Cognitive programs: coming of age in corrections.

Cognitive behavior programs are best understood when the historical roots upon which they are based are reviewed. There are two theoretical foundations, both well-researched and with rich program implementation. Aron Beck, a psychiatrist working with the mentally ill, first introduced cognitive restructuring. Essentially, cognitive restructuring is a process by which individuals are directed to assess their own thoughts, feelings, beliefs and attitudes in order to identify new thinking that reduces risk behaviors. Albert Ellis developed the first application of Beck's seminal work when he developed Rational Emotive Therapy (RET). RET was a structured process that helped individuals rationally deal with problems living within their affective domain. As a result of that early work, Ellis applied his theory to other areas and introduced Rational Behavior Therapy, which applied this cognitive process to the behavior of individuals, especially students in school settings.

Samuel Yochelson and Stanton Samenow were among the first to apply these principles to the criminal population. They designed a process to help staff and offenders identify the criminal-thinking errors that may cause criminal behavior. Yet another program based on cognitive restructuring principles is Cognitive Self-Change, developed by John Bush and Brian Biladou. This program was created for the most violent criminal offenders and teaches them to replace their risk behaviors by substituting their risk thoughts with new thinking. Offenders create a "thinking report," a technique taught in a group process, to help them resolve problem and/or stressful situations. The thinking report is a structured technique in which offenders identify a problem situation and then write (verbatim) their thoughts about the situation, the feelings they had during their thoughts, and the underlying attitudes and beliefs that culminate as a result of the thoughts and feelings they have expressed. The process is intense, and the group learns from each situation as it is provided.

Other programs that are based on this approach include: Rites of Passage, a program of change and transformation for blacks, developed by G. Rosaline Preudhomme and Leonard G. Dunston; Moral Reconation Therapy developed by Gregory Little and Kenneth Robinson; and Reasoning and Rehabilitation, developed by Robert Ross and Elizabeth Fabiano.

Cognitive Skills Programs

Albert Bandura is credited as the father of the cognitive skills programs, which are based on his work in social learning. It was Bandura who introduced the notion that individuals learn by modeling what they see others do and acquire skills by trying, through role-play situations, what has been shown to them. Based upon his seminal work, Arnold P. Goldstein designed a series of 60 skills to teach pro-social behaviors to mentally ill patients who were being deinstitutionalized as a result of the public policies of the late 1960s and early 1970s. That early work was later applied to at-risk youths, first by developing a 50-skill curriculum known as Skills treaming the Adolescent, and later, in collaboration with this author for juvenile delinquents and violent youths.

These cognitive skills principles were then applied to specific behavioral issues such as anger management. Donald Meichenbaum and Robert W. Novaco developed techniques to control angry outbursts with a variety of populations. They also developed strategies to reduce anger such as deep breathing, counting backward and pleasant imagery. These principles and strategies were then used as components for other programs that deal with aggression and violence. Eva Feindler developed one such program at Hofstra University in New York. She developed an anger control program for preschool children who exhibited severe aggression and hostility. Feindler introduced the Anger Behavior Cycle that served as the basis for teaching children the elements that comprise their anger. Based on her work, Goldstein and this author adapted her intervention as the affective component for their multi-modal cognitive behavior intervention, Aggression Replacement Training.

Other cognitive skills programs based on Bandura's and other such programs include: Problem-Solving (Juliana Taymans); Choices (state of Wisconsin); and Thinking for a Change (Glick, Taymans and Bush).

These major tracts--cognitive restructuring and cognitive skills--comprise the basis for which cognitive behavior programs have been designed and developed. Each of the programs identified has been implemented in a cross section of systems: juvenile justice programs, adult prisons, schools, community-based programs and mental hospitals. Their effects upon pro-social behavior have been well-documented. The skill development, habilitation and clinical impacts produced for individuals involved with these programs have been analyzed and shown to be effective interventions for the criminal justice, juvenile justice and mental health systems.

Cognitive Behavior Programs

It was not until the beginning of the 1970s and the design of the microchip, which placed personal computers on the desktops of statisticians and researchers, that meaningful progress toward understanding the science of aggression, violence and criminal behavior was better mastered. There are a number of individuals--movers and shakers, giants in the field--who have advanced the art and technology of cognitive behavior interventions to the point where the theory is better understood. Also, practitioners are able to prescriptively apply this knowledge to create better programs, services and interventions.

These individuals have taken programs that have been reported in literature and applied a statistical technique called meta-analysis to their sample of studies. Meta-analysis is a technique that allows the researcher to compare multiple variables simultaneously to discern which are most important to a particular factor. Below is a review of some of the work by the groups that have impacted correctional policy and program development.

Donald Andrews 

Andrews and his research group at Carleton University have analyzed thousands of independent studies to explore the relationships that exist between certain variables and criminal behavior. He identified a series of criminogenic factors that are highly related to criminal behaviors, including:

* Companions -- individuals with whom the offender associates, usually aggressive, violent and anti-social;

* Interpersonal relationships -- the ability to form relationships;

* Personal attitudes, values and beliefs supportive of crime;

* Behavioral history -- offenders usually have a history of anti-social, aggressive and violent behavior;

* Psychopathology;

* Lower social class origins;

* Personal temperament, aptitude, early behavioral history;

* Early family conditions;

* School-based risk factors -- often labeled special education, learning-disabled, developmentally delayed; and

* Personal educational, vocational and socioeconomic achievement.

As a result of these factors, certain programs may be designed to mitigate against these issues. Andrews has identified programs and services that successfully impact criminogenic needs, including:

* Changing anti-social attitudes;

* Reducing anti-social peer associations;

* Promoting familial monitoring and supervision;

* Promoting identification/association with anti-criminal role models;

* Changing anti-social feelings;

* Increasing self-control, self-management and problem-solving skills;

* Replacing the skills of lying, stealing and aggression with more pro-social alternatives; and

* Reducing chemical dependencies.

Paul Gendreau

Gendreau, of the New Brunswick University Group, has spent his career studying programs that work with aggressive and violent offenders. He has identified certain program characteristics that should be present in order to effect change in offenders. Essentially, these programs impact upon offenders' criminogenic needs, including social learning strategies, behavioral techniques, cognitive methods, and educational and family-based needs.

Programs that do not work with offenders and do not impact their anti-social, aggressive or violent nature include:

* Nondirective, client-centered counseling;

* Unstructured psychodynamic therapy;

* Programs that involve intense group interactions without regard to personal responsibility; and

* Variations on themes of official punishment.

Mark Lipsey

Lipsey studied programs that were reported to be effective in the literature for offenders who were involved in treatment interventions to help with their anti-social and aggressive personalities. He found, as a result of his meta-analysis, that the best treatments reduced recidivism by an average of about 30 percent; were structured and focused; and were those that had been defined as "appropriate" (clinically relevant), as defined by professional program staff or clinicians. Also, milieu therapy provided weak or no effects for treatment of serious juvenile offenders.

Edward Latessa

Latessa, of the University of Cincinnati and protege of Gendreau, uses the instrument Gendreau developed, the Correctional Program Assessment Inventory, to study programs throughout the United States and Canada. He has found that programs that effectively impact criminal behavior and reduce aggression and violence, as well as the offender's propensity to re-offend, were dependent on the extent to which the:

* Chief executive of the program was involved in the program's development and implementation;

* Program staff were trained, supervised and supported in their work;

* Offenders were involved with their own program planning and implementation;

* Program was evaluated and modified, based on the new knowledge acquired; and

* Program was developed with integrity, according to how it was designed and developed.

Observations

There are several critical interpretations and principles that should be considered as a program is developed, especially those cognitive behavior interventions frequently used to provide services to those in custody. These broad categories, while generic to all programs operated within correctional systems, are especially important to cognitive behavior interventions primarily because cognitive behavior programs are, in fact, treatment interventions conducted by trained staff at all educational levels and various job titles. It is imperative that all concerned--policy-makers, managers, direct line staff--understand how these issues impact their work. Listed below are some ideas to consider.

System Issues:

* Policy Direction -- It is critical that the programs provided in the system are supported and have adequate policies to operate. Such policies are essential to articulate philosophy, vision, mission, program goals and objectives.

* Budget and Finance -- Adequate funding to support the program is imperative. Often, programs become secondary to other operational issues and, as such, are underfunded. Also, lack of sufficient funds leads to one of the major faults identified by Gendreau--lack of program integrity.

* Establishing Clear Expectations -- Program managers are responsible for ensuring that the program philosophy and standards are articulated, both in policy and procedure.

* Certification and Standards -- It is important that program developers set appropriate standards that may be used by systems to monitor, audit and ensure program integrity. In addition, to the extent possible, systems should support certification for staff in cognitive behavior interventions or specific program interventions (by independent certification agencies) to ensure standardization of treatment, program integrity, as well as facilitate staff development.

Program Issues:

* Staff Training and Development -- Most cognitive behavior interventions require training for staff to adequately and successfully deliver the program. Those interventions that have developed a structured curriculum with articulated standards for delivery have been shown to be more effective than those that do not. Also, staff are more comfortable when delivering the program. To the extent that staff can document their competencies through certification programs, training will increase their confidence and enhance employability.

* System Support -- Managers and supervisors must support the program by ensuring that there is adequate space to operate the program, sufficient equipment, materials and supplies, and that staff are unencumbered by "add-on" tasks and responsibilities.

* Program Monitoring and Auditing -- Managers and supervisors need to know the program well so they can monitor program implementation and audit staff performance. Additionally, monitoring and auditing enhance program effectiveness and provide opportunities to refine program efficiencies.

* Program Evaluation -- Research and program evaluation conducted by an independent evaluator provide information to enhance further program development. They also provide data to support executives in their budget requests; to stakeholders, such as courts to document recidivism; elected officials to support legislation and policy direction; and communities to document rehabilitation efforts.

Recommendations:

* Agencies should adopt policies supporting a well-researched, theoretically' reliable cognitive behavior program independently evaluated to be effective in changing offender behavior.

* Agencies should adopt strategic plans that include sound staff development and training to ensure program integrity and standardized program implementation.

* Executives and managers should provide adequate budgets to support adopted programs.

* Programs should be regularly monitored, frequently audited and independently evaluated.

* Systems should seek independent credentialing agencies, either through professional organizations, such as the American Correctional Association, or independent credentialing agencies, such as the Center for Credentialing and Education.

* Agencies should regularly review programs to ensure they meet the agency's mission, goals and objectives, and continue to support its management and implementation plans.

Conclusion

Correctional systems now have interventions they may use to systematically, deliberately and prescriptively change criminal behavior. Research has shown that cognitive behavior interventions are the methods of choice that change antisocial criminal behavior in the most effective and efficient manner. Corrections professionals may no longer remain silent when challenged with the statement that "nothing works." There are programs and interventions that do work; and correctional agencies must train staff in the strategies that have been shown to be effective, credential their staff according to standards that have been set by professional associations and provide resources to allow programs to take effect. In turn, correctional staff must exercise due diligence to ensure that a safe and secure environment exists to support such program interventions and enhance offender learning.

Barry Glick, Ph.D., NCC, is a national consultant on juvenile justice and youthful offenders in adult prisons. He retired from New York state and was formerly the associate deputy director for local services with the former New York State Division for Youth.