Crane M.A.J., Blud L.
British Journal of Forensic Practice: 2012, 14(1), p.49–59.
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From the early 2000s cognitive-behavioural group therapy programmes have been relied on to improve the anti-offending record of UK prisons and probation services, but evidence has been scarce and generally negative. This prison study at least suggests that one such programme does promote the intended psychological changes.
Summary Many British prisons offer the Prisoners Addressing Substance Related Offending (P-ASRO) programme, a cognitive-behavioural intervention intended to reduce crime by helping prisoners for whom this is a risk factor overcome their dependence on substance use. During 20 two-hour group sessions to be delivered over six weeks, the programme aims to enhance motivation to change, strengthen self-control, develop strategies to avoid relapse to problem substance use, and encourage lifestyle change to reduce the risk of a return to substance use and offending. It is intended for prisoners with a low to medium severity of dependence on substance use.
The featured study set out to test the impact of the programme on some of the psychological processes it targets as a means of reducing substance use and crime. It used data collected anonymously from 81 male inmates in a prison in England who had completed Another nine had started the programme but not completed it, and for another six there was no record of their severity of dependence. the P-ASRO programme, the only one run by the prison to address substance use problems. They completed psychological assessment questionnaires before starting the programme and after completing it. Before the programme a standard questionnaire assessed their severity of dependence; 74 of the 81 prisoners scored as highly dependent and seven as low to medium, meaning that most would have been considered too highly dependent to be suitable for the programme.
The study reported changes from before to after the P-ASRO programme in assessments of:
Locus of control The extent to which individuals believe that they can control events that affect them.
Impulsiveness The tendency to act without planning and on the spur of the moment and to be unable to sustain focus on the task in hand.
Social problem solving An individual's problem-solving strengths and weaknesses; whether they approach problems positively and rationally.
Stage of change An assessment of whether in relation to a particular issue (in this case, substance use) someone is not yet contemplating change, considering it, taking action, or maintaining the changes they have made.
On all four measures the prisoners had substantially improved. There were statistically significant improvements in the degree to which they felt in control of their lives and in their approaches to problem solving, and a reduction in the tendency to behave impulsively. Before the programme just 25% of the prisoners were taking steps to change their substance use habits, but afterwards 86% were doing so, generally having progressed from merely contemplating change. In no case was the degree of improvement related to how severely dependent the prisoner had been before the programme started.
The findings of this study indicate that the P-ASRO programme may have a positive impact on key areas such as problem solving and self-control likely to affect pro-social behaviour change, and that it does so regardless of how severely dependent the prisoner was before the programme. After the programme, completers also were also more motivated to take action to change their substance patterns.
Improvement on the locus of control measure suggests the prisoners developed a greater sense of self-efficacy and belief in their ability to change, found in studies to be predictive of behaviour changes which minimise the risk of relapse. Impulsivity improvements suggests the offenders became more reflective in their thoughts and related actions, so possibly less likely to revert to drug use and more likely to consider the long-term consequences of their substance use. More positive problem-solving attitudes and better skills should enable offenders generate more pro-social solutions to problems and generally improve their problem-solving abilities. The stage of change assessments suggest that the P-ASRO programme may have motivated participants to take action towards achieving a lifestyle free of problem substance use.
However, the study could not assess whether these changes in the psychological processes presumed to generate substance use and crime actually did lead to longer term reduction in drug-related offending, nor whether users of different substances or polydrug users responded more or less well to the programme. Neither was there a control A group of people, households, organisations, communities or other units who do not participate in the intervention(s) being evaluated. Instead, they receive no intervention or none relevant to the outcomes being assessed, carry on as usual, or receive an alternative intervention (for the latter the term comparison group may be preferable). Outcome measures taken from the controls form the benchmark against which changes in the intervention group(s) are compared to determine whether the intervention had an impact and whether this is statistically significant. Comparability between control and intervention groups is essential. Normally this is best achieved by randomly allocating research participants to the different groups. Alternatives include sequentially selecting participants for one then the other group(s), or deliberately selecting similar set of participants for each group. group of similar prisoners who did not go through the programme against which to benchmark the observed changes, and there was no way to adjust the results for factors which might have affected them such as the prisoner's age or risk of reconviction. Also, a few prisoners who did not complete the programme were excluded from the sample. Had they been included, average degrees of improvement might have been lower.
commentary The results of this study at least suggest that the P-ASRO programme does not have counterproductive impacts; when like-minded people are brought together there is a risk that the group will reinforce the features they share, in this case, a tendency to criminogenic substance use. Regarding positive impacts, as the authors point out, it is impossible to say whether the changes they observed would have happened anyway, even without the programme, and whether they will translate in to less crime and substance use on release. On this score studies of similar programmes, and in Britain of the equivalent programme for offenders on probation, have not been promising ( below). However, the situation in prison is very different from that outside; in its favour, it seems many more prisoners than probationers complete the programmes, giving them a chance to have an impact, but motivation gained in prison is often of little consequence once the offender is released. It is then particularly disappointing that despite the thousands of prisoners who must have completed these programmes and the chance to match these to officially held reconviction records, it seems no such data has ever been collated and published.
P-ASRO is based on the ASRO programme for offenders serving community sentences outside prison, results from which have not been promising. In its 2008–2011 national drug strategy for offenders, the National Offender Management Service referred to research showing that re-offending rates fall by almost 7% for offenders placed on ASRO-type anti-offending programmes. This may refer to an unpublished Home Office evaluation Hollis V. Reconviction analysis of programme data using Interim Accredited Programmes Software (IAPS). London: RDS NOMS Research and Evaluation, 2007. not specific to the ASRO or P-ASRO programmes and which lacked a comparison group. Instead it compared predicted reconviction rates for offenders referred to programmes like ASRO with their actual convictions. The results appeared generally positive. Compared to a predicted rate of 61%, just 55% of all offenders were reconvicted within two years, while the reconviction rate for those completing a programme was 38% compared with a predicted rate of 51%. Though in the 'right' direction, the design of the research means its results cannot be relied on as indicating that the programmes reduced offending.
Set against this possibly positive finding are several studies which produced negative findings. Among these is British study which found that even the minority of offenders who completed an ASRO programme were no less likely to be reconvicted within the following year than similar comparison offenders. When from year 2000, ASRO-type cognitive programmes for offenders were being rolled out in Britain, an evaluation of their impact on offenders on probation found After other variables which might have influenced the findings had been taken in to account. no reduction in reconviction rates compared to offenders not placed on these programmes. There was, however, the familiar low level of reconviction among the minority who had completed the programmes, an effect which might have been due to factors which would have improved their prospects regardless of the programme, such as their motivation to change, ability to do so, and their stability. Among these programmes was the prototype ASRO, trialled on 62 offenders of whom 21% had completed it. Results from the ASRO paralleled those of the cognitive programmes in general.
Non drug-specific cognitive skills programmes also have a poor record in British prisons. A Home Office study including 2195 adult male offenders who had participated in one of two such programmes between 1998 and 2000 found they were no less likely than matched prisoners to be reconvicted over the next two years. A year after release prisoners who had completed one of the programmes (Enhanced Thinking Skills) were less likely to be reconvicted, possibly an artefact of their being more motivated or in a better position to avoid recidivism regardless of programme completion. But even this effect had disappeared by two years after release.
More generally, a review of studies which had randomly allocated offenders in or out of prison to anti-offending programmes found two which had evaluated ASRO-type cognitive skills approaches. These created no statistically significant gains on measures indicative of drug use or crime. Even when in a controlled study a cognitive programme has been found effective, this has not necessarily been maintained in a larger scale roll-out. In British prisons in the 1990s, early cognitive skills programmes aimed generally at tackling criminogenic attitudes and thought patterns at first evaluated positively but later the results were not replicated. Interventions for offenders are, it has been argued, highly context-specific; what works in one culture at one time may be ineffective in other settings and at other times.
P-ASRO and ASRO are among the programmes accredited by the Correctional Services Accreditation Panel for England and Wales. The panel's report for 2010–2011 notes that both will be replaced by a new programme, Building Skills for Recovery. By the last quarter of 2011–12, 21 prisons in England and Wales were running the new programme while 29 still offered P-ASRO. However, in 2010–2011 the dominant programme was neither of these but one intended for prisoners serving short sentences, on remand, or with just six months left to serve, also it seems to be replaced by Building Skills for Recovery.
In theory the panel required evaluation evidence before selecting programmes to accredit, but in practice this was rarely available within the time scale required to meet government implementation targets. Instead it usually accredited programmes on the basis that they embodied the general principles of 'what works', which (largely on the basis of North American evidence) meant cognitive-behavioural methods, of which ASRO is an example. Evidence on programmes as implemented in the UK derived largely from studies not capable of determining impacts on offending.
Thanks for their comments on this entry in draft to Mark Crane of HM Prison Service, Wolverhampton, England, one of the authors of the featured study. Commentators bear no responsibility for the text including the interpretations and any remaining errors.
Last revised 11 July 2013. First uploaded 03 June 2013
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