what works in offender rehabilitation university of birmingham ∙ september 2014 what works in...
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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.
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
• 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 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
7
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
15
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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
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
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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
20
Review of programmes for adult violence
(Jolliffe & Farrington, 2007/2009)
21
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
27
Search strategy
• Electronic databases:– 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)
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Search and retrieval process
Sequence of selection decisions
30
Items retrieved and screened
2,967
Downloaded195
Retained for detailed scrutiny
112
Full extraction
10
31
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)
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)
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
36
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
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)
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“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
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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
42
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)
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
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