Addiction and Anger Issues

Updated SAMHSA workbook for Addiction and Anger Issues

“Don’t make me angry. You wouldn’t like me when I’m angry.” These are the words of mild-mannered Bruce Banner in the 70’s TV show The Incredible Hulk. As a kid, I couldn’t wait to watch each week’s episode. I can still see the Hulk, played by massive Lou Ferrigno, battling it out with Bigfoot in a TV classic.

Many addicts, like Bruce Banner, have anger simmering just below the surface that, when triggered, can explode in rage on those around them. Others are inwardly angry but avoid and suppress it through addictive behaviors.

To help address the connection between addiction and anger, the Substance Abuse and Mental Health Services Administration (SAMHSA) recently released a clinicians guide for a 12-week cognitive-behavioral anger management group.

They state that the content “includes specific instructions and suggested remarks for group leaders, and exercises for group members. This model will work in a variety of clinical settings and with diverse audiences.”

The guide book, called Anger Management for Substance Use Disorder and Mental Health Clients: A Cognitive-Behavioral Therapy Manual, is an update of the same title from 2002.

It also comes with a companion participant guide called Anger Management for Substance Use Disorder and Mental Health Clients: Participant Workbook. Both are free for download at the SAMHSA website.

Elinore F. McCance-Katz, M.D., Ph.D., Assistant Secretary for Mental Health and Substance Use at SAMHSA writes in the introduction of the manual, “Anger and substance use disorders often co-occur, increasing the risk for negative consequences such as physical aggression, self-harm, distressed relationships, loss of a job, or criminal justice involvement.”

humility-before-changeFor addiction and anger Issues, there are four types of cognitive-behavioral interventions are included as part of the group process:

  • Relaxation training which targets the emotional and physiological components of anger.
  • Cognitive interventions target cognitive processes such as building awareness of cues and triggers, hostile appraisals and attributions, maladaptive beliefs, and inflammatory thinking.
  • Communication skills interventions target strengthening assertiveness and conflict resolution skills.
  • Combined interventions integrate two or more CBT interventions and target multiple response domains.

Addiction and Anger Lesson Plan

The leader manual for clinicians is 60 pages long. It is robust and detailed and provides lesson plans for each week of the 12-week course. These are the weekly topics:

  • Session 1 – Overview of Group Anger Management Treatment
  • Session 2 – Events and Cues: A Conceptual Framework for Understanding Anger
  • Session 3 -Anger Control Plans: Helping Group Members Develop a Plan for Controlling Anger
  • Session 4 – The Aggression Cycle: How To Change the Cycle
  • Session 5 – Cognitive Restructuring: The A-B-C-D Model and Thought Stopping
  • Session 6 – Practice Session #1: Reinforcing Learned Concepts
  • Sessions 7 & 8 – Assertiveness Training and the Conflict Resolution Model: Alternatives for Expressing Anger
  • Sessions 9 & 10 – Anger and the Family: How Past Learning Can Influence Present Behavior
  • Session 11 – Practice Session #2: Reinforcing Learned Concepts
  • Session 12 -Closing and Graduation: Closing Exercise and Awarding of Certificates

It is evident that a great deal of time and effort has been put into this resource. For mental health professionals looking for quality anger management content, I would highly recommend considering this resource.


Substance Abuse and Mental Health Services Administration. (n.d.). Anger Management for Substance Abuse and Mental Health Clients: A Cognitive-Behavioral Therapy Manual. Retrieved December 4, 2019, from

About the Author:

Travis StewartTravis Stewart, LPC has been mentoring others since 1992 and became a Licensed Professional Counselor in 2005. His counseling approach is relational and creative, helping people understand their story while also building hope for the future. Travis has experience with a wide variety of issues which might lead people to seek out professional counseling help. This includes a special interest in helping those with compulsive and addictive behaviors such as internet and screen addiction, eating disorders, anxiety, and perfectionism. Specifically, he has worked with eating disorders since 2003 and has learned from many of the field’s leading experts. He has worked with hundreds of individuals facing life-threatening eating disorders in all levels of treatment. Travis’ website is

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Reviewed and Approved by Jacquelyn Ekern, MS, LPC on December 30, 2019
Published December 30, 2019, on

About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.