Posts Tagged ‘cognitive behavioral therapy’

Recently, on Quora, I responded to a question about whether there were any interventions actually proven through research to help offenders change their behavior for the better. Not only is the answer to that question a resounding yes, but there are a number of approaches that are very effective in that regard. One primary group of interventions along those lines is Cognitive Behavioral Therapies, or CBT, as they’re often called.

In a correctional context, the various forms of CBT generally  involve changing the dysfunctional thought patterns that contribute to criminal behaviors by applying a structured intervention process, often in a group environment. CBT has been shown repeatedly to be effective in a wide variety of settings and with nearly all categories of offenders, including those at high risk to reoffend.

In one article published by the National Institute of Justice in 2010, Preventing Future Crime With Cognitive Behavioral Therapy, the authors wrote that:

programs based on cognitive behavioral therapy are effective with juvenile and adult criminal offenders in various criminal justice settings, including prison, residential, community probation and parole. [The authors] examined research studies published from 1965 through 2005 and found 58 that could be included in their review and analysis. The researchers found that cognitive behavioral therapy significantly reduced recidivism even among high-risk offenders.

In a separate study published by the National Institute of Corrections in 2007, Cognitive-Behavioral Treatment: A Review and Discussion for Corrections Professionals, the authors reached similar conclusions. Specifically regarding CBT’s affects on recidivism, they wrote that:

A meta-analysis of 69 studies covering both behavioral and cognitivebehavioral programs determined that the cognitive-behavioral programs were more effective in reducing recidivism than the behavioral programs (Pearson et al., 2002). The mean reduction in recidivism was about 30 percent for treated offenders. Other meta-analyses of correctional treatment concluded that cognitive-behavioral methods are critical aspects of effective correctional treatment (Andrews et al., 1990; Losel, 1995). Yet another study similarly determined that the most effective interventions are those that use cognitivebehavioral techniques to improve cognitive functioning (Gendreau and Andrews, 1990).

So, I would say there is significant scientific evidence that CBT provides positive therapeutic effects, including reductions in recidivism.  Like any intervention, it is not appropriate for every offender or every situation, but it is still one of the most flexible and effective groupings of rehabilitative interventions available.

What are your thoughts about CBT?

In modern society, our options for punishment are fairly limited. Actually, prisons are an improvement over early punishments that involved primarily putting people to death for anything and everything (see the Code of Hammurabi for some fun details about that).

The use of prisons has changed considerably over the years, but they are essentially the same as they’ve always been in terms of being graduate schools of crime. Placing criminally-minded folks with others who share the same worldview can be very counterproductive. But, there are important reasons that we continue to use prisons, and there are some emerging ways to reduce the risk of recidivism among incarcerated offenders.
Barb wire
First, it’s important to understand that prison is not really about changing people’s behavior, contrary to popular belief. There are actually five generally accepted goals of sentencing (retribution, deterrence, incapacitation, restoration, and rehabilitation) the first three of which are accomplished primarily through incarceration. When an individual commits a crime, they create what’s known as a social debt, which is a price that the offender should pay for harming the victim and society. The way we extract that debt used to be through torture or putting the person to death, but now we primarily extract it through imprisonment.

So, incarceration is not really about “fixing” people, rehabilitating them, or even about “teaching them a lesson,” it’s about extracting a cost for harming society. That’s an important point to keep in mind.

There’s no credible research showing that punishment in general is an effective way to reduce an individual’s risk of repeat criminal behavior in the future, contrary again to popular belief. Actually, the opposite has been shown to be true. When a low-risk individual is placed in contact with higher-risk individuals, the low-risk person’s risk of committing future crime actually increases.

The reason we continue using incarceration as much as we do is because our elected representatives do not want to be viewed as soft on crime. Supporting rehabilitative approaches smacks of a liberal ideology that rankles certain factions of the electorate, so legislators choose instead to pass laws that increase the use of prisons and make sentences even longer. Many voters like that.

So, prisons are an important part of our response to crime, but not for the reasons that many people believe. They provide a reasonable way to punish offenders, but that should not be confused with strategies that actually reduce the risk of reoffense. That’s important point number two.

Some argue that long prison sentences are warranted from a punishment perspective, especially if the crime is very serious, and they may be correct. Most crimes are not heinous, though. Others argue that all a long sentence does in most cases is defer the next crime. We send about 600,000 people to prison every year, and we release slightly less than that each year. That means we have a constant influx of released offenders who are really no better off in terms of their risk of reoffense when released than when they were initially sent to prison.

So, prison likely only pushes the crime problem downstream by the length of time the person is incarcerated. We haven’t really accomplished anything other than getting society’s pound of flesh from the offender.

What are some alternatives, then? One is to rely less on incarceration and more on research-based methods proven to reduce the risk of reoffense. The National Institute of Corrections has put together a great deal of information about Evidence-Based Practices shown to reduce the risk of recidivism.

The essential point here is that simply incarcerating someone does little to actually change behavior, it simply drives it underground and makes people more diligent about hiding their crimes from others. What we need to do instead is change an offender’s thoughts, feelings, and beliefs that contribute to criminal behavior.

One very promising way to do that is through use of Cognitive-Behavioral Treatment (CBT), which essentially helps offenders change their thinking. That, in turn, leads to positive changes in behavior. When they see the value in prosocial behaviors, they are more likely to engage in those behaviors.

That’s what society wants: Everyone to be a productive, contributing, and law abiding member of the social fabric. Incarceration does not create that outcome, but interventions such as CBT can.

Why don’t we use these types of interventions more often then? Refer to my earlier point about legislators fearing the electorate will view them as soft on crime. Understanding how CBT and other similar interventions work is much more complicated than just coming out and saying we should lock more people up for longer periods.

Until the public demands that we use effective strategies proven to reduce the risk of future crime, as opposed to just locking people away for as long as possible, we’ll continue using methods that are ineffective in that regard but that also appeal to society’s misguided notions that locking people up will change them for the better.