Deconstructing the Pipeline: Using Efficacy and Effectiveness
Data and Cost-Benefit Analyses to Reduce Minority Youth
Incarceration
David Osher, Ph.D.
American Institutes for Research
Mary Magee Quinn, Ph.D.
American Institutes for Research
Jeffrey M. Poirier, M.A.
American Institutes for Research
Robert B. Rutherford, Jr., Ph.D.
Arizona State University
Executive Summary
The civil rights movement in this country has been instrumental in making changes in our
society. However, the dismal outcomes experienced by many youth of color—epitomized by their
overrepresentation in the juvenile justice system—attest to the fact that our nation continues to
struggle with what 100 years ago W. E. B. DuBois called the color line. For example, whereas the
1999 rate per 100,000 juveniles in residential placement was 156 for white youth, the rates for
youth of color were black, 741; Hispanic, 356; American Indian, 483; and Asian, 140. Statistics
such as these bring to the forefront issues of inequality that perplex educators and justice experts.
Clearly our country has a long way to go before all our citizens realize equality.
However, this long journey does not have to be completely through uncharted territory.
An emerging research base on reducing risk factors and enhancing protective factors for youth at
risk for delinquency suggests the effectiveness of prevention and early intervention as well as the
harmful impacts of many of the more traditional reactive responses to juvenile delinquency.
Further, programs that prevent the development or continuation of delinquency can not only
reduce the human costs of victimization but also save tax dollars in both the short and long term.
Technical knowledge alone, however, will be insufficient to eliminate the pipeline.
Eliminating the pipeline also depends on developing the political will to redeploy wasted
resources, avoid harmful interventions, eliminate bias, and improve practice. A key policy
recommendation is to support the appropriate selection and effective implementation of
evidenced-based prevention and treatments that are community based and to eliminate costly,
wasteful, ineffective, and harmful interventions. A second recommendation is to provide ongoing
training and support to improve practice. It is also necessary to increase funding for effective
community-based prevention and treatment and to further draw attention to the long-term costs
and benefits of these programs. Research suggests that increased funding for these programs
would yield far more benefits for the dollars invested.
1
Introduction
The pipeline to prison is costly to individuals, their families, their victims (when there are
victims), and society. The cost begins well before children enter prison (e.g., family disruption
and loss of family income)1 and extends well after their release (e.g., gangs, recidivism, and
unemployment).2 Although these issues pertain to all children, they are particularly relevant to
children and youth of color. These children and youth are disproportionately placed at risk by
poverty, discrimination, and low-performing schools, and they are disproportionately removed
from family, school, and community through a variety of unproven, ineffective, or harmful
interventions.3 For example, whereas the 1999 rate per 100,000 juveniles in residential placement
was 156 for white youth, the rates for youth of color were black, 741; Hispanic, 356; American
Indian, 483; and Asian, 140.4
Although some suggest that these differences are due to different rates of serious
offenses, self-report data do not support this assumption.5 If we use our strongest national data,
self-report data on black youth, we see essentially no gap in the prevalence rate for self-reported
serious violence and property crime: black youth commit slightly more violent (as opposed to
serious violent) crime, the same amounts of serious violent and property crimes, and slightly less
drug crime than white youth.6 Paradoxically, the number of youth incarcerated and the attendant
costs of this incarceration have increased at the same time the National Research Council, the
Institute of Medicine, and the Surgeon General of the United States, in report after report,
identified the risks of punitive interventions and the promise of preventive ones.7,8
We know a great deal about what to do and what not to do relative to incarcerating
delinquents.9Further, cost-benefit analyses show that the monetary benefits of effective
prevention exceed the costs of such programs.10 Research has pointed to the comparative benefits
of effective preventive and community interventions, as well as the costs of unnecessary
incarceration, boot camp, and shock incarceration in terms of reducing recidivism and promoting
2
productive citizenship.11
We know enough to suggest that the best and most cost-effective place to stop the
pipeline is as close to the beginning of the pipeline as possible by preventing the incidence of
delinquent behavior and supporting the development of a youth’s assets and resilience. Effective
universal and early interventions can enable children and youth to navigate the normal hazards of
development that all children and youth encounter, as well as the exceptional hazards of poverty,
racism, and discrimination that children and youth of color confront.12 We also know enough to
suggest that once patterns of antisocial behavior and delinquency develop, we can reduce the
pipeline’s volume by employing intensive school- and community-based interventions that are
efficacious and cost-effective alternatives to detaining and incarcerating most youth.
A growing body of research indicates that delinquency prevention programs are a good
investment.13 Cost-benefit analyses begin with program evaluations to produce and compare the
outcomes of programs that are then examined in monetary terms.14 The findings of one such
analysis published in 2001 by the Washington State Institute for Public Policy (WSIPP) are
woven into this paper.15 WSIPP found that effective prevention programs yielded total benefits
greater than program costs, as shown in the table below while ineffective programsdemanded
costs that exceed program benefits.
Benefit-Cost Ratio16
Net Program Cost
Net Taxpayer and Crime Victim
Benefits, per participant
$738
$33,143
$44.91
$2,161
$59,067
$27.33
–$15,424
–$3,587
N/A
Multidimensional Treatment
Foster Care
$2,052
$87,622
$42.70
Multisystemic Therapy
$4,743
$131,918
$27.81
Nurse Home Visitation
$7,733
$15,918
$2.06
Perry Preschool Program*
$14,716
$105,000
$7.16
“Scared straight” programs
$51
–$24,531
N/A
Aggression Replacement
Training
Functional Family Therapy
Juvenile boot camps
3
Seattle Social Development
Project
*
$4,355
$14,169
These data are taken from a cost-benefit study other than that of WSIPP.
$3.25
17
Although we know a great deal about what to do, we do not use this knowledge well. For
example, a longitudinal study of 1,517 inner-city boys in Pittsburgh (more than half of whom
were black) found that almost half of the boys who eventually became persistent serious
offenders had exhibited some serious delinquent behavior by age 12. Two-thirds of the boys who
came to the attention of the juvenile court already had behavior problems for at least 5 years.
However, fewer than half of these boys had received any help from either mental health
professionals or personnel in schools.18 Similarly, when Orange County, California, initiated its
“8% Solution” to prevent serious repeat juvenile crime, it discovered that 35 of the 49 original
youth had significant mental health problems but that only 1 was receiving psychotherapy.19
Unfortunately, just when we know more about how to make schools safe and effective,
the pipeline’s volume may grow. Many schools are going in the opposite direction by increasing
class size or expelling more students .20 Similarly states, facing budget crises, are disinvesting in
prevention. Further, while evidence of the benefits of individualized community treatments21 and
the risks of group interventions and incarceration has accumulated22 most jurisdictions continue
to incarcerate large numbers of juveniles, --separated them from family, school, and community
and placing many in settings in which staff feel unprepared to address these issues.23 Between
1992 and 1997, 45 states passed laws making it easier to transfer juvenile offenders to the adult
criminal justice system, 31 states increased juvenile sentencing options, and 47 states loosened
confidentiality provisions for juveniles.24 The number of youth held for secure detention
increased by 72% between 1985 and 1995, when less than 29% of the youth in secure custody
were charged with a violent crime.25
This increase in punitive approaches disproportionately affects black, Latino, and Native
American children and youth who are more likely to be suspended or expelled from school, as
4
well as to be arrested, adjudicated, and incarcerated, than their white and Asian peers.26 For
example, whereas 56% of the youth held in detention in 1985 were white and 44% were youth of
color, these percentages reversed in 1995.
We will now present data on promising interventions that can reduce the pipeline. We
provide information on schools, communities, and programs that the authors have and are
continuing to study. We willl address the cost and benefits of these interventions and identify
challenges to implementing these interventions within a society divided by poverty, culture, and
race.
Promising Interventions
The following sections overviews some promising interventions that can reduce the
pipeline volume. All have been subject to rigorous research or evaluation. Many have been tested
in well-designed experimental field trials. Most have been identified as model, exemplary, or
promising by the Department of Justice’s Blueprints Initiative, the Substance Abuse and Mental
Health Services Administration’s National Registry of Effective Programs; The Department of
Education’s Safe, Disciplined and Drug-Free Schools Program’s List of Promising and
Exemplary Programs; the Surgeon General’s Report on Youth and Community Violence.27
Three caveats should be considered.. First, many of the programs that are included here
have been researched by the programs’ developers. However, in most cases they have also been
vetted though peer review processes and expert panels. Second, our strongest evidence comes
from randomized efficacy trials, and there is a gap between efficacy data, which often involves
research done in relatively ideal settings, and effectiveness data, which involves research in more
typical settings with more typical staff and staffing numbers.28 Fortunately, these interventions all
have demonstrated positive outcomes in real-world conditions. Third, the ability to implement
interventions depends on the fit between a setting, an intervention, the “targets” of the
5
intervention, and the ability and willingness of the people implementing it to do so with
appropriate fidelity.29
Intervening Upstream
Upstream interventions cancan be universal or selective. Universal interventions reduce the
incidence of problems by addressing risk factors for antisocial behavior and by developing
protective factors. Since for most youth, delinquency is a social event (most acts of juvenile
delinquency occur among groups of juveniles rather than individually),30 universal interventions
also reduce the likelihood that other children and youth can recruit specific individuals to be
delinquent or reinforce their delinquent behavior by serving as an audience or participating in the
delinquency.31 Universal interventions build a foundation, making it easier to identify individuals
who need more intensive interventions, as well as providing a base for those interventions.32
Selective interventions focus on individuals who are at risk for some problem. In the following
section, we introduce prenatal, preschool, and school-age interventions.
Nurse-Family Partnership
The Nurse-Family Partnership (NFP) is a well-researched intervention that intercedes
with at-risk kids even before they are born.33 Home health care nurses make weekly visits to atrisk, low-income, first-time-pregnant women whose unborn child is already recognized as having
multiple risk factors for delinquency. The visits begin in the second trimester of the pregnancy
and continue through the child’s second year. In addition to improving prenatal health and the
outcomes of the pregnancy, the nurse works directly with the mother to teach her the skills she
will need to care for her infant and toddler and all subsequent children (e.g., resolving family
problems resulting from child rearing, enhancing family relationships and communication).

This program has been studied in urban and rural settings with predominately
white and black families.
6
A 15-year follow-up study showed that when compared with children in the control groups, the
now 15-year-old children in the study experienced significant improvements in child behavioral
outcomes:34

Fewer incidents of running away (60%)

Fewer arrests (56%)

Less consumption of alcohol (56% fewer days)
The estimated net cost of Nurse Home Visitation is $7,733 per participant.35,36 Using
outcome data from two studies meeting the criteria for inclusion in its cost-benefit analysis,
WSIPP found that the program cost exceeded the estimated value of reduced criminal justice
costs by $2,067 per participant. However, when the estimated value of reduced victim costs were
considered along with that of reduced criminal justice costs, the benefits increased to $15,918.
With a benefit-cost ratio of $2.06, every dollar invested in Nurse Home Visitation is estimated to
yield more than $2 in total benefits.
Perry Preschool Programs (PPP)
Many affluent children with access to high-quality preschool, begin school with more
preacademic skills than do their peers from disadvantaged or low-income homesThis advanced
state of readiness has positive effects on affect school achievement and bonds between the child
and his or her family and the school, two protective factors against delinquencyMultiple
randomized research studies have shown that high-quality education programs for 3- and 4-yearold children from economically disadvantaged background can significantly affect school
performance and delinquent behavior later in life.
PPP tagets the social, intellectual, and physical development of children living in poverty.
PPPinvolves 2.5 hours of highly supervised and supportive learning each weekday for 30 weeks a
year and 90-minute weekly home visits with parents to discuss developmental, behavioral, and
educational issues.
7
PPP has shown improved long-term outcomes for children who participate:37

Academic: 19% fewer school dropouts, better academic achievement as reflected by
both grades and standardized test scores, and a greater bond with and improved
attitude toward school

Behavioral: fewer reports of delinquent behavior, fewer arrests, and fewer incidents
of antisocial behavior in school

Social Responsibility: higher rates of employment (50% vs. 32%), higher wages,
reports of greater job satisfaction, less reliance on public assistance, and fewer teen
pregnancies
A cost-benefit analysis of the Perry Preschool Program used outcome data from a
randomized longitudinal study of 123 black children, ages 3 and 4, from low-income families.
Initiated in 1962 and consisting of five waves through 1965, the study followed participants to
compare outcomes of the experimental and control groups. Researchers found that the estimated
benefits through age 19 were greater than the cost of 1 year of the program; when future
estimated benefits were considered (i.e., beyond age 19), estimated benefits exceeded the 2-year
cost of the program.38
This analysis “emphatically conclude[d] that the Perry Preschool Program was a good
investment for society at the cost of one year and that there is relatively strong evidence that it
was a good investment at the cost of two years.”39 The total net benefit, including benefits to age
19 and estimated future benefits, was $14,357 for 1 year of preschool attendance and $9,425 for 2
years of attendance (in 1981 dollars). These benefits were estimated after deducting the cost of
the program ($4,963 for 1 year and $9,708 for 2 years). In a recent cost-benefit analysis,
researchers found that the Perry Preschool Program brought average benefits of more than
$105,000 (in 2001 dollars) per participant in terms of estimated economic benefits for both
taxpayers and potential crime victims.40,41 Since the average cost of the program was $14,716 per
participant, the estimated benefit-cost ratio was 7.16 to 1.
8
Universal School- and Community-Based Interventions
Schools can provide a positive, supportive environment that builds assets, fosters
resilience, and protects children and youth against substance abuse and delinquent behavior.42
Schools can also be the setting for purposive intervention: since, “
“ by the amount of available time to reduce risk factors for crime, schools have more opportunity
to accomplish that objective than any other agency of government.”.43 However, schools can also
be places where students experience academic failure, punishment, and humiliation from adults
and teasing, bullying, and ostracism from peers can also create or intensify risk factors, further
increasing the risk of poor social outcomes.44 The schools’ ineffective responses to behavior and
academic problems can exacerbate these problems and support the socialization of antisocial
behavior.45
Effective schools have adequate financial resources and strong social capital. Although
they come in many forms, they often are small (or create small learning communities) and have
strong teacher morale and community, a sense they can make a difference in the lives of all
students, effective leadership that is committed to the success of all students, support for student
learning and behavior, an engaging curriculum, and links to families and the community. 46
Struggling schools often lack financial resources and social capital. These schools are often too
large; their teachers are too demoralized, isolated, and doubtful of their ability to affect student
outcomes. These schools, which often have ineffective or autocratic leaders who are willing to
accept the failure of many students, do not adequately support student learning and behavior, fail
to engage students academically, and have poor links to families and communities47
Unfortunately, students of color disproportionately attend struggling schools.48
Fortunately, it is possible to turn schools and districts around.49 Chicago school reform
provides an example. Those Chicago low-performing, high-poverty schools that enhanced their
performance had high levels of support for students as well as a strong academic focus.50 These
schools also had high levels of relational trust between and among school staff and families.51
9
Schools that had these characteristics in 1992 were much more likely to improve their
performance. Among those lacking high levels of trust in 1992, those that improved their
performance also improved their levels of trust. A comparison of two sets of 182 high-poverty
schools in which the first had made a 24% gain on the reading portion of the Iowa Test of Basic
Skills (ITBS) over 12 years and the other 182 had made only an 8% gain found that the
succeeding schools were characterized by strong leadership, parent-community partnerships,
school safety, teacher commitment to school, staff development and teacher collaboration, and a
staff priority on student learning.52
One Chicago school which we have studied exemplifies what can be done by creating
environments that connect students to school; support learning and behavior; and prevent the
downward spiral of academic failure, behavioral problems, punishment, and non-normative
mobility, which leads to suspension, dropout, and delinquency.53 Like other successful schools54
it has a strong principal , strong teacher solidarity, and uses it resources strategically. Staff expect
all students to succeed and believe that they had the capacity to make it happen. One of the 182
Chicago’s high-gain schools, Rachel Carson Elementary School, had a gain of 40% over the
period. This school serves 1,300 students, 99% Latino and 1% black. Compared with an average
of 88% in the other high gain schools and 93% in the low-gain schools, 98% of its students are
eligible for free or reduced-price lunch. Only 12% of the Rachel Carson students read at the
national average on the ITBS in 1992. One decade later, over half of the students do. As an
engaging and supportive school, Rachel Carson offers a safe learning environment without
suspending students. Rachel Carson did this, to quote its principal, by “caring about where
students will be 10 years later” and by using some of its limited resources to reach out to
families55. (SOAR) Seattle Social Development Project
SOAR focuses on the healthy development of young people by increasing opportunities
for active involvement in family and school, skills for successful participation in family, school,
peer groups, and community, and consistent recognition for effort and improvement. SOAR
10
targets school, family, and child risk factors and seeks to enhance protective factors of bonding to
family and school, opportunities for prosocial involvement, recognition for prosocial
involvement, setting healthy beliefs and standards for behavior, and social and emotional skills.
SOAR has three major components: a series of instructional improvement workshops and
classroom coaching for teachers in order to enhance academic achievement and bonding to
school, and reduce classroom behavior problems; developmentally sequenced parenting
workshops to increase attachment and enhance parents skills in helping their children succeed
academically and develop strong bonds to school; and social and citizenship skills training for
children to learn and practice social and citizenship skills and to learn and practice social and
emotional skills in the classroom and in social situations.
.56 In randomized studies of experimental and control multiethnic, public, regular
education classrooms and schools in high-crime urban areas, the intervention proved to have
significant effects on lowering the teacher-rated aggressive behavior in boys and self-destructive
behavior in girls57 and improving family management practices and bonding to family and school.
Further, the students who had received the intervention were significantly less likely to engage in
delinquent behavior and alcohol use.58 By the end of the 11th grade, the students who participated
in the project had reduced involvement in sexual activity, violent delinquency, drunkenness, and
drinking and driving.59
The estimated net cost of the Seattle Social Development Project is $4,355 per
participant.60 Using outcome data from one study meeting the criteria for inclusion in its costbenefit analysis, WSIPP found that the program cost exceeded the estimated value of reduced
criminal justice costs by $456 per participant. However, when the estimated value of reduced
victim costs were considered along with that of reduced criminal justice costs, benefits exceeded
program costs by $14,169. With a benefit-cost ratio of $3.25, every dollar invested in the Seattle
Social Development Project yields more than $3 in total benefits.
11
When Problems Get More Severe
Some children experience moderate to severe emotional and behavioral disorders that
significantly impair their functioning and quality of life across the domains of family, school,
peers, and community. Sometimes they express these disorders in an externalizing manner that
demands the attention of teachers, administrators, and police. Specific interventions and their
intensity depend on the nature, severity, and frequency of each child’s emotional and behavioral
problems. These children and youth require more intensive interventions, services, and supports.
Because these children are at great need, and because powerful intensive interventions involve
greater risk of harm, it is particularly important that the children and youth receive interventions
that are likely to help them avoid delinquency or recidivism.
For example, many early and intensive interventions congregate youth – a practice that
may be risky, particularly, since juvenile offenders are much more likely than adults to commit
serious violent crimes in groups.61 Data from the Oregon Youth Study show that early
involvement with deviant peers predicted substance use, health-risking sexual behavior, and
police arrests for youth from age 10 to age 18.62 Congregating high-risk youth can increase the
likelihood of delinquent behavior. Foremost, youth with deviant behaviors tend to have deviant
friends who model and reinforce antisocial behavior.63 For example, in a study of the Adolescent
Transitions Program, a program for high-risk 11–14-year-olds, participants were randomly
assigned to one of four groups (parent-focused, teen-focused, parent- and teen-focused, or selfdirected change groups).64 The groups that brought high-risk youth together produced greater
tobacco use, more problem behavior at school, and more favorable attitudes toward substance
use65.
Aggression Replacement Therapy (ART)
Experts agree that you cannot “take a behavior away” without replacing it with a more
efficient and more effective behavior.66 That is why it is often difficult to change behaviors of
12
people as they grow older. For example, by the time an angry child with aggressive behavior
becomes an adolescent, he or she has probably used aggression to control his or her environment
for a number of years. Aggressive behavior becomes almost an automatic response in situations
that frustrate, embarrass, or otherwise challenge the youth. Convincing someone for whom
aggression has become so easy and useful to change his or her behavior is often quite a problem.
ART enhances “interpersonal skills, self-mediated ability to control anger, and a youth’s
concern for the rights and needs of other.”67 ART’s “core” training comprises a social skills
curriculum, anger-control training, and training in moral reasoning. Juvenile offenders who had
participated in ART had significantly fewer rearrests than similar youths who were randomly
assigned to a no-treatment control group.68
Four studies passed WSIPP’s criteria for inclusion in the cost-benefit analysis of ART,
which was estimated to have a net cost of $738 per participant.69 WSIPP estimated that the value
of reduced crime outcomes of participants yields benefits to taxpayers of approximately $8,287 in
reduced criminal justice costs. When the value of reduced victim costs was also considered,
benefits increased to $33,143. With a benefit-cost ratio of $44.91, every dollar invested in
Aggression Replacement Training is estimated to yield almost $45 in total benefits.
Wraparound
Wraparound (to quote the Surgeon General’s Report on Youth Violence) demonstrates
what can be accomplished when the focus is “on providing services rather than instituting
greater penalties” and when “comprehensive services are tailored to individual youths, as
opposed to trying to fit youths into predetermined or inflexible programs.”70 Wraparound
is a child and family-driven planning process that results in a unique set of community services
and natural supports that are individualized for that child and family to achieve positive
outcomes.71.
13
Wraparound Milwaukee has applied it successfully to youth in the juvenile justice
system. It has reduced the use of residential treatment has decreased 60% and inpatient
psychiatric hospitalization by by 80%. The average cost of care per child has dropped from more
than $5,000 a month to less than $3,300 a month. Recidivism rates for a variety of offenses for
134 delinquent youth enrolled in Wraparound Milwaukee dropped by more than half at 1-year
follow up, from 18.5% to 7.8% across all types of offenses.72.
Multisystemic Therapy (MST)
MST posits that other approaches to treatment—incarceration, residential treatment
centers, and outpatient clinics in particular—have frequently been ineffective because they focus
too much on the juvenile individually, provide services in a setting different from the home
environment, and have little accountability for success. MST addresses these issues by providing
an intensive treatment that focuses on the multiple factors related to delinquency in various
settings or systems (e.g., school, family, peers) in the adolescent’s life. It provides this treatment
in the home and community of the youth. It has a well-defined and empirically grounded theory
of treatment and emphasizes accountability of service providers, effective implementation of the
treatment model, and long-term change.73
There have been eight randomized Eight radomized clinical traials of MST demonstate its
efficacy for black and white males and females..74. Re-arrest rates for chronic juvenile offenders
decreased by 25 to 70% compared with the rates for control groups.75 Long-term follow-ups have
found that compared with control groups, participants in MST spent between 47 and 64% fewer
days in out-of-home placements.76
In one study, 200 juvenile offenders ages 12 to 17 and their families, who were referred
by the Department of Juvenile Justice, were randomly assigned to either individual therapy (i.e.,
outpatient mental health services) or MST.77,78 A follow-up 4 years later found that the 63
participants who completed the individual therapy recidivated at a rate of 71.4%, and the 15
participants who partially completed and dropped out of MST recidivated at a rate of 46.6%.79 In
14
contrast, the 77 participants who completed MST had a 22.1% recidivism rate, and those who
recidivated were less likely to be arrested for violent or serious crimes and were arrested less
often.80
Three studies passed WSIPP’s criteria for inclusion in the cost-benefit analysis of
Multisystemic Therapy, which was estimated to have a net cost of $4,743 per participant.81
WSIPP estimated that the value of reduced crime outcomes of participants yields benefits to
taxpayers of $31,661 in reduced criminal justice costs. When the value of reduced victim costs
was considered along with that of reduced criminal justice costs, benefits increased to $131,918.
With a benefit-cost ratio of $27.81, every dollar invested in Multisystemic Therapy is estimated
to yield almost $28 in total benefits.
Functional Family Therapy (FFT)
FFTis an intensive intervention therapy designed to reduce delinquency, conduct
disorder, drug and alcohol abuse, and family conflict. FFT is a family-focused program targeting
youth ages 11–18 who are at risk for (or are experiencing) delinquency and related maladaptive
behaviors FFT reduces risk factors and enhances protective factors, including the risk of ending
the treatment early. To accomplish this, “it focuses on the multiple domains and systems within
which adolescents and their families live.”82 The program consists of three general phases:
engagement and motivation (building the perception that positive outcomes can result from
program participation), behavior change (developing and implementing plans that are intended to
change delinquent behavior), and generalization (helping the family maintain change and prevent
recurrence of the delinquent behavior).83
Clinical research shows that FFT “significantly reduces recidivism for a wide range of
juvenile offense patterns.”84 FFT also reduces potential delinquency for the siblings of program
participants. The effectiveness of FFT was recently examined at the largest FFT research and
practice site in the United States, the Family Project in Las Vegas. Over 2 years, FFT staff
contacted 231 families referred to the project by probation officers, of whom 80% completed FFT
15
services.85 After the first year, the recidivism rate of those who completed FFT was just under
20%, whereas that of the treatment group (i.e., those who received regular probation services)
was 36%. “These data suggest that FFT reduced recidivism by roughly 50%, a figure consistent
with previous FFT randomized clinical trials and replication studies.”86 In its comprehensive
review of FFT evaluations, WSIPP found an average effect size of approximately –0.25 for basic
recidivism.87 This suggests that FFT reduces future crime outcomes among participants by about
25% on average.
The estimated net cost of Functional Family Therapy is $2,161 per participant.88 Using
outcome data from seven studies meeting the criteria for inclusion in its cost-benefit analysis,
WSIPP found that the estimated value of reduced criminal justice costs exceeded the program
cost by $14,149 per participant. When the estimated value of reduced victim costs were also
considered, benefits increased to $59,067. With a benefit-cost ratio of $27.33, every dollar
invested in FFT is estimated to yield approximately $27 in total benefits.
Multidimensional Treatment Foster Care
Multidimensional Treatment Foster Care’s (MTFC) program model is rooted in the
research conducted in the early 1970s at the Oregon Social Learning Center in Eugene. The first
MTFC program was established in 1983, targeting serious and chronic juvenile offenders, and the
Oregon Youth Authority funds the program. In MTFC, community families are recruited, trained,
and supported to serve as foster families for participating youth. No more than two children or
youth are placed with any one family so that counterproductive association with problem peers is
restricted or eliminated. Intensive services are provided to the youth, the foster family, and, in
many cases, the biological family.
Three studies have employed an experimental design to evaluate MTFC. Two of these
involved youth with serious and chronic delinquency,89 and one involved youth being discharged
from a state mental hospital.90 Results were very favorable. One study followed 79 boys who
were persistent offenders who were randomly assigned either to Multidimensional Treatment
16
Foster Care or to standard community group care (group homes). Results showed that MTFC
boys ran away less frequently, completed the program more often, had significantly fewer
criminal referrals, and returned to live with relatives more often.91
Two studies passed WSIPP’s criteria for inclusion in the cost-benefit analysis of MTFC,
which was estimated to have a net cost of $2,052 per participant.92 WSIPP estimated that the
value of reduced crime outcomes of participants yielded benefits to taxpayers of approximately
$28,836 in reduced criminal justice costs. When the estimated value of reduced victim costs was
considered along with that of reduced criminal justice costs, benefits increased to $87,622. With a
benefit-cost ratio of $42.70, every dollar invested in Multidimensional Treatment Foster Care is
estimated to yield almost $43 in total benefits.
The Justice System as the Target of Intervention
The pipeline to prison reflects systemic issues in education, mental health, juvenile
justice, and other human services. Although systemic change alone may not reach down to the
practice level, it can create systems-level policies and principles that support the development or
implementation of new protocols and procedures that can transform service delivery.93There are a
number of examples of promising approaches to systems change. For example, a comparison
study of a system of care94 (SOC) community with a non-SOC community found that entry into
the juvenile justice system was delayed or reduced, recidivism decreased, and these effects were
greatest for repeat and serious offenders.95
Even if services are available, they may not be provided if decisions are made to arrest,
detain, or otherwise remove children and youth from their home and community. Once successful
iniative suggests how three jurisdications reduced or eliminate disparities in the juvenile justice
system.96 In Cook County, Illinois, where 90% of the youth detained from 1996 to 2000 were
youth of color, reform reduced the number detained by 31%, thus reducing the number of youth
of color detained from an average of 694 per day in 1996 to 478 in 2000. Santa Cruz, California,
17
where 64% of the youth in Juvenile Hall were Latino in 1997, reduced this percentage to 50% in
2.5 years, while also dropping its average daily census from 49 to 37. Multnomah County
Oregon, reduced the number of youth admitted to detention by half, from 1,107 in 1994 to 478 in
2000, while reducing the differential between the percentage of white, black, and Latino youth in
corrections from 13% white, 24% black, and 23% Latino, in 1994 to 9% white, 12% black, and
6% Latino, in 2000. Moreover, when paper referrals are eliminated from the equation (when a
youth is arrested but is not brought to detention at intake and is issued a summons to appear at a
later date), the discrepancy between the two groups was eliminated in 1999.97
There were similarities (as well as differences) in approach. All three modified their
programs to eliminate barriers, whether location or timing of services and developed communitybased alternatives to prevention, including shelter care, foster homes, home detention, and day
reporting centers. Santa Cruz added Spanish-speaking staff, which enabled families to talk to
intake officers. After determining that its diversion programs were culturally inappropriate, Santa
Cruz developed new programs that addressed the needs of Latino youth. Multnomah County and
Cook County reengineered their risk assessment instrument to eliminate incentives to detain.
Multnomah County also eliminated biases built into routines (e.g., criteria for “good family
structure,” or adding “productive activity” to “school attendance” as a mitigating factor). In
addition, Multnomah County was relentless in reducing disparities.
Challenges to Narrowing the Pipeline
We know from rigorous research and evaluation what can be done to narrow the pipeline
and that it is possible and cost-effective to do so. But four key challenges remain—redeploying
wasted resources and eliminating harmful interventions; eliminating bias; changing practice; and
developing political will.
18
Redeploying Wasted Resources
Communities have a finite amount of resources. Often they are employed to support
interventions that are ineffective or even harmful. For example, more than 80% of school districts
invest in D.A.R.E. (Drug Abuse Resistance Education), in spite of evidence that it is ineffective
in reducing youth drug use.98 Similarly, many schools employ punishment as a primary
intervention in spite of extensive data to show that punishment is ineffective or even likely to
increase problematic behavior.99
The first challenge is to avoid wasting resources. It is necessary to redirect the “three
strikes and you’re out” mindset of the general public and policymakers away from reactive and
punitive programs and toward an examination of the ineffectiveness of these programs. For
example, WSIPP looked at the costs and benefits of juvenile boot camps and “scared straight”
programs and found positive effect sizes; that is, participants in these programs had higher
recidivism rates than comparison groups.100 The “scared straight” programs had an estimated net
cost of $51 per participant, but as a result of higher recidivism among participants, yielded an
estimated loss of –$24,531 because of increased criminal justice and victim costs. Similarly,
juvenile boot camps, which had an estimated net cost of $15,424, yielded an estimated loss of –
$3,587.
Eliminating Bias
Although Multnomah County reduced disparities in those retained, it was unable to
address what it defined as disproportionalities “at the front door.”101 Even after Multnomah
County reduced these disparities, the proportions of black and Hispanic youth referred were 2.5
and 1.5, respectively, of their proportion in the county population. “We ‘inherited’ the problem,”
the Department of Community Justice complained.102
The problem is not just in Multnomah County. Whether the bias is conscious or
unconscious, it affects how behavior is perceived and interpreted. For example, an examination of
19
233 probation reports in one jurisdiction found that the probation officers tended to attribute the
delinquency of youth of color to internal causes (e.g., personality or character) and white
delinquency to external causes (poor home life, lack of role models).103 Similarly, an examination
of student statewide discipline data in South Carolina found much greater disparities in discipline
for the subjective charge of “disturbing the school” than for charges that had some objective
referent, such as possessing weapons or drugs.104
The process may also be transactional. The attitudes that youth take when they interact
with police can help determine whether they are arrested as well as the affect of both the youth
and police when the youth is brought to the police station.105 Distrust of police, misperception of
police behavior impulsivity, and poor social skills all can contribute to an arrest for “contempt of
cop.”106
Institutionalized racism, bias, and cultural incompetence, which contribute to disparities
in all service areas, continue to feed the pipeline. So do the disparities themselves. Health
disparities, for example, contribute to poor prenatal health, which creates risks for behavior
problems, as does disproportionate exposure to lead.107 Similarly, the disproportionate removal of
children of color from birth homes by child welfare and the failure of teachers to respond to
children’s behavior problems creates non-normative mobility that contributes to dropping out.108
Finally, inappropriate special education services and the lack of access to mental health services
in the community contribute to school drop out and delinquency among children of color.109
Even though people and institutions are hard to change, change can happen. The changes
that took place in Cook County were, in part, products of training that increased participants’
knowledge of the problem of excessive detention and what could be done to minimize the
unnecessary use of detention. Training alone, however, is not sufficient. It is important to
specifically target the problem of the pipeline and focus on actions that address that problem. In
Multnomah County, for example, an explicit focus on disparities drove the data analysis that
20
drove the discussions that led to the development of new strategies, which, when successful,
reinforced commitment.110
Changing Practice
It is easier to identify effective interventions than it is to change practice. A large gap
exists between efficacy data on what works in highly controlled field trials and effectiveness data
on what works in the real world, where children are complex and supervisory or coaching
resources are thin.111
This gap is sometimes attributed to the failure to implement interventions effectively or
the tendency to water down interventions by reducing the dosage, increasing caseloads, and
eliminating key elements. The pressures are great, even in settings that want to implement with
fidelity,112 Research on the effects of implementing evidenced-based programs indicates that less
than complete implementation can limit program impacts and effectiveness.113 This, in turn, can
contribute to a lack of commitment to the change process and the development of an attitude that
nothing can be changed or that the problem is with someone else (e.g., the youth, the
administrators, the other agencies)114.
Organizations, however, can work through these challenges. Doing so requires selecting
interventions that align well with the organizations’ goals and strengths, making sure that
program modification and adaptation do not leave out or water down essential ingredients, and
committing to a long-term process of change.115 These organizations also provide ongoing
training and support to staff through coaching, mentoring, supervision, and the use of data for
quality assurance and continuous improvement. For example, the impressive outcomes realized
by Wraparound Milwaukee and Multisystemic Therapy are related to their use of quality
assurance data and intensive supervision116.
21
Developing Political Will
Political will is often a problem when implementing systemic change or attempting to
change polices, procedures, and practices in professional bureaucracies. This is especially the
case in dealing with institutionalized racism and ethnocentrism, especially when public safety is a
manifest concern.
Still, political will can be developed, and with it, change can be realized. The
desegregation of our largest professional bureaucracy, the military, is a case in point.117 That
success was accomplished by employing the same basic approach that Multnomah County did
when it eliminated disparities in juvenile detention: establishing a goal, using data to measure
progress, adapting strategies when necessary, and being relentless until the goal is achieved.
Conclusion
The Pipeline to Prison is a pressing problem that is increasing in magnitude. Fortunately,
we know enough to address this problem, and we also know that the best place to start is at the
front end of the pipeline. Perhaps (in terms of technical interventions) this was not always the
case. Two decades ago, people doubted the efficacy and economic efficiency of prevention and
treatment. At that time we knew little about children’s mental health. We saw prevention and
treatment research that was not always of the highest quality and lacked strong statistical and
analytical tools.118 But this is no longer true.119 We have findings on the efficacy, effectiveness,
and relative costs and benefits of numerous interventions—starting before a child is born and
continuing through adjudication. We also know what is unlikely to work, what may be harmful,
and what wastes resources.
This paper presented data on interventions that can be employed to close off the pipeline.
Most of the interventions have been tested by experimental field trials. Others were evaluated by
well-designed studies with control group and pre-post test designs. Most were vetted by expert
panels..120
22
We know enough about the problems as well as what to do—including how to support
change. A century after W. E. B. DuBois wrote that the problem of the 20th century was the
problem of the color line and 49 years after Brown v. Board of Education, our nation is still
confronted with how we deal with what Lisa Delpit aptly characterized as “other people’s
children.” 121 The recent national focus on school climate and school mental health that was a
product of seeing white students shoot other white students clearly indicates that the stunning
disparities that feed the pipeline would be attacked with much more vigor if most people saw
these statistics as being about “their children.”
Technical knowledge alone is insufficient. Four key challenges remain—redeploying wasted
resources and eliminating harmful interventions; eliminating bias; changing practice; and
developing political will. The color line that W. E. B Dubois pointed out 100 years ago remains,
which suggests how formidable this barrier is. The news here is that the problem is a political
problem, not a scientific or technical one.
23
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16
The report by Aos, et al. appears to compute benefit-cost ratios by dividing the sum of estimated program
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These benefits include savings in reduced justice system and welfare costs and from reduced criminal
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74
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78
Ninety-two participants were in the MST group, 84 in the IT group, and 24 refused to participate. The
average number of previous arrests was 4.2 and 63% were previously incarcerated.
79
Borduin et al. (1995); MSTS (2000). Research on effectiveness, p. 7.
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Borduin et al. (1995).
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Aos et al. (2001).
82
Sexton, T. L., & Alexander, J. F. (2000). Functional family therapy. DC: DJ, p. 2.
83
Ibid.
84
Ibid. 5.
85
Ibid .
86
Ibid,. 6.
87
Aos et al. (2001).
88
Ibid..
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Chamberlain, P. (1990). Comparative evaluation of specialized foster care for seriously delinquent
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90
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Chamberlain & Reid. (1991).
Chamberlain & Reid. (1998).
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Aos et al. (2001).
29
93
Rosenblatt, A., & Woodbridge, M. W. (2003). Deconstructing research on systems of care for youth with
EBD: Frameworks for policy research. Journal of Emotional and Behavioral Disorders, 11, 27–37.
94
A system of care” is a comprehensive approach to coordinating and delivering a far-reaching array of
child- and family-drive services from multiple agencies.
95
Foster, E. M., Qaseem, A., & Connor, T. (2003). Can better mental health services reduce juvenile
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