Anger Management groups for adolescents: a mixed-methods study of efficacy and treatment preferences.

We compared the efficacy of, and adolescents' preferences for, a Cognitive Behavioural (CBT) and Personal Development (PD) Anger Management (AM) group. The CBT group aimed to help adolescents develop skills to manage predominantly reactive aggression. The PD group aimed to enhance motivation to develop less aggressive identities with less use of proactive aggression. Eighteen adolescents were randomly allocated to a 10-session CBT or PD AM Group; seven additional adolescents formed a control group. They completed pre- and post-intervention questionnaires to assess anger expression and control, use of AM coping skills (also completed by carers) and self-image. Participants were also interviewed pre- and post-intervention; transcripts were subjected to Interpretive Phenomenological Analysis. Both treatment groups demonstrated significant improvements in anger coping and self-esteem, relative to the control group. Participants' age was significantly correlated with self-image and anger control outcomes in the CBT group. Qualitative analysis identified factors associated with improved outcomes, particularly regarding participants' age, motivation and readiness to change, engagement in the therapeutic process, group dynamics and emotional expressiveness. Our ability to interpret data clinically was enhanced by the use of a mixed quantitative-qualitative methodology. The results help us to better match interventions to clients.

Risk, shame and the public injector: a qualitative study of drug injecting in South Wales.

Drug injecting in public places is associated with elevated health harm among injecting drug users (IDUs). Yet there is little research exploring the lived experience of injecting in public places, and specifically, a need to explore the interplay of public injecting environments, risk practices and social marginalisation. We undertook 49 qualitative interviews with IDUs in South Wales, UK, in six locations. Analyses focused on injectors' narratives of injecting in public places and risk identity. Findings show how the lived experience of public injecting feeds a pervasive sense of risk and 'otherness' among street injectors, in which public injecting environments act as contextual amplifiers of social marginalisation. Injecting in public places was characterised by urgency associated with a fear of interruption, a need to maintain privacy to prevent public exposure, and an awareness or sense of shame. We argue that daily interactions involving public exposure of injecting status, combined with the negative social meanings ascribed to public places used for injection, are experienced as potentially degrading to one's sense of self. We conclude that the public injecting environment is experienced in the context of other forms of public shaming in the lives of street injectors, and is thus productive of symbolic violence. This highlights tensions between strategies seeking to create safer communities and environmental interventions seeking to reduce drug-related health harm, including recent innovations such as the 'drug consumption room' (DCR).