Therapy for Anger Chap 21

Introduction  The treatment of anger-based disorders  Purpose Describe the further development of a cognitive behavior therapy: stress inoculation Describe the further development of a cognitive behavior therapy: stress inoculation Apply to a hospitalized depressive with anger problem Apply to a hospitalized depressive with anger problem  Prior application: Anxiety, Pain

Method  Treatment Procedure Cognitive Preparation Cognitive Preparation Skill Acquisition and Rehearsal Skill Acquisition and Rehearsal Application Practice Application Practice

Method  Treatment Procedure Cognitive Preparation Cognitive Preparation  Shared language system  Introduce rationale of the treatment approach  Instruction manual: nature & functions of anger

Method  Treatment Procedure Skill Acquisition and Rehearsal Skill Acquisition and Rehearsal Alternative view situations of provocation  Cognitive: task orientation self-instruction self-instruction  Affective: relaxation skills sense of humor sense of humor  Behavioral goals: effective communication of feelings task-oriented, problem-solving action

Method  Treatment Procedure Application Practice Application Practice Exposed to manageable doses of anger stimuli Exposed to manageable doses of anger stimuli  Imaginal, then role-playing inductions  Hierarchy of anger situations

Method  Case History Subject’s work situation Subject’s work situation Symptoms Symptoms Hospitalization Hospitalization Reaction to stressful situations Reaction to stressful situations Previous treatment Previous treatment

Method  Dependent Measures Behavior rating Behavior rating by clinical psychologist with 9 years of postdoctoral by clinical psychologist with 9 years of postdoctoral  Dichotomous ratings − Expression of anger: 14 項行為描述 (Antagonism-upset) (Antagonism-upset) − Constructive coping: 8 項行為描述  Scaled ratings (8-point scale) − Relaxed − Demonstrated anger − Restrained anger

Method  Dependent Measures Self-monitored ratings Self-monitored ratings 7-point scale 7-point scale  Frequency of anger  Degree of arousal  Degree of management 住院時期 : 只測週末回家時 住院時期 : 只測週末回家時 出院之後 : 每天測量 出院之後 : 每天測量

結果  Figure 1 Figure 1 Figure 1  Figure 2 Figure 2 Figure 2

問題  Single-subject design in clinical studies 該有的 特殊考慮？  為何必須提供完整的 case history ？  該研究如何確認實驗處理的效果？  該研究的 baseline 較短，為何如此設計？有 何利弊得失？