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CBT and The High Risk Offender
By Dr. Michael Pittaro
Published: 11/04/2019

Cbt2 For those of us who have worked in corrections, or continue to work in corrections, we can attest to the fact that working in a prison can be quite stressful and dangerous. The threat of violence at a moment’s notice is the reality of our chosen profession. We tend to be in a constant state of hypervigilance, keenly aware of our immediate surroundings at all times. We are also cognizant of the infamous cloud of uncertainty as to how and when the next incident will occur. We have become experts at assessing our surroundings. After all, our nation’s prisons are filled with some of the worst criminal offenders that humanity has to offer. Not all, but many of these criminal offenders have been deemed high-risk prisoners, which is often based on the outcome of an evidence-based risks and needs assessment conducted by the prison’s classification division. In short, classification is the process of assessing the prisoner’s risks and needs by taking into consideration obvious security concerns and programmatic needs. Therapeutic programs are intended to address the criminogenic factors that commonly contribute to the offender’s propensity towards crime. The severity of the prisoners’ crimes, past and present, as well as the prisoners’ past and present institutional record, and other factors are carefully assessed in determining where to house each prisoner; thereby, controlling the prisoner’s physical movements within the prison by restricting access to certain areas that a medium or minimum security level prisoner might have access to on any given day.

High-risk prisoners are typically housed in dedicated maximum-security prisons or within maximum security units whereby some of the most violent and vile offenders will spend the duration of their incarceration. Even though violence can take place within any security level, the high-risk prisoners are typically the prisoners that require an additional level of security based on the severity of their crimes, propensity toward violence, or risk of escape. Security is therefore paramount within any prison and as such, takes precedence over the prisoners’ programmatic needs. However, as we have learned over the past 30 + years, punishment alone is ineffective in creating positive change in an offender’s criminalistic behaviors and actions. We now accept and acknowledge that we must provide rehabilitative services that are intended to change the offender’s ways from law-violating to law-abiding, especially since over 90% of our nation’s prisoners will one day reenter society, and most will return to the same communities in which they once resided. Therefore, upon reentry, they will be confronted with the same challenges and uncertainty they faced before being sentenced to prison.

As a former prison administrator turned educator, I can say with confidence that most programs that have been implemented over past few decades have proven largely ineffective in creating the change we desire by reducing initial crime and recidivism rates. I have worked with a number of challenging offender-types over the duration of my corrections career, including violent sexual predators, and even though our success rates are not as high as we would hope, one particular therapeutic approach has proven effective among high-risk prisoners and that is cognitive behavioral therapy hereafter referred to as CBT.

Psychology Today defines cognitive behavioral therapy as a form of psychotherapy that differs from the former psychoanalysis approach that was once popular among correctional psychologists of past decades. Psychoanalysis focused on the prisoner’s childhood / adolescence, which is a time when many issues related to trauma, neglect, and abandonment originate; however, CBT focuses on solutions by encouraging prisoners to challenge distorted cognitions related to negative, often destructive behaviors by replacing them with positive, socially-appropriate thoughts and behaviors. Granted, I am a realist and as such, I realize that manipulation, trickery, and deceit are immersed within the typical offender’s arsenal of conning the system; however, in order for change to occur, the prisoner must embrace the necessary change that needs to take place and continually take action steps towards addressing those negative, often self-destructive thoughts and behaviors. Only time will tell if true change has occurred and that can only be determined by whether the prisoner can refrain from substance abuse, violence, and remain crime-free.

In its most basic description, CBT focuses on those thoughts and perceptions that ultimately influence our behaviors and once identified, CBT employs strategies to challenge and overcome negative, disparaging thoughts and perceptions. As the illustration above notes, our thoughts create feelings and those feelings create behaviors and those behaviors reinforce our thoughts. By identifying painful and upsetting thoughts and subsequently determining whether those thoughts are realistic, high-risk prisoners can learn the skills that are designed to help the prisoner in changing their thinking patterns. Unlike Freud’s psychoanalytic approach which focuses on the individual’s childhood / adolescence, CBT focuses on what is presently happening that is causing or contributing to the prisoner’s distress. The prison’s therapist can then discuss whether those thoughts are valid and productive and if not, help the prisoner in adjusting their thinking by moving forward and confronting those thoughts.

The effectiveness of CBT is not just supported within psychology, but also within criminal justice. For instance, an article published with the National Institute of Justice affirms the fact that CBT is effective in working with high-risk prisoners, including those with extensive substance abuse histories and documented histories of violence. Most would agree that prisons are not the most therapeutic environments for change to take place, but CBT has shown to be effective in various institutional and non-institutional, community-based settings. CBT does not solely focus on criminality, but rather the criminogenic factors that directly and indirectly contribute to criminality, including but not limited to improving the prisoner’s social skills, problem-solving skills, critical reasoning, moral reasoning, self-control, self-efficacy, and two of my personal favorites, coping and resiliency skill-building.

In 2007, the National Institute of Corrections published their exceptional findings in, “Cognitive Behavioral Treatment: A Review and Discussion for Corrections Professionals.” It is one of the most comprehensive studies to addressing CBT in corrections and as such, it is one that continues to resonate with me as a corrections subject matter expert. I started my career in corrections in April 1989 and at that time, the “get tough on crime” attitude among American citizens led the way to some of our nation’s most stringent laws in which punishment overshadowed the importance of rehabilitation. However, as of most recent, we have accepted that punishment and deterrence have not reduced recidivism rates, but therapeutic approaches that embrace skill building do.

Our collective beliefs, attitudes, and values affect the way we think, and these beliefs can distort the way we view reality, interact with others, and experience life. CBT essentially dismantles and restructures the high-risk prisoners’ distorted thinking and perception, which can ultimately change the prisoners unproductive, negative beliefs, attitudes, and values. And the aforementioned NIJ study affirmed that even those who embraced high-risk behaviors did not diminish CBT’s effectiveness. In fact, CBT had the greatest impact among more serious offender types. The NIJ researchers concluded that CBT’s self-help approach is more effective in engaging typically-resistant offenders, increases their participation, and therefore, the offenders benefit from active participation; however, the researchers were cautious in noting that CBT is most effective in reducing recidivism when prisoners simultaneously have a strong support network, have viable employment opportunities, a formal education, vocational training, and ongoing substance abuse / mental health counseling. As with most criminal justice system responses, this is an approach used with those already sanctioned by the criminal justice system. I have always been critical of the fact that, as a nation, we do not put in as much time, effort, resources, and of course, funding at the frontend with prevention programs, but rather have a heavy emphasis on intervention programs. Common sense dictates that it is far more challenging to confront years or decades-worth of problematic issues than it is to work with juveniles who are the initial onset of delinquency, or are at-risk of engaging in deviant, delinquent behaviors. The research has consistently shown that CBT is effective with high-risk offenders; therefore, we, as a society, would benefit from applying CBT programs at the frontend as a preventative approach to deviancy, delinquency, and crime, especially within communities that are most at-risk.

Dr. Michael Pittaro is an Associate Professor of Criminal Justice with American Military University and an adjunct professor of criminal justice with East Stroudsburg University and Northampton Community College. Before pursuing a career in higher education, Dr. Pittaro worked in corrections administration; has served as the Executive Director of an outpatient drug and alcohol facility; and as Executive Director of a drug and alcohol prevention agency. He has been teaching for the past 18 years while also serving internationally as an author, editor, and subject matter expert. Dr. Pittaro holds a BS in Criminal Justice (Who’s Who Among University Students – 1989); an MPA in Public Administration (Summa Cum Laude); and a PhD in criminal justice (4.0 GPA – Summa Cum Laude).

He can be reached at: crimeNjustice@ptd.net


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