Case study on Anger Management Counselling

1. Background to the case

Robert, a Middle level executive was causing unrest in the office always making arguments with his colleagues. The team members in his team are constantly facing conflicts and the employee stress levels are increasing day by day. Robert expresses frequent angry outbursts and confronts other colleagues.  The angry behavior of Robert is not only making him unrest but also consuming lot of time and de motivating others to attend their duties peacefully. As a result the employee morale in the department has decreased drastically within a quarter.

So the management of the organization seek the help of Professional counseling department to intervene into the situation and to mitigate the risks associated with such type of employee conflict due to anger. Then the Counselors made an investigation and determined that the team has to undergo training on the subject – “Conflict resolution” and made Mr. Robert a part of the total course to undergo for the sessions on angry management.  This way the counselors’ won the team’s agreement to cope up with the angry behavior of others with conflict resolution techniques. Especially the counselors succeeded in including Mr. Robert in Angry Management Coaching.
Over view of the Anger Management:
Anger is a sudden outward expression of inward emotional imbalance. The things around a person or the situation may conflict with his or her expectations and that imbalance can be expressed in an unpleasant manner. Osho defines Anger as a temporary madness. People behave madly and unbecomingly when they are in angry mode. The anger can be triggered by the factors like Frustration, Annoyance, Hurt, Disappointment, Harassment, Threats.
Oliver Ross in explaining the phenomenon of Anger and explaining the reason for conflict assumes that people “unrealistically expects all people to behave and all situations to turn out as they think they should”, Oliver Ross as cited in Phil Barker. Anger can vary in different forms from mild irritation to furious violence. Though anger is a natural phenomena of the Physical and biological expression and is also termed a productive tool, it can be destructive and problematic if it is not dealt properly. This stresses that Anger has to be managed properly in order to get a productive outcome.
Anger management can be practiced in three stages – 1. Managing anger before it even shows in,  2. Managing anger when you are angry, 3. Managing anger after your anger.
Also the Anger management involves counseling for different roles like – Individual who wants to overcome anger, victims to cope up with the angry persons like-life partner, children, colleagues, parents etc.,
So the current counseling practice involves both Mr. Robert and his colleagues in the Anger management coaching sessions.
2. The legal and policy context

§  Briefly describe the laws and policies that framed your work on the case.
§  How did your understanding of the legal and policy frameworks influence your work?
Angry creates a Work place unrest and can led to workplace violence. The work place violence is a serious issue to deal immediately otherwise the loss it can create can spill on literal monetary value as well as strategic HR value. So organisations adopt strategies and policy frameworks to maintain a healthy workplace environment. The problem of workplace anger management and violence management are addressed by Occupational Safety and Health. The work place violence can be identified as any of the physical assault, angry outbursts, threatening behavior, or verbal abuse that take place in the work place setting. However, OSHA monitors that every organisation’s management should have a commitment to create a safe work environment, and hence gives many guidelines on the safe workplace environment implementation. OSHA makes the employers liable for the actions of their agent. Under this policy legal framework it is expected that,  “If the employer knows — or should have known — of information indicating that a person is a risk for committing violence, the employer is responsible for any violent acts that that person commits.”
So OSHA even extends its coverage to make the organisations liable if they fail to keep the safe workplace. Under ‘Direct Employee negligence” the employer should be careful to avoid – negligent hiring or retention, avoiding the propensity for violence. And the organisation should clearly specify the acts that are not expected to do within scope of employment. Also the OSHA act makes the organisation liable if the organisation fails to act after proper notice of workplace violence and fail to warn an identifiable victim.
The other related legal frameworks that are interwoven with OSHA are – Worker’s compensation Act, Disabilities Act and State Disability Discrimination Laws, Privacy Laws, remedy acts for employee assault etc.,
OSHA standards are advisory in nature and informational in content to the organizations to provide a safe and healthful workplace through effective workplace violence programs.
The OSHA General Duty Clause Section 5 (a) (1) states that Each employer shall furnish to each of his employees employment and a place of employment which are free from recognized hazards that are causing or likely to cause death or serious physical harm.
This includes the prevention and control of the hazard of workplace violence. The same section i.e., 5 (a) (1) gives the enforcement authority for the violation of regulation.
OSHA gives some guidelines to the Managers to either to educate themselves on the violence or to acknowledge the assistance programs that are available for the victims at the time of help. OSHA suggests the organization to be prepared by keeping the available resources in the contact list, by keeping the up to date material on hand to distribute them around the workplace and to make the employees that they can get assistance on the issues like anger and violence.
So according to the OSHA guidelines Mr. Robert’s Managers are ready with the workplace violence policies and are ready to help the team working with Mr. Robert and  Mr. Robert also.
The assistance available to the employees in he conflict resolution is known to the employees by the Informational materials distribution of the organization in the form of Pamphlets, Anti violence Posters, Educational materials left discretely in restrooms and lounges and the Educational department wide emails. So employees are fully aware of their workplace environment safety rights and have approached the management to resolve the conflict with Mr. Robert’s anger. Employees are also aware that management will respond to their query and to the victim’s perpetrator issues in a non-judgmental ways.
So the Management as a commitment to the anti violence program in the workplace has administered an enquiry in to the situation and recommended the entire team to a an outside Professional counseling agency to counsel the entire team.
However, the training or coaching program will be recorded and evaluated by the organization for further references as per OSHA guidelines.
The training program highlighted the potential security hazards and ways of protecting themselves to all the staff
The basic training contents of the counseling program involved the following:

–          Workplace violence prevention policy
–         Risk factors that cause or contribute to assaults
–         Early recognition of escalating behavior or warning signs
–         Ways to prevent volatile situations
–         Standard response action plan for violent situations
–         Location and operation of safety devices

Sources of Assistance:
¨      OSHA Consultation Program
¨      OSHA Internet Site www.osha.gov
¨      NIOSH
¨      Public Safety Officials
¨      Trade Associations
¨      Unions and Insurers
¨      Human Resource and Employee Assistance Professionals

Theory behind the anger Management Case:

The bio-psycho-social Theory:  The bio-psycho-social model treats the anger as a mental health problems having its roots from the biological, psychological and sociological imbalances. For example Anger can be aggravated by a weak body (biological condition), or anxiety about an uncontrolled situation (psychological condition), or a habitual response to a social injustice (social symptoms). Further the anger can be expressed as high palpitation (biological symptoms), increased tone (psychological symptoms) and the destructive behavior ( anti social act).
So a Psycho social or bio-psycho-social treatment is necessary when the anger is associated with such context.
A Classical Conditioning theory is practiced as an intervention practice in most of the  anger management techniques. When the triggers of the anger are identified and conditioned properly either by eliminating or altering anger can not impact the victims badly.
The psychodynamic theory: The Psychodynamic approach was developed Dr, Freud in the late 1800s.  This theory stresses that super ego places a role in the social behavior of the person. So when a person’s super ego is not satisfied, his dissatisfaction is expressed as anger.

The humanistic approach: Developed way back in 1960s this approach stresses that the life conditions of a human moulds the behavioral patterns.  A healthy and balanced growth gives the capability to face the challenges. So when  a person has not received a balanced life style during his early life it can reflect as anti social behaviors at the later point of time. Anger is one such expression of such dissatisfied behavior towards life.
In the present case the initial assessment of Mr. Rrobert’s case analysis identifies that Mr. Robert is a very punctual, sincere and loyal profession to the company.  And when he finds his colleagues or peers not coping with the work timings and proficiency levels he gets irritated easily and tries to make them work by speaking them rudely.
So it can be assumed that Mr. Robert’s anger can be controlled by proper education given to him on the personal differences of the employees. It is every much important for Mr. Robert to understand that very individual employee has his own working style and accomplishing the tasks at different intervals. Also it is apparent to make Mr.Robert to understand that monitoring is not his job role, so he cannot be over concerned with other’s work. A Conditional learning of the roles and responsibilities and the communication patterns will definitely help to manage the angry behavior.
However, it is not easy to estimate and classify the reasons for the Angry behavior of the current client Mr. Robert basing on the above theories. It requires a time bound study to closely observe the triggers of angry with him. This is to further emphasize on the angry levels, patterns and the conditions, Peer pressures, stressors, therapeutic practices required, to assess the awareness topics like communication, personality development etc.,
As anger is a normal biological phenomena, it cannot be assessed as a mental health problem. So we conducted a psychosocial assessment with Mr. Robert. This assessment is to have a complete look at the Mr. Robert’s history as well as to assess the future occurrence of mental health problems that can arise from the current symptoms with the angry behaviour.
American Psychiatric Association have not declared anger as a mental health disorder. Therefore in this process of mental health assessment Mr. Robert cannot be diagnosed as having “anger” as one is diagnosed as having anxiety or depression.
So as part of Anger assessment with Mr. Robert the levels of anger, duration of anger and the frequency and recurrence of anger outbursts are assessed.
The assessment is basically concentrated to identify the deficiencies in the system and with the behaviour of Mr. Robert that align together to trigger the anger problem in the workplace.
Here in this case of Mr. Robert, anger management map or the Conover Assessment is used to assess the anger management.
The tool helped us to take the information on Mr. Robert’s  assertiveness skills, stress management skills, motivation to change, interpersonal aggression skills, communication skills, empathy, Change orientation and the ability to set boundaries and think independently of others etc.,
When Mr. Robert and the other group completed the test the computer gave an illustrious graphs of the results with textual interpretation of each category.  These results are used as a baseline to begin the anger management program.
When Mr. Robert is presented with graphical illustration of his assessment he was very much impressed   and acknowledge the core issues of his problematic behaviour and began to converse with the counsellors and started sharing his struggle. This led the counsellors to identify the problem more in depth when the client explained about the conflicts he is facing with his family members and other neighbours.
This previous assessment also helped to configure the contents of the training and coaching session to keep the client focused on the goals of treatment.
The same assessment was conducted again at the end of the tainting session in order to evaluate the effectiveness of the sessions.
When the anger management assessment has performed between the peers who are in conflict, the results are startling. The test results revealed that, the behaviour os each individuals, especially with anger management, are polar opposites. One colleague was found very empathetic while the other was not and when one is found assertive the other is non assertive. When one colleague is good at managing stress the other is poor in stress management.
The visual format and the graphical illustrations of the individual differences the team members began to understand the foundation of their work conflicts. The group members then began to work on the anger coping skills a way of conditional learning to communicate in a better way to reduce the conflict in a significant way.
The current counselling session like most other anger management sessions adopted the cognitive behavioural approach. The cognitive behaviour approach assumes that faulty thoughts and beliefs underlie anger problems.  The anger management intervention is a two pronged approach (1) decreasing the physiological arousal using relaxation procedure and (2) cognitive thought restructuring or simply changing how a person think.
Planning:
The counseling session was planned with the objectives to build group trust and group bonding.
The counseling Components of the anger management and conflict resolution were planned as given below:
Session
Activity
Time Period
Preliminary Investigation
3 days
Session-1
Orientation on Anger & Anger Management
1 hour
Session-2
Anger Assessment
2 hours
Session-3
Anger Trigger identification (CBT)
1 hours
Session-4
Training on Anger coping skills (CBT)
2 hours
Session-5
Orientation on Group conflict
1 hour
Session-6
Coping skills for conflict resolution (CBT)
2 hours
Session-7
Demo sessions for group interactivity
1 hour
Session-8
Evaluation and briefing
1 hour

The counseling session was planned according to the Cognitive Behavior Therapy with the available budgetary and time limits. As the clientele belong are from the professional context, much of the time cannot be allocated to the counseling session. So a Five day Counseling program was planned for 3 day preliminary investigation and a two day counseling session with orientation, assessment and practice session for anger management and conflict resolution. As it is well planned and intimated to different stakeholders well in advance the session were conducted as planned.
During the Session -1 The Orientation on Anger & Anger management is planned to begin with a one hour of teaching. Then a practical session of Anger assessment will be conducted with Conover Assessment for the entire group for a 2 hour session. The results were interpreted then and there it self to gain the confidence levels of the group members. Then assessment and discussion on anger triggers were conducted for 1 hour. The day’s session was concluded with giving the practical coping techniques for the anger management to the participants.
The second day’s session started with orientation on Group conflict for 1 hour. Then for the next 2 hours coping skills for conflict resolution were addressed and for the next 1 hour the acquired skills were made practiced with the participants. Then in the final 1 hour the Evaluation was conducted using the Conover Assessment again and the session was closed with a briefing on further requirements to maintain the pace of anger management.
Risk assessment and management:
As it is a workplace conflict resolution case, the risks though some are not personal as like with the anger management between couple; but are professional. In the sense, if the counsellor is not experienced in dealing with the anger and conflict issues properly, or if the clients perceive there is a perceived bias in assessment or treatment, the entire session can be more vulnerable to dissatisfaction and group unrest.

So the counsellors identified the risks to make sure they are monitored and mitigated during the different phases of the program. One such risk mitigation practice is the usage of computerised assessment tool for the angry assessment to highlight the individual differences. As this is a machinery based self assessment tool, the participants cannot assume any bias during the process, more over are more reliant and cooperative with the coaching process.

Reflections on Key Roles and Units
The Counseling program was run under the administration of organizational Human Resource development Division. The program have been conducted with the in house  stakeholders like- Management, Departmental head, the group members f the particular department.  The management has addressed the meeting to emphasize it commitment towards the workplace safety and restated the importance of  Violence free work place environment and emphasized much on the zero tolerance violence policy towards workplace environment. This made the participants feel more responsible to attend the sessions as it is addressed by the management.
Then the In house HR training departments have authorized the administration of the training by organizing the venue, participants’ registrations, facilities and refreshments for the 2 day sessions and the learning material and the administration of the Audio visual presentation tools, assessment tools like computers and software.
The in house staff who are intended for the counseling are the primary stakeholders as beneficiaries of the program.
In order to run this group counseling for the two day session, a considerable time was involved with the preparatory process. As counseling sometimes needs individual attention a private room was also required to facilitate individual counseling.
Reflection on the Group:
It is observed that the one to one sessions have given them the attention they needed for the work practice.  As their social needs were fulfilled in this way they begin to feel a need for approval from peers to achieve within the group. Once they have practiced the new behavioral skills in the demo session, they are encouraged o practice them daily in the workplace to achieve a good level of competence before they expect proficiency to operate in the group.
How the coaching helped to MR. Robert?
Robert agreed to participate in a 3 month coaching programme after the counseling session as suggested by his CEO. By participating in the group counseling and coaching session, Robert came to an understanding on the nature of the conflicts at work and he  learnt a lot about the individual differences and personal values of others and how they differed from those of his own values. After the Five day session, he was able to rationalize on some of the behavioral patterns of the others and started to analyze why some of the clashes had been occurring within the team.
For example earlier he valued deadlines and had zero tolerance for colleagues who failed to meet deadlines. But now he learned about the interdependencies of the workflow and the technical obstacles that can happen during the project executions. Instead of blaming the people and circumstances, he began to understand that the challenges do not lie on a single person’s shoulders. As the coaching generated awareness on Win- Win strategy and scenarios, Mr. Robert, now began to search for the solutions to help others by discussing the options around. Also he began to flex his working style to accommodate others.
Earlier he felt frustrated that management was not recognizing his effort and intelligence and is hampering his entrepreneurial skills. But after the coaching session he developed his communication skills and offered some valuable suggestions to the company by discussing the new business strategy for his department with the CEO. Ultimately the business idea was agreed by the CEO and Robert’s position was escalated to new higher role.
To the Counselor:
While working on this counseling assignment, there was an improvement in the negotiation skills and communication skills in dealing with different departmental heads and groups.
1. Listening Skills: While listening to the clients I  acquired a listening ear more than my previous assignments. This helped the clients to develop their thinking and give an intuitive thought on their problem.
2. Empathy: While listening with interest developed an empathy in me.
3. Non Judging: I maintained the mode of non judgment to make the clients feel safe and respected.
4. Paying Attention: While making the clients acknowledge that all their needs are cared properly by the counselor, I developed the sense of paying attention to them.
5. I developed understanding the clients from their perspective rather than my own experiences and understanding.
6. I started to think in terms of clients thinking and tried to give solution from my knowledge.
7. I developed the skill of Questioning more than before to make the clients more open and receptive to the orientation and training sessions.
8. Summarize: While summaries in the clients’ narration and repeating it to them, i enhanced my skills of understanding and comprehension.
9. Motivation: while leading the group towards the learning program by some special statements, i developed the skills of motivating the group.
10. Innovativeness: While suggesting the participants to try the new behavior patterns within their own context, I developed the innovative thinking.
11. Restraining the argument: Controlling skills were developed largely due to this Practice.
12. While doing the initial Assessment, I avoided the careful elimination of hurtful elements of the clients to make them more concentrated and focused on the current therapy session.
Reflections on the Values Requirements
Like any other counseling session, the current assignment of anger management an conflict resolution do also face some ethical limitations to observe during the process. As the group involved different races, gender, ethnicity, nation, origin, age, culture, language disabilities and socio economic conditions, it is necessary to gain approval and coordination to work with the group members by maintaining equality.
The counselor has work carefully to eliminate the differences to have effect on the counseling process.
The current counseling process, while addressing the conflict resolution has to deal with the power plays, gender bias, disability discriminations, and the cultural and language barriers to understand the work flow and to asses the elements of the conflicts.
Also the counselor had to carefully avoid the drifting into judgmental thoughts when the clients are explaining about themselves. For example, when a lady colleague explained about the angry behavior of Roberts when she came late to the office due to a transport problem, it can be easy to fall and judge sympathetically the lateness of the women worker. But that was out of the range and scope of the current counseling.
So in order to avoid such subjective impressions on the counseling process, the counseling has documented certain ethical standards before starting and observed carefully to practice them.
Some of them include, treating the participants with value, maintaining the confidentiality of the client history, background and information on the vulnerable areas.
Maintaining confidentiality with the test results of the anger assessment results. Maintaining authentication levels for the information disclosure while seeking help from different departments for the clients’ assistance. The relevance of code of practice and ethical guidelines were also thoroughly observed for the counseling process.
In order to make the Valuable counseling practice, I made it necessary to,
–          Demonstrate awareness and management of idealization by the client and to bring that awareness into the counseling process.
–          Demonstrate a mature approach to relationships in drawing out the life experiences.
–          Having a thorough theoretical knowledge and understanding of the counseling subject- anger and conflict before initiating the counseling process.
–          Demonstrating the psychological consequence of prejudices and discriminations
–          Recognizing the limits of my competencies as a counselor
–          Maintaining regular breaks to give space and privacy to the clients
–          Proper managing of my own emotions
–          Maintaining appropriate Sexual boundaries while dealing with opposite and same gender clients.
–          Making a appropriate understanding of the vulnerable areas of the clients and avoiding them during the counseling process
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