Friday, 15 May 2015

AFTER A GUILTY VERDICT: Treatment Programmes - Can treatments be effective in reducing criminal behaviour and recidivism rates


The Enhanced Thinking Skills programme and Reasoning and Rehabilitation programme:

Cognitive skills programmes are a form of specialised Cognitive Therapy. As with all forms (CT) it aims to improve cognitive functioning. Cognitive skills programmes work on the basis that if you change the cognitive patterns of criminals, then they will change their behaviour. Two forms of CT used specifically with offenders are:

1. Reasoning and Rehabilitation therapy targets moral development, encourages creative thinking, and teaches offenders to take a social perspective on life.

2. Enhanced Thinking Skills aims to boost pro-social behaviour by working on interpersonal skills and self-control.

You only need to learn one of these in-depth for your exam. Here is the R&R programme:

The objective of the programme is to reduce reconviction rates. The aim of the programme is to teach offenders ‘‘how to think, not what to think’’. The idea is that, when they are equipped with thinking skills, offenders will make pro-social behavioural choices that will allow them to move out of an offending lifestyle, which had previously been reinforced by poor thinking skills or criminal thinking

Through a sequenced series of structured exercises, the programmes aim to boost prisoners’ cognitive skills to enhance offenders’ ability to achieve worthwhile goals and ultimately reduce recidivism. 

The exercises are designed to target six key aspects of thinking skills linked with offending: self control, cognitive style (flexible thinking), social perspective taking, moral reasoning, critical reasoning and problem solving. 

The programmes consist of 36 two-hour sessions, and it is delivered to groups of six to 12 participants. Ideally, there should be two to four sessions a week. 

Activities that take place in a teaching session may include role-playing, thinking games, learning exercises, dilemma puzzles and problems. These activities challenge the offender’s selfish thinking and increases perspective-taking and reasoning skills. 

Cann: The impact of cognitive skills programmes in reducing reoffending - 

Aim: To find out if cognitive skills programmes were effective in terms of lowering re-offending rates in women. 

Sample: 180 offenders started on either R&R or ETS. This was compared with 540 females who did not participate in the cognitive skills programmes. 

Procedure: Women were matched on predictions to whether they were at high, medium or low risk of reconviction. Also actual reconviction rates were calculated after they had been released from prison. Both R&R and ETS were assessed separately on their effectiveness. 

No significant difference was found between the treated group and the non-treated group on predicted reconviction rates. 

No significant difference was found between the treated group and non-treated group on actual reconviction rates. 

No significant were found between the effectiveness or ETS and R&R, In fact, those on the R&R programme were significantly MORE likely to reoffend. 

These results add to a mixed picture of effectiveness of cognitive treatment programmes. Some studies have claimed success for male offenders, whilst others have not. Cann suggests reasons as to why the programmes may have not worked for women. 

Firstly, women offend for different reasons. Women tend to offend because of drug abuse, relationship problems and emotional factors. 

Secondly, the programme was inappropriate to women's needs, This is because it was a programme designed with men in mind. Therefore, women's cognitive differences were not considered. 

Finally, the programmes were not delivered consistently in the women's prison and did not meet the standards of the programme. This could have contributed to the lack of success on reducing re-offending rates. 


Anger is a strong emotion which many offenders struggle to control, and aggression is strongly associated with anti-social behaviour such as offending. Anger management programmes are therefore employed to help offenders combat their anger problems, and help them to better manage it. The main anger management course in prisons is Controlling Anger and Learning to Manage it (CALM). There are 6 stages of CALM, which generally focus on thinking patterns that lead to criminal behaviour, learning how to solve problems without getting angry, improving communication skills and developing strategies to prevent relapses of anger. This programme is a type of Cognitive Behavioural Therapy (CBT), there are a total of 26, 2 hour sessions that require completion in this programme. 

The first stage: The programme begins by focusing on motivating the individual to want to change.

The second stage: Group members are taught how to identify physiological changes that they experience when becoming angry and are provided with a range of techniques to help reduce feelings of anger. They then practice and receive feedback from the course leaders.  

The third stage: The course leaders work with the offenders to understand how their irrational and hurtful thoughts contribute to their aggressive feelings. Participants learn to replace this with more rational thoughts.

The forth stage: Participants learn a number of skills that help them to communicate with others more effectively in response to being provoked by others. These skills include: Thought-stopping: where the prisoner learns to stop thinking aggressive thoughts and direct them somewhere else e.g. sport. Fogging: where the prisoner learns to hear criticism without reacting aggressively to  it. They also learn how to remain in control of their emotions and to take responsibility about a situation without blaming others.

The fifth stage: The prisoners practice applying these skills in situations where they feel; jealousy, depression, anxiety, superman feelings (feelings of unlimited power).

The sixth stage: The prisoners identify the situations which are most likely to cause them to be aggressive. Programme leaders then develop prevention methods. In addition, they also teach coping skills if the offender relapses and becomes aggressive. 

Ireland - Investigating whether anger-management courses work:

Ireland (2000) conducted a natural experiment comparing 50 prisoners who had completed CALM and a control group of 37 who hadn't. The offenders were all matched on the following:

  • Responses to a cognitive behavioural interview
  • Wing Behavioural Checklist (WBC). This was completed by prison officers over 1 week. They rated their aggression on 29 different aggressive behaviours and all of these were rated 0= no evidence of 1= some evidence of, or 2= a lot of evidence of. 
  • A self-report questionnaire on anger management with 53 questions completed by the prisoners themselves. 

The measures stated above were given to both groups before the programme and after the completion of the programme.

Both measures were compared. Offenders who’d been part of a CALM programme rated themselves as less angry, and officers also tended to rate these offenders as less angry on the WBC.

92% showed improvement on at least one "angry behaviour" measure.

48% showed improvement on at least two "angry behaviour" measures.

However, 8% deteriorated on two measures. 

Conclusions: In the short-term prisoners appeared to be helped by the programme, but in this case there is no evidence to whether the programme reduces reoffending. The fact that 8% got worse shows that this treatment is not effective for all offenders. 


Wheatley: Use of acupuncture to treat drug addiction in prisoners

Drug (and alcohol) addiction has strong links to offending, as they tend to lower cognitive functioning and therefore individuals on drugs make irrational decisions. Additionally, a majority of recently imprisoned males were involved in hard drugs such as cocaine prior to their conviction. Therefore, it makes sense to target addiction to drugs when devising treatment programmes for offenders.

350 prisoners in 6 high security prisons who'd received ear acupuncture alongside the standard care programme called FOCUS. This group was compared to a control group who'd received the FOCUS programme on its own, without ear acupuncture.

The ear acupuncture was administered by two trained practitioners in small group sessions, where 5 acupressure points in the ear were targeted. After the acupuncture, offenders were given a 40 minute relaxation session. Prisoners underwent drug tests. In addition qualitative data was collected via interview about how they felt about the treatment.

The results were positive: 70% reduction in drug-related incidents 6 months after treatment

42% reduction in positive mandatory drug tests for those who'd been given the acupuncture.

The interview data showed that offenders reporting reduced nicotine cravings, improved sleep, and better cognitive functioning as well as improved health in general. They also made more effort to communicate with their families and attend classes.

Conclusion: Wheatley feels there is enough evidence to expand the delivery of the programme throughout the prison system and believes that acupuncture works as a complementary therapy with other programmes. 

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