Applied behavior analysts work with patients who have anger management issues by using operant conditioning methods to slowly retrain the patient into focusing their energy into more socially acceptable outlets. In many cases, a hybrid technique called Cognitive Behavior Therapy (CBT) is used to help patients train themselves to minimize or suppress anger responses.
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Anger management is one of the most common issues treated by applied behavior analysts, but it is very rarely encountered independently of other psychological or medical conditions. Anger is a frequent symptom that ABAs encounter when working with a variety of their largest patient populations, including those suffering from:
- Autism Spectrum Disorder (ASD)
- Attention Deficit/Hyperactivity Disorder (ADHD)
- Stroke and Traumatic Brain Injury (TBI)
- Borderline Personality Disorder (BPD)
- Dementia and Alzheimer’s Disease
Additionally, ABAs working in schools with general education populations or in criminal justice or geriatric care institutions are likely to encounter patients with anger management problems at some point in their careers.
Applied behavior analysis is unable to address anger, an emotion, directly, because the principles underlying the practice focus only on observable behaviors. However, anger issues that spark outbursts are treatable using a wide variety of techniques that ABAs are trained to implement.
Angry Behavior is Driven By Reinforcements That Can Be Adjusted Through Applied Behavior Analysis
Anger is often a self-reinforcing behavior in that it tends to provoke an immediate reaction from others. If it is driven by a need for attention, and that need is almost always met since it is ingrained in humans to react to expressions of anger as threats or indications of strong feelings that need to be accommodated.
This cycle of provocation and reinforcing feedback occurs within a schema describing all behaviors that is often known as the ABCs of applied behavior analysis:
- Antecedent – The prompt leading to a behavior—such as when a child with ASD wants a particular toy but cannot find it immediately.
- Behavior – The action or behavior in response to the antecedent, like a verbal or physical outburst from the child that draws the attention of a caregiver.
- Consequence – The reinforcement mechanism associated with the behavior—often, immediate attention from the caregiver and perhaps assistance in locating the toy.
Applied behavior analysts use operant conditioning techniques to try to replace the reinforcers with neutral redirections to alternative behaviors. A neutral redirection seeks to blunt accommodative responses to anger while still offering a socially acceptable mechanism to gain the attention desired. Examples might include instructing parents to ignore angry requests from a child, but to instead calmly and without acknowledgement present an alternative manner of making the request… a polite “Please” or “Excuse me,” for instance.
Other conditioning techniques focus on using visual cues to signal undesirable behavior and teach patience. Caregivers may use hand signals or visual timers when a child is starting to exhibit signs of anger, indicating that the child has been heard but that any outbursts would be inappropriate and that the source of frustration will be addressed in due time.
Anger often emerges from a sense of powerlessness, fear, or sadness. These all represent antecedent conditions that can rarely be directly addressed. But ABAs do focus on presenting alternative behaviors that can represent positive choices for expression when faced with such circumstances. Rewards, such as positive verbal reinforcement or a token (part of a system called Contingency Management) that can be exchanged later for treats or items of value, help provide a consequence to encourage the positive alternative.
Genuine Anger Management Has to Come From Within the Patient
Neutral response and contingency management systems have proven effective in settings as diverse as special education classrooms and prisons. But they represent a system of external management that ultimately has limited value when dealing with anger issues.
Although caregivers, parents, teachers, and other people around the patient might be involved in supporting the therapy, anger management differs from other ABA therapies in that it primarily involves self-treatment. The wellsprings of anger are internal and while behavioral techniques can only analyze external expressions of this emotion, the keys to managing it involve recognizing the impulses and preventing them from emerging in the first place.
This means that only the patient can ultimately recognize and provide reinforcement to extinguish the sources of anger.
ABAs working in anger management primarily work as coaches, then, teaching patients in a variety of self-care techniques that allow them to use operant conditioning techniques on themselves.
This need to engage and enlist the patient in their own treatment blends perfectly into the realm of cognitive behavioral therapy (CBT), a clinical technique that combines methods of behavior analysis with traditional psychological talk therapy.
CBT functions by helping the patient recognize and self-analyze triggers leading to anger, and to replace behaviors expressive of anger with more socially acceptable behavioral reactions instead. For example, therapists might work during a session on helping the patient recognize the antecedent situations in which they are likely to experience anger, and then train them in alternative coping mechanisms, including:
- Deep breathing techniques
- Using positive imagery
- Repeating calming words or phrases
- Engaging in physical exercises
This essentially trains the patient in using applied behavior analysis on themselves, teaching them to analyze the antecedents, behaviors, and consequences independently of the emotions they are experiencing in order to make more rational choices in stressful situations.
How to Prepare for a Career Treating Aggression as an Applied Behavior Analysis
Since ABAs frequently find themselves dealing with anger management in almost every practice domain available in the field, much of their core training is focused on handling such issues.
To this end, a common career path into ABA involves obtaining a master’s degree or higher in psychology, education, or applied behavior analysis and then acquiring a certification as a Board Certified Behavior Analyst (BCBA®). Offered by a non-profit organization called the Behavior Analyst Certification Board, BCBA® requirements include extensive and specialized education in coping with aggression, impulse control, and anger management issues.
It is also possible to specialize in anger management and aggression counseling as an ABA. Most people following this route will obtain an advanced degree in psychology, often a doctorate, or go into private practice as an anger management counselor. However, most private clinics treat a wide range of psychological issues.
There are two national certifications available in anger management counseling which may be valuable to ABAs dealing with anger management:
- The National Anger Management Association offers several degrees of credentialing under the broad umbrella of Certified Anger Management Specialist
- American Institute of Healthcare Professionals offers an Anger Management Specialist Certification
It’s also a good idea to gain some experience before going through the schooling and certification process necessary to become an applied behavior analyst. Fortunately, it is relatively easy to find this experience by volunteering with an organization that commonly deals with individuals with anger management issues.
Public schools, prisons, and social service agencies all accept volunteers and have populations that are likely to include individuals with anger management problems. Although volunteers cannot treat these patients independently, they are likely to have an opportunity to work with ABAs managing such cases and gain exposure to techniques of applied behavior analysis used in anger management.
Further Resources for Treating Anger Management Issues with Applied Behavior Analysis
National Anger Management Association – A non-profit dedicated to helping people deal with anger management issues, providing resources for both individuals and anger management counselors.
Volunteer Match – A resource for finding volunteer opportunities, including those in schools or with autism treatment programs where patients with anger management issues may be found.
The ABA Toolbox – A resource site outlining many common ABA treatment techniques, including a number for addressing anger and aggression.
Association for Behavioral and Cognitive Therapies – ABCT offers a resource page for dealing with anger management issues.