7.5. Rehabilitation

Rehabilitation

While its roots are more shallow than the three previous ideologies, rehabilitation is not brand new. Additionally, it is the only one of the four main ideologies that most accurately attempts to address all three goals of corrections, which are:

1. Punish the offender

2. Protect Society

3. Rehabilitate the offender.

Certainly, all four ideologies address the first two goals, punishment, and societal protection. However, the goal of rehabilitating the offender is either silent, or not addressed in retribution, deterrence, or incapacitation. This does come as a cost. As we will talk about in more detail when covering prisons and jails, our societal reliance on incarceration has resulted in a persistent paradox. Most offenders will come out of institutions – roughly 95% of all people who enter prisons are released – yet little is done to change them while they are there. This is mostly due to our attitudes towards offenders, the policies that guide prison life, and the institutions themselves. And yet, there is the expectation that these individual leaving prisons will not commit crimes in the future.

Rehabilitation has taken on different forms through its history in the United States. In the 19th century, a group of justice reformers theorized that prisons might serve as a place for spiritual rehabilitation. Offenders were conceptualized as “out of touch with God”, and so a solution to their criminality was to show penitence (or remorse after reflection). One of America’s earliest prisons was designed with this in mind. The Eastern State Penitentiary, opening in 1829, included outside reflection yards, so that offenders could look up to God in penance.

Reformatories, which followed the penitentiary model, were another example of how rehabilitation was viewed in the past. The reform movement tried to rehabilitate the offender through more humane treatment, to include basic education, religious services, work experience, and general reform efforts. This was done in an effort to “fix” and improve individuals, thus allowing them to come back to society successfully. The Elmira Reformatory was one of the earliest efforts of the reform ideal, and many prisons built in the United States were based on this prison. Below is a picture of Elmira.

Other attempts at rehabilitation included more medical approaches. Beginning in the early 20th century, some correctional theorists promulgated the idea that offenders were sick or biologically abnormal – sometimes incurably so. Such theories informed policies of informal prisoner sterilization, as well as surgical interventions that we would now recognize as pseudoscientific, inhumane, or cruel. The medical approach, while largely discredited, still informs some penal policies today. For example, the chemical castration of certain offenders does still occur. In Oklahoma, as of September of 2018, sex offenders must undergo mandatory treatment with medroxyprogesterone acetate before they are released to the community.

Rehabilitation, as an ideology, has had critics. This is in large part due to how it is perceived. Many have voiced the objection that such efforts are “soft” on offenders – a critique that is particularly effective during times where there is a high fear of crime. Yet researchers have also problematized the utility of rehabilitative efforts in prison, most notably Robert Martinson, who published a trenchant review of such polices in 1974, entitled “What Works?” In his review of over 230 programs, Martinson concluded that “With few and isolated exceptions, the rehabilitative efforts that have been undertaken so far have had no appreciative effect on recidivism” (Martinson, 1974, p. 25). ^[1] This was the spark that many needed to turn toward the more punitive ideologies that characterize the correctional system today. At the same time, this study did raise many important questions about why rehabilitation was not working, how to better evaluate rehabilitation, and how to understand the differences between what does, and does not, work for offenders.

Understanding Risk and Needs in Rehabilitation

Today’s rehabilitative efforts do still carry punishment and societal protection as goals, but the focus of rehabilitation is on the changing of offenders’ behaviors so that they are not dangerous in the future. This is done by better understanding risk factors for offending, and how some offenders are at a higher risk for recidivism than others. Such evidence-based risk factors include prior criminal history, antisocial attitudes, antisocial (pro-criminal) friends, a lack of education, family or marital problems, a lack of job stability, substance abuse, and personality characteristics (mental health and antisocial personality).

While we can’t change the number of priors someone already has, all of these other items can be addressed. These are considered offenders’ “criminogenic needs”. Criminogenic needs are items that, when changed, can lower an individual’s risk of offending. This is a core component of Paul Gendreau’s (1996) principles of effective intervention, and are at the heart of most modern effective rehabilitation programs. ^[2] Additionally, thousands of offenders have been assessed on these items, which has helped to further develop evidence-based rehabilitation practices. When these criminogenic needs are addressed, higher-risk offenders demonstrate positive reductions in their future risk for offending.

Over the last 40 years, efforts to change these characteristics, in order to reduce offending, have been varied. One of the most useful approaches to changing the antisocial attitudes and behaviors of offenders has come in the form of behavioral and cognitive behavioral change efforts. Cognitive behavioral change for offenders is based on the concepts that the behaviors that one exhibits can be changed, by changing the thinking patterns behind (before) the behaviors are exhibited. That is (criminal) behavior is based on cognition, values, and beliefs that are learned vicariously through interactions with and observations of others. It is especially relevant since we are receiving individuals from prison, where these ideas, peers, values, and beliefs may dominate the institution. Other evidence-based programs can be reviewed through the National Institute of Justice’s “Crime Solutions” web page, which rates correctional (and crime prevention) interventions   as effective, promising, and not effective, based upon available research.