Rehabilitation

Tony Ward, Shadd Maruna

• Publisher: Routledge
• Year: 2007
• ISBN:
  9781134169368
• Edition: 1
• Topic: Social Sciences
• Subtopic: Criminology
• Index: Social Sciences

Over the last two decades, empirical evidence has increasingly supported the view that it is possible to reduce re-offending rates by rehabilitating offenders rather than simply punishing them. In fact, the pendulum's swing back from a pure punishment model to a rehabilitation model is arguably one of the most significant events in modern correctional policy. This comprehensive review argues that rehabilitation should focus both on promoting human goods (i.e. providing the offender with the essential ingredients for a 'good' life), as well as reducing/avoiding risk.

Offering a succinct summary and critique of the scientific approach to offender rehabilitation, this intriguing volume for students of criminology, sociology and clinical psychology gives a comprehensive evaluation of both the Risk-Need Model and the Good Lives Model.

Rehabilitation is a value-laden process involving a delicate balance of the needs and desires of clinicians, clients, the State and the public. Written by two international leading academics in rehabilitation research, this book argues that intervention with offenders is not simply a matter of implementing the best therapeutic technology and leaving political and social debate to politicians and policy makers.

1
HOW DID “REHABILITATION” BECOME A DIRTY WORD?

No one but an academic simpleton will even use the word “rehabilitation” without apprehension.

Richard Korn (1992, p. 4)

There are not many subjects as sexy as criminology and criminological psychology. Step into a taxi, sit down for a haircut, or get chatting to a stranger on an airplane, and when you are asked, “So what do you do?” try responding: “I’m a psychologist who studies crime.” Watch their eyes light up. Getting inside the mind of the serial killer? Assisting police officers on their toughest cases? Outsmarting the smartest criminal masterminds? People love that stuff! Even the more mundane areas of criminology – prisons, prostitution, corporate crime, cop culture, gangs, sexual violence, political economy of crime, heroin markets – are all fascinating stuff.

But wait for the follow-up question, “What sort of research?” and try answering: “Offender rehabilitation.” First, there is a pause (always a pause), sometimes for a few seconds, sometimes for as many as ten or fifteen. They know the phrase, but it has been a while since they last heard it. Offender rehabilitation? Then you will get the inevitable reply: “H’m, bet it doesn’t work, does it?” And, no matter what you respond, the conversation will quickly turn to the weather or sport. At best you will get a “Well, good luck to ya, mate”, which is frequently followed by a mumbled “Better you than me”.

Indeed, offender rehabilitation has to be the single least-sexy topic within the broad umbrella of criminological research. Undergraduates who flock to courses on the “psychology of crime” will turn and run with equal speed away from a course titled “psychology of criminal reform”. Mention the topic to book publishers, faculty colleagues, aspiring PhDs, and watch the yawns and the attempts to escape the room without being rude.

The whole idea behind rehabilitation, let alone the word itself, has a musty, anachronistic quality to it, belonging to another era when society shared a sense of the “right” way to live (and, indeed, a “wrong” way as well). Who has the right to tell others how they should live? How dare some middle-class clinician lecture a group of disadvantaged, ghetto-dwelling youth about right and wrong? If someone wants to break the law, that is their choice, isn’t it? If they want to do the crime, they can do the time. Who needs the moral hand-wringing and condescension?

Indeed, there is something vaguely preachy and evangelical about the notion of rehabilitation. After all, who goes around saving sinners any more? To many of us, “rehabilitation” has become synonymous with workbook-centered lectures delivered in grim, windowless prison basements: tiresome bureaucratic exercises that are as meaningless to participants as they are to staff administering them. Nothing more than a way to tick a box (rehabilitation? check) and pass some dead time during the long years of incarceration. Others hear the word and associate it with an extreme “medical model” view of corrections. Borrowed as it is from the wider medical literature, the term “rehabilitation” invokes, for many, images of clinicians in white lab-coats surgically rewiring bad brains into good. Finally, to some, the word conjures the sexist image of “Sally Social Worker”: soft, gullible, heart in the right place, but dangerously naïve. Time to wake up to reality, Sally, this is 2007, not 1957. The world has changed. Crime has changed. Offenders have changed. Who needs a book about an embarrassing old relic like rehabilitation in 2007?

Now, “reentry”, on the other hand – there’s an interesting topic! The reentry of prisoners into the community is a different subject altogether. Ever since Jeremy Travis (2000) famously warned that “they all come back”, the criminological world has been feverishly pursuing this “new” topic of ex-prisoner reentry. In a ten-page document, the then director of the National Institute of Justice (NIJ) described the scale of the reentry project in the United States in clear terms and outlined how little attention the subject had received despite its potentially central role in community safety and recidivism reduction:

The explosive, continuing growth of the Nation’s prison population is a well-known fact. . . . Less well recognized is one of the consequences of this extraordinarily high figure. . . . If current trends continue, this year more than half a million people will leave prison and return to neighborhoods across the country.

(Travis, 2000: 1)

In other words, if you lock 2 million people up in jails, as the United States has done, you are going to create an enormous number of ex-convicts, so you had better be prepared (as had they). In all, it was a fairly unremarkable observation really. Yet the reaction among policy-makers, criminologists and research foundations internationally has been nothing short of amazing. Since the NIJ published this call to arms, there have been literally countless conferences, commissions, reports, articles, books, research projects and government initiatives launched around the issue of returning exprisoners in the US (for reviews, see Maruna and LeBel, 2003; Petersilia, 2003; Travis, 2005), culminating in the remarkably weighty 650-page Report of the Re-entry Policy Council (Re-entry Policy Council, 2005).

As is often the case (see Newburn, 2002), there have been parallel developments around resettlement in the United Kingdom over the last decade, with numerous new reports and commissions of equal importance (see especially Morgan and Owers, 2001; Social Exclusion Unit, 2001). In the United Kingdom, however, “resettlement” rather than “re-entry” has become the buzzword of choice. John Braithwaite (1989) popularized the longstanding notion of “reintegration” in his landmark book, Crime, Shame and Reintegration. Even “recovery” has become a term in vogue, spreading out from the addiction and mental-health literature to the criminal justice world more broadly (see especially Draine et al., 2006). This makes perfect sense considering the high proportion of those under criminal-justice supervision who also struggle with issues of addiction, mental illness and substance abuse. Finally, academic criminologists have started using the awkward term “desistance from crime” to describe the process of “going straight” or self-reform. Although the word, somewhat oddly, does not start with “re-”, desistance has become one of the most popular topics in criminological journals and books in recent years (see, e.g., Farrall and Calverley, 2006; Laub and Sampson, 2001).

So why title a book Rehabilitation when so many newer, shinier terms are available to choose from? We have no specific interest in resurrecting this particular word, especially as it has sadly become anathema to prisoners and probationers. At the same time, we worry about disguising old ideas and practices in new terminology, old wine in new bottles. Listen, for instance, to this definition of resettlement provided by the UK Association of Chief Officers of Probation:

A systematic and evidenced-based process by which actions are taken to work with the offender in custody and on release, so that communities are better protected from harm and reoffending is significantly reduced. It encompasses the totality of work with prisoners, their families and significant others in partnership with statutory and voluntary organisations.

(Cited in Morgan and Owers, 2001: 12)

How is this in any way different from what used to be called rehabilitation? Likewise, the word “reentry” is hardly ever defined (Lynch, 2006) and appears to have been chosen as the “buzzword” of the moment (Austin, 2001) almost entirely on the basis of its lack of connotations (Maruna, 2006).

The situation is marginally better for the more traditional term “rehabilitation” (see Raynor and Robinson, 2005, for a comprehensive review of definitions of rehabilitation in the criminological literature and beyond). In their article “Recent advances in rehabilitation” in the British Medical Journal, Wade and de Jong (2000) acknowledge that “a definition of rehabilitation has still not been universally agreed” in the medical profession but offer the following as the closest thing to the reigning usage of the word:

Rehabilitation is a reiterative, active, educational, problem solving process focused on a patient’s behavior (disability), with the following components:

• Assessment – the identification of the nature and extent of the patient’s problems and the factors relevant to their resolution
• Goal setting
• Intervention, which may include either or both of (a) treatments, which affect the process of change; (b) support, which maintains the patient’s quality of life and his or her safety
• Evaluation – to check on the effects of any intervention

This definition does not translate perfectly into the criminal justice arena. In particular, the term “treatment”, although widely used in the criminological literature, will sound awkward to the average probationer or prisoner. Unless they are enrolled in a methadone maintenance program or are receiving medication for a mental illness, few such individuals will feel they are undergoing any “treatment”. Yet the same can be said for many forms of therapeutic intervention (see Schneider, 1999). Besides, the word “treatment” has another, more generic usage, along the lines of “Describe your overall treatment by prison or probation staff”. If understood in this sense – or simply as a “relationship” as urged by Schneider (1999) – the above definition seems a perfectly adequate, open-ended description of the practices we call rehabilitation and others have rebranded as resettlement, reentry, reintegration, aftercare, and so forth.¹

Part of the purpose of rebranding is to throw off the “baggage” and reputation that came with the previous name. So, for instance, in Northern Ireland, the badly maligned Royal Ulster Constabulary (RUC) was rechristened the Police Service of Northern Ireland in an attempt to move on from the past into a new kind of future (see Mulcahy, 2006). The problem, as made obvious in the Northern Ireland example, is that it is far easier to rename an agency than to change entrenched bureaucratic cultures and practices. Indeed, one of the dangerous things about making up new words, as Stanley Cohen (1985, p. 152) points out, is the way new terminology gives the illusion of progress even when “much the same groups of experts are doing much the same business as usual”.

Changing names is also a poor way of preserving and learning from the past. For instance, judging only by the name (as one might reasonably do in this era of “key word” searches), “reentry” appears to have a fairly short history. The writer of a journal article on the topic can (and many do) put together a reasonably comprehensive literature review on the topic by summarizing the book-jacket copy of recent works by Travis (2005) and Joan Petersilia (2003). Rehabilitation, on the other hand, has a long, well-known and well-documented history. This history (or “baggage”) is not always pretty – in fact, it can be fairly characterized as consistently disappointing – yet it is crucial to acknowledge and learn from these dramatic experiences in order to develop better practice, and not just reinvent a broken wheel. Although this book will not attempt to review the history of rehabilitation endeavors in any way, there are numerous sources one can consult in this regard (see, e.g., Garland, 2001; Morris and Rothman, 1995; Raynor and Robinson, 2005; for addiction treatment, see especially White, 1998).

Maybe more than any other area of criminological research, rehabilitation has been plagued with new discoveries, miracle cures, revolutions and silver bullets, all buffeted by that all-powerful justification of “science” (see Cohen, 1985; Mair, 2004). Ours, on the other hand, is a rather unabashedly “old school” approach to this topic, as will be seen in later chapters. We seek to return to basics in some ways, recasting rehabilitation as a way of helping people who want to go straight. As such, we decided, after much consideration, that the old-fashioned term “rehabilitation” will suit our discussion just fine.

WWIII: THE THIRD COMING OF THE “WHAT WORKS” DEBATE

Now on to the next order of business: This rehabilitation stuff doesn’t really work, does it?

No self-respecting book on rehabilitation begins without a poke at a straw man named Robert Martinson. In his infamous 1974 article titled “What Works”, Martinson implied (and later stated) that the answer, when it comes to offender rehabilitation, is “nothing”. In doing so, Martinson created one of academia’s most remarkable legacies, the most painful aspect of which is that every article, chapter or book written on the subject of rehabilitation since 1974 has had to start by first knocking Dr Martinson down. Indeed, the history of rehabilitation, told so often, always follows the same classic arch; it is the great story of the rise and fall and rise again (redemption at last!) of the rehabilitative ideal.

Everyone knows this tune, so feel free to sing along. First, there was the Good Old Days when everyone believed in rehabilitation and prisons were about correction and reform. The ideal of rehabilitation possibly reached a sort of peak in California in the late 1960s and early 1970s when the state invested in both highly innovative, theoretically sound interventions with young people and the research needed to evaluate and improve these practices (see, e.g., Cressey, 1958; Palmer, 1975; Warren, 1969; but see Irwin, 1974, for the perspective of an ex-prisoner criminologist). Then came the Fall from Grace (or “California research at the crossroads” as Martinson [1976] labeled it). The Martinson Report was just one among a series of critiques from the political Left, Right and Center that helped to usher in an era of “nothing works” pessimism and “lock ’em up” punitiveness. Yet it should not be forgotten, as Garland (2001) convincingly argues, that these critiques alone cannot be blamed for the punitive turn. The War on Crime, the War on Drugs, “Prison Works” and the unbelievable escalation of prisoner numbers in the US and elsewhere were the product of discernible structural and cultural shifts in the social landscape. But Martinson’s report (and others like it) surely didn’t help things much.

But no need to despair. A hero was on the way – twelve of them, to be specific! – mainly blowing in from Canada and ushering in a new golden age of rehabilitative initiatives. A group of researchers and practitioners were labeled with the shorthand tag of the “What Works” Movement, self-consciously although somewhat ironically taking their name from Martinson’s notorious article. The evidence assembled by these “What Works” researchers was massive, sophisticated and seemingly incontrovertible (see, e.g., Andrews and Dowden, 2005; Lipsey, 1992; Redondo, Sanchez-Meca and Garrido, 2002). First we got meta-analyses, then we had meta-analyses of meta-analyses. In short, it was a campaign of “shock and awe” that seemed to end the thirty-year reign of skepticism following Martinson’s flawed, over-exposed and exaggerated review (for a review, see Gendreau, 1981; Palmer, 1975).

Indeed, in 2004, with an audience of nearly a thousand criminologists from around the globe, the President of the American Society of Criminology, Frank Cullen, symbolically tore down criminology’s statue of Robert Martinson for ever. In a talk, immodestly titled “The twelve people who saved rehabilitation: How the science of criminology made a difference”, Cullen announced that victory was, at last, in hand and that the Good Guys had won:

Three decades ago, it was widely believed by criminologists and policymakers that “nothing works” to reform offenders and that “rehabilitation is dead” as a guiding correctional philosophy. By contrast, today there is a vibrant movement to reaffirm rehabilitation and to implement programs based on the principles of effective intervention. How did this happen? I contend that the saving of rehabilitation was a contingent reality that emerged due to the efforts of a small group of loosely coupled research criminologists. These scholars rejected the “nothing works” professional ideology and instead used rigorous science to show that popular punitive interventions were ineffective, that offenders were not beyond redemption, and that treatment programs rooted in criminological knowledge were capable of meaningfully reducing recidivism.

(Cullen, 2005)

Unquestionably, Cullen was right; the past decade has witnessed something of a rehabilitation renaissance. In what Pallone and Hennessy (2003) describe as the “Rebellion of 2000”, California voters passed Proposition 36 requiring sentences of community-based drug treatment – not jail time – for most nonviolent drug offenders. In fact, the state that once removed the word “rehabilitation” from its constitution (Petersilia, 2003) actually rebranded its Department of Corrections with the bizarrely repetitive new name the California Department of Corrections and Rehabilitation. (See the warning above about new names for old practices, but this appears to be more than window dressing.) According to the Christian Science Monitor (May 27 2005), “After decades of tough policies, America’s most-populous state is poised to reverse direction in its approach to the incarceration of youth – from punishment to rehabilitation”.

Yet the story of rehabilitation is not exactly over. No sooner was Cullen’s presidential address published than along came the anachronistic sight of a slim book called Rethinking Rehabilitation: Why Can’t We Reform Our Criminals? In the book, published by the American Enterprise Institute, author David Farabee (2005: xvi) argues that “the majority of rehabilitative programs have little or no lasting impact on recidivism”. Arguing that our “overemphasis on rehabilitation distracts prisons from performing their role of protecting us” (see page), he calls for a shift to a hugely beefed up deterrence system involving vastly reduced parole case-loads and a widespread investment in satellite tracking technologies:

There is an extensive body of research literature that directly challenges the purported effectiveness of social programs on recidivism, and supports such common-sense approaches as increasing deterrence through closer monitoring. . . . To reduce recidivism, we must return to basic principles of behavior and do a better job of detecting crimes and swiftly applying sanctions. Change is possible without workbooks, videos, and group meetings.

(pp. 76–7)

Echoing these views only a few months later, the American Society of Criminology’s Criminology and Public Policy published an essay by Douglas Marlowe (2006, p. 339), who risked being branded “with the scarlet M (for Martinson)” by arguing that “what works” in fact “never did”:

Because any negative finding could be interpreted as casting pallor on the concept of rehabilitation . . . investigators often feel compelled to declare victory at every turn. If their primary hypotheses are not confirmed, they can usually rely on post hoc correlations to elicit some evidence of treatment effects. And if that is insufficient, the failsafe position is to conclude that the intervention might not have been adequately implemented. . . . The literature is so rife with “noise” touting unproven interventions that practitioners and policy makers have difficulty separating the wheat from the chaff.

(p. 339)

To quote Cullen (2005), “How did this happen?” What happened to the victory of science over politics in the rehabilitation debate? Is the ghost of Martinson back to haunt criminology? We appear to have, again, entered a period of uncertainty about the relevance, value and effectiveness of offender rehabilitation. It is too early to tell for certain; but, if so, Cullen would not be the first pres...

Table of contents

• COVER PAGE
• TITLE PAGE
• COPYRIGHT PAGE
• LIST OF FIGURES
• ACKNOWLEDGMENTS
• 1: HOW DID “REHABILITATION” BECOME A DIRTY WORD?
• 2: WHAT IS A REHABILITATION THEORY?
• 3: THE RISK–NEED–RESPONSIVITY MODEL OF OFFENDER REHABILITATION
• 4: EVALUATING THE RISK–NEED– RESPONSIVITY MODEL
• 5: THE GOOD LIVES MODEL OF OFFENDER REHABILITATION
• 6: EVALUATING THE GOOD LIVES MODEL
• 7: IN SEARCH OF COMMON GROUND
• NOTES
• REFERENCES