WHAT WORKS IN OFFENDER REHABILITATIONUniversity of Birmingham ∙ September 2014

What works in reducing re-offending

…19 years on

James McGuire

University of LiverpoolInstitute of Psychology, Health and Society

Department of Psychological SciencesWhelan Building

Liverpool L69 3GBUnited 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.

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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.

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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)

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Traditional objectives of sentencing

• Retribution• Incapacitation• Deterrence• Rehabilitation• Restoration

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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 deterrenceThe expectation that the public visibility of punishment will deter prospective offenders, i.e. there will be a broad suppressant effect of official punishments

Specific deterrenceThe expectation that the experience of punishment will reduce or suppress the likelihood of criminal acts by those who have previously committed them

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General deterrence:Homicide rates, Hong Kong and Singapore

1967-2007(Zimring & Hawkins, 2010, ‘A tale of two cities’)

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Homicide rates in Hong Kong and Singapore and the impact of capital

punishment

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Prison populations around the world

Rates of imprisonment per 100,000 population

Source: International Centre for Prison Studies, London, and University of Essex (2012)

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Prison population, England and Wales

1900-2009

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Deterrence in action?Impact of “three strikes” laws in

California

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Reduction in prison population in California

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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

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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

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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 well-established theoretical model, and meeting evidence-based criteria

• Take account of contextual variations and situational requirements; such “non-programmatic” factors have been neglected until recently

“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

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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

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Effectiveness of cognitive-behavioural programmes (Lipsey et

al., 2007)

Review of 58 studies published between 1980-2004. Majority quasi-experimental designs: only 33% randomizedAverage follow-up interval of 12 months.

•Mean Odds Ratio = 1.53Corresponds 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 cognitive-behavioural programmes(Lipsey et al., 2007)

Forest plot comparing outcomes

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Review of programmes for adult violence

(Jolliffe & Farrington, 2007/2009)

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Five more meta-analysesSource 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 = 0.46Drug use: d = 0.38

Wilson (2014) Antisocial Personality Disorder

6 No sig results but OR trends favoured treatment

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Comparative effects on recidivism of different interventions

(various sources)

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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”

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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?

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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 30Most research reports include participants

across these ranges and do not analyse data separately by specific age-bands

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Why focus on this group?

• This age-group is responsible for a disproportionately high volume of police-recorded 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

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Search strategy

• Electronic databases:– Scopus– Web of Knowledge– Web of Science– PsycINFO, PsyArticles– MEDLINE– NCJRS– Cochrane Library– Campbell Library

• Reference lists of articles located

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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)

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Search and retrieval process

Sequence of selection decisions

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Items retrieved and screened

2,967

Downloaded195

Retained for detailed scrutiny

112

Full extraction

10

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Study Participants/ sample size

Setting Intervention Outcome measure

Results

Armstrong (2003)

Exp = 110Con = 102

Detention center / County Jail

Moral Reconation Therapy (MRT)

Recidivism survival analysis

No significant differences observed

Braga et al. (2009)

Exp = 108 Con = 309

Discharge from prison to community

Boston re-entry initiative (BRI)

Recidivism at 1, 2 and 3 year follow-up

Significant differences:32% reduction

Cann et al. (2005)

Exp = 1,534Con = 1,534

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 = 388Completers versus dropouts

Community based: 30 sites in USA

YouthBuild (YB) USA Re-offending, revocation, re-incarceration

Small diffs found but may be due to sample diffs

Currie et al. (2010)

20 participants, no comparison group

Youth custody centre (Aus)

Aggression Replacement Training (ART)

Psychometrics: pre-, post-, 6-mo, 24-mo FU

Significant positive changes on all measures

Farrington et al. (2002)

(a) Exp = 176, Con = 127(a) Exp = 61 Con = 97

Two young offender institutions

High intensity regimes (HIT and MCTC)

Numbers of re-offences; Cost-benefit analysis

(a) HIT: sig drop in re-offences

(b) MCTC: no differences

Josi & Sechrest (1999)

Exp = 115 Con = 115

Parole/re-entry to community

Lifeskills’95 13-week, 39-hr programme

Rate of parole revocation and recidivism

Sig + diffs in parole, arrest + other variables

Pullmann (2011)

Study sample = 143 Mental health services

OHT: restrictive residential treatment unit

New criminal charges during ages 16-25

Criminal charges reduced by 43%

Shapland et al. (2008)

Scheme 1 = 50Scheme 2 = 742Scheme 3 = 132

Community-based

Restorative justice interventions

Recidivism at 2 yearsCost-benefit

Sig findings at 1 of 5 sites for one type of offence

Travers & Mann (2013)

18-20 = 4,06121-24 = 4,63725+ = 12,675

HM prison service

Cognitive skills programmes (R&R + ETS)

Predicted versus actual recidivism

Reductions for sexual, violent + drug offences

Key resultsIn 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)

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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?

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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)

17.25 hours

(individual mean)

Ventromedial pre-frontal cortex, right amygdala, right caudate nucleus, bilateral hippocampus

Spider phobia 4 x 3-hours(group)

Lateral pre-frontal cortex, para-hippocampal gyrus

Generalized anxiety disorder (GAD)

8 weekly sessions,

60-90 mins

Right ventromedial pre-frontal cortex, bilateral increase in amygdala activation

Obsessive-compulsive disorder (OCD)

16 sessions,

90-120 mins

Bilateral orbitofrontal cortex

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Illustrative CBT-based group offender rehabilitation

programmes Rehabilitation program

Target problem

Contact time Focus of change

Reasoning and Rehabilitation (R&R)

General/versatile offending

 76 hours

Problem-solving, self-control, social interaction, conflict resolution, negotiation skills, moral reasoning

Enhanced Thinking Skills (ETS)

General/versatile offending

 40 hours

Problem-solving, self-control, moral reasoning

Think First (TF) General/versatile offending

60 hours (prisons)54 hours

(community)

Problem-solving, self-management, social interaction, offence analysis

Aggression Replacement Training (ART)

 Violent offences

 36 hours

Social interaction, anger control, moral reasoning

Cognitive Self-Change (CSC)

Serious repetitive violent offending

 76 hours

Social appraisal, automatic thoughts, self-control, self-perceptions

Controlling Anger and Learning to Manage it (CALM)

Offences associated with angry aggression

 48 hours

Self-control of anger, social interaction skills

Sex Offender Treatment Programme (SOTP)

 Sexual offences

312 hours (prisons)180-260 hours (community)

As R&R + sexually deviant responses, cognitive distortions, low empathy, management of negative emotion

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“Non-programmatic” features of effective

interventions

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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)

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“Philosophy of treatment” Deterrence versus Human service / level of

treatment integrity(Lowenkamp et al., 2010)

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“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

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Core correctional practicesMeta-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

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New Jersey Intensive Probation Supervision (Paparozzi & Gendreau, 2005)

Compared probation officers classed as belonging to three groups. Figures show outcomes in percentages:

TECHNICAL NEW

VIOLATION CONVICTION REVOCATION

Law enforcement oriented 42.5 16.2 58.8Social work oriented 5.4 32.3 37.9Balanced 12.7 6.3 19.0

The “balanced role” can be induced through training in the “principles of effective intervention” (Fulton et al., 1997)

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Level of coercion and community vs. institutional setting

(Parhar et al., 2008)

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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

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