COGNITIVE-BEHAVIORAL TREATMENT

U.S. Department of Justice National Institute of Corrections

COGNITIVE-BEHAVIORAL TREATMENT

A Review and Discussion for Corrections Professionals

U.S. Department of Justice

National Institute of Corrections

320 First Street, NW Washington, DC 20534

Morris L. Thigpen Director

Thomas J. Beauclair Deputy Director

George M. Keiser Chief, Community Corrections/Prisons Division

Michael Guevara Project Manager Rachel Mestad Project Manager

National Institute of Corrections

COGNITIVE-BEHAVIORAL TREATMENT

A Review and Discussion for Corrections Professionals

Harvey Milkman, Ph.D.

Department of Psychology

Metropolitan State College of Denver

Denver, Colorado

Kenneth Wanberg, Th.D., Ph.D.

Center for Addictions Research and Evaluation (CARE)

Arvada, Colorado

May 2007

NIC Accession Number 021657

This document was funded by the National Institute of Corrections under cooperative agreement number 06C2020. Points of view or opinions stated in this document are those of the authors and do not necessarily represent the official position or policies of the U.S. Department of Justice.

The decision to include the six cognitive-behavioral treatment programs chosen for this publication was based on a focused literature review of cognitive-behavioral treatments for individuals involved in the criminal justice system (see References section of this report). The review showed these to be some of the prominently discussed, imple mented, and researched CBT programs used in correctional settings throughout the United States. These programs are not to be taken as exhaustive of effective CBT treatments for correctional clients, nor are they ranked in any order of impact on recidivism or number of clients served.

Contents

Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . vii

Preface and Acknowledgments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix

Executive Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi

Chapter 1: The Increasing Need for Effective

Treatment Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Incarceration and Release . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

The Need for Mental Health Services. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Cost-Benefit Analysis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Focus on Community Reentry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Chapter 2: What is Cognitive-Behavioral Therapy? . . . . . . . . . . . 5

History and Background . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Behavioral Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Cognitive Theory . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Blending the Two Theories. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Principles of CBT . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

The Cognitive Focus of CBT: Cognitive Elements and Structures . . . . . . 8

The Behavioral Focus of CBT: Interpersonal and Social Skills. . . . . . . . . 9

The Community Responsibility Focus of CBT: Prosocial Skills

Building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

The Cognitive-Behavioral Change Map . . . . . . . . . . . . . . . . . . . . . . . . . . 10

The Counselor's Role . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Personal Characteristics of the Counselor . . . . . . . . . . . . . . . . . . . . . . . . 12

Counselor-Client Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Correctional Counseling Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

iii

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