A randomized controlled trial of the efficacy of a cognitive-behavioural anger management group for clients with learning disabilities

Background Fourteen clients with learning disabilities referred for anger management were randomly assigned to a treatment group and a waiting-list control group. Methods Treatment consisted of nine 2-h group sessions, using brainstorming, role-play and homework. Topics addressed included: the triggers that evoke anger; physiological and behavioural components of anger; behavioural and cognitive strategies to avoid the build-up of anger and for coping with anger-provoking situations; and acceptable ways of displaying anger (assertiveness). The intervention was evaluated using two inventories of anger-provoking situations, which were completed independently by both clients and carers. Results Clients in the treated group improved, on both self- and carer-ratings, relative to their own pre-treatment scores, and to the control group post-treatment. The within-group improvement corresponds to a 'moderate' (0.68 SD) effect size, whereas the between-group improvement corresponds to a 'large' (1.76 SD) effect size. The degree of improvement during treatment was strongly correlated with Verbal IQ. Clients in the treated group showed further improvement relative to their own pre-treatment scores at 3-month follow-up. Conclusions The treatment was effective in decreasing anger, in this randomized controlled trial of routine clinical practice.