Treatment Programmes

Cognitive Skills Programmes

Why do you think that changing the way an offender thinks may prevent him from reoffending?

He may be able to reflect on his thoughts before he committed a crime and recognise any dysfunctional thoughts and alter these thought patterns so that he doesn’t reoffend.

Cognitive Behavioural Therapy helps to change negative thinking by challenging it. This therapy is extremely popular with individuals who suffer from anxiety and depression and has proven to be very beneficial.

But does it work with offenders? This is what Friendship (2002) sought to find out. Cognitive skills programmes were designed to help offenders rehabilitate by helping them to reflect on their thinking patterns and what it was they were thinking before they committed a crime. The idea was for them to be able to recognise their own thoughts and feelings so that they could avoid committing a crime in the future. Friendship found in 2002 that reoffending rates who received this therapy was 14% lower than those who hadn’t. However another study by Falshaw and Friendship (2003) failed to actually find a significant difference.

These therapies could fail with inmates due to

• Lack of incentive to carry it out (inmates)
• Lack of motivation (inmates)
• Demand characteristics
• Inmate has low IQ
• Inmate has poor literacy skills

A more recent study is that of Cann (2006) who also explored whether such cognitive skills programmes were successful in reducing recidivism and also found no significant difference between groups who received therapy and those who did not.

Cann commented that such programmes had been designed with men in mind and that women responded differently to therapy. It was also suggested that the therapy had not been delivered efficiently.

Anger Management

It is important for prisoners to learn how to manage and control their hostile aggression. Many crimes are committed when the individual is angry and impulsive.

An anger management course that is regularly used in prisons in this country is the CALM programme and this stands for Calming Anger and Learning to Manage It.

• MOTIVATION; helping the prisoner to want to change
• BIOLOGY; helping the prisoner to recognise bodily arousal
• IRRATIONAL THINKING; helping the prisoner to argue against irrational thinking
• COMMUNICATING; helping the prisoner to convey how he feels, to not blame others, etc
• APPLICATION; to apply the skills learned so far to other emotions
• REFLECTION; to reflect on situations in real life that may encourage them to be aggressive and how to rationally to them

When Ireland (2000) assessed whether anger management courses work, a natural experiment was used that compared 50 prisoners who had undergone the CALM therapy and a group who were suitable for the therapy but hadn’t undergone it. They received an interview and completed a checklist as well as a self report questionnaire.

The results of the CALM programme conveyed that the prisoners who had completed the programme considered themselves to be less angry and were rated lower by the prison officers than the control group. It appears there is a short term benefit of such a programmes but we don’t know the long term effects.

Ear Acupuncture

Motivation is greatly lacking in prison which is one of the problems of making talking therapies work for offenders. Ear Acupuncture is a cheap alternative and doesn’t need the prisoner to be highly motivated. Many prisoners have drug difficulties and Ear Acupuncture focuses on this.

Acupuncture involves inserting tiny needles into certain parts of the body

It is used to help the flow of chi which is an energy that flows through the body along pathways. The flow of chi can be blocked and this is when acupuncture can help release it.

It is an ancient medicine and there are over 200 acupuncture points on the ear. Below are the five locations that are particularly linked to drug problems.

• Lung point: helps with breathing and detox
• Kidney point: helps with kidney function
• Liver point: helps the liver repair
• Shenmen point: calms the mind
• Sympathetic point: helps with pain relief

Wheatley (2005) discovered some fascinating results with prisoners receiving acupuncture and a care programme called FOCUS compared to prisoners only receiving the care programme. The prisoners receiving ear acupuncture reported better sleep, more relaxation, overall health improvements and staff also reported that these prisoners communicated better and were calmer. The quantitative data was also impressive with a 70% reduction in drug related incidents in the first 6 months after treatment.

The advantage of this approach is that it treats the person holistically by trying to restore to health the whole person.

What effect could be occurring in this study?

• A - The placebo effect could have taken place whereby the patients believe it is going to work so it does work. This study could have done with a placebo condition.