Reducing Crime with Cognitive Behavioral Therapy
Cognitive behavioral therapy helped young urban men in Liberia and the United States become more focused on the future, reducing criminal and violent behavior and increasing graduation rates when delivered in school.
This page summarizes J-PAL's policy bulletin on the cognitive behavioral therapy, "Practicing Choices, Preventing Crime."
Across developed and developing countries, violence and crime concentrate disproportionately among young men in low-income settings, with detrimental effects on these men and their victims. In addition to these direct social costs, the uncertainty and risks of crime and violence can discourage economic growth. Many systemic factors contribute to these challenges, affecting not only the choices young men make, but how they think about making those choices. While young adults in many contexts struggle to develop a positive identity or skills such as self-control, those who grow up in low-income or violent settings, and who are often targets for mobilization into violence, may have more at stake and receive less support.
Cognitive behavioral therapy (CBT) is a comprehensive intervention to reduce self-destructive behaviors by teaching individuals to evaluate and modify the way they think and the decisions they make. Rather than simply teaching good behaviors or nudging participants towards certain choices, CBT teaches concrete methods of better relating to one’s environment and practicing strategies to regulate harmful, automatic behavior. Since the 1980s, CBT has been used to address mental health disorders such as depression, and policymakers globally are increasingly interested in using similar interventions to deter criminal and violent behavior. In contrast to policing approaches such as increased enforcement or broad social initiatives such as employment programs, CBT is targeted and short-term, making it a relatively inexpensive policy option.
Previous research suggests that CBT can help reduce crime and violence,1 but existing rigorous evaluations primarily focus on model programs with relatively few participants, rather than programs at scale in real-world settings. In addition, there are few rigorous studies on CBT’s effects among older youth or in non-US contexts. To address this evidence gap, researchers conducted randomized evaluations of three scalable CBT programs targeted towards young men with a history of criminal behavior: the Sustainable Transformation of Youth in Liberia program (STYL) in Monrovia, the Becoming a Man program (BAM) in Chicago Public Schools, and the CBT program at the Cook County Juvenile Temporary Detention Center (JTDC) in Chicago. These programs were designed as easy-to-deliver, low-cost interventions with a simple, standardized curriculum featuring similar CBT components such as self-reflection, experiential exercises, role-playing, and skill-building exercises.
Examples of program activities and mechanisms
Students are told to retrieve an object from a partner. Many try to use force. The counselor asks questions to highlight how their partners might have been willing to give them the object if they had simply asked for it.
JTDC Program, Chicago
Students state something they want to do better or differently to the group.
Physical uncleanliness is defined and highlighted as a problem through group discussion. Facilitators bring in a haircutter, shaver, and nail clippers for participants to clean up if they like. Homework assignments include cleaning up one's place of living.
CBT reduced criminal behavior.
Across all BAM recipients, arrests per student decreased by 12 percent by the end of the program, relative to the comparison group, though these effects disappeared one year later among participants of the first evaluation (for whom longer-term data is available). JTDC detainees who received CBT were 39 percent less likely to be readmitted within two months of release, a reduction that persisted eighteen months later. STYL participants in Liberia who received CBT or cash alone also reported committing one-third fewer thefts in the weeks following the program. The largest and most persistent declines occurred among men who received both; a year after STYL, these participants reported a 40 percent decline in the number of thefts committed in the past two weeks relative to the comparison group.
CBT also reduced violent and anti-social behavior.
By the end of the program, BAM decreased the number of violent crime arrests among participants by 20 percent, relative to the comparison group, though these effects disappeared after one year among participants of the first evaluation. In Liberia, aggressive and hostile behaviors declined among STYL participants who received CBT, and these effects were most sustained among men who received both cash and CBT; one year after STYL, participants who received both reported a 0.34 standard deviation decline on an index measuring behaviors such as yelling, cheating, and bullying. Receiving cash alone had no effect.
When delivered in schools, CBT increased graduation rates.
BAM improved schooling outcomes among participants by 0.1–0.19 standard deviations on a school engagement index of enrollment, attendance, and GPA. BAM participants from the first evaluation were 9 percent more likely to graduate high school on time relative to the comparison group. These effects could be particularly important in the long term as increased school achievement can lead to improvements in lifetime earnings and health. STYL, delivered to men already out of school, had only a temporary impact on their economic activities in the weeks following the program.
Among BAM students in the United States, CBT may have worked because participants learned strategies to relate to their environment, slowing down their decision-making processes.
In a game BAM researchers designed to test decision-making, BAM students took about 80 percent longer than comparison students to decide how to respond to a peer in a money transaction scenario, suggesting that BAM students had slowed down their decision-making processes.
In Liberia, CBT may have been effective because participants learned to plan ahead and to think differently about their self-identity and change their values.
In a combination of games and questionnaire answers, STYL participants who received CBT demonstrated greater patience and forward-looking behavior, with larger, more persistent effects among men who received both STYL and cash. One year after STYL, these men reported a 0.2 standard deviation increase on an index measuring these traits. Receiving cash alone had no effects. Though receiving cash or CBT alone had no effect on participants’ appearance or values, STYL participants who received both showed a marked improvement in physical appearance, including quality of dress and cleanliness, in the weeks after the program. These effects did not persist beyond one year, but researchers did find evidence of a longer-term shift in participants’ values; one year after STYL, men who received both CBT and cash scored 0.18 standard deviations lower on an index measuring self-reported criminal and violent values.
In Liberia, men who received cash grants earned and spent more in the short run, but neither the grant nor CBT affected recipients’ economic well-being in the long run.
Whether they received CBT or not, men who received cash grants used the money for productive reasons, spending about half on living expenses and business investments and increasing their weekly incomes by more than 20 percent in the weeks after the program. These results add to existing evidence that unconditional cash transfers are a powerful tool for raising incomes. After a year, however, these investments and income gains disappeared. Interviews revealed that about 70 percent of all men reported experiencing regular theft of their assets by the police or others in their community. More research is needed on how to sustain these economic impacts.
CBT can be a cost-effective approach to reduce criminal behavior among high-risk young men in cities across diverse contexts.
These CBT programs were short-term and relatively easy to implement, with standardized curricula delivered by minimally trained facilitators. Researchers estimate BAM’s overall societal benefits were anywhere from five to thirty times greater than the program’s cost, and the JTDC program reduced recidivism at a cost of US$114 per readmission avoided per year. Similarly, STYL could deter about 26 crimes per participant per year at a cost of US$21 per “crime not committed.” STYL implementers are exploring opportunities to scale up to thousands of youth in Liberia. BAM has since been scaled up across Chicago Public Schools and is currently being expanded into Boston Public Schools.
Providing young men with opportunities to continue practicing CBT techniques could be an effective way to reinforce recipients’ changed skills and behaviors.
The STYL results from Liberia demonstrated that receiving cash in addition to CBT increased and extended the effects of the therapy. In the short term, the cash helped because it temporarily stimulated self-employment and earnings, relieving the immediate financial need to return to crime. Importantly, the cash may have been effective in bringing about longer-term behavioral change because it provided men more time to independently practice and reinforce their changed behaviors. This suggests that programs that provide additional reinforcement, such as periodic “booster” therapy sessions, could be important to sustaining effects. Understanding the interaction between cash and CBT, as well as the impact and cost-effectiveness of reinforcing CBT interventions, are important areas of future research.
More research is needed to understand the channels through which CBT effects change.
The evaluations of BAM and STYL found that, among various mechanisms through which the programs may have affected behavior, CBT may have been effective in part because it slowed down participants’ decision-making processes, encouraged more planning, enabled more patient behavior, and/or shifted self-identity and values. Additional research to better understand the mechanisms driving CBT’s effects will be important to inform future interventions.
1Abt, Thomas, and Christopher Winship. 2016. “What Works in Reducing Community Violence: A Meta-Review and Field Study for the Northern Triangle."; Hill, Patrick L., Brent W. Roberts, Jeffrey T. Grogger, Jonathan Guryan, and Karen Sixkiller. “Decreasing Delinquency, Criminal Behavior, and Recidivism by Intervening on Psychological Factors Other than Cognitive Ability: A Review of the Intervention Literature.” NBER Working Paper #16698, January 2011.; Lipsey, Mark, Nana A. Landenberger, and Sandra J. Wilson. 2007. “Effects of Cognitive-Behavioral Programs for Criminal Offenders: A Systematic Review.” Campbell Systematic Reviews 3(6).
2Grit is a term used in psychology and behavioral economics and is defined as the tendency to sustain interest in and effort toward long-term goals. For more information, please see: Duckworth, Angela L., Christopher Peterson, Michael D. Matthews, and Dennis R. Kelly. 2007. "Grit: Perseverance and Passion for Long-Term Goals." Journal of Personality and Social Psychology 92(6): 1087.