Can Cognitive Behavioral Therapy Help Juvenile Offenders?

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Photo by Juvenile Office of Public Affairs, US Marshalls Service via Flickr

Looking back on childhood, a scene of handcuffs and reporting to probation officers does not usually come to mind. Unfortunately, this is the reality for many juveniles in the United States.

On any given day, nearly 53,000 youths sit in U.S. juvenile or criminal facilities due to involvement with the justice system, according to a 2018 report by the Prison Policy Institute (PPI).

The report also notes that “two out of every three confined youths are held in the most restrictive facilities,” with almost one in ten confined juveniles incarcerated in adult facilities.

Though there is no national average recidivism rate for juveniles, reports from individual states remain stubbornly high, with many re-arrest rates at more than 50 percent over a one- to three-year period, according to a paper prepared by The Council of State Governments Justice Center.

So, the question becomes, even with specialized courts and detention facilities responding to juvenile offending, why are so many children caught in the cycle of crime?

The answer to this behavior lies, in part, within the biology of the adolescent brain.

Neurobiology points to key differences between the brain composition of a juvenile compared to an adult. A study from the National Research Council (NRC) notes that juveniles’ lack of mature self-discipline in emotional situations, have increased susceptibility to peer pressure and instant-gratification incentives, and use less judgement based on future goals, fostering poor decisions that negatively impact themselves and others.

More specifically, according to the American Academy of Child and Adolescent Psychiatry, the prefrontal cortex, the area responsible for reasoning and decision-making is not fully developed in children and adolescences.

Depending heavily on the already-matured brain structure of the amygdala, the region responsible for emotional and impulse responses, juveniles rely less on logic and more on reaction to guide their behavior.

The Adolescent Brain

Despite adolescents’ predisposition to unpredictability and explosiveness, having a developing brain allows for the shaping of thought and actions, maximizing the effectiveness of treatment and diversion programs for those connected with the justice system—in effect, letting kids be kids and not kids behind bars.

A major player in treatment that utilizes this ability to mold and reform thoughts and behaviors is cognitive behavioral therapy (CBT).

CBT works under the premise that the way we think about a circumstance explicitly shapes our decisions and behavior; adverse thoughts lead to adverse behavior, while a positive mentality leads to positive behavior.

For example, enduring negative thoughts before giving a presentation such as “I know I’m going to mess up,” causes anxiety and fear which then dictates our behavior, making it more likely that these fears will come true. On the other hand, experiencing helpful thoughts such as “I am confident in my work and abilities,” will lead to a positive presentation outcome.

Though traditionally used in psychology to treat various disorders, the goal of CBT in the context of the justice system is to present a counterbalance to these automatic negative thoughts by helping participants understand the thinking processes and choices that precede criminal behavior.

For those youth who have a family member in jail or just grow up around maladaptive behavior, such as violence, abuse, and disrespect to authority, these actions are engrained into their minds as normal and automatic, simply “part of life.”

Many of these hardened criminals pass down the cycle of negative thought (wanting to be the most feared inmate in the state or swearing to never snitch on a fellow criminal, for example) to younger followers or family members.

Although this creates challenges in reforming these individuals solely through traditional punishment, CBT provides an escape from the “criminal mentality,” targeting offenders’ thinking through impulse management, critical and moral reasoning, means-ends problem solving, and social skill improvement, according to the National Institute of Justice.

Dr. Jack Bush, an Oregon-based cognitive therapist, has taken these foundational treatments and created his own version of cognitive behavioral therapy, called cognitive self-change.

Highlighting the need for reform, Dr. Bush argues in a recent article posted on the National Public Radio website, that “incarceration is a basic tool of criminal justice, but when the sole purpose is punishment and confinement, offenders respond, in the privacy of their own minds, with resentment and defiance.

“The thinking that led them to offend is not extinguished by punishment; it is reinforced.”

Dr. Bush focuses on minimizing the chance of recidivism by reforming dysfunctional thinking through four central steps:

  • Becoming more aware of thoughts and feelings;
  • recognizing how these thoughts and feelings are directly connected to harmful or unlawful behavior;
  • Brainstorming new ways of thinking that allow offenders to still feel good about themselves but which do not led to acts of crime; and finally
  • Applying this thinking to real-life situations.

Cognitive Self-Change (CSC), another way to describe the approach, stresses the skills offenders need in order to change themselves, rather than forcing an individual to change.

Participants in this program are given a pivotal message:

“When you learn how to steer your thinking away from crime and violence…you have a real choice to make. If you don’t learn these skills your important decisions will have already been made. Your decisions will be made in advance by the attitudes and habits of thinking you perform in your mind automatically, ‘without thinking.’”

Asked to assess CSC’s significance, Dr. Bush quoted one participant as saying, “I realized that the story of my past doesn’t need to be the story of my future.”

Dr. Bush commented: “I think that captures the heart of what CSC offers. It doesn’t cure a disease. It opens possibilities for new forms of life.”

He added that the approach can “change criminal justice attitudes.”

“CSC demands an attitude supportive of change by the criminal justice system,” he said. “This is contrary to punitive and condemnatory and exclusionary attitudes.”

The introspective treatment program of CBT has been found to be 79.2 percent in reducing crime among juveniles through a meta-analysis of 50 cognitive behavioral therapy programs conducted by the National Institute of Justice.

Additionally, CBT led to a 44 percent reduction in recidivism in a study of disadvantaged male youth (grades 7-10) from high-crime Chicago neighborhoods, by the National Bureau of Economic Research.

Encouraged by these successful statistics, more and more programs utilizing CBT have been implemented in prisons and jails across the country.

In 2016, the Sheriff’s Office of Thomas Dart in Cook County, Illinois started the ongoing initiative of Sheriff’s Anti-Violence Effort (SAVE), a program working to curb violence by changing the way high-risk offenders think. The program has also been adapted by the Davidson County Sheriff’s Office in Nashville, TN.

A Therapy Curriculum

With a focus on reducing gun violence, SAVE provides inmates with therapy curriculum including conflict resolution and anger management, according to the Cook County Sheriff’s Department.

Of the program participants, a study found that only 17 percent were readmitted to the jail within a year and a half, in contrast to the 75 percent readmission for those inmates who did not go through the program.

Not limited to inside correctional facilities, cognitive behavioral therapy also has an important role in schools, with the goal of providing youths with cognitive skills needed to keep them out of contact with the justice system in the first place.

Education has a close relationship with crime. If a juvenile is incarcerated, he or she is 13 percentage points less likely to graduate high school and 22 percentage points more likely to be incarcerated when they are an adult.

Without a high school degree, juveniles are susceptible not only to engaging in crime, but also face increased chances of unemployment and poverty, which are also major contributors to the factors behind committing a crime.

Striving to avoid these outcomes, The Center for Court Innovation, a nonprofit organization seeking to reform the justice system, has implemented a “restorative justice” program in five high schools in Brooklyn, NY.

“What restorative justice allows us to do is to look beyond the behavior and look at some of the root causes and see how we can prevent this from turning into something much bigger,” program coordinator, Mischael Cetout, said during a recent PBS News Hour special.

According to the Center for Court Innovation, its restorative justice approach works to “promote individual responsibility and participation, repair harm, and build relationships.”

Student participants develop empathy and communication skills through “harm circles,” a space where conversation is mediated by a program coordinator to resolve conflicts between peers and give time for the students to reflect.

Employing CBT practices, this program drills down to find the root cause of an issue and allows students to understand why they acted in a certain way and what they can do better in a similar situation in the future.

By giving youths these skills to handle an explosive or enraging situation, this design essentially works as a diversion program; lowering the number of disciplinary incidents which subsequently allows students to redirect from a path of delinquency and harm to one of respect and success.

Policy Loopholes Add Complications

Though CBT programs have successfully been implemented in and out of the justice system, issues still remain for juveniles in receiving the benefits of this therapy due to policy loopholes.

Recognizing that culpability of a crime may lay more on the composition of a growing brain (as opposed to an individual being purposefully defiant), the federal courts put in place specialized juvenile programs and standards, including the most recent authorization of the Juvenile Justice Delinquency Prevention Act (JJDPA) in 2002.

Setting forth safety and treatment standards for youth, the act establishes four core requirements: deinstitutionalization of status offenders, adult jail and lock-up removal, “sight and sound” separation of juveniles from adults, and disproportionate minority contact.

However, JJDPA was amended to “create an exception to the DSO [deinstitutionalization of status offenders] core requirement that allows judges to securely confine youth adjudicated for a status offense if the child violated a “valid” order of the court,” according to the Coalition for Juvenile Justice.

This exception converts a minor status offense such as skipping school or running away from home, into a criminal act. It does so by providing judges with a loophole; although truancy is not a detainable offense, youth can be punished for violating a court order to attend school every day.

The Vera Institute reports that “as of 2011 [the last year of available data], 27 states used the so-called VCO exception, and thousands of kids are still removed from their homes to be put in detention and out-of-home placements each year.”

Not only does this exception disrupt a child’s daily life, it can also put their safety at risk and limit their access to treatment.

The Campaign for Youth Justice estimates that 200,000 youth are tried, sentenced, or incarcerated as adults each year in the United States, while juveniles within the adult criminal system are between 34 percent and 77 percent more likely to be re-arrested for a crime.

The protection from adult offenders under the JJDPA do not apply to those youth who are prosecuted in the adult criminal justice, subjecting them to mandatory minimums, increased exposure to abuse, and use of solitary confinement to segregate.

When juveniles are exposed to hardened criminals, the destructive “criminal thinking” becomes more deep-seated, complicating reform and rehabilitation through cognitive behavioral therapy.

Additionally, due to the vulnerability of juveniles to abuse from older inmates, many officers tend to protect youths by confining them to a segregation unit. This limits the access to treatment and therapy for juveniles by isolating them, unable to ‘talk things out’ within a group of individuals.

Luckily, NRC researchers commenting on the legal effects of brain chemistry, note that “much adolescent involvement in illegal activity is an extension of the kind of risk-taking that is part of the developmental process of identity formation, and most adolescents mature out of these tendencies.”

Laura Binczewski

Laura Binczewski

So, by implementing CBT programs in and out of the justice system, juveniles armed with beneficial cognitive skills will be able to avoid or restrain their criminal behavior as they grow older.

Though CBT has been found to be successful for offenders as well as in reducing taxpayer money on incarceration, Dr. Bush notes that we should not “replace incarceration with treatment or let people out of prison early just because they have taken treatment.

“But,” he continued, “adding treatment to incarceration provides hope to offenders now, and benefits to society in the future.”

Laura Binczweski is a TCR news intern. She welcomes comments from readers.

2 thoughts on “Can Cognitive Behavioral Therapy Help Juvenile Offenders?

  1. I work in a facility that uses CBT based interventions and I truly believe that these interventions consistently fall short of their promise. There is definitely a certain cohort of kids that are reacting purely to cognitive distortions, but much of the kid’s issues come from the terrible poverty and traumatic environments they live in within their communities. You can’t begin a cognitive based intervention with unaddressed trauma triggers and uncontrolled physiological responses to stress and you can’t give someone enough skills to tough it out living in a society that oppresses and undervalues them (see Alexandra Cox’s book Trapped in a Vice). If we want these kids to have a better chance at being productive citizens we have to give their communities the resources that we all take for granted in our own success rather than constantly focusing on programming that places the responsibility solely on the individual.

    This is the same error that helping professionals and educators have made time and time again, labeling the individual’s dysfunction and creating solutions that don’t address the underlying issues. This in many ways is reminiscent of how schools were integrated – when desegregation occurred black schools were incorrectly labeled as inferior and closed, teachers were let go, students were transferred into institutions where they were unwelcome with no supports or representation-again a well-to-do higher class of individuals “helping” by fixing a problem that didn’t need fixing based on their own convenience and biases (see Malcolm Gladwell’s Revisionist History Podcast: Miss Buchanan’s Period of Adjustment). I really enjoyed your article though, this is in no way a critique of your piece, more so a commentary on what I see as an oppressive and antiquated system.

  2. This is a challenging group to work with for a variety of reasons. I’ve spend considerable time working on different treatment modalities for all types of offenders. In my experience, virtual reality offers a unique opportunity specific to juvenile treatment. I conducted my first pilot on this in 2013 (see article https://www.highbeam.com/doc/1G1-491848170.html). I’ve also recently published a book on the topic (http://a.co/d/ejAkATn). While VR isn’t a magic bullet that will solve all treatment issues, it does offer a new tool that I have found to be especially useful with juvenile populations.

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