questions Due 10/7/17 8pm est

September 2008 43

Cognitive-Behavioral Interventions: Where They Come From and What They Do

THE NEWS IS OUT and it's not good, but it comes as no surprise to corrections officials. Presently, more than one in every one hun- dred adults in the United States is confined in local jails and state or federal correctional facilities (Warren, 2008). The United States incarcerates more of its citizens than any oth- er country in the world. At the end of 2006, there were over five million adults under the supervision of federal, state, or local proba- tion or parole authorities (Bureau of Justice Statistics, 2007). Due to the rising incarcera- tion rates, many states face significant finan- cial shortfalls and must make tough decisions regarding their correctional populations. In 2005, the State of Washington focused its at- tention on the long-term fiscal consequences of prison expansion. As a result, the State Legislature directed the Washington State In- stitute for Public Policy (Institute) to explore options to imprisonment. After a thorough re- view of existing programs and research, the Institute identified several Evidence Based Practices (EBP), such as cognitive behavioral therapy (CBT), that might be effective in re- ducing recidivism, thus alleviating the need to build additional prisons (Washington State Institute for Public Policy. 2006).

Several other states have come to real- ize that non-violent offenders may be bet- ter served under community supervision rather than incarcerated. According to The Pew Center on the States (2008), "No poli- cy maker would choose this path if it meant sacrificing public safety. But gradually, some states are proving that deploying a broad range of sanctions can protect communities,

punish lawbreakers, and conserve tax dollars for other pressing public needs" (p. 4). This may reduce the overall inmate population, but community correction agencies may see an increase in numbers of individuals under some type of community-based supervision. Correctional administrators continue to seek low-cost, effective treatment interventions to assist in reducing recidivism and stopping the criminal justice system's revolving door, which has become the hallmark of correc- tions in the United States.

As noted by the Washington State In- stitute for Public Policy (2006) and many other researchers (Lipsey, Landenberger, & Wilson, 2007; Milkman & Wanberg, 2007; Przybylski, 2008; Pearson, Lipton, Cleland, & Yee, 2002; Wilson, Bouffard, & MacK- enzie, 2005; Landenberger & Lipsey, 2005), CBT is one evidence-based intervention vvhich shows promise in reducing recidivism. The purpose of this paper is to acquaint the reader with CBT, its history, and to explore several programs that have proven to be ef- fective in reducing recidivism. This paper only broadly touches on several of the im- portant researchers in the fields of cognitive therapy, behavioral therapy, and CBT. There are many others who have had an impact on these therapies and further exploration on the part of the reader is recommended.

Cognitive Therapy Cognitive Behavioral Therapy is not a single method of psychotherapy; rather, CBT is an umbrella term for therapies with many similar- ities. CBT is a marriage of sorts between social

Chris Hansen Chief U.S. Probation Officer

District of Nevada

learning theory, cognitive therapy, and behav- ioral therapy, all of which initially grew from experimental psychology (Weishaar, 1993).

From the cognitive therapist's perspec- tive, an individual's personality is formed by central values that have developed early in life as a result of factors in the individual's environment. These factors serve as the basis for the way the individual codes, categorizes, and evaluates their experiences and the stimu- li they encounter. Cognitive therapists believe that psychological problems stem from faulty leaming, making incorrect assumptions as the result of inadequate or incorrect information, and not being able to adequately distinguish between imagination and reality (Freeman & Dattilio, 1992).

Early views of cognition shaping one's view of the world came from early Greek phi- losophers including Plato. Philosophers during the seventeenth and eighteenth century viewed the'' world around the concept of the mind con- trolling reality (Milkman & Wanberg, 2005). In the nineteenth century cognitive therapy was practiced by two early psychologists, Wundt and James, who defined their discipline as the science of mental life (Allen, 2006). Wundt and James' research centered around cogni- tion such as the way individuals perceived, stored, and used information. Allen (2006) notes, "The methodology involved subjects trained in introspection, who examined their own cognitive processes during experimental tasks. This phase of research was overtaken by the behaviourist framework during the 1920s, largely due to difficulties in demonstrating the validity of self-report data generated by intro-

44 FEDERAL PROBATION Volume 72 Number 2

spective methods, and resultant concerns that

this would compromi.se psychology's standing

as a legitimate science'" (p. 143).

Modem cognitive therapy started to

emerge between 1955 and 1965, but was not

recognized in the literature as a separate and

distinct field of psychology until the 1970s

(Mahoney, 1993). According to many ac-

counts (Weishaar, 1993; Freeman & Dattilio,

1992), Aaron Tenüdn Beck founded the cogni-

tive therapy movement. Much of Beck's work

surrounded the treatment of depression. Early

research compared Beck's cognitive-based

approach with treating depression with anti-

depressant medication. One study found that

cognitive therapy was effective in reducing

the symptoms of major depression in mod-

erately ill patients who were non-psychotic

(Rush, Beck, Kovacs. & Hollen, 1977).

Behavioral Therapy Behavioral therapists oppose most of the

tenets of psychoanalysis and the related dy-

namic therapies. Tliey believe that psycho-

analysis is time-consuming and not based

upon a scientifically verifiable empirical

base. The behavioral therapist is focused on

the client's behavior, not on his or her internal

mental state (Korchin, 1976).

As with cognitive therapy, behavioral ther-

apy has deep roots in history. One of the earli-

est recorded behavior modification treatments

was implemented in first-century Rome by

Gaius Plinius Cecilius Secundus (23-79), also

known as Pliny the Elder. Pliny the Elder was

a military officer and legal advisor during the

reign of Nero (Barren, 2007). Pliny developed

an innovative method that attempted to cure

alcohol abuse through aversive conditioning.

He would put rotting spiders in the drinking

glasses of alcoholics in an effort to cure their

alcoholism (Maultsby, Jr. & Wirga. 1998).

Another example of early behavioral

therapy at work is the efforts of Alexander

Maconochie. Many students of corrections

arc familiar with the work of Maconochie,

who pioneered the precursor to parole. In

1840, Maconochie was appointed superin-

tendent of the penal colony at Norfolk Island,

located 1000 miles off the coast of Ausüalia.

Maconochie used a form of behavior modi-

fication (token economy) with prison colony

inmates. He introduced a mark system where

inmates could earn early release through good

institutional behavior and prosocial work

(Champion, 1999).

Modem behavioral therapy can, in part, be

traced back to the work of two renowned re-

searchers. A. Ivan Pavlov (classical condition-

ing) and B. F. Skinner (opérant conditioning).

Pavlov, a Russian physician and physiologist,

discovered classical or respondent condition-

ing (associative leaming) in the late nineteenth

century (Maultsby & Wirga, 1998). Pavlov is

best known for his experimental work with

canines. Pavlov observed that canines would

salivate in anticipation of being fed, even

when no food was present, due to extrane-

ous stimuli the canines associated with food.

Pavlov began to experiment, conditioning the

canines with other stimuli such as bells, buzz-

ers, lights, and the sound of a metronome. He

found that any stimulus would produce the

conditioned salivary' response as long as the

canines associated the sound with being fed,

without arousing fright or anger (Schultz,

1969).

In 1920, another behavioral ex|)eriment

gained as much popularity with students of

psychology as did Pavlov's canine experi-

ments. Watson and Rayner attempted to con-

dition a nine-month-old infant (Albert), to

detennine if the child could be inade to fear

an animal that appeared simultaneously with

a loud, fear-arousing sound. In addition, Wat-

son and Rayner wanted to determine if the

fear would be transferable to other animals

and how long the fear would persist. To test

their theory, a white rat was presented to Al-

bert at the same time a loud clanging sound

occurred whenever Albert touched the animal.

"After seven pairings of the rat and noise (in

two sessions, one week apart). Albert reacted

with crying and avoidance when the rat was

presented without the loud noise" (Harris,

2002, p. 238).

Pavlov, Watson, and Ramcr (among oth-

ers) laid the groundwork for the stimulus-re-

sponse model. The stimulus-response behav-

ior is not illustrative of the types of behavior

Skinner deñned as opérant behavior. Opérant

behavior, as opposed to classical conditioning,

occurs without any observable extenial stim-

uli (such as Pavlov's sound response). One of

Skinner's classical experiments involved the

use of rats in a specially designed box. The

box was designed to eliminate all extraneous

stimuli. According to Schultz (1969):

In this experiment, a rat that had been

deprived of food was placed in the

box and allowed to explore. In the

course of this general exploratory be-

havior the rat sooner or later, and by

accident, depressed a lever activating

a food magazine that released a food

pellet into a tray. After a few rein-

forcements, conditioning was usually

very rapid. Note that the rat's behavior

operated on the environtnent (pressed

the lever) and was instrumental in se-

curing food. (pp. 233-234)

Skinner's experience led him to conclude

one way to influence behavior was through

the use of positive or negative reinforcers.

Positive reinforcers may be food, water, com-

panionship, and sexual contact. A negative

reinforcer may be a loud noise, bright light,

electrical shock, or some other type of nega-

tive stimulus. When the negative reinforcer

is removed, the subject is conditioned to as-

sociate unpleasantness with the undesired

behavior (Skinner, 1953). When Skinner ex-

trapolated his findings to the therapeutic com-

munity, he noted the relationship between

the patient and therapist; ' T h e initial power

of the therapist as a controlling agent arises

from the fact that the condition of the patient

is aversive and that any relief or promise of

relief is therefore positively reinforcing" (p.

369), In this type of therapy thie therapist

does not criticize or object to his or her cli-

ent's behavior, but will have clearly defined

goals and objectives upon which the therapist

and client agree. The therapist operates un-

der the assumption that the client will follow

tlic goals and objective agreed upon and any

deviance from the agreement may cause the

therapist to stnmgly object (Stern and Drum-

mond. 1991).

As a discipline, behavioral therapy was

not recognized until the 1950s. It was intro-

duced in the literature by Kinner and Lindsley

in 1954, but gained acceptance through tlie

work of Ey.sench in 1960 (Wolpe, 1990). Be-

havioral therapists did not believe in the need

to focus on the individual's past as did tradi-

tional psychotherapists (Meyer & Chesser,

1970).

In the United States, behavioral therapy

was popularized by Joseph Wolpe in the late

1950s. Wolpe used a technique of systematic

desensitization for simple phobias. This type

September 2008 COGNITIVE BEHAVIORAL INTERVENTIONS 45

of therapy was based upon the principle of

reciprocal inhibition. Wolpe believed that if

a patient was made to relax upon a gradual

exposure to a fearful stimulus, the patient

could not experience fear at the same time.

This was due to the fear being blocked by the

relaxed state, i.e. reciprocally inhibited (Stem

&Drummond, 1991).

Up until the 1970s, most behavioral ther-

apists drew their understandings from labora-

tory experiments on animals and human vol-

unteers with specific fears, which was useful,

but had little clinical relevancy to clients with

real-world problems (Marks, 1981 ). Since that

time, behavioral therapy has proved to help a

wide variety of anxiety and other disorders.

Drummond and Kennedy (2006) provide a

concise definition of behavioral therapy: "it is

a collection of treatments whose central the-

sis is that psychological distress results from

leamed behaviour and that this behaviour can

be unleamed" (p. 167). Marks (1986) noted,

"the main aim is to alter that behaviour which

restricts the patient's social, work, and day-

to-day activities, thus improving his quality

of life" (p. I).

Cognitive-Behavioral Therapy In the 1950s, through the work of Ellis ( 1989),

and eventually Beck, there began a blending

of cognitive therapy with behavioral therapy

to form CBT. Ellis created rational-emotive

therapy (RET) in 1955. Ellis was a practicing

psychoanalyst who after six years of doing

classical and analytically oriented psycho-

therapy became disenchanted vvith the inef-

ficiencies of the approach. Ellis began using

behavioral therapy, which he had previously

used on himself to overcome his fear of dat-

ing and public speaking. According to Ellis

(1989):

I did not by any means wholly invent

cognitive-emotive-behavioral meth-

odology, I think I can safely say that I

was the first modem therapist to give

it heavy emphasis and considerable

publicity. From the beginning, I also

included some highly emotive exer-

cises and practices in RET. (p. 8)

Ellis' postulated good and comprehensive

CBT includes many features of existing ther-

apies but also focuses on scientific methods,

excluding some of the unscientific aspects

of psychoanalysis. In reviewing Ellis' work

with clients, Kuehlwein (1993) noted, "... El-

lis vigorously works with them to persuade

them to give up their irrational thoughts and

behaviors. While doing this, he emphasizes

his clients' unconditional worth as people,

maintaining that people are acceptable in

spite of negative behaviors and traits" (p. 3).

In the late mid-1980s, there was still re-

sistance to the blending of the two therapies,

despile the work of Ellis and Beck. Marks

(1986), a well-known behavioral therapist,

noted, "it is quite possible that current re-

search into cognitive therapy will yield more

promising results that would justify teaching

the approach to (behavioural) trainees inter-

ested in routine treatments. That moment has

not yet arrived" (p. 8). Despite the beliefs of

Marks (1986) and others in the field, in the

late 1980s and early 1990s, the cognitive and

behavioral fields merged to form CBT.

Cognitive and behavioral changes have

a reinforeing effect. When cognitive change

leads an individual to change his or her actions

and behavior, it results in a positive outcome

that strengthens the change in the individual's

thought pattems. When this occurs, changes

in thinking are reinforced by the changes in

behavior, which further strengthens those

behavioral changes. Milkman and Wanberg

(2005) note, "It is not just the reinforcement

of the behavior that strengthens the behavior;

it is the reinforcement of the thought struc-

tures leading to the behavior that strengthens

the behavior. This self-reinforcing feedback

process is a key principle, which becomes the

basis for helping clients understand the pro-

cess and maintenance of change" (p. 207).

Cognitive-Behavioral Therapy in Corrections Corrections officials are concemed vvith re-

cidivism and how CBT can assist with reduc-

ing recidivism. A meta-analysis conducted

by Pearson, Lipton, Cleland, and Yee (2002)

found that CBT programs were more effec-

tive in reducing offender recidivism than

strictly behavioral ones. The authors noted.

"The policy implication is that directors of

rehabilitation programs should consider hav-

ing cognitive-behavioral programming as

a priniiuy or secondary component of their

treatment programming" (p. 493).

CBT has been found to be one of the more

promising methods of rehabilitative treatments

for offenders. Offenders have been found to

distort cognition, which impairs their ability to

correctly read social clues, accept blame, and

morally reason. This creates a greater sense of

entitlement on the part of the offender (Lipsey,

Landenberger, & Wilson, 2007). This distort-

ed thought process can lead them to demand

instant gratification, mispereeive hannless

situations as threats, and confuse wants with

needs (Ross & Fabiano, 1985). CBT programs

use behavioral leaming techniques to alter the

general adaptive behavior of offenders. This

allows them to retum to tlieir natural environ-

ment with a bank of new skills that they can

reinforce in socially acceptable ways instead

of in their prior illegal ways (Pearson, Lipton,

Cleland, & Yee, 2002).

Tliere are many "pre-packaged" CBT pro-

grams for offenders, several of which will be

discus.sed in the following paragraphs. The

question for correctional administrators is

which program to utilize among the vast ar-

ray of options. A meta-analysis conducted by

Landenberger & Lipsey (2005) found that

it was not the specific program that held the

most benefit, but the general CBT approach

that was responsible for the overall positive

effects on reducing recidivism. Landenberger

and Lipsey noted that effective CBT programs

were characterized by having high quality im-

plementation, vvhich was represented by low

proportions of treatment dropouts, high fidel-

ity and monitoring of the treatment implemen-

tation, and adequate training for the providers.

The authors also found that CBT effects were

greater among high-risk offenders (those vvith

a greater risk of recidivism) than among those

with lower risk. This may be because the high-

er-risk offenders have more needs and areas

needing change than the low-risk ofïendere.

In order for a CBT program to have an

impact on offender recidivism, there must be

fidelity in the delivery of the program. Poorly

delivered programs along with failure to fol-

low tlie CBT curriculum will have diminished

results. Effective CBT programs consistently

use role play, rewards and punishers, graduated

rehearsal and practice, and appropriate model-

ing (Hubbard & Latessa, 2004). It should be

noted that homework is also an essential part

of most CBT programs. Since most face-to-

face contact in CBT programs is relatively

short (one to two hours each session) home-

work is necessary. According to Freeman et

46 FEDERAL PROBATION Volume 72 Number 2

al. (2005), homework can also serve as a mea- sure of the client's motivation for change. If clients are willing to work outside of the CBT session, they have the motivation to change. By following up on the exercises taught in the classroom and trying out new behaviors, ideas, or emotional responses, the client can make real what has been leamed.

Corrections officials seek CBT programs that are effective in reducing recidivism, low cost, and can be taught by correctional staff who may have little or no training in psychology or social work. There are many prepackaged programs that may peak the interest of corrections professionals. These types of programs usually require a short training course for the facilitator (normally 40 hours or less) and come with workbooks and course material. The programs are usu- ally relatively short in duration and the cur- riculum is highly structured. The programs are either open-ended (participants can join at any time) or closed-ended (curriculum builds on past lessons, participants must se- quentially pass from one step to the next and cannot join a group in progress). There are several programs which have shown positive results in reducing recidivism.

Cognitive Behavioral Therapy - Programs for Offenders

The two most well researched CBT programs for offenders are Moral Reconation Therapy (MRT) and Reasoning and Rehabilitation (R & R). Approximately two thirds of the available comparison studies examined these two CBT approaches (Wilson, Bouffard, & MacKenzie, 2005) and found that they are effective in reducing recidivism. Other pro- grams noted in the literature but not as thor- oughly researched include Aggression Re- placement Training; Criminal Conduct and Substance Abuse Treatment: Strategies for Self-Improvement and Change; Relapse Pre- vention Therapy; and Thinking for a Change. There are also many other encouraging pro- grams on the horizon.

Moral Reconation Therapy (MRT) MRT was developed by Little and Robinson (1988) in the mid-1980s in a prison-based Therapeutic Community (TC) program in Tennessee. The program has expanded be- yond TCs to both custodial and community- based entities: MRT incorporates cognitive

elements into a behavioral-based program that highlights moral reasoning (Little & Robinson, 2005). The goals of MRT are to enhance the social, moral, and behavioral def- icits of offenders. Its theory is based upon the ideas of Kohlberg's moral development the- ory (MacKenzie, 2006). Kohlberg postulates moral development advances through six stages, with the sixth stage being the high- est level of moral reasoning. Very few adults ever attain the sixth stage of moral reasoning. The higher levels of moral reasoning necessi- tate greater abstract thinking and the ability to take the perspective of others. Thus individu- als with high levels of moral reasoning are less likely to engage in criminal behavior.

Research conducted on both adult offend- ers and juvenile delinquents find them to be at the early stages of moral reasoning (Ar- buthnot & Gordon, 1988). Little and Robin- son (1988) found that criminal offenders had deficits in their moral reasoning along with deficits in other areas. They believed that of- fenders also had low ego/identity strength, poor self image, low self-esteem, strong narcissism, strong defense mechanisms, and strong resistance to change and treatment. They developed MRT around these deficits.

MRT facilitators undergo 32 hours of training to enable them to present the MRT materials. The program consists of work- books designed for the specific types of client and particular program characteristics. The program is open-ended. Offenders typically write short answers or chrawings to specific requirements from the workbooks, which do not require the offenders to have high read- ing skills or high mental functioning lev- els (Milkman & Wanberg, 2007). MRT is a 12-step process with four optional steps and usually takes 14 to 16 sessions (Van Dicten, 1997; Milkman and Wanberg, 2007).

Reasoning and Rehabilitation (R & R) R & R was developed by Canadian research- ers Ross and Fabiano (1985), who found literary evidence that outlined development delays in offenders' cognitive skills that are necessary for social adjustment. Similar to MRT, R & R is based on the theory that of- fenders suffer from social and cognitive defi- cits. R & R, however, does not focus on moral reasoning. R & R's aim is to enhance self- control, cognitive style, interpersonal prob- lem solving, social perspective taking, criti-

cal reasoning, and values (Wilson, Bouffard, & MacKenzie, 2005). The focus of R & R is to change the impulsive, illogical, egocentric, and rigid thinking of offenders. The program teaches offenders to stop and think before acting, recognize the consequences of their behavior, respond to interpersonal problems in altemative pro-social ways, and detemiine how their behavior and actions impact others (MacKenzie, 2006).

The R & R program is closed-ended and runs for 35 sessions over a period of 8 to 12 weeks with 6 to 10 participants. The sessions are composed of group discussions, audiovi- sual materials, games, puzzles, reasoning ex- ercises, role playing, and modeling (Milkman & Wanberg, 2007).

In 1996, Ross and Hilborn developed a shorter version of R & R known as R & R2. This program is for offenders over the age of 18 and is a .specialized 16-session edition. The updated program corrects shortcomings found in earlier versions that did not allow the program to be customized to the needs of the group. The program entails just over 1,000 tninutes of participant training, consisting of the transfer of cognitive skills to real-life events coupled with homework assignments. R & R2 principles include:

• Motivational interviewing • Prosocial Modeling • Relapse prevention • Desistance (encouragement to acquire a

long-term prosocial lifestyle). (Milkman & Wanberg, 2007. p. 26)

Aggression Replacement Training (ART)

ART was developed by Goldstein and Glick at the Syracuse University Center for Research on Aggression as a multimodal intervention designed to alter the behavior of chronically aggressive youth (Goldstein & Glick, 1994). The program has expanded to encompass adult offenders.

According to Milkman and Wanberg (2007), the program has three main components: • Social skills training (the behavioral com-

ponent) teaches interpersonal skills to deal with anger-provoking events.

• Atiger control training (the affective com- ponent) seeks to teach at-risk youth skills to reduce their affective impulses to be- have with anger by increasing their self- control competencies.

September 2008 COGNITIVE BEHAVIORAL INTERVENTIONS 47

• Moral reasoning (the cognitive compo- nent) is a set of procedures designed to raise the young person's level of fair- ness, justice, and concem with the needs and rights of others, (p. xiv)

• ART is a closed-ended, 10 week program, spanned over 30 hours. Participants (8 to 12 offenders) typically attend three one- hour sessions per week. Group facilitators are required to attend a 40-hour training program to be certified in delivering the curriculum.

Thinking for a Cbange ÍT4C) T4C was developed for the National Insti- tute of Corrections (NIC) by Bush, Glick, and Taymans in 1997 (Van Dieten, 1997). T4C integrates cognitive restructuring, so- cial skills, and problem solving to increase the offender's awareness and increase inter- personal problem-solving skills (Milkman & Wanberg, 2007; Przybylski, 2008).

T4C is a closed-ended, 22 sequential les- son program that is delivered to 8-12 partici- pants in the community or institutional set- ting. Each lesson lasts one to two hours and two sessions per week is the optimal recom- mended dosage. Only one session should be administered f)er day. Group facilitators are required to attend a 32-hour training program to be certified in delivering the curriculum.

Criminal Conduct and Substance Abuse Treatment: Strategies for Self-Improvement and Change (SSC).

SSC was developed by Wanberg and Milk- man as a treatment for adult substance abus- ing offenders involved in the criminal justice system. The program has three main phases: • Phase I: Challenge to Change. This phase

involves the client in a reflective-contem- plative process. A series of lesson experi- ences is used to build a working relation- ship with the client and to help the client develop motivation to change.

• Phase II: Commitment to Change. This phase involves the client in an active demonstration of implementing and prac- ticing change. The focus is on strength- ening basic skills for change and helping the client to leam key CBT methods for changing thought and behavior that con- tribute to substance abuse and criminal conduct.

• Phase III: Ownership of Change. This phase, the stabilization and maintenance phase, involves the client's demonstration of ownership of change over time. This involves treatment experiences designed to reinforce and strengthen the commit- ment to established changes. (Milkman & Wanberg, 2007, p. xv)

• SSC is a long-term program lasting up to one year. There are 50 two-hour sessions. It can be delivered both in the community or correctional institution setting. It is an open and closed-ended program - Phase I is closed and Phases II and III have specific entry points. Group facilitators are required to attend a 40-hour training program to be certified in delivering the curriculum.

Relapse Prevention Therapy (RPT) RPT was originally developed by Parks and Marlatt in 2000 as a maintenance program to prevent and manage relapse following treatment for substance abuse addiction. Currently, RPT is being used with a variety of offenders with a multitude of problems including substance abuse, .sex offending, violence, and other types of criminal con- duct (Milkman & Wanberg, 2007; Przybyl- ski, 2008). RPT intervention strategies fall into three categories: coping skills training, cognitive therapy, and lifestyle modification. Parks and Marlatt (2000) relate RPT teaches offenders the following strategies:

• understand relapse as a process, • identify and cope effectively with high-

risk situations, • cope with urges and craving, • implement damage control procedures

during a lapse to minimize its negative consequences,

• stay engaged in treatment even after a re- lapse, and

• leam how to create a more balanced life- style, (p. 2) RPT is an open-ended curriculum. Group

facilitators are required to attend a 40-hour training program to be certified in delivering the curriculum.

CBT in the Federal Probation and Pretrial Services System As part of the Researeh to Results (R2R) ini- tiative, several federal districts implerriented

cognitive-behavioral programs. In order to support implementation, the AO developed a "model implementation plan," which outlines for districts training, structure, and quality as- surance issues that will increase the likelihood of effective implementation of cognitive- behavioral programming. All districts that received grant funding were required to fol- low the implementation plan; other districts that are implementing cognitive-behavioral programming are also strongly encouraged to follow the plan. Beyond the plan components, districts were given wide latitude in choosing the program to implement and how it would be facilitated (i.e., through contract vendors or in-house staff). Districts chose to imple- ment a wide variety of programs, including take-home programs, which are especially useful for rural jurisdictions. During FY2OO7, using R2R funds, 123 officers were trained in cognitive-behavioral services and 248 of- fenders had begun receiving services. This is impressive, given that many districts did not receive funding until six months into the fis- cal year. Officers have been enthusiastic of the programs. Senior U.S. Probation Officer Darren Kems stated:

I have facilitated groups for adults and juveniles and have observed the positive effect it can have on of- fenders. Also, as a probation officer trained in T4C and other cognitive skills curricula, 1 am better able to reinforce the concepts with offenders when dealing with them on a daily basis. I like the skill-based approach which assists offenders in changing problematic behavior, thoughts, and beliefs. If offender buy-in is estab- lished, the participants leave the pro- gram with skills they can use to ef- fectively address situations that have caused them problems in the past.

U.S. Probation Officer Lisa Martinetto said: The more I understand about an of- fender's thoughts or beliefs, the eas- ier it is for me to identify potential thinking errors which may lead to future violations or recidivism. Ulti- mately, using the cognitive skills pro- gramming gives me the opportunity to more effectively supervise each offender. Offenders have also responded positively

48 FEDERAL PROBATION Volume 72 Number 2

to the program; one said: "1 really needed to start thinking for a change so thank you for this class. 1 really learned a lot." Another in- dicated that he attended "at first because my PO insisted. Then it became interesting and I obtained a lot from it. It helped me under- stand my thoughts, feelings, and actions a little better."

Three federal probation districts (Hawaii, Nevada, Northern Iowa) decided to take a unique approach to cognitive-behavioral pro- gramming; they teamed up with The Change Companies of Carson City, Nevada, to devel- op a CBT offender journaling program. The program, interactive Journaling, addresses the "Big Six" criminogenic need areas, in- cluding antisocial values, criminal peers, low self-control, dysfunctional family ties, sub- stance abuse, and criminal personality.

The Interactive Journals serve the oifend- er through application-focused exercises and skill-building activities ba.sed upon the trans- theoretical model of change, in addition to cognitive-behavioral concepts. As the offend- ers gather relevant infonnation related to their problem areas, they can map out their past, present, and future, creating a personal and lasting tool for change. The journals can be implemented in a group or individual setting. The District of Nevada is utilizing the exper- tise of the University of Nevada, Las Vegas, to design an experimental study of the Interac- tive Journaling program to assess its effective- ness in reducing participants' recidivism.

Conclusion Cognitive-behavioral programs have been shown to reduce recidivism as long as the programs are implemented well. As with any program, intensive planning about the program to use, logistics of providing the service, quality assurance, and evaluation of effectiveness should occur prior to actual implementation. Such planning will increase the likelihood of successful implementation, while evaluation of the program allows dis- tricts to address problems that may occur, par- ticularly around program fidelity. With good cognitive-behavioral programming, districts can increase their effectiveness in addressing offender issues.

References

Allen, N. B. (2006). Cognitive psychothera-

py. In S. Bloch (Ed.). Introduction to Psy- chotherapies. (4th ed., pp. 141-166). New York: Oxford University Press.

Arbuthnot, J., and Gordon, D. (J988). Crime and cognition: Community applications of sociomoral reasoning development. Criminal Justice and Behavior ¡5(3), 379-393

Barren, M. (2007). Pliny the Elder, World of Scientific Biography. Retrieved April 13, 2008, from http://scienceworld.wolfram. com/biography/Pl inytheElder.html.

Bureau of Justice Statistics. (2007). Proba- tion and parole in the United States, 2006. Washington, DC: Bureau of Justice Sta- tistics, U. S. Department of Justice.

Champion, D. J. (1999). Probation, parole, and community corrections. Upper Sad- dle River, NJ: Prentice Hall.

Dobson, K. S. (1988). Handbook of cogni- tive-behavioral therapies. New York: The Guilford Press.

Drummond, L. M., & Kennedy, B. (2006). Behavioural psychotherapy. In S. Bloch (Ed.). Introduction to Psychotherapies. (4th ed., pp. 167-196). New York: Oxford University Press.

Ellis, A. (1989). The history of cognition in psychotherapy. In A. Freeman, K. M. Si- mon, L.E. Beutler, & H. Arkowitz (Eds.), Comprehensive liandbook of cognitive therapy (pp. 5-21). New York: Plenum Press.

Freeman, A., & Dattilio, F. M. (1992). Com- prehensive casebook of cognitive therapy. New York: Plenum Press.

Freeman, A.. Felgoise, S. H., Nezu, A. M., Nezu, C. M., & Reinecke. M. A. (2004). Encyclopedia of cognitive behavior ther- apy. New York: Springer Science + Busi- ness Media.

Goldstein, A. P., & Glick, B. (1994). Aggres- sion replacement training: Curriculum and evaluation. Simulation & Gaming, 25(1), 9-26.

Harris, B. (2002). Whatever happened to little Alben. In W. E. Pickren, & D. A. Dews- bury. (Eds.), Evolving perspectives on the history of psychology (pp. 239-254). Washington, DC: American Psychologi- cal Association.

Hubbard, D. J., & Latessa, E. J. (2004). Eval- uation of cognitive-behavioral programs for offenders: A look at outcome and

responsivity in five treatment programs. Ohio Office of Criminal Justice Services.

Korchin, S. J. (1976). Modern clinical psy- chology: Principles of intervention in the clinic and community. New York: Basic Books.

Kuehlwein, K. T., Rosen, H. (1993). Cogni- tive Therapies in action: Evolving inno- vative practice. San Francisco: Jossey -Bass.

Landenberger, N.A. and Lipsey, M.W. (2005). The positive effects of cognitive behavioral therapy for offenders. Jour- nal of Experimental Criminology, 2005.

Little, G. L. (2000). Cognitive-behavioral treatment of offenders: A comprehensive review of MRT outcome research. Addic- tive Behaviors Treatment Review, 2(1). 12-21.

Littíe, G. L., & Robinson, K. D. (1988). Moral reconation therapy: A systematic step-by- step. Psychological Reports, 62(1), l35- 151.

Little, G. L., & Robinson, K. D. (2006). Re- cidivism outcome research on Moral Re- conation Therapy in prisons-based thera- peutic communities: A comprehensive review. Cognitive-Behavioral Treatment Review, 15(2), 14-17.

Lipsey, M. A.,Landenberger, N. A., & Wilson, S. J. (2007). Effects of cognitive-behav- ioral programs for criminal offenders. Nashville: Center for Evaluation Research and Methodology Vanderbilt Institute for Public Policy.

MacKenzie, D. L. (2006). What works in cor- rections: Reducing the criminal activities of offenders and delinquents. New York: Cambridge.

Mahoney, M. J. ( 1993). Introduction to spe- cial section: Theoretical developments in the cognitive psychotherapies. Journal of Consulting and Clinical Psychology. 61(2), 187-193.

Marks, I M. (1981). Cure and care ofNeuro- .ses. New York: Wiley.

Marks, I. M. (1986). Behavioural psycho- therapy: Maudsley Pocket Book of Clini- cal Management. Bristol, UK: IOP Pub- lishing Limited.

Maultsby, M. and Wirga, M. (1998). Behav- iour therapy, Assesment and Therapy: Specialty Articles from the Encyclopedia of Mental Health. Ed. Hov/ard Friedman

September 2008 COGNITIVE BEHAVIORAL INTERVENTIONS 49

Meyer, V., & Chesser, E. S. (1970). Behavior

therapy in clinical psychiatry. New York:

Science House.

Milkman, H. B., & Wanberg, K. W. (2005).

Criminal conduct and substance abuse

treatment for adolescents: Pathways to

.self-discovery and change. Thousand

Oaks, CA: Sage.

Milkman, H. B., & Wanberg, K. W. (2007).

Cognitive-Behavioral Treatment: A review

and di.scussion for corrections profes-^

sionals. Washington, DC: National Insti-

tute of Corrections.

Parks, G. A., & Marlatt, G. A. (2000). Re-

lapse Prevention Therapy: A cognitive-

behavioral approach. The National P.sy-

chologist, 9(5). 2-3.

Pearson, F. S., Lipton, D. S., Cleland, C. M.,

& Yee. D. S. (2002). The effects of behav-

ioral/cognitive-behavioral programs on

Recidivism. Crime & Delinquency, 48(3)

476-496.

Przybylski, R. (2(K)8). What works: Effective

recidivism reduction aiui risk-focused pre-

vention programs. (PS7/2.2/R24/2008).

Colorado Division of Criminal Justice.

Ross, R. R., & Fabiano, E. A. (1985). Time to

think: A cognitive model of delinquency

prevention and offender rehabilitation.

Johnson City. TN: Institute of Social Sci-

ences and Arts.

Rush. A. J., Beck, A. T., Kovacs, M., & Hol-

lon. S. D. (1977). Comparative efficacy

of cognitive therapy and pharmaco-

therapy in the treatment of depressed

outpatients. Cognitive Therapy and Re-

search. I (]): 17-37.

Schultz, D. P (1969). A history of modern

psychology. New York: Academic Press.

Skinner, B. F. (1953). Science and human be-

havior. New York: The Macmillan Com-

pany.

Stanley, D.T. (1976). Prisoners among us:

The problem of parole. Washington, DC:

Brookings Institution.

Stem, R. S.. & Dmmmond, L. M. (1991). The

practice of behavioural and cognitive

p.sychotherapy. New York: Cambridge

University Press.

Van Dieten, M. (1997). Cognitive-behavioral

programs: A resource guide to existing

services. Washington, DC: National In-

stitute of Corrections.

Warren, J. (2008). One in 100: Behind bars in

America 2008. Washington, DC: The Pew

Center on the States.

Washington State Institute for Public Policy

(2006). Evidence-based public policy op-

tions to reduce future prison construction,

criminal jiLstice costs, and crime rates. Re-

trieved Mareh 1, 2008, from http://www.

wsipp.wa.gov/rptfiles/06 10 1201.pdf.

Weishaar, M. E. (1993). Key figures in coun-

selling and psychotherapy, Aaron T. Beck.

Thousand Oaks, CA: SAGE,

Wilson, D. B., Bouffard, L. A., & MacKen-

zie, D. L. (2005). A quantitative review of

structured, group-oriented, cognitive-be-

havioral programs for offenders. Criminal

Justice and Behavior, 32(2), 172-204.

Wolpe, J. (1969). The practice of behavior

therapy. New York: Pergamon

Wolpe, J. (1990). The practice of behavior

therapy, 4th ed. New York: Pergamon

NY.