Cognitive-behavioral therapy (CBT) for offenders

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Decision Makers
Date last updated

Cognitive-behavioral therapy (CBT) helps clients discover and change the thought processes that lead to maladaptive behavior1. CBT programs for offenders emphasize personal accountability, help offenders understand the thoughts and choices that led to their crimes, and teach alternative behaviors and thought processes. Programs are delivered in correctional facilities for inmates or in community settings for probationers under supervision, as individual or group therapy2. Offenders are often referred to CBT programs through the justice system; some offenders choose to participate voluntarily.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Reduced crime

  • Reduced recidivism

What does the research say about effectiveness?

There is strong evidence that cognitive-behavioral therapy (CBT) reduces recidivism among youth1, 2, 3, 4 and adult offenders1, 2, 5, 6, 7, 8. CBT also reduces recidivism among sex offenders9, 10. Effects are strongest for offenders with a high risk of recidivism2.

CBT can also reduce recidivism among those with substance-related offenses11, 12, 13. For violent and chronic juvenile male offenders, CBT is particularly effective in reducing the recurrence of serious crimes14. An evaluation of a CBT program designed for female offenders suggests CBT can reduce rearrests and reconviction among female offenders when implemented with high fidelity15. Analysis of Canada-based CBT programs indicates that CBT is effective for offenders with various ethnic backgrounds7.

The most effective CBT programs usually include anger management and interpersonal skills training. Training providers in CBT, closely monitoring programs, and ensuring program fidelity also result in better outcomes2. CBT for juvenile offenders appears to reduce recidivism more when it includes group parenting education, particularly when parents complete the education3.

An Iowa-based cost benefit analysis estimates a $35 return for every dollar invested in CBT programs16.

How could this strategy impact health disparities? This strategy is rated no impact on disparities likely.
Implementation Examples

There are some cognitive-behavioral therapy (CBT) programs widely used in the U.S. criminal justice system, such as Aggression Replacement Training17, Criminal Conduct and Substance Abuse Treatment-Strategies for Self-Improvement and Change (SSC), Moral Reconation Therapy18, Reasoning and Rehabilitation19, and Thinking for a Change2021.

Implementation Resources

NIC-CBT - National Institute of Corrections (NIC). Cognitive behavioral therapy (CBT). U.S. Department of Justice.

Addictions-CBT - Addictions.com. Cognitive-behavioral therapy (CBT).

Footnotes

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1 Wilson 2005 - Wilson DB, Bouffard LA, Mackenzie DL. A quantitative review of structured, group-oriented, cognitive-behavioral programs for offenders. Criminal Justice and Behavior. 2005;32(2):172-204.

2 Campbell-Lipsey 2007 - Lipsey MW, Landenberger NA, Wilson SJ. Effects of cognitive-behavioral programs for criminal offenders. Campbell Systematic Reviews. 2007:6.

3 Jeong 2017 - Jeong S, Fenoff R, Martin JH. Evaluating the effectiveness of an evidence-based cognitive restructuring approach: 1-year results from Project ASPECT. International Journal of Cognitive Therapy. 2017;10(1):1-16.

4 Jewell 2015 - Jewell JD, Malone MD, Rose P, Sturgeon D, Owens S. A multiyear follow-up study examining the effectiveness of a cognitive behavioral group therapy program on the recidivism of juveniles on probation. International Journal of Offender Therapy and Comparative Criminology. 2015;59(3):259-272.

5 Ferguson 2013 - Ferguson LM, Wormith JS. A meta-analysis of moral reconation therapy. International Journal of Offender Therapy and Comparative Criminology. 2013;57(9):1076-1106.

6 Barnes 2017 - Barnes GC, Hyatt JM, Sherman LW. Even a little bit helps: An implementation and experimental evaluation of cognitive-behavioral therapy for high-risk probationers. Criminal Justice and Behavior. 2017;44(4):611-630.

7 Usher 2014 - Usher AM, Stewart LA. Effectiveness of correctional programs with ethnically diverse offenders: A meta-analytic study. International Journal of Offender Therapy and Comparative Criminology. 2014;58(2):209-230.

8 Feucht 2016 - Feucht T, Holt T. Does cognitive behavioral therapy work in criminal justice? A new analysis from CrimeSolutions.gov. NIJ Journal. 2016;(277):10-17.

9 Campbell-Schmucker 2017 - Schmucker M, Lösel F. Sexual offender treatment for reducing recidivism among convicted sex offenders: A systematic review and meta-analysis. Campbell Systematic Reviews. 2017:8.

10 Grady 2017 - Grady MD, Edwards D, Pettus-Davis C. A longitudinal outcome evaluation of a prison-based sex offender treatment program. Sexual Abuse: A Journal of Research and Treatment. 2017;29(3):239-266.

11 McMurran 2007 - McMurran M. What works in substance misuse treatments for offenders? Criminal Behaviour and Mental Health. 2007;17(4):225-233.

12 Quinn 2015 - Quinn TP, Quinn EL. The effect of cognitive-behavioral therapy on driving while intoxicated recidivism. Journal of Drug Issues. 2015;45(4):431-446.

13 Needham 2015 - Needham M, Gummerum M, Mandeville-Norden R, et al. Association between three different cognitive behavioral alcohol treatment programs and recidivism rates among male offenders: Findings from the United Kingdom. Alcoholism: Clinical and Experimental Research. 2015;39(6):1100-1107.

14 Campbell-Garrido 2007 - Garrido V, Morales LA. Serious (violent or chronic) juvenile offenders: A systematic review of treatment effectiveness in secure corrections. Campbell Systematic Reviews. 2007:7.

15 Duwe 2015 - Duwe G, Clark V. Importance of program integrity: Outcome evaluation of a gender-responsive, cognitive-behavioral program for female offenders. Criminology & Public Policy. 2015;14(2):301-328.

16 Pew-Results first 2013 - The Pew Charitable Trusts (Pew). The Pew-MacArthur Results First Initiative in Iowa (Results first). 2013.

17 EPISCenter-ART - Evidence-based Prevention & Intervention Support Center (EPISCenter). Aggression Replacement Training (ART). Pennsylvania Commission on Crime and Delinquency, Penn State University Prevention Research Center.

18 MRT - Moral Reconation Therapy (MRT). MRT changes minds.

19 R&R - Ross RR, Fabiano E, Ross RD. The reasoning & rehabilitation (R&R) program. Ottawa, CAN: Cognitive Centre of Canada.

20 NIC-T4C - National Institute of Corrections (NIC). Thinking for a Change (T4C). U.S. Department of Justice.

21 US DOJ-CBT - Thigpen ML, Keiser GM. Cognitive-behavioral treatment (CBT): A review and discussion for corrections professionals. Washington, D.C.: U.S. Department of Justice (U.S. DOJ), National Institute of Corrections (NIC); 2007.