Monday, May 20, 2013

COGNITIVE BEHAVIORAL THERAPY

Our post today comes from Colin Lentz, Communications Coordinator for Youth Justice Programs at the Center for Court Innovation.

Like many organizations that work with young people who have come in contact with the justice system, we are constantly looking for interventions that show some evidence of appropriately addressing the reasons underlying youth delinquency, preferably before that behavior gets them into real trouble. We’ve been particularly interested in cognitive behavioral therapy (CBT), which focuses on working with young people to help them develop better decision-making and impulse control to overcome the adolescent tendency to make problematic automatic decisions. It encourages thinking about thinking, or what is called “meta-cognition.” First used in the 1970s to address mental health disorders including substance abuse, anxiety, and depression, CBT is increasingly being considered appropriate for helping youth considered ‘at risk’ navigate the developmental shoals of adolescence . Instead of focusing on mitigating challenges arising from structural issues in young people’s lives, CBT offers a means to develop skills that young people can actively deploy in difficult situations to avoid getting into trouble.

The National Bureau of Economic Research recently released a paper, Preventing Youth Violence and Dropout, on a new study evaluating the efficacy of an intervention for at-risk young people that includes CBT as a component.  Researchers studied 2,740 male youth in Chicago Public Schools during the 2009-10 school year in neighborhoods on the south and west sides of the city. The young men, in grades 7 to 10, were randomly assigned either to a control group or to a group receiving an intervention called “Becoming a Man” and run by two local nonprofits. The intervention involved consistent exposure to pro-social adults, after school programming, and CBT. The CBT component included standard curriculum focused on the emotional reactions to events that are often influenced by automatic thoughts which can be controlled and processed. Participants were taught relaxation techniques to help avoid these automatic reactions. The curriculum also focused on helping youth put actions and attitudes in perspective to avoid acting out.  

The study found that participation in the intervention reduced violent crime arrests by 8.1 arrests for every 100 youth over the course of the program year. By comparison to the control group, this amounted to a 44% decline. Including non-violent, non-property, non-drug crimes, arrests decreased by 11.5 per 100 youth during the year, a 36% decline. Depending on how violent crime is monetized, the paper points out that the benefit-cost ratio is 30:1 based on the effects of the reduction in crime alone. The intervention may have also led to positive long term school outcomes. The increase in the grade point averages (GPA) of the study participants involved in the intervention was compared with an earlier study that looked at how increases in GPAs for 9th grade Chicago Public School students correlated with later graduation rates. Using the same correlation, the schooling impacts of the “Becoming a Man” intervention suggest potential gains in graduation rates of 7 to 22% by comparison to the control group.

The authors point out that while they cannot definitively isolate which components of the intervention, the exposure to pro-social adults, the after school programming, or the CBT, are most effective, other programs that just provide the first two components have not shown the same results. CBT seems to be an important component, and possibly the important component, the paper points out, of the intervention’s success. In fact, the authors conclude that given the results of their study, replication “would seem to be a priority for future research.” They are encouraged by a separate CBT experiment carried out in Cook County juvenile detention centers that seems to have positive early findings on the risk of readmission. While in need of further validation, these early signs indicate that CBT is an approach to helping young people stay out of trouble that merits continued use and study.

1 comment:

  1. Hello , Blogger

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