WHAT WORKS IN OFFENDER REHABILITATION
University of Birmingham ∙ September 2014
What works in reducing re-offending
…19 years on
James McGuire
University of Liverpool
Institute of Psychology, Health and Society
Department of Psychological Sciences
Whelan Building
Liverpool L69 3GB
United Kingdom
merc@liv.ac.uk
Objectives
To consider the effects of society’s dominant
response to criminal conduct.
To survey large-scale reviews of outcome
evidence focused on efforts to reduce criminal
recidivism.
To consider (briefly) underlying change processes.
To draw some general “big picture” conclusions.
2
Science and human purpose
Reduce criminal recidivism
= Reducing victimisation
There is no conflict between addressing the
problems presented by those who have
broken the law and serving the goal of
increasing public safety.
3
Where are we now?
The language of “evidence based practice
and policy” is widely spoken, but how
influential is it?
The current agenda appears to place
“evidence” in a secondary position (or
even lower)
4
Traditional objectives of sentencing
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•
•
•
•
Retribution
Incapacitation
Deterrence
Rehabilitation
Restoration
5
Origins of deterrence theory
 Cesare Beccaria (1738-1794), the
founder of classical criminology
 On Crimes and Punishments (Dei
delitti e delle pene), was
published in 1764
 Forwarded the view that
individuals calculate benefits and
costs of action before deciding
what to do
 Principal means of influencing
them is by increasing the costs
 Modern equivalent in Rational
Crime Theory
6
Deterrence: general and specific
General deterrence
The expectation that the public visibility of
punishment will deter prospective offenders, i.e.
there will be a broad suppressant effect of official
punishments
Specific deterrence
The expectation that the experience of punishment
will reduce or suppress the likelihood of criminal
acts by those who have previously committed them
7
General deterrence:
Homicide rates, Hong Kong and Singapore 1967-2007
(Zimring & Hawkins, 2010, ‘A tale of two cities’)
8
Homicide rates in Hong Kong and Singapore and the
impact of capital punishment
9
USA
Russian Federation
South Africa
Prison populations
around the world
Singapore
Brazil
Mexico
Algeria
Spain
England & Wales
Scotland
Malaysia
Rates of imprisonment per
100,000 population
China
Canada
Italy
France
Source: International Centre
for Prison Studies, London,
and University of Essex (2012)
Netherlands
Tanzania
Northern Ireland
Bolivia
Germany
Egypt
Sweden
Denmark
Japan
Pakistan
India
0
100
200
300
400
500
600
700
800
10
Prison population, England and Wales
1900-2009
11
Deterrence in action?
Impact of “three strikes” laws in California
12
Reduction in prison population in California
13
Rehabilitation
Attempt both to
• reduce risk of re-offending, and
• improve offenders’ prospects of reintegration in
their communities
by activities intended to influence their thoughts,
feelings, attitudes or behaviour in relation to the
above challenges
14
The evidence base
• There are many hundreds of studies evaluating
interventions to reduce criminal recidivism
• At least 105 meta-analytic reviews as of mid-2014
• Positive though modest mean effect size
…but some interventions have negative effects
• There are consistent patterns in combinations of
features that can increase effect sizes markedly
• They can also result in significant cost savings
• The principles of effective intervention are fairly
well understood
15
The Risk-Need-Responsivity (RNR) model
(Andrews & Bonta, 2010)
• Identify general risk factors for offending
• At an individual level those most reliably supported are
labelled by Andrews and Bonta as “the big eight”
• Use functional analysis and case formulation to identify
the combination operating for an individual
• Deliver interventions, designed according to a wellestablished theoretical model, and meeting evidencebased criteria
• Take account of contextual variations and situational
requirements; such “non-programmatic” factors have been
neglected until recently
16
“Risk factors”: variables recurrently associated with
serious and/or persistent offending
•
•
•
•
•
•
•
•
•
Poor parental supervision, low attachment to families
Difficulties in school and employment
Network of delinquent associates
Manifestation of anti-social attitudes
Distorted / biased patterns of information processing
Poor personal and social skills
Low levels of self-control; impulsiveness
Negative emotions and low level of constraint
Alcohol and other substance misuse
17
Extending the RNR model
Initially developed for general offending (mixed or
versatile criminal history), but analysis by specialists
in related areas suggests it is also applicable with:
• Sexual offending: Hanson et al., 2009
• Substance-related offending: Prendergast et al,
2013
18
Effectiveness of cognitive-behavioural
programmes (Lipsey et al., 2007)
Review of 58 studies published between 1980-2004.
Majority quasi-experimental designs: only 33% randomized
Average follow-up interval of 12 months.
•
•
•
•
•
Mean Odds Ratio = 1.53
Corresponds to a 25% reduction in recidivism.
Significant heterogeneity: (Q) = 214.02.
No significant differences found between randomized and non-randomized
designs.
Most prominent moderators = risk level of the participants, and the quality
of implementation of programme.
Mean Odds Ratio for studies with “best practice” features = 2.86.
(“Best practice” = intent-to-treat, zero attrition, moderate+ risk, median of 32 sessions)
Corresponds to a 52% reduction in recidivism.
19
Effectiveness of
cognitivebehavioural
programmes
(Lipsey et al.,
2007)
Forest plot
comparing
outcomes
20
Review of programmes for adult violence
(Jolliffe & Farrington, 2007/2009)
21
Five more meta-analyses
Source
Focus of review
Number of
effect-size tests
Mean effect size(s) or
other results
Ferguson &
Wormith (2012)
Moral Reconation
Therapy
33
r = 0.16
Usher and Stewart
(2012)
Ethnic diversity in
participants
50
ORs: Caucasian: 1.76
Aboriginal: 1.45
Black: 1.36
Other (mixed): 1.53
Koehler et al
(2013)
Young offenders
(Europe)
25
ORs: Treatment OR: 1.34
RNR based: 1.90
Deterrence: 0.85
Koehler et al
(2014)
Drug treatment
programmes
(Europe)
15
Crime: d = 0.46
Drug use: d = 0.38
Wilson (2014)
Antisocial
Personality Disorder
6
No sig results but OR trends
favoured treatment
22
CBT "best practice" programmes
CBT: sex offender treatment
CBT: forensic mental health
CBT: general effect
Comparative
effects on
recidivism of
different
interventions
Programmes for violent adults (mainly CBT)
Prison therapeutic communities
CBT: system-wide predicted vs. actual
Employment programmes
Standard probation supervision
Correctional "boot camps"
(various sources)
Standard imprisonment predicted vs. actual
"Scared straight" programs
Juvenile curfews
Deterrence-based sanctions (youth)
Intensive supervison/surveillance
Prison vs. Community Control
-60
-50
-40
-30
-20
-10
0
10
20
30
Perentage change in recidivism relative to selected comparator
40
23
Recent work of the Correctional Services Advisory
and Accreditation Panel (CSAAP)
To fill gaps in the existing review literature by conducting a
series of Rapid Evidence Assessments, for example on:
• Pro-criminal attitudes
• Criminal thinking styles
• Adult female offenders
• Offending by young adults
• Young adults and problematic substance abuse
• Alcohol-related offending
• Mentoring
• “What does not work”
24
Objective: to answer the question…
What interventions, services or approaches
designed to reduce reoffending have been
evaluated specifically with young adult offenders
and found to reduce reoffending?
25
Who are “young adult offenders”?
• Defined by age?
• Note varying ages of majority status
• Varying definitions of young adult age
range in research studies
– Starting at 16 or 18
– Ending at 21, 25, or 30
Most research reports include participants across
these ranges and do not analyse data separately
by specific age-bands
26
Why focus on this group?
• This age-group is responsible for a
disproportionately high volume of policerecorded crime
• Though only 10% of the population, they account
for one-third of prison admissions, of probation
caseloads, and costs of crime (est. £19 billion)
• Comparatively higher rate of self-harm in custody
• Costs of crime in an average “criminal career” are
at their highest in the age range 18-24
27
Search strategy
• Electronic databases:
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–
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–
–
–
–
Scopus
Web of Knowledge
Web of Science
PsycINFO, PsyArticles
MEDLINE
NCJRS
Cochrane Library
Campbell Library
• Reference lists of articles located
28
Inclusion and exclusion criteria
• To be included, a study had to:
– Have been published in the last 15 years
– Have evaluated the impact of interventions or services
on numbers or rates of reconviction, arrest, or some
other measure of re-offending; or
– Have measured change in a well-validated risk factor
variable mediating criminal recidivism
• Studies were excluded which:
– Focused on reduction of substance abuse (16 studies in
a related REA were checked for relevance)
29
Search and retrieval process
Sequence of selection decisions
Items retrieved
and screened
2,967
Downloaded
195
Retained for
detailed scrutiny
112
Full
extraction
10
30
Study
Participants/ sample
size
Setting
Intervention
Outcome measure
Results
Armstrong
(2003)
Exp = 110
Con = 102
Detention center /
County Jail
Moral Reconation
Therapy (MRT)
Recidivism survival
analysis
No significant differences
observed
Braga et al.
(2009)
Exp = 108
Con = 309
Boston re-entry
initiative (BRI)
Recidivism at 1, 2
Significant differences:
and 3 year follow-up 32% reduction
Cann et al.
(2005)
Exp = 1,534
Con = 1,534
Discharge from
prison to
community
HM prison service
Cognitive skills
programmes
(R&R + ETS)
Criminal recidivism
at 1 + 2 year FU
Difference at 1 yr for
completers; no diffs at 2
years
Cohen &
Piquero (2010)
Total n = 388
Completers versus
dropouts
Community based: YouthBuild (YB) USA
30 sites in USA
Re-offending,
revocation, reincarceration
Small diffs found but may
be due to sample diffs
Currie et al.
(2010)
20 participants, no
comparison group
Youth custody
centre (Aus)
Significant positive
changes on all measures
Farrington et al.
(2002)
(a)
Two young
offender
institutions
Psychometrics: pre-,
post-, 6-mo, 24-mo
FU
Numbers of reoffences;
Cost-benefit analysis
Sig + diffs in parole,
arrest + other variables
(a)
Josi & Sechrest
(1999)
Exp = 176,
Con = 127
Exp = 61
Con = 97
Exp = 115
Con = 115
Aggression
Replacement Training
(ART)
High intensity regimes
(HIT and MCTC)
(a)
(b)
HIT: sig drop in reoffences
MCTC: no
differences
Parole/re-entry to
community
Lifeskills’95
13-week, 39-hr
programme
Rate of parole
revocation and
recidivism
Pullmann (2011) Study sample = 143
Mental health
services
OHT: restrictive
residential treatment
unit
New criminal charges Criminal charges reduced
during ages 16-25
by 43%
Shapland et al.
(2008)
Community-based
Restorative justice
interventions
Recidivism at 2 years
Cost-benefit
Sig findings at 1 of 5 sites
for one type of offence
HM prison service
Cognitive skills
programmes
(R&R + ETS)
Predicted versus
actual recidivism
Reductions for sexual,
violent + drug offences
31
Scheme 1 = 50
Scheme 2 = 742
Scheme 3 = 132
Travers & Mann 18-20 = 4,061
(2013)
21-24 = 4,637
25+ = 12,675
Key results
In 6 out of 10 studies there are beneficial effects.
They emerge from a range of methods.
Strongest evidence (though still fairly limited):
• Two studies of structured parole re-entry systems (Braga et al., 2009;
Josi and Sechrest, 1999)
• Prison-based offending behaviour programmes (Travers and Mann,
2013)
• A structured high-intensity detention regime (Farrington et al, 2002)
• Some evidence from victim-offender conferences, applying a
Restorative Justice (RJ) model (Shapland et al., 2008)
• Evidence of changes on cognitive skills measures following the
Aggression Replacement Training (ART) programme (Currie et al.,
2010)
• Less consistent and more difficult to interpret findings from a study of
mental health problems (Pullman, 2011)
32
Theory of change
“There is nothing so practical… as a good
theory”
Kurt Lewin (1890-1947)
33
How do we decide if interventions are worth
trying?
Should it be a minimum requirement
that any intervention designed to change
offending behaviour should show the
capacity to alter patterns of thinking, feeling
and acting, and the relationship between
them, in a way that could be reflected in
neural change?
34
Brain changes as a function of experience
• Increased cortical representation of the fingers of the left
hand in string instrument players (Elbert et al., 1995)
• Spatial navigation and hippocampus volume in London cab
drivers (Maguire et al., 2000)
• Bilingualism and structural changes in the parietal cortex
(Mechelli et al., 2004)
• Reactivation of previously stimulated memory circuits
(Gelbard-Sagiv et al., 2008)
• Amygdala volume correlates with social network size and
complexity (Bickart et al., 2010)
• Socioeconomic disparities and prefrontal function in
children (Kishiyama et al., 2008; Lipona & Colombo, 2009)
35
Studies of neural change observed in fMRI
scans following CBT
Clinical problem Contact time Locations of observed neural changes
Major
depressive
disorder (MDD)
Spider phobia
17.25 hours
(individual
mean)
4 x 3-hours
(group)
Generalized
anxiety disorder
(GAD)
Obsessivecompulsive
disorder (OCD)
8 weekly Right ventromedial pre-frontal cortex, bilateral
sessions, 60- increase in amygdala activation
90 mins
16 sessions, Bilateral orbitofrontal cortex
90-120 mins
Ventromedial pre-frontal cortex, right
amygdala, right caudate nucleus, bilateral
hippocampus
Lateral pre-frontal cortex, para-hippocampal
gyrus
36
Illustrative CBT-based group
offender rehabilitation programmes
Rehabilitation
program
Target problem
Reasoning and
Rehabilitation (R&R)
General/versatile
offending
Enhanced Thinking
Skills (ETS)
General/versatile
offending
Think First (TF)
General/versatile
offending
Aggression
Replacement
Training (ART)
Violent offences
Cognitive SelfChange (CSC)
Serious repetitive
violent offending
Controlling Anger
and Learning to
Manage it (CALM)
Offences associated
with angry
aggression
Sex Offender
Treatment
Programme (SOTP)
Sexual offences
Contact time
76 hours
40 hours
Focus of change
Problem-solving, self-control, social
interaction, conflict resolution,
negotiation skills, moral reasoning
Problem-solving, self-control, moral
reasoning
60 hours (prisons)
Problem-solving, self-management,
54 hours (community) social interaction, offence analysis
36 hours
Social interaction, anger control, moral
reasoning
76 hours
Social appraisal, automatic thoughts,
self-control, self-perceptions
48 hours
Self-control of anger, social interaction
skills
312 hours (prisons)
180-260 hours
(community)
As R&R + sexually deviant responses,
cognitive distortions, low empathy,
management of negative emotion
37
“Non-programmatic” features of
effective interventions
38
Client factors: Risk-need adherence
There are clear indications from several meta-analyses of the
importance of appropriate allocation in terms of risk
– e.g. Lowenkamp et al. (2006):
– Study of 97 programmes, 13,676 participants
– Programmes were evaluated using the Correctional
Program Assessment Inventory (CPAI)
– As additional CPAI criteria were met, correlations with
recidivism effect increased from -0.05 to +0.18 (for
residential programmes) and from -0.14 to + 0.09 (for
non-residential programmes)
39
“Philosophy of treatment”
Deterrence versus Human service / level of treatment integrity
(Lowenkamp et al., 2010)
40
“Core correctional practices”
(Dowden & Andrews, 2004)
Specifies five areas of activity that may play a
crucial role in programme delivery:
• Effective use of authority
• Modelling and reinforcing pro-social and anti-crime
attitudes and behaviour
• Teaching concrete problem-solving skills for everyday use
• Making effective use of community resources (“service
brokerage”)
• Relationship factors
41
Core correctional practices
Meta-analysis of 273 studies
Practice
Absent
Present
Correlation with
effect size
Structured learning
235
38
.37
Skill factors
229
44
.35
Effective modelling
236
37
.34
Problem solving
228
45
.29
Relationship factors
260
13
.25
Effective reinforcement
258
15
.24
Effective disapproval
265
8
.17
Effective use of authority
258
15
.17
Advocacy/brokerage
228
45
.08
42
New Jersey Intensive Probation Supervision
(Paparozzi & Gendreau, 2005)
Compared probation officers classed as belonging to three
groups. Figures show outcomes in percentages:
TECHNICAL
VIOLATION
Law enforcement oriented
Social work oriented
Balanced
42.5
5.4
12.7
NEW
CONVICTION
16.2
32.3
6.3
REVOCATION
58.8
37.9
19.0
The “balanced role” can be induced through training in the
“principles of effective intervention” (Fulton et al., 1997)
43
Level of coercion and
community vs. institutional setting
(Parhar et al., 2008)
44
Conclusions
 We can be more confident than ever regarding the
evidence on reducing recidivism outcomes: there is a
sizeable evidence base it is wasteful to ignore
 It is difficult if not impossible to deliver high quality
interventions without adequate provision of
appropriately trained and well supported staff
 The most fundamental change that could enhance system
effectiveness would be a net transfer of resources from
prisons to community - on a large scale
 If planned and phased carefully, the sums released from
reducing prison numbers could finance community
developments and associated staff training
45