A course on anger management of eight weeks duration for six people with learning disabilities (in the mildmoderate range), and their keyworkers, is described. The programme drew on a range of techniques to assist in the exploration and control of difficult emotions, including relaxation, role-play, problem-solving and sharing in a group. With reference to the information we received from the participants (clients and staff) about their experience of being in the group, we discuss what appeared to have been helpful to group members in learning how to express angry feelings in appropriate ways, and to keyworkers in supporting clients in the management of aggressive behaviour.
IntroductionAnger is an emotional state, the expression of which, through aggression, can lead to considerable distress for people with learning disabilities and for those who work with them (Benson, 1986;Black et al., 1988;Whitaker, 1993). When discussing the running of a group for people with a learning disability on the subject of anger, we became aware of how people come to be referred to psychology services for anger management, and what this might mean for their experience of participation in a group. We thought about how difficult it can be to express anger towards people on whom we are also dependent, for fear of jeopardising the relationship we have with them. We also thought how difficult it may be for people in a devalued or minority group to feel safe in the expression of their anger, and how many contradictory messages we (as professionals and/or carers) often give about what is acceptable with respect to the expression of intense feelings.It has been suggested that people with a learning disability have problems with identifying the emotions of others (Gray ef al., 1983; Reed &Clements, 1989). However, Lindsay et al. (1994) have observed that people with mild or moderate intellectual disability can be accurate reporters of their own emotional state. Others (e.g. Gardner ef al., 1983; Rose, 1996) have pointed out how the problems raised by the consequences of angry feelings can be greatly compounded by the impact of having learning and other disabilities which hamper speech, hearing and understanding.Psychological research on the expression of anger through aggression is under-pinned by assumptions that violent acts are typically attempts to resolve problems, and that human aggression is learned (Blackburn, 1993). Clearly, aggression is a multiply-determined phenomenon, and interventions to reduce the frequency of aggression need to recognise this. In a comprehensive review of psychological methods that have been used with people with disabilities to reduce aggressive behaviour, Whitaker (1993) raises questions about the efficacy of 'traditional' and more recent types of intervention (ranging from behavioural approaches including punishment, to attempts to encourage clients to make use of self-control techniques). Aggression which occurs with low frequency (e.g. monthly rather than daily) presents particular problems in community...