Archives of Psychiatric Nursing 41 (2022) 166–174

Contents lists available at ScienceDirect

Archives of Psychiatric Nursing

journal homepage: www.elsevier.com/locate/apnu

The effect of solution-focused approach on anger management and violent

behavior in adolescents: A randomized controlled trial
Ebru Akbaş a, *, Gülay Taşdemir Yiğitoğlu b, 1
a
İbrahim Yirik Vocational and Technical Anatolian High School, Department of Health Services, İstanbul, Turkey
b
Faculty of Health Science, Department of Psychiatric Nursing, Pamukkale University, Denizli, Turkey

A R T I C L E I N F O A B S T R A C T

Keywords: Background: This study was carried out to evaluate the effect of a solution-focused approach on anger man­
Solution-focused approach agement and violent behavior in adolescents.
Adolescent Method: The study was an experimental and randomized controlled trial including pre-test and post-test mea­
Anger management
surements and control group. The sample of experimental (n = 24) and control groups (n = 24) of the study
Violent behavior
Psychiatric nursing
consisted of 48 students. A 7-session program of anger management and prevention of violent behavior based on
a solution focused approach was applied to the experimental group.
Results: There were no statistically significant differences between trait anger, anger in, anger out, anger control
sub-dimensions and VTS scores of the experimental and control groups before the intervention (p > 0.05). In
post-test and follow-up test, trait anger (23.32 ± 2.83) (21.10 ± 3.51), anger-out (14.95 ± 4.16) (15.50 ± 3.49)
and the mean scores of VTS (30.77 ± 4.01) (32.80 ± 4.53) of the individuals in the experimental group were
significantly lower, whereas their mean score of anger control (24.86 ± 3.62) (23.65 ± 4.44) were significantly
higher than the control group.
Conclusion: Solution-oriented approach programs should be used by psychiatric nurses to provide anger man­
agement and reduce violence tendencies in adolescents.

Introduction
Anger, that is one of the universal feelings, is a natural response
given to unsatisfied desires, inhibitions and unmet expectations (Lowth,
2015). The feeling of anger is a basic emotion which provides biological,
psychological and social survival in nature and has important functions.
Adolescents are the individuals who most experience the feeling of anger
that everyone frequently encounters in daily life (Anjanappa et al.,
2020; Karababa & Dilmac, 2015).
Stimuli that cause anger during adolescence period are generally of
social origin. These are reasons such as being mocked, ridiculed, criti­
cized, unfairly punished and ruled, having things going wrong and
having goods taken without notice (Balci, 2019; Gordeles Beser, 2014).
Moreover, factors such as lack of social support, bullying, impaired
domestic interactions, personality and physical environment at home
can cause anger (Balci, 2019).
Adolescents may have more difficulty in controlling anger compared
to the other age groups (Anjanappa et al., 2020; Marcus, 2017). Inap­
propriately expressed anger may result in several physical, social and
psychological problems such as disharmony in interpersonal relation­
ships, negative effects on health, disagreement at work, conflicts and
violence (Anjanappa et al., 2020; Balci, 2019; Lowth, 2015). Besides,
they may experience physiological problems (headache, sweating, dif­
ficulty in breathing), antisocial behaviors such as violence and aggres­
sion and many physical, psychological and legal problems such as
committing crime, depression, suicide, smoking, drug addiction and
eating disorder in connection with the inability to manage anger (Balci,
2019; Karababa & Dilmac, 2015).
Adolescents may show various violent behaviors by expressing anger
inappropriately since they do not know how to cope with the feeling of
anger (Karabulut, 2019; Marcus, 2017). Aggressive behaviors that
develop due to the tendency of violence pose a public health problem
considering their effects on mental health and well-being of the ado­
lescents (Bonell et al., 2015). In the studies examining victims of

* Correspondence author at: Silivri İbrahim Yirik Vocational and Technical Anatolian High School, 5 Çayır St. Silivri Rd., Ortakoy nbhd., Silivri, İstanbul 34582,
Turkey.
E-mail addresses: ebruakbas1981@hotmail.com (E. Akbaş), gyigitoglu@pau.edu.tr (G.T. Yiğitoğlu).
1
Pamukkale University, Faculty of Health Science, Departmant of Nursing, Floor 3, Block C, Kınıklı Campus, Denizli/Turkey, Postal Code: 20160, Turkey.

https://doi.org/10.1016/j.apnu.2022.07.029
Received 22 December 2021; Received in revised form 8 May 2022; Accepted 31 July 2022
Available online 5 August 2022
0883-9417/© 2022 Elsevier Inc. All rights reserved.
E. Akbaş and G.T. Yiğitoğlu
violence during adolescence period, victims were reported to have many
health and psychological problems. Depression, anxiety, weakening of
physical health, suicidal thoughts/behaviors, tobacco and illegal drug
use were reported among the victims (Bevilacqua et al., 2017; Moore
et al., 2017). These have some long-term negative effects not only for
victims, but also on the ones who engage in violent behavior. Elevation
of stress level and antisocial behaviors such as committing crime may be
given as examples to these (Safaria & Yunita, 2014). These problems
arising from violent behavior create a great concern for the families,
educators and mental health specialists (Bonell et al., 2015; Zorlu,
2017). For this reason, it is of great importance to implement psycho­
social interventions in order to gain anger management skills during this
period where a very rapid and significant development is exhibited in
personal, social and emotional aspects (Anjanappa et al., 2020; Avcio­
glu, 2019).
There are several approaches that support anger control in adoles­
cents in psychosocial terms. Preventive intervention programs are
applied to the adolescents including the subjects as causes of anger,
anger expression styles, anger management, problem solving tech­
niques, improving communicational skills and stress management
(Bedel & Kutlu, 2019; Canpolat & Atici, 2017; Siyez & Tan Tuna, 2014;
Zorlu, 2017). Solution-focused Approach (SFA), which is one of the
alternative methods that is practical and that ensures well-being in a
short time and that focuses on the solution, not the problem in the
management of anger and violent behavior, has begun to be used in
recent years (Brzezowski, 2011; Sharry, 2016; Siyez & Tan Tuna, 2014).
SFA is an intervention that respects individuals and believes in their
own resources and potential inside them. In SFA, individual's problems
are not examined; instead, individual's own resources and strengths are
identified. Accessing these resources provides a significant opportunity
to the individuals to discover their skills and abilities (Sharry, 2016;
Wand, 2010). SFA meets at a common denominator with the values and
principles of mental health and psychiatric nursing due to the in­
dividuals' search for skills and power resources inside themselves to use
in the process of change (Smith & Macduff, 2017; Wand, 2010). Psy­
chiatric nurses focus on the well-going and working solutions and on the
moments without any problems instead of focusing on the problems and
deficiencies in order to contribute to adaptation and solution generation
skills of the individual (Lakeman, 2018; Wand, 2010). Individuals are
given a significant opportunity for recognizing their personal traits and
improving social skills with this support (Akgul Gundogdu et al., 2016;
Sharry, 2016). SFA can be implemented for all age groups; and evidence-
based studies, where it was found to be most effective, are the ones that
include children and adolescents (Arslan & Akin, 2016; Fitriyah, 2017;
Gong & Hsu, 2016; Uysal, 2014).
In this study, it was aimed to make a contribution to literature by
examining the effect of SFA on promoting anger management and
reducing level of violence among the adolescents. SFA intervention can
be used as a nursing intervention for the adolescents whose anger con­
trol is low and violence tendency is high. It has been postulated that
psychiatric nurses can undertake an important mission to make a
contribution to the areas such as protection and promotion of adolescent
health, decrease in violent and aggressive behaviors, ensuring anger
management, empowering skills, abilities and capacities and treating in
case of illness for raising healthier generations free of violence by using
the principles and implementation steps of SFA.
Hypotheses
H1. Trait anger and anger expression style scores of the adolescents in
the experimental group which undergoes SFA intervention are signifi­
cantly different than control group.
H2. Violence tendency scores of the adolescents in the experimental
group which undergoes SFA intervention are significantly different than
control group.
167
Archives of Psychiatric Nursing 41 (2022) 166–174
Methods
Research design
This was a randomized controlled study with a control group in
which pre-test, post-test and follow-up measurements were carried out.
Research population and sample
The study was carried out in a vocational school located in the city
center. Sample size of the study was determined as 42 by using
G*POWER at a power of 80 %, an effect size of 0.8 and an error rate of
0.05. However, sample included 48 individuals considering that some
data would be missing. Students were assigned to experimental (n = 24)
and control groups (n = 24) by simple random sampling method.
Inclusion criteria
The students who were 10th and 11th graders, who approved to
participate in the study, whose trait anger and violence tendency scores
were high (25 or higher, and 30 or higher, respectively) and anger
control scores were low (18 or lower) were included in the study.
Students in the 9th and 12th grades were not included in the study. It
is thought that the 9th grade students are at the beginning of the middle
adolescence period (15–18 years) and they are in the process of adapting
to the changes in psychosocial development specific to this period
(Aydinli, 2014; Murphy, 2015). The 12th graders were not included in
the study due to the fact that they had not been attending to school
because of their internships three days a week. In addition, the possi­
bility of higher stress levels in 12th grade students were taken into ac­
count due to university exam preparations.
Exclusion criteria
Students who were diagnosed with a psychiatric disorder and an
organic chronic disease, who attended any support groups or psycho­
therapy and who required a special education were excluded from the
study. Besides, the ones who did not attend >2 sessions in the study
group, who did not attend repeated measurements performed in the
control group and who wanted to leave the study voluntarily were not
included.
Data collection tools
Personal information form, State-Trait Anger Expression Inventory
(STAXI) and Violence Tendency Scale (VTS) were used to collect data in
the study.
Personal information form
This form was developed by the researcher in line with the literature
(Sharry, 2016; Siyez & Tan Tuna, 2014). The form consisted of 10
questions including sociodemographic and personal characteristics of
the students. Moreover, this form included questions asking age, sex,
grade, marital status of the parents, number of siblings, parental atti­
tudes, academic success, socioeconomic levels and education levels of
the parents.
The STAXI
State-Trait Anger Expression Inventory (STAXI) was developed by
Spielberger et al. in 1983 in order to measure the feeling of anger and its
expression. It is a self-report scale with four subscales including trait
anger and anger expression styles [anger-in, anger-out, anger-control].
(Spielberger et al., 1983). Its adaptation to Turkish was carried out by
Ozer (1994).
E. Akbaş and G.T. Yiğitoğlu Archives of Psychiatric Nursing 41 (2022) 166–174

The scale is a 4-point Likert type and was composed of 34 items. Table 1
While the first 10 items of the scale indicate trait anger, other 24 items The content and flowchart of SFA group program for adolescent individuals.
measure anger expression styles. Therefore, scoring was made sepa­ Session 1: The Preparatory Interview
rately for each subscale. The highest score that can be obtained from Aim: Meeting/Establishing a Therapeutic Relationship
STAXI is 40 and the lowest is 10. The lowest and highest scores of each Goals
Enabling group members to meet each other.
subscale of STAXI (anger-in, anger-out, anger-control) are 8 and 32,
Establishing a therapeutic relationship by developing trust and sincerity.
respectively. A high trait anger score indicates that the person usually Informing the members about research process and SFA.
feels angry. High scores on anger expression indicate how often one Determining the rules which should be obeyed within the group
expresses anger in a certain style (anger-in, anger-out, anger-control). Session 2
Cronbach's Alpha internal consistency coefficient of trait anger scale was Aim: Discovering the aims and promoting positive aims
Goals
found to be between 0.67 and 0.92. It was observed that the Cronbach's
Creating an individual goal for group process with the following questions as “What
Alpha values of the anger expression style sub-dimensions ranged be­ is your purpose for coming here?”
tween 0.58 and 0.91 (Ozer, 1994). In this study, Cronbach's Alpha Identifying positive aims.
reliability coefficient was 0.75. Using magic ball technique.
Performing “scaling”.
Giving study proposal 1.
The VTS Session 3
Aim: Revealing the Change and Raising Awareness
Violence Tendency Scale (VTS) was developed by Haskan and Yil­ Goals
dirim in 2012 in order to determine violence tendency of the students Evaluating study 1.
Ensuring members to share their thoughts and feelings about anger and violence
studying at high school. It a self-report based, 3-point Likert type scale concepts with the group.
including 20 items. The lowest and highest scores that can be taken from Making to recognize positive effects that may be experienced in and around
the scale are 20 and 60, respectively. A high score indicates a high level themselves when violent behaviors are not seen.
of violence tendency (Haskan & Yildirim, 2012). Cronbach's alpha co­ Ensuring to express in detail what he/she wants to change by “Miracle Question”
technique.
efficient of the scale was found as 0.87 and test-retest reliability coef­
Drawing attention to the conditions that may occur among the members by “Future
ficient was 0.83 (Haskan Avci & Yildirim, 2015; Haskan & Yildirim, reading technique” when change emerges.
2012). Cronbach's Alpha value was 0.70 in this study. Giving study proposal 2.
Session 4
Research procedure Aim: Ensuring Motivation for Anger Management
Goals
Evaluating study 2.
Solution-Focused Approach (SFA) program is an intervention pro­ Increasing motivation of group members to reach their aims and ensuring them to
gram based on solutions of the adolescents' problems rather than the recognize their strengths.
problem itself. It was designed to give individuals, who have a high level Supporting their achievements with praise, appreciating sincerely.
Focusing on the times when problem is not experienced, identifying exceptional
of anger and experience difficulty in anger management, the opportu­
situations, ensuring to discover solutions by talking about what needs to be done to
nity to discover their own resources, achievements and strengths, to make these situations more frequent.
provide integration of these beneficial positive experiences into life Giving study proposal 3.
again, to help them for recognizing the obstacles that may emerge while Session 5
doing this and to make them develop coping strategies to struggle with Aim: Raising Awareness for the Consequences of Violent Behavior
Goals
these obstacles. The researcher has received theoretical/practical Evaluating study 3.
training and supervision about solution-focused therapy with a certifi­ Showing them that preventing possible negative situations is possible and it is
cation, so she designed the SFA program for the current study. Expert necessary to struggle with them.
opinions were taken for the developed program from the individuals Making members to notice that faulty/wrong thinking causes negative behaviors.
Reinforcing behavioral changes by “cheerleading” technique.
specialized in the field of SFA. Final version was given to SFA inter­
Giving study proposal 4.
vention program after making necessary revisions based on the expert Session 6
opinions. SFA intervention was composed of seven sessions including Aim: Recognizing Solutions
one as preparatory and six as solution-focused. Each session lasted for Goals
55 min. The completion of the scales was excluded from this duration. Evaluating study 4.
Making group members to recognize solutions that make a contribution to
The sessions were implemented for once a week as two groups (10th and themselves.
11th graders). SFA intervention program included SFA techniques such Providing these solutions to be used also in other problems.
as positive goal development, miracle question, future reading, identi­ Developing a strategy to overcome existing/possible barriers-flagging the minefield-
fying exceptional situations and flagging the minefield. Study proposals Giving study proposal 5.
Session 7
were given to the students at the end of each session for gaining solution-
Aim: Ending and Evaluating the Process
focused thinking skills. Detailed information about the program was Goals
given in Table 1. The sessions were carried out with each group between Evaluating study 5.
lunch hours on different days in the meeting room of the school. Some Making an overall evaluation of the process.
necessary physical arrangements were made in the meeting room Talking about the gains acquired during this process.
Making group members to experience positive feelings while saying goodbye.
(number of chairs, smart board, frame for wall postings, etc.) in order to Ending the consultation process.
create an appropriate environment for the sessions. No intervention was
applied to the students in the control group. Students in the experi­
mental and control groups were contacted at one week and one month researcher, obliging with the confidentiality principle (not sharing the
after the completion of 7-week sessions; and post-test and follow-up information about the interventions applied in the program, the rec­
measurement data were collected. ommendations given and the study suggestions with other students),
In order to prevent the interaction of the experimental and control participating in the research on a voluntary basis (Fig. 1).
groups with each other, a participation agreement which included
confidentiality obligations was signed by all the students in the experi­ Ethics
mental group. The agreement included obligations such as; following
the group study rules, completing the study suggestions given by the The study was conducted by adhering to ethical principles at each

168
E. Akbaş and G.T. Yiğitoğlu Archives of Psychiatric Nursing 41 (2022) 166–174

Fig. 1. Research procedure.

*IEP: Individualized Education Program.

phase. At the beginning of the study, an ethics approval was taken from
non-interventional Clinical Research Ethics Committee of the university
(No. 60116787-020/45987) and a permission to conduct the study was
obtained from the Provincial Directorate of National Education (No.
24606727). Moreover, students and parents who were volunteer to
participate in the study and enrolled in study and control groups were
made to sign an informed consent form including all information about
the study; and they all provided verbal and written consent. Students
were not given any information about which group they were assigned
to. This study was conducted in compliance with the Principles of the
Declaration of Helsinki.
Data analysis
Data of the study were analyzed by SPSS 24.0 package program. All
data were assessed at a significance level of p < 0.05. For the quanti­
tative variables, the mean (M) and standard deviation (SS) and for the
qualitative variables percentage and frequency measurements were

169
E. Akbaş and G.T. Yiğitoğlu Archives of Psychiatric Nursing 41 (2022) 166–174

employed for the data analysis. Compliant with parametric tests, Inde­ Table 2
pendent Samples t-test (t-table value) was used to compare two inde­ Sociodemographic characteristics of the students in the experimental and con­
pendent samples and “Repeated Measures” test (F-table value) was used trol groups.
for the comparison of dependent three or more groups. For nonpara­ Variable Experimental Control Test
metric data, “Mann-Whitney U” test (Z-table value) was used to compare Group (N = 24) Group (N = 24)
two independent groups whereas “Friedman” test (χ2-table value) was
Mean ± SS Mean ± SS Z/p
used for comparing dependent three or more groups.
Age 16.83 ± 0.76 16.54 ± 0.66 Z = − 1.362
p = 0.173
Results

Mean age of the individuals included in the experimental group was

Variable Experimental Control Test
16.83 ± 0.76 years old. In this group, 75 % were males, 25 % were fe­
males and 54.2 % were 11th graders. Parents of 83.4 % were married, Group (N = 24) Group (N = 24)
and 70.8 % had 1 to 3 siblings. Parents of 41.7 % of the students in this n % n % χ2/p
group were showing a democratic attitude; 83.3 % evaluated their ac­
Sex
ademic success as moderate and 66.7 % of them assessed their economic Female 6 25.0 6 25.0 χ2 = 0.000
status as good/very good. The mothers of 45.8 % of the students had an Male 18 75.0 18 75.0 p = 1.000
elementary school and fathers of 54.2 % of them had a secondary school
degree. Grade
Mean age of the students in the control group was 16.54 ± 0.66 years 10th grade 11 45.8 11 45.8 χ2 = 0.000
old. Among this group, 75 % were males, 25 % were females, 54.2 % 11th grade 13 54.2 13 54.2 p = 1.000
were 11th graders and parents of 91.6 % were married. 66.7 % of the
students in this group had 1 to 3 siblings and parents of 54.2 % had a Marital status of the parents
protective attitude. 75 % of the participants had a moderate level of Married 20 83.4 22 91.6 χ2 = 0.762
Divorced 2 8.3 1 4.2 p = 0.683
academic success while 58.3 % had an economic status at a moderate
Died 2 8.3 1 4.2
level. Mothers of 45.8 % and fathers of 58.4 % had a secondary school
degree. No statistically significant differences were found between the
Number of siblings
experimental and control groups in terms of age, sex, grade, marital Single child 4 16.7 1 4.2 χ2 = 3.430
status of the parents, number of siblings, parental attitudes, academic 1–3 17 70.8 16 66.7 p = 0.180
success level, socioeconomic level and educational states of the parents 4 and more 3 12.5 7 29.1
(Table 2; p > 0.05).
Mean STAXI and VTS scores of the adolescents in experimental and Parental attitude
control groups were similar before the intervention began; and they Irrelevant 2 8.3 – –
were not significantly different. It was found that students were assigned Democratic 10 41.7 4 16.7 χ2 = 6.965
Authoritarian 1 4.2 3 12.4 p = 0.138
to experimental and control groups homogenously (Table 3, p > 0.05). Protective 9 37.5 13 54.2
Mean STAXI and VTS scores of the adolescents in the experimental Authoritarian + protective 2 8.3 4 16.7
group at one week and one month following the intervention were
significantly different than the mean scores of the students in the control Academic success
group (p < 0.05). Trait anger, anger-out and VTS scores of the ones in the High 4 16.7 5 20.8 χ2 = 1.216
experimental group at post-test and follow-up were found to be signif­ Moderate 20 83.3 18 75.0 p = 0.544
icantly lower than control group. Similarly, anger-control score of the Low – – 1 4.2

experimental group was higher than the control group at a statistically

significant level. However, no statistically significant difference was Economic level
Very bad 1 4.2 χ2 = 4.596
found between both groups in terms of mean anger-in scores at one week – –
Moderate 8 33.3 14 58.3 p = 0.100
and one month after the intervention (Table 4; p > 0.05). Good/very good 16 66.7 9 37.5
In the study, the decrease in the mean trait anger scores of the stu­
dents in the experimental group were found to be continued at one week
Mother’s education
and one month after the intervention compared to pre-intervention (χ2 Literate/illiterate 5 20.8 3 12.5 χ2 = 1.021
= 26.519, p = 0.001). In advanced analysis; it was detected that trait Elementary school 11 45.8 10 41.7 p = 0.600
anger scores of the experimental group after one week and one month Secondary school and higher 8 33.4 11 45.8
were significantly lower than the scores before the intervention (1–2, p
= 0.001, 1–3, p = 0.001) (Table 5). Also, mean trait anger scores of the Father's education
students in the control group continued to decrease significantly Literate/illiterate 2 8.3 2 8.3 χ2 = 0.096
Elementary school 9 37.5 8 33.3 p = 0.953
compared to the scores before the intervention at post-test and follow-up
Secondary school and higher 13 54.2 14 58.4
(χ2 = 10.333, p = 0.006). At the end of further analysis, it was deter­
mined that pre-test and post-test results were significantly different than χ2 = chi-square test, Z = Mann-Whitney U test.
follow-up test (Table 5; 1–3, p = 0.008, 2–3, p = 0.003).
Mean anger-in score of the students in the experimental group was tests (χ2 = 28.085, p = 0.001). Further analysis showed that pre-test
decreased one week after the intervention and this decrease continued results were significantly different than post-test and follow-up test
also at one month (χ2 = 11.028, p = 0.004). Further analysis revealed (1–2, p = 0.001, 1–3, p = 0.001). No statistically significant difference
that pre-test results were significantly different than post-test and was found in anger-out scores of the students in the control group based
follow-up test (1–2, p = 0.001, 1–3, p = 0.001). No statistically signif­ on all tests (Table 5; p > 0.05).
icant difference was found between all tests in the control group in terms The difference between mean anger-control scores of the students in
of anger-in subscale scores (Table 5; F = 0.469, p = 0.629). the experimental group was found to be statistically significant based on
The difference between anger-out scores of the students included in all tests (χ2 = 29.154, p = 0.001). This difference was found to be
the experimental group was found to be statistically significant at all derived from the differences between pre-test and post- and follow-up

170
E. Akbaş and G.T. Yiğitoğlu Archives of Psychiatric Nursing 41 (2022) 166–174

Table 3 Table 5
Comparison of mean trait anger, anger expression style and violence tendency Comparison of experimental and control groups for trait anger, anger expression
scores of experimental and control groups before intervention. styles and violence tendency scale scores before and one week and one month
Variable Experimental group (N Control group (N Test
after the intervention.
= 24) = 24) Variable Experimental group Control group (n = 20)
(n = 20)
Mean ± SS Mean ± SS
Mean ± Mean ±
Trait anger 29.50 ± 2.5 28.96 ± 3.3 Z=
SS SS
− 0.946
p = 0.344 Trait anger Pre-test (1) 29.35 ± 28.55 ±
Anger-in 19.25 ± 2.8 18.58 ± 4.0 Z= 2.35 3.58
− 0.052 Post-test (2) 23.10 ± 28.45 ±
p = 0.959 2.85 3.90
Anger-out 20.83 ± 3.4 21.04 ± 4.6 Z= Follow-up 21.10 ± 26.85 ±
− 0.446 test (3) 3.51 3.48
p = 0.656 Test χ2 = 26.519 χ2 = 10.333
Anger-control 15.88 ± 2.8 16.25 ± 2.7 Z= *p ¼ 0.001 *p ¼ 0.006
− 0.523 **[1− 2, 3] **[1, 2− 3]
p = 0.601 1–2, p = 0.001 1–3, p = 0.008
Violence Tendency 38.83 ± 4.3 38.88 ± 6.3 t= 1–3, p = 0.001 2–3, p = 0.003
Scale − 0.026 Anger-in Pre-test (1) 19.20 ± 18.15 ±
p = 0.979 3.14 4.32
Post-test (2) 17.00 ± 17.85 ±
Z = Mann-Whitney U test, t = independent samples t-test.
3.74 4.27
Follow-up 16.45 ± 18.25 ±
test (3) 3.12 4.45
Table 4 Test χ2 = 11.028 F = 0.469
Comparison of experimental and control groups for trait anger, anger expression *p ¼ 0.004 p = 0.629
styles and violence tendency scores at one week and one month following **[1–2, 3]
intervention. 1–2, p = 0,001
1–3, p = 0,001
Variable Experimental Control Test Anger-out Pre-test (1) 20.75 ± 20.0 20.75 ± 21.5
group group 3.16 [3.0] 4.92 [7.8]
Mean ± SS Mean ± SS Post-test (2) 14.80 ± 14.5 20.75 ± 20.0
3.95 [4.8] 4.93 [9.5]
Post-test (n = Trait anger 23.32 ± 2.83 28.64 ± Z= Follow-up 15.50 ± 16.5 20.00 ± 19.0
44) 3.76 − 4.423 test (3) 3.49 [4.8] 3.99 [6.8]
p¼ Test 2
χ = 28.085 F = 1.966
0.001 *p ¼ 0.001 p = 0.164
Anger-in 16.77 ± 3.66 18.05 ± Z= **[1–2, 3]
4.11 − 1.237 1–2, p = 0.001
p = 0.216 1–3, p = 0.001
Anger-out 14.95 ± 4.16 20.95 ± Z= Anger-control Pre-test (1) 16.40 ± 17.0 16.05 ± 16.0
4.75 − 3.921 2.46 [5.0] 2.91 [5.8]
p¼ Post-test (2)
25.30 ± 25.5 16.55 ± 16.5
0.001 3.50 [3.8] 3.12 [5.5]
Anger-control 24.86 ± 3.62 16.27 ± t = 8.582 Follow-up 23.65 ± 24.0 18.45 ± 18.0
2.99 p¼ test (3) 4.44 [6.3] 4.17 [4.5]
0.001 Test χ2 = 29.154 F = 6.265
Violence 30.77 ± 4.01 39.69 ± t= *p ¼ 0.001 *p ¼ 0.014
tendency scale 6.65 − 5.381 **[1–2, 3] **[1–3]
p¼ 1–2, p = 0.001 1–3, p = 0.012
0.001 1–3, p = 0.001
Follow-up test Trait anger 21.10 ± 3.51 26.85 ± t= Violence Pre-test (1) 38.15 ± 37.0 38.95 ± 38.5
(n = 40) 3.48 − 5.202 Tendency 4.11 [6.8] 6.72 [10.3]
p¼ Scale Post-test (2) 30.45 ± 30.5 39.35 ± 39.0
0.001 4.06 [5.5] 6.83 [11.5]
Anger-in 16.45 ± 3.12 18.25 ± t= Follow-up 32.80 ± 32.0 37.20 ± 36.0
4.45 − 1.482 test (3) 4.53 [7.0] 6.95 [10.8]
p = 0.147 Test F = 44.310 F = 16.461
Anger-out 15.50 ± 3.49 20.00 ± t= *p ¼ 0.001 *p ¼ 0.001
3.99 − 3.800 **[1–2, 3] [2–3] **[1, 2–3]
p¼ 1–2, p = 0.001 1–3, p = 0.001
0.001 1–3, p = 0.001 2–3, p = 0.001
Anger-control 23.65 ± 4.44 18.45 ± t = 3.816 2–3, p = 0.010
4.17 p¼
0.001 F: repeated measures; χ2: Friedman test.
*
Violence 32.80 ± 4.53 37.20 ± t= p < 0.05.
**
tendency scale 6.95 − 2.373 Post hoc pairwise comparisons, Wilcoxon test, and Bonferroni correction
p¼ was used for multiple comparisons. [1–2, 3]: There are significant differences
0.024 between 1 and 2 and 1 and 3. [1–3]: There is a significant difference between 1
Z = Mann-Whitney U test, t = independent samples t-test. and 3.

tests (1–2, p = 0.001, 1–3, p = 0.001). Also, anger-control scores of the 0.012).
students in the control group were shown a statistically significant dif­ The difference between violence tendency scores of the students in
ference based on all tests (F = 6.265, p = 0.014). This difference was the experimental group was found to be statistically significant (F =
found to occur between pre-test and follow-up scores (Table 5; 1–3, p = 44.310, p = 0.001). Further analysis revealed that pre-test results were

171
E. Akbaş and G.T. Yiğitoğlu
significantly different from post-test and follow-up test results (1–2, p =
0.001, 1–3, p = 0.001). Similarly, a significant difference was found
between the values after one week and after one month (2–3, p = 0.010).
In addition, a statistically significant difference was found between
violence tendency scores of the students in control group at all tests (F =
16.461, p = 0.001). At the end of further comparisons, this difference
was found to occur between follow-up test and pre- and post-tests
(Table 5; 1–3, p = 0.001, 2–3, p = 0.001).
Discussion
This study aimed to examine the effect of solution-focused approach
on anger management and violent behavior in adolescents; and it is
considered to be a different study in this respect. The feeling of anger is
most frequently experienced during adolescence period (Anjanappa
et al., 2020; Marcus, 2017). Adolescents have more difficulties
compared to the other age groups about the management of this feeling
of anger that they experience (Anjanappa et al., 2020; Hoogsteder et al.,
2015). For this reason, it is of great importance to implement psycho­
social intervention approaches during this period where there is a rapid
and significant development in personal, social and emotional aspects in
order to gain anger management skills (Anjanappa et al., 2020; Avcio­
glu, 2019). In this study, trait anger, anger-in and anger-out scores were
found to be high and anger-control scores were found to be low before
SFA intervention among the adolescents in both experimental and
control groups (Table 2).
Descriptive, experimental and follow-up studies have reported that
violent behaviors such as aggressiveness, bullying and risk taking be­
haviors are more frequently seen among the adolescents (Arslan & Akin,
2016; Fitriyah, 2017; Haskan Avci & Yildirim, 2015; Hoogsteder et al.,
2015; Karabulut, 2019). In the study by Marcus (2017) which was car­
ried out on anger, anger management and aggressiveness, it was re­
ported that these problems were consistently seen mostly in adolescents,
this group responded to daily interpersonal problems by anger and used
mostly confrontation (anger-out) strategies in these problems. Also in
this study, violence tendency levels were found to be above the average
among the adolescents in experimental and control groups before SFA
intervention (Table 3). These results are similar with the relevant
studies; and show that violence tendency of the adolescents is high
(Fagan & Catalano, 2013; Fitriyah, 2017; Haskan Avci & Yildirim, 2015;
Hoogsteder et al., 2015).
While trait anger and anger expression style scores of the experi­
mental and control groups were similar before SFA intervention, trait
anger and anger-out scores of the adolescents in the experimental group
were found to be significantly lower and their anger-control levels were
found to be higher than the adolescents in the control group at one week
and one month following the intervention (Table 4). These data support
the hypothesis suggesting that trait anger and anger expression style
scores of the adolescents in the experimental group which undergoes
SFA intervention are significantly different than control group. In the
literature, most of the studies carried out for decreasing anger level in
adolescents, solving anger-associated problems, preventing violent be­
haviors and ensuring anger management were found to include cogni­
tive behaviorist interventions and yielded similar results (Hoogsteder
et al., 2015; Matjasko et al., 2012). Moreover, the studies where SFA
intervention was applied and other cognitive-based anger management
programs were used have shown parallel findings (Bedel & Kutlu, 2019;
Maleki et al., 2011; Siyez & Tan Tuna, 2014; Zorlu, 2017). Siyez and Tan
Tuna (2014) found in their study where they examined the effect of SFA
on anger control and communication skills of high school students that it
was effective on reducing trait anger, anger-in and anger-out and
increasing anger-control. Similarly, Zorlu (2017) reported a significant
decrease in mean trait anger and anger-out scores of the students in the
experimental group and a significant increase in mean anger control
scores following anger management training program which they
applied to high school students. In the randomized controlled study by
172
Archives of Psychiatric Nursing 41 (2022) 166–174
Puskar et al. (2015) on anger management in 14–18 year old adoles­
cents, training was determined to be effective in coping with emotional,
behavioral and social effects of anger. Brzezowski (2011) examined the
effect of SFA on the individuals whose anger expression style was mal­
adaptive; and found that anger was expressed more easily in the inter­
vention groups at a significant level. Based on the literature data and the
results of this study, it can be stated that SFA may be an approach
enabling to manage feeling of anger experienced by the individuals and
conflicts that may arise better. It is anticipated that including such in­
terventions in the context of solution-focused nursing practices can be
highly important during adolescence period where violent behaviors are
intensely observed. It is thought that adolescents can establish a positive
interpersonal communication, an empathetic perspective may be pro­
vided, anger and violent behaviors may be decreased and they may
acquire problem solving skills in this way.
Trait anger, anger-in and anger-out scores of the experimental group
following one week and one month were determined to be significantly
lower than the scores before the intervention. Thus, it was concluded
that the effect of intervention continued on the anger variable. This
result of the study supports the literature data and reveals that SFA
intervention may be effective on anger management in adolescents
(Puskar et al., 2015; Siyez & Tan Tuna, 2014; Zorlu, 2017). In the study,
a significant decrease was observed in trait anger scores of control group
after one week and one month following the intervention and a signif­
icant increase was seen in anger-control level. This situation was
considered to be associated with Covid-19 pandemic. The closure of
schools as of March might have an effect of reducing the number of
conflicts that students might experience in social relationships. Besides,
spending this period in a comfortable environment such as home within
the framework of an order and rules in line with their own wishes might
have been effective in ensuring their anger control. In their study
examining the effect of their group program on anger control skills,
Canpolat and Atici (2017) reported significant decreases in trait anger,
anger-out and anger-in levels and a significant increase in anger control
level. In the meta-analysis conducted by Candelaria et al. (2012) school-
based anger management programs were indicated to show a positive
effect on the social and emotional outcomes of the students. Moreover,
Bedel and Kutlu (2019) found in their relevant study that conflict res­
olution psychoeducation program caused a decrease in trait anger,
anger-in and anger-out scores and an increase in anger-control scores of
the adolescents. The result of this study also supports literature data; and
reveals the efficiency of SFA intervention on alleviating anger levels and
promoting anger management among the adolescents.
While violence tendency scores of the experimental and control
groups were found to be comparable before the intervention in this
study, a significant decrease was observed in the violence tendency
scores of the adolescents in the experimental group at one week and one
month following the intervention. The hypothesis as “violence tendency
scores of the adolescents in the experimental group which undergoes
SFA intervention are significantly different than control group” was
accepted based on this finding. There are also some studies in the
literature supporting this outcome. In the study by Arslan and Akin
(2016) which was carried out with high school students, a 6-session
group SFA intervention was found to decrease peer bullying levels of
the students in the experimental group and this was also preserved in the
follow-up test. The study by Fitriyah (2017) measured the efficiency of
SFA for decreasing aggressiveness in adolescents; and at the end of 4-
week group sessions, more constructive behaviors were seen among
the students and a reduction was observed in aggressive behaviors.
Moreover, Avcioglu (2019) stated that anger control training given to
the high school students was effective in alleviating their violence ten­
dency. In the study by Sarici Bulut (2010), it was aimed to treat tendency
for aggressiveness and a solution-focused brief therapy was imple­
mented for 7 weeks in groups. According to the findings of their study,
they reported a significant decrease in the aggressiveness scores of the
students in the experimental group compared to the control group and
E. Akbaş and G.T. Yiğitoğlu
indicated that positive effect of solution-focused brief therapy on the
state of aggressiveness continued.
It was also observed that violence tendency scores of the individuals
in the experimental group were decreased at one week and one month
following the intervention and it was increased at follow-up test
compared to the post-test at one week following the intervention. This
finding can be evaluated as a positive outcome since this increase in
violence tendency is less than the decrease in the control group at post-
test and follow-up measurements. This situation can be interpreted as
“SFA is effective in alleviating violent behavior and maintaining positive
change observed among the individuals”. We can explain the significant
(increase/decrease) changes observed at follow-up tests of both groups
as a reflection of the psychosocial effect (such as staying at home, lim­
itations in social life and communication problems experienced in
interpersonal relationships) created by Covid-19 pandemic on the ado­
lescents. In addition, the results of the study by Uysal (2014) revealed
that SFA intervention lowered risk taking levels among the adolescents
in the experimental group and this situation continued also at follow-up
tests. Gavine et al. (2016) indicated in their study that primary pre­
ventive programs aiming to decrease violence among 11–18 year old
adolescents were mostly implemented at school environment. In this
systematic review investigating the efficiency of school-based programs,
especially interventions that ensure social development and reveal so­
cial norms were shown to be effective. Furthermore, Maleki et al. (2011)
found that their anger management training program was effective on
the aggressiveness among 12–15 year old male students and this inter­
vention could be implemented at similar situations. Developmental
theories for violence tendency and violent behaviors among individuals
show that these are influenced by the factors coming from early ages.
For this reason, it is of great importance to implement effective in­
terventions especially before 18 years old. Besides, it has been stated
that single-component studies that focus on a specific area/specific
factors would be highly effective instead of multi-component practices
to reduce violence among the adolescents (Fagan & Catalano, 2013;
Matjasko et al., 2012). As seen, literature data appear to support the
results of this study.
Limitations
The study results were limited to 10th and 11th graders who were
studying in a secondary school. Therefore, these results cannot be
generalized to other individuals but can contribute to generalization.
Other limitations of the study included higher number of male par­
ticipants compared to female students (due to the departments at school
including informatics, electric-electronics, construction, metal, printing
press, machine technologies and furniture and interior design) and the
delivery of post-test and follow-up data by the researcher through phone
due to Covid-19. Moreover, the schools were closed and the education
became online during this period. There were many losses in both
experimental and control groups due to the chaotic effect of these times.
Conclusions
In this study, trait anger and anger expression style scores of the
adolescents in the experimental group where SFA was implemented,
were found to be significantly different than the control group. In
addition, it was found that violence tendency scores of the adolescents in
the experimental group were significantly lower than control group
following the intervention and this situation continued until the end of
one month. The results shed light on the benefits of applying solution-
focused approach for the adolescents. SFA intervention should be
applied to adolescents by psychiatric nurses within the scope of pre­
vention studies in schools.
173
Archives of Psychiatric Nursing 41 (2022) 166–174
Implications
Following suggestions were made based on the results of this study:
- Increasing the number of experimental studies on the effect of SFA
intervention on anger management and violent behavior,
- Using SFA intervention for protecting and promoting adolescent
health by integrating it into the nursing practices at schools,
- Preparing and implementing anger management program, which is
prepared through SFA principles and techniques, for the students at
various education levels (elementary school-secondary school-high
school) or their parents.
- Implementing SFA intervention for the solution of problems created
by violent behavior and for ensuring anger management in adoles­
cents should be done by the psychiatric nurses and informing ado­
lescents about the practice.
Ethics committee permission
This study was performed in line with the principles of the Decla­
ration of Helsinki. Approval was granted by the Ethics Committee of
Pamukkale University Health Sciences Institute (date: 03.07.2019-
E.45987 and decision no: 60116787-020/45987).
Data availability statement
The data that support the findings of this study are available on
request from the corresponding author. The data are not publicly
available due to privacy or ethical restrictions.
Funding statement
This research receive no specific grant from any funding agency in
the public, commercial, or not-for-profit sectors.
This study is going to be presented as a paper at the VI. International
X. National Psychiatric Nursing Congress (20–23 October 2021).
This article has never been published before.
This study was produced from a doctoral thesis.
CRediT authorship contribution statement
Made substantial contributions to conception and design, or acqui­
sition of data, or analysis and interpretation of data; EA, GTY.
Involved in drafting the manuscript or revising it critically for
important intellectual content; EA, GTY.
Given final approval of the version to be published. Each author
should have participated sufficiently in the work to take public re­
sponsibility for appropriate portions of the content; EA, GTY.
Agreed to be accountable for all aspects of the work in ensuring that
questions related to the accuracy or integrity of any part of the work are
appropriately investigated and resolved; EA, GTY.
Declaration of competing interest
The authors report no actual and potential conflicts of interest.
Acknowledgments
We would like to acknowledge Prof. Dr. Turkan Turan and Prof. Dr.
Sahin Kapikaran who did not spare their knowledge and support in
solution-focused practices during the study and all students and parents
due to their contribution to this study.
ClinicalTrials.gov identifier
NCT04951271
E. Akbaş and G.T. Yiğitoğlu Archives of Psychiatric Nursing 41 (2022) 166–174

References J Forens Psychiatry Psychol, 26(1), 22–37. https://doi.org/10.1007/s10608-012-

9476-1
Karababa, A., & Dilmac, B. (2015). The role of human values in predicting trait anger and
Akgul Gundogdu, N., Zincir, H., & Guler, N. (2016). Solution focused approach and usage
anger expression styles among adolescents. Elementary Education Online, 4(3),
of nursing. JCBPR, 3, 145–152. https://doi.org/10.5455/JCBPR.234017
1149–1158. 10.17051/io.2015.85927.
Anjanappa, S., Govindan, R., & Munivenkatappa, M. (2020). Prevalence and expression
Karabulut, B. (2019). Relationship between digital gaming addiction and tendency to violence
of anger in school going adolescents. Archives of Psychiatric Nursing, 34(1), 35–40.
among high school students [Unpublished master’s thesis]. Retrieved from: Hasan
https://doi.org/10.1016/j.apnu.2019.12.002
Kalyoncu University. https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.
Arslan, N., & Akin, A. (2016). The effect of solution focused brief group counseling on
jsp.
bullying among high school students. SUJEF, 6(1), 72–84. https://doi.org/
Lakeman, R. (2018). The withdrawn or recalcitrant client. In J. C. Santos, &
10.19126/suje.62580
J. R. Cutcliffe (Eds.), European psychiatric/mental health nursing in the 21st century: A
Avcioglu, S. (2019). The effect of anger management training on violence tendency to high
person-centred evidence-based approach (pp. 479–493). Switzerland: Springer.
school students. Retrieved from. Atatürk University https://tez.yok.gov.tr/UlusalTez
Lowth, M. (2015). Managing anger in adolescents. Pract Nurs, 45(12), 18–23.
Merkezi/tezSorguSonucYeni.jsp.
Maleki, S., Khoshknab, M. F., Rahgooi, A., & Rahgozar, M. (2011). The effect of anger
Aydinli, S. (2014). The investigation of adolescents' anger expression styles, social comparison
management training in groups on aggression of 12–15 years old male students.
level, hopelessness levels and conflict solving approach. Retrieved from. Halic University
Retrieved from Iran Journal of Nursing, 24(69), 26–35 http://ijn.iums.ac.ir/ar
https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp.
ticle-1-945-en.html.
Balci, E. (2019). Investigotion about the relationship between agression and temper levels of
Marcus, R. F. (2017). The development of aggression and violence in adolescence.
adolescents who live ın youth home (orphanage). Retrieved from. Sabahattin Zaim
Springer. https://doi.org/10.1057/978-1-137-54563-3
University https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp.
Matjasko, J. L., Vivolo-Kantor, A. M., Massetti, G. M., Holland, K. M., Holt, M. K., &
Bedel, A., & Kutlu, A. (2019). The effect of conflict resolution program on middle school
Cruz, J. D. (2012). A systematic meta-review of evaluations of youth violence
students’ conflict resolution skills, trait anger and anger expression styles. Elementary
prevention programs: Common and divergent findings from 25 years of meta-
Education Online, 18(1), 97–111. 10.17051/ilkonline.2019.527165.
analyses and systematic reviews. Aggression and Violent Behavior, 17(6), 540–552.
Bevilacqua, L., Shackleton, N., Hale, D., Allen, E., Bond, L., Christie, D., & Viner, R. M.
https://doi.org/10.1016/j.avb.2012.06.006
(2017). The role of family and school-level factors in bullying and cyberbullying: A
Moore, S. E., Norman, R. E., Suetani, S., Thomas, H. J., Sly, P. D., & Scott, J. G. (2017).
cross-sectional study. Retrieved from BMC Pediatr, 17(1), 160. https://doi.org/
Consequences of bullying victimization in childhood and adolescence: A systematic
10.3310/hta1953010.1186/s12887-017-0907-8.
review and meta-analysis. World Journal of Psychiatry, 7(1), 60. https://doi.org/1
Bonell, C., Fletcher, A., Fitzgerald-Yau, N., Hale, D., Allen, E., Elbourne, D.Viner, R., …
0.5498/wjp.v7.i1.60.
(2015). Initiating change locally in bullying and aggression through the school
Murphy, J. J. (2015). Solution-focused counseling in schools. In (3rd ed., p. 263). New York:
environment (Inclusıve): A pilot randomised controlled trial. Health Technology
John Wiley & Sons.
Assessment, 19(53), 1–110. https://doi.org/10.3310/hta19530
Ozer, A. K. (1994). Sürekli öfke (SL-ÖFKE) ve öfke ifade tarzı (ÖFKE-TARZ) ölçekleri ön
Brzezowski, K. M. (2011). A solution-focused group treatment approach for individuals
çalışması. Turk Psikoloji Dergisi, 9(31), 26–35.
maladaptively expressing anger [Professıonal dıssertatıon]. Wright State University.
Puskar, K. R., Ren, D., & McFadden, T. (2015). Testing the ‘teaching kids to cope with
Candelaria, A. M., Fedewa, A. L., & Ahn, S. (2012). The effects of anger management on
anger’ youth anger intervention program in a rural school-based sample. Issues in
children’s social and emotional outcomes: A meta-analysis. School Psychology
Mental Health Nursing, 36(3), 200–208. https://doi.org/10.3109/
International, 33(6), 596–614. https://doi.org/10.1177/0143034312454360
01612840.2014.969390
Canpolat, M., & Atici, M. (2017). The effect of anger control program secondary school
Safaria, T., & Yunita, A. (2014). The efficacy of art therapy to reduce anxiety among
students’ anger control. Retrieved from Turk PDR Dergisi, 7(47), 87–98 https://der
bullying victims. Int J Res Stud Psychol, 3(4), 77–88. https://doi.org/10.5861/
gipark.org.tr/tr/pub/tpdrd/issue/42743/515893.
ijrsp.2014.829
Fagan, A. A., & Catalano, R. F. (2013). What works in youth violence prevention: A
Sarici Bulut, S. (2010). The effect of solution focused group therapy on treatment of the
review of the literature. Research on Social Work Practice, 23(2), 141–156. https://
second grade primary school students exam anxiety, agressive tendency and problem
doi.org/10.1177/1049731512465899
solving ability. Retrieved from Gazi Üniversitesi Gazi Eğitim Fakültesi Dergisi, 30(2),
Fitriyah, F. K. (2017). Reducing aggressive behavior using solution-focused brief
325–356 http://www.gefad.gazi.edu.tr/tr/pub/issue/6741/90626.
counseling (Sfbc). Jurnal Bimbingan Konseling Indonesia, 2(2), 34–39. 10.26737/jbki.
Sharry, J. (2016). Solution-focused groupwork. In D. M. Siyez, Y. Soylu, Ü. Arslan, E. Esen,
v2i2.254.
& T. Bağatarhan (Eds.) (1st ed.). Ankara: Nobel Academy.
Gavine, A. J., Donnelly, P. D., & Williams, D. J. (2016). Effectiveness of universal school-
Siyez, D. M., & Tan Tuna, D. (2014). Effect of solution focused programme on
based programs for prevention of violence in adolescents. Psychology of Violence, 6
adolescents’ anger control and communication skills. Retrieved from Turk PDR
(3), 390–399. https://doi.org/10.1037/vio0000052
Dergisi, 5(41), 11–22 https://dergipark.org.tr/tr/pub/tpdrd/issue/21461/229935.
Gong, H., & Hsu, W. (2016). The effectiveness of solution-focused group therapy in
Smith, S., & Macduff, C. (2017). A thematic analysis of the experience of UK mental
ethnic Chinese school settings: A meta-analysis. International Journal of Group
health nurses who have trained in solution focused brief therapy. Journal of
Psychotherapy, 67(3), 383–409. https://doi.org/10.1080/00207284.2016.1240588
Psychiatric and Mental Health Nursing, 24(2–3), 105–113. https://doi.org/10.1111/
Gordeles Beser, N. (2014). Ergenlik dönemi ruh sağlığı ve hastalıkları. In O. Çam, &
jpm.12365
E. Engin (Eds.), Ruh sağlığı ve hastalıkları hemşireliği bakım sanatı (pp. 707–773).
Spielberger, C. D., Jacobs, G., Russell, S., & Crane, R. S. (1983). Assessment of anger: The
İstanbul: İstanbul Tıp Bookstore.
state-trait anger scale. Advances in Personality Assessment, 2, 161–189.
Haskan Avci, O., & Yildirim, İ. (2015). Prevalence of violence tendency in adolescents.
Uysal, R. (2014). The effect of solution-focused brief therapy oriented intervention program on
Retrieved from Journal of Theoretical Educational Science, 8(1), 106–124 https://derg
adolescents' level of risk-taking behavior. Retrieved from. Sakarya University htt
ipark.org.tr/tr/pub/akukeg/issue/29356/314123.
ps://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp.
Haskan, O., & Yildirim, İ. (2012). Development of violence tendency scale. Retrieved
Wand, T. (2010). Mental health nursing from a solution focused perspective. International
from Education and Science, 37(163), 165–177 https://www.proquest.com/openview
Journal of Mental Health Nursing, 19(3), 210–219. https://doi.org/10.1111/j.1447-
/ede5226c77b988738147d2ceb5897676/1?pq-origsite=gscholar&cbl=1056401.
0349.2009.00659.x
Hoogsteder, L. M., Stams, G. J. J., Figge, M. A., Changoe, K., van Horn, J. E., Hendriks, J.,
Zorlu, E. (2017). The effect of anger management education program over the high school
& Wissink, I. B. (2015). A meta-analysis of the effectiveness of individually oriented
students’ anger and anger state trait. Retrieved from. Necmettin Erbakan University htt
cognitive behavioral treatment (CBT) for severe aggressive behavior in adolescents.
ps://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp.

174