Can cognitive behavioral therapy reduce criminal behavior?

In recent years, the conversation around reforming the criminal justice system has grown increasingly urgent, with various stakeholders advocating for the expansion of rehabilitation programs that can help reduce recidivism. Among these approaches, cognitive behavioral therapy (CBT) has emerged as a potential tool for addressing problematic behaviors associated with criminal behavior. A newly-released paper by the Manhattan Institute provides a thorough examination of the effectiveness of CBT in this context, finding that while CBT can yield modest benefits, it is not a panacea.

The Promise and Limitations of CBT

CBT focuses on modifying harmful thought patterns that contribute to negative behaviors. For individuals at risk of reoffending, it aims to help them recognize and alter the cognitive distortions that may lead to criminal conduct. To defend the assertion that rehabilitation programs are more effective than incarceration in reducing recidivism, advocates frequently cite a 2007 Campbell Systematic Review that found that CBT interventions can lead to a reduction in recidivism rates (an average decrease of 25% across the 58 studies reviewed). However, this statistic must be viewed with caution and proper context, as the effectiveness of CBT can vary widely depending on implementation quality and the specific characteristics of the participants involved.

Programs that adhere closely to CBT principles, maintain fidelity, and are delivered with high quality are far more likely to yield positive outcomes. Conversely, programs that deviate from these standards often show negligible impacts. In other words, the effectiveness of CBT is not solely based on its theoretical foundations; it largely depends on how well the program is implemented. Programs that adhere to CBT principles and maintain high fidelity tend to show positive outcomes, while those that do not often yield negligible results. This raises critical questions about the quality and consistency of CBT programs across different jurisdictions. Additionally, many existing studies lack the necessary rigor to provide reliable data on their impact, making it challenging to draw definitive conclusions.

CBT’s effectiveness appears to be contingent upon various factors, including the intensity of the program, the risk level of participants, and the integration of additional support services. While CBT may offer a viable option for some offenders, particularly those who are motivated to change and can engage with the therapy, it should not be viewed as a standalone solution. Many individuals with serious mental illnesses require additional support and services beyond what CBT can provide. For instance, people who lack insight into their conditions or who are facing acute psychiatric crises cannot rely solely on CBT’s principles.

CBT Effectiveness in Chicago: Recent Experiments

The Manhattan Institute paper highlights recent experiments conducted by the University of Chicago Crime Lab, which has partnered with various organizations to study CBT interventions for over a decade. The lab uses randomized trials coupled with careful statistical methods to account for the fact that individuals randomized to participate in these programs sometimes do not participate.

Lab evaluations showcase both the promise of CBT-based efforts to reduce crime and the significant variation in results. This can be seen in the lab’s evaluations of four very different programs that vary widely in cost and focus on diverse groups, from low-income middle-school boys to high-risk young adult offenders facing serious violence charges.

Choose to Change

This program targets high-risk youth and combines trauma-informed CBT with mentoring. Participants receive at least eight hours of weekly mentoring from trained mentors, alongside trauma-informed cognitive behavioral therapy (CBT) sessions aimed at changing negative thought patterns and behaviors. The program also connects youth with community resources, such as educational and job training opportunities, and includes skill-building activities focused on social skills, conflict resolution, and emotional regulation.

The program demonstrated some success in reducing arrest rates, particularly for violent crimes. However, the overall impact on total arrests was less clear. While there was a statistically significant reduction in the likelihood of any arrest occurring—about 5 percentage points compared to a control group—the overall impact on the actual number of arrests (both violent and non-violent) was statistically insignificant for most comparisons. In fact, even at follow-up periods of six to 36 months, the reductions in total number of arrests remained insignificant.

In other words, while the program may have helped some participants stay out of trouble, the overall impact on reducing the number of arrests across all crime types was less clear.

CBT in Juvenile Detention

A program implemented in Cook County’s juvenile detention center involved a structured approach that included cognitive behavioral therapy (CBT) sessions held twice daily for the youth. These sessions replaced previously unproductive time spent watching television. Participants also engaged in “thinking reports,” where they documented the thought processes that led to their behavioral incidents, promoting self-reflection and accountability.

The program showed promising results in terms of reducing readmission rates to the detention center. Specifically, a 2017 study estimated a decline in readmission rates by about 16 percentage points after 18 months. However, when evaluating the broader measure of overall arrests or readmissions, the results were less impressive. While the program successfully reduced the likelihood of returning to the detention center, the impact on the number of times participants were rearrested or readmitted was not statistically significant. In fact, this broader outcome measure sometimes reflected a slight increase in readmissions compared to the control group. This suggests that while the program may have been effective for some people, it did not have the same level of effectiveness in reducing overall criminal behavior or repeat offenses more broadly.

Becoming a Man

Aimed at middle and high school students in low-income areas, the “Becoming a Man” program aims to help participants develop better decision-making skills and emotional regulation in potentially violent situations. The program involves weekly sessions rooted in CBT principles and focuses on teaching participants to slow down their thought processes and consider the consequences of their actions, often using role-playing and discussions to reinforce these lessons.

Despite its promising intentions, the program struggled to demonstrate substantial impacts on crime reduction. A 2018 study that aggregated results from four randomized trials suggested a possible reduction in violent crime arrests, but some analyses showed smaller, statistically insignificant reductions for property and drug arrests. Notably, when the researchers tried to account for all the different outcomes they were looking at (like various types of arrests), none of the results showed a clear, reliable impact on reducing crime. So, while there might have been some positive findings, they weren’t reliable enough to draw solid conclusions.

The inconsistency points to a broader issue regarding the effectiveness of CBT across different demographics. Factors such as varying levels of community support, differing family environments, and the presence of additional stressors like poverty and exposure to violence can influence the effectiveness of CBT interventions. While the program may provide valuable skills to some participants, its success seems to vary significantly depending on individual and contextual factors. This unfortunately limits the overall impact on crime reduction and recidivism.

READI Chicago

READI Chicago is a comprehensive intervention aimed at high-risk individuals, particularly those with a history of violence. The program provides extensive support, including cognitive behavioral therapy (CBT) sessions, professional development training, and subsidized employment opportunities. Participants typically attend three 90-minute CBT sessions each week and receive additional training focused on job readiness.

The READI program did have some notable effects in reducing arrests related to shootings and homicides. For those who actively participated in the program, the likelihood of being arrested for these serious offenses dropped significantly—by about 65%. However, for other measures of violence, such as serious violence not related to shootings or homicides, there were no significant improvements.

Additionally, the program had high costs—around $52,000 per participant—which raises questions about its overall effectiveness and sustainability. These complexities indicate that while the program shows promise, more research is needed to fully understand its impact and to identify the best ways to implement such interventions on a larger scale.

Recommendations for Enhancing CBT’s Effectiveness

While cognitive behavioral therapy (CBT) can be beneficial for some offenders—particularly those who are motivated and willing to engage with the therapeutic process—it is important to recognize its limitations. CBT focuses on modifying specific thought patterns and behaviors, making it effective for certain issues related to criminal behavior. However, many individuals in the criminal justice system struggle with serious mental illnesses that often require a more holistic approach to treatment. These complexities often necessitate additional support systems beyond what CBT can provide.

Several recommendations emerge for policymakers and stakeholders involved in criminal justice reform.

1. Invest in High-Quality Programs

Funding should prioritize CBT programs that adhere to evidence-based best practices. Programs should be regularly evaluated to ensure fidelity to CBT principles and to assess their impact on recidivism. While there are indeed programs that strive to follow these principles, not all initiatives currently in place do so effectively.

For example, not all programs are held to the same standards, and some may lack rigorous oversight or evaluation mechanisms. As a result, they might incorporate elements of CBT without fully adhering to the core principles or evidence-based practices. Relatedly, programs may face budget limitations, leading them to adopt less effective or poorly implemented strategies due to a lack of funding for training, supervision, or ongoing evaluation. Budget constraints can also lead to training gaps, wherein mental health professionals may not receive adequate training in CBT, leading to inconsistencies. In some cases, programs may be developed in response to political mandates or public opinion rather than being rooted in empirical evidence. This can result in initiatives that prioritize immediate visibility or popularity over proven efficacy.

2. Target High-Risk Populations

Resources should be focused on interventions that address the needs of higher-risk offenders, who often require more intensive support, including frequent therapy sessions, mentorship, and wraparound services such as housing assistance, job training, and education. Tailoring programs to this demographic increases the likelihood of success. This may involve incorporating elements that specifically target behavioral triggers, coping strategies, and skill development tailored to their life circumstances.

Further, involving family members and community resources in the rehabilitation process can provide essential support systems. Programs that incorporate family therapy or community-based support can enhance commitment and accountability. Similarly, integrating peer support programs can create a sense of community and shared experience. Higher-risk offenders may benefit from connecting with others who have successfully navigated similar challenges.

3. Integrate Continuity of Care

Acknowledging the significant overlap between mental health issues and criminal behavior, efforts should be made to ensure continuity of care for individuals transitioning out of the system. This means providing a seamless flow of services that begins during incarceration and continues after release.

For instance, inmates should have access to comprehensive mental health assessments and individualized treatment plans that address their specific needs while they are still in the system. Upon release, it’s vital that these individuals are connected to community resources—such as outpatient therapy, support groups, and case management services—so they can continue receiving the necessary support.

This continuity not only helps mitigate the risk of recidivism but also promotes overall mental wellness, aiding individuals in reintegrating successfully into society. Without these essential links, the gains made during incarceration can be lost, potentially leading to a cycle of reoffending and deteriorating mental health. Therefore, investment in coordinated care models that bridge correctional and community services is crucial for fostering recovery and reducing crime rates.

4. Continue to Invest in Rigorous Research

Investing in rigorous research, particularly randomized controlled trials (RCTs), is crucial for understanding and improving the effectiveness of CBT in the criminal justice system. RCTs provide high-quality evidence about what works in various contexts, allowing for tailored interventions that address the specific needs of different populations. This research is needed to help refine implementation strategies and identify barriers to success, so that programs can be better tailored to the needs of high-risk offenders.

Conclusion

In conclusion, while CBT can serve as a useful tool for some individuals, its limitations must be acknowledged. The Manhattan Institute’s assessment reveals significant uncertainty surrounding the effectiveness of CBT across various populations and contexts. Policymakers should remain cautious, recognizing that while CBT can yield modest impacts, it is not a panacea for the complex challenges within the criminal justice system. Advocates for effective strategies must take a balanced and measured approach that prioritizes evidence over optimism