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1. AU S T RAL IAN I N S T I T U T E OF CRIMINOLOGY No. 227 trends Anger Management and & Violence Prevention: issues Improving Effectiveness in crime and criminal…
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  • 1. AU S T RAL IAN I N S T I T U T E OF CRIMINOLOGY No. 227 trends Anger Management and & Violence Prevention: issues Improving Effectiveness in crime and criminal justice Kevin Howells, Andrew Day, Susan Bubner, Susan Jauncey, Paul Williamson, Ann Parker and Karen Heseltine The management of anger is a crucial issue in the prevention of violent crime. Programs that aim at anger management can be highly cost-effective. The 1990s and early 2000s have witnessed a renaissance of interest in the rehabilitation of offenders in many criminal justice systems throughout the world. The causes of this re-awakening of interest are many, but include the increasing evidence that rehabilitation programs have a significant impact on rates of recidivism (McGuire 1995; Hollin 1999, 2001). As this evidence has accumulated, the notion that “nothing works” in offender rehabilitation has slowly given way to an emphasis on identifying the characteristics of programs that are likely to be effective and, conversely, the characteristics of those that are likely to have no effect or even an adverse effect on rehabilitation rates (Andrews & Bonta 1998; Howells & Day 1999). This paper focuses on anger and aggression rehabilitation programs within correctional settings in South Australia and Western Australia. June 2002 Adam Graycar Director ISSN 0817-8542 V iolent crime is not necessarily related to anger, but it has been argued that poor anger control often plays a role in violent offending and can be considered a criminogenic need for many ISBN 0 642 24268 2 violent offenders (Howells et al. 1997). The experience and expression of anger has been studied in a wide range of clinical and non-clinical populations, including students, community residents, health-care clients, psychiatric/ residential patients and adolescents in institutional care (Kassinove 1995). Cognitive behavioural anger management programs have Australian Institute been developed for use with many of these populations and initial of Criminology research suggests that they are effective in reducing problems with GPO Box 2944 anger expression (Beck & Fernandez 1998). Similar cognitive behavioural programs may also be appropriate for offender groups. Canberra ACT 2601 A number of studies have highlighted the role of cognitive factors Australia in anger arousal and expression in offenders. Findings such as these have lead to the widespread implementation Tel: 02 6260 9221 of anger management programs in prison and community corrections Fax: 02 6260 9201 settings around the world. These are often brief (up to 10 sessions) cognitive behavioural programs designed to reduce anger arousal For a complete list and the full text of the and improve anger control (Novaco, Ramm & Black 2001). Anger papers in the Trends and Issues in management programs take a skills approach and attempt to help Crime and Criminal Justice series, visit program participants develop alternative strategies in the control the AIC web site at: and expression of angry impulses (for a discussion of the rationale for anger management with violent offenders, see Howells 1998; http://www.aic.gov.au Novaco 1997). This paper focuses on anger and aggression rehabilitation programs Disclaimer: This research paper does not necessarily reflect the policy position of the within correctional settings in South Australia and Western Australia. Commonwealth Government. A review of international literature on the effectiveness of such
  • 2. Australian Institute of Criminology programs is provided, before the reducing anger problems (Beck & misconduct and observational results of the recent Australian Fernandez 1998; Edmondson & measures of aggressive behaviour. study are discussed. Finally, some Conger 1996). Watt and Howells suggest recommendations for improving several reasons for these findings, Does Anger Management anger management outcomes are including: offered. Work with Offenders? • poor motivation of participants, A small number of studies have • the high complexity of the been conducted with offenders, program content, Content of Anger Management but many have methodological Programs • low program integrity and problems, including lack of • limited opportunities to practice control groups, absence of the skills learned. The content of cognitive behavioural behavioural measures or poorly It is also clear from Watt and therapeutic interventions for anger specified comparison groups. Howells’ account that the and aggression has been described Among the more promising participants were not subjected to in a substantial number of clinical studies have been those by a pre-treatment assessment to accounts, research reports and Stermac (1986), McDougall and establish whether their violent reviews (Howells 1998; Novaco Boddis (1991) and recent studies offending was actually anger- 1997). It is clear that anger reported in the New Zealand mediated (this is discussed in management training has a number correctional system (Polaschek & more detail below). of possible components, including Reynolds 2001). An additional consideration in relaxation training, social skills Dowden, Blanchette and Serin the Australian context is the over- training and cognitive restructuring, (1999) conducted a substantial representation of Indigenous and that these various components study of the effectiveness of an people in offender populations. may have differential effects on anger management program with Issues about adapting anger the different dimensions of anger offenders in Canada. The program programs to make them relevant (Edmondson & Conger 1996). An itself was a reasonably substantial to Indigenous participants have outline of the programs forming one—25 two-hour sessions—and received little attention in the the basis of the present study is was shown to have an impact in published literature (Mals et al. shown in Table 1. reducing recidivism over a three- 2000). year period, although this In brief, although anger Previous Studies of Anger improvement was found only for management and violence- Management high-risk offenders. It is reduction programs have noteworthy that this program is developed and proliferated with A relatively large number of far more intensive than anger violent offenders, the empirical outcome studies have been management programs offered in and controlled evaluation of the reported for anger management many Australian jurisdictions. effectiveness of such programs is programs. However, some of None of the abovementioned at a very early stage. Large-scale these studies have been conducted studies were conducted in outcome studies are needed in with university students with Australia, however, two small- which high-risk, seriously violent anger problems or similar groups, scale controlled studies have been offenders are exposed to anger rather than with offenders. The undertaken in an Australian management and similar findings cannot necessarily be context. These studies (reported programs, and comparisons made generalised to offender populations. by Watt & Howells 1999) were with no treatment and other Narrative reviews of the conducted in Western Australia, conditions. Comprehensive general effectiveness of anger and suggest a need for caution outcome measures are needed, management (Howells 1998; before applying anger management which would include self-reports, Novaco, Ramm & Black 2001) have indiscriminately with violent psychometric measures, concluded that this therapeutic prisoners. behavioural observations and approach is effective. In recent The Western Australia studies recidivist rates. years one of the common methods are of particular interest because for evaluating treatment effects the anger management programs has been meta-analysis, which evaluated were of a type and The Present Study allows for a statistical summary of format common in various a large number of outcome jurisdictions in Australasia. In two The findings in this paper are studies to determine whether a separate samples of violent based on an assessment of general pattern of effectiveness is prisoners undergoing anger approximately 200 male offenders demonstrated. There have been management therapy, the authors (mainly prisoners) in South two published meta-analyses of found no difference between the Australia and Western Australia anger management, which have treatment groups and untreated before and after they participated come to similar conclusions; controls on a range of dependent in an anger management namely, that this form of treatment measures, including anger intervention. The project was has a moderate to large effect in experience, anger expression, prison conducted from February 1999 to January 2001. The aim was to 2
  • 3. Australian Institute of Criminology determine what changes had is not provided. The tendency for although, again, the difference occurred and then compare these problem behaviours to be reactive was very small in absolute terms. with a control group of offenders to the assessment process itself No significant differences who had been selected for (that is, for problems to decrease were observed for community intervention but had not yet following testing) is a well-known versus prison participants, received the program (“waiting phenomenon for psychological however, the number of list controls”). The offenders (the and psychiatric treatment community participants was very vast majority of whom had interventions. This finding does small. Future research should re- convictions for violent offences) highlight the need for a control examine community versus were assessed on a wide range of group in any future evaluations of prison differences in a more tests of various aspects of the anger management (or any other) substantial way, given the general experience and expression of programs in correctional view that rehabilitation programs anger. environments. Without a control in the community are more The core question for this group, it is possible to make an effective than in institutions. research was: incorrect inference that a pre-test/ Andrews, Bonta and Hoge (1990) What is the impact of anger post-test improvement in a have suggested that appropriate program participation on program evaluation is attributable treatments delivered in offenders? to the particular program community settings produce two With some consistency, the results implemented. to three times greater reductions demonstrate that the overall The critical issue is whether in recidivism than prison-based impact of the anger management the improvements that occurred programs. It has also been interventions was small. Although in the treated group were suggested both that the social the treated group consistently significantly greater than those climate of prisons works against made changes in the expected that occurred in the controls. The the effective delivery of programs, direction, the changes ware not results of the present study show and that recidivism is related large enough to be of real clinical that there were very few more to what happens in the significance. It was also the case statistically significant differences community than what that similar small changes in the between the treatment and subsequently happens in direction of improvement were control groups. There were only institutions (Clarke 1985). observed for the control group on two exceptions to this pessimistic The question of whether many measures. This would conclusion: the findings for treatment gains brought about by suggest that the act of completing “anger knowledge” and, to a less intervention (for example, anger anger assessments, the passage of clear extent, for “readiness to reduction) endured over the time or other factors might have a change”. The treated group subsequent months after the small beneficial effect in improved their anger knowledge program ended is a very themselves, even when treatment more than the controls did, important one for any psychological intervention. It is Table 1: Outline of the South Australian Anger Management Program and the Western Australian Skills Training for Aggression Control equally important for anger management in correctional Session South Australia Western Australia settings. In the present study, 1 Understanding what Understanding anger selected participants in the anger is treatment group were followed 2 Recognising anger and change Recognising our anger/monitoring up for two months and six our anger months respectively. Given that 3 Staying in control by using Staying in control of our anger/ the changes brought about by the timeout and relaxation using timeout and relaxation program were modest, it is not 4 Socialisation identifying early Indentifying early patterns/ easy to determine whether patterns increasing awareness of our improvements were maintained thoughts/beliefs: changing negative in the follow-up period, and some thoughts to positive thoughts caution is required in interpreting 5 How thoughts and beliefs affect Becoming friends with ourselves/ trend analyses. The analyses anger coping with provocation using self- conducted suggested that talk different follow-up trends 6 Communication Enhancing the way we communicate occurred for different measures. It 7 Styles of communication Expressing anger assertively is encouraging that the 8 Stopping the violence in Managing our anger in close improvements in anger relationships relationships/developing positive knowledge were maintained and relationships even increased over the six-month 9 Managing our anger in close Conflict resolution follow-up. Linear trends were also relationships found for general measures of 10 Making a commitment to Review/relapse prevention anger, angry cognitions and other relapse prevention aspects of angry behaviour. This Source: Adapted from Howells et al. (2001), Appendix A. 3
  • 4. Australian Institute of Criminology suggests that the positive changes and ready to work on their anger d. limited opportunity to practice brought about by the program problems showed greater the skills learned in the program. were further improved upon at improvements on a wide range of The results from the present the two-month follow-up. Some anger measures, Conversely, study rule out explanation c other anger measures also showed those who were poorly motivated because program integrity was a tendency to improve further at to do so showed less or no relatively high. Explanations a, b the six-month follow-up. change. and d still stand as potentially Another influential principle applicable. It could be argued that Who Does Anger Management explanation a is given increased in correctional rehabilitation has Work Best For? been program integrity. Programs credibility by the present study in The second major question high in integrity typically have that motivational-type factors addressed in the study was: greater impact than those low in were shown to predict whether What participant characteristics integrity (Day & Howells 2002; improvement occurred. are associated with making Hollin 1999). Integrity, here, refers Explanations b and d amount, treatment gains in the anger arguably, to the suggestion that to the extent to which the management programs? program is delivered in practice in the programs are too short for the This is an important question for a amount of work that needs to be the way in which it was designed number of reasons. It is widely done (low intensiveness). and planned in principle. The acknowledged that violent Both the motivational and low present study suggested that offenders are a heterogeneous intensiveness explanations are various aspects of integrity were group with a multiplicity of credible and are not mutually high in both the Western criminogenic needs. Howells et al. exclusive. To these two Australian and South Australian (1997) have previously argued explanations can be added a programs. Nevertheless, it is that some offenders who are possible third—multiple problems inevitable that some variation referred to anger management in offender populations. Again, occurred in practice, with some programs in correctional systems this explanation does not exclude facilitators introducing variations worldwide may not actually have the other two. Indeed all three from the program manual more high anger problems—the factors may interact to diminish than others. “instrumental”, the “psychopathic” program effectiveness. In this study some differences and the “over-controlled” violent Motivational problems on the in outcome were shown to relate offender are all possible examples part of program participants are to program integrity. Although of this phenomenon. If this were readily identified by most differences were not apparent on true, then it would be expected correctional staff as a major factor all measures, low-integrity that the measured impact of anger determining progress in program programs were associated with management programs (for sessions. Motivational issues have less positive outcomes, example, in pre- and post- been curiously neglected in the particularly in the areas of anger treatment comparisons) would be anger management literature. control and anger following significantly diminished because Howells (1998) has argued that provocation. More detailed the treatment would only be anger management needs to be analysis will be possible at a later relevant to some participants. preceded by an analysis of the stage into the various components Thus, understanding the effect of “goal structure” of the offender of the integrity measure that was individual differences among and has suggested that developed, to see if any particular offenders is crucial. considerable variation in goal aspect of integrity is particularly The results of the study structures occurs within offender important. support the notion of individual populations. Serin’s work (1998) There were no differences in differences being important. The in Canada has also begun to outcomes for Indigenous and extent of change (improvement) unravel some of the important non-Indigenous offenders in this of an individual undertaking the dimensions of motivation. study. programs was shown to be Renwick et al. (1997) have predictable from a number of pre- described the problems at a treatment measures. Across a Explaining the Low Impact of clinical level. They point to the range of anger measures, those Offender Programs therapeutic pessimism felt by high in anger and low in anger both clients and therapists in control at the pre-treatment In previous work, Watt and correctional and high-security assessment showed the greatest Howells (1999) put forward settings, and to enduring change at the post-program re- several possible explanations for problems of low motivation, test. In everyday terms, the worse the modest effectiveness of the treatment resistance and you were, the more you benefited. programs they studied, including: avoidance. These authors note the The readiness/motivation a. poor motivation of participants; resentful, distrustful and even scale also proved to be a b. the content of programs being combative style of some offender consistent predictor of too complex for the limited program time available; participants in therapeutic improvement in treatment. groups. Additionally, the clients Offenders who were motivated c. low program integrity; and 4
  • 5. Australian Institute of Criminology had realistic concerns about the recommended for offenders with formal psychometric measures of effects of disclosure of their high levels of need. The programs anger proneness and of emotions and past behaviour on studied in the present research readiness/motivation for release or parole plans. Similarly, were of 20 hours duration (10 treatment. Cut-off points would Novaco (
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