Difficulty controlling anger is the most commonly reported problem that military service members and veterans report upon reintegration after deployment. Research shows that more than half of veterans using VA services report problems controlling anger. This results in legal, employment, social interaction, or relationship problems for many veterans. Chronic, unmanaged anger can lead to aggression, interpersonal violence, and suicidal thoughts.

Chronic hostility, anger, and aggression are common after a person experiences betrayal betrayal. More than one fourth of service members and combat veterans report experiencing events involving military-related betrayal, either by the military or individuals during military service, including loved ones.

Seeing a need for an intervention to address anger and aggression in active duty military personnel, STRONG STAR investigators have designed a pilot study to test a treatment that directly targets reducing chronic anger and aggression and improving interpersonal relationships. The treatment, Countering Chronic Anger and Aggression Related to Trauma and Transgressions (CCAARTT), will focus on helping service members heal after transgressions they have suffered.

How the program works

CCAARTT will combine evidence-based anger regulation and interpersonal effectiveness skills with betrayal-focused processing. This might include such things as making meaning of betrayal, letting go of ineffective resentment, and finding purpose after betrayal. The study will prominently include promotion of forgiveness and compassion for self and others as a way to reduce anger and improve interpersonal functioning. Forgiveness and compassion-focused interventions have been found to be effective in prior research, but this has not yet been tested in a military population.

The research team has worked to fine-tune the intervention by consulting with service members, military leaders, and key military-serving providers to ensure that the treatment approach aligns with military culture.

Led by Initiating Principal Investigator (PI) Vanessa Jacoby, PhD, and Partnering PI Alan Peterson, PhD (Lt Col, USAF, Ret.), of The University of Texas Health Science Center at San Antonio, the team will recruit participants from the Fort Cavazos (formerly Fort Hood) area in Killeen, TX, including mental health clinics where STRONG STAR has ongoing and well-established relationships.

A four-phased approach

The CCAARTT intervention is heavily based on an approach called the Process Model of Forgiveness. Using this model, the intervention is divided into four phases to guide patients through the process of forgiveness:

• Developing motivation for change by exploring the benefits of forgiveness and negative impact of holding onto anger or resentment
• Making the decision to work toward forgiveness
• Building skills of empathy and compassion to reduce anger and find peace, and
• Exploring the emotional freedom one has gained by putting down the burden of chronic anger.

Expected benefits

The research team believes that participants will experience significant reductions in the frequency and intensity of distressing anger, psychological aggression, and physical aggression, as well as improvements in their interpersonal functioning.