anchoring the

corners with Feel, Think, and Do

ThinkFeel Do

Discuss how the corners are related in thateveryone has thoughts and feelings whensomething happens, and people usuallychoose their actions or Dos, based onhow they think and feel.

Ask the group for examples of feelings,thoughts, and dos and write them on theboard. Ask the group where aggression fits.Sometimes students with learning challengesor those who are not yet familiar withdescribing thoughts or feelings have a hardtime separating feelings and thoughts.Stating that thoughts are like clouds thatfloat through your mind and givingexamples may be helpful. Discuss thatdos are not automatic but are chosen

based on thoughts and feelings.

The good news is we can learn to change

things at each corner. By the end of groupyou will learn how to think about things

differently, learn ways to feel better, and do

less of what gets you into trouble.

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III. Identification

FeelingsDiscuss that although we often say sad, bad,

mad, and happy when people ask us how wefeel, there are many more feelings that weexperience everyday. Explain that it isimportant to be able to identify what we arefeeling in order to deal with those feelingsbetter. Either pass out a feelings list ordirect the participants attention to a feelingsposter. (There are many feelings posters andsheets available with corresponding faces toassist students who have difficulty reading.A feelings poster is available at

feelingsunlimited.com for about $15.95.)

Introduce and go over the feelings listed onthe sheet or poster and discuss how this cangive them a cheat sheet for the nextactivity. Ask for a brave volunteer to gofirst and hand them a die. Explain to theparticipants that each of them will draw anindex card. The index card will say happy,mad, sad, or bad, or good. Each participant

will then roll the die and name that numberof feelings that are like the index card theypicked. For example, if they rolled a 3and picked Sad, they would name threeother feelings that are like sad. Then, they

would give an example of when they feltone of those feelings. A suggestion wouldbe to give an identified reward to theparticipant who volunteered to go first andafter each feeling listed for all participants.

IV. HomeworkAsk participants to complete the homeworksheet by listing two situations and thefeelings that they felt. Let the participants

know that they cannot chose happy, mad,sad, bad, or good as their feelings. Explainthat it is OK if they do not write down theirhomework, but they need to come to groupready to share their situations and feelings.

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Feelings Homework

What Happened? Feelings?

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I. Review HomeworkAsk participants to share their experienceand feelings with the group. For memberswho did not complete the homework, askthem if they can identify two feelings on thelist and share a time when they felt thosefeelings.

II. IdentificationThe MaskRemind the group that anger is a normal

natural feeling and then let them know thatanger is different than some other feelingsbecause often there are other feelings behindanger. Ask the group what a mask is andwhy people wear masks.

People wear masks so others see who they

are pretending to be and to hide who theyare. Anger is not a pretend feeling, but it is

often a feeling used to hide other feelings.

For example, someone may say something

about a wrong answeryou gave in class andyou may feel angry, but you also feelembarrassed and are worried that other


II. Identification Continued

Mask ActivityIII. Homework

MaterialsT-shirts

Sheets of Paper

Index Cards

Fabric Markers

Identified Rewards

___________________

people in the class may figure out you are

having trouble with the assignment and saymore mean things and laugh at you.Remember John? He was feeling

disappointed and used along with feelingangry. We often show the anger, but hide

the other feelings. The hidden feelings are

often driving the Dos on our triangle.

Ask the group to give more examples andlist them on the board or on paper. Ask for abrave volunteer to give a personal example

of a time when he/she expressed anger inhis/her Do, but also felt another feelinglisted by the group.

Provide each group member with a white t-shirt or a piece of paper and give membersfabric or regular markers to share. Ask thegroup to use the front of the shirt/paper toshow feelings they let the world see, likeanger, and the back shirt/paper to showfeelings that are behind the mask feelings

that they do not show anyone. Give groupmembers the suggestion of using differentcolors to represent feelings, like red foranger. They can make a key on a piece ofpaper. Let them know they can use words,drawings, or anything they like to show theirfeelings. It is helpful to have a fewexamples of completed works with oneabstract example and one that has drawingsand/or words. There are no real guidelineshere, just a creative way for self expression

that allows the group to name underliningfeelings.

Give ample time for the group to completethe activity, and then ask each member todescribe their work.

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This activity may take some guidance forthe facilitator/s. Allow for this, as it isimportant to know what feelings areexperienced when the group moves on tothought changing and problem solving.

Remember to be a cheerleader and praiseparticipants for any efforts they make.

V. HomeworkAsk Participants to think about behind themask feelings they experience throughoutweek and be ready to discuss them at thebeginning of the next session. Those whowish to can use the homework sheet torecord their situations and feelings.

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Behind The Mask Homework Sheet

WHAT HAPPENED BEHIND THE MASK FEELING

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I. Review HomeworkAsk participants to share their experience andfeelings with the group. For members who did notcomplete the homework, ask them if they canidentify two feelings on the list and share a timewhen they felt those feelings.

II. Identification Continued

Physical Reactions to AngerExplain that as humans our bodies have ways ofsending us signals. Ask the group if anyone hasever been sick. Ask members to share what kindsof signals their bodies sent them to let them knowthey were sick. Then discuss the fact that ourbodies also send signals to let us know that we aregetting angry. Identifying these signals can help usknow it is time to do things that help us calm downor let us know we may not be thinking clearly.Also, let them know that looking at what their

bodies go through when they are angry can alsoshow them how anger or stress may be unhealthy.

Give one example of a physical reaction to anger.

One thing that can happen to your body when you

get angry is your stomach may hurt.

Group Session 5_________________________

Ask the group what happens to them when they get

angry. Ask the group to take out the Signalsworksheet and write their signals on the sheet.Provide assistance where necessary. List theirresponses on the board or a sheet of paper. Add tothose responses, comment that these responses arecommon, and state that everybody its their ownwarning signals. Read the list and ask participantsto raise their hand if they have that response andreflect how many participants share similarresponses.

AgendaI. Review Homework

II. Identification, ContinuedPhysical Reactions toAnger

Anger MeterIII. Homework

MaterialsIdentified Rewards

The Anger MeterThe goal of this section is to give participants a wayto identify and track how angry they are getting incertain situations and begin to notice that when theyare higher on the meter (more aroused) it is moredifficult to make good decisions. Also, they willlearn that even when they do nothing, their bodieswill calm down at some point. Also, they canidentify what calms them down already.Remember, the things they are doing now may beaggressive, but it is important to identify that they

are using something and that strategy can bereplaced with something healthy that will workwithout harming anyone.

Introduce the Anger Meter by holding up a copyof one. Explain that a low number is less anger andthat a higher number means a more intense anger.A 0 is calm and happy, where a 10 is feelinglike your going to explode. Ask the group to helpanchor the numbers by giving examples of how

each would feel and what they might be doing ateach number. This part can be tough for studentswho lack self-awareness. It may be helpful to givea few suggestions for each number and then letmembers choose for themselves.

Now that we have decided what each number feelslike and what we might be doing, you are ready to

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start to keep track of how angry you are getting,

what you are getting angry at, what feelings might

be behind the mask of anger, and to know if what

you are doing to express your anger is aggressiveor may harm someone.

III. HomeworkHave Participants look at the Anger MeterActivityworksheet and go over it. Let them knowthat for the next session, they will begin withsharing their experiences.

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My Signs

1.________________________2.________________________3.________________________4.________________________5.________________________6.________________________

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ANGER METER

10._____________________________

9.______________________________

8.______________________________

7.______________________________

6.______________________________

5._______________________________

4.______________________________

3._______________________________

2._______________________________

1._______________________________

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Anger Meter Homework

What Happened Meter # Feelings Do

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II. Identification, Continued

Triggers

III. ReviewIV. Homework


I. Review of HomeworkAsk participants to share their experiences,place on the anger meter, feelings, andactions with the group. For members who

did not complete the homework, ask them ifthey can identify a situation in the past weekwhere they remember feeling angry and askthem to identify parts of the homework sheetfor the group by memory.

II. Identification, Continued

Triggers

The goal here is to help participants

understand that certain people, places, orevents can trigger their feelings of anger.Give an example.

Lets say John just got off of the bus and

was looking forward to playing football with

his friends. He was feeling happy andthinking, We are going to have a good

game today. On his way home, he saw theboy who beat up his best friend. As soon as

he saw the boy, he felt his face get hot and

his heart begin to beat fast. He chased afterthe boy and pushed him to the ground

yelling. John was feeling calm and happy

and was looking forward to football, but

that changed when he saw the boy who hurthis friend.

Group Session 6___________________

Discuss how a thermometer needs heat torise. Triggers are everyones individualheat sources.

Just like anger signals, different people,places, things, or events can trigger anger

signals for different people. It is important

to know what triggers anger in order to beprepared and have a plan to help ourselves

feel better, think better, and choose more

helpful actions or Dos. It may also be

helpful to know why a trigger bothers youand think about the mask feelings that are

behind it. We will practice how to check

our thoughts about our triggers later to seeif they really are a big deal after all.

Index Cards

Activity

Place cards with Person, Place, Thingor Event in a bag or hat. Haveparticipants draw a card and give anexample of a person, place, etc. that they

know angers them. Reflect commonalitiesamong members and explain that what wethink about those people, places, things andevents can bring up angry feelings prettyquickly right now because of pastexperiences. Open it up to the group toshare other triggers other than those linkedto the card they chose. Reinforce that twopeople can be in the same place at the sametime and only one may have their angermeter go up or get mad.

III. ReviewTie the materials the group has learnedtogether. Use the cognitive triangle todemonstrate that a situation or event triggersfeelings and thoughts. This can raise theanger meter and then lead to choosing anaction. Review with group on how well

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people think when they are at a 7 orhigher on the meter. Ask the group to link anevent with thoughts, feelings, anger meterlevel, and possible actions or Dos.Choose a possible trigger such as a teacher

yelling at them and a positive event such asa getting compliment from a teacher oradult. Students may bring up negativethoughts about the compliment scenariosuch as they are only doing this becausesomeone else is in the room. Honor thatthought and let them know the group isgoing to be talking about checking ourthoughts at the next group session.

V. HomeworkAsk members to complete another sheet thatnow includes identifying their triggers Letthem know that the group will discuss theirassignment at the beginning of the nextsession. Let them know that from now onthey will be learning how to think and feeldifferently to help them manage their angerand meet their goals.

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My Triggers1.________________________2.________________________3.________________________4.________________________5.________________________6.________________________7.________________________

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My Triggers Homework

WHAT

HAPPENED?

ANGER

METER #

TRIGGER FEELINGS DO

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Group Session 7

I. Review Homework

I. Review of HomeworkAsk participants to share their experiences,place on the anger meter, trigger, feelings,and actions or Dos with the group. Formembers who did not complete thehomework, ask them if they can identify asituation in the past week where theyremember feeling angry and ask them toidentify the parts of the sheet for the groupby memory.

II. ManagementFinally! Lets talk about how to helpourselves feel better. A great place to start iswith bringing down the anger meter.Remind students that their meters comedown over time even when they do nothing.Now let them know there are things they cando to bring them down faster. Ask the groupto share what they are already doing to calmdown. List these on the board and comment

on how even Dos that are aggressive mayalsobring anger meters down because theyrelease negative feelings that build up in thebody just like exercise. However, there arehealthy ways to release anger that will notget them in trouble, and they will feel betterabout themselves. Distribute the sheet DealWith It, and discuss ideas that are on it that

the group did not mention. Facilitators mayoffer to type another sheet that includes thegroups ideas for next session.


II. ManagementBreathing

III. Homework


BalloonsDiscuss how there are a lot of tools that canhelp manage anger, and from this point onthey will be the ones in charge of how theyfeel no matter what other people do or say.

Let them know that the group will be tryingnew tools out. The key is to choose healthyways to take care of yourself that help anddo not harm anyone else. Let the groupknow that some tools will work for themwhile others may not be a good fit. It isimportant to be open to trying all of the toolsa few times to see what happens.

BreathingExplain how breathing can be used as a tool

to calm down and is something everyonedoes without thinking most of the time.When anger is triggered and signs of angerare recognized it can be very helpful tofocus on breathing to calm down.

Activity

Deep BreathingIt may be helpful for a facilitator to stand upto model this skill. Ask participants toreport where they are on the anger meter

now. Then ask students to find acomfortable position in their chair or tostand. Instruct them to breathe through theirnoses and out through their mouths.

Take in a really deep breath. Bring the airall the way into the bottom of your lungs

near your stomach. While you do this, place

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one hand on your chest and one hand on

your stomach and see if which rises more.

Practice bringing in air so that you push

your lower belly out more than your chestwhen you breathe in the air. Picture

blowing up a balloon in your stomach.

Have a facilitator demonstrate deepbreathing while holding his/her hands onhis/her chest and stomach to show the lowerstomach being pushed out farther that thechest. Have a facilitator blow up a balloonto demonstrate how we bring air into ourlungs just like we blow air into a balloon.

Now we are going to take in air in through

our noses for four counts, hold it for twoseconds, and then let air out through our

mouths for six counts. You can count out

loud or silently. Clear everything out ofyour head except to notice the air going in

and out of your body. If you would like, you

can imagine clean calm air going in andangry air going out. It may also be helpful

to picture someones negative words about

you going out of your body when youbreathe out and then not bothering you

anymore. Some students have said that

thinking of a positive song that they reallylike, but does not make them angrier, while

they practice breathing may be helpful in

calming them. You can try that too if youwould like.

Explain that this is something everyone cando without anyone noticing in class or athome. Discuss the connection betweenexercising to the point where they arebreathing heavily and how practicing deepbreathing can have the same effect.

Give each participant a balloon.

Lets practice blowing up these balloons tonotice how much effort it takes and to get airinto them. Lets use the same effort in

practicing deep breathing so we get the best

results. We are going to practice this for

four minutes and see how we feel

afterwards. You can do this exercise withyour eyes open or closed.

When the fours minutes are up, ask theparticipants to share how they feel andwhere they are the anger meter. Do theyfeel calmer? Did this help? Was it difficultto stay focused? Did anyone use any of theextra thoughts to help them out? Askparticipants if this might be something theywill use outside of group? Where mightthey use deep breathing to calm themselvesdown and lower their anger meter?

III. HomeworkAsk members to practice deep breathingwhen they are calm and not angry twice overthe next three days. Remind participantsthat it easier to learn new skills when theyare calm. They are more likely to use skillsthey know when they are higher on theanger meter because people do not thinkwell when angry or stressed out. Askparticipants to then try using deep breathingtwice during the rest of the week when theynotice their anger signs and when their angermeter is going up. Ask them to record theirnumber on the anger meter before usingdeep breathing and after they try using theskill.

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Deal With IT

Drink water

Phone a friend*

Watch TV*

Listen to music*

Run

Walk

30

Play a sport

Watch a movie*

Write in a journal

Yell (In private)*

Slam a door (when home alone)

Walk away*

Count

Talk to an adult you trust

Punch a pillow

Shop*

Draw/Paint

Read

Eat*

Help out someone else

Take care of/hang out with your

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Play a video game*

Ride your bike

Clean/organize your room

Sing

Dance

Go out with friends to a place

you like

Cry*

Take a shower/bath

Put on your pjs

Hang out in a place that

relaxes you

Paint your nails

Do your homework

Go to sleep*

Ask for a moment to get

yourself together

Go to the bathroom (with

permission, of course)

Keep quiet

Ask for a neck or foot

massage from a friend

Squeeze a stress ball

Make a list of all of the

great things about you

Think of your favorite place

Think of something you did really well

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Think, My problem will not be as bad

tomorrow/next week.

Think, I will get through this.

Think, I will be home at ____.

Think of something funny/Laugh

*Remember, these are good if you do

them at the right time and you dont pick

something/someone that will anger you

out more. Also, some of these you cannot

do without creating more stress. For

example, if you walk away from a teacher

while they are still talking to you there

will be more stress!! Finally, eating,

shopping, sleeping, and crying are good if

you dont do too much of them. If you

find youre doing too much of these, you

still cant calm down, or you are hurting

yourself. TELL AN ADULT YOU TRUST

and get some help!

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Deep Breathing Homework

ANGER METER#

WHATHAPPENED

ANGER METER#

BEFOREBREATHING

AFTERBREATHING

DO

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I. Review of HomeworkAsk participants to share their experienceswith the deep breathing skill and their angermeter numbers before and after using deepbreathing. For members who did notcomplete the homework, ask them if theycan identify a situation in the past weekwhere they could have used deep breathingand ask other participants who found itlowered their anger meter numbers to sharehow it may help those participants. Ask

participants who did not practice to committo practicing deep over the next week. Haveparticipants place completed homeworksheets in their folders.

II. Management

Muscle Tension and AngerAsk participants to take out their signssheet from their folders and look to see ifany of their anger signs had to do with tight

or sore muscles. Did anyone list that theirneck or shoulders are tight? Headaches ormake a fist? Explain that these are related totightening of the muscles called tension.When tension is released our muscles aremore relaxed and it can be a good tool to useto calm down. Relate this to contact sportslike football, boxing, and lifting weights.


II. ManagementMuscle Relaxation

III. Homework


Squeeze Stress Balls

Activity

Progressive Muscle Relaxation

Many students report that fighting releasestheir energy related to anger. This isunderstandable because some peoplerespond well to heavy tension or impact ontheir bodies. Getting the muscles to tenseand then relax can also have the same effectof releasing negative energy. Explainprogressive muscle relaxation as a way towork with their bodies to release tension and

anger by tightening certain muscle groups ata time until all the groups have been workedon and relaxed.

Have the members either sit in their chairscomfortably or lie down on the floor. Passout a stress ball to each participant to use forthe activity and keep to use in the future.

We are going to try something to release

tension form our bodies. Lets start with our

toes and work up the body. Squeeze yourtoes as hard as you can by curling your toes

towards the bottom of your feet. Hold it

(about 5-7 seconds), hold it, now let yourtoes go and relax. Next, the legs. Stretch

your legs out in front of you and tense or

squeeze your thighs, your upper part of yourlegs, your knees, and your calves, and the

lower part of your legs. Squeeze them so

tight that they raise up off of the ground.

Hold it, hold it, now let go and relax. Nowon to our rear ends. Squeeze them really

tight. It should feel like you are rising out of

your chair. Hold it, hold it, now let go andrelax. Now we are going to tighten our

stomach and lower back. Squeeze them tightand you should be feeling yourself become

like a rock in the middle. Hold it, hold it,

now let go and relax. Next, the hands. Ball

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your hands up in fists and squeeze as hard

and you can. You may pick up your

stressball and squeeze it if you would like.

Hold it, hold it, and now relax. Now thearms. Hold them down at your sides and

squeeze your lower arms, your elbows, andyour upper arms. Hold it, hold it, now let goand relax. Next the shoulders and upper

back. Squeeze and lift your shoulders up

toward your ears and head. Hold it, hold it,now let go and relax. Now for the face.

Tense or squeeze your jaw, squeeze your

eyes shut, and squeeze your cheeks and

forehead. Hold it, hold it, now let go andrelax. Now we are going to tighten up

everything at once. Hold it, hold it, and now

relax. Take a minute to notice what parts ofyour body are heavy and relaxed and if any

parts are still tense. Go back and do that

body part now and see if you can feel adifference. Ready? Squeeze it, and hold it,

now let go and relax. Great job!

Ask the participants to share how they feelnow and report their number on the angermeter now. Do they feel calmer? Did thishelp? They can expect to feel heavy insome parts of their bodies. However,sometimes this activity is difficult for some

students, and the facilitator may want tocontinue asking participants if they wouldlike to try ten push ups and then report howthey feel. Have the participants list activitiesthey already do or activities they can try that

will release muscle tension. It may behelpful to list some activities that can bedone at home and some that can be used atschool. There is not a lot of opportunity toplay football at school, but they can tensetheir muscles anytime!

III. HomeworkAsk members to practice progressive musclerelaxation when they are calm and not angrytwice over the next three days. Remind

participants that it is easier to learn newskills when calm, and they are more likely touse skills they know when they are higheron the anger meter because people do notthink well when angry or stressed out. Askparticipants to then try progressive musclerelaxation and any other activity that is notaggressive that releases tension in theirmuscles during the rest of the week whenthey notice their anger signs and their angermeter going up. Ask them to record theirnumber on the anger meter before musclerelaxation and after they try using the skill.

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Muscle Relaxation Homework

WHATHAPPENED

ANGER METER#

BEFOREMUSCLE

RELAXATION

ANGER METER#

AFTERMUSCLE

RELAXATION

DO

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II. Management

Distraction

Imagery Activity

III. Homework


CD or Download of Ocean Sounds

I. Review of HomeworkAsk participants to share their experienceswith the progressive muscle relaxation andtheir anger meter numbers before and after

using this skill. For members who did notcomplete the homework, ask them if theycan identify a situation in the past weekwhere they could have used a musclerelaxation or release skill and ask otherparticipants who found this type of skilllowered their anger meter numbers to sharehow it may help those participants. Askparticipants who did not practice to committo practicing a muscle relaxation or a tensionrelease skill of their choice over the next

week. Have participants place completedhomework sheets in their folders.

DistractionRemind participants of the cognitive triangleand how thoughts also affect how we feeland what we do.

When we think negative or angry thoughts

it can be very hard to keep our anger meters

from going up. Sometimes it is really

helpful to put other thoughts in our head totrick our brains into thinking something else

that calm us. This is called distraction.

Many of us may have been told we are easilydistracted, and that would be a good thing

for our next relaxation skill. We are going

to replace negative angry thoughts with amini vacation at the beach! Although we

Group Session 9

arent really gong to leave school and go to

the beach, we will have our imaginationstake us there to get our brains to stop

thinking angry thoughts. This will then help

us calm down and feel less angry.

Activity

Guided ImageryAsk members where their favorite place isand ask them to describe what that placelooks like, sounds like, and smells like. Is ithot or cold? Remind the members that theyare in charge of what they think and theycan create a mini vacation right in theirhead. they can take their thoughts away fromwhat is getting them angry and help themfeel positive and calm at the same time.Voice that you do not recommending theyspend all of their time thinking about thisplace, because that can get them intotrouble. Imagery is used create a shortperiod of time, say 3 to 5 minutes, that canget them back on track and help them feelcalmer. Ask participants to report what theirnumber on the anger meter is now.

A sound track of the ocean may be used hereto add a nice auditory piece. If one is notavailable, just proceed with the activity without it.

For this mini vacation, we are going to go

to the beach. When you do this on your

own, you can go to a favorite place of yourchoice. Lets get comfortable in our chairs.

(Model a comfortable posture for the group)

Close your eyes and see the beach in yourmind. The water is slowly coming up on the

sand and then going back out the sea. See

the white foam of the waves as they come onthe shore and gets closer and closer to your

toes. Feel the softness of the sand as you

dig your toes into it and they sink down

Sand squishes between your toes. Feel the

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heat of the sand and smell the salt in the air.

The sun is warm and bright warning your

whole body so you are sweating, but it feels

nice and refreshing. Feel the water as itreaches your toes and is cold, cooling you

off. Hear the seagulls over your headmaking noises as they dive into the ocean forfood. You watch as the seagulls dive over

and over again into the water. Let the sound

of the waves relax you as you lay back andlook up at the little clouds passing by. This

feels relaxing with no worries or cares. Just

hanging out enjoying the sounds of the

water, the blue of the ocean and the feel ofthe warm sand. Now think about how calm

and relaxed you are as you start to say

good-bye to the beach and return to yourday. Think about how the place you are

going back to is only a small part of your

day and will not last forever. Think abouttaking the warm sunshine with you in your

mind and in your heart. Remember that you

can come back here whenever you need toenjoy some quiet time or to get away. On

the count of five open your eyes and start to

get back into your day calmer and OK. 1 2 3 4 - 5. Open your eyes.

Ask members to share their experiences.What did their beach scene look like? Whatdid their bathing suit look like? Was anyonewith them? What color was their ocean?Light blue or dark blue? Ask them howthinking about seeing, hearing, feeling, andsmelling everything changed the experiencefor them.Explain that the more detail theycan imagine the more distracted they will befrom their angry thoughts. Ask participantsto report what their number on the angermeter is now and discuss when they mightfind this useful.

III. HomeworkAsk participants to practice imagery threetimes each over the next week. Ask them torecord their numbers on the anger meter

before and after they do the imagery. Askparticipants to practice when they are calmand when they are angry and to notice ifthey are thinking less negative or angrythoughts after they complete an imagery

activity.

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Imagery Homework

WHATHAPPENED

ANGERMETER

ANGERMETER

#AFTER

IMAGERY

DOLESS

NEGATIVETHOUGHTSAFTERIMAGERY?

Yes or No?

#BEFORE

IMAGERY

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I. Review of HomeworkAsk participants to share their experienceswith imagery and their anger meter numbersbefore and after using this skill. Formembers who did not complete thehomework, ask them if they can identify asituation in the past week where they couldhave used imagery, ask other participantswho found this type of skill lowered theiranger meter numbers to share how it mayhelp those participants. Ask participants

who did not practice to commit to practicingimagery over the next week. Haveparticipants place completed homeworksheets in their folders.

II. Management

ThoughtsRemind participants of the cognitive triangleand discuss how thoughts can affect feelingsand Dos or actions. Often thinking about

negative thoughts over and over again canlead to more anger without any help from atrigger. That can make it difficult to calmdown. Discuss last session and howparticipants learned that they have controlover what they think, and by changing theirthoughts to positive thoughts, they broughttheir anger meters down and felt calmer.


II. Management

Thoughts

Your Thoughts Activity

Correcting Johns Thoughts

Change Your Thought Activity

III. Homework


Introduce the idea of common thought errorsor mistakes. Ask participants if they haveever had a thought that turned out to befalse. For example, have they ever thoughtthings would not get better after anargument with a friend and they did?Explain that there are nine common thoughterrors that people make all of the time, andthese mistakes are what often keep ournegative thoughts going.

When we learn how to check our

thoughts to see if they are even correct

before getting angry, it is a lot easier to keep

our cool and stay calm. Also, when wecatch a mistake in our thoughts we can

change that thought to a more realistic and

positive thought that helps us deal with thesituation better and choose Dos that

dont get us into trouble.

Your Thoughts Activity

Pass out the Your Thoughts sheet andread each thought error. If you have a groupthat can read, have participants take turnsreading them. If the group has difficultyreading, read the sheet to them stoppingafter each item to give examples. Ask groupmembers to share examples of when theyhave made these thought mistakes as well.

Correcting Johns Thoughts ActivityRemember John from session 3. Askparticipants to listen to the story about John

again, and explain that as a group they aregoing to Johns thoughts for errors thatare listed on their sheet.

John has been waiting for weeks to watch a

new episode of his favorite TV show. He has

been talking about it at home and at school.

The day has finally arrived. John comes

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home from school does his homework and

turns on the TV. Just as he sits down on the

couch and the show begins, his mom comes

in and says, Turn off the TV. I need you towatch your brother and sister while I go to

the store. John becomes very angry,yells at his mother, pushes his sister to theground, and goes to his room and slams the

door.

Let the participants know that the story doesnot list Johns thoughts, but as a group theycan guess what he might be thinking. Assistthe group in identifying Johns possiblenegative thoughts, and ask participants toidentify which thought mistake from their

sheet they might be. Inform the group thatsome thoughts may fall under more than onemistake. Prompting may be necessary forthis activity because it is challenging.Provide a lot of praise and continue touniversalize Johns errors with everydayexamples that they might run into.

Change Your Thought ActivityRemind participants that they are in chargeof their thoughts, and they have the power tochange them. Let participants know you aregoing to give each participant a thought andthey are going to name the mistake andchange the thought to a more realisticpositive thought. This is a good activity tohave participants work in pairs. Or keep theactivity open to the whole group if workingindependently is too difficult.

III. HomeworkAsk participants to record two negativethought mistakes over the next week and listpossible realistic positive thought to take theplace of the negative thought. Ask them torecord their number on the anger meterbefore they begin the activity and after. Letparticipants know they can list feelings and

Dos after the activity if they would like.That way than can also track if changingtheir thoughts affected the other corners ofthe triangle; Feel and Do.

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Activities ----- Group Session 10

YOUR THOUGHTS

1. All or Nothing Everything is perfect or awful. Things always or neverhappen.

2. Yes, But Thinking Throw out the +s and only see the s.3. Mind Reading - You can read peoples minds and can tell what they are

thinking.

4. Telling the Future You can see the future and are sure you know whatwill happen.

5. Feel Thinking You are letting the way you feel tell you what to think.6. Labeling: Because something happened you now say you are a ________,

he is _________, I am a _________.

7. Should Thinking: I should have, he should have ________. Also, becareful of have to. There are many ways to do things, not just one.

8. Know it All Thinking: Because of one or two things you think you know itall.

9. End of the World Thinking You think everything will turn out in theworst possible way.

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Your Thoughts Homework

WhatHappened?

Meter#

- ThoughtMistake

+Thought

Meter#

Feelings Do

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II. Management

Problem SolvingNow and Later Activity

III. Homework


I. Review of HomeworkAsk participants to share their experienceswith checking their thoughts. Did theiranger rating go down? How did theirthoughts affect their feelings and Dos?What were the most common thoughtmistakes in the group? Universalize thateveryone makes thought mistakes by linkingsimilar participant mistakes. For memberswho did not complete the homework, askthem if they can identify a situation in thepast week where they made a thoughtmistake and ask them to change thatnegative thought to a more realistic positivethought and that might affect their feelingsand actions. Ask participants who did notpractice to commit to practicing imageryover the next week. Have participants placecompleted homework sheets in their folders.

II. Problem SolvingHaving clear steps to take to choose a Dothat has positive consequences is helpful.Discuss the idea that even Do choices thatget participants into trouble have at least onepositive for each person or they would notchoose it.Here is an example. John told Tim that he

is stupid in front of the class, and Tim chose

Group Session 11

to punch John because in that moment he

thought the other students in the class mightthink he is tough. Maybe, Tim releases his

anger and tension pretty well by hitting.

Both of those ideas are positives for Tim, sohe may go with his choice to hit John. For

every Do there are positive and negative

now consequences and positive andnegative later consequences. The

situation I just gave about Tim and John

gives examples of positive now

consequences.

Pass out the Now and Later sheet andask participants to fill in what happenedwhen John said that Tim is stupid and listthe above consequences under Now +s.Ask participants to give examples of somenegative now consequences and list themin Now - box. (If participants havedifficulty writing, a facilitator can takedictation for that participant or choose to fillout a sheet for the group.) Some examplesmight be Tim gets yelled at by the teacher,John punched Tim back, Tims girlfriendtells him she is angry with him for fighting.Move on to later consequences anddiscuss both positive and negative thingsthat could happen because of Tims choiceto hit John. Explain that sometimes it ishard think of positive consequences foraggressive or negative behaviors. Assist thegroup in identifying some if they get stuck.Gaining a reputation of someone who istough is an example. Fill out the rest of thesheet using John and Tims example. Assistthe group in also thinking of laterconsequences that affect their life goals.

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Examples are graduating from school andgetting a job.

Discuss that is it important to know bothpositives and negatives of the Now and

Later to make a choice that you wantinstead of making a quick choice withoutthinking. Ask participants to pick anothermore positive behavior that Tim couldchoose to do instead of punching John, andfill in the boxes for now and laterpositive and negative consequences as agroup. Ask the group to decide whichbehavior they want to choose and discusshow they came to that choice and if thatchoice fits their own personal goals.

III. HomeworkAsk participants to take a situation and listthe now and later positive and negativeconsequences for an aggressive Do choicethat they might have chosen in that situationin the past and an alternative positive Dochoice. Ask them to go through the processfor each behavior and then make a choice.They will need to be able to explain howthey made their choice to the group nextsession.

Inform the group that next session is areview session where they will be split intotwo groups to complete a final task wherewhich they will be asked to explain thingsthat they have learned in past sessions andput everything together,

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Lets Make a Choice

What Happened?

NOW LATER

Aggressive Do

+s +s

-s -s

+s +s

Alternative +Do

-s -s

Choice Why?

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Lets Make a Choice

What Happened?

NOW LATER

Aggressive Do

+s +s

-s -s

+s +s

Alternative +Do

-s -s

Choice Why?

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I. Review HomeworkAsk participants to share their situations,both positive and negative consequences foraggressive and alternative choices, and theirfinal choice.

II. ReviewIt is time to wrap up and review learnedmaterials. Have past session writtenmaterials handy to show participants to helpjog their memories.

Ask the participants to talk about and giveexamples for the concepts of the cognitivetriangle, myths of anger, some feelings thatare behind the mask of anger, physical and

cognitive signs of anger, thought errors, oftheir ratings on the anger meter, triggers,examples of relaxation techniques and dealwith it ideas, and positive and negativeconsequences for behavior choices.

II. Team Activity

Group Session 12AgendaI. Review HomeworkII. Review

Cognitive Triangle

Myths of Anger

Underlying Feelings Behind Anger

Physical Signs

Thought Signs

Anger Meter

Triggers

Relaxation Techniques

Problem Solving

II. Team Activity

Scenario to apply all learnedtechniques

III. Homework


Divide the group into teams of two to three

people for the final activity.Provide the whole group with a scenario anda paper with all of those concepts listed.Read the scenario aloud and ask them tocomplete their sheets letting the teams knowthe group will come back together to discusstheir work. Give the teams approximately20 minutes to work through their task.Facilitators may need to assist groups or dothe activity as a whole depending on groupmembers functioning.

List each groups answers on the board. Asthe first team gives their feedback, list theiritems on one side. Then list only itemsthesecond team provides that the first teamdid not list. Discuss all feedback, evenanswers that may not be helpful and let thegroup respond with their thoughts. Apossible scenario is as follows:

Max comes into class and sits down

at this desk. He hears John talking to someother kids saying Maxs shoes are lame.

His Mother must have picked them out for

him. The other students laugh and thenMax feels a ball of paper hit him in the back.

He feels his face getting hot and his fists ball

up. He thinks, He is always messing withme. Everyone is laughing. I know he will

keep doing this all day. I am lame. I have

to fight him or everyone will think I amletting him disrespect me. Max also thinks

about how he just came back fromsuspension and got his privileges back at

home. He doesnt have much, but he has abike. He does not want to lose it for 2 weeks

again. He was also told that he may haveto repeat the 8

thgrade if he misses any more

school and fails Math and Science again.

Max stomach is burning and he is trying to

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figure out what to do. Tyra says to him,

Dont listen to John, hes just jealous

because his girlfriend likes you. The

teacher comes in and hands out the warm upactivity.

III. HomeworkAsk participants to really try to use theirskills over the next week. Inform them thatthey will discuss how putting everything alltogether worked for them, their individualprogress, and their progress as a group at thenext session. Also, as the next session is thelast one, facilitators can inform the group ofany treats they can expect. For example, ifthe facilitators plan to provide pizza, the

group can be asked their preferences and beinformed not to eat lunch that day.

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Review Activity

Signs of Anger:

_____________, ______________, _______________

Thoughts:

Your Thoughts. What errors is Max making?

_____________, ______________, _________________

Real and KEEP thoughts:

______________, ______________, ________________

Feelings Behind the Mask:

________________, ________________, _______________

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Number on Anger Meter: _______

Triggers:

________________, ________________, _____________

What relaxation techniques orDeal With IT activities can he try?

__________________, ___________________, _______________

__________________, ___________________, _______________

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Choices

NOW LATER

Aggressive Do

+ +

_ _

Other + Do

+ +

_ _

My Choice

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Feelings Behind the Mask:

________________, ________________, _______________

Number on Anger Meter: _______

Triggers:

________________, ________________, _____________

What relaxation techniques orDeal With IT activities can his try?

__________________, ___________________, _______________

__________________, ___________________, _______________

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Choices

NOW LATER

Aggressive Do

+ +

_ _

+ +

Other + Do

_ _

My Choice

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I. Review HomeworkAsk participants to share their experiencesfrom the past week in putting all of theirskills together.

II. Feedback

Review GoalsAsk participants to pull out their goals fromthe first session and take a moment to lookthrough the goals they chose. Ask membersto share what goals they believe theyreached and what goals they would like tocontinue to work on.

Growth

Group InputAsk participants to share thoughts on theprogress they think they have madeindividually and as a group. How would

Group Session 13


II. Feedback

Review Goals

Growth

Group Input

Facilitator Input

Favorite Items

Future Suggestions

III. Termination

Next Steps

Certificates

Celebration


Certificates

Celebration Treats

others in their lives like teachers andcaregivers say they have changed?

Facilitator InputParticipants look to the facilitator/s forpraise and feedback. Provide eachparticipant with thoughts of how you thinkthey have grown. Remember that nopositive change is too small to mention.Also, take a moment to discuss how thegroup has grown as a whole and commenton the support participants have shown eachother, the groups cohesiveness, and theresponsibility the participants have taken fortheir progress as a group.

Favorite ItemsAsk members to share some favorite thingsthey learned in group. What tools did theyfind most helpful to manage their anger, andwhat tools might they share with friends tohelp them out?

Future SuggestionsAsk participants to share what they likedleast and what they would like to changeabout the group format or items learned.How would they make it better for the nextgroup?

III. Termination

Next StepsAsk participants to share how they will usewhat they have learned going forward.When do they think they will need these

skills the most? Provide encouragementstating that the more they practice, the morethey will become experts of how to managetheir anger, control their thoughts, and makepositive choices. If they keep it up, theywill be on their way to make their goals inlife.

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CertificatesPresent each member with a certificate ofachievement to acknowledge his/her effortsand accomplishments. Even high school

students like to receive items of appreciationand positive feedback.

CelebrationOffer participants treats to celebrate thesuccessful ending of the group!!!CONGRATULATIONS! YOU DID IT!

anger management protocol

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