This Article on anger management group therapy was written for and published in the Sept 2007 Newsletter of the San Francisco chapter of the California Association of Marriage and Family Therapists.

Why Many Anger Management Clients Don’t Get Better

“I no longer refer anyone to anger management groups because they don’t work”. This intriguing comment was made by a seasoned clinician, someone for whom I have a great deal of respect. She is a very smart, very skilled therapist who regularly refers her patients to a host of adjunctive services like twelve step meeting and group therapy.

This prompted me to thinking about the fact that even though I am a therapist who specializes in anger management, I largely agree with her comment. It seems that there are many clients who spend time in individual or couples therapy but continue to “lose it”. I wrote this article to explain why some clients go for years without making much progress with their anger.

Some Anger Management Clients Are Seeking “Band Aid” Approaches

This is one of the most important factors. The typical client with “anger issues” tends to minimize, deny and blame others for their anger. They often lack the motivation to change and it is common that their chronic mismanaged anger is ego syntonic. Similarly to substance abusers, the people who are most disturbed by their behavior are often those around them. When they seek help, they often underestimate the enormity of the therapeutic task. Those who struggle with the chronic anger habit often have personality structures that are organized around regulating core chronic shame. Anger frequently is also used to cover up fear, hurt or grief. This can lead many patients to seek short term approaches as defensive maneuvers. They may abandon treatment quickly, or seek superficial solutions in an effort to regulate profound feelings of which they are unaware. For example, I get many phone calls from men and women who want to come in and meet with me even though they state directly that they “don’t really have a problem”. Usually they are calling because a husband, wife, or employer has given them an ultimatum and their most pressing concern is to decrease the interpersonal pressure that is being placed on them.

Many “Anger Management” Programs Are Not Facilitated By Therapists

When help is sought they are likely to attend a group that is facilitated by someone with no mental health training. Many of the clients in my practice have attended groups run by clergy members, peers, or non professional “staff counselors”. They have attended groups in which members are not screened for co- occurring mental health issues, or for motivation level. In the bay area, one well established anger management provider openly prides itself in running a peer led program that is free of any licensed professional staff. Clients with mental health issues are regularly mandated into this program by the criminal justice system. Those who have attended this program report to me that the “treatment” mostly involves lectures, confrontation, and presentations about gender roles and social power. While perhaps interesting to some, for many they are insufficient for producing meaningful behavioral change.

Clients Don’t Meet The “Three Key Requirements For Permanent Change”


Awareness of their own body’s arousal signals is the first skill that must be developed in order to permanently break the anger habit. After years, or perhaps decades of ignoring the signs sent to them by their sympathetic nervous system, clients often have a robust tendency toward “disconnecting” or dissociating. In order to change, they must reconnect with their body. They must learn to respond to these signals early before the physiological responses sweep them away. They must learn to calm themselves so that they then may think rationally and respond skillfully. Developing these awareness skills requires monitoring and practice. Those who attend anger management classes which are solely psycho-educational usually are unable to master this necessary first step.


Insight is the second thing that is required for permanent change. Clients must have a good grasp on how they “do anger”. This entails the traditional work of psychotherapy; making the client’s unconscious working models conscious, and identifying the particular beliefs that tend to lead to anger. Unexamined beliefs about oneself and others can act like hidden embers and keep anger’s fire burning. Sometimes, when clients learn only to take “time-outs” and do not learn to reflect on the underlying beliefs that fuel the anger, they are in a continual effort to “try to stay calm”. While this works in the moment, it is an insufficient long term strategy.

Going Beyond Awareness and Insight

Awareness and insight are not enough. Every day I meet with clients who have spent years in individual or couples counseling. Often this has resulted in no significant behavioral change. Sometimes this is because the therapy did not include a skill building aspect, did not provide an accountability structure, or only gave the client a “place to vent”. This backfires because it provides only a rehearsal space for anger and not a laboratory in which to develop new emotional regulation skills. Once the client is working with a therapist who is able to help him or her master the first two steps, they must go further. The third requirement for permanent recovery is that all of the common underlying co-factors must be treated. Trauma history, relationship conflict, insecure attachment style, anxiety, depression, substance abuse, unresolved grief and personality disorders are all key factors in relapse. When they are fully addressed, the client can expect a more stable and permanent recovery.

Michael G. Quirke, MA. M.F.T. is a therapist who practices in San Francisco and San Mateo. He specializes in working with men and women who have decided that they want to stop anger from harming their relationships or careers. Through individual counseling, couple counseling and group therapy he teaches the key steps that are necessary to break the anger habit once and for all. For more information, call (415) 820-3943 or contact Michael.

How Can You Be Sure We Are A Good Fit?

My services are a little bit different than some other approaches. In our work, we not only find ways for you to feel better, but we also clean up the root issues.

That’s why my therapy and coaching services are best suited for individuals who are ready, willing, and eager to make positive changes in their lives. Overcoming deep-rooted issues and long-standing emotional wounds takes dedicated effort.

Ask Yourself Now, Are You:

  • Strongly committed to healing and growth?
  • Determined to level up? (It's okay if you have doubts and insecurities. That's human! And I can help.)
  • Ready to discover and be your best self...even if it scares you a bit?
  • Seeking expert guidance and also understand its worth?
  • Ready to let go of what no longer serves you...even though you might need some hand-holding?
  • Up for changes, growth, and expansion?
  • Fed up with having to settle?

That's Why I Work Exclusively With Those Who:

  • Need help creating and implementing a plan.
  • Value kind, direct feedback.
  • Want support and encouragement to aim higher.

Overcoming temporary obstacles and building skills for short-term gains is helpful and necessary. But my approach goes much further and deeper. It is about digging in, getting to the core of major issues, and resolving them...for good.

That means working together to uplevel and improve everything from:

  • Career
  • Relationships
  • Personal mental health concerns
  • Emotional resilience
  • Ditching bad habits and replacing them with life-enhancing ones
  • Growing first-class communication skills

I Really Want To Make Sure You Know What You Are Signing Up For.

For that reason, there are a few additional things I would like you to do before you schedule an interview:

  • There is no better way to get a good sense of if we are a fit than by scheduling a 90-minute, new client initial appointment. You can schedule that via my online scheduler here:


  • Please review my website thoroughly to gain a better understanding of my services before attempting to schedule a time to talk. I want you to be educated about my services. This will help us make the best use of the no-cost, 15-minute phone call I offer. Rather than fielding questions about what I do and how I approach the healing process, I would like to focus on gathering information about you and your situation. That will help determine if I recommend whether you should book the standard initial consultation appointment.
  • If we schedule a phone call, I request that you have only one question/concern in mind that you would like to discuss. This concern should be about something that is perhaps preventing you from seeking therapy or making you wonder if we will mesh well together.
  • In case you have any financial questions, please be sure to read the information I’ve provided on the My Practice page. Many of my clients want a high level of confidentiality, which is why I do not accept insurance. I do, however, provide superbills for my services that you can then use to seek reimbursement from your insurance provider if desired.
  • My business hours are Monday through Friday 9 AM to 5 PM, so please make certain that you can consistently attend appointments during those hours.
  • Since my practice serves people who are raring to make changes, I meet with clients at least once per week.
  • Also, please thoroughly review my Phone Call Prep and FAQ page and decide whether you would like to participate in online video therapy, in-person sessions, or a combination of services.
  • One last thing: try to determine in advance what your personal goals for therapy are so we can hit the ground running and start making progress from day one.

Here's the most important element of the process: you are interested in being an active and engaged participant in your own healing journey.

I want you to be ready to take action to level up and make the most out of your career, relationships, and personal ambitions.

Let's Get To Work And Improve Your Life

If you’re ready to create real change and achieve a level of healing that’s deeper and more sustainable than what most traditional therapeutic and coaching approaches can provide, I want to help.

Once you’ve reviewed the information on this page and researched my site, please acknowledge that you meet the criteria above to set up your free, 15-minute consultation. This complimentary phone call involves a structured interview, so I ask that you reflect on that, thoroughly prepare for our conversation, and only schedule a time to talk if you are ready to pursue therapy but still have something holding you back.

Although I’m only legally allowed to provide online and in-person psychotherapy to residents of California, I also offer a range of coaching services for all US and international residents. However, if you are in the midst of a crisis and need immediate assistance, please call 911.

Business hours are Monday-Friday 9a.m.-5 p.m. Can you attend appointments during those hours? *

Financial information about my services is listed on my "my practice page"

Have you reviewed the information about fees which is listed on the my practice page? *

Phone Call Prep and FAQ are listed on my "Phone Call Prep and FAQ page"

Yes, I meet the criteria outlined on this page. I've read the phone call prep page and would like to request a 15-minute phone call. *
I agree to schedule a 15 minute initial consultation call so you can advise me on whether or not to book an appointment *

If you’re ready to learn more about how I may be able to help you achieve your personal and professional goals, I encourage you to skip the 15-minute consultation and set up a time for us to talk directly.

Thank You!

If you've answered "yes" to the above questions, it's likely that we would be a good fit. 

Every day, I receive a very large number of inquiries from people who wish to become patients in my practice.

Please note that due to this volume I'm unable to respond if you have clicked "no" on any item.

Kind regards, 

Michael G. Quirke L.M.F.T.