Effects of wisdom therapy on anger and mood as adapted for use among substance-dependent clients in a nonmedical residential setting

Although anger has functionally adaptive value for survival, excessive and/or chronic anger is maladaptive, weakening social bonds, contributing to disease, and interfering with problem solving ability. Studies have shown cognitive behavioral techniques to be effective in reducing self-reported anger. Few studies, however, have examined other treatment modalities or have used physiological measures. This study adapted Wisdom Therapy for use with substance abusers, employing anger, humility, perceived stress, depression, social desirability and personality self-reports, as well as the physiological measure, heart rate variability (HRV). The 40 adult male participants were residents in a San Jose, California residential drug and alcohol treatment program. Drugs of choice included methamphetamine (70%), cocaine (15%), heroin (5%), PCP (5%), alcohol (2.5%), and marijuana (2.5%). A 2 x 2 mixed design was used with 2 levels of treatment and 2 levels of time. The treatment conditions were Rational Emotive Behavioral Therapy (REBT) and an adapted version of Wisdom Therapy. Each treatment comprised 10 group sessions over a 10 week period. The 2 time intervals were pretest and posttest. Participants were highly antisocial, sadistic (aggressive), anxious, and avoidant. Expected high levels of narcissistic trait were not found. Multiple findings, in the aggregate, lend support to the mounting evidence that treatment applied too early after cessation of drug use, particularly stimulant abuse, may be futile. There was a significant negative correlation between humility and anger. Findings also suggested addicts become more avoidant with age. Main effects for time and treatment, specific to the hypotheses, were not found. The main effect of condition on HRV during the "Anger" and "Appreciation" epochs was nonsignificant. The main effects of treatment condition on trait anger, anger expression and control, humility, perceived stress, and depression were nonsignificant. However, the study findings showed Wisdom Therapy significantly reduced HRV Very Low Frequency (VLF) power and the ratio of VLF to High Frequency (HF) power during baseline epochs as compared to REBT.