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.

Wednesday, December 31, 2008

Anger Management Guru Offers Free Internet Marketing to Providers

2009 is predicted to be an awesome year for trained anger management providers nationwide. To assist all providers in marketing their practices, internationally recognized anger management Guru, George Anderson, is offering a free listing on The Anger Management Resource Directory.

The Anger Management Resource Directory is currently the most important, visible, and highest rated anger management website on the Internet. Listing on this website will automatically insure prominent internet presence for any provider.

George Anderson is internationally recognized as the voice of professional anger management services worldwide. The Anderson & Anderson anger management curriculum is the industry standard. In September of 2008, this model was featured on “Losing It”, an award winning Griff Rhys Jones documentary produced for the British Broadcasting Channel 2 in the United Kingdom.

Any legitimate, trained anger management provider can visit The Anger Management Resource Directory at, and carefully follow the instructions for placing a listing on this site.

Working together, legitimate anger management providers can and should make 2009 the year that anger management is accepted as the intervention of choice for civility throughout the world.

Rasheed Ahmed
Office Manager
Anderson & Anderson, A.P.C.
Trusted Name in Anger Management
Ph: 310-207-3591
Fax: 310-207-6234

Tuesday, December 30, 2008

Predictions for Professional Anger Management During 2009

Well trained, Certified Anger Management Facilitators will enjoy increased international recognition as useful intervention for stress, anger, communication and emotional intelligence. The increase in demand for services will come from the following areas:

· The state of Texas will mandate anger management classes for all middle school students.

· California will require the completion of a 52-week anger management class for all Parolees whose original offence included aggression or violence.

· Most state prisons will implement anger management for inmates with a history of violence.

· The San Francisco Public Defenders office, under the leadership of Attorney Jeff Adachi, will initiate a community-based strategy for addressing gang violence by using anger management as a key component.

· Many states will mandate “civility” training for attorneys following the lead of Illinois.

· California will be the first state to establish standards for Certified Anger Management Facilitators. These standards will be patterned after the current 40 hour training plus 105 hours of internship for Batterers’ Intervention providers in California.

· Human Resource Managers will use their considerable influence to make anger management the intervention of choice for employees who demonstrate problems managing anger.

· Many governmental agencies and businesses refer problem employees to Employee Assistance Programs. Unfortunately, anger management is not one of the Core Skills in the training for EAP Professionals. Therefore, as these professionals acquire knowledge in anger management, they will increase the number of referrals to anger management providers nationwide.

· The Municipal Court for Huntsville, Alabama is the first court in the nation to mandate anger management assessments for “divorcing couples” with children, rather than psychological evaluations. California is presently considering implementing similar requirements in the Superior Courts statewide.

· “Losing It”, the Griff Rhys Jones BBC two part Documentary on anger management, has dramatically increased interest in legitimately trained anger management facilitators in the UK.

· College and University Departments of Judicial Affairs will institute mandated anger management referrals for disruptive students.

· Organized sports will opt for legitimate anger management facilitators who are able to demonstrate the success or lack of success for each participant.

· Attorneys, Law Enforcement, Celebrities, Physicians and other high profile clients will select anger management facilitators who offer individual anger management coaching offered in confidential environment.

In spite of the recession, well trained, Certified Anger Management Facilitators will be able to charge and receive fees ranging from $50 per hour for group sessions and $250 for individual coaching. 2009 will be a great year for the emerging field of anger management.

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

Monday, December 29, 2008

Recession Causes a Shakeout Among Bogus Anger Management Providers

One of the unanticipated results of the current recession is the shakeout of untrained, unethical charlatans who were using the Internet to advertise bogus anger management online classes and inappropriately structured in-class settings. The cost of Goggle Ads, coupled with closer scrutiny on the part of consumers, has forced the closure of most of these scam artists nationwide.

This shakeout will almost certainly increase the number of referrals to legitimately trained anger management facilitators nationwide. In addition, this will provide some protection to consumers.

The Anderson & Anderson Certified Anger Management Provider List is published in January and July of every year. This list of providers is the Official list of Superior Court Approved Anger Management Providers for all courts in the County of Los Angeles. These providers are also approved by Hearing Officers for the Los Angeles District Attorney’s Office and the Los Angeles City Attorneys. To date, no court anywhere in the nation has failed to accept the services provided Anderson & Anderson Certified Anger Management Facilitators/providers.

All Certified Anderson & Anderson Anger Management Facilitators have a minimum of 40 hours of training in anger management assessment and intervention. In addition, all providers are required to complete 16 hours of continuing education each year and use Pre and Post Tests. Legitimate providers provide client workbooks to all clients and make use of ancillary DVDs and training material. This curriculum is available in Spanish and English.

For a list of Certified Anger Management Providers nationwide, visit the Anderson & Anderson website and click on 'Certified Providers'. You may also find a list of providers by visiting These providers are members of the American Association of Anger Management Providers.

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, Predictions for 2009

The Anderson & Anderson model of Executive Coaching/Anger Management expands the assessment process by including a custom assessment designed exclusively for use with the new Anderson & Anderson client workbook, "The Practice of Control".

The new non-psychiatric emotional intelligence coaching assessment includes:

--Intrapersonal Skills: Self-Esteem – Growth Motivation

--Interpersonal Skills: Assertion – Interpersonal Awareness - Empathy

--Work/Life Skills: Drive Strength – Decision Making – Time Management – Leadership – Commitment Ethnic – Stress Management

--Communication Skills: Interpersonal Assertion – Interpersonal Aggression –
Interpersonal Deference

The result of the above comprehensive assessment determines the focus of the intensive intervention. Client workbooks, along with the “Practice of Control”, contain exercises and skill enhancement lessons designed to address the areas that need improvement.

This model is approved by the State of Illinois for mandated "civility training" for Attorneys. It is also accepted nationwide for "disruptive physicians", as defined in the new standards of the Joint Commission for the Accreditation of Healthcare Organizations.

Based on the success of this model during 2008, we predict that it will quickly become the coaching intervention of choice for physicians, attorneys in need of "civility training", and high profile clients who demand the utmost confidentiality with the option of On-site services.

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

Monday, December 22, 2008

How to find a JCAHO Consistent Program for Disruptive Physicians

The missing link in the new Joint Commission Standards for “disruptive physicians” is an Internet Published directory or list of credible programs to address this challenging issue. One consequence of this oversight is the creation of a new cottage industry of programs claiming competence in treating, curing and intervention for physicians who are engaging in disruptive behavior toward medical staff and/or patients.

In California, traffic schools and domestic violence intervention programs have suddenly begun advertising on-line classes for physicians with the seductive fee of $45. In North Carolina, one anger management provider has developed a program called Executive Conflict Coaching that is being heavily marketed on the east coast. No one knows what executive conflict coaching is.

Psychologists, Marriage Counselors and Licensed Professional Counselors throughout the nation are suddenly experts on providing DSM-IV diagnoses and counseling or psychotherapy for physicians. Unfortunately, without a list of credible programs, Physician Well-being Committees, Hospital Credential Committees and Medical Licensing Boards have little or no guidance in helping physicians seek assistance for “disruptive behavior”.

The oldest and best known programs in the nation for physician assistance are the University of California at San Diego (PACE Program) and Vanderbilt University School of Medicine (Distressed Physician Program). Both of these programs limit enrollment to 32 participants per year. Both programs are currently full through July 2009.

In the absence of a directory featuring acceptable intervention programs for disruptive physicians, the following are guidelines for selecting a credible program:

•Carefully review the JCAHO “Sentinel Alert for Disruptive Physician Policy for Health Care Organizations”.

•Notice that there is nothing in this policy to suggest that “disruptive physician” behavior implies psychopathology, sexual abuse, or substance abuse. Therefore, assessments and intervention regarding these problems are not necessary, nor appropriate, in addressing disruptive behavior.

•Legitimate programs should include a non-psychiatric assessment (pre- and post-test) and aftercare (follow-up). Observation and a 360 degree assessment should be available when requested.

•Coaching or classes should be structured with a focus on self-control, social awareness, empathy, stress management and positive communication skills. Skill enhancement should be the overall goal. Client workbooks with exercises are useful.

•Review the related training and experience of the program providers. Make certain that you or your referral is not the program’s (or Coach’s) very first client.

•Ask for references and contact at least three former clients (or their referral sources, i.e. the hospital’s physician referral). You are interested in learning whether or not the provider in question is legitimate.

•Determine whether you can afford to travel to a distant provider, or if it is in your best interest to have the Program send an Executive Coach to your office to provide the service.

•It is best to be proactive and seek assistance voluntarily rather than waiting to be mandated by some external source.

When the New Year begins, hospitals will be rushing to make sure that the standards employed by the JCAHO are being met. Providing a directory for physicians and well-being committees to refer to when looking for a legitimate program will add more structure to this process.

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

Assertive Communication, An Exercise in Emotional Intelligence at Work

The following is a proven strategy for successful interpersonal relationships in Health Care Organizations:

·Practice Optimism: Think in terms of positive outcomes and solutions. Select your words to uplift and empower ancillary staff and colleagues.

·Always demonstrate civility: Be courteous and respectful. Speak honestly without viciousness or attack.

·Speak candidly. Be straightforward, direct, and open.

·Stick with the facts. Speak clearly and with precision, exactness, and a focus on facts. Be balanced in your use of facts in any claim that you make. Be informative to the listener.

·Use active listening. Listen more than you speak. Listen as if you are going to be tested on understanding the speaker’s words.

·Model the four domains of emotional intelligence: Maintain self-awareness, self-control, social awareness and relationship management.

Practicing and mastering the simple techniques listed above has been demonstrated to be effective in fostering positive interpersonal relationships between physicians and ancillary staff, and also with patients and colleagues.

George Anderson, MSW, BCD, CAMF
Executive Coaching/Anger Management for “disruptive physicians”
Anderson & Anderson®, The Trusted Name in Anger Management

Saturday, December 20, 2008

Self-Control is one of the Four Domains of Emotional Intelligence

The four domains of emotional intelligence are:

·Self-awareness/anger management


·Social Awareness

·Relationship Management

Anger management is actually the key to managing all intense, negative emotions. Emotions determine our styles of communication as well as our ability to make decisions. Anger is a common symptom of stress.

All legitimate anger management classes, as well as Executive Coaching Programs, must include an assessment that is designed to determine the participants level of functioning in managing anger, recognizing and managing stress, preferred styles of communication and the skill level in exhibiting empathy.

Following the non-psychiatric assessment, skill enhancements are provided via individual Coaching or small group facilitation. Both methods of intervention include client workbooks, DVDs, and videos.

Anger management coaching is, and should be, viewed as a positive intervention for people interested in increasing their emotional intelligence.

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

Friday, December 19, 2008

Certified Anger Management Facilitators Are Doing Good and Well

In spite of the current global recession, Certified Anger Management Facilitators (CAMF) who were trained by Anderson & Anderson are thriving in both private and non-profit organizations. The Anderson & Anderson Curriculum is the industry standard worldwide.

Some of the keys to success in the current recession include the following:

· An established, recognized curriculum with a Pre and Post Test.

· Internet presence, i.e. saturation of the model used on all search engines.

· Complete turnkey package including, workbooks, videos and DVDs and ancillary
training material.

· Brand awareness. The Anderson & Anderson brand is the unquestionable leader
in anger management worldwide.

· Continuous Internet, television, and print media marketing.

· All Anderson & Anderson Certified Anger Management Facilitators have an opportunity to list their practices on the Anderson & Anderson website at as well as the Anger Management Resource Directory at

There is simply no other anger management model, which enjoys the same level of credibility as this curriculum. A sample list of successful providers are listed below:

Ashland, Alabama

Clay/Coosa Community Services, Inc.
20 First Ave. 2nd Floor (Courthouse Bldg.)
Ashland, Alabama 36251
Telephone: 256-354-2296

Huntsville, Alabama

Family Services Center
Frank Morales, M.S., CAMF
600 St. Clair Avenue,Bldg. 3
Telephone: 256-551-1610

Long Beach, California

City of Long Beach Health and Human Services
2525 Grand Ave. #210
Telephone: 562-570-4100

Tokyo, Japan

U.S. Military Base
M.C.C.S. Counseling & Advocacy
FPO, AP 96373-0523

San Rafael, California

Marin Anger Management
1005 A Street, Suite 209
San Rafael, CA 94901
Telephone: 415-258-4515

Henderson, Nevada

Anger Management
Dr. Steven J. Sinert, CAMF
871 Coronado Center Drive
Suite 200
Henderson, NV 89052
Telephone: 702-353-1750

Tehachapi, California

Positive Solutions Certified Anger Management
20430 Brian Way, Suite 3
Telephone: 661-303-5669

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

The Tai Chi DVD Given to Angelina Jolie by Brad is Worthless

The Internet Celebrity Blogs are ablaze with reports of Brad Pitt's enrollment of Angelina Jolie in an anger management class. Unfortunately, rather than a legitimate anger management class, Brad purchased Streming Furies, a tai chi DVD for Angelina. Tai Chi is about as effective for anger management as chewing bubble gum.

George Anderson, BCD, LCSW
Director, Anderson & Anderson

Wednesday, December 17, 2008

Resources for "Disruptive Physicians"

Open Letter to Physician Well-Being Committees, Medical Licensing Boards and Disruptive Physician Resource Organizations

As healthcare organizations struggle to meet the January 1, 2009 deadline for establishing policies for the handling of "disruptive physicians", one glaring problem needs to be addressed. Currently, there are no published resource directories for acceptable intervention programs for disruptive physicians any place on the internet.

When physicians are mandated to attend an intervention program to address issues such as anger, stress or other issues associated with disruptive behavior, it is extremely difficult to find these needed resources. There are no resources listed on the websites of the national or state medical organizations, nor are any resources listed on the sites of state Medical Licensing Boards. The Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) does not currently provide a resource directory containing intervention programs for disruptive physicians.

A number of medical schools, including Vanderbilt University and the University of California at San Diego, offer nationally recognized programs for disruptive physicians. However, these programs are very small and generally have long waiting lists. UCSD offers it’s PACE Program four times a year with 8 physicians in each course. It is currently full through July 2009. Vanderbilt University is also limited in the total number of referrals it is capable of handling. According to its website, Vanderbilt is full through March 2009.

Physician Well-Being Committees, Credential Committees, Risk Management Officers, H.R. Managers, and those responsible for making referrals to programs for disruptive physicians need to have easy access, via the internet, to credible Executive Coaching/Anger Management programs for physicians.

The JCAHO may be the most logical organization for establishing a directory of resources for physicians and making such a directory available to all of the stakeholders.

Anderson & Anderson is the nation’s largest provider of On-site Executive Coaching/Anger Management for physicians. The Anderson & Anderson coaching curriculum and workbook is consistent with the new, 2009, JCAHO standards for "disruptive physicians". This program is available on-site anywhere in the United States. Coaching can be scheduled on a short notice for any day of the week.

For more information, please call Anderson & Anderson at 310-207-3591.

George Anderson, MSW, BCD, CAMF, CEAP
Program Director
Anderson & Anderson, A.P.C.
Trusted Name in Anger Management

Saturday, December 13, 2008

Incredible Strides in The Growth of Anger Management During 2008

December 12th, 2008

1.) BBC Documentary on anger management

The internationally recognized Anderson & Anderson anger management curriculum was featured in a two part documentary on the BBC entitled “Losing It”. This film was produced by Griff Rhys Jones and was selected for an award for best documentary on the BBC for September.

2.) JCAHO standards for “disruptive physicians”

The Joint Commission on the Accreditation of Health Care Organizations issued new standards for “disruptive physicians”. These new standards specifically require anger management coaching for these mandated physicians. Given Anderson & Anderson’s international prominence in anger management, we were immediately thrust into the forefront in this new area of specialization.

3.) Hospitals across the nation select Anderson & Anderson to provide Executive Coaching/Anger Management for mandated physicians.

4.) On-site Coaching takes hold

On-site coaching for “disruptive physicians” was initiated at the request of Dr. Willie Williams, former Medical Director of Tenet Health Care who recognized the difficulties posed for busy physicians who are unable to take time away from their practices to attend a coaching course. The concept has quickly become the norm for most out of state referrals for executives and physician coaching clients nationwide.

5.) Civility training for Attorneys

The Anderson & Anderson anger management model is now accepted by the state of Illinois for continuing legal education in civility. The Illinois Supreme Court approved our Emotional Intelligence/Civility training in April of 2008.

6.) Anger management coaching for Geriatric patients

Assisted Living Facilities are now routinely referring residents who have problems managing anger for individual coaching.

7.) Organizational Anger Management proves its effectiveness

Law offices, hospitals and businesses have quickly recognized Organizational Anger Management as a proactive intervention to prevent hostile work environments or problem anger.

8.) George Anderson was selected as the Editor of the Anger Management Forum on Topix: This is the most important and visible anger management page on the Internet.

9.) Military based Family Advocacy Programs adopt the Anderson & Anderson anger management curriculum along with the appropriate client workbooks and assessment components for use with active duty service personnel.

10.) Veteran Hospitals in many states have adopted anger management as an intervention for PTSD patients. While the appropriate treatment for this psychiatric disorder is psychotherapy and medication, anger management has been added as a needed intervention.

11.) George Will, the New York Times, the Chicago Tribune and the Baltimore Sun Times all carried major articles on the Anderson & Anderson model of anger management

2008 will go down as the year that anger management gained credibility worldwide from the business community for Executive Coaching for senior management, disruptive physicians and special populations such as assisted living clients. In addition, educational institutions and the criminal justice system have endorsed anger management as an intervention.

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

Wednesday, December 10, 2008




During this rather long trial by combat, John learned that his father, with whom he was very close, was diagnosed with terminal cancer. John knew immediately that this not only would be a tragic loss; but he would be called upon to assist the family both emotionally and financially. To John, this was not how his life was to unfold. Presently, John is an angry person and an angry attorney.

In fact, stressed and tired, John was in Court today. Unfortunately, the Judge reprimanded John for his unacceptable tone and unprofessional behavior against the Prosecutor and State’s witness. John could not shake the comments of the Judge regarding the difference between assertiveness vs. bullying. At first, John thought that he was being singled out for zealously representing his client. However that night John took a long look into the mirror and asked himself: “Am I too aggressive and unprofessional?” John decided to rethink the way that he was handling his emotions and anger. He decided also to sharpen his anger management tools.


Unfortunately, attorneys are said to be even more vulnerable to the emotions of anger because of the adversarial nature of their profession, the fear of being perceived as weak and the perception of some that anger can foster success. Realistically, the very components of professionalism: courtesy and civility, candor, loyalty to client, meritorious claim, and zealous representation are affected directly by poor anger management skills.

ANGER MANAGEMENT TOOLS: Some suggestions are:

1. Take several deep breaths while sitting or lying down.
2. Change your environment.
3. Exercise
4. Slowly count to 10 (or 20 or more) and think before you respond.
5. “Laugh away” your anger by find the humor in minor upsets.
6. Take a break and listen to your favorite soothing music.
7. Think before you speak. Then express yourself in a way that helps you find solutions to the problems that 8. contribute to your anger.
9. Show respect for the other person and for yourself.
10. When the person responds, give your full attention.
11. Speak clearly and assertively, but avoid sounding or acting pushy.

Take time to relax and enjoy hobbies, friends, family and pets. Talk out minor problems before they escalate. Simplify your daily routine and don’t be afraid to say “no” to avoid getting stressed out.

Recognizing that much of his anger shared space with his deepest fears, our attorney John decided that he needed both an anger-management workshop and counseling. Additionally, John learned problem-solving techniques, stayed in shape, turned complaints into requests, learned to let go of resentments and made sure that he put a statute of limitations on his anger.

For more information on this subject, or if you, or someone you know needs support and help, contact the Delaware Lawyers Assistance Program (De-LAP) at (302) 777-0124 or 1-877-24DELAP or e-mail

Monday, December 08, 2008

Assisted Living Residents, a Neglected Population for Anger Management Intervention

Anderson & Anderson, A.P.C., was recently contacted by an Assisted Living Facility requesting anger management for an 89 year old resident. The presenting complaints were aggressive and verbally abusive communication to staff and fellow residents. The clinical assessment revealed that this client was suffering from reactive depression with a range of symptoms that include anger, stress, agitation and sleep disturbance. The non-psychiatric anger management assessment indicated deficits in empathy, assertive communication, and stress management. There was also a high score in aggression. On the positive side, there was a high score on motivation to change.

This case is significant in that this is only the second time in 12 years that we have received a request for service to anyone in this age group or in a similar situation. One reason for the lack of Geriatric referrals may well be a failure of medical/health care community in recognizing the need for anger management in the elderly population. Another reason may be that professional anger management providers are simply not addressing this population.

Currently, elderly persons represent the fastest growing group in the United States. Within this group, there are an increasing number of individuals who reside in long term care facilities.

Approximately 23% of residents in assisted living facilities suffer from depression. There is a positive relationship between anger and depression. Residents who report their anger experiences are also likely to report depressive mood symptoms.

In spite of these findings, professional anger management resources are rarely made available to Geriatric patients or clients in long term care facilities for the aged.

Anderson & Anderson offers anger management On-site to individuals or groups in assisted living facilities.

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

Saturday, December 06, 2008

Executive Coaching/Anger Management for Attorneys

The legal profession is beginning to address the decline of civility by imposing training in civility/anger management for attorneys. Anderson & Anderson, A.P.C. was the first to conduct Emotional Intelligence/Civility for Attorneys in the state of Illinois. This training was conducted for 30 attorneys at the Profit Loss and Research Bureau in Chicago.

Anderson & Anderson is now offering Executive Coaching/Anger Management for attorneys experiencing stress, burnout or “disruptive behavior”. While anger is a normal human emotion, there is no justification for incivility in the legal profession.

Our coaching model consists of non-psychiatric assessments designed to determine the level of functioning in 13 domains including, self-awareness, interpersonal assertion, interpersonal aggression, stress management, empathy, time management, leadership, motivation and self-esteem.

The Anderson & Anderson new client workbook, The Practice of Control, contains exercises and lessons used to coach attorney clients in skill enhancement in all of the areas mentioned above. This curriculum was featured in two part documentary entitled “Losing It” on the British Broadcasting Channel in September 2008. These programs can be viewed by visiting our website at:

All of our coaching is provided on a confidential individual basis with follow-up phone sessions. This service is provided on-site anywhere in the nation. Please call our office at 310-207-3591 for more information.

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

Thursday, December 04, 2008

Arrogant and Abusive Doctors Pose Safety Risks to Patients

From New York Times--December 2, 2008

Nearly every nurse can tell stories about doctors who yelled at them in public, threw scalpels across the operating room, ignored calls to come to a patient’s bedside, or otherwise acted in an arrogant and abusive way. While this behavior used to be tolerated as an inevitable byproduct of working in a high-stress environment, health care leaders are increasingly recognizing that bad behavior can endanger patients’ lives. And they’re taking action. As the New York Times reports, the Joint Commission which accredits hospitals is urging hospitals to send disruptive doctors to anger management classes and to take other steps to curb abusive behavior.

The problem for patients is that for health care to work well, members of the health care team need to be able to communicate freely with each other, without fear of having their heads bitten off by someone with a superior attitude. Surveys have shown time and again that errors such as “wrong site surgery” or medication overdosing happen in part because someone who knew better, but who lacked status in the pecking order, was afraid to speak up — or was ignored when they did.

The Times article reported how one boy with a shunt in his brain almost died because of his on-call resident’s arrogance. The resident dismissed the nurse’s warning each time when she called to inform him that the boy was showing signs that the shunt was blocked, telling her “You don’t know what to look for – you’re not a doctor.” The nurse eventually notified the attending doctor, who operated on the boy immediately and barely prevented brain damage.

At a California hospital, a baby died because the resident who feared the attending doctor, “who was notorious for yelling and ridiculing the residents,” didn’t call him about a problem with a fetal monitoring strip. This resident is only one in many others who don’t feel “empowered enough to speak up” about preventable tragedies that include doing the wrong surgery on patients, says Dr. Angood of the Joint Commission.

While patients are the direct victims of overstressed physicians (especially in neurosurgery, orthopedics and cardiology), nurses often bear the direct brunt of the abuse on a regular basis.

These doctors are a small minority, perhaps 3 to 4 percent of all practicing physicians, according to one doctor who gives anger management classes. But even that is too many.

Disruptive doctors are being challenged by nurses who are backed up by hospital officials, sent to anger management courses, or (eventually) dismissed by the hospitals. Hospitals are also developing ways to cultivate a better working relationship between doctors and nurses.

Disruptive and abusive behaviors create communication barriers that can interfere with diagnosis in addition to causing medical errors. But poor communications can be an issue even when there is no out-and-out abusive behavior. Often doctors just need to slow down and listen to their patients. The Washington Post’s Sandra Boodman writes about a patient saved by a doctor who listened. Carol Welsh didn’t know she had something growing in her head until she saw a doctor who “[took] the time to listen” and figured out that an undiagnosed brain tumor was the cause behind her nausea, vomiting, weight loss and mental fuzziness. Dr. Clifford Henderson saved Welsh’s life by finding the tumor and getting it removed. A few more weeks and she would have died. That there might be a brain tumor did not cross the mind of the previous doctor who treated her for five months.

Tuesday, December 02, 2008

American Recession Increases Person-Directed Aggression

As our economy continues to decline, there is a dramatic increase in referrals to anger management coaching programs. It is generally recognized that stress is rampant among persons who have lost jobs, faced foreclosures and other consequences of a down economy. The holiday period exacerbates these stresses.

Anger is a secondary emotion that is always preceded by some other emotion. Generally, it is stress that precedes anger. As we become overloaded with stress, or become burned out, our potential for person-directed anger tends to lead to aggressive behavior.

In contrast to previous holiday periods, this holiday season is generating an unprecedented number of men who are mandated to attend anger management classes or coaching by their significant others. These clients tend to be highly motivated to change as they see their relationships are at risk.

While anger is a normal human emotion, it is a problem when:

·It impacts, damages or destroys interpersonal relationships

·Occurs too frequently

·Lasts too long

·Is too intense

·Has health consequences

Anger management coaching on an individual basis is more effective and focused than any intervention that is offered in groups. Some experienced, well-established anger management coaches are offering these services on-site nationwide.

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