COGNITIVE BEHAVIORA TREATMENT REVIEW

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1 COGNITIVE BEHAVIORA TREATMENT REVIEW L CORRECTIONAL COUNSELING INC. GERMANTOWN, TENNESSEE VOLUME 19, #2 SECOND QUARTER 2010 An MRT -Based Cognitive-Behavioral Treatment for First-Time DUI Offenders: Two and Three-Year Recidivism in a Cohort of Davidson County, Tennessee Offenders With a Comparison to Other Programming Table of Contents DUI Treatment Outcomes...1 Juvenile Treatment Court Results with MRT...10 Josephine County, Oregon Community Corrections Profile...13 Cognitive Behavioral Treatment Review & Moral Reconation Therapy (MRT ) News 2028 Exeter Road Germantown, TN (901) FAX (901) [email protected] CCI WEB SITE: MRT WEB SITE: Kenneth D. Robinson, Ed.D. Executive Editor E. Stephen Swan, M.Ed. Editor Katherine D. Burnette, M.S. Associate Editor Copyright 2010 by Correctional Counseling, Inc. All rights reserved. by Gregory L. Little, Advanced Training Associates, Kenneth Baker, Behavioral Treatment Providers, LLC, Deanna McCarthy, Michael Davison, & Julie Urbaniak Driving under the influence of drugs or alcohol (DUI) is one of the most prevalent crimes in America. Approximately 800,000 arrests for DUI are made each year in the United States (FBI, 2008), and Tennessee records 13,000 DUI convictions annually (Kedia, 2008). While statistics vary widely by region, first-time DUI offenders typically comprise about onequarter of annual arrests with prior DUI offenders comprising the remainder (Clements, 2002; Kedia, 2008). Since the early 1960s various educational treatments for drunk drivers have been developed, implemented, and evaluated, but outcome results were largely disappointing until the late 1980s. For example, a review of 48 outcome studies (Foon, 1988) concluded, There is as yet no definitive evidence in the literature that any treatment program for convicted drinking drivers is effective in reducing the subsequent recidivism of those participating. In Foon s evaluation, lack of control groups, inappropriate comparison groups, and poor quality evaluations were noted in the thencurrent research. In the late 1980s a host of new approaches were developed to meet the changing requirements of state laws mandating the consequences of DUI as well as regulations for DUI schools and treatment programs. Many of these newer programs were purely educational while others were cognitive-behavioral in nature. At that time, cognitive-behavioral approaches were developed from psychological theory and adapted to specific offender groups (Little, Robinson, Burnette, & Swan, 2010). One notable program is Moral Reconation Therapy (MRT ), which was first implemented in 1985 in a Tennessee prison (Little & Robinson, 1988). MRT was initially utilized with felony drug offenders and was then adapted to a newly formed alcohol treatment program for inmates serving sentences for multiple DUI offenses. Nationwide DUI rearrests and reincarceration data of the MRT-treated offenders was tracked for a full ten years after the participants release, with the MRT-treated offenders showing significantly lower recidivism in each study. One year after release, 115 MRTtreated offenders (averaging 4.4 prior DUI convictions) showed an 8.7% rearrest rate

2 2 CBTR Second Quarter 2010 for DUI or other drug charges (Little & Robinson, 1989). After two years, the recidivism rate of the initial 115 treated offenders was 10.4% (Little, Robinson, & Burnette, 1990). At three years, the recidivism had increased to 18.3% (Little, Robinson, & Burnette, 1991; Little, Robinson, & Burnette, 1992). By years 5 to 6, 40% of the treated participants had been reincarcerated as compared to 52.3% of nontreated controls (Little, Robinson, Burnette, & Swan, 1995). At the 10-year data collection point, 44.35% of the MRT-treated group had been reincarcerated as compared to 61.5% of nontreated controls (Little, Robinson, Burnette, & Swan, 1999). These results received wide publicity (Little & Robinson, 1990; Little, Robinson, & Burnette, 1992; Robinson, 1994). MRT is a workbook-based cognitive-behavioral program now widely employed in criminal justice in 48 states and several countries. The program is used in a host of drug courts, DUI courts, and other community corrections agencies and has received official designation as a Nationally Recognized Evidence-based Program and Practice (NREPP) by the Federal Substance Abuse and Mental Health Administration (SAMSHA). The program is typically conducted in weekly sessions where participants process homework in a group setting over an average of 30 to 35 group meetings (Little, Robinson, Burnette, & Swan, 2010). However, because the program takes longer than 12 hours, it has not been employed for first-time DUI offenders except in special cases and in specialized courts. This is because most states require firsttime DUI offenders to only complete a 12-hour DUI or safety school, which typically includes basic alcohol and drug education, laws and regulations, and other issues. MRT s Adaptation to First-Offender DUI Schools While numerous DUI school curricula are employed in the United States, many agencies conduct ongoing evaluations of their outcomes and continually search for more effective alternatives. In 2004, the authors of MRT were asked by the Cook County, Illinois Probation Department (Chicago) to create an MRT-based curriculum which could be incorporated into the state requirements for DUI programming. The subsequent workbook (which consists of 6 hours of group activity) is combined with 6 hours of basic education, laws, and other issues to form the basis of a 12-hour DUI school curriculum titled Driving the Right Way (Little & Robinson, 2005). The program was implemented in Illinois in early 2005 and was then adapted for use in Tennessee in the same year. The program is now in use in Georgia, Idaho, Louisiana, Nebraska, New Mexico, Ohio, and Washington State. The initial Tennessee utilization of Driving the Right Way (DTRW) took place in Davidson County, Tennessee (Nashville) in 2005, but it is now used in other Tennessee DUI schools. The Nashville program, provided by a state licensed DUI School (Behavioral Treatment Providers) is one of two different DUI school approaches provided in the county. The other approach, Prime For Life (PFL) is utilized by the Davidson County Sheriff s Department and the DUI Intervention Safety School operated in conjunction with the General Sessions Court. Background for Recidivism Outcome Comparisons Between Programs Prime For Life is a 16-hour program that has been used by the Nashville government providers since Based on two reports from the local government implementation of Prime For Life with DUI offenders, the state s agency overseeing DUI school operations initiated efforts to mandate Prime For Life throughout the entire state, and they announced in January 2009 that Prime For Life would be required to be used by all DUI schools (TDMHDD, 2009). However, the mandate was temporarily postponed due to legislative inquiry and other issues. At that time public information was requested from the Davidson County Sheriff s Department regarding necessary details of their outcome study so that genuine recidivism comparisons could be made. These efforts were denied though because the department had already determined that Prime For Life has shown a great deal of success here and in other States so we feel it is the best option (Mulloy, 2009). Questions and inquiries about data collection, group numbers, and definitions were not answered. Two well-publicized recidivism evaluations on Prime For Life graduates were released by the DUI Intervention School and Sheriff s Department (Hill, 2006; Kedia, 2008; Reynolds, 2004, 2005, 2006, 2007). According to these reports, after just over two years of program graduation, DUI rearrest rates have been steady in yearly cohorts: 7.7% (Kedia, 2008), 4.47% (Hill, 2006), 4.47% to 7.73% (Reynolds, 2004), and 4.47% (Mulloy, 2008). All of these reports compared the Prime For Life graduates to a Meta Analysis in 1990 in which researchers found the average two-year recidivism rate for control groups completing remedial intervention for DUI drivers to be 19 percent (Reynolds, 2004). Based on the comparison, it has been consistently reported that the Davidson County Prime For Life program has the best results in the nation, and a move to mandate this program in the entire state has continued. Limitation to the Davidson County Reports Few details regarding the Davidson County studies on Prime For Life (PFL) are made available; however, various details (numbers treated, categorization of offenders, general outcomes) have been obtained from several sources. The major limitation of the Davidson County PFL results are made apparent by a single sentence included in each of the 2004, 2005, and 2006 annual reports of the Davidson County General Sessions Court (Reynolds, 2004; 2005; 2006): All graduates from the year 2002 were reviewed for re-arrests in Davidson County. In brief, the recidivism outcomes reported by these programs include rearrests in only one of Tennessee s 95 counties (1.05% of counties) and include no rearrests from other states. The 19% recidivism rate in national studies used as a comparison in these reports (Reynolds, 2004) comes from comprehensive

3 CBTR Second Quarter statewide evaluations and national rearrest databases (Wells- Parker & Williams, 1990). That the reported Davidson County two-year recidivism rates were considered to be low by their program proponents (4.47% to 7.7%) is not surprising since only one of Tennessee s counties was assessed. By way of contrast, Washington State s nationally recognized Institute for Public Policy (2007) found that over three years, 22.6% to 29.7% of first-time DUI offenders were rearrested for DUI within their state. A statewide DUI recidivism evaluation in Vermont found that after 5 years, 21.2% had new DUI arrests. Overview of the Present Study The present study presents a comprehensive description of a cohort of over 200 Davidson County DUI offenders who participated in the Driving the Right Way (DTRW) curriculum in 2005 to All of the offenders were arrested for DUI in Davidson County, attended the DTRW DUI School in Davidson County, and were reassessed for subsequent rearrests in Davidson County so that an accurate statistical comparison to the reported PFL results could be made. The program participants were assessed for new DUI arrests after a 25-month period after program completion, and these results were compared to the two-year results for the Davidson County PFL evaluations. An additional set of analyses investigated 36-month recidivism and other variables. Participants The participants were 203 adult offenders assigned to the DTRW program by courts in Davidson County. The mean age of participants was years with a range of 18 to 74 years (SD = 11.07). Males comprised 70% of the participants. Just under one-third (32%) of the participants had prior criminal records with approximately 20% showing more than one prior DUI arrest. These participants would be considered to be highrisk multiple offenders, but were included in the study. At the time of recidivism data collection in 2010, the participants had averaged months time from each individual s program completion date. The post-program completion time range was 26 to 59 months (SD = 9.64). Several t-tests showed that males and females in the treated sample were of statistically identical ages (t = 0.824; p =.411) and had been released for identical time periods (t = 0.923; p =.357). The Driving The Right Way program was conducted over two consecutive days, with 6 hours in classes each day. Participants were assessed prior to program entry with standardized tests to determine the level of alcohol or other drug use problems. In addition, the initial program participants were given a set of research tests, which are described in the results. Data Collection Consistent with the PFL data collection method, the arrest status for each of the 203 DTRW participants was collected from computerized records maintained by the Davidson County General Sessions and Criminal Courts. Data was collected on all arrests for each participant starting on the date of program completion. Two sets of recidivism data were formed covering the time period of 25 months directly after program completion. DUI rearrests and all drug and alcohol rearrests were utilized for comparison to the Davidson County report. Data were analyzed by SPSS. Comparison Group. It was initially hoped that comparisons to three participant categories of recidivism reported by Davidson County could be made (Reynolds, 2004). Their participants, numbering just under 1900 in that study, were broken into three categories in their reports: 1) Low-risk firsttime offenders (who showed no prior records) had a reported two-year DUI recidivism of 4.47% and 7.78% for any type of alcohol/drug offense; 2) High-risk first-time offenders (who were assessed and deemed to have more serious problems and were also required to attend 12-Step meetings) had a reported twoyear DUI recidivism of 7.73% and 12.73% for any type of drug/ alcohol offense; and, 3) High-risk multiple offenders (who were assigned to additional treatment) had a two-year DUI recidivism of 9.04% and 12.88% for any type of drug/alcohol offense. However, due to the low cell frequencies found in DUI recidivists in the high-risk offenders in the Driving The Right Way program, a statistical comparison of all three groups was inappropriate and not possible. Thus, only the first two categories of the Davidson County PFL offenders were collapsed into a single group after the actual numbers in each subgroup were obtained. The highest-risk group of the Davidson County PFL sample (with the highest recidivism rates) was excluded from the analysis. However, all of the offenders in the DTRW program, including all of the prior offenders (32% of the group) were included. The overall combined two-year DUI recidivism of the Davidson County PFL group (all first-time DUI offenders) was found to be 5.51% while the recidivism for any drug/alcohol offense in this group was 9.36%. One additional comparable recidivism report was identified from Saratoga County, New York (Karp, 2005). That study evaluated two and three-year recidivism outcomes in just over 1,000 first-time DUI offenders within that urban county. That study found that two years after the offenders completed a 10-hour drinking driver program, 7.02% had been rearrested for DUI. After three years, 10% had been rearrested for DUI. Results on Two-Year DUI Recidivism Of the 203 graduates of the Driving the Right Way program, and after a period of just over two years (25 months on each participant), 10 individuals, or 4.93% were found to have a new DUI charge in Davidson County. A chi-squared analysis was performed between the Driving The Right Way recidivism (4.93%) and the PFL comparison group recidivism (5.51%). The resultant statistic was nonsignificant (X 2 1 = 0.128; p =.72), indicating that the two outcomes were statistically equivalent. A chi-square analysis between the Driving The Right Way recidivism (4.93%) and the comparable Saratoga County recidivism (7.02%) was also nonsignificant (X 2 1 = 1.17; p =

4 4 CBTR Second Quarter ), indicating that the two outcomes were statistically equivalent. Results on All Two-Year Drug/Alcohol Related Charges Of the 203 graduates of the Driving the Right Way program, and after a period of just over two years (25 months on each participant), 22 individuals or 10.84% were found to have a new drug or alcohol-related charge in Davidson County. A chi-squared analysis was performed between the Driving The Right Way recidivism (10.84%) and the PFL comparison group recidivism (9.36%). The resultant statistic was nonsignificant (X 2 1 = 0.46; p = 0.498) indicating that the two outcomes were statistically equivalent. Additional Analyses Rearrests on all 203 Driving The Right Way participants were also collected for the entire time period that had passed for each individual since program completion. As related in prior sections, the mean time following program completion was months with a range of 25 to 59 months (SD = 9.64). Results showed that at an average of 36 months after release, 8.4% of the participants had additional DUI arrests. A chi-square analysis between the three-year Driving The Right Way recidivism (8.4%) and the comparable Saratoga County recidivism (10%) was also nonsignificant (X 2 1 = 0.508; p =.48), indicating that the two outcomes were statistically equivalent. Prior offenders (high-risk multiple offenders) in the Driving The Right Way program showed higher rearrest rates for both DUI (t = 1.94; p =.05) and all drug/alcohol rearrests (t = 4.31; p =.000). Males showed a 6.3% rearrest rate as compared to 13.1% for females. A chi-square analysis revealed that the observed difference between males and females was nonsignificant (X 2 1 = 2.55; p =.11). Total rearrests for any drug or alcohol charges were also collected at the 36-month period. Results showed that 11.33% of the participants had been rearrested. Pearson correlations were conducted on the relationship between age and rearrest status for both DUI and all drug/alcohol arrests. Results showed that age was not significantly related to DUI rearrests; however, the correlation approached significance (r =.104; F 1, 202 = ; p =.14). Age was not related to other drug/alcohol rearrests (r =.04; p =.58). Prior to admission to the Driving The Right Way program, a battery of objective tests was completed by the initial 79 participants both before and after treatment. These were the Michigan Alcohol Screening Test (MAST), the Rosenberg Self- Esteem Inventory (ROSE), and the Drinking-Related Locus of Control Scale (DRIE) (Little, 2000). The MAST is a widely used test designed to determine the level of alcohol problems in individuals. The average MAST score was 6.88 (SD = 7.97) indicating moderate alcoholism. The ROSE is a self-esteem test designed to measure the level of self-esteem in individuals. The mean score on the ROSE was 23.65, a score indicating moderately high self-esteem. Mean scores on the DRIE was 2.05, indicating strong internal control, a desirable finding. There were no significant or notable changes from pre- to posttest results. Self-esteem as indicated by the ROSE slightly increased, but did not approach statistical significance (t 78 = 1.3; p =.193). Pre- to posttest correlations showed that all the tests were statistically reliable with highly significant correlations found on each. Inter-test correlations were generally strong with virtually all correlations between the DRIE and the ROSE being statistically significant, which indicates inter-test validity. Discussion The results of this study point out a host of intriguing questions and also provide answers to others. Clearly the two programs evaluated in this outcome study lead to identical results. Prime For Life does not lead to better results than the Driving The Right Way program, nor is the reverse true. The real question, an important one that remains unanswered, is whether these programs are actually superior to other interventions. Asserting that the present programs are better than others because of the use of comparison studies that evaluated recidivism in an entire state is inappropriate, inaccurate, and misleading. In essence, while the outcomes reported herein are accurate, they cannot be considered to be true comprehensive recidivism reports or really honest in a purely ethical sense. Davidson County may be interested in repeat DUI offenders within their own county since that would cost the county money; however, the assertion that the program is better than others is unproven. In fact, it is likely that within some of Tennessee s rural counties, specific DUI schools that might conduct a similar recidivism study and evaluate rearrests only in their county would find results close to zero percent recidivism after only two years. On the other hand, past research has shown that DUI offenders who do recidivate, more often than not, do reoffend near home. Thus, it is true that the present study does give a snapshot of the recidivism of the participants, although not a complete picture. Davidson County, however, is the center point of several urbanized surrounding counties. Thus, a future additional statewide DUI recidivism study is planned on the participants from this study. A related issue was cited in a 2009 audit of the Tennessee Department of Correction (Wilson, 2009), was highly critical of the misleading and inappropriate manner in which the department defines, collects, and reports recidivism. The report notes that the ability to determine the effectiveness of their programs is undermined by their definition of recidivism and its collection. The same can be stated for the present report. The public obtains information from governmental agencies and officials and decision-makers use the supplied information to make changes sometimes drastic changes that affect many people. When such decisions are found to be made on inaccurate or misleading facts, public confidence in government is undermined. A 2010 textbook in criminal justice (Little, Robinson, Burnette, & Swan) directly addresses the current lack of ethics in criminal justice program reporting: Until very recent times, correctional programs and drug treatment have actually had what often seems to be a near absence of ethics as it pertains

5 to claimed results and program effects, and in many instances this persists to the present (p. 103). In essence, programs tend to form studies and report their results in a way that makes their results seem favorable. One additional recidivism issue is relevant to this discussion. Recidivism cannot be designated a final, definitive percentage. Recidivism within a given time period can be assigned such percentages; however, providers and agencies should be careful to always define recidivism with the time period studied. It is curious why Davidson County only collects two-year recidivism on their DUI offenders when data is now available for up to a 10-year study. Such a study would help further our understanding of the needs and long-term behavior of DUI offenders. References Clements, W. (2002) How many come back? DUI offender recidivism in Vermont. The Vermont Bar Journal, March, 1-4. FBI (2008) 2007: Crime in the United States 10 year DUI arrests trends by sex U.S. Department of Justice, FBI, Criminal Justice Information Services Division. September Foon, A. E. (1988) The effectiveness of drinking-driving treatment programs: a critical review. The International Journal of the Addictions, 23, Hill, J. N. (2006) Driving under the influence (DUI) education program models, research memo. Cheyenne, Wyoming: Wyoming Legislative Service Office. Karp, D. R. (2005) Drunk Driving in Saratoga County, New York: A Report to the Saratoga County District Attorney. Saratoga Springs, N.Y.: Skidmore College. Kedia, S. (2008) Treatment effectiveness for DUI offenders in Tennessee ( ). University of Memphis, Institute for Substance Abuse Treatment Evaluation. Little, G. L. (2000) Objective tests & measures resource book. Memphis: Advanced Training Associates. Little, G. L., & Robinson, K. D. (2005) Driving the right way. Memphis: Eagle Wing Books, Inc. Little, G. L., & Robinson, K. D. (1988) Moral Reconation Therapy: a systematic, step-by-step treatment system for treatment resistant clients.psychological Reports, 62, Little, G. L., & Robinson, K. D. (1990) Reducing recidivism by changing how inmates think. American Jails, 4 (3), Little, G. L., & Robinson, K. D. (1989) Treating drunk drivers with Moral Reconation Therapy: a one-year recidivism report. Psychological Reports, 64, Little, G. L., Robinson, K. D., & Burnette, K. D. (1992) Cognitivebehavioral treatment for offenders: the successful approach of Moral Reconation Therapy. The IARCA Journal on Community Corrections, Sept., 5-8. CBTR Second Quarter Little, G. L., Robinson, K. D., & Burnette, K. D. (1991) Treating drunk drivers with Moral Reconation Therapy: a three-year recidivism report. Psychological Reports, 69, Little, G. L., Robinson, K. D., & Burnette, K. D. (1990) Treating drunk drivers with Moral Reconation Therapy: a two-year recidivism report. Psychological Reports, 66, Little, G. L., Robinson, K. D., Burnette, K. D., & Swan, E. S. (2010) Antisocial personality disorder and criminal justice: Evidence-based practices for offenders & substance abusers. Memphis: Eagle Wing Books, Inc. Little, G. L., Robinson, K. D., Burnette, K. D., & Swan, E. S. (1996) Review of outcome data with MRT: seven-year recidivism results. Cognitive-Behavioral Treatment Review, 5 (1), 1-7. Little, G. L., Robinson, K. D., Burnette, K. D., & Swan, E. S. (1995) Sixyear MRT recidivism data on felons and DUI offenders: treated offenders show significantly lower reincarceration. Cognitive-Behavioral Treatment Review, 4 (1), 1; 4-5. Little, G. L., Robinson, K. D., Burnette, K. D., & Swan, E. S. (1999) Tenyear outcome data on MRT-treated DWI offenders. Cognitive-Behavioral Treatment Review, 8 (2), 1-4. Mulloy, P. (2009) from Davidson County Sheriff s Office (9/28/ 09). Mulloy, P. (2008) s from Davidson County Sheriff s Office based on the Sheriff s program results announced on the DCSO website. These have since been removed from the website. (9/05/08). Reynolds, M. (2004) DUI intervention. Davidson County, TN: 2004 Annual Report: Davidson County General Sessions Court. Reynolds, M. (2005) DUI intervention. Davidson County, TN: 2005 Annual Report: Davidson County General Sessions Court. Reynolds, M. (2006) DUI intervention. Davidson County, TN: 2006 Annual Report: Davidson County General Sessions Court. Reynolds, M. (2007) DUI intervention. Davidson County, TN: 2007 Annual Report: Davidson County General Sessions Court. Robinson, K. D. (1994) Breaking out of the prison cycle.business Perspectives, 7 (3), TDMHDD (2009) Prime For Life Presentation implementation announcement. Tennessee Department of Mental Health and Developmental Disabilities. Washington State Institute for Public Policy (2007) Deferred prosecution of DUI cases in Washington State: evaluating the impact on recidivism. Olympia, WA: WSIPP, August. Wells-Parker, E., & Williams, M. (1990). Identifying and interviewing with drinking drivers in various venues: a research review. In: Mayhew & Dussault (Eds.) (2002) Proceedings of the 16 th International Conference on Alcohol, Drugs, and Traffic Safety. Montreal, Canada: August 4-9. Wilson, J. P. (April 2009) Performance audit Department of Correction. Nashville, TN: State of Tennessee, Comptroller of the Treasury, Department of Audit, Division of State Audit.

6 6 CBTR Second Quarter 2010 MRT as an Evidence Based Practice 2008 MRT granted Evidence Based Practice status (NREPP) by SAMHSA MRT cited as an Evidence Based Practice by the Oregon Department of Human Services. Source: (2008) Oregon Department of Human Services, Addictions and Mental Health Services website. Ref. practices.shtml 2008 MRT cited as an Evidence-Based Program that seeks to decrease recidivism among juvenile and adult criminal offenders by increasing moral reasoning. Source: (2008) National Registry of Evidence-based Programs and Practices (NREPP), a service of the Substance Abuse and Mental Health Services Administration (SAMHSA). Ref: MRT cited as providing Strong Evidence that MRT programs are Effective in reducing the recidivism of offenders. Source: What Works in Corrections Ref: MacKenzie, D. L. (2006) What Works in Corrections; Cambridge University Press, MRT cited as Evidence Based Practice with female juvenile offenders. Source: Florida Department of Juvenile Justice (November 2005) Moderate- and High-Risk Residential Programming for Girls MRT cited as Evidence-Based Practice in probation. Source: State of Connecticut Judicial Branch (April 2005) Re-Engineering Probation Towards Greater Public Safety: A Framework for Recidivism Reduction Through Evidence-based Practice MRT cited as Proven to Reduce Recidivism in DWI courts. Source: National Drug Court Institute (2005) The Ten Guiding Principles of DWI Courts MRT cited as Evidence-Based Practice in probation and parole. Source: State of Connecticut, Judicial Branch, Court Support Services Division. Ref: White, T. F. (February 2004) A Framework for implementing evidence-based practice in probation and parole. State of Connecticut, Judicial Branch, Court Support Services Division MRT cited as Cost Effective and Proven to Reduce Recidivism. Source: Citizens Crime Commission of Portland, Oregon. Ref: A report of the recidivism reduction committee of the Citizens Crime Commission of Portland, Oregon (May 2002) MRT cited as Evidence-Based Practice with Adults and Promising Practice with Juveniles. Source: SAMHSA - Appendix II: Examples of Evidence- Based Programs, Guidelines for Building Mentally Healthy Communities MRT cited as a Best Practice for offender substance abuse treatment. Source: North Carolina Department of Correction. Ref: Pearce, S. C., & Halbrook, D. (August 2002) Research findings and best practices in substance abuse treatment for offenders. North Carolina Department of Correction, Office of Research and Planning MRT cited as one of few programs that actually Reduces Recidivism. Source: United Nations Programme Network Institutes. Ref: MacKenzie, D. L. (2001) United Nations Programme Network Institutes Technical Assistance Workshop; Vienna, Austria, May 10, 2001: Sentencing and Corrections in the 21st Century: Setting the Stage for the Future. National Institute of Justice MRT cited as Successful Approach to reduce recidivism. Source: University of Maryland research Ref: Allen, L. C., MacKenzie, D. L., & Hickman, L. J. (2001) The effectiveness of cognitive behavioral treatment for adult offenders: a methodological, quality based review. International Journal of Offender Therapy and Comparative Criminology, 45, MRT cited as a Proven Treatment to reduce recidivism. Source: Oregon Office of Alcohol and Drug Abuse Programs Ref: What works for offenders in substance abuse treatment? (January 2001). Oregon Office of Alcohol and Drug Abuse Programs MRT cited as an Effective Approach for ex-offender employment. Source: Buck, M. L. (2000) Getting Back To Work: Employment Programs For Ex-Offenders. Field Report Series, Public/Private Ventures, Fall MRT cited as a Program That Works to reduce juvenile violence. Source: Seifert, K. (1999) The violent child: profiles, assessment and treatment. Paradigm, Fall, MRT cited as an Innovative Practice in the Adult and Juvenile criminal justice systems. Source: Koch Crime Institute, a private, non-profit organization devoted to improving criminal justice. Ref: Koch Crime Institute (1998) Innovative Practices in the Criminal and Juvenile Justice Systems. Topeka, KS: Koch Crime Institute.

7 CBTR Second Quarter ANGER MANAGEMENT Group Starter Kit with Training DVD & Book on CD or Tape COPING WITH ANGER A Cognitive-Behavioral Workbook Coping With Anger is a 49 page cognitive-behavioral MRT workbook designed for eight (8) group sessions and is one of CCI s most popular programs. Used in probation & parole, prisons, community corrections, and other treatment sites, Coping With Anger is ideal for use with violent offenders, argumentative or oppositional clients, and with those who have trouble expressing feelings of anger. Training DVD Now Available! A 1.5 hour DVD has been created to assist programs and counselors who want to observe how the anger management program is conducted. The DVD shows how clients should complete homework for each of the program s 8 modules and how the homework in each module is presented in group. It is available in a newly packaged, discounted Group Starter Kit or can be purchased individually. A FREE CD with the training on a Quicktime file is included in the Group Starter Kit (for use on computers). Coping With Anger, on CD or cassette tape, also included in Starter Kit! The entire Coping With Anger workbook is now available on CD or cassette for use with clients who have problems reading. It has Dr. Greg Little reading the text and explaining the exercises. Group Starter Kit, a $345 value, is only $245! A 29% Discount Anger Management Group Starter Kit contains: 15 Coping With Anger workbooks 2 Facilitator Guides 2 5-Minute Stress Manager CDs or cassette tapes 2 Relaxation/Progressive Muscle Relaxation CDs or tapes 1 Anger Management Training DVD 1 FREE Anger Management Training Quicktime CD ITEM PRICES Group Starter Kit $245 Training DVD $100 Book on Cassette or CD $50 Coping With Anger workbook $10 Facilitator s Guide $5 5-Minute Stress Manager CD or Tape $8.95 Basic Relaxation/Muscle Relaxation CD or Tape $8.95 Call to order

8 8 CBTR Second Quarter 2010 What is MRT? Moral Reconation Therapy is a systematic, step-bystep cognitive-behavioral treatment system initially designed for offender populations. MRT is designed to alter how offenders think and how they make decisions about right and wrong. MRT: Addresses the unique needs of offender populations including criminologic factors, values, beliefs, behaviors, and attitudes. Enhances ego, social, and moral growth in a step-by-step fashion. Develops a strong sense of personal identity with behavior and relationships based upon higher levels of moral judgment. Reeducates clients socially, morally, and behaviorally to instill appropriate goals, motivation, and values. Is easy to implement in ongoing, openended groups with staff trained in the method. Your staff can be trained in MRT in a week-long, state-of-the-art training. Once training is complete, your staff can implement the groups by obtaining copies of the appropriate MRT workbook for clients. Many drug courts require clients to bear the costs of workbooks and groups. Questions? Call or Sharron Johnson or Lacy Kennedy at [email protected] or Offenders Think Like Criminals! Offenders believe everyone lies, cheats, and steals. Offenders believe no one can be trusted. Offenders believe that rules and laws don't apply to them. Offenders look for short-term pleasures. Offenders view relationships from an exploitative position. Offenders have a negative identity. Samenow and Yochelson pioneered research that captured the essence of criminal thinking. It is known that treatment approaches that don't alter criminal thinking and behavior fail to produce beneficial changes. MRT effectively alters criminal thinking and behavior and organizes the criminal personality into several stages. These stages also capture the essence of criminal thinking, but MRT does not directly address each criminal thought one by one. Some programs may wish to dispute each specific thought: from fundamental dishonesty, lack of trust, lack of acceptance, to ideas about relationships. Thinking For Good, does just that in preparing offenders for making changes. The MRT stages of Disloyalty, Opposition, Uncertainty, Injury, and Non-Existence are described in detail and specific criminal thinking commonalities are identified in each. Exercises explore each thought and allow for the disputation of each belief in groups. Thinking For Good 70 pages; 8.5 X 11; 10 modules. $10.00 per copy GLACIER CONSULTING, INC. EVALUATION & RESEARCH SERVICES AVAILABLE FOR STATE CRIMINAL JUSTICE PLANNING AGENCIES & DRUG COURTS GCI offers practical, cost-effective evaluation and research services for drug courts, treatment programs, facilities, and departments within the criminal justice and corrections system. GCI will design data collection systems for your agency and interpret the data for evaluation. GCI's research team has many years of research experience evaluating program effectiveness. Contact Robert Kirchner, Ph.D., Research Director, at [email protected] for additional information. One-Day MRT Review Training for Trained & Certified MRT Facilitators MRT Review Training is a one-day (8-hour) workshop designed to enhance MRT facilitators knowledge of MRT, develop additional group facilitation skills, and review the objective criteria for operating MRT groups. This workshop is a refresher course available to only those individuals who have already completed basic MRT training. A certificate of completion is awarded to all participants. The One-Day MRT Review Training is held in Memphis and can also be scheduled at other sites. The basic cost is $150 per person. For more information or to schedule a training, call Lacy Kennedy or Sharron Johnson at Cognitive Behavioral Treatment Review (CBTR) is a quarterly publication from Correctional Counseling, Inc All rights reserved. Correctional Counseling, Inc. provides a wide range of services and products and specializes in cognitive-behavioral interventions. Our major service areas are: Cognitive-Behavioral Training and Materials Moral Reconation Therapy Training and Materials Domestic Violence Treatment & Materials Relapse Prevention Drug Treatment Programming Mental Health Court Treatment Drug Court Services DWI Programming Specialized Probation/Parole Programs Criminal Justice Staff Training Therapeutic Community Programs

9 What Do Drug Court Professionals Know That You Should Know? MRT WORKS! CBTR Second Quarter Research Shows... Substantial research has been generated and published from programs utilizing MRT. Recidivism research covering 10 years after participants treatment with MRT have shown consistently lower recidivism rates (25-60%) for those treated with MRT as compared to appropriate control groups. An 8 year evaluation in 2007 of the Thurston County, Washington Drug Court utilizing MRT as its primary treatment modality showed a 55% lower recidivism rate of program participants after graduation. Other data analyses have focused on treatment effectiveness (recidivism and re-arrests), effects upon personality variables, effects on moral reasoning, life purpose, sensation seeking, and program completion. MRT has been implemented state-wide in numerous states in various settings including community programs and drug courts. Over 120 research evaluations have been conducted and published on MRT. These evaluations have reported that offenders treated with MRT have significantly lower reincarceration rates, less reinvolvement with the criminal justice system, and lessened severity of crime as indicated by subsequent sentences for those who do reoffend Thurston County, Washington Drug Court 55% Lower Recidivism Rate for MRT Graduates 45% Control Group Over 8 Year Period 20% Graduates 7% Drug Felony Graduates Parole/Probation Program Shoplifting Program Something for Nothing Something for Nothing is an eight-hour, 17-page CBT workbook designed to be utilized in weekend or weekly groups with shoplifters by Greg Little. Easy to implement, easy to follow workbook, shows virtually 100% completion rate with initial offenders in program. Also available in Spanish! Something For Nothing English & Spanish versions: $10 each. Also Available: Something For Nothing Tape or CD (English): $50 Nationally recognized cognitive-behavioral counseling approach. Open-ended program with flexible client participation and pre-printed materials. History of successful corporate performance for over 20 years. Record of effective imple- mentation at multiple sites. Comprehensive, proven training. Competitive costs. For information on implementing MRT in your drug court, call Sharron Johnson or Lacy Kennedy at MRT cited as Proven to Reduce Recidivism in DWI courts. Source: National Drug Court Institute (2005) The Ten Guiding Principles of DWI Courts. MOTIVATIONAL INTERVIEWING TRAINING AVAILABLE FROM CCI Motivational Interviewing is an Evidence- Based Practice used to enhance outcomes with treatment resistant clients. CCI now has a certified MI trainer to assist your agency in improving the treatment skills and effectiveness of your staff. Contact Sharron Johnson at (901) for additional information or to schedule a Motivational Interviewing training.

10 10 CBTR Second Quarter 2010 Interventions in Juvenile Treatment Court Programs: Effectiveness of Cognitive Behavioral Therapy by Robert A. Kirchner, Ph.D., Glacier Consulting, Inc. As with all programs targeted to meet the needs of juveniles, the implementation of juvenile treatment courts has faced numerous challenges and obstacles. This reality is particularly true when adolescents abuse drugs and alcohol. Research suggests that the area of the brain where adult motivation forms is not formed in adolescence, and addiction occurs more rapidly and often permanently. The result of a less mature neurological system of inhibition. Drug and alcohol abuse produces behaviors that frequently bring juveniles in contact with the criminal justice system Over the past two decades, the introduction of juvenile treatment courts as a new innovation to dealing with juvenile drug offenders have resulted in mixed results, but we have learned important lessons in knowing what works, and what does not work. Although the primary objective of these programs to eliminate drug use through treatment, the reality is that to create permanent change a client s behavior must also be addressed and interventions must be designed to ensure post program success. Glacier Consulting, Inc., a non-profit, research organization, has conducted a number of evaluations of juvenile treatment programs, including juvenile treatment courts over the past ten years. The findings and results of these studies have lead to a conclusion that to produce both desired process and outcome objectives cognitive behavioral therapy (CBT) interventions are effective in establishing permanent changes in adolescent behavior. Although we have experienced adult treatment programs utilizing CBT interventiosns, The only modality developed for juveniles was Juvenile Moral Reconation Therapy (MRT) 1. Glacier conducted five (5) long term evaluations of programs using this intervention (See Box) Juvenile Treatment Court Programs Using Juvenile MRT Volusia County, Florida (Daytona & DeLand) Anne Arundel County, Maryland (Annapolis) Valencia County, New Mexico (Los Lunas) Lincoln County, New Mexico (Ruidoso) Dona Ana County, New Mexico (Las Cruces) In numerous studies of many adult treatment programs, Moral Reconation Therapy (MRT), a cognitive behavioral therapeutic modality,has proven to be an effective intervention in accelerating client s progress to recovery completion of MRT leads to increases in graduation rates. The juvenile version of the modality has also proven its effectiveness within these programs by supporting a number of program objectives. Program Progress and Success Engagement Often a major challenge for juvenile offenders, engaging participants quickly through MRT groups has improved progress in implementing these programs. The modality is opened ended and self-paced, and clients can start group attendance immediately upon admission to the progam. Retaining clients in treatment All five programs exceeded 60% retention rate, one reached 78 percent, which far exceeds the average of 28% reported in research for substance abuse treatment programs. Graduating clients Participants completing the Juvenile MRT program are significantly more likely to graduate than those that do not complete or never attend MRT groups. If juvenile treatment court participants graduate, they are twice as likely to never re-offend again in the future. Reducing recidivism Across the five programs evaluated Re-Offend rates ranged from 6.8% to 21%, which far exceeds this objective for each program. Additionally, this result compares to the average juvenile drug offender re-offense rate of 78%.

11 CBTR Second Quarter Why Juvenile MRT Works Comparing the results of the evaluations of these five programs with juvenile treatment programs not using Juvenile MRT, the following conclusions help to explain the effectiveness of the modality. Most counseling or therapy in juvenile treatment delivery is delivered in a non-directive approach, and the clients do not gain ownership of their recovery. Cognitive behavioral interventions appear to be an effective intervention for drug abusers. Juvenile MRT has additional delivery features that produce outcomes to support successful programs. The delivery of Juvenile MRT is both highly structured and directive, which gets clients engaged and keeps them on track. Achievements of each step in the program are clearly understood and client progress can be documented at every stage of the program. Clients quickly establish ownership of their participation in the program because the program emphasizes feedback and client reflection. Each step in the program involves completing specific assignments and reporting on how they completed the step. The program is culturally neutral and gender sensitive. Standardized curriculum and facilitator training ensures consistent program delivery and quality assurance. Finally, given the difficulty of funding specialty court programs, Juvenile MRT is extremely costeffective compared to other programs. Focus on Outcomes Foremost among the concerns of citizens in dealing with drug offenders is the need to ensure public safety for the community. While juveniles are participating in the drug court program their behavior results in reduced criminal activity. The cost to the criminal justice system of frequent and continuing criminality by juveniles is constantly rising. Successful graduates of the program produce sustained cost savings for the juvenile justice system. Of course, the most valued outcome in this area is increased security in the community through the replacement of drug using delinquents with responsible young citizens. Finally, when institutionalized, these program can lead to improvements in the overall juvenile justice system. The principal outcome expected through treatment services is sobriety. However, drug use is often a symptom of other problems juveniles encounter, and other behavioral changes are desired as well. Based on our assessments, these programs address the total needs of each participant and seeks permanent, cognitive behavioral changes that directly yield client outcomes, such as: improving the client s image to others and within the community; removing the link to crime; and reinforcements for future living. Although the results of an innovative, or alternative programs like juvenile treatment courts may only have the capacity to respond to the needs of a small proportion of the target population we know exists, the changes that innovation brings are often far reaching beyond the program within the agencies and relationships that are developed because the program is in operation. References Little, Gregory L., and Kenneth D. Robinson (1997) Juvenile MRT How To Escape Your Prison: A Moral Reconation Therapy Workbook. Memphis, TN: Eagle Wing Books. MacKenzie, Doris Layton (2006) What Works in Corrections: Reducing the Criminal Activities of Offenders and Delinquents. New York, NY: Cambridge University Press. Little, Greg, and Kenneth D. Robinson, Katherine D. Burnette, and Stephen Swan (1999) Successful Ten- Year Outcome Data on MRT Treated Felony Offenders,Cognitive-Behavioral Treatment Review Vol. 8, No. 1. You can order books online at Notice to CBTR Readers CBTR is a quarterly publication featuring the latest cognitive-behavioral information and CCI news. It is now distributed electronically to everyone on our mailing list. If you would like to be notified when a new issue is available, please forward your name and address to [email protected]. Previous newsletters are now available on our website located at Please contact us if you need any additional information.

12 12 CBTR Second Quarter 2010 WHY is MRT the Best Choice for Your Prison Treatment Programs? SAMHSA NREPP Evidence-Based cognitive-behavioral counseling approach. Open-ended program with flexible client participation and pre-printed materials. 20-Year history of successful performance. Record of effective implementation at multiple sites. Comprehensive, proven training. Competitive costs. Register online for MRT training at or call Sharron Johnson or Lacy Kennedy at (901) for additional information. Antisocial Personality Disorder & Criminal Justice: Evidence-Based Practices for Offenders & Substance Abusers To minimize anger, maximize DRAMA Current Criminal Justice Numbers & Costs COST: $18.95 Connection between Crime & Drug Abuse Causes of Antisocial Personality Effective Treatment Approaches 169-page soft cover text detailing the latest research regarding antisocial personality disorder, criminal justice treatment issues and evidence-based practices. Contains sections on recidivism, female offenders, & juvenile justice. The DRAMA (Dispute Resolution And Managing Anger) Club, an evidence-based, cognitive-behavioral approach to conflict resolution, has achieved measurable success in its original, group counseling format. Now, with the introduction of the personal workbook, your clients can benefit from The DRAMA Club while working with you alone in an individual sessions. Using a structure you clients already know and enjoy movies and theatre the DRAMA Club helps them learn how to become good actors. It works: teachers in a Baltimore alternative school reported that the DRAMA Club reduced the intensity and number of anger-related incidents per week. Before implementing the DRAMA Club, 0% of the teachers agreed with the statement our students positively solve problems among themselves. After implementing the DRAMA Club, 70% of the teachers agreed with that statement. Here s what this research-based program can do: in your client sessions Leverages client homework (reading, exercises, journaling) which you can review and process in as little as 15 minutes or use as a guide for the entire session Is user friendly and facilitator friendly Is designed with the APD/conduct disordered client in mind Can accommodate all learning styles Join the community therapists who are giving clients the insights to curb anti-social thinking, the caseworkers who are meeting court-ordered treatment while changing offenders' behavior, and the residential counselors who are raising their clients' chances for a successful re-entry into home and work. In educational, correctional and mental health programs around the country, counselors and educators are seeing that adding DRAMA reduces anger. For more information or a free sample, visit SecondThoughtAlternatives.com or call Tony Myers at

13 PROGRAM PROFILE Josephine County, Oregon Community Corrections Division Cognitive Skills Program CBTR Second Quarter Cognitive Skill Programs envelope several different programs ranging from clients recognizing what their behavior has done and continues to do to self and others and how they may choose to change. The major reason for spending time and money on such programs is to lower the recidivism rate of our clients. Statistics have shown that in most cases studied that programs can lower those that repeat offenses by as much as thirty three percent. The program presently used is Moral Reconation Therapy or MRT. The MRT basic program is the core of a group of programs that are directly affiliated to MRT skill building program. The core MRT program is a sixteen step program which requires a client to attend and participate for at least twelve weeks with the average graduate taking twenty weeks to complete the program. This program lets a client compare where they are today, identifies what they really want in life and educates the person how to reach their goals. Each person works at his or her own speed. The group is run by the participants with a facilitator present to insure adherence to the rules of the group and of the program. This program is also used with the Juvenile department with separate groups for boys and girls. MRT Relapse Prevention is an eight module program that is used by the Community Justice Department. This program uses the same component as the basic program, in that it holds the client responsible to change. When a person graduates from this group, they have the tools to identify damage caused by there addiction. They will know how to change addictive thinking and how to find support to keep from giving into their addictions. Clients are also given directives that will help them remain sober thru NA or AA, sponsorship and support groups. MRT Employment program teaches clients to recognized that not getting a job is mainly because of their behavior; not showing up on time, not doing as directed, or doing only half a job. They recognized that many people with criminal records still get employment and it is mainly because of attitude. They are challenged by having to assess potential employees to see who they would hire as part of an exercise. In doing this clients recognized that the needs of the employer are paramount and that it is not a personal attack on the person applying. This class is difficult for many because the client has to admit that they are the biggest problem in getting employed. Breaking Barriers, while not part of the MRT groups, is an extension of the groups. The program is much briefer, lasting only eight days, but helps a client organize and plan their lives to reach realistic and attainable goals. The goal of cognitive programs is to get the client to realize that they are in control of their life and what they do with it is up to them. When a person graduates from these groups they have identified what they have done and that they, not another person, are responsible for their actions. They have identified what they really want in life and how they can choose to go there. They also know that if the choose not to change that their will be consequences and they will be totally responsible for those consequences. These programs meet the standards as directed by the State of Oregon as Evidenced Based Practices. Objectives Provide evidenced based intervention with high and medium risk offenders. Coordinate with treatment agencies and parole and probation officers regarding offender progress. The MRT groups for probationers and parolees of high and medium risk cases have implemented for 4 years. The Community Corrections Division believes this program Is making a difference. Oregon measures recidivism as a felony conviction within 3 years of being placed on community supervision, which was the standard used to compare rates with Josephine County and the State. Of 67 graduates, thirteen (13) had been convicted of new felonies resulting in a recidivism rate of 19.4%. The average recidivism rate for Josephine County is 48% and the Oregon statewide average is 38%. It is important to note the county and state rates include all offenders (high, medium, low and limited risk) which make our MRT rates even more impressive.

14 14 CBTR Second Quarter CEU WORKSHOPS Nashville, TN Your Lifework Training 2 Days 12 CE Hours Your Lifework is a 12-hour workshop designed to lead participants through a deep exploration of their work behavior and career ambitions. Your Lifework training dates: May 20 & 21 July 22 & 23 September 16 & 17 December 9 & 10 One Day Workshops 6 CE Hours June 17 August 12 October 28 November 18 Dying for a Smoke Training/Workshop Anger Management Training/Workshop Relapse Prevention TrainingWorkshop Dying for a Smoke Training/Workshop Behavioral Treatment Providers, LLC is an Approved Education Provider: (NAADAC)#747 National Association of Alcohol and Drug Abuse Counselors. Attendees will receive a quality certificate of attendance from Behavioral Treatment Providers with either six or twelve contact hours (depending on training) at the completion of each workshop/training. For more information or to enroll visit: or call Kenneth Baker at Now Available From CCI A Complete Product Catalog for All of Your Cognitive- Behavioral Treatment Needs CCI is now including a copy of our new product catalog in each shipment or it can also be downloaded from our website at You will find a description of all treatment workbooks, textbooks, and related materials as well as ordering information. Download a pdf of the catalog at therapy.com

15 CBTR Second Quarter SMOKING CESSATION PROGRAM with Workbook & Two CDs Dying For A Smoke A 72-page workbook designed as a smoking and tobacco use cessation program. It has 8 sessions and includes two CDs affixed inside the back cover as supportive material. Cost: $29.95 per workbook with the CD set. Training is not required to purchase this workbook. Target Population & Use Dying For A Smoke is targeting individuals who want to stop smoking and programs and organizations implementing stop smoking assistance programs. Implementation Settings This workbook is designed to be used in a small group format with clients who are in the process of stopping tobacco use to meet, share ideas, lend support to each other, and make good decisions. It can be used in private practice settings, employee assistance programs, and with clients in treatment. How It Is Conducted There are 8 chapters in the book and participants complete the written exercises for a new chapter before attending a group session. The first 5 sessions are designed to prepare an individual to cease all tobacco use by making an individualized plan of action. Session 6 is designed to be the point where the individual actually ceases all tobacco use or begins the process of reducing use. The groups are designed to be open-ended where new participants can enter at any time. Supportive Materials Two audio CDs are included. The first CD begins with an overview of the workbook and explains the program. Tracks 2 and 3 can only be used at times when you can sit down and close your eyes. Track 2 presents the Three-Breath Relaxation Technique, which is designed to teach participants to deal with stress and anxiety in a quick, effective way. Track 3 is an extended version of the Three Breath Technique and also contains visualizations. The second CD contains a 50-minute music presentation with a background of Sleep-Motivation suggestions designed to allow the listener to fall asleep. It should be used at bedtime or at other times when the listener can take about an hour to relax and close his or her eyes. A Facilitator s Guide ($10) is also available. Available June 1, Advance orders are now being accepted. Call to reserve your copies.

16 16 CBTR Second Quarter 2010 DRIVING THE RIGHT WAY A Cognitive-Behavioral Program for DUI/DWI Offenders by Dr. Gregory Little & Dr. Kenneth Robinson Traditional educational programs for DWI and DUI offenders have been utilized for nearly 40 years, but research consistently shows that these programs do not impact subsequent reoffending. Cognitive-behavioral interventions-changing how offenders think and make decisions-are the preferred, state-of-the-art treatment approaches for offenders. The Driving the Right Way program consists of four sessions, focused on changing thinking and decision-making. The program is implemented in ongoing, open-ended groups. A simple facilitator s guide is available as well as the program on cassette tape. In addition, CCI can customize workbooks with DUI statistics for your State! Now available for Tennessee, Illinois, Idaho, Ohio, Louisiana, Georgia, Nebraska, New Mexico, and Washington. You only have to order 50 books and we can add your state! The workbook is only $10.00 with discounts available for bulk purchases. The Facilitator s Guide is free with workbook purchase. Moral Reconation Therapy Increases Community Corrections Treatment Effectiveness A 2005 meta-analysis 1 of nine published outcome studies detailing the results of MRT treatment on the six-month to three-year recidivism of parolees and probationers showed that MRT cut expected recidivism by nearly two-thirds. These studies included 2,460 MRT-treated individuals and 7,679 controls. A 2001 meta-analysis 1 of seven published outcome studies on the results of MRT treatment on one-year recidivism in community-based corrections showed that MRT cut expected recidivism by one-half. These studies included 3,306 MRT-treated individuals and 10,538 controls. Over 100 outcome studies have documented MRT MRT is the premiere cognitive-behavioral program MRT is easy-to-implement MRT enhances staff attitudes MRT is cost-effective MRT enhances offender compliance MRT significantly reduces recidivism MRT is a Best Practice MRT is an Evidence-Based Practice For information on MRT and other specific cognitive-behavioral programs: Anger Management Relapse Prevention Shoplifting Underage Drinking & False IDs Parenting Criminal Thinking Codependence Sex Offenders Domestic Violence Juvenile CBT Training call Correctional Counseling, Inc or visit our websites PARENTING AND FAMILY VALUES A Cognitive-Behavioral MRT Workbook A 12 group session workbook aimed at assisting parents and caregivers to discover and develop appropriate and effective parenting methods while focusing on the underlying family values. In this 75- page workbook, parents confront their own parenting styles, values, and methods of discipline. Parenting and Family Values is $15.00 per copy. Parents of Delinquents Offenders With Children Substance Abusers With Children Parents Experiencing Problems Parents Seeking Understanding

17 CBTR Second Quarter Upcoming Trainings In MRT & Domestic Violence MRT TRAINING May 25 to May 28, Chamberlain, SD June 21, 2010 to June 25, Germantown, TN June 28 to July 1, Bernalillo, NM July 26 to July 30, 2010 Germantown. TN August 10 to August 13, Hillsboro, Oregon August 16 to August 19, 2010 Seattle,WA August 23 to August 27, 2010 Germantown, TN September 13 to September 16, 2010 Cour d Alene, ID October 5 to October 8, Chamberlain, SD October 19 to October 22, 2010 Albuquerque, NM November 15 to November 18, New York City, NY DOMESTIC VIOLENCE TRAINING May 24, 2010 to May 28, Germantown, TN June 22 to June 25, Bernalillo, NM Note: Additional trainings will be scheduled in various locations in the US. See our website at or call CCI concerning specific trainings. CCI can also arrange a training in your area. Call for details. Is your relapse prevention component too complicated for your clients? Is it hard for them to understand or difficult to complete a 300 page "brief relapse prevention" workbook? RELAPSE PREVENTION THAT WORKS STAYING QUIT: A Cognitive-Behavioral Approach To Relapse Prevention 40-page client workbook based on principles of cognitive-behavioral relapse prevention designed for eight group sessions. Focuses on risky situations, scripting changes, coping with urges and cravings, being around users, understanding support issues, and taking charge of life. Recent research (Burnette, et. al., 2004; Little, 2002) shows that the addition of the Staying Quit relapse prevention program significantly increases Life Purpose, significantly shifts Locus of Control to a more internal locus, increases moral reasoning, and enhances several measures of social support. The Staying Quit client workbook is $10. A simple-to-follow Facilitator's Guide is available for $5. The Staying Quit Audiotape Set (boxed, $50.00) contains the entire workbook text oncd or cassette, a 15 min. relaxation exercise, a 15 min. progressive muscle relaxation exercise, a 20 min. clean & sober visualization, and a 25 min. desensitization CD or tape. A Group Starter Kit is available and contains 11 workbooks, 1 Facilitator's Guide, review article, and a complete Audio Set. The Starter Kit is $ (discounted from $170). Staying Quit Starter Kit Contents 11 Staying Quit workbooks 1 Facilitator s Guide Workbook on CD or cassette 15-minute Basic Relaxation CD/tape 15-minute Progressive Relaxation CD/tape 20-minute Clean and Sober Visualization CD/tape 25-minute Desensitization CD/tape

18 18 CBTR Second Quarter 2010 COGNITIVE BEHAVIORAL MATERIALS AVAILABLE FROM CCI To order go online at use the coupon on page 23, or call The Punishment Myth Understanding the criminal mind and when and why conventional wisdom fails. 8.5 x 11 softcover by Dennis A. Challeen, J. D. and Ken Robinson. $ Antisocial Personality Disorder & Criminal Justice: Evidence-Based Practices New 169-page softcover text by Drs. Greg Little & Ken Robinson, Katherine Burnette, & Stephen Swan. Details relationships between APD, criminal justice treatment issues, & evidence-based practices. $18.95 Crisis Intervention Strategies for Chemical Abusers & Offenders 61-page text covering crisis intervention techniques; $ Five-Minute Stress Manager CD/cassette tape of three, 5-minute relaxation segments used in MRT, Domestic Violence, & Anger Management; $8.95. Parenting and Family Values 75 page, 12 session MRT group workbook designed to be used with parents of children experiencing problems; $ Imaginary Future 15 minute CD/cassette tape used in Step 7 of MRT to assist clients in visualizing appropriate goals; $8.95. Imaginary Time Out 15 minute CD/cassette tape used in MRT domestic violence to assist clients in visualizing appropriate time out strategies; $8.95. Family Support 26 page (8.5 X 11 softcover) CBT workbook used in groups with clients who fail to pay child and family support. Exercises for group work; $9.00. Job Readiness 26 page (8.5 X 11 softcover) CBT workbook designed for use in groups with clients who have faulty beliefs about the work world; $9.00. Something for Nothing 17 page (8.5 X 11 softcover) CBT workbook used in groups with offenders who are charged with shoplifting. Exercises for group work; $ Something for Nothing (Spanish) $ Something for Nothing (CD/audiotape) $ You Can Get There From Here 85-page softcover book by Father Bill Stelling telling how addictions can be changed. A priest tells how he overcame alcoholism; $8.95 Effective Counseling Approaches for Chemical Abusers & Offenders 104-page softcover text by Little, Robinson, & Burnette summarizing 7 major counseling theories used with offenders. Designed for assisting counselors preparing for substance abuse certification; $ The Joy of Journaling 110-page softcover by Drs. Pat & Paul D'Encarnacao covers the hows and whys of journaling. Shows how counselors can use journaling as a CBT method of aligning clients' beliefs and behavior; $ PSYCHOPHARMACOLOGY: Basics for Counselors 279 page softcover text covering the basics of the field - up-todate and comprehensive; $ Coping With Anger 49-page anger management cognitive behavioral workbook. Designed for use in 8 group sessions; $10.00 Coping With Anger Group Starter Kit contains 15 Coping With Anger workbooks, 2 Facilitator Guides, 2 5- Minute Stress Manager tapes, 2 Basic Relaxation & Progressive Muscle Relaxation CD/tapes, book on cassette tape, Training DVD, plus free Quicktime file of training on CD; $ Facilitator's Guide for Coping With Anger 8 page how-to guide for implementing the Coping With Anger anger management groups; $5.00. Coping With Anger Training DVD 1.5 hours, shows how to start and operate an ongoing anger management program; $ Coping With Anger (book on CD or tape) $50.00 Making Changes for Good 56-page workbook designed for sex offender relapse prevention group program; $ Facilitator's Guide for Making Changes for Good - 12 page how-to guide for implementing the sex offender relapse prevention program; $ Untangling Relationships: Coping With Codependent Relationships Using The MRT Model 28-page workbook for use with those who have codependent issues; Also in Spanish. $10.00 Staying Quit: A Cognitive-Behavioral Approach to Relapse Prevention 40-pg client workbook for relapse prevention groups. 8 program modules; $ Facilitator's Guide to Staying Quit 8 page how-to guide for implementing Staying Quit relapse prevention groups; $5.00. CD/Audiotape set for Staying Quit CD or cassette audiotapes with the Staying Quit workbook on CD/tape, basic relaxation, progressive muscle relaxation, clean & sober visualization, and desensitization; $ Staying Quit Group Starter Kit 11 client workbooks, 1 Facilitator's Guide, review article, and CD/audiotape set; $ Responsible Living 26-page client workbook with 8 group sessions designed for "bad check" writers, shoplifters, and petty crime misdemeanants; $ Thinking For Good Group workbook directly addressing criminal thinking, behaviors, and beliefs from MRT personality stages. 10 sessions criminal thinking is disputed; $ Thinking For Good Facilitator s Guide A simple, easy-to-follow facilitator s guide for implementing Thinking For Good; $5.00. Character Development Through Will Power & Self-Discipline CBT group exercise workbook for use with probationers, parolees, and juveniles. Designed for 16 group sessions with scenarios discussed in group; $ Character Development Facilitator's Guide 54-page counselor's guide to Character Development; $ It Can Break Your Heart 424-page softcover book outlines the issues involved in obesity and weight loss comes with SmartLoss 60-Day Health Journal 81-page, large softcover book. Special offer: both books (normally retailing for $40.90) can be purchased for a total of $5.00 with any other order from CCI. Programs and individuals can order multiple sets. Driving the Right Way 4-session client workbook for DWI/DUI offenders. Customized DUI statistics for any State. Also in Spanish. $ Facilitator's Guide for Driving the Right Way 4-page how-to guide ; $5.00 or free with workbook. Your LifeWork - 70-page workbook focused on understanding how one s principles relate to a personal purpose and a mission in life. $ (DVD & Starter Kit also available) Only those trained in MRT may order the following materials MRT Counselor's Handbook Bound 8.5 X 11, 20- page book giving the objective criteria for each MRT step. Includes sections on group processes, rules, dynamics, hints, and instructions for starting an ongoing MRT group; $ MRT Freedom Ladder Poster - Poster of MRT stages, steps, and personality descriptions (B/W); $ How To Escape Your Prison CD or Cassette Tape Set The complete text of the MRT workbook, How To Escape Your Prison, contains brief explanations by Dr. Little of exercises and tasks. For use with clients in groups where reading assistance is not present. Boxed in a vinyl tape book with color coded tapes for easy reference to steps; $ How To Escape Your Prison The MRT workbook used in criminal justice, 138 pages, 8.5 X 11 perfect bound format, with all relevant exercises by Drs. Greg Little & Ken Robinson; $ How To Escape Your Prison in Spanish The Spanish MRT workbook used in criminal justice, 138 pages, 8.5 X 11 perfect bound format, identical to English version by Drs. Greg Little & Ken Robinson; $ How To Escape Your Prison CD/Audiotape Set in Spanish The Spanish MRT workbook on CD or cassette tapes - boxed.; $ Juvenile MRT How To Escape Your Prison MRT workbook for juvenile offenders, 8.5 X 11 perfect bound format, with all exercises.; $ Domestic Violence Workbook 119 pages in 8.5 X 11 format, titled, Bringing Peace To Relationships, for use with perpetrators of domestic violence. The MRT format contains dozens of exercises specifically designed to focus on CBT issues of faulty beliefs, attitudes, and behaviors leading to violence in relationships; $ (Must be trained in MRT s Domestic Violence program to order.) Domestic Violence Facilitator's Guide 21 pg. how-to facilitator's guide to Bringing Peace To Relationships domestic violence groups; $ Filling The Inner Void MRT workbook, 120-page spiral bound, used with juveniles, in schools - by Drs. Little & Robinson. Discusses the "Inner Enemy" (the Shadow in Jungian psychology), projection, and how we try to fill basic needs; $ Discovering Life & Liberty in the Pursuit of Happiness MRT workbook for youth and others not in criminal justice; $25.00.

19 CBT Materials Order Form Item Price Each # Ordered Subtotal The Punishment Myth $10.00 Something for Nothing shoplifting (Workbook) $10.00 Something for Nothing (Spanish Workbook) $10.00 Something for Nothing (book on CD or tape)$50.00 APD & Criminal Justice $18.95 Effective Counseling Approaches text $12.00 Crisis Intervention text $10.00 Five-Minute Stress Manager (CD or cassette) $8.95 Parenting and Family Values $15.00 Imaginary Future (CD or cassette) $8.95 Imaginary Time Out (CD or cassette) $8.95 Family Support (CBT workbook) $9.00 Job Readiness (CBT workbook) $9.00 You Can Get There From Here $8.95 The Joy Of Journaling $11.95 Psychopharmacology: Basics for Couns. $24.95 Coping With Anger (workbook) $10.00 Coping With Anger Facilitator Guide $5.00 Coping With Anger Group Starter Kit $ Coping With Anger Training DVD $ Coping With Anger (book on CD or tape) $50.00 Making Changes Sex Offender Workbook $18.00 Making Changes Facilitator Guide $10.00 Untangling Relationships Wkbk Eng./Span. $10.00 Staying Quit (workbook) $10.00 Staying Quit Facilitator Guide $5.00 Staying Quit Group Starter Kit $ Responsible Living workbook $10.00 Thinking For Good workbook $10.00 Thinking For Good Facilitator Guide $5.00 Character Development $20.00 Character Development Facilitator's Guide $20.00 Driving the Right Way Workbook Eng./Span. $10.00 Driving the Right Way Facilitator s Guide Free Your LifeWork Book (DVD & Starter Kit also available) $15.00 MRT Materials below can only be ordered by trained MRT facilitators MRT Counselor's Handbook $10.00 MRT Poster (Freedom Ladder) $10.00 How To Escape Your Prison (CDs or tapes) $60.00 How To Escape Your Prison $25.00 How To Escape Your Prison (In Spanish) $25.00 How To Escape Spanish (CDs or tapes) $60.00 Juvenile MRT - How To Escape Your Prison $25.00 Domestic Violence (Must take Dom. Vio.) $25.00 Domestic Violence Facilitator's Guide $10.00 Filling The Inner Void $25.00 Discovering Life & Liberty... $25.00 Name: Agency: Address: City/State/Zip: You can now order online! Go to our web site at and clink on the Store link. Ordering Instructions To order materials, clip or copy coupon and send with check, money order, or purchase order. All orders are shipped by UPS no post office box delivery. When ordering only one item, the shipping fee is $8.00. If you order more than one item, you should call CCI at (901) for shipping, insurance, and handling charges. Orders are typically shipped within 5 working days of receipt. Materials below the line stating "MRT Materials..." can only be ordered by persons or agencies with trained MRT facilitators. Call for details if you have any questions. CREDIT CARD ORDERS: (901) ORDER COUPON Your Name and Shipping Address: Phone: Send form and payment to: Correctional Counseling, Inc Exeter Rd. Germantown, TN = TOTAL ORDER = (call for Shipping) = Grand Total

20 COGNITIVE-BEHAVIORAL TREATMENT REVIEW 2028 Exeter Road Germantown, TN PRST STD US postage PAID Memphis, TN Permit 225 Memphis MRT Training Daily Agenda This schedule is for Memphis trainings only. Regional times and costs vary. Lunch served in Memphis only. Lecture, discussion, group work, and individual exercises comprise MRT training. Monday 8:30 a.m. to 5:00 p.m. (Lunch-provided in Memphis) Introduction to CBT. Treating and understanding APD and treatment-resistant clients. Background of MRT personality theory. Tuesday 8:30 a.m. to 12:30 p.m. (Lunch - on your own) Personality theory continued. Systematic treatment approaches. MRT Steps 1-2. About 2 hours of homework is assigned. Wednesday 8:30 a.m. to 5:00 p.m. (Lunch - on your own) MRT Steps 3-5. Thursday 8:30 a.m. to 12:30 p.m. (Lunch - on your own) MRT Steps 6-7. About 2 hours of homework is assigned. MRT Or Domestic Violence For Your Program Training and other consulting services can be arranged for your location. For more information please call Upcoming Trainings MRT TRAINING May 25 to May 28, Chamberlain, SD June 21, 2010 to June 25, Germantown, TN June 28 to July 1, Bernalillo, NM July 26 to July 30, 2010 Germantown. TN August 10 to August 13, Hillsboro, Oregon August 16 to August 19, 2010 Seattle,WA August 23 to August 27, 2010 Germantown, TN September 13 to September 16, 2010 Cour d Alene, ID October 5 to October 8, Chamberlain, SD October 19 to October 22, 2010 Albuquerque, NM November 15 to November 18, New York City, NY DOMESTIC VIOLENCE TRAINING May 24, 2010 to May 28, Germantown, TN June 22 to June 25, Bernalillo, NM Friday 8:30 a.m. to 2:00 p.m. (Lunch - provided in Memphis) MRT Steps How to implement MRT. Questions & answers. Awarding completion certificates. Note: Additional trainings will be scheduled in various locations in the U.S. See our website at or call CCI concerning specific trainings. CCI can also provide training at your location.. Call or [email protected] for details.