Louise Bartel March 2013
Anger – what is it? Teenagers and anger. Possible reasons why some Anger Management programmes fail. Setting up an effective service. Ways of working ‘Simply’ Anger Management?! Pupil reflections Copyright Louise Bartel
‘Anger is healthy. Anger is passion, resilience, being alive, engaging…it fuels creativity. It gets things done.’ (Luxmoore, 2006)
‘Everyone is crossing the road to avoid the ‘hoodie generation’ (Batmanghelidjh, 2009)
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Three instinctual responses when faced with an angry or aggressive individual.
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Message that ‘Anger is wrong’ People need help to ‘get rid of’ anger HOWEVER Anger is a fundamental human emotion Healthy expression is vital Adolescents often need help to learn how to vent their frustrations in a socially acceptable way.
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The Frontal lobes are still developing throughout the teenage years (Giedd at al. 1999). Frontal lobes enable reasoning and reflection, planning ahead, impulse control, organisational skills and stress regulation. With a limited ability to do these things, adolescents are often caught in the ‘fight, flight, freeze’ response. Copyright Louise Bartel
‘Imagine that your brain is a car. Normally your frontal lobes are in control. Now imagine that you’re driving down the road when you see something that triggers your anger. The old mammalian and reptilian parts of the brain reach over and grab the steering wheel and the next thing you know you’re swerving out of control’ (Crist, 2008) Copyright Louise Bartel
Deborah Yurgelun-Todd (2002) MRI scans showed a difference in brain activity between adults and teenagers when identifying emotion. Adults – activity in the prefontal cortex, teenagers – more lower brain activity.
Adult brain scan
Teenager brain scan
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The relationship an adolescent has with his or her parental figures is a key factor in the ability to remain resilient in the face of adversity. A secure attachment provides an individual with the capacity for emotional regulation. It promotes the development of top-down pathways in the brain and consequently facilitates the ability to reason, reflect and empathise. Vital parental functions – protection, attunement, validation, soothing and containment. Over time the child will start to internalise these and consequently is able to self-soothe when the parent is absent.
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Rapid regressions in behaviour and shifts in emotional states Aggressive behaviours towards self and others Poor physiological and emotional regulation Self-hatred, self-harm and self-blame Risk-taking behaviours Feelings of helplessness Troubled relationships Copyright Louise Bartel
Traditional, short-term courses which aim to ‘stop’ anger often have limited success. Strangers– adolescents are often very wary of ‘some strange counsellor who thinks he knows me’. Anger – reliable defence mechanism. Used to keep people at a safe distance. This is often very effective. Teenagers often don’t want to ‘get rid of ‘ this anger. Copyright Louise Bartel
CASE STUDY BESD School for boys aged 11-17. Long histories of anger and violence, resulting in numerous school exclusions. Displays of violence towards staff and other pupils. ‘Anger Management’ – term repeatedly mentioned. Referral to outside agencies – often a long, drawn out process. Copyright Louise Bartel
Need for immediate support. Decision that an ‘in house’ Anger Management programme was needed. In 2007 one member of staff began meeting with 3 pupils. In 2013 a team of 3 full time members of staff meet with 41 pupils – 80% of the School population. Copyright Louise Bartel
Long term Anger Management programmes where relationship is key. Weekly 1:1 meetings, with the same Anger Management coach – providing consistency. Communication with staff enabling integration of strategies and understanding by all teams in school (teaching, care, learning support, medical). Individualised programmes – delivered at pace suiting each pupil.
Copyright Louise Bartel
Referral process Staff – skilled team, familiar faces. Individualised ‘programme’. We work with the needs of the individual, rather than delivering a blanket course e.g. flexible meeting times or set meeting times. Pupil recommendations. Open and honest communication. They want to come! Copyright Louise Bartel
Match affect – intensity of expression (Hughes). Show the adolescent that you ‘get it’. If a child is in a state of rage staying completely calm can increase the anger (you don’t understand). However, if you respond with anger this will also increase their level of anger. Need to match the energy – not the feeling. Reflective listening. Copyright Louise Bartel
We meet with pupils when they are calm. Considering the neurobiology of rage, there is no point meeting with pupils when they are angry. We revisit episodes of anger – consider what they could try to do differently next time. ‘Developing a Solution’ – ask pupils to reflect on their behaviour. They are often over critical, it is important to also focus on the positives. ‘Rewind’ scenarios. Repetition of information. Copyright Louise Bartel
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Take away the external reasons for violence – make them safe. Provide safe ways to release the tension in the limbic system through intensive physical activity. Therapeutic work using the Arts. This is
containing and allows the process of emptying and comprehending the trauma. 4. Teaching calm. This is through the presence of a compassionate other, which will in time become internalised (attachment relationship).
(Batmanganhelidjh) Copyright Louise Bartel
Anger ‘triggers’ The firework model ( Faupel, Herrick and Sharp) Fuse ‘shorteners’ The anger rules The role of anger (past and present) The effects of anger on health Warning signs Anger styles – aggression, repression, suppression or displacing anger. Thoughts and feelings – Emotional literacy Safe expression of anger, ‘clean anger is healthy’ Masking emotions – especially prevalent with adolescent boys (what is underneath your anger?) Recognising archaic anger – the difference between present and past anger. Neurobiology – what is happening in the teenage brain. The incredible 5 point Scale (Kari Dunn Buron) Copyright Louise Bartel
Worksheets – developed to engage pupils. Board games – lots of board games to encourage discussion around anger issues. Role play Flexibility – working environment (dog walking!)
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The Incredible 5 Point Scale www.5pointscale.com
Kari Dunn Buron
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Education not punishment. Consequences – raise awareness. Avoid ‘shaming’ or ‘put downs’ Separate ‘behaviour’ from ‘individual’. A long term intervention, based on relationship. Educate about thoughts, feelings, behaviours. Challenge past behaviour patterns, consider alternatives. Raise awareness – ways of relating, making contact. Pathway planning – future hopes? How can they achieve these? Copyright Louise Bartel
‘Evolution’ not ‘Revolution’ Involvement of staff members working in the wider school environment, throughout the introduction of the service. INSET – training to raise awareness and allow the opportunity to ask questions or voice concerns. A skilled and empathic staff team Accepted and integrated as an important aspect of support available at School (by staff and pupils) Copyright Louise Bartel
We now have a department working within School providing Additional Therapeutic Services Anger Management Therapeutic Counselling Consultant Psychologist Drug, Solvent and Alcohol guidance Group Work Social Skills and Emotional Literacy Whole School – Team Teach & Reality Therapy Practised Copyright Louise Bartel
These sessions allow adolescents the therapeutic space to reflect and feel. Core issues integral to adolescence are explored. Integrative model using the Arts. Provides containment. Aims to acknowledge, recognise and name repressed feelings. Contributes to a pupil’s individualised programme, integrating the service with existing systems.
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Assistant Head Teacher Consultant Psychologist
UKCP reg Supervisor Additional Services Manager (Anger Management Coach and Therapeutic Counsellor)
Anger Management Coach (full-time) Copyright Louise Bartel
Anger Management Coach (full-time)
We continue to look to improve the provision
Development of department building
We are hoping to create a studio, to enable drama therapy/body/movement work
Family work Copyright Louise Bartel
It has helped me in a lot of situations in and out of School when I or someone else is angry
It has helped me, I don’t get so frustrated by other people It helps when I have someone to talk to about my anger
It’s helped me when people try to wind me up by calling me names I think that it has helped me lots to keep my placement – to calm me down. I’ve used Lou and Kaz to tell people how I feel when I can’t’ ‘I can now walk away
We Asked… What do you think??
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It’s nice to talk to someone about things that other people don’t understand
I can talk to people, rather than ‘shutdown’
It’s helping me to stop punching people and to stop swearing
Any further comments or queries, please contact me
[email protected]
Copyright Louise Bartel
