An article in The Denver Post (“Arrest. Release. Repeat,” Nov. 2) quoted a national researcher on the effectiveness of cognitive behavioral mental health treatment for inmates.
After 23 years of treating offenders in Colorado, it is clear that one treatment approach does not fit all, as the researcher would have us believe. That treatment is only one approach to address criminal behavior. It is not a panacea, and is not appropriate for all offenders.
An effective relationship between client and therapist is a positive indicator for successful treatment. If you don’t trust your therapist and develop an effective alliance with your client, the client will not work with you. Sitting in a psycho-educational cognitive behavioral group does little to foster a positive therapeutic relationship, thus limiting its effectiveness.
However, “cognitive” and “behavioral” are the buzz words in the correctional field. Probation officers, parole officers and halfway house case managers who have little if any training in mental health seek out providers who provide such treatment.
Correctional staff “own” the client. Group treatment is the primary approach not because it is the most effective treatment, but because it costs less. Clients are not screened for their appropriateness for groups, even when another treatment might be more effective.
When inmates are placed on parole, they often repeat treatment programs similar to those they attended in prison. This reduces the motivation for clients to participate. Placing clients in the wrong treatment programs with the wrong approach does not increase community safety. It reduces it by frustrating and angering clients, thus increasing the risk they will become oppositional, defiant and act out.
Here’s the kicker: Taxpayers are financing this broken system of community treatment. However, it is clear that this money is being wasted, as recidivism rates have not decreased. Also, the best and brightest in the field of mental health are leaving corrections because they are not able to treat clients as they believe they should be treated.
So what works?
A flexible and tailored approach that identifies specific treatment issues and the modalities they can best be addressed in.
Individual weekly counseling where the needs of clients can be addressed in depth.
Group treatment that can augment individual treatment when the client has been assessed as capable of utilizing such an approach.
Job-seeking skills.
Case-management services to help clients obtain support services including medical care.
By utilizing the above “integrated” approach, the whole individual is being treated.
Yet we waste money on an outdated and inefficient system. When will we learn?
Robert Wolfsohn of Aurora is a licensed clinical psychologist in private practice.
