As the title implies, this site will continually update changes and trends in anger management services, research,referrals and provider training. In addition, books,CDs,videos and DVDs used in anger management programs will be introduced.

Monday, August 25, 2008

Anderson & Anderson Certified Anger Management Facilitator Logo Program

Anderson & Anderson, the largest provider of Certified Anger Management Facilitator training in the world, provides Certified Anger Management Facilitators (C.A.M.F) with a new logo. Certified Providers are now able to identify themselves using a widely recognizable and highly regarded professional designation. Certified Providers should visit our Certified Logo page to view the new Anderson & Anderson ® logo, and for instructions on adding the CAMF logo to your website. Consumers should look for the C.A.M.F designation and logo when identifying and selecting an anger management facilitator.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

Saturday, August 23, 2008

Three Days Of Anger Management Certification Training

The American Association of Anger Management Providers


George Anderson,BCD, LCSW, CAMF

Three Days Of Anger Management Certification Training

October 8th, 9th, & 10th, 2008
8:30am until 4:30pm
12301 Wilshire Blvd.
Suite 418
Los Angeles, CA 90025

The Anderson & Anderson model of anger management is the most effective and widely recognized curriculum in the world. This model, which has been featured in Los Angeles Times Magazine, focuses on enhancing emotional intelligence and assertive communication while introducing behavior strategies for identifying and managing anger and stress. Our certification training and approved provider list are the industry standards and dominate the internet.

The First day of training will focus on Adolescent Anger Management and will use the Anderson workbook “Controlling Ourselves” as the text. A demonstration and discussion of the Conover Assessment Component will be conducted. This one-day training is designed for Nurses, School Counselors/Psychologists, Substance Abuse Counselors, Case Managers, HR Managers, Clinicians, Probation Officers, as well as staff from group homes, and agencies serving families and youth. This curriculum is currently being used in school districts in Los Angeles, Oakland, Sacramento, Concord and San Diego, as well as school districts in Texas and Louisiana. In addition, probation departments in Arizona, Kansas, California and Texas use this model.

On the Second day, Adult Anger Management will be examined. A demonstration of the Conover Assessment will be conducted with a discussion of its usefulness. “Gaining Control of Ourselves,” in conjunction with experiential exercises and videos, will be used to initiate the participants to this intervention. Most major corporations have accepted this model for use by H.R. and EAP Managers.

The Third day of Training is Advanced Anger Management. An overview of the adult & adolescent trainings will include discussions on branding, marketing, Emotional Intelligence Training, and the process of capitalizing on your anger management practice. Those who attend all three days will receive a copy of the Motivational Interviewing Component on CD-ROM.

Cost: $500.00 per day includes client workbook, facilitator guide, and certification. *Those attending all three days will receive a 30% discount on all Anderson & Anderson DVDs and CD-ROMs purchased on the training days.

Approved for 8 CEU’s by CAADAC (#2n96-341-0805), BBS (#PCE60),CAADE (#CP40-793-C-1009), TCBAP, and the CA. Board of Corrections

This training is also available on interactive CD’s. Please visit for more information, or call our office at 310-207-3591.

Friday, August 22, 2008

Losing It - Griff Rhys Jones On Anger on BBC Two this autumn

Category: Factual & Arts TV;
BBC Two Date: 10.07.2008
Printable version

Losing it can, of course, be funny. It’s a loss of control and it’s particularly funny when it happens to other people. But anger can also be embarrassing and shameful. People in positions of responsibility are not supposed to lose their rag. But there are times when we just can’t help it. The pressure builds up, the tension mounts and we search for a means of release.” Griff Rhys Jones talks about anger in his new two-part series Losing It – Griff Rhys Jones On Anger on BBC Two this autumn.”

"About a year ago, I made a film for the BBC about a sailing race and, during the course of it, I got into a filthy temper," says Griff. "I started shouting at the blameless people who were racing with me. I flew into a rage about something which was completely beyond my control. It was actually nothing new for me. I do get… cross. This is a film about being angry; I’m going to talk to other people about their propensity to fly into a rage, to throw a wobbler, to… lose it." Griff wanted to make these programmes to explore his own anger and to work out where it comes from. He also wanted to examine how anger affects us all in every day life from road rage to anger in families, and looks at potential solutions. He tries to release his frustration by boxing, meditating and taking part in an anger management course in Los Angeles.

"In a survey by the Mental Health Foundation released in March 2008, more than 1 in 10 of those polled said they had trouble with their tempers," says Griff. "Thirty-two per cent said they were worried by anger in the family. In these programmes, I’m going to look at what makes people angry, whether there’s more of it about, and what, if anything, can be done about it." Griff says his workload makes him lose his temper: "I’m an actor, I’m a writer, I run a production company. I’m successful with a lot of work – perhaps a bit too much – which I insist on doing myself… and I have to admit, when it all builds up there are times when it gets too much."

Griff reveals that he comes from quite a cross family and, as he gets older, he finds himself becoming more like his dad. In the first programme, his family, friends and people who’ve worked for Griff talk about his anger and how it has affected them. But it is not just Griff who admits to losing his temper. Journalist Rosie Millard, chef Heston Blumenthal, writer Muriel Gray and comedian Rory McGrath also talk about their anger and give examples of instances when they have lost it and what the triggers have been.

"Losing It – Griff Rhys Jones On Anger" is a fascinating exploration of a subject which affects us all, yet is rarely explored as it is in these two programmes. The films are also a journey of self-discovery; an honest and revealing account of Griff’s experience with which many viewers will identify. They will be shown on BBC Two this autumn. Much of the filming for these documentaries were done in the Brentwood Office of Anderson & Anderson, as well as the home of George and Nancy Anderson. It is the Anderson & Anderson anger management model which is demonstrated in the assessment and intervention of Mr. Jones.

Thursday, August 21, 2008

Costs of Coworker Bullying

Posted by Molly DiBianca On August 18, 2008 In: Jerks & Bullies at WorkWorkplace bullying has been a hot topic since the release of the 2007 Zogby survey, which showed that 49% of American workers report that they've been the target of a bully's bad behavior. Employers have begun instituting tolerance training and implementing respectful-workplace policies. Awareness is key in preventing this prevalent workplace disease. One way to make top management place value on eliminating jerks at work is to talk dollars.

Bullying costs companies big money. Here are some of the ways that your bottom line is directly affected if you fail to eradicate bullying at work:

1. Targeted employees have higher absenteeism rates. Wouldn't you? When the workplace becomes increasingly intolerable and unpleasant, people stop coming to work.

2. Decreased productivity. Those who do manage to get themselves into work are less productive. They're nursing emotional wounds, meaning they're more likely to hide in their office than dare engage with others at the risk of being put on the firing range. Stress-related illness is not conducive to high productivity, either. If you don't feel well, you're not putting your best efforts into your work.

3. High turnover. Replacing an employee can cost a business up to 3 times that employee's yearly salary. And dedicated, enthusiastic employees are not easy to find. Yet, employees who are bullied at work will almost certainly leave. Some leave because of their health. Others leave because the bully has succeeded in sabotaging their reputation.

4. Unhealthy Employees Are Expensive. Employers have campaigned to rid the workplace of smokers, who are more costly to insure. Obese employees may be next on the list. But what about bullied employees? Targets are affected with depression, anxiety, post-traumatic stress disorder, which is especially common with male targets, and other stress-related illnesses. Physiological illnesses, such as headaches and backaches.

5. Infected-Workplace Syndrome. As devastating as these effects can be, they can, and likely will, get worse. Bullies are infectious and contagious. Other employees who witness bullying behavior feel sympathy for their coworkers and guilt for doing nothing about it. They shrivel up, just like the target, in the fear that the bully will turn his or her anger towards them next.

E-Rage: the new cause of office stress

August 20, 2008 by twentzphd

If you see one of your colleagues hitting, kicking or throwing their computer, they might be suffering from what Eclipse Internet calls E-rage.

Eclipse recently carried out a survey into the effects of email downtime on business owners and workers. They found that for some, the frustration of not having access to email can see them resort to extreme measures in an attempt to ‘fix’ the problem.

In Newcastle upon Tyne, a whopping 77% of office workers and company owners agree that e-mail downtime causes major stress at work. But it would seem that office workers in this city are less prone to E-rage than in other parts of the UK. Only 6% of workers in Newcastle would take out their frustration by kicking their PC compared to 18.5% in what appears to be a very angry Glasgow.

Mark Thomas from Eclipse Internet said: “We wanted to understand the impact of email downtime on small business owners. We know that in at least 40% of small companies email is set up and maintained by unqualified personnel. As a result, these companies are more susceptible to suffering the consequences of E-rage. For those companies that do outsource their email, levels of E-rage are much lower.”

Coincidentally, Eclipse Internet provides businesses with a service designed to reduce email downtime. Who’d have thought it?

T.L. Wentz, PhD, CAMF, CEC, Diplomate, Faculty Member
Anderson & Anderson
Trusted Name in Anger Management

Wednesday, August 20, 2008

Hospitals Face Challenges in Implementing the new Joint Commission (JCAHO) Standards

“Leaders create and implement a process for managing disruptive and inappropriate behaviors”.

Many healthcare organizations are encountering significant resistance to new standards for “disruptive physician behavior.” Here are some of the most typical areas of tension in drafting standards in this area:

  • Mandated psychiatric assessments for physicians considered to exhibit “disruptive behavior.” This is by far the most contentious requirement. Physician groups fear the potential damages to physicians who are required to undergo a psychiatric or psychological assessment for a normal, human emotion gone temporarily awry. Angry/disruptive behavior is not defined as a nervous or mental disorder by any psychiatric or psychological paradigm; it is difficult to justify such a requirement.
  • Pros and cons of reporting mandated physicians to Medical Quality Assurance/ Licensing Boards since interventions can be offered in-house or by programs designed for this purpose. Justifiably, physicians fear having this information become a part of data banks on physician competence.
  • Listing doctors in the National Practitioner Data Bank can make finding a similar position at another hospital nearly impossible.
  • Temporary loss of hospital privileges.
  • Potential loss of patients and professional practices.
  • Failure to offer intervention proactively as opposed to reactively.

As the Joint Commission has expanded the mandated interventions to all healthcare professionals and workers who demonstrate “disruptive and abusive” behaviors, mandating psychiatric assessments due to expressions of anger, stress or frustration may contribute to:

  • Personnel shortages throughout all healthcare professions and industry
  • Increased litigation and opening of HR records of accusers and accused alike
  • Increased lawsuits by falsely accused offenders against healthcare organizations
  • Further litigation against healthcare organizations for failure to control stress in the workplace

George Anderson, MSW, BCD, CAMF
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

Excerpts from: Treating Anger for Profit

Anne Gorman

Each Week, a New Skill On a recent Tuesday night in Brentwood, Whatley the jaywalker, Yakota the college student and Helmy the shouter sat in a circle holding their workbooks, “Gaining Control of Ourselves.” Each week, George Anderson or one of his fellow teachers covers a new skill: Active listening. Identifying high-risk situations. Controlling negative emotions. This week: Communicating effectively. The participants took turns introducing themselves, telling why they got referred to the class and what they could have done differently to prevent getting arrested. Then they watched a video about communication styles and practiced ways to express anger and frustration without provoking a fight.

Anderson described the pretend situation: You’ve cooked a nice meal and your partner comes home two hours late and the food is ruined. His students’ responses–though a bit formal–hit the mark: I feel hurt when you come home late for dinner because it makes me feel like you don’t value our time together. Moheb Helmy, 22, said his rage consumes him and he is constantly slamming doors, cursing and fighting with his family. “I have so much anger,” he said. “I would love to change because it hurts everybody around me.” Helmy, who has been ordered by a judge to attend 12 weeks of classes, said the skills he is learning seem logical. “But when it comes time to do it, I forget it all,” he said. Anderson, a clinical social worker and former UCLA lecturer, has been teaching anger management for three years and currently has about 200 students at four Los Angeles locations. “I don’t know if it works or not,” he said. “But anger management teaches practical skills. I think if they come for a long period of time, they’ll benefit.”

Some clients come voluntarily, but most are required to attend and aren’t happy about it. Inevitably, a few bring along an attitude: I don’t have a problem. I don’t need to be here. Sandra Whatley, a native Texan with a self-described temper problem, had those exact feelings when she first started the class. She thought the police officer needed anger management more than she did. But during a year of classes, Whatley said, she has realized that she has to take take some responsibility for getting arrested. Now, she leaves her workbook open on her dresser to remind her to take a deep breath when she is about to explode. “I’ve had an aggressive personality my whole life,” said Whatley, 40. “It’s in my blood. I need this. But I cannot even begin to tell you I have toned myself down.”

Monday, August 18, 2008

Yacine Bell, CAMF Will Help Lead AAAMP to National Success

Yacine Bell is an Oakland, California based anger management provider and executive coach with considerable experience providing anger management assessments and intervention to business and industry in Northern California. Ms. Bell is a popular lecturer, speaker, writer and visionary.

AAAMP (American Association of Anger Management Providers) appointed Ms. Bell to head up this organization in part because of her exceptional leadership skills and clear vision and desire to increase the visibility and credibility of the organization.

"As our society becomes more stressed and our natural support systems are lost, our ability to manage anger is reduced. Anger management is by far the most promising intervention available to address the issues of incivility, anger, stress, miscommunications and lack of emotional intelligence" stated Ms. Bell.

AAAMP was organized in 2003 to become the leading voice to express the concerns of Certified Anger Management Facilitators (CAMF) nationwide. Today, there are thousands of certified anger management facilitators nationwide representing the most highly trained individuals in anger management in the world.

While Anger Management as a specialized practice is in its infancy, AAAMP continues to advocate for excellence on the part of practitioners and scholars in the field. Practice based research will be imperative to further develop evidenced based solutions to inappropriate expressions of anger and person-directed violence.

Like her predecessor, she will work to achieve the following major objectives: 1) To increase the visibility of the Association in every state among schools, organizations and individuals; 2) To provide members with technical support and assist them in providing relevant services; 3) To increase membership; 4). To establish state standards nationwide for all professional anger management providers; 5) To ensure that AAAMP becomes the single most respected voice on anger management issues nationwide.

Through greater visibility in the print, television media and over the Internet she will make the voice of the American Association of Anger Management Providers known nationwide on emerging social issues.

Complete and full details on the American Association of Anger Management Providers can be found by visiting To reach Ms. Bell directly, please call to 510-393-0250 or email her at

# # #

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

Executive Coaching/Anger Management for Physicians

In response to the need for a one on one individual and sensitive intervention model for physicians, Anderson & Anderson is now offering a twelve-hour coaching class with 6 months of aftercare for doctors. This class is available at our Brentwood office or on-site anywhere in the United States. The Anderson & Anderson® Executive Coaching/Anger Management program is listed in the Directory of Physician Assessment And Remedial Education Programs, and Federation of State Medical Boards. No other anger management provider is authorized to use this model.

Components of the class include:

-One day, on-site observation (optional)

-Assessment at intake focusing on the participant’s level of functioning in managing stress, anger, communication and emotional intelligence. We do not provide psychological testing nor is our intervention considered counseling or psychotherapy.

-Two client workbooks which includes didactic information and exercises focusing on enhancing emotional intelligence, improving assertive communication, as well as behavioral strategies for recognizing and managing anger and stress. Therefore, there are no stigmas attached.

-Complimentary “Gaining Control of Ourselves DVD” along with follow-up kit.

-“Styles of Communication” and “A Day Without Stress” are two power DVDs that are also complimentary.

-Post-test at termination designed to determine the level of change during the course.

-Bi monthly follow-up sessions are provided for a six-month period.

-Our services are provided with the utmost in confidentiality for all participants.

-Anderson & Anderson is the Preferred Provider for Kaiser Permanente of Southern California.

For more information, call our office at 310-207-3591 now.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

Doctors Behaving Badly

Behaving badly A survey of more than 4,500 physicians, nurses and other health professionals at about 100 community hospitals suggests that disruptive behavior may affect patients and staff. Respondents who believe disruptive behavior is linked to: Staff dissatisfaction 75% Detrimental effects on quality 72% Medical errors 71% Adverse events 66% Compromises in patient safety 53% Patient mortality 25% Respondents who said they witnessed disruptive behavior by: General surgeons 31% Cardiovascular surgeons 21% Neurosurgeons 15% Orthopedic surgeons 7% Cardiologists 7% Ob-gyns 6% Gastroenterologist s 4% Neurologists 4%

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

Thursday, August 14, 2008

Work Bullies

Work bullies can ruin a culture, destroy productivity and make your life -- and those of everyone else they target -- miserable.

And it's not just bullying bosses who are the problem. Co-workers and employees also use bullying behavior, which creates a hostile workplace.

Excluding lethal weapons, here are the top dozen techniques bullies use to ruin a workplace.

-Yelling, physical threats and throwing things. This in-your-face method makes targets think actual physical attacks will follow.

-Verbal abuse, emotional intimidation and personal insults in private and public. This includes put-downs and demeaning, rude or cruel comments.

-Harassment based on race, religion, gender and physical attributes. Sexual contact, lewd suggestions, name-calling, teasing and overtly nasty personal jokes. Stealthy bullies often follow their put-downs or threats by laughing and saying "I was just kidding" to make it hard for their targets to fight back.

-Backstabbing, spreading rumors, manipulating, lying, distorting, hypocrisy and exposing your personal problems and performance mistakes. Repeated character assassination is another favorite technique.

-Taking the credit for the work of others. Never accepting blame, but instead spreading the blame to blameless employees. Withholding information and then cutting targets down for failing in a task because they didn't know the crucial information.

-Anonymous attacks and cyber-bullying -- flaming e-mails, personal innuendos, threats and porn. Invading the personal space and privacy of targets by rummaging through desks, listening to phone calls, asking personal questions and eating their food.

-Hypersensitive over-reactions, throwing tantrums. Bullies want to train others to walk on eggshells, back off in order to avoid a scene or beg forgiveness as if they really did something wrong.

-Dishonest evaluations, through praising and promoting favorites and destroying the careers of targets.

-Demeaning meetings: yelling, pointing fingers, interrupting, ignoring, derisive laughter or snorts, and nonverbal comments behind targets' backs, such as rude noises, facial gestures, answering a phone or text messaging, or working on a computer.

-Forming cliques and ganging up to harass and demean. Perpetuating turf wars about budgets, hiring, etc.

-Micromanaging everything. Bullies make it clear they believe other people are so stupid and incompetent that the bully has to do everything to make sure it's done right.

-Managing in a panic. Waiting until the last minute so everyone moves from crisis to crisis. Making every task a matter of life or death, so people are continually pressured.

Most bullies use combinations of these methods. The relentless application of these techniques reinforces humiliation, pain and fear. It can make the targets feel helpless and that the situation is hopeless.

We've all seen the effects of bullies and the hostile workplaces they create. Teamwork, productivity, responsibility, efficiency, creativity and reasonable risk-taking decrease. Promotions are based on sucking up to difficult people, not on merit. The best people leave as soon as they can.

Your operational system may look wonderful on paper, but the wrong people in the wrong culture always can find ways to thwart it. Your pipeline leaks money and profits plummet. It's possible to turn these terrible situations around. But it takes time, perseverance and processes tailored for each specific situation. You also need a leader dedicated to wiping out these behaviors.

A common mistake in dealing with bullies is trying to educate, explain, understand, accept, forgive, beg, bribe, ignore, reason with or appease them. These approaches won't convert dedicated bullies into reasonable, civil and professional people. These approaches only stop people who aren't really bullies, but have behaved badly one time.

Determined bullies don't take your understanding and acquiescing as kindness. They take your giving in as weakness and an invitation to abuse you more. Bullies bully repeatedly and without real remorse. They might appear to apologize sincerely, but you should accept only behavioral change, not good acting.

The best way to stop a bully is to stand up to them. Expose and isolate them. Or catch them doing something outrageous or illegal in front of witnesses.

LEICHTLING is a Denver-based leadership adviser. Contact him at

Wednesday, August 13, 2008

A Message for Professional Anger Management Providers

Regardless of orientation, well-trained, certified anger management providers are the current rage in Human Resource Management, Substance Abuse Treatment, Risk Management and Court Diversion Programs as well as the Criminal Justine System.

Healthcare organizations have recently joined the movement towards recognizing Certified Anger Management Facilitators (CAMF) as the providers of choice for Joint Commission (JCAHO) defined “disruptive physicians”. Currently, physicians whose behavior impact patient safety and risk medical errors are referred to well trained Executive Coaches who specialize in anger management for “disruptive physicians”.

Psychologists, Psychiatrists, Clinical Social Workers and Licensed Professional Counselors are beginning to recognize the income potential available in this new area of specialization. Anderson & Anderson, the leading voice in anger management advocacy is launching an all out campaign to publicize the value of anger management in all areas of interpersonal interaction.

Anyone interested in learning more about anger management as a private practice specialty should visit any or all of the websites listed below: The American Association of Anger Management Providers is the official organization advocating for state licensing of professional anger management providers nationwide. Membership is open to all providers regardless of orientation. The Anger Management Resource is the second must popular anger management website on the worldwide web. Any anger management provider can place a free listing of his or her practice on this site. Anderson & Anderson is the industry worldwide in anger management and executive coaching. This is the most widely recognized anger management website on the Internet.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

News for Nurses

Posted by Kathy Quan RN BSN at August 11, 2008

A couple of items worth bringing to your attention:

Behavior Affects Patient Safety

JCAHO recently issued a Sentinel Alert calling for all JCAHO accredited institutions to take note of findings hat patient safety is being undermined by inappropriate and unprofessional behavior exhibited by health care professionals.

Nurses, physicians, pharmacists, therapists and support staff who demonstrate intimidating and disruptive behavior toward other health care professionals, patients and others will need to be dealt with if facilities wish to comply with JCAHO standards as of January 1, 2009.

For far too long, inappropriate behavior has been ignored, unreported and never addressed for fear of reprisal or being labeled as a “whistle blower.” Research has shown that patient safety is being compromised and JCAHO has taken the lead to put an end to such issues.

You can read more about this in my post at

Bad Economy Results in An Increase in Anger Infractions

While it is unfortunate for the victims of anger related issues, it is instructive to note that the bad U.S. economy is resulting in a dramatic increase in referrals to anger management providers nationwide. The following is a summary of referral trends to Certified Anger Management Facilitators:

•The high cost of gas has caused Transportation Companies in California to contract with local anger management providers for Pre-employment testing for new hires as well as organizational anger management for line staff and coaching for managers and supervisors.

•The increase in road rage incidents is beginning to clog many courts in major American cities. Misdemeanor offenses for driving violations are off the charts.

•Psychiatrists and Psychologists are referring an increasing number of clients to Certified Anger Management Facilitators for anger management assessments and intervention.

•Managed Health Care Providers are recognizing the cost effectiveness of anger management as opposed to psychotherapy of psychotropic medication for aggressive behavior.

•Small, medium and large businesses have adopted zero tolerance for person-directed aggression in the workplace. This has caused an increase in employer mandated referrals to anger management classes.

•Hospitals and physician practices are now referring health care professionals whose behavior may create a “hostile work environment” or impact patient safety.

The keys to success in providing anger management are superior training, certification, Pre and Post Tests, client’s workbooks and ancillary DVDs and training material.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

Tuesday, August 12, 2008

Language in Business: Communication is also part of the business

Language in Business: Communication is also part of the business

Monday, August 11, 2008

Listening First Aid

Gregorio Billikopf

The Panama Canal may serve as an adequate analogy for the role of effective listening skills. As a youth, I traversed the canal several times as we sailed in a freight ship from the port of Valparaiso in Chile, to New York. Massive lock gates are utilized to manage the water levels in the canal, so that ships can move from one direction to another. The water level behind one set of closed locks can be much higher than that of the next compartment through which a ship will travel.

We can compare this scene to the state of mind of an individual suffering from deep emotional wounds, or involved in a serious interpersonal conflict. With disparate water levels there is a buildup of pressure behind the closed locks. If one were to open these lock gates, the flow would be mostly unidirectional. Likewise, a party who is holding in her emotions needs a release. Such an individual is unlikely to (1) think clearly about the challenge or (2) be receptive to outside input from another.

The role of the listener or helper is to allow such an individual to open the lock gates. When he does, the water gushes out. During this venting process, there is still too much pressure for a person to consider other perspectives. Only when the water level has leveled off between the two compartments, does the water begin to flow evenly back and forth. The role of the listener is to help empty the large reservoirs of emotion, anger, stress, frustration and other negative feelings until the individual can see more clearly. Not until then, can a party consider the needs of the other. Perhaps we can think of it as listening first aid.

Hospitals try to calm doctors' outbursts

Medical road rage affecting patient safety, group says

By Liz Kowalczyk
Globe Staff / August 10, 2008
The Boston Globe

During an operation at a Salem hospital last summer, an orthopedic surgeon, frustrated by a pair of scissors that wouldn't cut, threw them and narrowly missed a nurse.

In many hospitals, outbursts from a top surgeon who generates significant revenue or a star researcher who wins huge grants often have been tolerated. But in this instance, North Shore Medical Center disciplined the doctor who threw scissors and required mandatory team training for all operating room staff under a recent policy requiring physicians to treat their colleagues with "civility and respect."

North Shore is part of an emerging effort to crack down on what some call healthcare road rage. The push is inspired by a growing body of research suggesting that swearing, yelling, and throwing objects are not just rude and offensive to co-workers, but hurt patients by increasing the likelihood of medical errors.

The national group that accredits healthcare organizations issued a safety alert to hospitals last month, saying outbursts threaten patient safety because they prevent caregivers from working as a team. The organization, The Joint Commission, for the first time is requiring all hospitals, nursing homes, and other healthcare facilities to adopt "zero-tolerance" policies by Jan. 1, including codes of conduct, ways to encourage staff to report bad behavior, and a process for helping and, if necessary, disciplining offenders.

Dr. Peter Angood, chief patient safety officer for the commission, said most hospitals have tolerated healthcare road rage to the point where it has become an accepted part of the culture. That can be particularly true, others said, in high-stakes surgery, a field that can attract high-intensity physicians who are used to being in charge.

The typical attitude, Angood said, is "let's not irritate the physicians or else they're going to take their patients to another hospital."

Some surgeons have escaped discipline even after frequent offenses. At Saint Vincent Hospital in Worcester, orthopedic surgeon Peter Mulhern repeatedly yelled at colleagues over six years - including calling one nurse a "lame-brain" and "an idiot" for seeking additional consent prior to a patient's surgery - before the hospital suspended him in late 2002, according to the state Board of Registration in Medicine, which licenses physicians.

The last straw: He threw two 10-pound sandbags, used to position a patient's arm, to the operating room floor; one hit a nurse's foot, according to the board.

It was the ninth complaint about Mulhern, who moved to practice in Georgia after his suspension. Current administrators at the hospital, which is under new ownership, said they are not sure why the situation was allowed to continue for so long. Mulhern, who completed an anger management program, did not respond to a request for a comment.

Dr. Anthony Esposito, chief of medicine, said that a case now goes to the medical executive committee for a decision after a person has three outbursts. As for Mulhern's nine episodes, he said, "the number is absolutely unacceptable."

In calling for a new policy, the Joint Commission cites several studies linking bad behavior to errors. For example, one survey found that some nurses and pharmacists had avoided consulting with a prescribing doctor because they did not want to interact with that particular doctor.

"The number one issue in the errors that occur is bad communication," said Angood. "The industry needs to put a stop to this."

Many hospitals have already adopted civility policies, including Massachusetts General Hospital, where leaders of the hospital's patient safety initiative saw a link between errors and disruptive behavior, said Jeff Davis, senior vice president for human resources.

But policies are just a first step. Specialists say a key issue is making sure staff members are comfortable reporting colleagues' outbursts without fear of retaliation.

At North Shore's Salem Hospital, nurses did report Dr. Murray Goodman when he threw the scissors. Fran O'Connell, head of the hospital's nurses' union, said tension was high in the operating room because Goodman was running late for two surgeries to correct carpal tunnel syndrome and the two nurses were new.

"The scissors didn't cut to his liking; he was trying to cut suture material. He said they were dull. He tossed them across the room. One of the nurses had to dodge the scissors," O'Connell said.

O'Connell said nurses were frustrated because they felt the hospital was slow to take action - and when the hospital did discipline Goodman, administrators would not tell nurses the details. Dr. Marc Rubin, who implemented the civility policy when he became chairman of the surgery department two years ago, said the specifics of the discipline are confidential. Goodman declined to comment.

North Shore spokeswoman Laura Fleming said administrators learned from this incident. When the civility policy was expanded to the entire medical staff this year, it was streamlined so that cases that can't be resolved informally reach the medical staff professional conduct committee, a group of doctors and administrators that makes disciplinary decisions, more quickly.

"These incidents happen because the OR environment is so high stress," said Rubin. "Surgeons hold patients' lives in their hands, yet they're dependent on equipment and people who are outside their control. This incident was over a year ago and there has not been another incident with this physician."

Most hospitals don't track how many doctors, nurses, and other employees engage in disruptive behavior. But administrators at Vanderbilt University Medical Center estimate that 4 percent to 6 percent of doctors and nurses have repeated outbursts. Vanderbilt, which has one of the most extensive programs to track and deal with such behavior, began focusing on the problem a decade ago when administrators found that physicians who were sued often were more likely to have abusive outbursts. The medical center now advises 34 healthcare facilities on addressing the problem.

Some leaders in the field believe the number of doctors and nurses acting out is rising. Angood said Joint Commission surveyors hear about the issue constantly when they visit hospitals, where frustration is escalating amid growing financial pressures.

"You're looking at a very stressed out industry," agreed David Yamada, a Suffolk University law professor who specializes in employment issues including workplace bullying. "You have an industry in crisis where people are having to do much more with limited resources. That combination can be a potent one."

But others believe that the problem is not necessarily getting worse, but, rather, that the patient safety movement has focused more attention on the conditions that lead to medical errors, encouraging staff to report bad behavior more often and hospitals to respond more quickly.

Liz Kowalczyk can be reached at

© Copyright 2008 Globe Newspaper Company.

This article can be retrieved through the internet by visiting the following link:

Friday, August 08, 2008

Consumer Alert for JCAHO Members

Renegade Anger Management Providers in Orange County, California are issuing bogus completion certificates to "disruptive physicians". In a scheme to collude with resistent doctors, money-hungry anger management providers are routinely providing mail-order certificates for mandated physicians referred to anger management and/or executive coaching for disruptive behavior.

Home Study and on-line classes are clearly inappropriate for "disruptive physicians". These courses should not be accepted by physicians who need legimate Executive Coaching Services, and are clearly not accepted by the JCAHO. It is important to carefully verify the legitimacy of these easy, cheap and useless classes.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management

Tuesday, August 05, 2008

Better Hospital Manners by Mandate

Posted by Theo Francis

Coming soon to a hospital near you: Rules for good behavior — for doctors, nurses, pharmacists and others.

Even well-run hospitals are fraught with tensions beyond the life-and-death concerns of treating the sick and wounded. Doctors yell at underlings. Nurses can be passive aggressive. Surgeons have even been known to hit subordinates for making mistakes in the OR. And that’s just what we’ve seen on soap operas.

In real life, bad behavior can’t be good for care. Intimidated nurses may balk at warning doctors of mistakes, residents may hesitate to speak up, pharmacists may not raise quality concerns with bullying administrators. So the Joint Commission, the biggest hospital-accrediting body in the land, is going to do something about it. Sort of. Starting Jan. 1, hospitals must have in place a policy outlining “unacceptable behavior” and how the institution intends to deal with it. (You may remember the Joint Commission as the tongue-twisting JCAHO, the Joint Commission on Accreditation of Healthcare Organizations.)

The JC hasn’t quantified just how often bad behavior by medical professionals contributes to sentinel events–serious injuries or deaths that trip the quality alarm. But poor communication of one sort or another underlies roughly 70% of sentinel events, and bad behavior seems to be a bigger component than previously thought. An alert issued today goes into more detail.

Still, it’s not clear just how much the new rule will change things. Hospitals that fail to follow their behavior policies aren’t likely to have their accreditation yanked or lose their state licenses. The JC isn’t even specifying what’s unacceptable behavior, or how hospitals should deal with it, leaving the organization open to familiar criticism that it’s toothless.

Certainly, good communication encourages better care, Kevin Pho, a New Hampshire internist and blogger, tells Health Blog. So any policy that cuts down on intimidation and abuse is well-intended, “in concept,” he says. “The question is, how will it be enforced?”

Bad habits may prove be hard to change. Grena Porto, an R.N. and senior vice-president at consulting firm Marsh Inc., all but acknowledged as much in the Joint Commission’s Q & A with reporters this afternoon. She recounted seeing a doctor become “very vocal, angry” with hospital staff, in a way that disturbed her, while working in a clinical setting some years ago.

“I didn’t do anything,” she said. “I was a staff nurse — I looked around and saw no one was going to take this on, and I wasn’t going to step in and do it myself.”

Today, from her perch as a consultant, Porto says she reports such incidents directly to hospital CEOs. But hospital employees may not be so willing to stick out their own necks until they’re convinced it’s safe.

Correction: An earlier version of this post referred incorrectly to the Joint Commission on Accreditation of Healthcare Organizations.

This article is originally featured in the Wall Street Journal. Please use the below link to find the original web version of this article.

Monday, August 04, 2008

A Report From Front Line Anger Management Providers

Certified Anger Management Facilitators (CAMF) throughout the nation are doing well. Trained anger management providers who use the Anderson & Anderson curriculum, along with the Pre and Posttests, are now able to objectively report the success of their intervention.

Yacine Bell, CAMF who practices in Oakland, CA. reports a 99% success rate with motivated anger management clients. She tells an interesting story about her one failure. “I saw a 68 year old Catholic Nun who was referred for corporal punishment of a student. This client insisted that her approach to disciplining students has always worked and she was not willing to change.” Yacine explains that this was not really a failure since the client was simply not motivated to change.

Ms. Bell has also developed a protocol for providing assessments of “new hires” for Bay Area Businesses. She reports this activity to be the fastest growing aspect of her practice.

Dr. Thomas Wentz, CAMF, who is a member of the Anderson & Anderson Training Faculty, is developing a reputation as an effective anger management facilitator and an executive coach for "disruptive physicians". Google and the Joint Commission on The Accreditation of Health Care Organizations (JCAHO) routinely publishes his blogs. Dr. Wentz is also the editor of the upcoming Anderson & Anderson book, "The Practice of Control: Executive Coaching/Anger Management for Physicians".

1AAA Family Harmony—Armonia Familia, with 9 locations in Los Angeles County, has a major contract with the Los Angeles County Probation Department for most of the juvenile probation camps. Family Harmony is also the major provider of anger management for Spanish speaking clients in Los Angeles County.

Gregory Kyles, CAMF, President of Houston based Anger Management Institute is moving to expand his practice to include Batterers’ Intervention.

Anderson & Anderson is in negotiations with Terry Schmitz, President of The Conover Company, to partner in new assessment components, as well as intervention strategies for Civility Training and Emotional Intelligence.

The new Anderson & Anderson Executive Coaching book, “The Practice of Control: Executive Coaching/Anger Management for Physicians” is now in press. It will be available in late September. The level of interest, which is already being expressed, suggests that this book is destined to be a best seller.

Stay in tune with the Anderson & Anderson website and blogs for continuing news in the emerging specialization of anger management.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomate, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management