Tuesday, February 14, 2012

Health

It May Be All the Rage, But Does It Work?

Some doubt anger-management class helps

By Brendan I. Koerner
Posted 4/4/99

Nikolai learned the hard way that sassing cops is a bad move. The passenger in a car pulled over last spring, he got fresh when two policemen started frisking him. "I said, `Look, all you're going to find is a highlighter,' " says Nikolai, 25, a Washington, D.C., graduate student. He began to up the ante--"What the hell have I done?"--and when his tongue became too tart, he says, he found himself handcuffed and down on the ground, under arrest for obstruction of justice

A subsequent guilty plea earned him a sentence that included 48 hours in jail and 500 hours of community service. But the worst part of his punishment was not the weekend behind bars--where "the butterscotch pudding was pretty good"--but rather the anger-management class the court required him to take. "It seemed . . . ridiculous," he remembers thinking at the prospect of seven weeks in a "psycho-educational program," sitting in a circle with a group of bar fighters, domestic abusers, and reckless drivers while learning how to take a "timeout."

Classes like the one Nikolai ended up in are increasingly a consequence of law-breaking. In the last decade, the number of alternative-sentencing programs has tripled, and such programs often require offenders to complete an anger-management course to avoid incarceration. (No national statistics track how many people take the classes each year.) Crimes that can lead to anger management range from contempt of court to assault and battery, and the roster of alumni includes a slew of famous names: actress Shannen Doherty, rocker Tommy Lee, soul crooner Bobby Brown, and basketball Hall-of-Famer Kareem Abdul-Jabbar.

"Anger is cool." Whether the classes actually help steer anyone onto the straight and narrow, however, is undocumented. Few regulations govern the classes, which are usually operated by community resource centers or private therapists for fees of $20 to $40 per session. Most focus on how to prevent anger from translating into aggression. "First of all, the big understanding is that anger is cool," says Don Shive, who teaches a class at Pikes Peak Mental Health Center in Colorado Springs. "We're not out to eradicate anger. Anger is an emotion; we're wired that way. What we're out to do is change behaviors." Mark George, a therapist at the Ranch Acres Men's Anger Program in Tulsa, Okla., says the primary message is "that regardless of stress or provocation, violence is not warranted." Instructors drill that point home with the aid of role-playing, videos, and slogans scrawled across dry-erase boards. At Nikolai's class, the central lesson was reinforced through a barrage of handouts like "Ten Things You Should Know About Your Anger" ("You have the right to be angry. The crucial issue is--what will you do with your anger?") and "Anger Management Strategies" ("think before you act," avoid caffeine, and get plenty of exercise).

Instructors may have their hearts in the right place, but there is scant research to support the treatment's efficacy. Adele Harrell, a researcher at the Urban Institute in Washington, D.C., says the jury is still "really out" regarding anger management's impact on recidivism rates. "To my knowledge, the most rigorous evaluation of these [classes] indicates they are not very effective," she says. Although the classes have been around since the early 1980s, when they were known as "impulse control," they have rarely been scrutinized. The few studies in existence have found mixed results, and all dealt with only minuscule samples. Many programs have high dropout rates; Mark George's program, which usually loses around 40 percent of its enrollees over the course of its 14-week run, is typical. Dropouts either get a second chance to complete the course or have their probation revoked and wind up in jail. Sometimes, however, they simply slip through the cracks.

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