Volunteer Coaching for Anger Management Shows Dramatic Increase - Topix

Volunteer Coaching for Anger Management Shows Dramatic Increase - Topix

Anger Management Requires Much More Than Just Managing Anger - Topix

Anger Management Requires Much More Than Just Managing Anger - Topix

Look back at anger

Look back at anger     From seething stars to peeved politicians, everyone’s doing anger management. Ariel Leve finds out why it’s all the rage. In the colossal list of things wrong with me, being an angry person has never ranked high. I am impatient, but I don't lose my temper. I am volatile, but I don't hit people. I get angry over something I have little control over, but quickly the anger turns into frustration. I'll grind my teeth at night or develop a pain in my stomach, which means the frustration is immediately sidelined by worry that I might have given myself an ulcer. But then I remember I can't afford to have an ulcer, so I am reminded that whatever I'm upset about isn't worth it, and this, for reasons only a therapist could explain, is my form of anger management. George Anderson has a different method. A Harvard-trained psychotherapist turned entrepreneur, he virtually invented the industry of anger management. Based in California, his clients include Hollywood studios that send their angry stars and executives to him, the Department of Defense and even the vice-president's old company, Halliburton. Anger is a booming business. Soon Anderson will begin selling franchises abroad. So why now? Anger has been around since the beginning of time, but behaviour that was once tolerated isn't any more, by individuals, employers, courts and legislators. Anderson & Anderson has become the world's largest provider for anger-management certification and classes. When you hear about someone being ordered by the court, this is where they are sent. George Anderson also provides "executive coaching", where he works privately with CEOs, law enforcement, movie stars - and now, me. At the Los Angeles headquarters of Anderson & Anderson, I am given two questionnaires. One is called the "anger management map" and the second will determine my emotional intelligence. My scores will be tallied and I will meet Mr Anderson, privately, to discuss the results. He is an affable man. He begins by making the point that anger is a secondary emotion. There is always something else that precedes the anger, and commonly it's stress, frustration, disappointment, anxiety, shame, etc. "Anger is a normal human emotion," he says. "Everyone experiences anger. It is only a problem when it is too intense, occurs too frequently, leads to harm of the self or others - if it leads to violence." In other words, always? "When you are tired, are you less patient than when you're not?" he asks. I tell him yes. He asks if I'm more likely to be irritable. Yes. "What about when you're hungry?" Yes, I become tense and would lean towards being less charitable to others. "So something came before the anger and it's how you respond to it." This seems obvious. What came before the anger was not eating. How I responded to it? Having a sandwich. But what about a more complex emotional minefield? Rapidly, I fire off the what-ifs. "What if there is someone married to someone mentally ill? Or an alcoholic? What if there is a family member with a permanent disability?" Anderson reiterates that you can't change the feelings, you can only respond differently and change your behaviour. Part of this is common sense and part is emotional discipline. I have neither. We go over my results on the emotional intelligence scoring grid. I did well in self-awareness, emotional awareness of others and creativity. But I scored abysmally low - as in the bottom range of "CAUTION" - for resilience (defined as an ability to bounce back and retain a hopefulness about the future); trust radius (the degree to which I expect people to be inherently "good" and an inclination to trust until there is reason not to) and personal power (the degree to which I believe I can meet life's challenges). Anderson tells me the opposite of personal power is hopelessness and helplessness, and based on the results of my tests, anger is the least of my problems. This makes sense. If I have no reason to trust, and no reason to be hopeful, then no wonder I'm not angry - I'm always prepared to be disappointed. And if anger is the result of unrealistic expectations, my expectations are so low to begin with I have nowhere to go but up. So, as I see it, scoring low in these areas is a good thing. But Anderson isn't convinced. As I defend my hopeless existence, I can see him begin to squirm. Hopelessness is not exactly the control mechanism that he's advocating. The more he tries to improve my trust radius, the more sceptical I become. Just then, something occurs to me. Have I succeeded in making the guru of anger management... angry? There is a moment of silence while he stares at me. Speechless. But then he laughs. "Well, you're from New York," he says. There is no scientific proof that Anderson's anger-management training and classes work. But they can't hurt. The real question is whether there is any long-term and significant change, since these classes are not treating the deeper issues. Shame, fear, mental illness, pathologies - all of this must be addressed in psychotherapy and counselling. Having experienced a few hours of the executive coaching, I am invited to sit in on one of the classes. A semicircle of strangers are seated in a small room. They are breathing deeply and following instructions from a relaxation tape. It's making me jittery. I am the only one whose eyes are not shut, so I look around. Five men, one woman. Jessica, 21, dressed in black with dark wavy hair and blue eyes, punched a police officer. Karl needs tools to manage his stress. Richard, a soft-spoken middle-aged dad in khaki trousers and a variety of pens in his shirt pocket, was ordered to attend for 52 weeks by the court for being verbally abusive to his ex-wife. He is in week 51. Each person has brought their "anger log", where incidents that occurred during the week are recorded and then discussed. In this room, there are two posters on the wall. The Wheel of Destructive Interactions, and the Wheel of Constructive Interactions. For the next two hours, one by one, episodes where anger was displayed during the week are candidly shared, and people are asked to identify the hostility, rage, avoidance, manipulation, etc, on the negative wheel, and then refer to the constructive wheel (expressing feelings, seeking compromise, stating needs, etc) to pinpoint what they would have done differently. Nobody is being told not to be angry, they are being taught skills to manage anger. Anderson & Anderson calls the shots because there are no laws regarding anger management. The courts rely on the company to set the standards - 26 weeks is the average. For the client to gain something, he or she has to do the exercises. The stress log and anger log must be completed every day, so they learn to know in advance the situations that would stress them out - and then do something about it. Sean Coffey, a Brit, met George Anderson after reading an article on him. His background was in psychology and he's had various jobs, such as caddying, coaching football and running a promotion agency. He plans to open an Anderson clinic in London. But will the British be able to speak as candidly as Americans? He tells me: "They do find it difficult to express their emotions, unless they feel aggrieved about something in particular. Ironically, the higher up the social scale one goes, and the more eloquent one would expect them to be - the less likely they are to verbalise their emotions and so it stays bottled up." And just as it took years for the benefits of psychology and psychiatry to filter through to Britain, Coffey fears it may be the same for anger management. "I'm not sure that British people are ready to pay for this service," he says. "Also, admitting that one requires psychiatric or psychological assistance is seen as a sign of weakness." The difference between the types of anger displayed and experienced by people in Britain and in the United States has mainly to do with alcohol-related violence (the UK beats the US) and weapon-related violence (the US is the winner by far). The common ground is car-related violence, where both nations have unrealistic expectations when it comes to traffic and journey times. Back in my hotel room and unable to sleep, I turn on the television. There is yet another form of anger management. It's called Star Wars. And the wisdom of Yoda is undeniable. "Fear leads to anger, anger leads to hate, hate leads to suffering." That's 52 weeks of class right there.

Evidenced Based Intervention Is The Missing Link In programs for "disruptive angry physicians".

Two of the three current coaching, classes or continuing education programs for "disruptive physicians" do not offer evidence of the success of its interventions.

The Joint Commission On The Accreditation Of Healthcare Organizations in its Sentinel Alert regarding "disruptive physicians" announced its initiative to require all Healthcare Organizations to establish policy for addressing the issue of anger and abuse on the part of practicing physicians. It is this alert that lead to the development of these programs.

Below is a summary of the three largest programs for "disruptive physicians" in the nation.

Anger Management for Healthcare Professionals Program

This course is designed to help those physicians and healthcare providers who have contributed to a disruptive working environment by way of inappropriate expression of anger. Conflict, stress and disruption in the hospital and clinic setting create low morale, heightened rates of staff turnover, and patient safety concerns.

The Anger Management for Healthcare Professionals program is a small, (6-8 participants), intensive and highly interactive three-day course taught by US San Diego faculty from the Department of Psychiatry. Participant coursework in the form of self-reported inventories of mood and interpersonal conflict as well as reading is required.

The objectives and goals of this course include:

•                Aiding participants to identify triggers in the workplace leading disruptive behavior.

•                Didactic instruction providing constructive tools and strategies to aid in diffusing and managing anger and conflict in an appropriate and professional manner including:

◦               Increasing Emotional Intelligence

◦               Empathy Training

◦               Transforming conflict into cooperation

•                Practicing both behavioral and cognitive strategies, including coping mechanisms, leading to healthier communication and interactions in the healthcare environment.

•                Developing a personalized plan of action (Commitment to Change)

PACE provides a dynamic training program that offers professionals an opportunity to obtain educational information and personalized assessment in a highly sensitive, supportive and confidential environment away from the workplace.

The University of California, San Diego School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The University of California, San Diego School of Medicine designates this educational activity for a maximum of 30.50 AMA PRA Category 1 Credits™.  Physicians should only claim credit commensurate with the extent of their participation in the activity.

There is no mention of a Pre and Post Assessment in this important model of intervention for "disruptive physicians".

Center for Professional Health, Vanderbilt University School of Medicine.

§      Background


§      The disruptive physician is an emerging issue for all who are concerned about physician wellness, positive outcomes in patient care, and a healthy working environment for the healthcare team. Disruptive behavior of these physicians in group practice or on hospital staffs is well documented. The American Association of Physician Executives polled their membership and found that a small percentage of physicians in the practice groups were responsible for most of the disruptive physician behavior. Nurses were often the targets of these physicians’ rage or uncontrolled frustration. 

The continuing medical education (CME) course for distressed physicians was developed at the Center for Professional Health (CPH) because of the belief that these physicians could be helped in an educational environment. The need to address this problem was confirmed by the experience of Dr. Roland Gray, Director of the Tennessee Physician Health Program, with disruptive physicians that were being referred to him on a daily basis from hospitals and practice groups in Tennessee. Cases of disruptive behavior by physicians who are acting out their frustrations with variety of inappropriate behaviors are very complicated and time-consuming. These behaviors become so routine that nurses are afraid to work with them either on the wards or in the operating room.
The CPH at Vanderbilt organized the Program for Distressed Physicians in 2005 patterned on the format of the other CME courses that had proven successful for physicians in the CPH. They are described on the CPH web site: www.mc.vanderbilt.edu/cph. 


This intervention model includes a formal psychiatric association prior to admission. Both of the above interventions are offered in a group format based on "role play". There is no mention of a Pre or Post Test or Aftercare.

General Description:

The Anderson & Anderson Disruptive Physicians / Executive Coaching / Anger Management Program™ is designed to meet the needs of high-level executives, physicians, and those clients who prefer to be seen on an individual basis for specialized coaching and privacy.  The program includes, The Practice of Control, the Anderson & Anderson “disruptive physician” client workbook, along with Gaining Control of Ourselves DVD, and Contrasting Wheels of Behavior – the does and don’ts of self-control.

EQ-i 2.0 Pre & Post Assessment:    SAMPLE REPORT PDF

Each of our coaching clients will receive an E-mail containing access to the internationally recognized Bar On EQ-i 2.0 Model of Emotional Intelligence.  This is conveniently online 24/7 available to fit your schedule. Our Clients report back that it takes about 13 – 20 minutes to complete. We actually encourage you to “not think” while taking it for most accurate helpful results. So the fast routine is read and answer. Next. Read and answer and so on. You will find it easy.

This comprehensive assessment examines the following Emotional Intelligence competencies:

Emotional Self-Awareness, Self-Regard, Self-Actualization, Emotional Expression, Independence, Assertiveness, Interpersonal Relationships, Empathy, Social Responsibility, Impulse Control, Reality Testing, Problem Solving, Stress Management, Flexibility, Stress Tolerance, Optimism.

Following the Pre Test plus six months of individual coaching a Post Test is administered to determine the level of success or lack of success. This means that each client and each referral source can determine the results of the intervention for his physician.

In contrast to the two University based programs, the Anderson & Anderson model consists of 12 hours of live individual coaching  along with six months of skill enhancement coaching via phone.

This is the only program that offers on-site coaching anywhere in the U.S.

George Anderson, MSW, BCD, CEAP, LCSW

Certification for "disruptive physician" Coaching

Anderson & Anderson, APC is now planning to sell licensing agreements and Certification for "disruptive physician" Coaching.

The training will be limited to 5 persons most of whom will be physicians. The training will consist of two on-line modules and three days of live training, which will be offered in Los Angeles. Each trainee will be required to read and prepare a 30-minute mini lecture for the group. Each trainee will complete an on-line Bar-On EQ Assessment prior to the training.

Each trainee will receive feedback from another colleague as well as those attending as well as the faculty.

Each Licensee will be required to market the program in his or her state and Anderson & Anderson will market all locations nationwide. We will control the content of the curriculum as well as the cost of each 6-month coaching program.

Currently, each physician client who accesses this coaching must pay $4900 in advance if the program is locally provided and $5900 plus expenses if the service is provided on-site.

Each provider will pay a fee of 20% for each client and pay for the assessment and training material that must be purchased from Anderson & Anderson.

The cost of the training and License will be $7000.

Let us know if you are interested.

Anger Management/Emotional Intelligence Coaching - Topix

Anger Management/Emotional Intelligence Coaching - Topix

Emotional Intelligence Coaching for Angry Physicians

Emotional Intelligence Coaching for "Disruptive (angry) Physicians

The Joint Commission On The Accreditation Of Healthcare Organizations (JACHO) requires all hospitals and healthcare organizations in the U.S. to have written policy regarding how "disruptive physicians" must be addressed.

Disruptive behavior is defined as “any abusive conduct, including sexual or other forms of harassment, or other forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.” Disruptive physician behaviors include, but are not limited to, the following:

•       Physical or verbal intimidation or challenge, including disseminating threats or pushing, grabbing, or striking another person involved with the hospital

•       Physically threatening language directed at anyone in the hospital

•       Physical contact with another individual that is threatening or intimidating

•       Throwing instruments, charts, or other items

•       Threats of violence or retribution

•       Sexual or other forms of harassment including, but not limited to, persistent inappropriate behavior.

In summary, "disruptive behavior" is really poor impulse control or problems managing anger on the part of a practicing physician.

Intervention Programs for "disruptive physicians"

Currently, most coaching programs for "disruptive physicians" begin with a comprehensive Emotional Intelligence Assessment. Emotional Intelligence Assessments are designed to identify strengths and deficits in self-awareness, self-control, empathy, assertive communication, self-control, social awareness and relationship management. Since anger is not an illness, formal psychiatric assessments are not required.

Following the assessment, each physician is given feedback on the results of his or her assessment along with two client workbooks and other skill enhancement material.

Coaching is conducted via phone for a six-month period with a focus on skill enhancements in emotional intelligence. At the end of the coaching a Post Test is administered to determine the success in addressing the physician's level of functioning in 35 emotional intelligence scales.