Reducing Adolescent Clients' Anger in a Residential Substance Abuse Treatment Facility

Background: Sundown Ranch, a residential behavioral health care treatment facility for adolescents, tracked the progress and results of treatment by selecting performance measures from a psychosocial screening inventory. The temper scale was one of the two highest scales at admission and the highest scale at discharge. A clinical performance improvement (PI) project was conducted to assess improvements in clients' ability to manage anger after the incorporation of Rational Emotive Behavior Therapy (REBT) into treatment. Methods: Eighteen months of baseline data (July 1, 1999-February 1, 2001) were collected, and 20 months of data (May 1, 2001-December 31, 2002) were collected after the introduction of the PI activity. In all, data were collected for 541 consecutive admissions. Results: A comparison of five successive quarterly reviews indicated average scores of 1.4 standard deviations (SDs) above the mean on the temper scale before the PI activity and .45 SD above the mean after. The performance threshold of reduction of the average temper scale score to <= 1 SD was met for 17 of 20 months. Discussion: The fact that the PI activity reduced the temper scale elevations by almost one full SD is highly suggestive of the efficacy of REBT with the treatment population. After the project was completed, REBT was promoted as an additional therapeutic modality within the treatment program.