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Washington State Institute for Public Policy
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Cognitive behavioral therapy (CBT) (in the community) for individuals convicted of sex offenses

Adult Criminal Justice
  Literature review updated March 2025.

This analysis includes an evaluation of cognitive behavioral therapy (CBT) treatment using Risk-Needs-Responsivity (RNR) principles delivered in the community to individuals convicted of sexual offenses.

The program in our analysis required participation in confrontive and cognitive-behavioral treatments emphasizing teaching skills to identify and change cognitive deficits, distortions, and flawed thinking processes that can trigger criminal behavior.

Using RNR principles, corrections and treatment staff align the level of services with the individual’s risk for re-offense (risk principle), provide types of services based on the individual's unique needs (need principle), and determine a treatment method that is appropriate for the individual based on unique abilities and motivation levels (responsivity principle).

Studies were included in this analysis if the treatment had at least one programmatic component of CBT and mentioned utilization of RNR principles or used risk/need assessments to prioritize individuals to treatments. We excluded evaluations of non-CBT programs and programs that do not use RNR principles.

Individuals in the included study were mandated to participate during the usual intensive supervision requirements to address the behaviors associated with their current offense. Supervision and treatment for these individuals lasted 12 months.

Evaluations of integrated prison-to-community sex offense treatment programs, and evaluations of treatment during incarceration only, are reported in separate analyses.
 
ALL
META-ANALYSIS
CITATIONS

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change over time. For those effect sizes, we estimate outcome-based adjustments, which we apply between the first time ES is estimated and the second time ES is estimated. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Effect sizes (ES) and standard errors (SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
Crime
Involvement in the criminal justice system (e.g., arrests, charges, convictions, incarceration) measured through administrative records (e.g. court records, arrests) or self-report.
 32 1 73 -0.222 0.166 33 -0.222 0.181

Citations Used in the Meta-Analysis

Baird, C., Wagner, D., Decomo, B., & Aleman, T. (1994). Evaluation of the effectiveness of supervision and community rehabilitation programs in Oregon. San Francisco: National Council on Crime and Delinquency.