|
An Anger Management group in a special
school for children with physical impairment:
Issues and reflections
Introduction
Background to Anger
Management groups in Southampton
Anger management groups
have been run in Southampton since 1997.
Following Local Government Re-organisation,
the newly formed LEA for the city identified
Emotional Literacy as a key objective,
publishing it as a priority in the then
Strategic Education Plan. The Educational
Psychology Service (Southampton Psychology
Service) was keen to integrate therapeutic
work into its model of working with children.
Identifying group settings as a context
in which challenging children find it
particularly difficult to manage their
behaviour, this was chosen as the ideal
setting for a delivery of such intervention.
Sharp and Herrick, reviewing this work
in 2000, wrote, “The opportunity
for young people to practice in vivo,
positive anger management and other social
skills, and to be regularly and publicly
reinforced for their efforts, is the main
reason why a group approach is more likely
to be successful than individual therapy
or counseling” (p. 125). At that
time, forty-five anger management groups
had been run in thirty-eight Southampton
schools.
Materials developed
for the model of anger management group
intervention formulated and employed by
the Psychology Service were published
in Anger Management: A Practical Guide
(Faupel, Herrick & Sharp, 1998); further
resources, including a training video,
have also been produced (and are available
from Smallwood Publishing). Anger Management
groups are run in schools by Educational
Psychologists co-working with at least
one member of school staff, usually a
SENCo or class teacher assisting the EP
with a third adult observing, the intention
being that these two go on to run jointly
further groups themselves. Typically groups
consist of five to seven children and
each session, of which there are six,
lasts about 45 minutes.
Modifying the Anger
Management materials
It was felt by some
that the materials used for these groups
were too ‘dry’ to be accessed
successfully by children in the primary
age range. Working together in the year
2000, Funmi Oke (EP, Southampton Psychology
Service) and Harrie Atkinson (SENCo and
Deputy Headteacher) produced a more lively
and accessible set of materials that maintained
the original programme’s progression
of learning objectives and mixture of
group, individual and paired work activities.
These materials have not been published
(they are available from Southampton Psychology
Service), but are now widely used in Southampton
schools for use with children of this
age range.
Working with
physically impaired children in a special
school setting
Cedar School is Southampton
LEA’s special school for children
with physical difficulties and caters
for youngsters from 2½ to 16 years
of age. Planning service delivery for
the year 2001-2002, anger management was
identified as a requirement in the Senior
School – that is to say, Years 7
to Year 11. This, then, was to be the
first anger management group to be carried
out in this type of special school setting
in Southampton.
Planning the group
From the onset it was
clear that there would be many new considerations
to take into account in the planning of
this new group. Of the participants identified
to take part, most had degrees of (moderate)
learning difficulty and physical impairment
that precluded written work. All were
able to communicate verbally, but there
was variation in the degree to which this
was physically easy. At either extreme,
one boy could speak fluently and one required
significant time in which to form and
articulate his words. It was decided that
the primary version of the anger management
materials would be used, with written
tasks adapted according to need: in most
cases individual writing tasks would be
supported by adult scribes; in the few
remaining they would be turned into whole
group activities (for example, a task
in which children were required originally
to identify physical sensations in their
bodies as they became angry, through labeling
a picture of a child, was modified such
that the picture was enlarged and put
on display, and labeled by the group leader
according to the children’s suggestions).
A high level of adult support was made
available, with one adult for each child
in the group (four school staff plus the
EP leading the group).
Of course an aim of
all group conversations would be to provide
opportunities for reflection on, and discussion
of, personal and shared issues; the content
of these would therefore reflect quite
naturally the contexts and cultures of
the participants’ lives. Where appropriate,
the content of some of the materials was
modified to reflect these issues also.
On a worksheet for the generation of angry
thoughts and non-angry thoughts to given
‘triggers’, for example, an
alteration to the existing text could
be as simple as the sensitive removal
of a particular word (from A group of
children call you a rude name as you walk
past to A group of children call you a
rude name) or could involve the addition
of completely new items known as relevant
to the participants (for example, the
statement My mum asks me to do something
I find difficult). Identifying such items
in the latter case required the experience
of the school staff working with these
children, who provided ‘pen picture’
summaries for each child in advance of
the initial session.
Implementation of
the group
Prior to the start of
the course, parents/carers of the participants
(whose consent had been sought and received
earlier in the term) were invited to a
meeting with the EP, in which the course
content and rationale was presented. The
group itself met weekly during the latter
half of the autumn term 2001. An afternoon
slot was chosen, each session commencing
shortly after the end of lunch break.
Accommodation was varied, but always spacious,
since all participants used wheelchairs.
As with all anger management
groups, Session One aimed to establish
a group ethos of trust and respect through
the setting of ground rules and the modeling
of desired interactions in a game of “All
About Me” (Barnados). Anger logs,
which are used throughout the six week
course, are introduced at the end of this
session and given to the participants
for daily completion at school, with support
from a scribe. These diaries – unstructured
writing for the first week, with the identification
of trigger, fuse and actions (the keywords
of the ‘firework model’ of
anger) required thereafter – form
the basis of each subsequent session’s
initial activity: a review of the week
that has passed, using the emotions vocabulary
built up thus far.
In summary, objectives
aimed at through the activities employed
for the remainder – the larger part
– of individual sessions are:
- recognizing ‘the
face’ of anger (how our faces
change to reflect anger and other emotions);
- identifying the
things that make us (personally) angry;
- understanding and
applying the ‘firework model’
as a metaphor for our anger;
- identifying how we
feel physically when we become angry
(to help us spot the signs of its approach);
- identifying good
anger management role models and their
qualities and skills;
- distinguishing between
angry thoughts and non-angry thoughts;
learning to generate non-angry alternatives
to angry thoughts (ie, cognitive reframing
to prevent anger);
- identifying and practicing
calming strategies (to manage anger
present or approaching).
Issues
arising from the group
High status of the
group
The large number of
adults supporting this group appeared
to give it a significant status amongst
its participants, who were ready from
the first session with their views on
what the course would entail, and treated
each successive meeting very seriously.
It was not my impression, however, that
the quantity of adults alone achieved
this; rather it appeared that the proximity
of these adults to the everyday lives
of the children attending made the important
difference. Often in mainstream schools
it is the Special Educational Needs Co-ordinator
(SENCo) who co-runs the group with the
EP rather than the children’s own
classteacher (in many cases, the children
attending such groups are drawn from more
than one class, so this would not be possible
anyway); in this case all the adults working
on the programme had a daily or close
to daily influence on its participants.
Extending the focus
of the Anger Management programme beyond
the individual sessions themselves is
an objective targeted through the use
of the anger logs and also occasional
homework tasks (for example, identifying
and interviewing a respected role model).
Fundamentally, of course, we are hoping
through this intervention to bring about
(or at least to initiate) a lifestyle
change in the way participants manage
their anger on a day-by-day basis. It
is desirable for the programme therefore
to be experienced as more than just six
‘lessons,’ and for the children
attending to be encouraged to identify
contexts in which their skills learnt
could be applied and generalized. The
effectiveness of these tasks in broadening
the scope of the programme, however, becomes
dependent upon adults ‘external’
to the group in most mainstream settings
– in an extreme example, six children
attending a group from six different classes
would require six different teachers to
reinforce concepts learnt in the sessions,
to remind them of homework tasks and to
make available a daily amount of time
in which to complete anger logs.
Although in this case
it appeared less the completion of interim
tasks that was important in maintaining
and broadening the focus over the weeks
as it was the daily interactions between
the children and the staff involved (in
fact, the tasks appeared no ‘better’
completed in this group than in others).
The co-leader, for example, was often
heard to make during discussions about
school-based events comments to children
such as, “Do you remember how I
told you that your fuse was burning?”
In short, it was the value placed on the
programme by the adult staff supporting
it – and their daily communication
of this to the participants – that
I feel brought about the high regard in
which the group was held. To couch this
in other terms (and encourage the observation
away from purely a special school context),
an everyday ethos that valued and promoted
such emotional literacy skills appeared
to enhance the experience of the group
shared by its members.
Discussions –
content and time considerations
The time allowed for
an anger management session is generally
45 minutes with an additional 5 –
10 minutes at the end for refreshments
(a social period – both a reward
for participation and an opportunity to
start applying new skills learnt in a
slightly modified setting to the taught
session itself). It was clear very quickly
that keeping to this time limit would
be very difficult; precisely because the
participants held the group in such high
regard, they were each ready and waiting
with their own reports on the past week
at the start of each session! Due to the
speech and learning difficulties mentioned
earlier, this discussion period by itself
could sometimes take up as much as half
an hour of the time allocated for the
session, often resulting in an overrun;
as the programme progressed, firm rules
had to be agreed on to enable each child
to have a fair amount of time to report
in. These children appeared very used
to discussing their feelings; this is
evidence of the effectiveness of the everyday
school climate. The one child, in fact,
who appeared to want to avoid talking
in earnest about his own feelings was
one who had recently transferred from
another school. Two pupils expressed frustration
occasionally that unequal amounts of time
were being allocated per child.
Restricting discussion
time, when such enthusiasm for its continuation
existed, felt like a harsh thing to do;
obviously the right balance had to be
found that allowed for issues to be discussed
appropriately without becoming distracted
from the objectives of what is ultimately
a time-restricted programme. The content
of our discussions were very emotive issues
for the participants. Occasionally they
strayed into areas common with other groups
I have run, such as playtime disputes
with peers (on one occasion, a dispute
between two of the participants, evolved
from a misunderstanding and which, once
understood was resolved well). In the
main, however, discussions tended to center
on issues arising from physical impairment,
in particular from frustration and resulting
anger from the dependency brought about
by this impairment (frustration from one
participant, for example, that he would
be unable to spend Christmas with a relative
as he had hoped due to the lack of facilities
installed in her house).
In evaluation of the
course it was agreed that a future modification
might be to put discussion at the end
of the session and leave unresolved issues
for a follow-up session held by school
staff (ie, without the EP) on the next
school day. This would give also the opportunity
to revise and overlearn key concepts presented
in the main session itself, as appropriate
to the learning needs of the children
concerned.
Outcomes and
reflections
It was not difficult
for the adults involved in the running
of the course to agree that the intervention
had been a beneficial one for the children
involved. As has been indicated earlier,
the opportunity alone to spend dedicated
time on self-reflection and discussion
was one which the children clearly appeared
to find satisfying. The main overall benefit
observed by the school staff was that
the group’s cohesiveness grew considerably,
each member appearing better able to listen
to others and to communicate their own
needs and feelings more clearly. Individual
improvements were also noted: one participant
in particular appeared a lot less angry
following the intervention and was known
to be actively using calming strategies
on a regular basis; another participant
was appearing much more able to talk about
his anger and its triggers, even though
the actual frequency of incidents appeared
unaffected. It was felt that all children
would benefit from revisiting the programme
material.
Anger management, of
course, is a set of skills, rather than
a single skill in itself. The realistic
outcome of a discreet piece of work such
as a six week course (discreet at least
from the point of view of the EP’s
involvement) should be that children are
moved on in their skills, not ‘cured’.
The best evidence of such an improvement
in this particular group came from the
children themselves in an evaluation session
conducted with them some five months after
the finish of the course. All were able
to give, when asked, a strategy that they
knew to help calm them down. These strategies
were varied and by themselves give a good
indication of the different points reached
in the development of the children’s
self-knowledge. They are given below in
a possible order of complexity:
Child 1:
Beating up a pillow. Eating chocolate.
Child 1 had also started
to think about taking himself away from
conflict situations (although he stressed
he had only thought about this); he told
us of a phrase he knew about this: “it
takes a bigger man to walk away from a
fight”.
Child 2:
Self-instruction – repeating to
himself, “No – I’m not
going to be angry – I’m going
to be a good boy.”
Child 3:
Distraction – watching television
(at home). Writing down feelings in a
letter (recently used by this child to
help resolve a conflict).
Child 4:
Distraction – listening to music.
Asking for help more to prevent frustration
building. Staff had observed both of these
strategies being used by this child in
school. This member also had started to
‘coach’ other children in
anger management techniques.
Child 5: Visualisation
– imagining a peaceful forest. Also
writing thoughts and feelings in a diary
(although this child feared other people
finding the diary and reading it’s
contents).
What did the children
think of the course itself? A range of
positive comments were made by the participants
on this subject, ranging from “you
can use your own [strategies] –
you don’t have to use the ones on
the course” to “it will stop
your anger.” Of course anger management
is not about telling children they are
not allowed to be angry; rather it is
about how they manage their anger on a
day by day basis: this might involve re-evaluating
a response to a trigger which has resulted
previously in anger (ie, formulating a
non-angry interpretation to replace a
common angry one), but also it involves
calming strategies to deal with anger
present. Above all, it involves understanding
anger processes. One child, for example,
said, “I didn’t understand
anger at all before the anger management
course.”
Conclusion
The objective of this
report has been to summarise the work
carried out in Cedar School for the Anger
management course from the point of view
of identifying the particular issues to
arise from this. This has been the first
Anger Management course run in the school;
in truth it has indeed been a different
experience to the courses I have run in
mainstream schools, but the issues to
come out of this work have implications
for continuing mainstream work as much
as they do for special school work. In
particular the benefit noted of a school
ethos that places a high value on emotional
and social skills supports the importance
proposed by promoters of emotional literacy
of its embedded integration into the school
curriculum, rather than it being an add-on
activity accessed only by a few ‘special’
children.
References
Faupel, A., Herrick,
E. & Sharp, P. M. (1998) Anger Management
- A Practical Guide, London: David Fulton
Sharp, P. & Herrick,
E. (2000) ‘Promoting emotional literacy:
anger management groups’, in N.
Barwick (ed) Clinical Counselling in Schools,
London: Routledge
Colin Woodcock (Educational
Psychologist, Southampton Psychology Service)
c.woodcock@southampton.gov.uk
Added autumn 2002
|
