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 [email protected]

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 delitti e delle pene ), was published in 1764 ( Dei 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

Prison populations around the world Rates of imprisonment per 100,000 population Source: International Centre for Prison Studies, London, and University of Essex (2012)

USA Russian Federation South Africa Singapore Brazil Mexico Algeria Spain England & Wales Scotland Malaysia China Canada Italy France 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 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 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.

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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

Source

Koehler et al (2013) Koehler et al (2014) Wilson (2014)

Five more meta-analyses

Focus of review Number of effect-size tests

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Mean effect size(s) or other results

r = 0.16

Ferguson & Wormith (2012) Usher and Stewart (2012) Moral Reconation Therapy Ethnic diversity in participants Young offenders (Europe) Drug treatment programmes (Europe) Antisocial Personality Disorder 50 25 15 6 ORs: Caucasian: 1.76

Aboriginal: 1.45

Black: 1.36

Other (mixed): 1.53

ORs: Treatment OR: 1.34

RNR based: 1.90

Deterrence: 0.85

Crime: d = 0.46

Drug use: d = 0.38

No sig results but OR trends favoured treatment 22

Comparative effects on recidivism of different interventions (various sources) -60 -50 -40 -30 -20 -10 0 10 20 30

Perentage change in recidivism relative to selected comparator

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CBT "best practice" programmes CBT: sex offender treatment CBT: forensic mental health CBT: general effect Programmes for violent adults (mainly CBT) Prison therapeutic communities CBT: system-wide predicted vs. actual Employment programmes Standard probation supervision Correctional "boot camps" Standard imprisonment predicted vs. actual "Scared straight" programs Juvenile curfews Deterrence-based sanctions (youth) Intensive supervison/surveillance Prison vs. Community Control

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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” 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 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) 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 Armstrong (2003) Braga et al. (2009) Cann et al. (2005) Participants/ sample size Exp = 110 Con = 102 Exp = 108 Con = 309 Exp = 1,534 Con = 1,534 Cohen & Piquero (2010) Currie et al. (2010) Total n = 388 Completers versus dropouts 20 participants, no comparison group Farrington et al. (2002) Josi & Sechrest (1999) (a) (a) Exp = 176, Con = 127 Exp = 61 Con = 97 Exp = 115 Con = 115 Pullmann (2011) Study sample = 143 Shapland et al. (2008) Travers & Mann (2013) Scheme 1 = 50 Scheme 2 = 742 Scheme 3 = 132 18-20 = 4,061 21-24 = 4,637 25+ = 12,675 Setting Intervention Outcome measure Results Detention center / County Jail Moral Reconation Therapy (MRT) Recidivism survival analysis No significant differences observed Discharge from prison to community HM prison service Community based: 30 sites in USA Youth custody centre (Aus) Two young offender institutions Parole/re-entry to community Mental health services Boston re-entry initiative (BRI) Cognitive skills programmes (R&R + ETS) YouthBuild (YB) USA Aggression Replacement Training (ART) High intensity regimes (HIT and MCTC) Lifeskills’95 13-week, 39-hr programme OHT: restrictive residential treatment unit Community-based Restorative justice interventions Recidivism at 1, 2 and 3 year follow-up Criminal recidivism at 1 + 2 year FU Re-offending, revocation, re incarceration Psychometrics: pre-, post-, 6-mo, 24-mo FU Numbers of re offences; Cost-benefit analysis Difference at 1 yr for completers; no diffs at 2 years Small diffs found but may be due to sample diffs Significant positive changes on all measures (a) HIT: sig drop in re offences (b) MCTC: no differences Rate of parole revocation and recidivism New criminal charges during ages 16-25 Sig + diffs in parole, arrest + other variables Criminal charges reduced by 43% Recidivism at 2 years Cost-benefit Significant differences: 32% reduction 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, 31

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?

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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) Spider phobia Generalized anxiety disorder (GAD) Obsessive compulsive disorder (OCD) 17.25 hours (individual mean) 4 x 3-hours (group) 8 weekly sessions, 60 90 mins 16 sessions, 90-120 mins Ventromedial pre-frontal cortex, right amygdala, right caudate nucleus, bilateral hippocampus Lateral pre-frontal cortex, para-hippocampal gyrus Right ventromedial pre-frontal cortex, bilateral increase in amygdala activation Bilateral orbitofrontal cortex 36

Illustrative CBT-based group offender rehabilitation programmes Rehabilitation program Reasoning and Rehabilitation (R&R) Target problem General/versatile offending Contact time 76 hours Focus of change Problem-solving, self-control, social interaction, conflict resolution, negotiation skills, moral reasoning Enhanced Thinking Skills (ETS) Think First (TF) General/versatile offending General/versatile offending Violent offences 40 hours 60 hours (prisons) 54 hours (community) 36 hours Problem-solving, self-control, moral reasoning Problem-solving, self-management, social interaction, offence analysis Social interaction, anger control, moral reasoning Aggression Replacement Training (ART) Cognitive Self Change (CSC) Controlling Anger and Learning to Manage it (CALM) Sex Offender Treatment Programme (SOTP) Serious repetitive violent offending Offences associated with angry aggression Sexual offences 76 hours 48 hours 312 hours (prisons) 180-260 hours (community) Social appraisal, automatic thoughts, self-control, self-perceptions Self-control of anger, social interaction skills As R&R + sexually deviant responses, cognitive distortions, low empathy, management of negative emotion 37

“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 Program Assessment Inventory (CPAI) Correctional 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

Practice

Core correctional practices

Meta-analysis of 273 studies Absent Present Structured learning Skill factors Effective modelling Problem solving Relationship factors Effective reinforcement Effective disapproval Effective use of authority Advocacy/brokerage 235 229 236 228 260 258 265 258 228 38 44 37 45 13 15 8 15 45 Correlation with effect size .37

.35

.34

.29

.25

.24

.17

.17

.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 58.8

Social work oriented 5.4 32.3 37.9

Balanced 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 45