Module 2
Offender Treatment and Rehabilitation
a. Violent Offenders
Violent offenders are among the most dangerous offenders in the criminal
justice system, having been arrested, convicted, and imprisoned for felony crimes
such as robbery, assault, rape, and homicide. Violent offenders are also among the
most common type of offenders in the national prison system and constitute 49% of
the state prison population. In addition, violent offenders accounted for approximately
53% of the growth of the state prison population for the 10-year period of 1990–2000.
Moreover, the majority of violent offenders (70%) have a prior arrest record, and
more than half (56%) have been arrested for a previous violent felony. It is clear that
successful treatment and rehabilitation of such a prolific and persistent group of
offenders are of great value to society.
The development and implementation of any treatment program for offenders
start with a thorough assessment of the individual offender. Because treatment success
in forensic settings is most often measured by subsequent reductions in offender
recidivism rates, the measurement of an offender’s risk of recidivism is an integral
part of the development of any treatment plan. A number of such instruments have
been developed over the last decade and generally fall into two categories: risk
assessment instruments that measure static (i.e., historical or invariant) variables, such
as the Violence Risk Appraisal Guide (Quinsey, Harris, Rice, & Cormier, 1998), and
risk assessment instruments that incorporate both static and dynamic variables
(variables related to reoffending that change over time, such as pro-criminal attitudes),
such as the History, Clinical, Risk 20 (Webster, Douglas, Eaves, & Hart, 1997), the
Violence Risk Scale (Wong & Gordon, 2006), and the Level of Service Inventory
(Andrews & Bonta, 1995).
Dynamic risk assessment instruments are favored in the development of
treatment plans because they allow for the targeting of specific variables that are
theoretically amenable to change. Although the Hare Psychopathy Checklist–Revised
(Hare, 1991) and its screening version, the Psychopathy Checklist: Screening Version,
are often used in risk assessment procedures, the presence of psychopathy is often
considered only one significantly predictive clinical variable, albeit a powerful one,
among a panoply of variables related to recidivism risk and therefore is not
considered to be a standalone risk assessment instrument.
Over the last 20 years or so, research on the development, implementation,
and evaluation of treatment program effectiveness for violent offenders has
proliferated (Polaschek & Dixon, 2001). With regard to the specific structure of
treatment for violent offenders, research has demonstrated support for cognitive–
behavioral and social learning theory–based intervention programs (Cullen &
Gendreau, 1989; Quinsey, Harris, Rice, & Cormier, 2006). Although they contain
many of the same elements as nonviolent offender treatment models, violent offender
treatment programs typically encourage the development of offenders’ insight into the
functional role of their violent behavior and attempt to teach offenders alternative
behavioral strategies that will allow them to navigate conflict more effectively. An
example of such a program was designed and implemented by Polaschek and Dixon
(2001) with a New Zealand sample of violent offenders.
It consisted of several components consistent with these theoretical
approaches targeting anger management, communication skill training, and the
acquisition of parenting, interpersonal, social problem solving, and general life skills.
In addition, substance abuse and health education were incorporated into the program,
concurrent with individual therapy sessions. Although this particular program
consisted of up to four 90- minute sessions per day, 5 days per week for 3 months,
recommendations for treatment duration vary. Gendreau and Goggin (1997)
recommend that intense treatment should last for at least 4 months, with a minimum
of 100 contact hours, whereas others argue that in order for a significant reduction in
recidivism to be demonstrated, treatment should last at least 6 months (Bush, 1995).
In addition, researchers caution that special consideration must be exercised
when treatment programs for psychopathic violent offenders are developed (Hare,
1999). Hare suggests that when dealing with psychopathic offenders, cognitive–
behavioral treatment should deemphasize empathy development in favor of targeting
the development of appropriate attributional styles (i.e., teaching offenders to accept
sole responsibility for their actions rather than blaming victims). Additionally,
psychopathic offenders’ repertoires of behavioral responses should be expanded,
enabling them to fulfill their needs using more prosocial methods.
Surprisingly little research has investigated the effectiveness of treatment and
rehabilitation programs designed to reduce recidivism in violent offenders (Polaschek
& Dixon, 2001). Historically, what little research has been done regarding the
effectiveness of offender rehabilitation and treatment has been less than optimistic
(Andrews et al., 1990; Serin & Brown, 1996, 1997). However, reexamination of prior
research (Andrews et al., 1990) and current research using more sophisticated
methods, with greater scientific rigor, have provided much more promising results.
Despite the promising results of these most recent studies, there is a general
consensus in the clinical and research communities that in order for any therapeutic
gains to be maintained, treatment must not end upon an offender’s release (Marshall,
Eccles, & Barbaree, 1993; Tate, Reppucci, & Mulvey, 1995). Effective treatment
modalities must be implemented as comprehensive, ongoing treatment programs that
continue after release, often necessitating the involvement of a therapeutic community
environment and careful monitoring by parole or probation offices.
b. Sexual Offenders
An offender’s risk level is an important consideration before treatment
services are provided. The RNR model posits that offenders who pose the highest risk
of reoffense should receive the most intensive treatment services (Andrews & Bonta,
1998). A number of risk assessment tools have been developed to specifically assess
risk for recidivism among sex offenders. Although these tools are critical in assessing
an offender’s risk for reoffending before release or other change in custodial status,
such risk-related information is also an important consideration for pretreatment
planning, insofar as these tools are used to determine which sex offenders need the
most intensive treatment services.
Although general measures of cognitive ability (e.g., the Wechsler Adult
Intelligence Scale [Wechsler, 1997]) or personality style (e.g., the Minnesota
Multiphasic Personality Inventory [Butcher, Dahlstrom, Graham, Tellegen, &
Kaemmer, 1989]) are often used before treatment to enhance understanding of
offender motivational or personality structure or to match learning or interpersonal
style to treatment groups or program offerings, a number of specialized assessment
instruments have also been developed for use with this population. The Multiphasic
Sex Inventory–II (Nichols & Molinder, 1984) is a self-report inventory that includes
an assessment of deviant sexual history and interests and an examination of thought
patterns and other behavioral and emotional characteristics related to deviant sexual
interest. The Abel Assessment for Sexual Interest (Abel, Huffman, Warberg, &
Holland, 1998), a computer-based screening measure, was designed to identify the
presence of deviant sexual interest in children. Involving a series of images of
children, adolescents, and adults of varying age ranges, this screening tool includes a
measure of visual reaction time to images of these various sexual interest subgroups,
allowing evaluators to compare viewing time with established norms. Given that
evaluees are not aware that the viewing time is being measured, the Abel measure
may be of particular utility in assessing deviant sexual interest where honest
disclosure may be an issue.
The penile plethysmograph (PPG), which includes a measure of blood flow to
the penis and other measures of physiological arousal, is perhaps the most direct
measure of sexual response and interest. Through presentation of video or audio
stimuli involving suggestive sexual content, the PPG allows the identification of those
who have a physiological response to inappropriate or deviant sexual stimuli.
Although its use in legal settings may be problematic (Barker & Howell, 1992), the
PPG can provide an important measure of pretreatment and post-treatment response
and, like the Abel measure, may be particularly useful where disclosure is of concern.
The relapse prevention model, adopted from the substance abuse literature,
aims to help sex offenders recognize their offense patterns, toward the goal of
identifying cognitive, emotional, and situational factors that lead to offending. The
aim of this model is to allow offenders to proactively intervene in their offense cycle
so as to prevent reoffense. Cognitive–behavioral therapy (CBT), a short-term and
typically time-limited set of techniques, involves strategies to modify both behavioral
habits and cognitive assumptions that may be linked to some form of, in this case,
sexual deviance. CBT techniques, which are often used in relapse prevention models,
focus on identifying and modifying thoughts, behaviors, or feelings that have some
link to sexually deviant behavior. Because CBT has received a great deal of empirical
support, it is generally considered to be an efficacious form of therapy with this
population. The central tenet of the good lives model approach to the treatment of sex
offenders is enhancement of human well-being. By focusing on the development of
prosocial behaviors and the acquisition of human goods (e.g., intimacy, safety,
creativity, or education), the treatment reduces motivation to reoffend.
Doubt remains as to the effectiveness of sex offender treatment. Although the
field has evolved greatly over the past couple of decades (Ward, Mann, & Gannon,
2007) and evidence suggests that newer treatment models are more effective than
older forms of therapy (Hanson et al., 2002), the question as to whether sex offender
treatment works continues to arouse debate. However, researchers have generally
found that sex offender treatment can reduce both sexual and general recidivism.
Hanson et al. (2002), who conducted a meta-analysis of 43 sexual offender
treatment outcome studies, found that 12.3% of sex offenders who completed
treatment sexually recidivated (i.e., committed a new sexual offense, typically defined
in these studies as rearrest or reconviction), whereas 16.8% of those who did not
complete treatment sexually recidivated over the follow-up period (average 46
months). Moreover, Hanson et al. reported recidivism rates of 9.9% for offenders who
completed more modern forms of treatment (e.g., CBT) and 17.4% for offenders who
did not receive these newer forms of treatment. Similar sexual and nonsexual
recidivism reduction rates based on CBT interventions have also been identified by
other researchers (e.g., Barbaree & Seto, 1997; Gallagher, Wilson, Hirschfield,
Coggeshall, & MacKenzie, 1999; Hanson, 2000; Looman, Abracen, & Nicholaichuk,
2000; Marshall, Barbaree, & Eccles, 1991; McGrath, Cumming, Livingston, & Hoke,
2003; McGrath, Hoke, & Vojtisek, 1998; Nicholaichuk, Gordon, Deqiang, & Wong,
2000; Scalora & Garbin, 2003). A more recent meta-analysis showed that sexual
offender treatment programs that adhered to RNR principles showed the largest
reduction in both sexual and nonsexual recidivism (Hanson, Bourgon, Helmus, &
Hodgson, 2009).
Given heightened concern about reoffense with this population, evaluation of
sex offenders typically involves an evaluation of recidivism risk. Because clinical
judgment (or a more subjective, impressionistic approach) has been shown to be
inferior to actuarial decision making (or a more statistically based, formal approach)
to risk assessment (Grove et al., 2000; Hanson & MortonBourgon, 2004), adherence
to best practices implies the use of empirically validated risk tools. The development
of these tools has relied on the work of Hanson and Bussiere (1998), Hanson and
Morton-Bourgon (2004), Hanson et al. (2002), and others in identifying individual
factors (e.g., age) or offense characteristics (e.g., gender of victim, use of violence)
that most strongly correlate with recidivism. Whereas some risk assessment
instruments provide overall risk scores based on the combined weightings of a set
number of risk factors, such as the Sex Offender Risk Appraisal Guide (Quinsey et al.,
1998), Rapid Risk Assessment for Sex Offence Recidivism (Hanson, 1997),
Minnesota Sex Offender Screening Tool–Revised (Epperson et al., 1999), and Static-
99 (Hanson & Thornton, 2000), others, such as the Sexual Violence Risk–20 (Boer,
Hart, Kropp, & Webster, 1997) and the Risk for Sexual Violence Protocol (Hart et al.,
2003), use a structured professional judgment approach that provides decision makers
with structured guidelines for considering a list of empirically validated factors but
does not provide probabilistic estimates of risk based on the combination of such
factors.
Comparative analyses of the utility of specific risk instruments have been
undertaken elsewhere, and although each instrument seems to have its particular
strengths, as yet there appears to be no single instrument with a well-accepted
superior predictive capability, although each has a demonstrated reliability and
predictive validity that exceeds that of clinical judgment. Continued refinement of
these instruments should enhance our predictive capabilities in the realm of
recidivistic sexual violence, but at present such instruments seem to provide decision
makers with the best available evidence regarding likelihood of recidivism. Indeed,
Janus and Prentky (2003) highlight the transparency, accountability, and consistency
that actuarial tools bring to the risk-finding process and suggest that actuarial risk
assessment provides the most accurate indication of long-term reoffense risk.
c. Intimate Violence Offenders
Intimate partner violence is an all too common social phenomenon, with a
yearly average of approximately 511,000 women and 105,000 men reporting having
experienced violence at the hands of an intimate between 2001 and 2005 (Catalano,
2007). Furthermore, 22% of women report experiencing intimate partner violence at
some point in their lives (Tjaden & Thoennes, 1998). Intimate partner violence has
serious psychological and physical sequelae for victims and has been estimated to cost
the U.S. government approximately $5.8 billion annually in direct (e.g., health care)
and indirect (e.g., lowered productivity) costs (National Center for Injury Prevention
and Control, 2003). It is clear that treatment and prevention programs targeting
intimate violence are vital.
Research into the assessment of intimate violence offenders has not enjoyed
the same allocation of resources often devoted to the study of other offender
populations (Geffner & Rosenbaum, 2001), such as sex or violent offenders.
However, the limited body of literature examining this issue suggests that the risk
factors for intimate violence recidivism may be similar to those for peer violence,
such as exposure to family and community violence, attachment difficulties, and child
abuse (Moffitt, Krueger, Caspi, & Fagan, 2000; Wolfe & Feiring, 2000). A handful of
risk assessment instruments have been specifically designed for use with intimate
violence offenders. The three most widely used are the Spousal Assault Risk
Assessment Guide (Kropp, Hart, Webster, & Eaves, 1999), a 20-item checklist of
clinical variables comprising five broad risk domains (intimate violence history,
criminal history, psychosocial adjustment, characteristics of index offense, and other);
the Revised Conflict Tactics Scale (Straus, Hamby, Boney-McCoy, & Sugarman,
1996), a 36-item self-report measure that assesses the degree to which intimate
partners attack each other, physically and psychologically, and their use of more
adaptive methods of conflict resolution (e.g., reasoning and negotiation); and the
Danger Assessment Scale (Campbell, 1986), a 14-item dichotomous yes/no scale
assessing the presence of factors found to be empirically associated with battery-
related homicide.
The first intervention program for intimate violence offenders began in the
mid-1970s, with the number of such programs proliferating in subsequent decades
because of the growing awareness in the legal community of the need for such
treatment programs (Geffner & Rosenbaum, 2001; Scott, 2004). However, despite
such growth the scientific community did not become involved in the development,
implementation, and evaluation of such programs until well into the 1980s (Babcock,
Green, & Robie, 2004). Although there has been growing demand and interest in
intimate violence offender interventions, many of the programs currently offered lack
standardization and, unfortunately, lack sufficient empirical support to warrant their
continued use. Among the most common intimate violence offender programs are
those founded in feminist-based psychoeducation and cognitive– behavioral
principles.
Historically, research regarding the effectiveness of intimate violence offender
treatment programs has been hampered by several factors. First, before individual
states mandated treatment for all intimate violence offenders, engagement in
voluntary treatment programs was abysmally low (Geffner & Rosenbaum, 2001).
Furthermore, more recent research suggests that the intimate violence offender
population is much more heterogeneous than previously believed. An identified subset
of these offenders are viewed as highly treatment resistant because of their reluctance
to initially engage in treatment and to remain in treatment once engaged, with some
estimates suggesting that 50–75% of these offenders drop out early in treatment (Daly
& Pelowski, 2000; Geffner & Rosenbaum, 2001). Only with the advent of mandatory
treatment has enrollment in intimate violence offender treatment programs reached a
level conducive to empirical scrutiny.
Second, early research on treatment effectiveness with intimate violence
offenders has been plagued by methodological flaws including poor
operationalization of outcome variables (Whitaker et al., 2006). In other words,
measurement of treatment success has varied widely, precluding comparisons across
studies. Typically, treatment effectiveness has been measured by a reduction in a
partner’s use of physical violence, through self- or partner report, criminal complaints,
or offender rearrest.
Despite these challenges, recent research has emerged elucidating intimate
violence offender treatment program effectiveness, although the results have been less
than optimistic. For instance, recent meta-analyses and other outcome studies have
consistently found small effect sizes for such programs (Davis & Taylor, 1999;
Dunford, 2000; Green & Babcock, 2001; Levesque & Gelles, 1998), regardless of the
treatment modality, with average effect sizes of approximately 5% reductions in rates
of recidivism (Babcock et al., 2004). Proponents of intimate violence offender
treatment argue that although such a modest reduction in reoffense rates may seem
inconsequential, a reduction of even 5% would equate to approximately 44,000 fewer
women being physically abused each year. However, critics point out that even these
modest treatment gains apply only to recidivism in terms of physical abuse, with other
studies demonstrating that treatment is even less effective in reducing other forms of
intimate partner violence such as psychological or verbal abuse (Gondolf, 2002).
Taylor, Davis, and Maxwell (2001) provide more optimistic findings, concluding that
when offenders are categorized and excluded from analysis based on low treatment
motivation, a significant effect for treatment on reoffense rates does emerge. That is,
for offenders who express interest in and actively engage in the treatment process,
significant therapeutic gains can be made.
Currently, treatment programs for intimate violence offenders are designed to
be universally applicable. With the surge of interest and research in the development,
implementation, and evaluation of such programs, there has been a move to assess
and refer individual offenders to programs specifically designed to suit their
individual capacities and criminogenic needs (Holtzworth-Munroe, 2001). It is
believed that such a paradigmatic shift, consistent with the RNR model, would lead to
better risk management services for intimate violence offenders.
d. Juvenile Offenders
The assessment of juvenile offenders for risk of recidivism and treatment
planning has been hampered by a disproportionate allocation of resources to the study
of adult offender populations. Although the risk assessment of adult offenders has
generally shifted from reliance on subjective clinical judgment to more objective
actuarial methods, the risk assessment of juvenile offenders has been slow to follow
suit (Hoge, 2002). Only recently has research into the development and validation of
juvenile assessment instruments accelerated. In the last decade, numerous structured
instruments specifically designed for use with juvenile offenders have been
developed.
Among the more commonly used risk assessment instruments are the Youth
Level of Service/Case Management Inventory (Hoge & Andrews, 2001), a structured
clinical inventory consisting of 42 items and 8 subscales that can be administered with
minimal training; the Child and Adolescent Functional Assessment Scale (Hodges,
1994, 1999), a structured instrument designed to ascertain impairments in emotional
and behavioral functioning associated with recidivism; the Structured Assessment of
Violence Risk in Youth (Borum, Bartel, & Forth, 2003), a 30-item structured
instrument designed to assess four major domains (historical, social/contextual, and
individual risk factors and protective factors); and the Hare Psychopathy Checklist–
Youth Version (Hare, Forth, & Kosson, 1994), a 20-item adaptation of the adult
version designed to measure the presence of psychopathic traits in juveniles,
particularly older juveniles. It should be noted that the use of this instrument with
juveniles remains controversial because of concerns about the construct validity of
juvenile psychopathy (Hoge, 2002).
Intervention programs grounded in cognitive–behavioral and social learning
principles target maladaptive thought processes and impairments in social
problemsolving skills found to be linked with the onset and maintenance of antisocial
behavior (Tarolla, Wagner, Rabinowitz, & Tubman, 2002). Although the specific
techniques used in any given cognitive–behavioral treatment program can vary
somewhat, many programs use a number of the following techniques in a group
therapy format: cognitive skill training, cognitive restructuring, interpersonal problem
solving, social skill training, anger management, moral reasoning, victim impact,
substance abuse counseling, behavior modification, and relapse prevention
(Landenberger & Lipsey, 2005). Supplemental individual therapy is often offered to
maintain active therapeutic engagement and to reduce attrition. Some researchers and
clinicians have criticized the use of CBT-based approaches as too narrow in their
focus, arguing that such treatment modalities ignore the role of dysfunctional family
relationships, deviant peer groups, and negative school and neighborhood
environments in the etiology and maintenance of juvenile antisocial behavior
(Borduin et al., 1995).
Among the most successful family system treatment approaches is
multisystemic therapy (MST), developed in the 1980s by Henggeler et al. (1986).
This treatment seeks to keep the family intact while addressing a number of issues
believed to be related to the juvenile offense cycle, such as maladaptive cognitive
styles and attitudes, social and relational difficulties (at both the immediate micro and
larger macro levels), and symptoms of mental illness (e.g., depression), if relevant.
MST uses numerous empirically supported treatment approaches including techniques
based in cognitive–behavior therapy, social learning, strategic and structural family
therapy, and behavioral training for the juvenile’s parents or primary caregivers.
Research suggests that without treatment, 60–96% of juvenile offenders will
reoffend within approximately 1 year of arrest (Jenson & Howard, 1998; Lattimore,
Visher, & Linster, 1995; Lewis, Yeager, Lovely, Stein, & CobhamPortorreal, 1994).
Despite skepticism about the effectiveness of treatment with juvenile offenders, recent
advances in intervention development and implementation have provided promising
results for both cognitive–behavioral, social learning–based, and family system
therapy.
Mounting literature supports the effectiveness of cognitive–behavioral
approaches in enhancing social problem-solving skills and regulating impulsive
behavior, reducing rates of reoffense among juvenile offenders (Andrews et al., 1990;
Dowden & Andrews, 2003; Gendreau & Ross, 1979; Larson, 1990; Lipsey & Wilson,
1998; Redondo, Sanchez-Meca, & Garrido, 1999). Redondo and colleagues found that
CBT programs, in general, produced a mean reduction in recidivism rates among
treated juvenile offenders of 25%. Moreover, this effect resulted in a 50% reduction
for treated offenders who received programs optimally configured to include the most
effective components (i.e., those that included anger management and interpersonal
effectiveness as targets). Interestingly, treatment programs that included victim impact
and behavior modification components were found to be less effective. Furthermore,
CBT-based approaches appeared to be most effective with higher-risk juvenile
offenders, directly contradicting clinical lore suggesting that high-risk offenders are
untreatable (Landenberger & Lipsey, 2005).
Similarly, a significant body of literature supports the use of more holistic
family system approaches (Kazdin, 1987; Shadish et al., 1993), particularly MST
(Borduin, 1999; Henggeler, 1996; Schoenwald, Ward, Henggeler, Pickrel, & Patel,
1996). MST has been demonstrated to produce both short-term and long-term
reductions in recidivism among juvenile offenders, including persistent and seriously
violent ones (Borduin et al., 1995). More specifically, it was found that 14 months
after referral for MST services, juvenile offenders had been rearrested 50% fewer
times than their treatment-as-usual counterparts (Henggeler, Melton, & Smith, 1992).
Furthermore, MST-treated juvenile offenders had an overall reincarceration rate of
20%, compared with 68% for their treatment-as-usual counterparts. Finally, treatment
effectiveness has been maintained for follow-up periods of up to 4 years, with MST-
treated juvenile offenders being arrested at much lower rates than the offenders who
received treatment as usual; when rearrest did occur, the MST-treated offenders
committed significantly less serious crimes (Borduin et al., 1995).
As with treatment of all offenders, treatment of juvenile offenders should be
viewed as an ongoing, dynamic process following the RNR paradigm. That is,
intensity of treatment should be matched to the perceived risk of the juvenile offender,
and criminogenic factors should be targeted for treatment, with the assumption that
they may change as the juvenile develops (Borum & Verhaagen, 2006). Furthermore,
only empirically supported treatments should be implemented, treatment should be
customized to suit the unique capabilities and characteristics of the individual juvenile
offender and his or her environment, and both treatment providers and community
supervision agents should continually monitor, reassess, and modify intervention
programs to ensure that treatment gains are maintained.
e. Female Offenders
Little research has focused on the treatment of female offenders, which may
stem from the fact that females offend at much lower rates than do males, making up
8–18% of the total population of offenders (Bonta, Pang, & Wallace-Capretta, 1995).
Given their lower rates of offending, research has either neglected female offender
populations or treated them similarly to male offender populations, with little
attention paid to whether motivations for offending or crime patterns and recidivism
are distinct for female offenders. Therefore, it is not known whether the needs and
patterns of female offenders are unique
Given that female offenders may have unique life experiences and
responsibilities (e.g., pregnancy, childcare) (Koons, Burrow, Morash, & Bynum,
1997) and may be affected more frequently by certain life events (e.g., child sexual
abuse, domestic violence, adult sexual assault) and clinical syndromes (e.g.,
depression or posttraumatic stress disorder) (Poels, 2007), it stands to reason that
gender-specific issues warrant attention in a clinical evaluation. Indeed, although
measures of personality, cognitive functioning, substance abuse history, or mood
dysfunction are likely to be the same as those used with male offenders, a full and
comprehensive evaluation should consider the unique needs and obstacles that female
offenders may face both in accessing treatment and in benefiting from services
offered. Although gender-specific measures are seldom used, at least some evidence
suggests that economic disadvantage and social relationships may have differential
impact on risk for offending among men and women (Heilbrun et al., 2008).
Given the aforementioned unique needs of female offenders, some suggest
that more gender-responsive treatment services be offered (Koons et al., 1997;
Morash, Bynum, & Koons, 1998). For example, like their male counterparts, female
inmates may be cut off from family and supportive networks. However, this
separation could be particularly difficult for mothers with young children, and
maintaining family contacts and connections may be an especially important
treatment target for females (Monster & Micucci, 2005). However, some evidence
suggests that specific programming for causes of female criminality may not be
offered in correctional settings (Monster & Micucci, 2005), although there is a shift
toward offering more gender-specific programming (Heilbrun et al., 2008). Moreover,
evidence suggests that most treatment programming may be based on patterns of male
offending (Monster & Micucci, 2005). However, little is known about whether the
existing treatment literature or existing treatment programs can be simply extended to
female offenders or whether different models of treatment should be used with this
population.
Little research has specifically examined the effectiveness of treatment for
female offenders. Using meta-analytic techniques, Dowden and Andrews (1999)
examined 26 studies that investigated the effectiveness of correctionsbased treatment
for female offenders, finding support for the RNR model of treatment. Indeed,
Dowden and Andrews found larger treatment effects for programs that directed more
treatment services to higher-risk (rather than lower-risk) female offenders and larger
treatment effects in programs that focused on criminogenic (vs. noncriminogenic)
needs. Specifically, focus on interpersonal criminogenic needs (family process or
antisocial associate variables) was most strongly associated with reduced reoffending.
Program focus on antisocial cognition and self-control deficits also had a significant
association with reduced reoffending (Dowden & Andrews, 1999). Notably, although
substance abuse and basic education may intuitively appear to be important treatment
targets, Dowden and Andrews did not find these variables to be associated with
treatment outcomes in female offenders. Importantly, no research has looked
specifically at treatment responsivity in female offenders, specifically whether women
may have particular learning or interpersonal styles that affect recidivism rates
(Dowden & Andrews, 1999). Although what works with female offenders may in
many ways be an extension of what works with male offenders, more research
attention, particularly with regard to issues of treatment responsivity, is needed in this
area.
Because their pathway to crime may be different, it stands to reason that risk
assessment should also consider unique risk factors predictive of future offending
among women who commit crime. Unfortunately, given a dearth of research
identifying risk correlates for female offenders, little is known about whether there are
specific and unique risk factors for this population. Therefore, risk assessment tools
may lack predictive utility if applied to female offenders. Although identified factors
that predict future offending for male offenders may be similar to those that predict
future offending for female offenders, this is not necessarily the case. Moreover, even
if the factors are similar, their levels of association with future offending and
combinations may be quite different. Although at least some evidence suggests that
risk factors may be generally similar for male and female offenders (Heilbrun et al.,
2008; Loucks & Zamble, 2000), there do appear to be at least some distinctions in
pathways to and maintenance of offending (Heilbrun et al., 2008). As with any
population or subgroup not well represented in the developmental samples on which
risk assessment tools are based, it may be premature to extend risk estimates to female
offenders without a more established normative comparison group (Poels, 2007).
Clearly, more research is needed that establishes how males and females differ, and
this research can be used to extend or develop genderspecific assessment tools and
develop or enhance more gender-responsive programming.
f. Offenders with Serious Mental Disorders
Mental illness is prevalent among forensic populations. Since the
deinstitutionalization movement of the latter half of the 20th century, a significant
increase in the number of people with severe and persistent mental illness in the
prison system has been observed (Lamb & Weinberger, 2008). These mental illnesses
include bipolar disorder, major depression, and psychotic disorders such as
schizophrenia (American Psychiatric Association, 2004). In the United States, the
numbers of people with mental illness in prisons vary according to the method used to
assess prevalence. For instance, the Bureau of Justice Statistics (2006) reported that
approximately 55% of male offenders and 73% of female offenders in state prison had
a diagnosable mental illness based on self-report, and others have estimated the
prevalence of mental illness among prison inmates to be approximately 16% based on
mental health service records (Ditton, 1999). However, it is believed that only about
one third of offenders with mental illness receive any treatment for their mental illness
while they are incarcerated (Bureau of Justice Statistics, 2006).
Inmates are generally screened for mental illness at intake (Beck &
Maruschak, 2001). Currently there appears to be no standard approach for assessing
mental illness among offenders. Practices include clinical interviews and assessments
and actuarial approaches (Adams & Ferrandino, 2008). The overarching goal of these
assessments is to identify offenders who need mental health treatment and to assess
their needs and security level.
Several measures have been used to assess need based on the RNR model.
One such measure is the Level of Service Inventory–Revised (Andrews & Bonta,
1995), a rating scale designed to assess the risk for general recidivism. However, this
instrument was designed for use with the general prison population and not
specifically for mentally ill offenders (Long, Webster, Waine, Motala, & Hollin,
2008). More recently, scales specifically designed to assess treatment needs
(Camberwell Assessment of Need; Thomas et al., 2003) and security needs
(Operationalized Risk Factors; Brown & Lloyd, 2008) among mentally disordered
offenders have been developed. Both scales have been found to be useful and improve
mentally ill offenders’ access to care (Brown & Lloyd, 2008; Long et al., 2008).
Recently more focus has been placed on psychological interventions for
mentally ill offenders with the passage of the Mentally Ill Offender Treatment and
Crime Reduction Act of 2004 in the United States. This act provides funding to train
correctional and mental health staff to treat mentally ill offenders and provides
mentally ill offenders with greater access to mental health treatment both while
incarcerated and when released into the community (American Psychological
Association, 2004). Such interventions include in vivo training of goal-directed
actions for offenders with treatment-resistant schizophrenia (Hodel & West, 2003),
CBT for long-term inpatients with psychotic disorders and forensic histories (Garrett
& Lerman, 2007), dialectical behavior therapy for offenders with borderline
personality disorder characteristics (Linehan, 1993), and the Dangerous and Severe
Personality Disorder Programme (Mullen, 2007).
Some prisons have developed therapeutic communities (TCs). Generally TCs
in prisons are usually separate from the general population and are considered
therapeutic milieus. In this environment offenders develop prosocial skills that can be
used to transition back into the community (Adams & Ferrandino, 2008). Although
TCs traditionally have been used to treat offenders with substance use disorders (see
Linhorst, Knight, Johnston, & Trickey, 2001), these programs also have been
modified to treat other types of offenders, including those with mental illness (Saum
et al., 2007). Staff in the TC environment receive specialized training on how to deal
with mentally ill people, and many TC programs have elements of aftercare to help
offenders with mental illness in the community (Wormith et al., 2007).
Another form of treatment for people with mental illness is the mental health
court. These courts were established in an effort to divert people with serious mental
illness from prisons and jails (Slate & Johnson, 2008). The goal of these programs is
to provide these people with the treatment and services they need in an effort to
prevent recidivism (Lamb & Weinberger, 2008). Traditionally, mental health courts
heard cases of mentally ill people who were accused of misdemeanor crimes, but
some courts are also hearing cases of mentally ill people who have been charged with
violent felonies (Fisler, 2005). Mental health courts differ from traditional courtrooms
in that all those involved (such as the judge, prosecutors, and defense counsel) have
had training and experience in working with people with mental illness. Furthermore,
they are familiar with community mental health resources, and they make every
attempt to provide mental health treatment and support to offenders once they are
released from jail and reenter the community (Lamb & Weinberger, 2008).
Evidence suggests that people with severe mental illness benefit from
treatment, which lowers their recidivism rate (Swanson et al., 2006). However, a
substantial proportion of people with mental illness who commit crimes are resistant
to psychiatric treatment (Draine, Solomon, & Meyerson, 1994; Laberge & Morin,
1995). For example, they may refuse referrals, miss appointments, refuse to take
medication, and abuse substances. The failure to participate or adhere to treatment can
substantially interfere with treatment success (Lamb & Weinberger, 1998). Therefore,
programs that meet the specific needs of those with mental illness are likely to have
the greatest success. For example, Griffith, Hiller, Knight, and Simpson (1999) found
that TCs were the most cost effective for those at highest risk for recidivism, such as
those with mental illness. Furthermore, Lees, Manning, and Rawlings (1999) found
that TCs significantly decreased recidivism rates for offenders with borderline
personality disorder and other mental disorders. The outcome research on mental
health courts is still in its infancy, but preliminary studies have found that mentally ill
offenders who successfully completed mental health court programs were less likely
to recidivate and engage in future acts of violence than those who did not participate
in mental health court programs (McNeil & Binder, 2007).
A recent development in risk management for offenders with mental illness is
the emergence of assertive community treatment for forensic populations (FACT).
FACT is based on assertive community treatment (ACT), with the primary goal of
preventing reincarceration. ACT is designed to prevent repeat hospitalizations for
mental illness by providing a clinical team to help these people in the community
around the clock (Morrissey, Meyer, & Cuddeback, 2007). Whereas ACT programs
target clients of local hospitals and mental health agencies, FACT teams target county
jails. The effectiveness of ACT has been well established (see Bond, Drake, Mueser,
& Latimer, 2001). In theory FACT should operate on the same premises as ACT but
with mentally ill forensic outpatients; however, in practice, resources are not available
for FACT programs to adhere to ACT guidelines. Preliminary uncontrolled findings
suggest that FACT programs decrease arrests and hospitalization and reduce yearly
service costs (see Morrissey et al., 2007, for review).
g. Cognitive Behavioral Approaches
Cognitive–behavioral therapy (CBT) is a diverse family of treatment
interventions, which are rooted in the merging of behavioral modification, cognitive
therapy, and social learning theory. Behaviorism proposes that human behavior is
either induced by sensorial cues or determined by its consequences. Just as behavioral
patterns are conditioned by rewards or punishments in previous experiences, they are
also susceptible to planned change through careful administration of rewards and
punishments. Alternatively, cognitive therapists assert that maladaptive behavior has
been shaped by experience, but they assert that self-defeating behaviors are the result
of unproductive thought patterns relating to these past experiences. Social learning
theorists believe that behavior is learned and can be unlearned not only through
conditioning but also through modeling and imitation. The amalgamation of these
theories renders a particular understanding that sees cognition (e.g., beliefs,
expectations, ideas, and attitudes) modeled in social situations during one’s
upbringing as influential antecedents and powerful consequences of human behaviors.
Despite their many differences, different types of CBT share some
fundamental commonalities. To begin, it is assumed that human emotions and
behaviors are determined and shaped by cognitive habits such as beliefs and thoughts
(Lipsey, Landenberger, & Wilson, 2007; Milkman & Wanberg, 2007). Factors outside
the mind of the individual, such as family events, situational contingencies, and other
people, are believed to be less influential on the person’s feelings and acts than
established patterns of perceptions and thinking. This assumption shifts the emphasis
of treatment away from changing social relations or external circumstances to
changing the way people think and feel about things, values, others, and themselves.
Gresham Sykes and David Matza (1957) first proposed that delinquents
develop a special collection of rationalizations for their antisocial behavior to silence
the voice of their conscience. Such rationalizations permit juveniles to temporarily
neutralize their commitment to social norms, freeing them to commit delinquent acts.
Five basic techniques of neutralization are identified: denial of responsibility, denial
of injury, denial of the victim, condemnation of the condemners, and appeal to higher
loyalties.
Samuel Yochelson and Stanton Samenow (1976, 1977) formalized an
etiological theory of criminal thinking with practical clinical implications. They
developed a system of 52 thinking errors that underlie the criminal behaviors of most
offenders. Several prominent elements of the criminal thinking are a schema of
entitlement, fascination with power and control, sentimentality, overoptimism,
cognitive indolence, and overvaluation of the present. Other notable thinking errors
include self-justificatory thinking, misapprehension of situational cues, dislodgment
of responsibility, and immature ethical reasoning. People with such cognitive
distortions may misperceive neutral situations as threats, interpret benign remarks as
disrespectful or hostile, thirst for immediate gratification, and confuse wants with
needs. These patterns of perception and reasoning often become consolidated by
offenders’ involvement in a criminal subculture.
Lasting transformation in the offender requires a focus on thinking and not on
behavior. Reckless offenders may clean up certain areas of their lives, but unless there
is a change in their cognitive habits, there will be no change across the many aspects
of their relationships and social functions (Lipsey et al., 2007; Milkman & Wanberg,
2007). Readiness to be held accountable signals the first commitment to change.
Criminal justice–based CBT programs focus on personal responsibility and
seek to help offenders to visualize the thinking processes and choices that
immediately preceded their antisocial activities. Change begins when offenders learn
to self-monitor thinking and to single out and modify problem cognitive habits. All
CBT interventions deploy structured techniques for fostering prosocial cognitive
skills and reorganizing cognition in areas where offenders’ thinking is distorted.
In general, CBT programs seek to achieve cognitive modification within a
short period of time. On average, a treatment regimen of no more than 20 sessions is
prescribed to criminal offenders. Therapists have a focused agenda for each session,
and special techniques and concepts are applied during treatment. The goal of therapy
is to suppress maladaptive behaviors through unlearning of undesired cognition and to
model prosocial behaviors through the learning of positive attitudes and healthy
reasoning skills. The premise of the CBT interventions is that when offenders
understand how and why they are doing well, they acquire the skills to maintain their
confirmative and normative behavior and thus continue to do well.
Offenders in treatment are encouraged to closely examine their thoughts and to
directly confront their own beliefs. The therapist is to provide new information that
directly challenges the accuracy and legitimacy of clients’ old cognitive habits and to
guide them to change their thinking to be in line with the reality of the situation. Role
play and practice in real situations are the most widely used tools to practice and
consolidate prosocial behaviors supported by cognitive habits newly learned in group
discussions, multimedia sessions, and reading assignments.
CBT programs have been extensively experimented with and evaluated among
juvenile offenders, substance-abusing offenders, violent offenders, sex offenders and
violent and sexual offenders. In contrast to traditional CBT interventions that are
somewhat egocentric, correction-based CBT interventions are essentially sociocentric.
Rather than asking clients to identify their own problems and helping them to fulfill
their inner goals and expectations, therapists and educators direct offenders’ attention
to self-control and responsibility toward others and the community. A recent review
by the National Institute of Corrections concludes that six CBT programs are most
commonly used in correctional settings.
Criminal Conduct and Substance Abuse Treatment: Strategies for
SelfImprovement and Change (SSC). SSC provides a standardized and structured
approach to the rehabilitation of adult substance-abusing offenders. When compared
with other CBT strategies, SSC intervention is unusually long and requires 9 to 12
months of rigorous programming. The SSC curriculum comprises 12 treatment
modules organized around three phases of recovery. These phases are Challenge to
Change, in which the offender engages in a reflective–contemplative process aimed at
the development of motivation to change and positive therapeutic alliance;
Commitment to Change, in which the offender is shown new cognitive and behavioral
patterns and asked to practice these skills to foster a law-abiding and drug-free
lifestyle; and Ownership of Change, in which the offender actively consolidates both
the internalization of prosocial thinking and the stabilization of new behaviors in
different settings and social situations.
Moral Reconation Therapy (MRT). Originally developed for substanceabusing
offenders, MRT has since been applied to drunk drivers and offenders who commit
violence against women. Moral reconation is the continuous evaluation and
adjustment of decisions about behaviors based on socially accepted values. MRT
seeks to address the fundamental obstacle in the rehabilitation of offenders: their
failure to replicate new attitudinal and conduct patterns learned in therapeutic settings
in noncontrol environments. This failure to implement prosocial thinking and
behaviors in high-risk situations causes recidivism and is caused by deficient
personality traits in treated offenders.
h. Multisystemic Approach
The basic tenet of MST is that human behavior is determined by multiple
interactions between the child and his or her social environment, composed of family,
peers, school, neighborhood, and other community settings. Because of shared causal
pathways, different forms of antisocial behaviors such as substance abuse,
delinquency, and sexual promiscuity tend to develop within overlapping and
dysfunctional social systems. Five interdependent systems are identified: individual,
family, peer, school, and community (Henggeler, 2002). Different correlates of
deviant behaviors are found in each of these systems. Problem behavior is a function
of deficit in any of the pertinent systems and deficits or conflicts that characterize the
interfaces between systems (e.g., family– school relations, family–neighborhood
relations).
At the individual level, low verbal skills, acceptance of deviant values,
psychiatric symptoms, and tendency to attribute hostile intentions to others increase
the risk of deviance. Determinants at the family level include lack of monitoring,
ineffective discipline, low warmth, high conflict, and parental deviance such as
substance abuse and criminality. Association with deviant peers, alienation from
prosocial peers, and poor social skills are also precursors of antisocial behaviors.
Academic failure, dropout, low commitment to education, and poor school
environment (e.g., low morale and inadequate management) pose unique hazards.
Finally, at the neighborhood level, high residential mobility, low community cohesion,
and presence of criminal subcultures can exacerbate disadvantages in other social
systems and encourage deviance. The primary purpose of MST is to reduce problem
and antisocial behaviors among adolescents by decreasing weaknesses and enhancing
strengths in the multiple social systems in which a young life develops.
MST services are usually delivered by teams of three master’s-level clinicians
who are supervised by a doctoral-level mental health professional. Although MST
programs target individual, family, peer, school, and community variables
simultaneously, the family of the troubled youth is most often considered as the unit
of intervention. In this family preservation model, services are delivered to the family,
with targeted activities undertaken with or on behalf of individual members of the
family. A typical intervention lasts up to 5 months. Meetings are flexibly scheduled to
meet the family’s needs, and services are tailored for each family member and
delivered in the home.
MST teams routinely contemplate a set of different interventions such as
cognitive–behavioral strategies directed at individual beliefs and attitudes, various
family therapies, and parenting training. These therapeutic components disrupt
dysfunctional patterns of communication and relationships within the family and
cause them to settle back into a healthier and more adaptive direction. A frequent
purpose is to improve parents’ capacity to oversee the activities and whereabouts of
their teenage children and to reinforce their responsible behaviors. At the peer level,
the adolescent is trained to avoid delinquent and substance-using peers and to
associate with positive friends and find satisfaction in these friendships. Parents are
taught to maintain a fluid communication with schoolteachers and staff to promote
better monitoring of and assistance in their children’s academic performance.
Quality assurance mechanisms are routinely imposed to maximize program
fidelity and effectiveness. Common mechanisms include a 5-day orientation for
administrators and clinicians, weekly onsite supervision by a senior professional,
quarterly booster training, weekly consultation with MST experts, and ongoing
centralized review of caregiver reports.
Swenson, Henggeler, and Schoenwald (2000) review eight evaluations that
examined MST for serious juvenile offenders using randomized control and
comparison groups. Summarizing 10 years of research, they conclude that rigorous
studies of youths with severe antisocial behavior unambiguously show the short-term
impact of MST to improve family relations and the long-term ability of MST to
reduce rearrest, nondelinquent problem behaviors, and violent acts. Because of better
results than those yielded by traditional interventions, MST has been identified as a
cost-saving intervention model for juvenile offenders (Aos, Phipps, Barnoski, & Lieb,
1999). In a comparative study, MST produced an average net gain of $61,068 per
treated youth, as compared to the net loss of $7,511 reported for juvenile boot camp
(Henggeler, 2002). These findings have boosted MST as one of the best rehabilitation
models for juvenile offenders and may also have far-reaching implications for reentry
and reintegration programs for released adult inmates.
i. Therapeutic Community
The modern therapeutic community (TC) is a new application of an ancient
concept. The communal practices of an ascetic religious lifestyle were designed and
implemented to combat human weaknesses of greed, cruelty, lust, selfishness, and
laziness by the Jewish Qumran community and a number of Christian monastic
groups. Change of lifestyle and the maintenance of a transformed lifestyle were
thought to require strict adherence to the rules and teaching of the community.
Reacting to the perceived failure of mainstream psychiatric institutions in the wake of
World War II, structured communal living with a participative and group-based
approach was introduced to treat chronic mental illnesses, personality disorders, and
substance addiction.
In 1969 the first TC established in a prison was created at Marion Federal
Penitentiary. Known as the Aesklepieion program, this prison-based TC was designed
for serious felons transferred from a maximum security facility, Alcatraz (Wexler &
Love, 1994). Other federal prisons followed suit and created TC units on their
premises. But this movement in federal prisons ended within a decade as a result of a
general loss of confidence in rehabilitation triggered by the Martinson report (1974).
Connecticut and Virginia state prisons were the first state facilities to adopt TC
programs. Although plagued by suspicion from the correctional establishment and
public mistrust, some of these state programs, such as the Stay’n Out program in New
York, survived the backlash against rehabilitative interventions through the 1980s.
The model was revived as a promising strategy to combat the crowding of prisons by
drugabusing offenders in the 1990s. It remains popular among correctional
administrators today. Unlike TC programs in non–criminal justice settings that
emphasize permissiveness, communality, and democratic participation, criminal
justice–based TCs tend to be much more hierarchical, more authoritarian, and
confrontational.
TC philosophy sees criminal behavior or problem conduct such as drug abuse
or sexual deviance as a symptom of a complex malady of the whole person, not the
essence of the disorder, and therefore treats it with a holistic approach (De Leon,
2000). Self-destructive behavior, self-defeating thinking, and negative emotions
disrupt the lifestyle of the offender. Lifestyle is defined as the multifaceted expression
of the psychosocial being of the offender, including the ways he or she behaves,
thinks, manages feelings, interacts with others, and perceives himself or herself and
the world. A lifestyle malfunctions when a negative identity is developed and deviant
coping skills such as lying and manipulation are deployed with lasting psychological,
social, legal, and economic harms to the person.
This disordered lifestyle is defined by the failure of the person to assume
responsibility for his or her actions and decisions. The very act of seeking or agreeing
to participate in treatment is interpreted as a call for help that interrupts the person’s
troubled way of living. Taking responsibility implies that the offender makes a
voluntary decision to cease criminal acts as a prerequisite for transformation. How
and when a person arrives at this decision varies enormously. Some offenders make
that conscious determination only when health, legal, and family pressures have
reached a crisis. For others, the decision evolves gradually in a process of awakening,
without external coercion. The TC environment is available to help the offender at
every step of the awakening and transformation process. The goals are to create
changes in both lifestyle and personal identity.
Communal living is both the context and the tool in the therapeutic process.
Both staff and residents are seen as agents of change. The transformation unfolds as a
developmental process of multidimensional learning in the intimate climate of group
affiliation and loyalty. According to De Leon (2000), “The community teachings,
which are collectively termed right living, consist of moral injunctions, values,
beliefs, and recovery prescriptions” (p. 84). Learning the right way of living entails
practice in a real community, and TC provides an around-the-clock setting in which
residents can be monitored in all their routines: how they work, relate to peers and
counselors, maintain personal hygiene, and participate in group and community
meetings. Helping residents become invested in a peer self-help community is a
fundamental step in preparing them to engage in the world outside.
TCs are residential centers that adopt a hierarchical organization with progress
phases that represent growing levels of responsibility and privilege. Peer influence,
calibrated through a number of group activities, is used to help residents internalize
social norms and externalize healthier social skills. Besides the role of the group as a
primary catalyst of transformation, another basic TC ingredient is self-help. Self-help
means that offenders in rehabilitation contribute to their own transformation. Mutual
self-help implies that offenders also take partial responsibility for the change of other
residents by mentoring and sponsoring peers, who in turn could reinforce an
offender’s own rehabilitation (see Gideon, in press).
TC treatment typically comprises three major phases. Phase 1, known as
induction and early treatment, usually encompasses the first month of treatment and
introduces the resident to the subculture of the treatment setting. The new resident
learns the rules, nurtures trust with counselors and peers, begins an evaluation of
needs, starts to appreciate the nature of problem behaviors, and works on readiness for
change. Phase 2 is the main treatment stage and models prosocial attitudes and
behaviors through a progression of increasing levels of achievement, responsibility,
and privilege. Although ancillary services meeting legal, vocational, and psychosocial
needs are routinely made available to residents, mutual self-help remains the
backbone of TC intervention. The last stage, Phase 3, is the phase of reentry, which is
designed to aid the resident’s departure from the TC and return to the community.
Post-residential aftercare services such as self-help groups, family counseling, and
vocational guidance are often made available to TC graduates.
The TC model has shown a surprising versatility in serving criminal
populations with special needs (De Leon, 1997). It has been modified to provide
childcare services for mothers, developmental guidance for teenagers, psychiatric
services for offenders with co-occurring disorders, and connections to medical care
for offenders with HIV and AIDS. Clinical practices and management style often are
customized in terms of disciplinary measures, group dynamics, and level of
confrontation.
j. Intensive Community Supervision
ICS refers to probation and parole programs that build on a foundation of
rigorous monitoring. These community-based sanctions are variously labeled as
intensive monitoring, alternative penalties, intermediate sanctions, and intermediate
punishments. There are ICS interventions that take the form of diversion programs
designed to reroute prisonbound offenders to the community, as an alternative or an
adjunct to prison sentences. Others are enhancement programs—such as graduated
sanctioning and electronic monitoring—developed to make regular probation or
parole programs more coercive and incapacitating. Intensive supervision is indicated
for offenders who are too dangerous to be put on regular probation or parole but not
so dangerous that they could not be handled in the community under a surveillance
regimen more stringent than that found in regular community supervision.
ICS proponents find in this particular mode of punishment an intermediate
penal option between the humane but ineffective sanction of probation and the harsh
and expensive (and inconsistently effective) choice of incarceration. Others see it as a
useful and just method to relieve the pressure from an overcrowded prison system and
overextended government budgets. Most ICS programs entail some combination of
weekly contacts with a supervising officer, curfew, random drug tests, electronic
monitoring, home confinement, and a very strict enforcement of release conditions
(e.g., treatment participation, maintenance of a job, community service). Although
therapeutic and human services are often routine components of ICS programs, they
never constitute the defining core of this correctional strategy. These features are
expected to catalyze the right dosage of punitiveness and control to prevent recidivism
among supervised offenders.
The idea that regular probation and parole practices should be made much
more punitive and intrusive shares some assumptions with the classic school of
penology represented by Cesare Beccaria and Jeremy Bentham. The tenets of classical
theory include the belief that a human being is a rational agent, capable of
instrumental calculation, and the view that a person freely chooses all his or her
behavior. With all other circumstances held equal, a person’s choice will be directed
toward the optimization of personal satisfaction and the minimization of pain.
Individual decision making can be manipulated through the perception and
understanding of the potential consequences that follow a behavior.
Enhanced supervision is said to prevent crime through close scrutiny, thereby
reducing the need for future imprisonment. Monitoring and contacts are provided as
therapeutic controls or constraints of deviant behaviors with lasting effects. Frequent
meetings between the offender and the monitoring officer can be seen as brief
interventions that manipulate negative reinforcements and expectations affecting
offender behavior (Taxman, 2002). In fact, in his study of released participants of a
prison-based TC, Gideon (2009) found that the majority of respondents were in favor
of supervision after release, and they identified supervision with support and guidance
as an essential condition for their successful reintegration. Supervised offenders are
deterred from committing new offenses because surveillance increases the chance of
getting caught and being sent to prison. They are constrained from committing crimes
during their sentences because the supervision conditions limit their opportunities.
An implicit extension of this argument assumes that the suppression of
criminality would continue beyond the expiration of the community sanction because
the maturation process has had a chance to set in. Having been exposed to the
consequences of both an unrestrained criminal lifestyle and an artificially induced
law-abiding lifestyle, the formerly supervised offender would be able to rationally
assess the positive and negative consequences of his or her future actions and then
behave in his or her own self-interest (MacKenzie, 2006). The transformative process,
which begins with the offender’s compliance with the release conditions and
supervision rules, is reinforced by the rapport between the offender and the
supervision officer and can develop into respect for social codes of civility and legal
norms after sentence completion.
Although the earliest evaluations of intensive community supervision
programs completed in the early 1980s reported recidivism reductions and cost
savings in some jurisdictions, the methodological design of these studies was
seriously weakened by the lack of matched controls (General Accounting Office,
1990). The first large-scale experimental evaluation of ICS programs was conducted
by RAND researchers between 1986 and 1991 (Petersilia & Turner, 1993). This
federally funded project involved 14 sites in nine states and randomly assigned
eligible adult offenders to either traditional processing or ICS programs. Results show
that ICS programs were too small to reduce prison overcrowding because ICS
programs admit hundreds of offenders, whereas prison populations ran into tens of
thousands. As a matter of fact, the closer surveillance required by the ICS model,
which was able to more quickly detect technical violations of release conditions,
increased the number of prison inmates in a few states. This unintended consequence
also led to higher costs of program maintenance: ICS programs were not less
expensive than incarceration.
Investigators hypothesized that the effectiveness of ICS in reducing recidivism
hinges on small caseloads and frequent contacts. Having supervision officers manage
smaller caseloads would allow frequent meetings, closer scrutiny, and more positive
rapport to develop, which in turn could produce better outcomes. Evaluation results
were quite disappointing. Smaller caseloads did not result in lower recidivism rates
than regular caseloads (Petersilia & Turner, 1993; Taxman, 2002). Furthermore, when
ICS participants were compared with offenders supervised under regular probation
and parole regimens, increased contacts did not cause a steeper decline in criminality
as measured by arrests for new offenses and technical violations (MacKenzie, 2006).
However, one clear benefit of ICS programs was improved public safety: The intense
monitoring prompted early detection and arrest of ICS recidivists, which could be
interpreted as an increase in accountability.
The core lesson gleaned from the implementation of Intensive Correctional
Supervision (ICS) underscores the limitations of surveillance and control alone in
reducing recidivism. Taxman (2002) emphasizes that while surveillance and control
measures are important components of correctional supervision, they are insufficient
on their own to address the underlying factors driving criminal behavior. Instead,
successful recidivism reduction requires a holistic approach that integrates therapeutic
and service components into supervision models.
Taxman's development of the seamless system of supervision in collaboration
with the Maryland Department of Corrections exemplifies this principle in action.
Recognizing the need to go beyond traditional surveillance-based approaches,
Taxman's model prioritizes the integration of treatment services alongside supervision
to address the complex needs of justice-involved individuals. By incorporating
therapeutic interventions, such as counseling, substance abuse treatment, mental
health services, and skill-building programs, into the supervision process, the
seamless system aims to provide comprehensive support that addresses the underlying
issues contributing to criminal behavior.
This innovative approach reflects a shift towards a more holistic and
individualized understanding of correctional supervision, one that recognizes the
interconnectedness of factors such as substance abuse, mental health, education, and
employment in shaping behavior. By addressing these underlying needs and providing
individuals with the tools and resources necessary for successful reintegration into
society, the seamless system of supervision seeks to break the cycle of recidivism and
promote positive outcomes for justice-involved individuals and communities.
Moreover, Taxman's collaboration with the Maryland Department of
Corrections highlights the importance of partnership and collaboration in developing
effective supervision models. By leveraging the expertise and resources of both
correctional agencies and community service providers, the seamless system of
supervision is able to offer a more comprehensive and coordinated approach to
rehabilitation and reentry support.
Moving forward, the lessons learned from Taxman's work underscore the
importance of adopting evidence-based, multidisciplinary approaches to correctional
supervision. By integrating therapeutic and service components into supervision
models, policymakers and practitioners can better address the underlying factors
driving criminal behavior and promote successful reintegration into society. Through
continued innovation, collaboration, and commitment to evidence-based practices, the
criminal justice system can work towards reducing recidivism and fostering safer,
more resilient communities.
