A Guide for Counselors to Address a Client’s Rage at Any Age: Emotional Intelligence and the Development of

Emotional Regulation

AACC World Conference

Pre-Conference Workshop

Nashville, TN

Introductions

Anita Knight Kuhnley,

Ph.D.E. John Kuhnley, MD

Photo Credit: Brett Hartley Photo Credit: Olan Mills

Laughter is the Best Medicine.

A boy smiling for the camera. Retrieved from https://unsplash.com/photos/sAmwQxM_3FI

• Participants will:

1) Understand the experience of anger and rage of individuals in the world of

the child, adolescent, and adult, including psychiatric conditions that include

anger and rage.

2) Understand emotional intelligence including emotion-regulation, and the

counselor’s role in assisting clients in skill development.

3) Recognize the importance of a comprehensive life approach to helping

individuals develop self-awareness and emotion-regulation.

Objectives

The reason we got started…

Starting with Why?

• Sinek’s (2009) Golden Circle• What is our what?

• Identify and regulate emotions, specifically rage• What is our how?

• Skills associated with emotional intelligence, attachment system regulatory functions, research-based interventions, and medication when necessary

• What is our why?• Create a safer world for tomorrow’s generation by

helping children of all ages learn “feelings are mentionable, manageable” and modifiable

• Who?• Counselors and Clients

Silvey, Knight, & Sibcy (2019)

Why why?

1) Understand the experience of anger and rage of individuals in the world of

the child, adolescent, and adult, including psychiatric conditions that include

anger and rage.

The Experience of Anger & Rage

(Kuhnley,2013)

ANGER is………..

A normal emotion in reaction to perceived:–Threat of harm to self, others, property

•Incitement of the fight / flight / freeze response

–Being wronged, offended, challenged, shamed, or unfairly treated or

witnessing suchTypes of anger include:

–Situational / episodic

–Dispositional / characterological

–Purposeful / manipulative (Kuhnley, 2013)

The Continuum

ANNOYANCE

DISTRACTION

DISAPPOINTMENT

FRUSTRATION

IRRITATION

AGITATION

ANGER

RAGE

FURY

https://pixabay.com/photos/young-woman-isolated-arms-crossed-3061646/

https://pixabay.com/photos/annoyed-woman-irate-angry-mad-3126442/

https://pixabay.com/photos/furious-upset-person-woman-angry-2514031/

https://pixabay.com/photos/young-woman-isolated-arms-crossed-3061646/https://pixabay.com/photos/annoyed-woman-irate-angry-mad-3126442/https://pixabay.com/photos/furious-upset-person-woman-angry-2514031/

Causes of Irritability

•Normal Development Adjustments / Change

–Preschoolers and Adolescents

•Nutritional Deprivation/Inadequacy

•Psychosocial Circumstances/Interactions

•Traumatic Experiences/Abuse

•Sleep Deprivation

•Allergic Conditions

•Psychiatric Conditions

•Substance Use/withdrawal

•Medical Conditions

•Inflammation

•Medications

•Toxins

(Kuhnley)

ANGER

•Anger may cause a loss in self-monitoring capacity and objective observability

•Anger may be internalized or externalized

•Anger may have physical correlates such as increases in

heart rate, blood pressure, and levels of adrenaline and

noradrenaline.

(Kuhnley)

THE LIMBIC SYSTEM

Structures including:

❖ Amygdala,

❖ Hippocampus,

❖ Thalamus,

❖ Hypothalamus,

❖ Basal ganglia, Fornix

and Cingulate gyrus.The limbic system. Retrieved from

https://courses.lumenlearning.com/boundless-psychology/chapter/structure-

and-function-of-the-brain/

https://courses.lumenlearning.com/boundless-psychology/chapter/structure-and-function-of-the-brain/

THE LIMBIC SYSTEM

Functions including:

❖ Emotion (Anger, fear)

❖ Behavior,

❖ Motivation

❖ Long term memory,

❖ Learning

The limbic system. Retrieved from https://courses.lumenlearning.com/boundless-

psychology/chapter/structure-and-function-of-the-brain/

https://courses.lumenlearning.com/boundless-psychology/chapter/structure-and-function-of-the-brain/

The Brain

Frontal lobe controls cognitive skills: attention, reasoning, problem-solving, planning, organizing, language and communication, memory, judgment, impulse control, social and sexual behaviors, and personality

Temporal lobe is involved in processing sensory input or information.

Cerebellum is in the back of the brain. It provides for maintaining balance, coordinating eye movements, posture, and smooth body movement.

Basal ganglia include the globus pallidus, caudate nucleus, subthalamic nucleus, pallidum, putamen, and substantia nigra. Among the numerous functions, they serve to facilitate and coordinate movement and motor learning.

Function of Human Brain with Diagram. Retrieved from https://www.humanbrainfacts.org/human-brain-functions.php

https://www.humanbrainfacts.org/human-brain-functions.php

The Frontal Cortex

The frontal cortex is important for the regulation of anger and the basic threat response. Different parts of the frontal lobe have been found to decrease amygdala activity which could have implications with emotional suppression.

(Kuhnley, 2013)

Differential Diagnosis & Comorbidity

(Kuhnley, 2013)

Aggression / Anger

•ODD = common; purposeful, not impulsive; fail to take responsibility

•ADHD = less common; impulsive, less purposeful; remorseful

•ANX = not common; fight or flight reaction to fear; impulsive or reactive

during episodes of anxiety; remorseful; more directed inward than outward

•MDD = not common; reactive during episodes of depression; remorseful;

more directed inward than outward

•BD = episodic and may be sustained during episode

•DMDD = non-episodic rages, i.e. not a change from baseline chronic irritability

(APA, 2013)

Severe Mood Dysregulation

(Leibenluft, 2011)

Amplification of Frustration

(Leibenluft, 2011)

Ellen Liebenluft

The anterior cingulate cortex and medial frontal gyrus—both

hyperactivated in children with SMD (Severe Mood Dysregulation)

following negative feedback—were the same areas activated in

healthy control children following positive feedback.

“It makes you think about cognitive training or therapies that could

perhaps train children with SMD to pay greater attention to positive

feedback and less attention to negative feedback,” Leibenluft (2011)

said.

Unpacking Emotional Intelligence & Emotion-Regulation

2) Understand emotional intelligence including emotion-

regulation, and the counselor’s role in assisting clients in skill

development.

Demonstration

Step 1: Think of a situation that brought frustration or even anger

Sep 2: clench fists

Step 3….

Circle of Security and Organizing Feelings

Photo Credit: Anita Kuhnley

Symbol used for secure base= open hands.

Nesting hands (Marvin & Seagroves, 2017)

Side Note: Linehan’s strategy of willing hands to diffuse anger.

(Marvin & Seagroves, 2017)

(Graphic used with

permission from:

Hawkins, Knight,

Sibcy, Silvey &

Warren, 2019)

Bob Marvin, to all counselors on the topic of Attachment

(Marvin & Seagrove, 2017)

(Wimmer & Brady, 2002)

Retrieved from:

https://www.gocomics.com/search/roseisrose?ut

f8=✓&terms=fully+charged+indicator+wiggle

https://www.gocomics.com/search/roseisrose?utf8=%E2%9C%93&terms=fully+charged+indicator+wiggle

Links: Between EI, Attachment, & Anger

The attachment system serves a regulatory function (Coan, 2010)

Attachment, circle of security demonstrates part of the role of the attachment figure is to help one make sense of feelings

Emotional Intelligence, can involve organizing feelings through the process of identifying/labeling them, using them to inform thought, using them to provide a fuller understanding of life’s events. .

(Knight &

Sibcy, 2018

Redeeming

Attachment)

EI Schools of Thought

Models of Emotional Intelligence

Popular

Research Based

Ability Model (Mayer, Caruso, & Salovey, 2016)

Self-report; Trait based Model (Petrides, 2010)

Daniel Goleman’s Model of EI (2006)

Skills involved in EI

1) Identify emotions2) Use emotions to facilitate thoughts3) Understand emotional info4) Manage emotions

(Mayer, Caruso, & Salovey, 2007)

Hierarchical Abilities

(Sibcy & Knight, 2013; Modified from Salovey & Saluter , 1997)

Using Emotions to facilitate Thought

Second branch of emotions-

Using emotions to facilitate thought

Ask the following questions:

- What is the emotion telling me?

- What do i need to learn from this?

- Why am I having this emotion?

-understanding of the brain

- cingulate gyrus the brain’s gear shifter (stuck on an emotion)

Climbing the Tree

If we travel up the branches to get to a spot with a clear perspective:

1) Identify emotion

Ex: sadness

1) Emotion to facilitate thought

Ex: Sad mood, may influence my perspective

3) Understanding and Managing Emotions

*Interpret meaning emotions convey

For ex: Sadness often communicates loss of something of value. I feel sad when I miss my grandmother, since she died a few months ago.

4) Regulate- involves engaging or detaching based on utility

For ex: Tonight I need to complete paperwork, thinking on this will make it hard to focus, I may need to re-engage these feelings on the weekend and take time to cry, journal, look at pictures/create a photo album/memory books.

(Mayor, Caruso, & Salovey, 2007)

What Emotion is Conveyed Here?

I want to be creative

What emotion may promote creativity?

Thought Bubble. Retrieved from https://pixabay.com/photos/thought-idea-innovation-imagination-2123970/

https://pixabay.com/photos/thought-idea-innovation-imagination-2123970/

Trait Based EI

We conducted research exploring the correlation between trait-based EI and Counselor Burnout (Harrichand, Captari, & Knight, 2017).

As EI increases, burnout decreases; we are developing EI trainings to help protect counselors from burnout

https://pixabay.com/vectors/shield-axe-sword-crest-armor-33957/

https://pixabay.com/vectors/shield-axe-sword-crest-armor-33957/

Identifying Traits (Petrides, 2010)

Facets High Scorers perceive themselves as:

▰ Adaptability… flexible and willing to adapt to new conditions ▰ Assertiveness… forthright, frank and willing to stand up for their rights ▰ Emotion perception (self and others)… clear about their own and other people's feelings▰ Emotion expression… capable of communicating their feelings to others▰ Emotion management (others)… capable of influencing other people’s feelings ▰ Emotion regulation… capable of controlling their (own) emotions▰ Impulsiveness (low)… reflective and less likely to give in to their urges▰ Relationships…capable of having fulfilling personal relationships▰ Self-esteem… successful and self-confident▰ Self-motivation… driven and unlikely to give up in the face of adversity▰ Social awareness… accomplished networkers with excellent social skills▰ Stress management… capable of withstanding pressure and regulating stress▰ Trait empathy… capable of taking someone else’s perspective ▰ Trait happiness… cheerful and satisfied with their lives▰ Trait optimism… confident and likely to ‘look on the bright side of life’

Other Benefits of Trait EI

Trait EI is positively linked to functional coping strategies:

• Problem-solving,

• Social support seeking,

• Reappraising,

And negatively linked to dysfunctional strategies:

• Inhibition of emotional expression,

• Substance abuse

(Mikolajczak, Petrides, & Hurry, 2009)

Developing EI Traits

(Mikolajczak, Petrides, & Hurry, 2009)

“Also, one day workshops or seminars can be useful in raising

awareness of EI, but in themselves are unlikely to lead to the kind of

change that would be required for a person to successfully improve

their EI (Zeinder, Roberts, & Matthews, 2008). It may take several

weeks, with periods of relection between activities to effect longer

lasting change”

“A journey of a thousand miles begins with a single step”

- Chinese proverb, (Lao Tzu, nd.)

(Petrides, 2009)

The Trait emotional intelligence questionnaire short form is

available for a donation. It is a very useful one page assessment.

Please see this website for more information:

http://psychometriclab.com/obtaining-the-teique/

An example of an item on the assessment is:

“Expressing my emotions with words is not a problem for me.”

Participants are asked to rank this on a likert scale.

Assessments like the MSCEIT and the TEIQUE-SF and TEIQUE

may be helpful for use with clients with difficulties with emotion

regulation, or who want to work on enhancing emotional

intelligence.

http://psychometriclab.com/obtaining-the-teique/http://psychometriclab.com/obtaining-the-teique/

Attachment & EI

Attachment serves a regulatory function (Coan, 2010)

Research has revealed that caregiving experiences inform the development of both self-regulatory and neuro-regulatory processes over the course of the life span (Schore, 2016).

Emotion regulation is a branch of EI, or a trait of EI & develops rapidly during childhood

https://pixabay.com/illustrations/brain-heart-brain-

icon-3269655/

https://pixabay.com/illustrations/brain-heart-brain-icon-3269655/

Attachment styles and Anger

Avoidant - dismissing; cold

Ambivalent- preoccupied; oscillations; frustrated

Secure- regulated

Disorganized- highly unregulated, changing from dismissing and cold, to pre-occupied/hot anger, to regulated, and a combination of all.

If disorganized lack a positive mental rep= strategies like Father’s love letter

Video retrieved from:

https://youtu.be/6TcxA_7_fi8

Tools and Strategies for Regulation

Tools. Retrieved from https://pixabay.com/photos/tools-hammer-nail-nails-drill-nut-15539/

https://pixabay.com/photos/tools-hammer-nail-nails-drill-nut-15539/

EAR DEMONSTRATION

EAR

Empathy

Assertiveness

Respect

From David Burns Essentials of Good Communication

(Burns, 2008, p. 71)

Bio-Psycho-Social-Spiritual Model

3) Recognize the importance of a

comprehensive life approach to

helping individuals develop self-

awareness and self-regulation.

Multimodal (Integrative) Treatment

(Kuhnley, 2013)

The Neuroscience of Anger

● Biological considerations● What do we know about

the brain and anger?

https://pixabay.com/illustrations/brain-anatomy-human-science-health-512758/

https://pixabay.com/illustrations/brain-anatomy-human-science-health-512758/

Neuroscience of Anger

Daniel Amen (2015, p. 4) Recommend clients read:“Change your brain change your life: The breakthrough guide to conquering anxiety, depression, obsessiveness, anger, and impulsiveness”

Temporal lobe is associated with emotional stability

(Amen, 1998)

Enhancing the temporal lobe

Temporal lobe workouts can come in the form of:

- Learning a musical instrument- dancing/ moving in rhythmic ways - Creating an album of positive experiences to look back at - (Amen, 2015, p 264-268)

Spiritual Interventions/Neuro-theology

● The right temporal lobe is associated with spiritual experiences● Wired into our brains for God to communicate with us● This part of the brain is active during prayer/meditation● Andrew Newberg, Professor and Researcher at an institute of

integrative health ● Conducted research on Franciscan nuns using SPECTS & found

increased PFC activity ● Amen described brains for those engaged in prayer and

meditation had fuller, healthier and less anxious

(Newberg, 2019)

Social

Research examining the impact of suppression in emotions during transition to

college revealed three social costs associated with suppression of emotion:

● Lower social support

● Less closeness to others

● Less social satisfaction

(Srivastava, Tamir, McGonigal, John, & Gross, 2009; p. 883)

Demonstrates the importance of helping people organize their feelings

Psychological

3 M’s

Mentionable

Manageable

Modifiable

Contrasted with the 3 F’s

Fight

Flight Freeze

Anger in Children

Daniel tiger https://www.youtube.com/watch?v=ljWp8_5zvPM

https://www.youtube.com/watch?v=ljWp8_5zvPM

Mister Rogers- Regulation in action

(Kuhnley, 2020)https://www.youtube.com/watch?v=fKy7ljRr0AA

https://www.youtube.com/watch?v=fKy7ljRr0AA

Psychological Approach

● ANT’s

(Amen, 2010)

DBT Emotion Regulation Skills, examples

STOP SKills:

What Is the STOP Skill?

The STOP skill consists of the following sequence of steps: Stop, Take a step back, Observe, and

Proceed mindfully.

*Treatment to avoid first impulse

Willing hands:

Doing the opposite of clenched fists (anger) to open hands

(Linehan, 2015)

Why

The EI of anger- communicates something important to us regarding injustice, perceived threat, blocked.

Triggers Fight or Flight or Freeze

How to switch to 3 M’s

▻ Mentionable, mangeable, modifiable

MIndfulness*

3 M’s

(McGuire, 1993; Rogers, 1969; Kuhnley, 2020)

Building upon the

work of Dr.

McFarland & Mister

Rogers

Other considerations

If you sense something neurological is happening- Dr. Daniel Amen has shared a case where a cyst had to be removed because it was producing aberrant behavior and created higher risk for the client due to the location of the cyst

He reported 15 other cases associated with aggression that required a surgery to remove a cyst

Do not be afraid to refer clients to a neurologist to rule out a brain abnormality

Recommended Resources

https://pixabay.com/photos/book-table-read-knowledge-wisdom-2592783/

Recommended Resources/Readings by topic

▰ Attachment:

▰ Clinton, T., & Sibcy, G. (2009). Attachments: Why you love, feel, and act the way you do. Brentwood, TN: Integrity Publishers.

▰ Knight, A. M. & Sibcy, G. A. (2018). Redeeming Attachment: A Counselor’s guide to facilitating attachment to God and earned security. Dubuque, IA: Kendall Hunt Publishing. Free chapter available at: https://he.kendallhunt.com/product/redeeming-attachment-counselors-guide-facilitating-attachment-god-and-earned-security

▰ Hawkins, R., Knight, A., Sibcy, G., Silvey, J. & Warren, S. (2019). Research based counseling skills: The art and science of therapeutic empathy. Available at: https://he.kendallhunt.com/product/research-based-counseling-skills-art-and-science-therapeutic-empathy

https://he.kendallhunt.com/product/redeeming-attachment-counselors-guide-facilitating-attachment-god-and-earned-securityhttps://he.kendallhunt.com/product/research-based-counseling-skills-art-and-science-therapeutic-empathy

Recommended Resources/Readings by topic

▰ Brain:

▰ Amen, D. G. (1998). Change your brain change your life: The breakthrough program for conquering anxiety, depression,

obsessiveness, lack of focus, anger, and memory problems. New York,

NY: Harmony Books.

▰ https://www.amazon.com/Change-Your-Brain-Revised-Expanded/dp/110190464X/ref=sr_1_3?keywords=amen+Change+your+brain+change+your+life&qid=1572468291&sr=8-3

▰

https://www.amazon.com/Change-Your-Brain-Revised-Expanded/dp/110190464X/ref=sr_1_3?keywords=amen+Change+your+brain+change+your+life&qid=1572468291&sr=8-3

Recommended Resources/Readings by topic

▰ Interventions:

▰ Kuhnley, A. (2020 forthcoming). The Mister Rogers Effect: 7 secrets to brining out the best in yourself and others from America’s beloved neighbor. Ada, MI: Baker Books.

▰ Linehan, M. M. (2015). DBT skills training: Handouts and worksheets (2nd ed.). New York, NY: Guilford Publications. Retrieved from

https://projecticee.files.wordpress.com/2018/12/lin-c-dbt-handouts.pdf

▰ Emotion regulation resources for kids:

▰ Daniel Tigers’ Neighborhood PBS

▰ Mister Rogers’ Neighborhood PBS

Recommended Resources/Readings by topic

▰ Parenting:

▰ Kuhnley, EJ. (1999). Program for Effective Parenting, Winchester, Virginia: PEP Publishing.

▰ Available directly from the author, email jk1951va@Hotmail.com

mailto:jk1951va@Hotmail.com

References

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obsessiveness, lack of focus, anger, and memory problems. New York, NY: Harmony Books.

Amen, D. G. (2010). Automatic Negative Thoughts [web log post].

Amen, D. G. (2015). Change your brain change your life: The breakthrough program for conquering anxiety, depression,

obsessiveness, lack of focus, anger, and memory problems. New York, NY: Harmony Books.

APA (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Association.

Burns, D. D. (2008). Feeling Good Together: The Secret to Making Troubled Relationships Work. Harmony.

Cicchetti, D., & Toth, S. L. (1998). The development of depression in children and adolescents. American Psychologist, 53(2), 221–

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Coan, J. A. (2010). Adult attachment and the brain. Journal of Social and Personal Relationships, 27(2), 210-217.

doi:10.1177/0265407509360900

Danieldeibler. (2015). May 1, 1969: Fred Rogers testifies before the senate subcommittee on communications [Video]. Retrieved

from https://www.youtube.com/watch?v=fKy7ljRr0AA

Daniel Tiger’s Neighborhood. (2018). Daniel Tiger when you feel so mad you want to roar song [Video]. Retrieved from

https://youtu.be/ljWp8_5zvPM

Eisenberg, N., Spinrad, T. L., & Eggum, N. D. (2010). Emotion-related self-regulation and its relation to children's maladjustment.

Annual review of clinical psychology, 6, 495–525. doi:10.1146/annurev.clinpsy.121208.131208

Goleman, D. (2006). Emotional Intelligence: Why it can matter more than IQ (the 10th anniversary ed.). New York, NY: Bantam

Dell.

Harrichand, J., Knight, A., & Captari, D. (2017). The Impact of Emotional Intelligence on Counselor Burnout. Virginia Counselors

Journal, 35, 40-46. Retrieved from

https://www.academia.edu/36714618/The_impact_of_emotional_intelligence_on_counselor_burnout_vca_journal_spring

References Continued

Kuhnley, A. K. (Forthcoming: 2020) The Mister Rogers Effect: 7 Secrets to Bringing Out the Best in Yourself and Others from America’s

Beloved Neighbor. Ada, MI: Baker Publishing Group.

Hawkins, R., Knight, A., & Sibcy, G., Silvey, J., & Warren, S. (2019). Research-based counseling skills: The art and science of therapeutic

empathy. Dubuque, IA: Kendall Hunt.

Lao Tzu. (nd.). Tao Te Ching.

Leibenluft, E. (2011). Severe mood dysregulation, irritability, and the diagnostic boundaries of bipolar disorder in youths. American Journal of

Psychiatry, 168(2), 129–142. https://doi.org/10.1176/appi.ajp.2010.10050766

Linehan, M. M. (2015). DBT skills training: Handouts and worksheets (2nd ed.). New York, NY: Guilford Publications. Retrieved from

https://projecticee.files.wordpress.com/2018/12/lin-c-dbt-handouts.pdf

Marvin, B., & Seagroves, A. (2017). Attachment workshop. Liberty University Medical School. Lynchburg, VA. Retrieved from

http://theattachmentclinic.org/AboutUs/circle_of_security.html

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North Tonawanda, NY: Multi-Health Systems. Retrieved from https://humancapitaltalent.co.za/wp-content/uploads/2018/11/MSCEIT-

Personal-Summary-Report.pdf

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McGuire, P. A. (1993, May 14). Welcome to the neighborhood Mr. Rogers soft sell still smoothes the way. The Baltimore Sun. Retrieved from

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Mikolajczak, M., Petrides, K. V., & Hurry, J. (2009). Adolescents choosing self-harm as an emotion regulation strategy: The protective role of

trait emotional intelligence. British Journal of Clinical Psychology, 48(2), 181-193. doi:10.1348/014466508X386027

Newberg, A. (2019). How do meditation and prayer change our brains. Retrieved from http://www.andrewnewberg.com/research

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%20contents)%20-%20KV%20Petrides.pdf

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Salovey, P., & Sluyter, D. (1997). Emotional development and emotional intelligence: Educational Implication. Basic Books: New York:

NY.

Schore, A. N. (2016). Affect Regulation and the Origin of the Self: The neurobiology of emotional development (Psychology Press &

Routledge Classic Editions). New York, NY: Taylor and Francis.

Sibcy, G. A., & Kuhnley, J. (2013). Childhood rage: Diagnosis and treatment strategies for severe mood dysregulation part 2: Diagnosis and

treatment. Faculty Publications and Presentations, 70. http://digitalcommons.liberty.edu/ccfs_fac_pubs/70

Silvey, J., Knight, A., & Sibcy, G. (2019). The journey of becoming. In R. Hawkins, S. Warren, A. Knight, & G. Sibcy (Eds.), Research-

based counseling skills: The art and science of therapeutic empathy. Dubuque, IA: Kendall Hunt.

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tedcomshare

Srivastava, S., Tamir, M., McGonigal, K. M., John, O. P., & Gross, J. J. (2009). The social costs of emotional suppression: a prospective

study of the transition to college. Journal of personality and social psychology, 96(4), 883–897. doi:10.1037/a0014755

Wimmer, D. & Brady, P. Rose is Rose. Fully Charged Indicator Wiggle. Retrieved from:

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Zeidner, M., Roberts, R. D., & Matthews, G. (2008). The science of emotional intelligence: Current consensus and controversies. European

Psychologist, 13, 64-78. Retrieved from https://doi.org/10.1027/1016-9040.13.1.64

Contact Info & Website

Anita Knight Kuhnley

https://dranitakuhnley.com/contact/

https://dranitakuhnley.com/contact/

When Counseling is not Enough

Excerpt from Introduction to Counseling

- Vignette of medication leading to engagement in counseling

- (Hawkins, 2019)

Additional reading bibliography (Composed by Rachel Birkeland)

Barnicot, K., & Crawford, M. (2018). Dialectical behavior therapy v. mentalization-based therapy for borderline personality disorder.

Psychological Medicine, 49, 2060-2068. doi:https://doi.org/10.1017/S0033291718002878

Through comparing the effectiveness of Dialectal Behavior Therapy (DBT) and Mentalization-Based Therapy (MBT) on 90 patients with

Borderline Personality Disorder (BPD) over a year, it was noted that DBT was significantly more effective than MBT. Patients had a more

evident decrease in self-destructive behaviors and emotional dysregulation in the DBT group, which indicates that DBT is a more effective

treatment in regards to enhancing emotional regulation.

Christou-Champi, S., Farrow, T. F. D., & Webb, T. L. (2015). Automatic control of negative emotions: Evidence that structured practice

increases the efficiency of emotion regulation. Cognition and Emotion, 29(2), 319-331, doi:10.1080/02699931.2014.901213

This article proposed that structured practice can enhance emotional regulation (ER). The aim for this study is to help clients gain a sense of

automatic emotional regulation, and to help clients improve their natural and immediate ability to control their negative emotions. The study

was done through a one-week training, with the introduction of pictures and short videos that would induce negative emotions in 27

participants. After the training, it was reported that participants are able to take less time to enhance their ER and decrease their negative

emotions. The participants were also reported to have a sense of automatic control of their ER

Derella, O. J., Johnston, O. G., Loeber, R., & Burke, J. D. (2019). CBT-enhanced emotion regulation as a mechanism of improvement for

childhood irritability. Journal of Clinical Child & Adolescent Psychology, 48(1), 146-154. doi:10.1080/15374416.2016.1270832

A cognitive behavioral approach to helping oppositional defiant teens in healthy emotional regulation is found in the intervention course

SNAP, which stands for Stop Now and Plan. SNAP is used to treat clients in their anger management, touchiness, and temper control. When

comparing SNAP with regular behavioral treatment, the authors noted that when the targeted teens were given tools to better regulate their

mood, they also had a significant improvement in their frustration tolerance level, resulting in having less negative emotions. This study also

noted that one’s ability for emotional regulation has a positive correlation with one’s level of irritability.

Additional reading bibliography

Finlay-Jones, A. L. (2017). The relevance of self-compassion as an intervention target in mood and anxiety disorders: A narrative

review based on an emotion regulation framework. Clinical Psychologist, 21, 90-103. doi:10.1111/cp.12131

Finlay-Jones desired to find therapeutic and research implications from the relationship that has been exhibited from the

relationship between emotional regulation and mood and anxiety disorders, as self-compassion was used as a therapeutic

method within Cognitive Based Interventions. It is noted that self-compassion has a positive influence on emotional awareness,

emotional regulation, secure attachment, self-acceptance, stress response, and more.

Ford, J. D., & Blaustein, M. E. (2013). Systemic self-regulation: A framework for trauma-informed services in residential juvenile

justice programs. Journal of Family Violence, 28, 665-677. doi:10.1007/s10896-013-9538-5

The authors promoted self-regulation as a emotional regulation intervention for delinquent children, they noted that the benefits

of self-regulation allows one to have focused attention, awareness on interpersonal and environmental cues, here and now adapt

through past memories, and a better sense of emotional control that enhances one’s long term well-being. Systemic Self-

Regulation interventions come in many forms in the juvenile justice programs, such as: Attachment, Self-Regulation, and

Competency (ARC); Sanctuary; Structured Psychotherapy for Adolescents Responding to Chronic Stress (SPARCS); Trauma

Affect Regulation: Guide for Education and Therapy (TARGET); and Trauma Systems Therapy (TST). The authors concluded

that the Systemic Self-Regulation is structured, theory based, and are trauma-informed tools for youth who can have a second

chance. Such treatment will be beneficial for clients and staff members as clients gain healthier emotional regulation from their

reactions to trauma and find a better projection on their future.

Additional reading bibliography

Lemberger-Truelove, M. E., Carbonneau, K. J., Atencio, D. J., Zieher, A. K., & Palacios, A. F. (2017). Self-regulatory growth effects for

young children participating in a combined social and emotional learning and mindfulness-based intervention. Journal of Counseling and

Development, 96, 289-302. doi:10.1002/jcad.12203

A small group of preschool-aged students from lower economic status families were provided with treatment that integrates Social and

Emotional Learning (SEL) and Mindfulness-Based Interventions (MBIs) for eight weeks. Significant results were found in this study,

and children who enrolled in treatment showed greater signs of self-regulation in task work and in experiential activities, children were

also noted to be more cordial in speech and in behavior during the treatment phase. The authors noted that a combination of SEL and

MBI will be beneficial to young children.

MacIntosh, H. B., Cloitre, M., Kortis, K., Peck, A., & Weiss, B. J. (2018). Implementation and evaluation of the skills training in affective

and interpersonal regulation (STAIR) in a community setting in the context of childhood sexual abuse. Research on Social Work

Practice, 28(5), 595-602. doi:10.1177/1049731516656803

The evidence based group therapy Skills Training in Affective and Interpersonal Regulation (STAIR) is presented in this study was

analyzed in this article after it was put into practice for two years, implementing 10 week intensive training treatment for 85 adult

patients who have experienced childhood trauma (23 male, 62 female), with a mean age of 43, SD = 11. It is noted that STAIR is

beneficial to individuals who have experienced childhood trauma or abuse, and are participating in group therapy. The tools used for

STAIR are the Life Event Checklist (LEC), the Difficulties in Emotion Regulation Scale (DERS), the Dissociative Experiences Scale

(DES), the Inventory of Interpersonal Problems (IIP), and the International Classification of Diseases Trauma Questionnaire (ICD:

PTSD). Authors found a significant lowering of scores on the DERS t(84) = 4.31, p < .001; DES t(84) = 1.98, p < .05, IIP t(84) = 3.18, p

< .002, and ICD:PTSD t(84) = 2.99, p < .004 posttreatment. These significant lowering of scores indicate a significant benefit to one’s

ability regulate emotions, handle interpersonal issues, as well as his ability to cope with trauma symptoms. The therapists who trained

clients in this study also provided positive feedback on STAIR as it was concrete, relevant, tangible and experiential for their clients.

Additional reading bibliography

Pena-Sarrionandia, A., Mikolajczak, M., & Gross, J. J. (2015). Integrating emotion regulation and emotional intelligence traditions: A meta-analysis.

Frontiers in Psychology, 6, 1-27. doi:10.3389/fpsyg.2015.00160

Through a meta-analysis of 90 studies with a total of 23,174 participants, the authors noted that emotional regulation (ER) and emotional intelligence

(EI) comes hand in hand. EI is an important ingredient to one’s ability for ER and that a bidirectional benefit will emerge through the integration of EI

and ER. The authors grouped EI attributes into five ER categories: Situation selection, situation modification, attention deployment, cognitive change,

and response modulation. It is noted that in order to be more emotionally regulated, an individual with high EI would work around his presenting

situations and promote actions and behaviors that help him cope better. Healthy ER is related to better stress management, better ability to manage

emotions in stressful situations, and less of a tendency for harmful behaviors. It is also noted that individuals who are higher in EI also have lower

relational or substance dependencies.

Rothenberg, W. A., Weinstein, A., Dandes, E. A., & Jent, J. F. (2018). Improving child emotion regulation: Effects of parent-child interaction-therapy

and emotion socialization strategies. Journal of Child and Family Studies, 28(3), 720-731. doi:https://doi.org/10.1007/s10826-018-1302-2

82 young children took part in this Parent-Child Interaction Therapy (PCIT) study, which was tested to be a viable intervention for

children to better regulate their emotions. The PCIT pre- and posttest sought to find correlations to a child’s emotional regulation in the

child’s behavior improvement, positive parenting skills, and positive parent emotion socialization strategies use for emotional connection.

The authors noted that children showed better improvement in their behavior when they had relatively better behavior during the pre-

treatment phase, as well as when parents had positive emotional socialization strategies with their kids. It was also tested that PCIT as an

intervention successfully and significantly enhanced a child’s behavior and increased a child’s ability to have healthy emotional

regulation.

Additional reading bibliography

Smyth, J. M., & Arigo, D. (2009). Recent evidence supports emotion-regulation interventions for improving health in at-risk and

clinical populations. Current Opinion in Psychiatry, 22, 205-210. doi:10.1097/YCO.0b013e3283252d6d

The authors studied the effectiveness that aerobic exercise have on emotional regulation in an 8-week intervention on 61

participants that were spilt into a waitlist group and a study group. It was noted that there is a positive correlation between

emotional regulation, aerobic fitness, and mindfulness. Moreover, the authors noted that such positive correlation results from

changes in the prefrontal and parietal cortices through exercise, the same brain regions also regulate one’s emotions.

Zhang, Y., Fu, R. F., Sun, L., Gong, Y. J., & Tang, D. H. (2019). How does exercise improve implicit emotion regulation ability:

Preliminary evidence of mind-body exercise intervention combined with aerobic jogging and mindfulness-based yoga.

Frontiers in Psychology, 10, 1-9. doi:10.3389/fpsyg.2019.01888

The authors studied the effectiveness that aerobic exercise have on emotional regulation in an 8-week intervention on 61

participants that were spilt into a waitlist group and a study group. It was noted that there is a positive correlation between

emotional regulation, aerobic fitness, and mindfulness. Moreover, the authors noted that such positive correlation results from

changes in the prefrontal and parietal cortices through exercise, the same brain regions also regulate one’s emotions.