Editing Anger management (section)

==Impediments==
There are a number of factors that can lower the probability of a successful anger management intervention. One such obstacle is the level of the individual's [[motivation]]. Overall low readiness is an impediment to the effectiveness of anger management due to the lower attendance rates and negative effect on the [[therapeutic alliance]].<ref>{{cite journal|author1=Howells, K.|author2=Day, A.|name-list-style=amp|year=2003|title=Readiness for anger management: Clinical and theoretical issues|journal=Clinical Psychology Review|volume=23|issue=2|pages=319–37|pmid=12573674|doi=10.1016/S0272-7358(02)00228-3}}</ref> Involuntary assignment to an anger management program, for example court mandated sessions, will result in a lower average motivation level than voluntary admission. In one study with incarcerated inmates, there was a correlation found between individual readiness and improvement.<ref>{{cite journal|author=Heseltine, K.|year=2010|title=Brief anger interventions with offenders may be ineffective: A replication and extension|type=report|journal=Behaviour Research and Therapy|volume=48|issue=3|pages=246–50|pmid=19896643|doi=10.1016/j.brat.2009.10.005|url=http://www.hsjcc.on.ca/Resource%20Library/Forensic%20Clinical/Brief%20anger%20interventions%20with%20offenders%20may%20be%20ineffective%20-%202010.pdf|access-date=2016-12-17|archive-url=https://web.archive.org/web/20161217232433/http://www.hsjcc.on.ca/Resource%20Library/Forensic%20Clinical/Brief%20anger%20interventions%20with%20offenders%20may%20be%20ineffective%20-%202010.pdf|archive-date=2016-12-17|url-status=dead}}</ref>

Additionally, given the component of anger as a [[Social constructionism|social construct]], difficulty with communication between cultures can serve as another impediment.<ref>{{cite book|first=J.R.|last=Averill|year=1993|contribution=Putting the social in social cognition, with special reference to emotion|editor1=R.S. Wyer|editor2=T.K. Srull|title=Perspectives on anger and emotion: advances in social cognition|volume=VI|pages=47–56|url=https://books.google.com/books?id=-2aYAgAAQBAJ&pg=PA47|isbn=9780805813272|publisher=L. Erlbaum Associates}}</ref> What is deemed an appropriate expression of anger is culturally dependent. Therefore, a mismatch between client and therapist could result in a misunderstanding as to the end goal of the program. For example, a client could only wish to decrease physical violence, while the therapist aims to decrease both verbal and physical outbursts. Gender-dependent expectations of anger expression can contribute as well to societal standards. The same violent outburst for a man and woman is subject to different interpretations due to anger being seen as more permissible in males.<ref name=":02"/>

The cost of taking anger management could also be a significant obstacle if the person does not have health insurance. The time required for anger management depends on the program. Weekly one-hour sessions with eight to 12 sessions per program are common, but a single intensive all-day session variety exists as well. The monetary cost can amount to $90–$120 per session for general therapy, or much higher fees for specialized coaching. The availability of anger management programs locally can be problematic for more isolated areas, creating an additional cost for travel. However, online options can follow the same structure as an in-person intervention with similar outcomes.<ref>{{cite journal|author1=Morland, L. A.|author2=Greene, C. J.|author3=Rosen, C. S.|author4=Foy, D.|author5=Reilly, P.|author6=Shore, J.|display-authors=etal|year=2010|title=Telemedicine for anger management therapy in a rural population of combat veterans with posttraumatic stress disorder: A randomized noninferiority trial|journal=Journal of Clinical Psychiatry|volume=71|issue=7|pages=855–63|pmid=20122374|doi=10.4088/JCP.09m05604blu}}</ref>