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An analysis of programs and practices in CrimeSolutions finds that cognitive behavioral therapy can deter crime, assist victims and prevent recidivism.
Thomas Feucht; Tammy Holt, "Does Cognitive Behavioral Therapy Work in Criminal Justice? A New Analysis From CrimeSolutions," May 25, 2016, nij.ojp.gov: https://nij.ojp.gov/topics/articles/does-cognitive-behavioral-therapy-work-criminal-justice-new-analysis-crimesolutions
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Perhaps no other intervention has attracted more attention across the criminal justice system than cognitive behavioral therapy (CBT). First widely used in the latter half of the 20th century, as large numbers of people with mental illness were deinstitutionalized and treated in community settings, CBT has since found its way into nearly every aspect of the justice system, often supplementing or displacing other programs and interventions. Practitioners today use CBT to reduce recidivism among adults and juveniles; help victims deal with the aftermath of crimes; and address substance abuse, depression, violence and other problematic behavior. [1]
So what is CBT? And more importantly, does it work?
CBT is a class of therapeutic interventions based on a common theory about the connection between our thoughts, attitudes and beliefs — cognitions — and our behavior. The core premise of CBT is simple: The way we think about situations shapes our choices, behavior and actions. If flawed or maladaptive thoughts, attitudes and beliefs lead to inappropriate and even destructive behavior, then changing those thoughts, attitudes and beliefs can lead to more appropriate, pro-social behavior. That is the therapeutic promise of CBT.
CBT focuses on providing, through individual or group therapy, the means to correct flawed cognitive-behavior processes. A key goal of CBT is to help people make better behavioral choices by understanding the way they think. Once people become more cognitively self-aware, CBT theorists argue, they can learn strategies to help them refrain from problematic behavior and make wiser behavioral decisions.
Rigorous evaluations have examined CBT-based interventions in criminal and juvenile justice. You can find many of these evaluations in NIJ's CrimeSolutions, the U.S. Department of Justice clearinghouse for what works, what doesn't and what's promising in criminal justice, juvenile justice and crime victim services. CrimeSolutions uses research to rate the effectiveness of programs and practices in achieving outcomes as "Effective," "Promising" or "No Effects." Programs and practices may also be classified as "Insufficient Evidence." [2]
To better understand what the evidence tells us about using CBT in criminal justice, we reviewed and tabulated 50 individual programs and eight "practices" (or meta-analysis results) in CrimeSolutions that incorporate CBT as a central part of the intervention. [3] These programs and practices address a range of issues and populations, and they differ in their CrimeSolutions ratings. But the overall evidence in CrimeSolutions is clear and consistent: Individual CBT programs that have been rigorously evaluated are effective at deterring crime, assisting victims and preventing recidivism. [4]
You can perform a similar analysis using other CrimeSolutions topics of interest.
Focusing first on the 50 CBT programs, we looked for program features that might be linked to effectiveness, such as clients served, topic area and whether CBT was the program's primary or secondary focus. We also looked for any common attributes among programs rated "Effective."
The CBT programs in CrimeSolutions serve juveniles, adults or both (see Table 1 ). About half ( n = 24) focus on juveniles. [5] Programs serving juveniles or both juveniles and adults were somewhat more likely to be rated "Effective" than programs serving only adults. Seven CBT programs targeting only adults received a "Promising" rating, but only one was found to be "Effective."
We also examined the gender of clients CBT programs served but found little variation: CBT programs are comparable in effectiveness for either gender. [6]
The CBT programs cover seven topic areas (see Table 2 ), and nearly every topic area includes programs rated "Effective" and "Promising." However, corrections and re-entry, crime and crime prevention, and victims and victimization have larger numbers — and higher proportions — of "Effective" or "Promising" interventions. Only a small number of the CBT programs in CrimeSolutions deal with sex offenders or domestic violence, and although most of these are rated "Promising," none are rated "Effective."
* The total counts add up to more than 50 because programs fall into multiple categories.
Thirty-five of the 50 CBT programs in CrimeSolutions feature CBT as the primary focus of the intervention (see Table 3 ). The remaining 15 interventions use CBT along with other intervention strategies or therapeutic modalities, such as lifestyle and life skills training, medication management, or day treatment programs. The programs in which CBT is a primary feature were more likely to receive "Effective" ratings than were programs in which CBT is a secondary feature or is used in combination with other therapeutic approaches.
We also found this pattern among the 24 programs targeting juveniles: Programs using CBT as a primary feature received more "Effective" ratings than those using CBT as a secondary feature. The pattern did not hold among the 15 adult-focused CBT programs.
We also examined evidence from eight CrimeSolutions CBT practices, which incorporate results from 18 different meta-analyses. These meta-analyses, in turn, contain results from 299 evaluations of individual programs.
The eight practices focus on six different justice topics (see Table 4 ):
CrimeSolutions' practices can examine evidence for multiple outcomes as long as the underlying studies provide evaluation evidence for those outcomes. [7] In Table 4 , the number of outcomes assessed reflects the total number of outcome ratings across all practices on that topic. For example, the two practices on victim trauma each reported on two outcomes, for a total of four outcomes.
The columns to the right show the frequency with which the practices received "Effective," "Promising" and "No Effects" ratings for individual outcomes. For instance, the two victim trauma practices were rated "Effective" for all four outcomes. In contrast, neither of the practices on treating sex offenders received "Effective" ratings for any of the six outcomes, and the practice for preventing domestic violence reoffending received a "No Effects" rating for both intended outcomes.
Studies we may have excluded: CrimeSolutions reviews and screens crime and justice research to find studies showing program effectiveness. The screening process intentionally focuses on finding, reviewing and rat
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