Theses and Dissertations

Issuing Body

Mississippi State University


Looby, Eugenie J.

Committee Member

Justice, Cheryl A.

Committee Member

Morse, David T.

Committee Member

Dooley, Katherine

Date of Degree


Document Type

Dissertation - Open Access


Counselor Education

Degree Name

Doctor of Philosophy (Ph.D)


College of Education


Department of Counseling, Educational Psychology and Foundations


Research is lacking on the efficacy of aggression management training programs based on clinical outcomes. This study examined the efficacy of an aggression management training on managing aggression and violent behavior at East Mississippi State Hospital (EMSH), an inpatient behavioral health program. This training, The Mandt System, replaced a previous training, Techniques for the Management of Aggressive Behavior (TMAB), which was considered to be non-replicable outside state facilities in Mississippi. This study should not be seen as a comparative study between The Mandt System and TMAB, but rather as an investigation into the effects of implementing The Mandt System as a new training at EMSH. The efficacy of The Mandt System was examined through 4 key variables: patient to patient incidents, patient to staff incidents, seclusion episodes and restraint episodes. Over a 6 year period, incidents of aggression and violence were identified by extracting archival data from incident reports. Archival data were examined 3 years prior to the implementation of The Mandt System and 3 years after the implementation of the training. The researcher found that the rate of patient to patient incidents decreased as well as the rate of seclusions and restraint episodes following implementation of The Mandt System training. The rate of the patient to staff incidents did not decrease. Effective training on the management of aggression is essential in decreasing aggressive and violent behavior. Nevertheless, these findings are difficult to validate due to a scarcity of research that is supported by evidence from randomized controlled studies. A review of the literature revealed that researchers do not give precedence to the study of aggression management training when dealing with aggressive behavior in inpatient behavior health settings. This is possibly due to the findings of Hage, Van Meijel, Fluttert, and Berden (2009) that research on the effectiveness of intervention strategies requires a more complicated study design and involves many methodological and logistical challenges. Although the results of this study suggest that this training can have a positive effect on aggression and violence, much more needs to be done to evaluate the effectiveness of aggression management training programs.