full day workshop

ANGER ASSESSMENT AND TREATMENT
Raymond Novaco, University of California, Irvine, USA

AC Hotel Room: Eixample

Anger dysregulation is commonly observed in various personality, psychosomatic, and conduct disorders, in schizophrenia, in bipolar mood disorders, in organic brain disorders, in impulse control dysfunctions, and in a variety of conditions resulting from trauma.  Anger is a common precursor of aggressive behaviour, and it can be unsettling for mental health professionals as a treatment focus.  Clients with recurrent anger problems are often not eager to engage in treatment.  As treatment should be grounded in assessment of anger control deficits, various psychometric, staff-rated, and interview methods will be presented.  CBT anger treatment will be overviewed, highlighting work with forensic patients.  The workshop will address getting treatment engagement with challenging clients, cognitive restructuring and arousal reduction techniques, the “stress inoculation” provocation hierarchy procedure, and the use of role play to foster behavioural coping skills.  Both individual-based and group-based treatment will be illustrated.  Anger assessment is not straightforward, because of reactivity to the testing situation and the multi-dimensionality of anger.  Targeting anger treatment and ascertaining therapeutic gains, hinges on assessment proficiency and case formulation.   Issues of validity will be delineated, and recommendations for clinical service will be given.  Anger psychometrics, including use of an imaginal provocation test, will be presented.  Getting treatment engagement with chronically anger people presents multiple challenges, especially if they are seriously disordered and historically assaultive.  Cognitive-behavioural anger treatment has demonstrated efficacy with patients in secure hospitals, patients with developmental disabilities, and a variety of community outpatients, including clients having severe posttraumatic stress disorder.  Core themes arising in the treatment process and ways of obtaining leverage for change through a “preparatory phase” will be discussed.  Achieving therapeutic change by addressing symbolic structures associated with anger and aggression will be illustrated. Participants will be introduced to a new group-based 18-session anger intervention, and will be given the opportunity for intensive training in that treatment protocol.

Professor Ray Novaco pioneered the cognitive-behavioural treatment of anger.  His ongoing research includes treatment studies in Scotland and England with patients in forensic facilities, combat veterans with severe PTSD, and women and children in domestic violence facilities

Key References:
Novaco, R. W. (2006).  Anger dysregulation.  In T. Cavell & K. Malcolm, Anger, aggression, and interventions for interpersonal violence. 
Taylor, J. L., & Novaco, R. W. (2005).  Anger treatment for people with development disabilities.  Chicester, England: Wiley.  Novaco, R. W. (2003).  The Novaco Anger Scale and Provocation Inventory manual.  Los Angeles: Western Psychological Services.