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Program Profile: Choosing to Think, Thinking to Choose

Evidence Rating: No Effects - One study No Effects - One study

Date: This profile was posted on February 07, 2018

Program Summary

This is a cognitive–behavioral therapy program, consisting of 14 sequential classroom lessons, for high-risk probationers and delivered by probation officers in a community correctional environment. This program was rated No Effects. Results indicate that participants had a statistically significant lower recidivism rate, measured as committing any new offense compared with nonparticipants, however, no statistically significant differences were found across individual offense types.

This program’s rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Description

Program Goals
Choosing to Think, Thinking to Choose (Choosing to Think) is a cognitive–behavioral therapy (CBT) program, designed to reduce recidivism among high-risk offenders, delivered in a community correctional setting. The program curriculum consists of 14 sequential classroom lessons that cover a range of topics, including anger management, dealing with stressful situations, successful management of criminal justice and community correctional interactions, and management of interpersonal and professional relationships. Each of the areas focuses on a particular aspect of behavior or cognition that is considered to be theoretically related to criminal behavior. 
Target Population
Choosing to Think specifically targets individuals designated as high risk of committing a new serious offense (murder, attempted murder, aggravated assault, robbery, or sexual crime) during their probationary period in a community correctional setting.
Program Theory
CBT is a psychological approach to behavior modification that has been used to manage a variety of psychological disorders and more recently applied to treatment of anger, violence, and criminal activity. CBT focuses on bringing about change by modifying the way participants respond to the automatic thoughts and emotional reactions triggered by stressful, external stimuli. Participants are taught to observe, manage, and reform maladapted and antisocial thought patterns and learn new coping skills and cognitive models. In turn, these newly learned approaches may change subsequent behaviors, improve social skills, and increase community integration. 
CBT treatment for criminal activity integrates training focused on interpersonal and social skills, since both are thought to influence the propensity to commit crime. This approach includes reinforcing attitudes that encourage responsible conduct, development of empathy, and assessment of consequences (Beck and Fernandez 1998; Little 2000).
Program Components
The 14 classroom sessions are held on a weekly basis for about 2 hours. Classes operate continuously, with a new block of instruction beginning every 7 or 8 weeks. Each instruction block is divided into three sections, with each containing a maximum of 15 enrolled students. Students have flexibility in choosing the day of the week to attend, but the time of day is fixed, with classes available during the late morning or early afternoon. The coursework is cumulative in nature, and therefore students are only permitted to miss one class in the 14-week sequence. A second absence results in removal from the instruction block, in most cases.  

Students receive an overview of the program, highlighting the need for positive life changes, in weeks 1 and 2. They receive basic information about CBT in weeks 3 and 4, as they are introduced to the relationship between thinking and feeling and behavior. During week 5, they learn about the concepts of choice and consequences or the importance of thinking about options before taking action. Weeks 6 and 7 are designed to help students identify prosocial, achievable goals (i.e., educational aims and securing legitimate employment) and to identify a realistic plan for meeting them. 
A three-session, anger-management block begins in week 8 and fulfills any court-stipulated, anger-management requirement. Week 9 focuses on the differences between anger, aggression, and assertiveness, while week 10 focuses on a plan for dealing with difficult situations. Week 11 highlights the social skills needed for successful community interactions, and week 12 focuses on cognitive strategies to make stressful conversations, including those with probation officers and law enforcement figures, less difficult.
Finally, during week 13, students learn to both plan ahead and develop patterns of behavior that will assist them in continuing to make positive progress. The final class meeting comprises a course review and graduation ceremony (Hyatt 2013). 
Participation in Choosing to Think is considered a mandatory part of supervision during an individual’s probationary period. However, probationers are excused from participation if 1) they are deemed unsuitable for the CBT classroom (due to mental health or language issues), 2) their in-office reporting requirements are less frequent than the weekly class schedule, or 3) if they are scheduled to begin some other form of treatment. If any of these conditions exist, then the offenders are eligible for placement in future classes. To encourage completion, probationers who participate in all 14 weeks of the course and meet all conditions of supervision prior to graduation receive a reduction in their reporting requirement, from four times per month to twice per month (Hyatt 2013).

Evaluation Outcomes

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Study 1
While Barnes, Hyatt, and Sherman (2017) found a significant difference between the probationers in the Choosing to Think program compared with control group probationers with regards to reoffending for all offense types, there was no significant differences on measures of reoffending for serious, violent, nonviolent, property, and drug offenses. Overall, the preponderance of evidence suggests the program did not have the intended effect on participants. 
Reoffending – Any Kind of Offenses
There was a small, statistically significant difference in the prevalence of reoffending across all offense types. During the first year after random assignment, high-risk probationers in the Choosing to Think program were less likely to be charged with a new offense (33.7 percent) than the control group (40.5 percent).
Reoffending – Serious Offenses
No statistically significant differences in reoffending of serious crimes were found between the treatment and control groups. 
Reoffending – Violent Offenses
There were also no statistically significant differences in reoffending of violent crimes between the treatment and control groups. 
Reoffending – Nonviolent Offenses
There was a small difference between the treatment group and the control group in nonviolent offending, in that the treatment group was more likely to commit nonviolent offenses. However, the difference was not statistically significant. 
Reoffending – Property Offenses
There were no statistically significant differences in reoffending of property crimes between the treatment and control groups. 
Reoffending – Drug Offenses
There were no statistically significant differences in reoffending of drug crimes between the treatment and control groups.
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Evaluation Methodology

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Study 1
To evaluate the impact of Choosing to Thinking, Thinking to Choose (Choosing to Think) on recidivism, Barnes, Hyatt, and Sherman (2017) used a randomized experimental design to detect significant differences in concentrated measures of reoffending between participants and nonparticipants who were newly assigned to the high-risk unit of Philadelphia, Pa.’s Adult Probation and Parole Department (APPD) during fiscal year 2013.  
Since 2009, Philadelphia’s APPD has used a series of random forecasting models to stratify offenders into three different risk groups: low, medium, or high. The same computer application used for traditional stratification was used for random assignment. For this evaluation, only male probationers who were living in Philadelphia, were forecasted to commit a new serious offense (murder, attempted murder, aggravated assault, robbery, or sexual crime), and were beginning a new instance of supervision with APPD’s high-risk unit were considered eligible. Individuals were randomly assigned to either standard, intensive probation (control group) or to the treatment group, where they received the same supervision intensity while also participating in the program. Additional tests of eligibility for random assignment excluded offenders who were 1) assigned to a high-risk unit within the previous year, 2) placed into the agency’s specialized supervision units (drug treatment, mental health, sex offenders, and domestic violence), and 3) already participating in the city’s Youth Violence Reduction Partnership program, among others. 
Of the 5,492 cases forecasted as high-risk, only 1,289 (23.5 percent) were fully eligible for the study. Of these, 457 were randomly assigned to the treatment group and 447 to the control group. The treatment and control groups were compared across 48 different variables, including age, race, income, presenting charges, prior adult charges, onset age of crime, prior terms of APPD supervision, prior county prison, and prior sentences to incarceration. Participants averaged less than 30 years of age, were primarily African American (72 percent for the treatment group and 73 percent for the control group), tended to come from disadvantaged neighborhoods, with a mean household income at the 29th percentile of all Philadelphia zip codes. Participants also tended to have substantial prior histories of violent offending. Roughly 45 percent of participants were beginning a new term of supervision due to a violent offense, almost all (92.7 percent) had at least one prior violent crime in their adult criminal history, and most (65.4 percent) had been under prior agency supervision and prior stays in county prison (96.1 percent). While random assignment was successful in producing statistically equivalent study groups, only one variable, the prevalence of one or more prior stays in the Philadelphia prison, indicated statistically significant differences: the treatment group was more likely to have more stays than the control group. 
Intent-to-treat analyses and survival analysis were used to evaluate the differences in reoffending (all crimes, serious crimes, violent crimes, nonviolent crimes, property crimes, and drug crimes) between program participants and the control group during the 12 months following random assignment. More than 95 percent of the participating offenders spent at least some portion of the year under supervision, but the majority (69.9 percent) experienced at least one break in continuity of supervision due to factors such as judicial orders into other specialized supervision units, absconding, or local incarceration. Only 63.7 percent of the treatment group experienced a consecutive period of availability required for the 14-week program (in four sequential months). Despite the difficulty of maintaining continuous and consistent supervision conditions for high-risk probationers, a majority of the treatment group (54.7 percent) participated in at least some component of the classroom program within this 1-year period, with 35 percent completing the entire sequence within 12 months of the start of their supervision.
Data for the analysis was drawn from ADDP’s supervision records, which were maintained by probation officers assigned to four high-risk units included in the study. All participants receiving the Choosing to Think program were assigned to a separate unit, while those in the control group were supervised by three other high-risk units (which included offenders not in the study). Although there were some variations between officers and units, the same supervision protocol applied to all units. No subgroup analyses were conducted.
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There is no cost information available for this program.
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Implementation Information

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The program is designed by experienced psychologists, but implemented by probation officers. There are three officers or facilitators assigned to the program at all times. Each facilitator participates in 100 hours of rigorous training, which includes written examinations in the principles of CBT and teaching observations, to ensure an understanding of the curriculum and the cognitive skills being taught. To ensure that there is no significant deviation from lesson plans, psychologists conduct regular observations during the early stages of the program (Barnes, Hyatt and Sherman 2017).
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Evidence-Base (Studies Reviewed)

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These sources were used in the development of the program profile:

Study 1
Barnes, Geoffrey C., Jordan Michael Hyatt, and Lawrence W. Sherman. 2017. “Even a Little Bit Helps: An Implementation and Experimental Evaluation of Cognitive-Behavioral Therapy for High-Risk Probationers.” Criminal Justice and Behavior 44(4):611–30.
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Additional References

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These sources were used in the development of the program profile:

Beck, Richard, and Ephrem Fernandez. 1998. "Cognitive-Behavioral Therapy in the Treatment of Anger: A Meta-Analysis.” Cognitive Therapy and Research 22(1):63–74.

Hyatt, Jordan Michael. 2013. The Impact of Cognitive-Behavioral Therapy on the Recidivism of High Risk Probationers: Results from a Randomized Trial. PhD diss., University of Pennsylvania.

Little, Gregory L. 2000. “Cognitive-Behavioral Treatment of Offenders: A Comprehensive Review of MRT Outcome Research.” Addictive Behaviors Treatment Review 2(1):12–21.

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Related Practices

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Following are practices that are related to this program:

Cognitive Behavioral Therapy (CBT) for Moderate- and High-Risk Adult Offenders
This is a problem-focused, therapeutic approach that attempts to help people identify and change dysfunctional beliefs, thoughts, and patterns of behavior that contribute to their problems. For adult offenders, CBT teaches them how cognitive deficits, distortion, and flawed thinking processes can lead to criminal behavior. The practice is rated Promising for reducing crime committed by moderate- and high-risk adult offenders.

Evidence Ratings for Outcomes:
Promising - One Meta-Analysis Crime & Delinquency - Multiple crime/offense types
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Program Snapshot

Age: 18+

Gender: Male

Race/Ethnicity: Black, Other

Geography: Urban

Setting (Delivery): Correctional, Other Community Setting

Program Type: Cognitive Behavioral Treatment, Group Therapy, Probation/Parole Services, Violence Prevention

Targeted Population: High Risk Offenders

Current Program Status: Active