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Cognitive-Behavioral Treatment for Antisocial Behavior in Youth in Residential Treatment

NCJ Number
Bengt‐Åke Armelius ; Tore H. Andreassen
Date Published
October 2007

The authors of this paper report on their investigation into the effectiveness of cognitive-behavioral therapy, concluding that there is no evidence that the results of CBT are better than those of alternative treatments; they discuss their objectives, search methods and selection criteria, data collection and analysis, and results.


In this paper, the authors’ primary objective was to investigate the effectiveness of cognitive-behavioral therapy (CBT) in reducing recidivism of adolescents placed in secure or nonsecure residential settings, and a secondary objective was to see if interventions that focus particularly on criminogenic needs are more effective than those with a more general focus on cognitions and behavior. The authors searched a number of databases and they also contacted experts in the field concerning current research. The authors included randomized controlled trials as well as studies with nonrandomized comparison groups. Participants had to be young people aged 1222 and placed in a residential setting for reasons of antisocial behavior. Two reviewers independently reviewed 93 titles and abstracts; 35 fulltext reports were retrieved and data from 12 trials eligible for inclusion were extracted and entered into RevMan. Results were synthesized using a random effects model, due to the significant heterogeneity across included studies. Results are reported at six, 12, and 24 months posttreatment, and presented in graphical (forest plots) form. Odds ratios are used throughout, and intentiontotreat analyses were made with dropouts imputed proportionally. Pooled estimates were weighted with inverse variance methods and 95 percent confidence intervals were used. The results for 12 months followup show that although single studies generally show no significant effects, the results for pooled data are clearly significant in favor of CBT compared to standard treatment with an odds ratio of 0,69. The reduction in recidivism is about 10 percent on average. There is no evidence of effects after six or 24 months or when CBT is compared to alternative treatments. The authors conclude that CBT seems to be a little more effective than standard treatment for youth in residential settings. The effects appear about one year after release, but there is no evidence of more longterm effects or that CBT is any better than alternative treatments. Publisher Abstract Provided