QUALIFICATIONS AND QUALITIES OF GROUP LEADERS

The program we will discuss was designed as a school-based intervention for use by a trained co-leader team consisting optimally of a counselor and a school psychologist. The involvement of a community mental health professional as a co-leader is also appropriate (Lochman & Wells, 1996). Although busy schedules and tight resources may demand that only a single group leader manage the intervention, a co-leader situation is most advantageous for the following reasons:

1. Two adults in the group room provide a greater sense of personal security for the children and may reduce any anxiety they have concerning their own safety and well-being. It is not unusual for the children to initially “test” the group environment to determine whether it is one that will be characterized by control or lack of control. The visible presence of two adults can help to reduce or alleviate some of these concerns.
   1. Co-leaders can divide the group leaders’ chores, with one addressing the training and the other concentrating on behavior
   2. management concerns. This issue is discussed in a later section.
2. The addition of a second adult allows the leaders to plan and execute behavioral modeling of the activities or skills for the children to observe. The Anger Coping Program is a skills-based intervention and, as such, draws procedures from effective teaching as well as from counseling. Skills are generally trained using what might be termed a “discuss, observe, rehearse, apply” model, thus allowing the group members to watch the leaders role play the designated skill is a critical feature.
3. The co-leaders can debrief one another following each session to gain additional insight into the progress and direction of the group. Using immediate postsession time to share observations, make training adjustments, and plan strategies is very important to the potential effectiveness of the intervention.

It is highly desirable for at least one of the co-leaders to have had previous supervised experience with school-based therapy/counseling groups. Disruptive, noncompliant, and highly externalizing young children are not the population with whom to begin learning group counseling techniques without supervision! Although a good anger control intervention is comparatively structured and clear with regard to session-to-session activities, there is little substitute for the skills and confidence gained through previous experience in managing a counseling group.

Because the most effective anger control programs are based on a cognitive-behavioral framework that draws heavily on a social-cognitive model of anger arousal (see Lochman & Wells, 1996), it is essential that the group leaders have a strong working foundation in the theoretical underpinnings of the program prior to implementation. In general, the graduate training of school psychologists and guidance counselors is excellent preparation for the group leader’s role. Indeed, their individual disciplines and expertise combine well in addressing both selection assessment concerns and the group counseling aspect. However, not all preparation programs place emphasis on working with aggressive children. In lieu of specific graduate course work in cognitive-behavioral theory and intervention techniques, an intense study of the first two chapters of this book, along with selections from “Recommended Further Reading” (found at the end of this book), is highly recommended. Requesting that the local university provide a continuing education opportunity in work with angry, aggressive children can also be very beneficial.

Broadly defined, the primary responsibilities of the group leader in an anger control counseling group are the following:

1. Initiate, design, and cooperate with the classroom teacher, parents, and relevant others in the process of screening and selection of group members.
2. Establish a collaborative relationship with the classroom teacher, and assist that individual in learning and enacting the necessary responsibilities for classroom support of the intervention.
3. Collaborate with the classroom teacher on the determination of behavioral goals for the group members.
4. Obtain informed parental consent; determine and implement the appropriate level of parental involvement in the intervention.
5. Inform and involve the administrator in understanding and enacting his or her role in the intervention.
6. Develop a behavioral management plan for the group setting, including procedures for moving the students in and out of the classroom.
7. Secure the appropriate physical setting and necessary supplies for implementing the program.
8. Conduct the intervention training in accordance with the prescribed procedures.
9. Design and implement appropriate progress monitoring and outcome efficacy assessments.
10. Arrange and conduct booster sessions with the group members following the completion of the intervention.

Let us address the first three critical elements in the group leader’s responsibility, as they effectively set the stage for the rest and involve the classroom teacher to a significant extent. The teacher has three important responsibilities in an anger control intervention: (1) participating in screening and selection, (2) collaborating on treatment generalization in the classroom, and (3) evaluating classroom behavioral goal attainment efforts. In this chapter, we examine how the group leader and teacher work together in each of those areas.

SCREENING AND SELECTION OF STUDENTS

Some years ago, a school psychologist was settling his anger control group in for their first meeting, when one of the children asked how it came to be that he was selected for this group. Before the group leader could answer, another boy piped up, “He just asked the teacher who the baddest kids was, and here we are!” That answer, although reduced to its most oversimplified and colloquial elements, was not far off the mark. However, not every aggressive child needs anger control group skills training, and for some it may even be contraindicated. Although the kids may see it as simply identifying the “baddest” pupils, the real process is considerably more complex.

The participation of the teacher in the identification and treatment of students in the anger control group is fundamental to any hope for successful outcomes. Identifying the students who are most likely to benefit from a small-group skills training is the first phase of what will be a collaborative effort between the teacher and the group leaders over the course of many weeks to come. The school psychologist or counselor who perceives that a direct intervention group may be the treatment of choice for some problematic students needs to begin the process in a systematic and thoughtful fashion. The teacher may be ready to merely point out “the baddest kids” and leave the rest to the group leaders, but his or her role goes much beyond that.

An effective anger control program is designed to provide angry, aggressive children with important anger management and problem-solving skills and to prevent progressively more serious conduct problems in later years. Consequently, finding and selecting the children most likely to benefit is paramount. The goal of an effective identification process is the early and reliable identification of children most at risk of later serious antisocial behaviors (Charlebois, LeBlanc, Gagnon, & Larivee, 1994). The term reliable is key here. The limits on the time and resources of school personnel make it essential that the process identify children who are at “true risk” rather than those with adequate skills and other protective factors who are merely going through a difficult, time-limited period (known as “false positives”).

In addition, the screening and identification process itself must be time-and cost-effective. Procedures that place excessive demands on human hours and school budgets stand little chance of being absorbed into the regular fabric of the education program. Although providing each child at the grade level with a complete psychological evaluation would likely yield adequate data for reliable selection, few if any school psychologists have time for such an assessment. Some manner of middle ground between that option and simply having the teacher rattle off the names of the most problematic children should be adopted. Because of his or her expertise in assessment, the school psychologist should be consulted at each step of this screening process, even if he or she is not a part of the treatment team.

The use of multiple gating procedures for the identification of children at high risk for later conduct problems has been advanced by a number of authors (e.g., Loeber & Dishion, 1983; Loeber, Dishion, & Patterson, 1984). These methods use relatively inexpensive ratings as a first “gate” and more sophisticated identification procedures for later gates (Charlebois et al., 1994). This “ever-narrowing gate” process is an effort to both identify those children at true risk and reduce the number of those who may be false positives. A number of models have been examined, including those that utilize teacher-driven ratings (e.g., Sinclair, Del’Homme, & Gonzalez, 1993; Walker et al., 1988), peer and teacher ratings (e.g., Roff, 1986), and parent and teacher ratings (e.g., Whebby et al., 1993). Jones, Sheridan, and Binns (1993) used deficits in early social skills as identifying variables for high-risk children.

A large body of research suggests that economic disadvantage, inadequate parental discipline practices, and early oppositional behavior are among the major risk factors related to later conduct disorders (see Kazdin, 1987a, 1995, for reviews). Specific research on the Anger Coping Program indicates that children with the highest initial level of disruptive-aggressive off-task classroom behavior and with the poorest problem-solving skills have been shown to make the strongest gains (Lochman, Lampron, Burch, & Curry, 1985). An effective multiple gating process must acknowledge these risk factors and marker behaviors and attempt to target the children at highest risk. The multiple gate screening and selection process described here makes significant use of both teachers and parents’ observations and ratings of behavior.

Gate 1: Lowest Socioeconomic Group

Because of the strong relationship between low socioeconomic status and a host of later risks (e.g., Attar, Guerra, & Tolan, 1994; Yung & Hammond, 1998), economically disadvantaged districts, or school attendance areas within larger districts with the higher proportions of economically disadvantaged families, should be targeted as the first gate. This is not to say that comparatively well-off school districts do not have children at risk for aggressive behavior; clearly, they do. However, poverty has the capacity to potentiate other risk factors to such a great extent that its role in the selection process cannot be ignored. If there is no clear variation in the socioeconomic status of the student body, then the process should proceed to Gate 2.

Gate 2: Teacher Nominations

At the identified grade level, teacher nominations of pupils who show at least three of the following should be solicited: (1) marked difficulties with interpersonal problem solving and anger management (including interpersonally aggressive and nonaggressive responses), (2) oppositional and disruptive responses to teacher directives, (3) rejection from the more adaptive peer culture, and (4) academic failure or underachievement. A sample Teacher Nomination form is shown in Appendix A.

Our experience has been that some teachers are afraid that nominating a child for consideration will “label” him or her unfairly. Group leaders should provide assurance that the teacher is only suggesting names of students who will go on to be carefully screened later. There is no danger that a child will receive services based only on the ratings at this second gate. To that end, teachers should be advised to err on the side of possible overidentification at this stage. There are a number of other factors to be considered in the nominations:

1. Children whose aggression provides them with high peer status and who do not express any motivation to change should be left out of the nomination process. Often these children are seen as the school bullies, and they may use their aggressive behavior proactively to intimidate, harass, and physically as
2. sault other students. These children are a significant source of concern, and their needs—along with those of their victims— should also be addressed by school personnel. Helpful work by Batsche (1998) and Olweus (1993) may provide guidance for such intervention efforts.
1. Avoid inclusion of children who are substantially different from the proposed pool of nominees. For instance, children who are in the same classroom grade but 2 or more years older, as a result of multiple retentions or for other reasons, may be inappropriate because of differing developmental issues. Similarly, aggressive children who are typically withdrawn or who have very fragile self-concepts may be inappropriate for this intervention, as their impulses may become excessively aroused during the role-playing activities (Lochman et al., 1987).
2. Aggressive children who are currently being served in special education programs for those with emotional disabilities should be included if their co-occurring disorders do not (a) provide excessively high stimulation for possible verbal or physical abuse from more aggressive peers or (b) offer the potential for extraordinary behavior management concerns for the group leader.
3. Because of the need to understand the social-cognitive processes involved in the training, pupils in the anger control program should be functioning at, at least, a low average intellectual level.

Gate 3: Teacher Screening Scale

Following informed parental consent, the group leaders should meet with the teacher and assist in the completion of the Teacher Screening Scale (adapted from Dodge & Coie, 1987) for all of the children nominated in Gate 2. This scale is shown in Appendix B. (Parental consent at this step is necessary and proper because a subset of individuals, rather than the entire class, is being assessed.) This scale was selected because of its promising support in research trials and its simplicity and ease of use for larger-scale screenings. However, professionals who trust and have experience with other similar scales should feel free to substitute them. The goal of this stage of the selection process is to establish a hierarchy of need and risk among those children first identified by the teacher.

The Teacher Screening Scale has demonstrated modest promise in the ability to discriminate reactive and proactive aggression patterns. Note that the first three items (single asterisks) are representative of reactive aggression, and the final three items (double asterisks) show proactive patterns. Although the data indicate that teachers typically view aggressive behavior patterns in children as unidimensional (Dodge & Coie, 1987), the two-factor nature of this instrument can prove useful in those cases in which the teacher reports strong ratings in one direction or the other. For example, if a child scores very high on items 10, 11, and 12 and very low on items 1, 2, and 3, the treatment team may want to further assess whether the child would be better suited in a bullying intervention rather than an anger control program. Caution is advised against overinterpretation of the Teacher Screening Scale, however. The lack of adequate research support in an applied setting argues for a very conservative approach. Look for broad, sweeping differences in scores rather than minor variations. The school psychologist’s expertise in psychometrics will be most valuable in this analysis.

Comparison of the global ratings on this instrument will give the group leaders and teacher a working hierarchy of children considered in need of anger and aggression management training. Revisiting the initial Gate 2 nomination list with the new data may allow them to move selected children from anger control group consideration to less invasive classroom-level interventions.

Gate 4: Broadband Assessment

The teacher and the parents of each identified child should be asked to complete a broadband behavior checklist. Well-standardized instruments such as the Child Behavior Checklist (CBCL; Achenbach, 1991), the Behavior Assessment System for Children (BASC; Reynolds & Kamphaus, 1992), or other related multidimensional parent/teacher rating instruments should be utilized. The use of multidimensional instrumentation allows for examination of possible co-occurring symptoms, which may lead to additional recommendations for treatment. For instance, the high occurrence of aggression and oppositional behavior among children diagnosed with attention-deficit/hyperactivity disorder (Barkley, 1998) demands that the possibility for the presence of this disability be considered. In this instance, the use of a broadband instrument at this juncture allows the treatment team to look for significant elevations on hyperactivity and attention deficit indices. In addition, studies with children who have conduct problems have reported rates of comorbidity with internalizing difficulties as high as 52% (McConaughy & Skiba, 1993). These findings indicate the necessity to examine the protocols carefully for the existence of all co-occurring problems that may require additional intervention.

Parents should subsequently be contacted and interviewed in order to clarify their responses and gather specific behavioral information. This is an opportune time to begin to understand the strengths and willingness of the parents to participate in the intervention (see section on parent participation in Chapter 4). At this gate, the treatment team is most interested in whether the child is displaying behaviors at home similar to those seen in the school. Issues of setting demand (i.e., differing demands and behavioral expectations between home and school settings) should be taken into account. For instance, it is common for parents who place few compliance demands on their children to be unaware of the noncompliant or oppositional behavior seen at school.

Those children observed by parents and teachers to have significant externalizing behavior problems in both the home and school environments should be identified and considered the first priority for intervention. Children who have been reliably identified as problematic in the school setting but not in the home setting should be included in the second tier of candidates.

Preintervention Individual Assessment

Once the pool of pupils has been identified through the multiple gating process, the treatment team needs to further evaluate their individual characteristics. How much does anger play a part in these pupils’ difficulties? What are their current problem-solving competencies? What is the function of their aggressive behavior? For instance, children with highly affective reactive aggression will have intervention needs that are, in many ways, distinct from those of children with lower-affect, proactive aggression levels (Dodge & Coie, 1987). In addition, children with primarily proactive aggression patterns and adequate peer social acceptance tend to view their behavior as less problematic than their more reactive peers and, consequently, may be less motivated to participate in treatment (Lochman, White, & Wayland, 1991). This individual assessment will allow the group leaders to (1) better understand the functional antecedent and consequent events associated with the problematic behavior, (2) individualize the intervention emphases to meet the particular needs of the group, and (3) select out those pupils for whom the intervention may be contraindicated because of their characteristic anger or aggression.

The choice of the assessment instrument or procedure will naturally be guided by the nature of the assessment question. Although an exhaustive description of individual assessment procedures and instruments is beyond the scope of this chapter, a number of excellent resources are available. Lochman, White, and Wayland (1991) have provided a comprehensive discussion of assessment options for use with aggressive children. These authors suggest procedures and instruments for the evaluation of social problem-solving strategies, peer group status, familial/parental functioning, cognitive/academic deficits, and self-concept. Furlong and Smith (1994) review an extensive selection of psychometric measures intended to assess anger, aggression, and/or hostility in children and youth. McMahon and colleagues (McMahon & Estes, 1997; McMahon & Wells, 1998) provide a model of assessment that stresses not only the assessment of the child’s behavior per se, but the behavior in interactional contexts of school and home environments. In addition, three scales for the measurement of anger—the Children’s Anger Response Checklist (Feindler, Adler, Brooks, & Bhumitra, 1993), the Anger Response Inventory for Children (Tangney, Wagner, Hansbarger, & Gramzow, 1991), and the Children’s Inventory of Anger (Nelson & Finch, 2000)—provide useful assessments of anger-related problems and affect.

Pretreatment Authentic Data

In addition to these psychometric data, group leaders at this time should also obtain “authentic” or school record data on the selected group members. These data may include (1) accumulated discipline reports, such as office referrals, detentions, and suspensions, (2) tardy or absentee reports, (3) academically related data, such as homework return rate or other teacher-suggested measures of adaptive classroom skills resulting in a permanent product. This information will serve the dual purpose of helping the group leaders to better understand the actual problems the children are having in school and providing a comparison baseline for posttreatment evaluation. Having a useful, data-based estimate of the relative effectiveness of the intervention is essential to good counseling practice. The preintervention data, psychometric and authentic, can contribute to that assessment effort. (See Chapter 10 for additional discussion on assessing progress.)

Once the group members have been identified, it is now time to assist the teacher to further understand and refine his or her collaborative role in the intervention.

TEACHERS AS TREATMENT COLLABORATORS IN THE CLASSROOM

From a group leader’s perspective, the anger control program brings together both direct and indirect intervention—the group leader working directly with the children in the treatment room and indirectly through the teacher in the classroom. For this combined approach to result in positive outcomes for the children, the group leader and the teacher must have a strong, professional working relationship.

When school psychologists and other supportive services personnel engage in direct intervention efforts, it is not unusual for the child’s classroom teacher to be relegated exclusively to the role of clock-watcher, who says to the child once a week: “Time to go to group.” Not that this function is unimportant, but it hardly stretches the potential of the classroom teacher to participate in the change process. One of the principal factors that make school-based therapy so viable in comparison with clinic-based therapy is its location in the authentic setting (Coie, Underwood, & Lochman, 1991; Tharinger & Stafford, 1996).

Along with the obvious benefit of ease of access to the population of concern, the potential for generalization offered by conducting treatment in the school is considerable. School is where the children interact with one another and is a major arena for interpersonal aggression. Having ready access to the problematic individuals while they are within the problematic setting provides significant opportunities for creative, collaborative, and potentially generalizable treatment programs.

To upgrade the classroom teacher from “time keeper” to true collaborator, the group leader must take into consideration two pertinent issues: (1) the skill and the willingness of the teacher to become involved in classroom-level interventions and (2) the actual time the teacher has available to participate, given the myriad other responsibilities.

Experience has shown that most teachers are willing—sometimes eager—to assist in the treatment of children in their classrooms. However, it is a rare teacher who will spontaneously volunteer to work with a group leader unless the two have collaborated similarly in the past. Typically, the group leader—school psychologist or coun-selor—must initiate the collaboration.

The literature on school-based consultation is rich with discussions and recommendations for consultants attempting to establish effective working relationships with teachers (see, for example, Brown, Pryzwansky, & Schulte, 1995; Conoley & Conoley, 1992; Marks, 1995). Some related points are addressed here.

Promoting an Egalitarian Relationship

Like a consultation between teachers and supportive services staff members for purely academic problems, the cooperation between teacher and group leader is a collaboration of two professionals, each with his or her own area of expertise. If the group leader attempts to enter this collaboration with the implied message, “I’m here to rescue you from these difficult children,” a potentially ruinous hierarchy, consisting of the “Expert Therapist” and the “Inadequate Teacher” may evolve. The capacity for this hierarchy to become firmly entrenched, particularly with new or less-skilled teachers, is significant. When a group leader enters a classroom and hears the teacher say, “Well, guess what your kid(s) did today?” then the time has come to reexamine the collaboration.

The group leader needs the teacher as an equal working partner in order to achieve success in the intervention. Communicating respect for the expertise that teachers bring to the collaboration is a critical feature leading to that desired partnership. Among other important skills, the classroom teacher has (1) a knowledge of the course and the nature of the curriculum, (2) instructional abilities, (3) classroom discipline strategies, (4) an understanding of the interpersonal dynamics in the classroom, and (5) a knowledge of his or her own skill and willingness to participate in the intervention. Also important, the teacher has regular access to the child and influence over the child’s behavior. The capacity of the classroom teacher to be an effective agent of change should not be underestimated.

Emphasizing Voluntary, Time-Limited Cooperation

Assure teachers that their cooperation is voluntary and that the classroom aspect will be limited to that allowed by their available time and energy. If at all possible, avoid any implication that a “greater authority” (e.g., the principal or a powerful parent) is encouraging or requiring the intervention. This sets up the teacher’s role in the intervention as another “duty” that is being observed from above, and few teachers believe they have extra time for more duties. In similar fashion, a group anger management program should not brought to the teacher disguised as some manner of benevolent gift that the teacher has no choice but to accept (e.g., “I’m the school psychologist and I’m here to do you a really big favor”).

Instead, the most effective collaborations arise logically and systematically out of the authentic situation. Because direct intervention is more “invasive” than indirect—in that the children must be extracted from the classroom environment for the treatment—it should be among the last interventions attempted. A pryamidal structure of intervention with a schoolwide discipline plan at the base, working upward toward direct intervention near the top, exemplifies this principle (see Figure 3.1). Has the teacher exhausted all the classroom-level interventions? Should this intervention be directed instead at enhancing teacher skills in an area such as classroom discipline or conflict resolution?

The amount of time the teacher must devote to his or her part of the intervention is a major variable in acceptability (Conoley & Conoley, 1992; Elliott, Witt, Galvin, & Peterson, 1984). Group leaders who themselves have never had responsibility for the day-to-day education of an entire classroom of elementary children may have difficulty understanding a teacher’s hesitancy to surrender even small amounts of time. While working as a school psychologist, one of us (Larson) was approached by a teacher, who requested that he administer an intelligence and an achievement test to all 32 of her second-grade pupils. Because it was September, she reasoned that the data would be a helpful guide in her instruction as the year progressed. This well-meaning teacher was ignorant of the other demands on the psychologist’s time and may not have understood either his initial look of horror or his attempts to gently suggest an alternative strategy.

In similar fashion, nonteaching support personnel must respect classroom teachers’ ownership of their available time. An honest estimate, based on experience if possible, should be provided so that teachers can realistically assess their availability to participate. For example, the group leader might say the following:

“In my experience, teachers have found that an extra 10 minutes per day is the average time they have devoted to the Anger Coping Program responsibilities, with perhaps a little more on our meeting day.”

Or:

“Well, this is my first group, so I am unsure about what your time commitment might be. Can we see how the first week goes and make any adjustments we feel necessary at our next meeting?”

It is also important to be open to teachers’ conclusions about what they can or cannot do. When teachers say, “I’ll do this, but I don’t think I have time to do that,” they almost always mean it. Trying to persuade a reluctant teacher to agree to additional intervention time creates a genuine danger that he or she may say yes to an unrealistic commitment. Such a collaboration, in which one partner believes that he or she is working too hard, is not a healthy situation for either party.

The Teacher as an Agent for Generalization

Treatment is not only about change, it is about generalization of that change. It is one thing to demonstrate anger management skills in the group room, but it is quite another to do so in the authentic environment of the classroom. Most experienced group leaders working with children who show angry, aggressive externalizing behavior problems in the school setting have anecdotes about failure to transfer or generalize what was supposedly learned in the therapy room. The experience of a group leader believing a student client may now have finally acquired alternative-to-aggression skills, only to find that student fighting before the morning is out, is not an unusual one. Working hard in the treatment room but leaving generalization to chance often yields predictable results:

GROUP LEADER: He teased you and you hit him? STUDENT: Yeah.

GROUP LEADER: But didn’t we just work on that in the group? STUDENT: Yeah.

GROUP LEADER: And what is the thing to do? STUDENT: Just walk away or use my self-talk to calm down. GROUP LEADER: Why didn’t you do either of those? STUDENT: I don’t know.

A useful example with which readers may identify is a student learning to drive an automobile. The simulators in the driver’s education classes provide an opportunity to enact many of the behaviors necessary for the required skills in the safety of the classroom. It is, however, unimaginable that students would subsequently be handed the car keys without additional effort aimed at getting them to generalize those skills to a “real” situation. “Learner vehicles” with dual breaking systems and giant, cone-lined driving courses are all a part of that generalization effort.

Elliott and Gresham (1991) discussed three classes of generalization: setting generalization, behavior generalization, and time generalization. Setting generalization refers to the child’s ability to exhibit a behavior out of the setting in which it was originally trained. For example, if a child has been taught to use self-instruction to control angry outbursts in the training group and then subsequently uses this skill in the classroom, setting generalization has occurred. If a child has learned a problem-solving procedure in the therapy situation and later utilizes that procedure to nonaggressively resolve a problem on the playground, then setting generalization has occurred.

Behavior generalization refers to behavior changes that are related to, but are not the focus of, direct training. For example, a child who was trained to replace aggression with verbal assertion in peer interaction is observed to have also begun to use negotiation strategies. Related behaviors in response to the same problem situation are grouped together under the rubric functional response class. Students referred for intervention because of aggressive behavior may have numerous verbally and physically aggressive responses available to them. For instance, a student accused of misbehavior by the teacher might throw a book, knock over a desk, swear at, threaten, or even assault the teacher, particularly if any or all of these responses have led to a positive outcome in the past. All of these behaviors belong to a functional response class. One of the goals of direct intervention, therefore, is to establish and expand the more adaptive functional response class.

Finally, time generalization refers to the ability of the child to maintain the intervention behaviors after the training is discontinued. Behaviors will be maintained to the extent that they continue to be functional and reinforced. Changes that occur during treatment stand a greater likelihood of maintaining or generalizing over time if the reinforcements remain the same (Kazdin, 1982; Martens & Meller, 1990). This finding argues for the use of naturally occurring reinforcers such teacher and peer approval or positive regard ultimately used to replace any more artificial procedures.

There is, however, absolutely no research suggesting, or reason to believe, that skills trained in the group room will transfer or generalize usefully anywhere else—whether to the classroom, the playground, or the neighborhood—without specific generalization guidelines built into the fabric of the intervention. Pupil insight and skill mastery within the setting of the group room are critical prerequisites, but they are only prerequisites. The most important objective—in-deed, the raison d’être of the entire effort—is to facilitate the adaptive transfer of the desired skill to the authentic environments of school and home. The mechanism for this to happen cannot be conceived as an afterthought or an add-on; it must be integrated into the structure of the intervention at the onset. Too much is at stake in the lives of these children to rely on the “train and hope” model.

Lochman and Wells (1996) pointed out that children who have a history of noxious behavior in the classroom setting create an expectation on the part of the teacher that the behavior will continue. This creates a self-perpetuating mechanism in which the teacher assumes that a particular child is responsible for any disruptive behavior and may automatically blame the child even in questionable circumstances. The unfairly blamed child then responds in anger and quickly transforms him-or herself from “victim” to “perpetrator,” reinforcing the teacher’s belief. This insight makes it absolutely essential that the teacher become an active, full partner in the intervention process.

Ensuring that teachers have a sense of ownership in the effort at the outset by involving them systematically in the selection process is the first important step. The next step is to educate them regarding their specific roles. For teachers to take on these roles as true collaborators, it is necessary for them to know on what they are collaborating. Although this seems obvious, it is frequently the case that psychologists and counselors do not share the specifics of the treatment with classroom teachers. It may well be that some supportive service people prefer to mention a certain “mystique” about what happens in the treatment room, or, more likely, it may be that they have never perceived the need to be more forthcoming with teachers. The group leader and the classroom teacher, as a collaborative team, need each other to be as informed as possible about what is happening in the other’s environment. Role plays and behavioral rehearsals in the treatment room that are directly related to actual classroom dynamics are more useful to the child than those that are unrelated. Similarly, in the classroom the teacher is more able to accurately observe and reinforce a newly acquired treatment behavior if the teacher knows what to look for and expect.

For teachers of pupils in the anger control program to facilitate this generalization in the authentic environment, it is critical to provide them with an adequate understanding of the goals, objectives, and procedures of the intervention. The following serves as a useful procedure for group leaders in accomplishing this task:

1. Find 30 minutes to 1 hour in the week before the sessions begin when you can gather together all of the teachers in the building who will have students in the Anger Coping Program group. A group meeting is preferable because teachers can share concerns with one another, and it saves time.
2. Provide the teachers with a handout that summarizes the objectives of each session and offers suggestions for facilitating generalization in the classroom (see Appendix C for an example). If the Anger Coping Video (Larson, Lochman, & McBride, 1996) is available, it can provide a helpful visual aid for selected sessions.
3. Proceed through the sessions in order, discussing the objectives and soliciting ideas for mutual assistance—for example, “How can we best help one another so that the intervention is most effective? How might this skill be transferred to the classroom setting?”
   1. Solicit input from the teachers regarding treatment group be
   2. havior management strategies with the children identified for the intervention. Their knowledge of the children can prove valuable and allow initial meetings to progress more efficiently. For example, knowing ahead of time that Manuel is instantly angered by Jason’s chronic teasing about his father, or that Derrick responds very well to adult praise, can be of genuine assistance.
4. Make arrangements to meet with each teacher individually prior to the start of the first group meeting to gather behavioral data for the goal-setting activity.

Now that the teachers have a knowledge of the goals and structure of the treatment and have shared their concerns and ideas, their ability to function collaboratively with the group leader is increased. Our experience is that some teachers will welcome the new challenge and others will be less enthusiastic. Group leaders must always remember that the children were referred initially because their teacher viewed them as problematic, and the children remaining as candidates once the selection process is complete are the most problematic. It does not take much imagination to understand why a teacher, besieged with the needs of a classroom full of other children, cannot match the group leaders’ enthusiasm in addressing the needs of the most disruptive. As the process moves to the goal-setting interview, patience, support, and understanding will help carry the day.

GOAL ATTAINMENT EVALUATION UTILIZING THE GOAL SHEET PROCEDURE

A central feature of an effective anger control intervention involves the development by the individual group members of classroom behavioral goals. In the program manual contained in Chapter 7, the entirety of the second session is devoted exclusively to instruction and practice in the development and writing of personal behavioral goals. Each subsequent session opens with an evaluation of how the children are progressing toward these goals. Attained goals are replaced with newer ones.

A goal is defined for the group members as meeting the following two criteria:

1. Something you want and are willing to work for.
2. Something that is real and possible for you.

The training involves helping the group members devise classroom goals that address behaviors that are currently problematic but within their ability to alter in a positive direction. Overbroad, ill-defined goals such as, “I will not get into any trouble” are rejected in favor of more specific, behaviorally defined goals such as, “I will remember to ask permission to get out of my desk during seat work time.” The goals are written on individual Goal Sheets and delivered to the classroom teacher at the conclusion of each group session.

The group members’ goals are the major training link to generalizing behaviors to the authentic setting. The question of whether a group member has or has not attained his or her goal is the sole domain of the classroom teacher who signs the Goal Sheet (Appendix D) at the conclusion of each school day. This makes it essential that each goal, as derived and defined by the child, is clearly expressed and pertinent to teacher concerns. A goal devised by a child that the teacher sees as meaningless or too easy among the child’s larger constellation of problematic behaviors will work against both generalization and teacher cooperation. For instance, a child may express a goal of “no fighting in the classroom for at least 4 out of 5 days,” only to have the teacher confirm later that historically the child’s problem has been at recess and never in the classroom.

The Teacher Interview

To help ensure that the children will be using the Goal Sheet procedure to address classroom behaviors that their teachers agree are problematic, a pregroup conference between group leaders and the classroom teachers is essential. This conference should occur once the final roster of group members has been solidified and before the first meeting. The role of the Goal Sheet in the anger control intervention should be thoroughly explained to the teachers.

“If you will recall from our previous discussion of the Anger Coping Program curriculum, the children will be learning how to develop personal behavioral goals at our second meeting. This is a very critical aspect of our effort because it serves as one of the major bridges between what we are doing in the group room and what you are doing in the classroom. To facilitate the children’s goal development, it will be helpful for you to give me some guidance regarding the nature of their problems in your classroom. If I understand your concerns, I can more easily help guide the children toward useful, appropriate goals.”

Group leaders are urged to familiarize themselves with techniques of behavioral interviewing (e.g., Busse & Beaver, 2000; Kratochwill & Bergan, 1990) and, if necessary, goal development (e.g., Fuchs, 1995; Meichenbaum & Biemiller, 1998). Teachers of children with externalizing behavior problems often have a difficult time expressing their concerns in terms amenable to intervention. “He never does what he is supposed to do, he’s always out of his seat, blows up at everything, and he can’t keep his hands to himself” expresses the teacher’s frustration adequately but provides only minimal guidance for behavioral goal setting. Once teachers have described the problematic behaviors in their own terms, group leaders should encourage them to focus their concerns in a more behaviorally discrete manner.

GROUP LEADER: It certainly sounds like Michael is quite a handful. I am glad we have decided to work together on his problems. You mentioned that he doesn’t comply with your directions, hits other children, aggravates the hamster with his pencil, and pushes and shoves in the recess line. Are those the problems of greatest concern to you?

TEACHER: Yes, along with never finishing his seat work in math. GROUP LEADER: Okay, considering those problem behaviors, when you say that he “doesn’t comply with your directions,” what do you mean by that? Can you provide me with a typical behavior? TEACHER: I guess I mean that he is the slowest one in the class to comply with what I want them to do. I’ll say, “Take your social studies book out,” and 5 minutes later, Michael is still engaged in whatever we were doing previously.

Group leaders should work through the teachers’ concerns in such a manner as to acquire a useful behavioral definition of the problem. For example:

“In unstructured settings such as recess, Michael will strike an

other child with his fist when upset or frustrated an average of

three times per week.” “Michael will have to be told to keep his hands out of the hamster cage an average of once a day.” “Michael gets out of his seat without permission an average of four times per hour during seat work periods.”

Once these topographical descriptions of the behavior are agreed upon, the group leader should determine which of the behaviors the teacher believes to be within the ability of the child to self-monitor and exert some control. It is important to note that the behaviors need not of necessity be aggressive or anger-induced to be appropriate for the goal-setting activity, particularly at the outset. Aggressive, externalizing children often have a host of disruptive, poorly socialized behaviors that contribute to their overall problematic adjustment in school. The goals may address not only aggression toward peers, but social skills with peers, oppositional and disruptive behavior, and failure to complete various school tasks (Lochman & Wells, 1996). The objective of the goal-setting activity—again, particularly in the beginning of the intervention—is to provide the child with an opportunity to move him-or herself in a positive social direction through his or her own self-control efforts. Because Michael has been referred to the anger control group to learn anger and aggression management, it makes little sense to expect it from him early on. If, however, in the initial weeks he succeeds in reducing his out-of-seat behavior during seat work time, this can be viewed by all parties as a positive social and academic gain. As the training in the group progresses, those goals should become more directly associated with anger and aggression management.

GOAL ATTAINMENT EVALUATION USING THE MODIFIED GOAL ATTAINMENT SCALING PROCEDURE

Goal attainment scaling (GAS) as a procedure for monitoring progress in behavioral interventions has been widely used in community mental health programs for nearly 3 decades. The methodology involves (1) identification of a target behavior, (2) an objective description of the desired outcome of the proposed treatment, and (3) the development of three to five descriptions of the target behavior that approximate the desired outcome (Sladeczek, Elliott, Kratochwill, Robertson-Majaanes, & Callan-Stoiber, 2001). This procedure has applications in the Anger Coping Program with teachers who are motivated to spend a little extra time to provide the data. Appendix E provides a model GAS worksheet that we have found useful. With this procedure, the teacher determines a current level of performance relative to the classroom goal that the child has decided upon, develops a series of approximations, and rates the child daily in his or her efforts toward that goal.

For example, assume that the child’s goal is stated as follows: “I will not get out of my seat without permission during seat work time.” The rating scale is as follows:

0= Current level of performance, or what the child typically does during this time; the expected level of performance, perhaps 4 to 5 incidences of out-of-seat behavior; this is placed in the middle of the scale.

To the left of the expected level of performance on the scale:

+1 = Improvement over the expected level of performance, perhaps only 2 to 3 incidences +2 = Much improvement over the expected level of performance, perhaps 0 to 1 incidence

To the right of the expected level of performance on the scale:

–1 = Poorer than the expected level of performance, perhaps 5 to 7 incidences –2 = Worst possible outcome, much poorer than the expected level of performance, perhaps more than 7 incidences.

These data may then be quantified and charted by the group leaders over time to provide both a formative and summative progress measure of the effects of the intervention relative to the specified classroom goals. Readers interested in further discussion of goal attainment scaling are referred to Kiresuk, Smith, and Cardillo (1994), and for more general issues in outcome measurement, to Ogles, Lambert, and Masters (1996).

With the group members now identified, the teacher provided in-service in the intervention and enlisted as a collaborator, and the goal-setting activity prepared, the group leaders can begin the final preparations for the start of the intervention.

THE TEACHER AS GROUP CO-LEADER

Implementing the anger control group in a small-population classroom for students with emotional/behavioral disabilities can be an efficient and effective way to address some of the children’s behavioral problems. In such a scenario, the classroom teacher is an ideal candidate for the role of co-leader in partnership with an experienced school psychologist or counselor.

One of us (Larson) encountered the opportunity for such an arrangement while working as a school psychologist in a large elementary school. Following a presentation to the general faculty on the roles of the school psychologist, including a brief discussion of implementing anger control training, he was contacted by one of the special education teachers. Her classroom was composed of fourth-and fifth-grade students who had been diagnosed with emotional/behavioral disabilities. It was a resource-type classroom, into which various groupings of students came and went during the day, depending on the instructional settings described in their Individualized Education Plans (IEPs).

The teacher approached the school psychologist with concerns regarding a particular group of fourth-grade children whom she saw for a 2-hour block daily for math and science instruction. She described the children as similarly impulsive, quick to anger, and quick to fight. The teacher was concerned because so much of her time was dedicated to physically restraining students or putting herself between a pair of potential combatants that very little math or science was being taught or learned. These patterns of behavior were also carried over into the general education inclusion classes and onto the playground. She wondered whether she could collaborate on an anger control program with her entire classroom of students.

The school psychologist observed the classroom and reviewed the existing assessment information in the special education folders. Clearly, five of the children were a handful and were everything the teacher described them to be. A sixth boy and a single girl, who completed the classroom population, were much more inhibited and withdrawn than the other five. Parental consent for additional assessments were obtained for the five aggressive children. The teachers of the general education inclusion classroom were asked to complete a broadband classroom rating scale on each child, and parents were asked to complete the home version. The resulting data, although somewhat variable among the children and demonstrating some anticipated differences between settings, was supportive of significant externalizing difficulties in the school setting for each child.

Because the students were in special education, an IEP team had to be convened for each student in order to approve the adjustments in the plan for the Anger Coping Program and to provide an alternative instructional setting for the two children who would not be involved. At those meetings the intervention was explained to the parents, and informed consent was obtained.

The classroom teacher had a solid training foundation in behavior modification techniques, but needed to learn the procedures in the Anger Coping Program before the program could begin. Before the start of the school day, the school psychologist helped the classroom teacher to learn the intervention. It was decided that the school psychologist would take the role of the skills trainer while the teacher would take the role of managing group behavior.

This teacher was a truly outstanding co-leader. Her deep knowledge of the children and the skills she learned and applied as a behavior manager within this setting were a perfect complement to the skills of the school psychologist. Although no “publication-ready” behavioral data were obtained on the effectiveness of this intervention, the teacher was clearly pleased with the effects, and a graphing of discipline reports showed a trend in a positive direction. Anecdotal reports from the general education classroom teachers were also encouraging.

When working with a teacher as a co-leader in “ready-made” groups such as described, group leaders should keep the following in mind:

1. For students who are protected under the Individuals with Disabilities Education Act (IDEA), additional approval procedures are required prior to implementation of any behavioral intervention not already defined in the IEPs. This can be a time-consuming task that the teacher may not have anticipated.
2. Be certain that the teacher has cleared his or her schedule for the period of the intervention and knows that it must be maintained for the duration. As busy as most teachers are, it is enticing for them to occasionally double-schedule the time slot for other obligations, knowing that their co-leader will be with the class. Although this may be the innocent move of an overtaxed educator, it can have a disruptive influence on the group.
3. Help the teacher to avoid problems with his or her dual role as sometimes the students’ teacher and sometimes the group co-leader. Being able to “take off the teacher’s hat and put on the co-leader’s hat,” leaving any previous interpersonal classroom problems behind, can sometimes be a challenge.
4. Remember that it is ethically irresponsible to involve a child in an intervention for whom an assessment has not indicated a need. Take care not to allow some students to “sit in” on the group only because they happen to be assigned to a particular classroom at the time scheduled for the anger control program. It may indeed be true for some that “it won’t hurt them any,” but psychological or counseling services are not delivered under such premises. Alternative programming, consistent with the IEP or other educational plan, should be provided.
5. Our experience is that co-leaders can successfully lead a group of as many as seven children. A single leader is advised to limit the group to four or five children.

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