Practice Profile: Cognitive Behavioral Therapy (CBT) for Antisocial Behavior in Youth in Residential Treatment

Evidence Rating for Outcomes

Crime & Delinquency | Multiple crime/offense types

Date: This profile was posted on September 26, 2019

Cognitive behavioral therapy (CBT) is a problem-focused, therapeutic approach that attempts to help people identify and change dysfunctional beliefs, thoughts, and patterns that contribute to their problem behaviors. This variant of CBT focuses specifically on youth in residential settings. This practice is rated Ineffective for reducing recidivism, at the 24-month follow-up period.

Practice Goals/Target Population

Cognitive behavioral therapy (CBT) is a problem-focused, therapeutic approach designed to help individuals identify and change dysfunctional beliefs, thoughts, and patterns that contribute to problem behavior. In general, CBT has been used to address a wide range of problems, including antisocial behavior (i.e., a wide variety of problem behaviors such as violence toward people or animals, destruction of property, deceitfulness, oppositional-defiance, theft, and/or serious rule violations).

This CBT practice, however, focuses specifically on youth within residential facilities with antisocial behavior who committed a serious crime or offense resulting in contact with the juvenile justice system (Armelius and Andreassen 2007; Dishion, Dodge, and Lansford 2006). The overall goal of CBT for youth in residential treatment (including both secure and non-secure settings) is to reduce recidivism and increase prosocial behaviors.

Practice Components

CBT focuses on teaching youth prosocial skills that will help them to interact positively with other people. CBT is based on the idea that thoughts, images, beliefs, and attitudes are closely related to behavior (Armelius and Andreassen 2007). Treatment may focus heavily on cognitive change, or it may incorporate several strategies such as interpersonal cognitive problem solving, social skills training, anger control, critical reasoning, values development, negotiation abilities, and creative thinking. Examples of these broader, more comprehensive CBT programs for these youths include Aggression Replacement Training (Goldstein and Glick 1987), Reasoning and Rehabilitation Program (Ross and Fabiano 1985), and Moral Reconation Therapy (Little and Robinson 1988).

CBT interventions for youth in residential facilities also include components that specifically focus on addressing criminogenic needs such as correction of criminal thinking errors. Criminal thinking errors include victim-stance, which refers to youth viewing themselves as victims rather than perpetrators and therefore refusing to take responsibility for their actions. CBT helps to correct this pattern by teaching youth to recognize and admit culpability for problem behavior while learning to adjust their self-perceptions (Greenwood and Turner 1993).

CBT programs vary in duration, ranging from shorter programs that last a week to longer programs that last for a year (Armelius and Andreassen 2007).

Meta-Analysis Snapshot
	Literature Coverage Dates	Number of Studies	Number of Study Participants
Meta Analysis 1	1973-2005	12	2692

Meta Analysis 1

Armelius and Andreassen (2007) conducted a meta-analysis to assess the effectiveness of cognitive behavioral therapy (CBT) in reducing recidivism of youth placed in secure or nonsecure residential settings. Eligible studies included randomized controlled trials or quasi-experimental designs to evaluate CBT provided to youth, ages 12 to 22, who were in residential settings for antisocial behavior. Both published and unpublished studies were included in the literature search. Interventions that only included a behavioral or cognitive component, but not both, were excluded. Residential settings included out-of-home group settings with more than two members of staff, which excluded foster homes and family-like interventions. Secure settings included prison and similar restrictive placements, and nonsecure settings included training schools and treatment programs in open or semi-open areas with fewer restrictions (i.e., walls, bars, fences).

The authors searched numerous databases for studies that took place between 1963 and 2005. The final sample included 12 published studies conducted between 1973 and 2005. Of the 12, five used randomized controlled trial designs. A total of 4,820 participants were included across the 12 studies. Eight studies were conducted in the United States, two in Canada, and two in the United Kingdom. Eight studies included only males, and one included only females. The age of the youth at time of participation ranged from 12 to 21 with an average age of 15.5. One study focused specifically on CBT for youth with mental health problems.

The type of CBT intervention used in the studies varied. Nine studies used specific interventions, including Reasoning and Rehabilitation, enhanced thinking skills, Moral Reconation Therapy, social interactional training or social modeling, dialectical behavior therapy, cognitive mediation training, and situational decision making. The only interventions that were used by more than one study were Moral Reconation Therapy and Reasoning and Rehabilitation, which were each used twice. The remaining three studies evaluated a greater number of comprehensive programs with non-specific interventions. The total duration of the intervention ranged from 20 hours to 1 year of daily activities.

Data were obtained from official police or juvenile justice records. Six of the 12 studies reported recidivism rates at a 24-month follow up, which included data on 2,692 of the 4,820 participants in the original sample of studies. The data were analyzed using a random effects model. All analyses were conducted using odds ratios with a 95-percent confidence interval. Sensitivity analyses were performed on study design, intention-to-treat, and rate of retention.

Date Created: July 17, 2024

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Practice Snapshot

Age: 12 - 21

Gender: Male, Female

Race/Ethnicity: White, Black, Hispanic, Asian/Pacific Islander, Other

Targeted Population: Prisoners, Young Offenders

Setting (Delivery): Correctional

Practice Type: Cognitive Behavioral Treatment, Residential Treatment Center

Unit of Analysis: Persons

Practice Profile: Cognitive Behavioral Therapy (CBT) for Antisocial Behavior in Youth in Residential Treatment

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Practice Summary

Practice Description

Practice Goals/Target Population

Practice Components

Meta-Analysis Outcomes

Meta-Analysis Methodology

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