Anger and substance use disorders frequently co-occur, significantly increasing the risk for adverse outcomes including interpersonal violence, self-injurious behaviors, relationship dysfunction, occupational impairment, and criminal justice system involvement. Recent longitudinal research demonstrates that trait anger significantly predicts both substance use initiation and escalation over time (Birkley & Eckhardt, 2019).

Contemporary research supports the efficacy of integrated cognitive-behavioral interventions for co-occurring anger and substance use issues. A randomized controlled trial by Shorey et al. (2020) demonstrated that cognitive-behavioral anger management treatment, when integrated with substance use treatment, resulted in significant reductions in both anger expression and substance use at 6-month follow-up. Similarly, a meta-analysis of 28 studies found that cognitive-behavioral interventions for anger management showed large effect sizes (d = 0.82) when delivered in substance use treatment settings (Lee & DiGiuseppe, 2018).

Many clients with substance use and mental health issues experience traumatic life events, which, in turn, lead to substance use, anger, and increased risk for violence. Meta-analyses have reliably demonstrated the efficacy of cognitive–behavioral therapy in the treatment of addictions and other mental health issues, such as depression, traumatic stress, and anxiety.

To provide clinicians with tools to help deal with this important issue, the Center for Substance Abuse Treatment at the Substance Abuse and Mental Health Services Administration is pleased to present revised and updated versions of Anger Management for Substance Use Disorder and Mental Health Clients: A Cognitive–Behavioral Therapy Manual and its companion book Anger Management for Substance Use Disorder and Mental Health Clients: Participant Workbook, which were originally published in 2002.

The anger management treatment design in this manual, which has been delivered to thousands of clients over the past three decades, has been popular with both clinicians and clients. This format of the manual lends itself to use in a variety of clinical settings; can be adapted to accommodate different racial-ethnic minority groups and genders, and diverse treatment settings; and will be a helpful tool for the field.

7/2020 At Health requested and received permission to use SAMHSA publications (with proper citation) in their entirety for CE Courses at athealth.com.

Format: Asynchronous, reading-based distance learning. Non-interactive.

Published by At Health 9/2/2020

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Page last modified or reviewed by athealth.com on Apr 19, 2026.

Numerous people contributed to the development of this manual (see appendix). The publication was written by Patrick M. Reilly, Ph.D., and Michael S. Shopshire, Ph.D., of the San Francisco Treatment Research
Center. Sharon Hall, Ph.D., was the Treatment Research Center’s Principal Investigator.
This publication is, in part, a product of research conducted with support from the National Institute on Drug Abuse, Grant DA 09253, awarded to the University of California–San Francisco. The research for this publication was also supported by funding from the Department of Veterans Affairs to the San Francisco Veterans Affairs Medical Center. This publication was updated under contract number 270-14-0445 by the Knowledge Application Program (KAP) for the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS).

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