JCAHO Disruptive Physician Alert Offers Few Guidelines for Intervention

One glaring omission of the January 1, 2009 JCAHO Policy guideline for "disruptive behavior" in Health Care Organizations is the lack of recommended intervention to address the "Behaviors that undermine a culture of safety".

It is clear, however, that interventions should be designed to specifically address the behaviors that are defined in the Alert. In addition, education and skill-based training and coaching are referenced. Finally, "cultural assessment tools" are suggested to determine 'whether or not attitudes change over time'.

Here is an excerpt from the JCAHO Sentinel Alert:

"Educate all team members – both physicians and non-physician staff – on appropriate professional behavior defined by the organization’s code of conduct.The code and education should emphasize respect. Include training in basic business etiquette (particularly phone skills) and people skills. Provide skills-based training and coaching for all leaders and managers in relationship-building and collaborative practice, including skills for giving feedback on unprofessional behavior, and conflict resolution. Cultural assessment tools can also be used to measure whether or not attitudes change over time."

The first two programs designed to help "disruptive physicians" are the PACE Program at the University of California at San Diego, and the Distressed Physician Program at Vanderbilt University School of Medicine.

Both of these programs combine emotional intelligence and anger management to teach skill enhancement. Unfortunately, these programs are offered in a small group format rather than individual coaching, and are limited to participants who can travel to Nashville, Tennessee or San Diego, Ca. on a quarterly based. The total number of new participants seen per year is 32 for each program. These programs are already filled through 2009.

The Anderson & Anderson Executive Coaching/Anger Management Program is unique in a number of ways. The Anderson & Anderson coaching is an anger management program based on emotional intelligence. It includes a Pre- and Post-Test designed to determine the participants’ level of competence in recognizing and managing anger, recognizing and managing stress, primary and secondary styles of communication and empathy/emotional intelligence. The four domains of emotional intelligence are self-awareness, self-control, social-awareness and relationship-management.

Like the PACE Program and the Distressed Physician Program, the Anderson & Anderson Executive Coaching/Anger Management model were already being offered years before the JCAHO Sentinel Alert. This program is offered on-site, seven days a week at a location selected by the participant or in the Brentwood/Los Angeles office of Anderson & Anderson. It can be provided over a two-day 12 -hour period followed by twice monthly phone sessions over a six month period. Post-tests are given at three months and six months. For physicians who live in the locally near the Brentwood/Los Angeles office, the option of being seen two hours on a weekly basis for six weeks (for the initial twelve sessions) is available.

For information on the Anderson & Anderson Executive Coaching for Physicians Program, click here or call our office at 310-207-3591.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org

Two Day Live Anger Management Training Experience

Anderson & Anderson, A.P.C.

Presents

Anger Management Guru: George Anderson, BCD, LCSW, CAMF

When: July 31ST, 2009 & August 1ST, 2009
8:30 am – 4:30 pm

Where: Park Plaza Hotel
150 Hegenberger Road
Oakland, CA 94621

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.

Cost: $500.00 per day includes client workbook, facilitator guide, and certification.

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

For more information, please call 310-207-3591, or visit http://www.andersonservices.com/certificationseminars.html

This Month At Anderson & Anderson

May has been an incredible month for Anderson & Anderson, the trusted name in Anger Management intervention. The following is a list of some of the exciting events that have taken place:

• The new Anderson & Anderson Affiliate Marketing Program was initiated resulting in an impressive response. We will continue to work hard to insure success for all of our affiliates.
• This week, we embarked upon our first 40-hour Facilitator Certification Training in Spanish. This specially designed tutorial was for Dr. Bernardo Stamateas, Psychologist and Minister from Argentina. During the summer, we will offer this training in Buenos Aries, Argentina under the sponsorship of Dr. Stamateas.
• George Anderson’s presentation on "the Angry Physician", which was sponsored by the Riverside Medical Association and was given on May 20, 2009 at the University of California (Riverside) was a tremendous success. He has been asked to return as a presenter for 2010.
• "Comment Contrôler la Colère", the Canadian French version of our adult anger management workbook, was published and made available in Canada. This publication will be listed on our Online store.
• In order to meet the anticipated need for more Executive Coaching/Anger Management intervention, we are moving quickly to train two needed coaches in the Anderson & Anderson curriculum.
• We opened a Twitter Account: http://www.twitter.com/geoanderson. We already have over 500 followers. Follow us and we will return the favor.
• Andrew Singer, a student of Indiana University, has joined Anderson as a business Intern for the summer of 2009. Andrew will focus on marketing the Anderson & Anderson Affiliate Program.

We would like to thank all of our providers, affiliates and colleagues for your continued support.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org

Help in Finding Executive Coaching/Anger Management Programs for Disruptive Physicians

Hospital Administrators, Physician Well-Being Committees and Hospital Credential Committees are struggling to find appropriate resources for the assessment and treatment/intervention for physicians whose workplace behavior has been labeled as "disruptive". The JCAHO Sentinel Alert and Guidelines for "disruptive physicians" did not provide the appropriate guidance for intervention programs to address this issue.

Things to consider in examining programs for "disruptive physicians":

• Is the program specifically designed to address behaviors defined in the Sentinel Alert as disruptive? Counseling, psychotherapy, substance abuse treatment, sexual abuse treatment or psychiatric impairment treatment are not appropriate interventions for "disruptive behavior".
• Anger Management with emotional intelligence is the intervention of choice for disruptive behavior. Emotional intelligence is a practice based intervention designed to increase competence in self-awareness, self-control, social-awareness and relationship management. Skill enhancements in these four areas are critical in improving interpersonal relationships in any setting.
• Does the program offer non-psychiatric assessments designed to determine the client's skill level in recognizing and managing anger, recognizing and managing stress, primary and secondary styles of communication and empathy or emotional intelligence? Physicians suspected of sexual abuse, substance or psychiatric impairment should not be referred to programs for "disruptive physicians".
• Does the program have curricula specifically designed to teach skills in anger management, communication, listening, empathy/emotional intelligence and stress management? The intervention strategies used in credible programs for "disruptive physicians" must be practice based with ancillary teaching material and exercises to master skill development in the above mentioned areas.
• Just as aftercare is critical to maintain gains made in other mandated programs, so it is for "disruptive physician" programs. A minimum of 6 months is standard for most credible programs. Aftercare services should be provided via weekly or bi-monthly phone contacts and/or small group meetings.
• In recognition of the schedules of many busy physicians, programs need to be flexible enough to offer on-site intervention followed by phone sessions. In addition, these services must be made available on weekends and evenings.
• The two most respected programs in the nation for "disruptive physicians" are the PACE Anger Management Program for Healthcare Professionals at the University of California in San Diego, and the Distressed Physician Program at Vanderbilt University School of Medicine. Both of these program are skill based with after-care components.

For a list of programs which meet most of these standards mentioned above, click here.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org

Frank Morales on Negative Emotions

On May 15th, Frank Morales, MS, CAMF from Family Services Center in Huntsville, Al gave a presentation on Managing Negative Emotions at the annual Alabama Employee Assistance Program Coordinators convention. Over 90 Attendees from employee assistance offices, along with representatives from substance abuse treatment centers, military behavioral health, and individual practitioners heard this Anderson & Anderson based talk on the value of managing these emotions, causes/sources, how they work in today's personal relationships/ workplace, and finally how to deal with the emotions themselves before they interfere with behavior. This presentation also dealt with how to deal with difficult people.

Both topics deal strongly with taking personal responsibility and the power of Emotional Intelligence, a strong component of the Anderson & Anderson model. This is so important in today's society, where the current climate has led many to experience hardship and develop many negative thoughts and emotions. However, it should not be an excuse for irrational behavior. Everyday we can read about some violent behavior, where one feels justified, or at the lower end, knows someone who justifies venting. Many people believe in venting, but, simply put, venting is all about you. It means you are probably a poor communicator as you do not care how your message is received or how it affects the listener (elements of self awareness). Secondly, it masks the real problem, that of not learning to be assertive.

The Anderson & Anderson curriculum is perfectly suited for these issues that are currently plaguing our society. Managing the negative emotions is our job, we are the gatekeeper.

Frank Morales, MS
Family Services Center
Huntsville, Alabama

Riverside County Physician Well-Being Conference--A Smashing Success

The Riverside County Medical Association held its annual Physician Well-Being Conference on May 20, 2009. Most of the Hospitals in Riverside County were represented at this training.

"The Angry Physician", the topic presented by George Anderson, was widely received and had the largest attendance. Anderson gave a detailed explanation of how Executive Coaching/Anger Management for Physicians works to assist physicians in achieving skill enhancement in recognizing and managing anger, recognizing and managing stress, enhancing emotional intelligence and improving assertive communication.

He offered suggestions of how Well-Being committees could best assist physicians in accessing appropriate programs for "disruptive behavior".

Finally, all those in attendance were given a free copy of "The Practice of Control", the Anderson & Anderson client workbook for "disruptive physicians". He announced his decision to establish and publish a list of appropriate providers of anger management coaching for "disruptive physicians".

For information regarding the Executive Coaching/Anger Management for Physicians, please contact our office at 310-207-3591 or visit our website at www.andersonservices.com.

Rasheed Ahmed
Office Manager
Anderson & Anderson, A.P.C.
Trusted Name in Anger Management
Ph: 310-207-3591
Fax: 310-207-6234
greynotions@aol.com
http://www.andersonservices.com

Anderson & Anderson Offers Affiliate Marketing Program: A Great Opportunity for Passive Income

Anderson & Anderson’s new Affiliate Market is now on-line. This new affiliate program will serve as a remarkable source of income for serious internet savvy website owners.

Affiliates will receive assistance in placing the Anderson & Anderson logo, advertising banners, links to all our products and training seminars, and executive coaching services on their web site. By conducting a google search on the internet, one finds that the Anderson & Anderson anger management curriculum is the industry standard worldwide. Furthermore, according to www.google.com/trends, anger management counseling is one of the fasting growing niche markets on the internet.

This model has been featured in Los Angeles Times, NBC’s "Starting Over", BBC’s "Losing It", ESPN, Toronto Star, Baltimore Sun Times, London Times and many other print and media outlets.

The new Anderson & Anderson Affiliate Marketing Program sells relatively expensive services and products, which makes it potentially lucrative for each Affiliate. A sample of products, services and the payouts include the following:

•The 12 hour Executive Coaching/Anger Management Program for Physicians, cost= $3200, pay out= $960

•The three-day Anger Management Facilitator Certification Training, cost= $1500, pay out= $450

•40 hour Anger Management Home Study CD-ROM Facilitator Certification Training, cost= $797, pay out= $239.10

•Conover Assessment Program, cost= $595, pay out= $178.50

If you would like to know more about the affiliate program system we are using works, please visit http://jam.jrox.com/. To sign up for our affiliate program and create an account, please visit http://www.andersonservices.com/jam/. If you have any general questions, please call our office at 310-207-3591.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org/
http://www.linkedin.com/in/geoanderson
http://www.anger-management-resources.org/

According to goggle.com/trends, Anger Management Counseling is Hot

Anger management classes, books, DVDs, Posters and other related materials and services are one of the fastest growing niche markets in existence. This is the best time ever to become a Certified Anger Management Facilitator or an Anger Management Marketing Affiliate.

The time and money required to establish a full or part-time anger management practice is low in comparison to other potential income streams available. In addition to using your website as an Affiliate Marketing instrument, here are a sample of services that can be offered by a Certified Anger Management Facilitator:

• Anger management classes
• Individual and Couples classes
• Organizational Anger Management
• Introductory Anger Management classes
• Anger management for Court mandated clients
• Anger management for Human Resource Managers referrals
• Anger management for adults
• Anger management for adolescents

Capital Anger Management, based in Sacramento, California offers two one-hour anger management classes on Tuesdays and Thursdays, and one eight hour class on Saturdays. With an average of ten persons in of each the three classes, the average gross income is around $12,000 per month. This is not bad for conducting classes only 12 hours per week.

Well trained, Certified Anger Management Facilitators are able to enjoy multiple streams of income while offering a needed service.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org

Three Day Live Anger Management Training Experience

Presented by Anderson & Anderson, A.P.C.

Host: George Anderson, BCD, LCSW, CAMF

When: July 22, 2009 - July 24, 2009

Where: Anderson & Anderson Main Office
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 which is worth 16 hours of training.

Cost: $500.00 per day includes client workbook, facilitator guide, and certification.

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

Additional Benefits:

*Each training day counts for 8 of the total of 40 hours required for Certification
*Free One-Year membership in the American Association of Anger
*Those attending all three days will receive a 30% discount on all Anderson & Anderson
DVDs and CD-ROMs purchased on the training days.

For additional information, or to register by phone, please call our office at 310-207-3591. If you would like to register on-line, please visit www.andersonservices.com.

Recession Fuels Anger in Business and Industry

Anger management was initially developed to address out of control emotions that frequently lead to person-directed violence. In most instances, the perpetrators were arrested and charged with battery of some type of criminal behavior. Most anger management classes were populated by Court mandated referrals.

Beginning in 2007, the situation began to change dramatically. Rather than Court mandated referrals, the trend was for Human Resource Managers to mandate employees to anger management classes based on the liability caused by the potential for violence in the workplace. As the economy continued to decline, the volume of H.R. mandated clients have steadily increased.

This new mixture of court mandated and H.R. mandated clients have lead to a distinct increase in the quality and motivation of all participants in anger management classes. Human Resource Managers are highly selective of the anger management programs they are willing to use. They demand credibility. This means that any program interested in receiveing H.R. referrals must employ Certified Anger Management Facilitators. In addition, programs must use a curriculum that is designed to teach skills in recognizing anger, stress, improving communication and enhancing emotional intelligence.

Finally, programs must have a Pre and Post test designed to show evidence of the success or lack of success for each client. For a national list of Anderson & Anderson Certified Anger Management Providers, go to goggle and type in anger management classes, along with your town or city. All Certified Anger Management Providers are well trained and meet the standards required by courts and Human Resource Managers nationwide.


George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org

Louisiana High Court Slaps Cussin’-N-Brawlin’ Lawyers

Excerpt from the Wall Street Journal

By Ashby Jones

In our next life, we’re going to be from southern Louisiana. Yes, there’s the food, the drink, the music, the bon temps that roulez — but there’s something else, too: a seeming never-ending flood of news-making personalities. Just this week, for instance, you’ve got a mayor who can’t remember a trip he took in 2005 and a porn star thinking of running for a U.S. Senate seat.

Something tells us that various aspects of legal practice down there might be no less wacky. Take, for instance, the case of lawyers Douglas Greenburg and Anthony Lewis. The Louisiana Supreme Court this week handed down sanctions for both lawyers, who engaged in fisticuffs back in 2006. As described in the court’s opinion:

In 2005, respondents represented opposing parties in a bitterly contested succession matter pending in Terrebonne Parish. Jean Claire Williams v. Debra Williams Jones, No. 121,049 on the docket of the 32nd Judicial District Court for the Parish of Terrebonne. On May 26, 2006, respondents appeared in open court for a motion hearing before Judge Randall L. Bethancourt. During the hearing, Mr. Greenburg suggested that "some hanky-panky" on the part of Mr. Lewis might well justify an award of attorney’s fees to Mr. Greenburg’s client. The followingexchange then occurred:

Mr. Lewis: Here we go again, Your Honor, the former D.A. is always suspect –

Mr. Greenburg: Your Honor, I’m going to object right now–

Mr. Lewis: – or somebody . . . the law –

The Court: Gentlemen, quiet.

Mr. Greenburg: – and ask that this jackass –

The Court: Gentlemen, quiet. Quiet, gentlemen.

Mr. Greenburg: – quit bringing up anything –

Mr. Lewis: Jackass?

Mr. Greenburg: Jackass.

Mr. Lewis: Your mother is a jackass.

The Court: Hey, hey, hey. All right, y’all are both in contempt.

Following the exchange of profanities, Mr. Greenburg grabbed Mr. Lewis’ suit jacket and both men fell to the floor. Judge Bethancourt immediately recessed the proceeding, cleared the courtroom, and restored order. He then informed respondents on the record that he was holding both of them in contempt of court but that sentencing would be delayed until a later date.

It sounds like something from a lousy 1970s era television show. But it really happened. And when things like this happen, lawyers don’t just dust themselves off and go on their merry way, apparently. In 2007, Greenburg was found guilty of battery, though he reportedly spent only one night in jail.

In the ruling issued this week, the Louisiana Supreme Court issued Lewis a public reprimand and suspended Greenburg’s license for six months, though it chose to "defer" all but 30 days of the sentence provided Greenburg get some anger-management help.

"This stunning lack of decorum and civility occurred in open court, in front of lawyers, court personnel, and ordinary citizens of Terrebonne Parish. Such conduct undermines public confidence in and respect for the legal system, and it cannot be condoned by this court."

The Importance of Emotions in Anger Management

Emotions Are Important. Our emotions are a critical source of information. Our emotions are necessary for us to make decisions. Studies show that when a person has an accident in which those structures of the brain that deal with emotions is damaged the person cannot make even simple decisions. Why? Because the person has lost the capability to feel and thus, evaluate their decision. Social Neuroscience has demonstrated cognition requires emotion in order to complete the transaction of the decision-making process. Without emotion, cognition remains incomplete and unfulfilled.

Our Bodies Talk. Our emotions help us communicate with others. Our facial expressions, for example, can convey a wide range of emotions. If we look sad or hurt, we are letting the other person know that we need their help. If we are verbally skilled we will be able to express more of our emotional needs and thereby have a better chance of filling them. If we are good at listening to the emotional needs of others, we are better able to help them feel understood, important, and cared about. The emotionally intelligent person is able to read, with some accuracy, the feelings conveyed non-verbally by those with whom he or she interacts.

Stress Reduces Our Ability to Feel. As our society has become more pressured and we are constantly overwhelmed by stress, our ability to recognize and respond to our own feelings and those of others is diminished. Overwhelming feelings of stress result in a reduced ability to manage intense feelings and an increase in stress-related disorders. Consequently, there is an increase in road rage, desk rage, air rage, voice-mail rage, verbal and physical aggression, violence against others, substance abuse, and other inappropriate displays of anger.

Emotions Bring People Together. Our emotions are perha ps the greatest potential source of uniting all members of the human race. This is what makes us human and creates the potential for our humanity. Clearly, our various religious, cultural and political institutions have not united us. Far too often, in fact, they have even divided us. Emotions, on the other hand, are universal.

Emotions are Universal. The emotions of…

• Empathy - The ability to understand and share someone else’s feelings.

• Compassion - The ability to care about and give to someone else.

• Cooperation - The ability to work together to achieve a common goal.

• Forgiveness - The ability to pardon someone for a grievance against you or against someone one or something you care about.

All of these emotions have the potential to unite us as people. Our thoughts may tend to divide us, whereas our emotions, if given the chance, will unite us in our humanity.


George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org

Incivility/Disruptive Behavior is an Epidemic Among Attorneys

Work related stress and the down economy is having a devastating impact on the practice of law in the United States. A number states, including Illinois and Utah, have already mandated civility training for attorneys who demonstrate unprofessional conduct in relation to clients, colleagues or the courts.

Many law practices throughout the nation are providing Organizational Anger Management Training for all of their professional staff with the goal of proactively reducing the potential for workplace aggression or hostile work environments.

Executive Coaching/Anger Management is the intervention of choice for attorneys whose anger meets the criteria of incivility or unhealthy/problematic anger. When any of the following behaviors appear in interpersonal relationships with others in the work environment, incivility needs to be addressed:

1. The anger is too intense
2. The anger occurs too frequently
3. The anger lasts too long
4. The anger is person-directed
5. The anger leads to health problems
6. The anger damages interpersonal relationships
7. The anger results in aggression or violence

Executive Coaching/Anger Management works best when it is provided on-site over a 12 hour, two day period with a 6 month follow-up via phone on an as needed or bi-monthly basis.

Professional Executive Coaching/Anger Management must begin with a comprehensive non-psychiatric assessment. Such an assessment must be designed to determine the client's level of functioning in recognizing and managing stress, recognizing and managing anger, primary and secondary styles of communication and the degree or level of emotional intelligence.

The coaching should provide skill enhancement for any or all of the issues above in which the client scores in the deficit range. Post-tests should be conducted three months and six months after the initial in-person sessions.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org

Unsuspecting Physicians Being Mandated to Psychiatric Treatment

Under the new JCAHO Guidelines for "disruptive physicians", many physicians nationwide are being mandated to attend counseling, psychotherapy or substance abuse treatment. Many of the providers to whom these physicians are referred have little knowledge or training in anger management or emotional intelligence. Any physician who undergoes a psychiatric assessment can be sure that he will be diagnosed with some type of Axis I and Axis II diagnosis as a way of justifying his admission to the program and treatment.

"'Disruptive physicians' are doctors whose behavior undermines their personal and professional effectiveness", Ronald Schouten, M.D. said at the annual conference of the Academy of Organizational and Occupational Psychiatry.

"We are talking about people who engage in problematic behavior that interferes with their relationships at work or at home and has a potential impact on patient care, productivity, and administrative functions," said Dr. Schouten, director of the law and psychiatry service at Massachusetts General Hospital, Boston.

Displays of anger proved to be the most common reason for referrals. In 36 cases (out of 69), doctors were referred because they had lashed out physically or verbally, or because they had spooked their colleagues with behaviors such as wearing a gun in the operating room.

Diagnosing disruptive doctors involves a caveat, Dr. Schouten said. When physician referral programs send doctors for a psychiatric evaluation, they often are unable to keep physicians in a behavior improvement program without a diagnosis of an Axis I or II disorder.

"There is a bias in favor of finding something to write on the form," Dr. Schouten said. As a result of that bias, the most common diagnosis in his sample was "personality disorder not otherwise specified," for 37 doctors, followed by 15 cases of major depression. There were also 10 cases of substance abuse, 9 diagnoses involving personality traits, 7 cases of adjustment disorder, and 6 cases each of bipolar disorder and sleep disorder.

"Motivating anyone--even physicians--to sustain behavioral change is difficult", Dr. Schouten said. The process of seeing a psychiatrist causes a short-term change in behavior; however, over time, people tend to revert to their baseline habits. Many physicians who are referred for a psychiatric consultation resent any suggestion that they be held accountable for their actions. But the term "anger management" meets with less resistance than does "psychotherapy", because it lacks the stigma associated with a mental health problem, he noted.

Programs designed exclusively to provide help for "disruptive physicians" should not mirror the programs designed for psychiatric treatment, substance abuse or sexual abuse/boundary issues. This means that no psychiatric assessment is indicated.

Non-psychiatric assessments focusing on anger management, stress management, communication and emotional intelligence are far more appropriate. Anger is a problem, but is not a DSM IV diagnostic category.

Anderson & Anderson is the largest provider of assessments and intervention for "disruptive physicians". Our services are provided nationwide on-site or at our offices in Los Angeles.


George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
http://www.linkedin.com/in/geoanderson
www.anger-management-resources.org