An anger-management workshop for women inmates

Approximately one million persons reside in prisons and jails across the United States. Most of these inmates are serving sentences in state and county facilities. For the past 10 years, concern has been growing about the lack of mental health services provided to these inmates. Anger has a profound effect on the mental health of inmates. In fact, most inmates would admit that uncontrolled anger has had a significant impact on their criminal behavior. If inmates are to improve their behavior and mental health, they must learn how to manage anger more effectively.

The present article describes an anger-management workshop provided to a random sample of 11 women inmates at the Utah State Prison in Draper, Utah. The workshop had four objectives. Its first objective was to describe some of the common symptoms of anger. The next objective was to discuss why people get angry. The third objective was to understand how anger can be managed more effectively. The final objective was to help women inmates incorporate some of these anger-management suggestions into their lives. The workshop was conducted on three consecutive Fridays from January 31 to February 14, 1992. Each session lasted approximately two hours, for a total of six contact hours.

SAMPLE AND METHODS

Approximately 2,200 inmates at the Utah State Prison are housed in minimum-, medium-, and maximum-security units and in a separate women's facility. Approximately 1,500 of these inmates are medium-security prisoners. The sample for this study consisted of 11 medium-security women inmates drawn randomly from a population of 120 at the women's facility. The original sample included 12 women inmates; however, one inmate failed to attend the first session. All 11 inmates attended each of the three workshop sessions.

Demographic data were gathered from the women inmates at the beginning of the workshop. Selected assignments used during the workshop provided additional information for the study. The Novaco Anger Scale was used as the before-and-after measure for the workshop (Burns, 1980). This 25-item inventory is a valid and reliable instrument that has been used with various populations, including inmates (Novaco, 1980). The 11 women inmates completed this instrument at the beginning and end of the workshop.

ANGER-MANAGEMENT WORKSHOP

First Session

The first session began with a general introduction of the workshop objectives, after which the women completed the Novaco Anger Scale. The remainder of the session focused on the common symptoms of anger (American Psychiatric Association, 1987). is discussion identified the emotional, physical, cognitive, and behavioral symptoms that people experience when they are angry. The ways in which people use anger as an excuse to avoid taking responsibility for their own actions were also discussed (Dyer, 1976).

The first session ended with a discussion of how the inmates might monitor their anger prior to the next week's session. They were asked to keep a daily record according to the following four-point scale: not angry, a little angry, angry, and very angry. The women were also asked to identify symptoms or "cues" that indicated to them that their anger had reached a dangerous level. The monitoring assignment also instructed inmates to identify events that might contribute to their anger.

Second Session

The second session began with a review of the women inmates' anger-monitoring assignment. The women were asked to comment on their anger evaluation for each day during the past week, the symptoms that led them to make their assessment, and the events that might have contributed to anger. The discussion also focused on identifying symptoms or "cues" that indicated to the inmates that their anger had reached a dangerous level.

The remainder of the session focused on how the women inmates could more effectively manage their anger (Monat & Lazarus, 1991). The anger-management strategies included walking away and counting to 10, deep breathing and relaxation exercises, asking for a "time out," leaving the conflict scene and starting a rigorous physical activity, and cognitively reviewing the conflict (Burns, 1980; Tavris, 1982).

The women inmates' assignment for the following week was to continue monitoring their anger each day, along with the symptoms and events that might be contributing to their anger. The women were also asked to implement an anger-management strategy that they described on paper.

Third Session

The final session focused on the actions the women took during the preceding week to alter their anger and the effects of their actions. The discussion reviewed common strategies for managing anger, focusing on the strategies that seem most helpful.

The workshop concluded with a general review of what the women inmates had learned about anger during the three-session workshop. The session ended with the inmates completing the Novaco Anger Scale for the second time.

RESULTS

Demographic Characteristics

The mean age of the 11 inmates was 35.4 years (sd = 5.6); the youngest inmate was 28 years old and the oldest was 45. Seven inmates were white, three were black, and one was Hispanic. Five inmates were serving time for drug convictions, three for felony theft charges, two for forgery, and one for murder. The mean time spent in prison was 2.2 years (sd = 1.8), with a range of one to seven years.

The Novaco Anger Scale

The Novaco Anger Scale is a 25-item inventory that measures level of anger on a 100-point scale. e scale is a valid and reliable instrument that has been used with various populations, including women inmates (Novaco, 1980). Scores on the inventory are interpreted as follows:

0-45: The amount of anger and annoyance you generally experience is remarkably low. Only a few percent of the population will score this low on the test. You are one of the select few!

46-55: You are substantially more peaceful than the average person.

56-75: You respond to life's annoyances with an average amount of anger.

76-85: You frequently react in an angry way to life's many annoyances. You are substantially more irritable than the average person.

86-100: You are a true anger champion, and you are plagued by frequent intense furious reactions that do not. quickly disappear. You probably harbor negative feelings long after the initial insult has passed. You may have the reputation of a firecracker or a hothead among people you know. You may experience frequent tension headaches and elevated blood pressure. Your anger may often get out of control and lead to impulsive hostile outbursts, which at times get you into trouble. Only a few percent of the adult population react as intensely as you do (Burns, 1980, pp. 137-138).

When the 11 women inmates were given the Novaco Anger Scale at the start of the workshop, the mean score on the inventory was 69.6 (sd = 10.1). This score suggests that the inmates were expressing an average amount of anger. When individual scores were examined, nine women scored 60 or higher, whereas only two scored lower than 60 (Table 1). (Table 1 omitted) The highest score recorded on the anger inventory was 89; 52 was the lowest score.

At the end of the workshop, the women again completed the anger scale. The mean score on the second administration of the inventory was 54.6 (sd = 1.3), suggesting that the inmates were less angry at the conclusion of the workshop than they were when it began. When individual scores were examined, only two inmates scored higher than 60. The highest score recorded on the second administration of the inventory was 81; 40 was the lowest score (Table 1).

A paired t-test was used to determine significant difference between the before and after scores on the anger inventory. The t-value was 4.39 (df = 10), which indicates that the women inmates felt significantly less anger at the conclusion of the workshop than they did when it started (see Table 1).

Monitoring Mood

After the first session was completed, the women inmates were asked to monitor their mood for the next week using a four-point scale of not angry, a little angry, angry, and very angry. The mean score of the 11 inmates for the first week was 3.3 (sd = .7), which put the average response in the "angry" category. Following the second session, the inmates again monitored their mood for seven days. The average score for the second week was 1.9 (sd = .6), which put the average response in the "a little angry" category.

In describing the symptoms that made them feel "very angry" or "angry" the women most often identified a flushed or red face, increased heart rate, general agitation, pounding headaches, shakes, clenched jaws, inability to sleep, and obsessive thinking. Increased heart rate and flushed or red face were the most common symptoms mentioned by the inmates. Those inmates who described their mood as "a little angry" or "not angry" said that they felt good physically, their sleep was peaceful, and they had a good appetite.

When the women inmates were asked what caused them to feel "very angry" or "angry," they identified confrontations with staff and other inmates, an argument with a friend or family member during a visit, lack of visitors and no mail, and cell shakedowns and reassignments. The most common response was confrontations with staff or inmates. Those inmates who felt "a little angry" or "not angry" identified the cause as a visit from family and friends, mail, church activities, and a good cellmate.

When the women inmates were asked what they did to manage their anger, most indicated they left the conflict scene as soon as possible and tried to "cool down" in some other area of the prison. Many of those inmates who could not escape the scene of the conflict used breathing exercises and cognitive strategies to control their anger. One inmate said, "I went to my room and told myself off for letting my cousin push my buttons. Then I started laughing." Another inmate stated, "I reduced my anger by understanding that they had a legitimate point in denying my parole, [that is] my safety. I was very suicidal and probably would have acted on it had I been released."

DISCUSSION

The women inmates' mean score of 69.6 (sd = 10.1) on the first Novaco Anger Scale approximated the average score of the general population and suggested that their anger score was normal. In analyzing the individual scores, one inmate scored between 46 and 55, which suggested that she was more peaceful than the average person. Eight inmates, on the other hand, scored between 56 and 75, which indicated chat they responded to life's annoyances with an average amount of anger. The remaining two inmates had scores that suggested they were more irritable than the average person or they were true "anger champions."

When the Novaco Anger Scale was administered to the women inmates at the conclusion of the workshop, the mean score was 54.6 (sd = 11.3), which indicated a 15-point reduction in their initial score. Analysis of the individual scores showed that 10 inmates had lowered their anger score. A paired t-test calculated on the before-and-after scores showed that the inmates felt significantly less angry at the conclusion of the workshop than they did when it started (t = 4.39, p = .001). These results demonstrate that a three-session workshop on anger management can have a significant impact on women inmates.

The women inmates' monitoring of mood revealed that a positive change occurred during the workshop as their mood changed from "angry" to "a little angry." The data showed that the most common symptom that inmates associated with anger was an increased heart rate, followed by a flushed or red face. The inmates' comments also indicated that confrontations with staff and inmates contributed most to their anger. Inmate anger was also affected by lack of visits and mail.

In reviewing the inmates' comments, it is clear that the most effective anger-management skill they learned was walking away from a conflict and "cooling down" in some other area of the prison. When this was not possible, inmates used breathing exercises to calm themselves. The self-reports also suggested that some inmates were quite skilled in using cognitive interventions to control their anger, including concentrating on pleasant thoughts and positive imagery, and problem solving, whereby the individual tries to learn more about the source of her anger. Many of the inmates found that they became angry when someone they trusted or loved hurt them or treated them unfairly.

"Thinking" about anger was a very important outcome of the workshop. When the workshop began, it was stressed that many people fail to control their anger because they act before they think about the consequences of their actions. The main focus of the workshop was to help the women think before they act. Walking away from a conflict and "cooling down," breathing exercises, and cognitive interventions gave inmates time to think before they acted when they became angry. If women inmates can increase the amount of thinking time before they act, they are likely to act in ways that are not destructive to themselves or to others.

These findings are tempered by the small sample utilized in this study. The authors purposely chose a small sample to work with because they believe group education and treatment is more effective with a sample of 15 or fewer inmates. The generalizability of the findings would be enhanced if the sample size were larger. Adding a control group to the research design would also increase the validity of the findings.

REFERENCES

American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

Burns, D. B (1980). Feeling good: The new mood therapy. New York: New American Library.

Dyer, W. W. (1976). Your erroneous ones. New York: Avon Books.

Monat k, Lazarus, R. S. (Eds.). (1991). Stress and coping: An anthology. New York: Columbia University Press.

Novaco, R. W. (1980). Novaco Anger Scale (mimeograph). Irvine, CA: Department of Psychology, University of California.

Tavris, C. (1982). Anger defused. Psychology Today)r, 16(11), 25-35.

Larry. L. Smith is Professor, School of Social Work, University of Utah, Salt Lake City, Utah. James N. Smith is Deputy Warden, Women's Facility, and Beryl M. Beckner is a clinical social worker, Utah State Prison, Draper, Utah.

Copyright Family Service America Mar 1994
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