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Compendium 2000 on Effective Correctional Programming

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CHAPTER 11

Treatment and Intervention Approaches with Families

CLAUDIO VIOLATO, MARK GENUIS, and ELIZABETH ODDONE-PAOLUCCI1


This chapter deals primarily with intervention and treatment programs in corrections. It also provides a brief overview of theories of causes, in particular criminality, family, social and psychological theories. The focus of the intervention programs is on tertiary prevention, particularly for youth already convicted of crimes, with the objective of reducing rates of recidivism.2

THEORIES OF CRIMINALITY

Social control theory

Social control theorists posit that socialization is the process by which people become bonded to family, school, and law (Hirschi, 1969). In this theory, conformity is explained through socialization and bonding between the individual and society (Wiatrowski et al., 1981). This is a process whereby individuals develop commitment to society leading to some form of internal control. This bonding consists of four main elements: attachment, commitment, involvement, and belief. The stronger the bond, the less likely the person will demonstrate criminal behaviour. Social control theory maintains the importance of conventional value attachments as instrumental in the prevention of juvenile criminality, and the weakening of such attachments is likely to induce involvement in criminal behaviour.

Subculture theory

In subculture theory, individuals are socialized into violating the law as a result of their exposure and affiliation with deviant influences. The greater the youth's association with his criminal peers, the greater the possibility of differential association with them, and therefore with definitions conducive to criminality. The most commonly stressed variables in subculture formulations are criminal associates and peer approval for criminality. It follows that if criminality is committed in accordance with values and attitudes learned from peers, such behaviour should be exhibited by individuals whose friends approve of such illegal activity.

Segrave and Hastad (1985) did find criminal behaviour to be positively associated with both criminal associates and peer approval for criminality. They found that criminal companions are related to committing criminal acts, regardless of the level of attachment or of conventional attitudes for women and, especially for men. The apparent overpowering strength of peer involvement is disputed in the findings of Williamson (1978), who found that lack of appropriate activities for youth is a major determinant of criminality.

Strain theory

One of the postulates of Strain theory (Brennan, Huizinga & Elliott, 1978) is that the greatest amount of criminality is among people of lower socioeconomic status. Such a position states that there is a perception within the individual that sees only limited access to legitimate opportunities. The motivation to deviate is enhanced when individuals accept and internalize culturally formulated goals of success and perceive legitimate avenues for achieving them as severely limited. Thus criminal individuals see themselves, more so than their middle or upper class con-temporaries, as being blocked from reaching their goals. This theory postulates that such members of society are “forced” to deviate in order to achieve goals they are not able to attain through legitimate channels.

Family systems theory

There are two basic emphases in family-systems: Learning in the family focusing on modelling, child-rearing and dysfunctional relationships within the family, and Lack of affectional bonds, especially between parent-child (Henggeler, 1998).

In the first variant of family systems, the parents themselves model dysfunctional and criminal behaviour. In these families, one or more parent may be a criminal and thus pass this on to their children. Moreover, these parents have difficulty in their child-rearing practices employing harsh, punitive, and violent discipline strategies. These children have little opportunity to model self-control, restraint and moral reasoning. There are four aspects of criminality in parents that have failed to provide to their children: 1) house rules, 2) adequate parental monitoring of behaviour, 3) proper effective contingencies, and 4) adequate crises and problem solving.

The second variant of family-systems revolves around the endemic difficulty of parent-child relationships. These negative attachments are thought to create rejection in the children as well as a lack of responsibility, poor concern for consequences, impulsive behaviour and inability to learn from experience. Stott (1982) in a 5-year longitudinal study of 102 offenders, and a 10-year follow up of 700 juvenile offenders, concluded that 93 percent of criminal acts stemmed from a “breach of affectional bond between parent and child” (p. 318). The insecure attachment had been communicated to the adolescent by threatened rejection, loss of the preferred parent with no substitute, the mother was undependable, and the adolescent feared the loss of the preferred parent.

A further complicating factor in family systems is stress that can happen due to breakdown: illness, death, unemployment, abandonment, poverty, and difficulties of general living. These stresses create discord that threatens family existence and lead to maladaptive emergency response, including criminality.

Summary of theories of criminality

The major theories of criminality and statements about their relative validity are summarized in Table 11.1. It can be seen that family systems theory is indicated as having the highest validity because current data and evidence provide strong support for it. Strain theory received the poorest endorsement of validity.

TABLE 11.1 Summary of major theories of criminality and their relative validity based on current data

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Theory Explanation Validity
.

Social Control Theory

Criminality is caused by individual characteristics that might be inherited, developed or learned (e.g., genetic disorders, psychiatric problems, learning disabilities). Substantial evidence supports this view, though critics argue that this theory is not sufficient to fully explain criminality by itself
.
Subculture Theory Criminality is caused when the individual fails to become properly socialized to accept the values of family, school, law and morality. Juveniles are socialized into violating the law as a result of exposure to and affiliation with deviant influences. Evidence indicates that criminal behaviour is positively associated with criminal associates and peer approval for criminality. These, however, probably reflect antecedents to criminality rather than its cause.
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Strain Theory Criminality is caused by chronic poverty and low socioeconomic status. There is a definite relation between poverty and criminality but this is probably a correlation rather than a cause.
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Family Systems Theory Children learn dysfunctional criminal behaviour from their parents and/or endemic difficulties of parent-child relationships that create developmental pathology in children such as criminality. This view is one of the most currently accepted causes of criminality although substantial empirical work is still required.
.

Criminality is associated with numerous variables and is explained by several theories. Given the plethora of explanations and variables, complex causal models will undoubtedly be required to delineate the factors that are central to criminality. Such results from complex studies may demonstrate the multidimensional nature and causality of criminality and thus support the social-ecological model of behaviour. Thus a viable model of criminality is one that includes multiple pathways from the key systems in which youths are embedded, particularly the family.

TREATMENT AND INTERVENTION APPROACHES

The role of mental health services

The multidimensional nature of criminality requires the intervention of many agencies. Because mental health professionals have expertise in family systems and/or behavioural treatment approaches, their contribution to the effort of reducing violence among adolescents can be considerable. Many offenders may be receiving treatment from other professional sectors (private practice psychiatrists and psychologists, hospitals, counsellors and psychologists). Even so, there is unquestionably a need for further involvement of mental health services with offenders.

Figure 11.1 indicates an ideal relationship between public health (Mental Health) and the criminal justice systems in dealing with criminality. Public health strategies are aimed at understanding, reducing, and preventing risk factors to criminality not merely to responding to specific episodes. Multi-institutional and multi-disciplinary models that change behaviour, knowledge and attitudes are central to such an approach. Mass media, health care institutions, public schools, businesses and health fairs, are all sources of education, information and intervention. Once criminality is understood as a health problem, effective interventions may emerge.

Anyone who wishes to replicate a particular program in their own jurisdiction must be certain that their clients are similar to those involved in the initial implementation of the intervention. Moreover, care must be taken to secure the services of the appropriate practitioners and resource allocations. Failure to do so will not only lead to unsuccessful implementation, but may be a disservice to the clients as well.

The discussion surrounding intervention has frequently been characterized by the belief that “nothing works” when dealing with offenders. This incorrect depiction of the effects of intervention has been a serious barrier to the implementation of successful intervention. If practitioners and politicians believe that nothing can be done, the drive for conceptualizing effective service delivery for offenders is lost and the problems continue unabated.

Figure 11.1 Ideal relationship between public health and criminal justice systems for preventing criminality*

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diagram
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*Adapted from Prothow-Stith and Spivak (1992), p. 807

 

INTERVENTION WITH FAMILIES OF OFFENDERS

A basic assumption of family therapy is that problems are closely associated with dysfunctional family interactions and consequently, treatment must ameliorate problematic family relations.

Behavioural Parent Training and Functional Family Therapy are the two most promising approaches to family therapy for offenders. The aim of Behavioural Parent Training is to assist parents in accurately monitoring child behaviour and to pro-vide consistent reinforcement for positive behaviour and punishment (e.g., loss of privileges) for negative behaviour (Henggeler, 1998). To date, such approaches have tended to be more effective with adolescents.

Consistent with family systems approaches, Functional Family Therapy assumes that criminality reflects maladaptive interactions with the family. A variety of techniques are used with this approach including contingency contracting and training in communication skills among family members. To this point this type of intervention appears to be most effective with more moderate young offenders.

Wade et al. (1977) described and evaluated an intensive family crisis intervention program. The intervention strategies included five components:

  1. Immediate referrals to capitalize on the motivation of the family crises situation;
  2. Intensive but time-limited outreach services in the young offender's home;
  3. A focus on the family as a system which was functioning maladaptively;
  4. Both male and female counselling teams of the same ethnic origins of the family; and
  5. Reliance on adjunct agencies and professionals as needed. Half of the 153 families served over a two-year period had experienced some degree of family disorganization such as divorce, separation, remarriage, adoption or death of a natural parent.

The program was considered a success based on both recidivism data and goal attainment data (Wade et al., 1977). After one year, the recidivism rate was low (14.75%), and only 1 of 66 adolescent siblings came before the court during the one year follow-up. A number of goals were also assessed and found to improve substantially, including improved family communications, increased school attendance, reduced runaways, and increased acceptance of responsibility in the family.

In a family preservation program called Homebuilders, Haapala and Kinney (1988) found that 87% of 687 high-risk status offenders avoided out-of-home placement for 12 months after service intake. The program included a multiplicity of treatment orientation including behaviour modification in the natural environment, crisis intervention theory, client-centered therapy, value clarification, assertiveness training, and multiple-impact therapy. As the program evolved over a 15-year period, additional treatment interventions such as Rational Emotive Therapy were added. This program has been so successful that by 1987, 28 state programs based on the Homebuilder model that began in Washington State in 1974, have been developed.

Over the past decade it has become increasingly clear that the treatment of choice for most offenders is family therapy (Gordon & Arbuthnot, 1988). Professionals are often in private practice and are very expensive. Therefore, there is an emerging trend to use paraprofessionals such as caseworkers, teachers, ministers, probation officers, students, parents and volunteers. Because paraprofessionals are much less expensive than professionals, family based intervention can be expanded. In a systematic review of the literature comparing the effectiveness of paraprofessionals to professionals, Gordon and Arbuthnot concluded that paraprofessionals achieve results equal to or superior to those achieved by professionals. Obviously, the use of paraprofessionals should be explored further given these positive results.

Community-based programs

Although the stress is on including the family of the offender in the treatment program, for many offenders it is unrealistic to expect that it will be possible to involve the family. Clearly, there is a need for an effective program that could be applied in a community that does not necessitate direct intervention with the offender's home.

“Community based programs” is a general term that encompasses a plethora of activities and projects. These include placing offenders in individual foster homes, establishing group homes for offenders, establishing community centres which provide athletic, recreation and cultural activities, and public works projects (tree trimming, litter removal, playground maintenance, etc.). Skills based programs involve vocational training and job placement, tutoring, and educational upgrading. Social support includes the buddy system as well as discussion and support groups. Finally, community based prevention measures include mass media campaigns and the development and implementation of school based curricula.

The Violence Prevention Project of the Health Promotion Program for Urban Youth (Prothrow-Stith, Spivak, & Hausman, 1987), represents an effort to reduce the incidence of criminal behaviour and associated social and medical hazards for adolescents at the community level. This program is based on individual behaviour modification through risk communication and education. In consultation with a host of individuals from various therapeutic services, a curriculum was developed and became the central material for a grade 10 health class. The program offers support for the value of education in attempting to reduce criminality in one of the most demanding communities for the adolescent: the community school.

In another innovative community program, O'Donnell et al. (1979) employed a “buddy system” where adult paraprofessionals were paired with offenders who had been referred by public schools for behaviour and academic problems. The main tasks of the buddies were to help reduce the presenting behaviour problems and to help increase the adolescents' school attendance and academic performance through contingency management using praise, social support, and money as reinforcers. The primary purpose of this buddy system, however, was the prevention and remediation of criminal behaviours. All of the subjects had committed major criminal offences.

Results of the O'Donnell et al. study showed that of 335 offenders in the buddy system group, they experienced 22.3% fewer arrests after three years than did those in a control group. The overall arrest rate was 20.7%, though the over-all rate ranged form 10.8% to 81% when recent offence history, sex, and type of crime committed was considered. There were no data provided on school attendance information or achievement in the study, though O'Donnell et al. pronounced the buddy system a success solely on re-arrest rates.

Many other community-based programs have been shown to be successful in reducing re-arrest rates and generally improving the conduct and behaviour of the young offenders. Walter and Mills (1989), for example, described a successful program where offenders were placed in jobs and monitored both by professionals and employers. Henggeler (1989) has described a number of community based programs including public works projects, group homes and vocational training which have been successful with young offenders. Finally, Fabiano et al. (1990) have described skills based programs (knowledge and social) which has reduced recidivism in offenders, and Quigley et al. (1992) are attempting to implement a computer-assisted vocational life skills program for offenders in Newfoundland in hopes to reduce recidivism rates.

Multisystem interventions

The essence of multisystem interventions is the recognition that there are multiple determinants of anti-social behaviour. The context of intervention from this perspective is the various systems in which the adolescent functions including the family, peers and school. One type of intervention is the Multisystemic Therapy. This type of intervention is a family-based approach that emphasizes adolescent cognitive variables and the youth's and family's relations with extra-familial systems. To date several studies have shown that multisystemic therapy is effective in changing the types of family interactions which are associated with criminality, decreasing the youth's association with deviant peers and reducing the overall rate of adolescent behaviour problems.

Vocationally oriented psychotherapy is another form of multisystem intervention in which the therapist provides both intensive psychotherapy and assistance in obtaining educational and vocational placement. Follow-up studies indicate that adolescents receiving this approach evidenced better social adaptation to family life, employment success, and legal difficulties than did comparison boys (Henggeler, 1998).

Child Advocacy Treatment is another form of multisystems intervention which uses paraprofessionals (e.g., university or college students) as intervention agents with juvenile offenders. Non-professionals use behavioural contracting techniques and child advocacy to intervene in a wide range of problem areas (e.g., peer, family, school). Preliminary outcome data suggest that this approach is very promising (Gordon & Arbuthnot, 1988).

Effective treatments of criminality must recognize the multiple determinants of adolescent anti-social behaviour. All three interventions described above address individual and systemic characteristics, are pragmatic and problem-focused, are conducted in a variety of community settings, and are as flexible and intensive as necessary.

SUMMARY AND CONCLUSIONS

By way of summary, the treatment and intervention approaches together with their relative efficacy are compiled in Table 11.2. As can be seen from Table 11.2, family interventions and multi-systems intervention are rated as most effective.

TABLE 11.2 Summary of treatment and intervention approaches for offenders and their relative efficacy

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Treatment or Intervention Explanation Validity
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Family Intervention Since the families of offenders are frequently dysfunctional, this approach seeks to ameliorate this and reduce recidivism and improve family relations. Well-implemented and executed family interventions have proven to be highly successful in most of their goals. Unfortunately, families of some offenders will simply refuse to participate in any program.
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Community Programs These include a plethora of activities and projects such as group homes, public works, vocational training, educational upgrading, community centre activities, etc. The success of these has been mixed. It depends largely on the type of programme, the needs of the juveniles, and the resources of the program.
.
Multisystem Intervention Multisystemic therapy (family based), vocationally oriented psychotherapy, and child advocacy treatment are the main types. These are broad-based treatment approaches that intervene at multiple levels of the youth's ecology (e.g., school, family, peers etc.). Preliminary outcome studies indicate that well implemented and intensive programmes show promising results. More research is required to establish efficacy, however.
.

By the mid-1970s researchers and policy makers had become pessimistic about the efficacy of correctional treatment in general. Research and outcome studies since that time, however, have shown that many carefully designed and executed programs have been successful. Perhaps the most successful and promising are family based interventions and multisystem interventions. Other interventions such as diversion programs, community based programs, and even some in correctional institutions have demonstrated success. Some of these programs can be very expensive because of the intensive use of professionals in direct con-tact with the offender, the family, peers and so on. Fortunately, an emerging trend has been to use paraprofessionals under the supervision of professionals. More fortunately still, outcome studies and evaluations have shown that paraprofessionals are generally as effective or more effective than professionals in dealing with offenders (Gordon & Arbuthnot, 1988).

As the above program descriptions indicate, there are a variety of interventions which have been successfully implemented with offenders. The key to successful implementation is to deter-mine the specific needs of an offender and then to match those needs to the appropriate program. Failure to do this will likely result in the failure of the intervention.


1 National Foundation for Family Research and Education

2 For more details on tertiary prevention, see Chapter 1, Defining Correctional Programs by James McGuire


REFERENCES

Brennan, T., Huizinga, D., & Elliott, D. S. (1978). The social psychology of runaways. Lexington, MA: DC Heath.

Fabiano, E., Robinson, D., & Porporino, F. (1990). A preliminary assessment of the cognitive skils training program pilot project. Ottawa, ON: Correctional Service of Canada.

Gordon, D. A., & Arbuthnot, J. (1988). The use of paraprofessionals to deliver home-based family therapy to juvenile delinquents. Criminal Justice and Behavior, 15, 364-378.

Haapala, D. A., & Kinney, J.M. (1988). Avoiding out-of-home placement of high-risk status offenders through the use of intensive treatment. Criminal Justice and Behaviour, 15, 334-348.

Henggeler, S. W. (1989). Criminality in adolescence. Newbury Park, CA: Sage.

Henggeler, S. W. (1998). Delinquency. In M. Fisher, K. Schonberg, & E. Alderman (Eds.), Comprehensive adolescent health care. (2nd ed). New York, NY: Mosby.

Hirschi, T. (1969). Causes of criminality. Berkeley, CA: University of California Press.

O'Donnell, C. R., Lydgate, T., & Fo, W. S. (1979). The buddy system: Review and follow-up. Child Behaviour Therapy, 1, 161-169.

Prothrow-Stith, D. (1989). Interdisciplinary interventions applicable to prevention of violence and homicide in black youth. In Surgeon General's Workshop on Violence and Public Health DHHS (pp. 35-43). Pub. No. HRS-D-MC 86.1. Washington, DC.

Prothrow-Stith, D., & Spivak, H. R. (1992). In S. B. Friedman, M. Fisher, & S.K. Schonberg (Eds.), Comprehensive Adolescent Health Care (pp. 806-8 1 1). St. Louis, MO: Quality Medical Publishing.

Prothrow-Stith, D., Spivak, H. R., & Hausman, A. J. (1987). The violence prevention project: A public health approach. Science, Technology and Human Values, 12, 67-69.

Quigley, M., Jeffery, G. H., & McNutt, M. (1992). Computer-assisted vocational life skills program for offenders. Canadian Journal of Counselling.

Segrave, J., & Hastad, D. (1985). Evaluating three models of criminality causation for males and females: Strain theory, subculture theory, and control theory. Sociological Focus, 18, 1-17.

Stott, D. (1982). Criminality: The problem and its prevention. New York, NY: SP Medical and scientific Books.

Wade, T. C., Morton, T. L., Lind, J. E., & Neuton, R. F. (1977). A family crisis intervention approach to diversion from the juvenile justice system. Juvenile Justice Journal, 28, 43-51.

Walter, T. L., & Mills, C. M. (1989). A behavioural-employment intervention program for reducing juvenile delinquency. In J. S. Stumphauzer (Ed.), Progress in behavior therapy with delinquents. Springfield, IL: Charles C. Thomas.

Wiatrowski, M. D., Griswold, D. B., & Roberts, M. K. (1981). Social control theory and criminality. American Sociological Review, 46, 525-541.

Williamson, H. (1978). Choosing to be a criminal. New Society, 9, 333-336.

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