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Cognitive Behavioral Interventions and Misconduct Behind Bars: A Randomized Control Trial of CBI-CC

NCJ Number
Date Published
72 pages

This study investigated whether evidence-based, cognitive behavioral treatment (CBT) program would reduce misconduct compared to non- or less intensive CBT programming.


To address the problem of institutional conduct, especially violent misconduct, in prisons, this project tested whether an evidence-based, cognitive behavioral treatment (CBT) program would reduce misconduct, including incidents of violent misconduct, and post-release arrests compared to non or less intensive CBT programming. The Delaware Department of Correction (DOC) implemented CBT-based programs in their institutions, which included the Cognitive Behavioral Interventions – Core Curriculum (CBI-CC) Thinking Things Through program developed at the University of Cincinnati. Three programs addressed in this report include Thinking Things Through (TTT), Road to Recovery (R2R), and Reflections. TTT consisted of the instruments and materials of the CBI-CC, whereas R2R and Reflections utilized general CBT skills and techniques. The Center for Drug and Health Studies (CDHS) in collaboration with DOC evaluated the impact of CBC-CC TTT using administrative records and surveys with program participants. Two major goals were identified: evaluating the efficacy of the current CBI-CC Thinking Things Through (TTT) treatment program being administered in all Delaware institutions; and validating the fidelity tool through collaboration with University of Cincinnati. A novel approach utilizing propensity weighting procedures to account for differences between groups was employed successfully in order to conduct the most robust set of analyses possible. The project was able to look across multiple programs and examine the impact on persons who were placed in them through the classification and referral process as it is conducted day-to-day in the DOC providing a much wider view of overall CBT programming than would have been possible under the original design. Findings indicate participation in programming had a significant impact on arrest and appears to have an impact on reincarceration. 

Date Published: January 1, 2024