How to Help Teens Handle Powerful Emotions

We all get angry sometimes.

Some of us get angry often, while some of us have a sunny disposition by default. We don’t angry very often and don’t get bothered by much.

Those of us who do get angry a lot learn how to manage that anger. If we don’t, we have family problems, relationship problems, problems at work, and, in some cases, problems with the law. All of us understand that anger is a powerful emotion. We understand anger can cause us to say and do things that, upon reflection, we know were wrong, and cause harm to both people we love and ourselves.

As adults, we understand all this. As we grow, we learn coping mechanisms that help us recognize when we’re angry. We learn how to calm down. We learn that acting out of anger is not healthy. When we’re full-grown, we can apply our coping mechanisms because we have a fully developed brain. Most importantly, a fully developed prefrontal cortex – that helps regulate emotion and control our emotional impulses.

That’s a big deal – and it’s something adolescents don’t have.

Understanding the Teenage Brain: What Adults Need to Know

Here’s a quick lesson on the human brain, the way it develops, and why knowing this information is important for understanding anger management in teens. This is a vast oversimplification, but for our purposes, it’s accurate and helpful.

Fast Brain Facts: Adolescents and Anger

1. The parts of our brain related to emotions – the parts that generate base-states like love and fear – develop first. These parts of the brain have fancy names – the amygdala – but for our purposes, we’ll lump them all together and call them the emotional brain.
2. The part of our brain related to logical thinking – the one responsible for risk/reward analysis, impulse control, and fact-based decision making – develop last. We already mentioned the fancy name for this part of the brain: it’s the prefrontal cortex. For our purposes, we’ll call it the rational brain – but forgive us if we slip up and throw in the occasion prefrontal cortex here and there.
3. Although the rational brain begins a period of rapid development during adolescence, this period does not end until our early- or mid-twenties. This explains why an adolescent can do things like advanced calculus, play complex musical passages on difficult instruments, and write insightful research papers on intellectually advanced concepts. It also explains why these same adolescents – who may often look, act, and talk like adults – will still make some decisions that make absolutely no logical sense at all.

The point of sharing these facts with you is so you know there are reasons the emotional brain can easily overpower the rational brain. It does not happen in every instance or for every emotion that occurs, but it does happen – especially in teens. Anger is one of the emotions that can easily overwhelm and bypass the developing rational brain. Adults see it happen in young children every day. In young children, however, the consequences of anger are often minimal and easily repairable. Parents can recognize and take steps to manage anger in children. They can use the simple strategies found in articles like this one, which we published early last year:

Handling Childhood Anger

However, the consequences of anger in adolescence can be far more significant than the consequences of anger in childhood. And, unlike the consequences of anger during childhood, anger in adolescence can lead to consequences that are difficult to repair with an “I’m sorry” or restorative behavior that balances the effect of the anger.

That’s why anger management is an important thing for teens to learn and for parents to understand.

There’s something else to consider here, too. When anger or angry outbursts are related not only to the difficult and challenging quirks of adolescent development but also to a mental health disorder, that changes things.

That’s also important for parents and teens to understand.

Anger, Teens, and Mental Health Disorders

Anger, aggressive behavior, irritability, and angry outbursts – a.k.a. tantrums – are symptoms associated with several mental health disorders. These disorders can appear as early as six years old for some people, and as late as adulthood for others. With that said, the Diagnostic and Statistical Manual of Mental Disorders – Volume 5 (DSM-V) identifies anger as a symptom associated with over thirty mental health disorders. Those include the disorders in the following list, all of which may develop before or during adolescence:

• Oppositional defiant disorder (ODD)
• Disruptive mood dysregulation disorder (DMDD)
• Conduct disorder (CD)
• Borderline personality disorder (BPD)
• Bipolar disorder (BD)
• Major depressive disorder (MDD)
• Anxiety disorders – GAD, SAD, and others
• Attention deficit hyperactivity disorder (ADHD)
• Obsessive-compulsive disorder (OCD)
• Alcohol and substance use disorder (AUD/SUD)

When adolescent anger is associated with one of these disorders, typical approaches to anger management might not work. That’s because, in addition to the ability of the emotional brain to overpower the rational brain and lead to risky behavior, poor decisions, or behavior that causes harm, the chemical imbalances related to the disorders themselves can exacerbate the preexisting developmental imbalance and render common anger management techniques ineffective.

A teen with a mental health disorder for which anger is a symptom – and for whom that symptom causes problems – may need professional support and treatment in order to manage their anger. We’ll talk about therapeutic techniques for managing adolescent anger in a moment. First, we’ll offer a short list of common anger management strategies that can work for teens who do not have a mental health disorder.

Basic Anger Management for Teens

The following list is for parents with teens who are not diagnosed with a mental health disorder but have problems with anger, irritability, or angry outbursts. Parents should go through this list and make sure their teen:

1. Gets adequate sleep every night.

Lack of sleep is connected to hormone imbalance and anger in teens.

2. Eats three regular, healthy meals per day.

A diet high with plenty of whole grain, fresh fruits and vegetables, and lean protein can reduce stress, which is associated with anger in teens.

3. Gets plenty of exercise.

Movement and activity reduce stress, release energy, and increases the amount of hormones associated with positive mood and feelings of wellbeing. A teen who is not sporty does not have to become sporty. They do, however, need movement and activity every day. Please read our article New CDC Guidelines on Exercise and Activity: What They Say for Adolescents for recommendations on the type, frequency, and duration of exercise and activity considered healthy for teens.

4. Has people to talk to.

Whether that person/people is a parent, a friend, or a therapist/counselor, a teen needs to feel connected to people that will listen with a sympathetic and empathetic ear. Important point: therapy is for anyone who needs someone to talk to in order to work through emotions. There is no rule anywhere that says you need a diagnosed mental health disorder to benefit from regular conversations with a counselor or therapist.

5. Learns stress management techniques.

These include simple things like counting to ten before answering a question while angry, taking a self-timeout and going for a walk when things get heated, listening to music, or keeping a journal. These also include mindfulness techniques such as progressive self-relaxation, meditation, and mindfulness-related activities like yoga or tai chi.

You’ll find advice like the last two tips in the therapeutic approaches to anger management we talk about in the next section of this article, as well. Therapy and mindfulness work for people with or without a mental health disorder. In the context of treatment, however, they take on a special significance, because they can serve dual duty: they reduce anger and promote recovery. Also, when taught and applied in the context of treatment, teens may take them more seriously.

Anger Management for Teens in Treatment: Therapeutic Approaches

A study published in 2016 called Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents leads with the following statement:

“Anger, irritability, and aggression are among the most common reasons for child mental health referrals.”

The study reviews two effective approaches to anger management in youth: parent management training (PMT) and cognitive behavioral therapy (CBT). We offer that quote so you know that if your teen is angry, irritable, and aggressive you’re not alone: parents around the country and world face this situation every day. We also offer that quote because if your teen has a mental health disorder that’s characterized by angry outbursts, irritability, and aggression, you’re also not alone: parents around the country and world face that situation every day.

They don’t do it alone.

They do it with professional help.

Two additional studies – Dialectical Behavioral Therapy For Oppositional Defiant Disorder In Adolescents and A Modified DBT Skills Training Program for Oppositional Defiant Adolescents: Promising Preliminary Findings – review another approach to managing anger in teens, called dialectical behavior therapy (DBT).

We’ll now discuss what PMT, CBT, and DBT are and how they can help teens with mental health disorders that include problematic anger or aggressive behavior. We sourced all the information below from those three articles, as well as our own article on how DBT helps teens manage anger, called What Is Emotional Dysregulation in Teens?

We’ll start with PMT.

Parent Management Training

What is PMT?

PMT is a technique that helps parents “reduce the child’s aggression and noncompliance by improving parental competence in dealing with these maladaptive behaviors.”

How does PMT work?

During PMT training, parents learn to:

• Identify why their teen displays maladaptive behavior (i.e. excessive anger or aggression)
• Praise their teen for appropriate behavior
• Ignore (when safe) maladaptive, attention-seeking behavior
• Establish clear behavioral expectations and outcomes (i.e. rules and consequences)
• Follow through on behavioral outcomes to unmet behavioral expectations (i.e. enforce consequences consistently

Does PMT work?

Yes. Evidence from over one hundred peer review studies shows that PMT can:

• Improve conduct in children and teens
• Reduce frequency and duration of angry outbursts in teens
• Reduce frequency of noncompliance with behavioral expectations
• Improve parent-teen communication
• Improve emotional communication skills for parents and teens

It’s clear that PMT – as implied in its name – focuses on the parents. That’s important, because parents play a role in their teen’s anger. They may unconsciously facilitate it by focusing only on negative behaviors, rather than understanding these behaviors as efforts to make connections and seek attention. They may consciously reduce anger in their teens by establishing clear behavioral expectations and outcomes, and learning to communicate those outcomes in a healthy, productive manner.

Cognitive Behavioral Therapy

What is CBT?

CBT is a therapeutic technique that:

“…targets deficits in emotion regulation and social problem-solving skills that are associated with aggressive behavior. The label “cognitive-behavioral” is used to refer to interventions that are conducted with the child and have an emphasis on the learning principles and the use of structured strategies to produce changes in thinking, feeling, and behavior.”

How does CBT work?

In the context of anger management for teens, a CBT therapist will focus on:

• Emotion regulation:
  • Teens learn to identify anger triggers
  • Teens learn skills to manage emotion, such a cognitive reappraisal and self-relaxation
• Social problem-solving:
  • Teens learn to develop multiple approaches to a problem
  • Teens learn to evaluate consequences for various responses to a problem
• Social skills that help prevent and resolve conflict:
  • Teens learn to analyze interpersonal conflicts and develop alternative solutions
  • Teens learn prosocial skills, such as the importance of emotional communication. For instance, they may learn for the first time the importance of telling others how they feel, rather than responding first with aggression
  • Teens learn to enhance verbal communication skills in order to prevent conflict before it arises, and defuse conflict if it happens.

Does CBT work?

Yes. Evidence from research on CBT for anger management in teens shows:

• A 52% reduction in disruptive behavior, compared to teens with no CBT therapy
• A 69% improvement in symptom severity, compared to teens with no CBT therapy
• Reduction in teacher reports of aggression
• Improvements in self-reported anger control
• Reduction in hostile behavior

In this context, CBT, as opposed to PMT, focuses on teens. Specifically, on their ability to recognize, process, and control their response to extreme states of emotion like anger. The data shows that the more a teen understands their emotions, the better they’re able to manage them. It also shows that when a teen learns they have agency – i.e. a level of control and choice – over their responses, the more likely they are to apply that agency and from alternate responses to their emotions. In other words, they learn there are more responses to difficult situations and challenging emotions beyond anger and aggression. When they learn those alternatives, prosocial options, they’re more likely to choose them.

Dialectical Behavior Therapy

What is DBT?

DBT is a therapeutic technique derived from CBT wherein a DBT-trained therapist teaches teens the skills they need to accomplish their goals and reduce behaviors that get in the way of achieving these goals.

How does DBT work?

In the words of the founder of DBT, Dr. Marsha Linehan, DBT:

“DBT is very simple. The therapist creates a context of validating rather than blaming the patient. Within that context, the therapist blocks or extinguishes bad behaviors, drags good behaviors out of the patient, and figures out a way to make the good behaviors so reinforcing that the patient continues the good ones and stops the bad ones.”

A DBT therapist teaches teens the five core modules of DBT:

1. Mindfulness. Teens learn to increase awareness of and focus on the present moment
2. Emotion Regulation. Teens learn to manage turbulent and disturbing emotions
3. Interpersonal Effectiveness. Teens learn to manage family, school, and peer relationships
4. Distress Tolerance. Teens learn to tolerate difficult, stressful, and challenging situations
5. Walking the Middle Path. Teens learn to apply ideas and techniques derived from mindfulness practices.

Does DBT work?

Yes. Evidence shows that DBT helps teens:

• Accept the world as it is, without judgment, and without trying to change it.
• Understand it’s possible to see every situation from more than one point of view.
• Validate other points of view about a situation or circumstance.
• Validate their own point of view about a situation or circumstance.
• Believe that action creates change
• Believe they can change how they react both internally (emotions and thoughts) and externally (words and action) to any situation or circumstance they face.

In the context of anger management for teens with mental health disorders, therapists use the five modules of DBT during individual, family, and group therapy. They also use them during one-on-one coaching during crisis situations. Dr. Linehan and the therapists and clinicians who use DBT in adolescent DBT programs around the world say the goal of DBT is to help adolescents create a life worth living. In the context of anger management, that means a life that’s not dominated by anger, angry outbursts, aggression, or hostility. DBT helps teens with severe emotional dysregulation issues find balance in all aspects of life, including school, family and personal relationships, internal wellbeing, and life satisfaction.

Helping Your Teen Manage Anger

If your teen has problems managing anger and the typical approaches to helping them do not work, it’s possible they have an underlying mental health condition that contributes to their anger management problems. By typical approaches, we mean the basic anger management strategies we mention earlier in this article. Your teen needs adequate sleep, good food, plenty of activity, and someone to talk to. They should also learn basic stress reduction techniques.

When those approaches do not help at all, we advise you to arrange a full biopsychosocial evaluation and assessment for your teen. The assessment should be administered by a mental health professional. If a professional assessment indicates a mental health disorder, then your teen will probably receive a referral for outpatient treatment, an intensive outpatient program (IOP), a partial hospitalization program (PHP), or support in a residential treatment center for teens (RTC).

It’s hard enough being a teen. The developmental facts we describe in the introduction to this article mean they ride a rollercoaster of emotion simply because of where they are in their journey to adulthood. In the presence of a mood, behavioral, or addiction disorder, adolescence becomes more difficult than it already is.

Anger management techniques – learned in the context of professional support and treatment or elsewhere – can help teens learn to manage their emotions and find balance in their life and their relationships. For teens who need treatment, it’s important for parents and teens to understand that treatment works. The sooner a teen with a mental health disorder receives evidence-based treatment for that disorder, the better chance they have at a full, sustainable recovery.

Finding Help: Resources

Parents seeking treatment for their teen can navigate to our page How to Find the Best Treatment Programs for Teens and download our helpful handbook, A Parent’s Guide to Mental Health Treatment for Teens.

In addition, the American Academy of Child and Adolescent Psychiatry (AACAP) is an excellent resource for locating licensed and qualified psychiatrists, therapists, and counselors. Both the National Institute of Mental Health (NIMH) and the National Alliance on Mental Illness also provide and high-quality online resources, ready and waiting right now.