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Anger/Rage Management Part
1
Objectives
• To encourage you to be more alert to and
mindful of safety issues
• Provide information about how to detect the
potential for physical violence
• To consider alternative responses in potentially
dangerous situations
• To help understand the application of
communication skills in some situations of
potential danger
• To introduce safety awareness in the facility and
treatment process
Resons for violence
• Perceived role of “Control” for case
managers
• Negative preconceptions of counselors
• Increasing violence in society
Anger
• http://www.ksat.com/video/18428265/index
.html
Causes of Aggression/Violence
• Is violence inevitable to human beings?
• Is it a part of Human Nature?
• Is it learned?
• Is it an outcome of life’s frustrations?
• Is it driven by society?
Causes of Violence
• Aggressive impulses are innate and build
up if blocked
• Disequilibrium in power can trigger
violence
• Aggressiveness is socially learned and
rewarded
• Frustration leads to aggression
• Aggression can be initiated by human
need
• A single intervention won’t work
• “flexibly” consider varied ways of
responding
• Learning safety needs to be ongoing
Predictive individual factors
• History of violence
• Mental illness
– Substance abuse/dependence
– History of child abuse
– Various demographics
• Between 15 and 40
• Male
• Criminal history
• Military training
• Social isolation
• Isolated area of treatment center
• Patient history of violence
• Presence of many potential weapons
• Unknown patient
• Etc…
Predictive individual factors
• Clinicians who:
– Introspective < violence
• More safety conscious and non-blaming attitudes
– Authoritarian approach > violence
• Exacerbates feelings of powerlessness
– Gender
• Not shown to be a factor
Anger
Anger
Anger
Anger
Anger
Pushing Buttons
• Imagine there are no buttons to push – it’s
easy if you try
• The million dollar question 
Environmental signals
• Are there other patients who could get hurt
near by?
• Is there anyone who would serve as an
inciting audience?
• Are there any other staff members
available to assist you?
• Are there any obvious weapons?
Internal signals
• What are your own inner reactions?
• Do they give you any indication of
potential danger?
Person-in-Environment
• Association with Peers that may influence
me
• Peers as a source of “normalization” of
negative feelings
De-escalating verbal
communication
• Facilitate expressing feelings and thoughts
• Respond succinctly
• Encourage problem solving
• Redirect (changing the subject)
Other De-escalating techniques
• Be conscious of physical approach
• Mirror (opposite) Body Language
• Set Limits appropriately
• Equalize Relationship
• Personalize (self-disclosure)
• Stay calm and THINK
• Retreat
• Allow patient to retreat
Discuss
• When have you felt unsafe?
• What changes can La Hacienda make to
improve safety?

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Anger

  • 2. Objectives • To encourage you to be more alert to and mindful of safety issues • Provide information about how to detect the potential for physical violence • To consider alternative responses in potentially dangerous situations • To help understand the application of communication skills in some situations of potential danger • To introduce safety awareness in the facility and treatment process
  • 3. Resons for violence • Perceived role of “Control” for case managers • Negative preconceptions of counselors • Increasing violence in society
  • 6. Causes of Aggression/Violence • Is violence inevitable to human beings? • Is it a part of Human Nature? • Is it learned? • Is it an outcome of life’s frustrations? • Is it driven by society?
  • 7. Causes of Violence • Aggressive impulses are innate and build up if blocked • Disequilibrium in power can trigger violence • Aggressiveness is socially learned and rewarded • Frustration leads to aggression
  • 8. • Aggression can be initiated by human need • A single intervention won’t work • “flexibly” consider varied ways of responding • Learning safety needs to be ongoing
  • 9. Predictive individual factors • History of violence • Mental illness – Substance abuse/dependence – History of child abuse – Various demographics • Between 15 and 40 • Male • Criminal history • Military training • Social isolation
  • 10. • Isolated area of treatment center • Patient history of violence • Presence of many potential weapons • Unknown patient • Etc…
  • 11. Predictive individual factors • Clinicians who: – Introspective < violence • More safety conscious and non-blaming attitudes – Authoritarian approach > violence • Exacerbates feelings of powerlessness – Gender • Not shown to be a factor
  • 17. Pushing Buttons • Imagine there are no buttons to push – it’s easy if you try • The million dollar question 
  • 18. Environmental signals • Are there other patients who could get hurt near by? • Is there anyone who would serve as an inciting audience? • Are there any other staff members available to assist you? • Are there any obvious weapons?
  • 19. Internal signals • What are your own inner reactions? • Do they give you any indication of potential danger?
  • 20. Person-in-Environment • Association with Peers that may influence me • Peers as a source of “normalization” of negative feelings
  • 21. De-escalating verbal communication • Facilitate expressing feelings and thoughts • Respond succinctly • Encourage problem solving • Redirect (changing the subject)
  • 22. Other De-escalating techniques • Be conscious of physical approach • Mirror (opposite) Body Language • Set Limits appropriately • Equalize Relationship • Personalize (self-disclosure) • Stay calm and THINK • Retreat • Allow patient to retreat
  • 23. Discuss • When have you felt unsafe? • What changes can La Hacienda make to improve safety?