21st Century Cognitive Behavioural Therapy for Anger: A Systematic Review of Research Design, Methodology and Outcome

Ephrem Fernandez, Catia Malvaso, Andrew Day, Deepan Guharajan
  • Behavioural and Cognitive Psychotherapy, February 2018, Cambridge University Press
  • DOI: 10.1017/s1352465818000048

Cognitive-Behavioural Therapy For Anger: An Update So Far This Century

What is it about?

The effect of CBT on anger was statistically significant in 41 out of 42 studies in this field and clinically reliable in all but one of 21 studies; the one study with nonsignificant outcome had controlled for social desirability bias. The vast majority of studies used the RCT design and self-report measures of which the STAXI was the most common. Though highly favorable, the results might be tempered a little if future research were to examine bias against reporting anger and measures of actual angry behavior as observed by self and others.

Why is it important?

This systematic review shows that 21st century research supports CBT as a significantly effective treatment for anger problems. However, the findings may be a little inflated by self-report and bias against reporting anger. The majority of studies in this field and in this era adopt gold standards in methodology , namely the RCT design and the STAXI instrument, though further innovation in measurement is encouraged.


Ephrem Fernandez
University of Texas at San Antonio

Cognitive-Behavioural Therapy (CBT) has become the dominant approach to treating many psychological disorders including maladaptive anger. This generally involves reappraisal and relaxation strategies, though it can be greatly enhanced with affective or emotion-focused techniques as in Cognitive Behavioural Affective Therapy (CBAT). With research methodology being fairly standard, where innovation is particularly needed is in the actual substance of therapy. Last but not least, there are different types of maladaptive anger ranging from the intermittent explosive to the passive aggressive and suppressed anger. These are long overdue for inclusion in psychiatric classification systems such as the DSM. Regardless of that, it is timely to customize psychological treatments to such specific anger disorders.

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The following have contributed to this page: Ephrem Fernandez