Applying CBT to Antisocial Behavior

While CBT was initially tailored to the treatment of depression and anxiety, it has been adapted for the treatment of antisocial behavior. Modifying CBT for antisocial behavior involves a shift in how practitioners approach clients and a different focus in terms of the cognitive and behavioral patterns targeted in treatment. Three foundational components form the basis of an integrated forensic CBT approach: (1) enhancing motivation for change, focusing treatment on reducing criminal risk-relevant factors, and (3) addressing thinking patterns that facilitate antisocial behavior.

Because offenders are often coerced into treatment, they commonly approach treatment with a lack of interest, if not outright hostility. Therefore, one component of treatment is an initial focus on improving motivation to change. This is accomplished through the use of motivational interviewing, a communication style that emphasizes collaborative discussions about why change would be important, as well as how change might occur. The main objective in using motivational interviewing with offenders is to elicit and explore their own motivations for changing their risky and self-defeating behaviors.

Treatment with offenders focusing on the changeable nature of the Central Eight risk factors (with the exception of criminal history) means that their improvement reduces the risk of criminal behavior and reoffending, while their worsening increases the risk for future offending. There is a complex interrelationship, however, between criminal risk factors on treatment. For example, an unemployed offender may spend free time with friends who drink heavily and use drugs. The friends reinforce the offender’s unproductive beliefs about work, the offender’s drug use diminishes the likelihood of passing preemployment drug screens, and the offender’s substance abuse and criminal companions further distance the offender from prosocial family members. Thus, the various risk factors specific to this case impact each other in an interrelated destructive system. On the optimistic side, a positive change in one of these areas could facilitate positive changes in the others. For example, full-time employment would result in less time with antisocial friends, less time to engage in substance abuse, and exposure to new peers who express prosocial thoughts and model more productive lifestyles.

Conceptualizing cognitions that are relevant for offenders can be approached effectively by taking into consideration the empirical literature that has developed around criminal thinking patterns that facilitate antisocial behavior. Many of these patterns are the opposites of those found in people with depression and anxiety. For example, offenders are unlikely to harshly blame and judge themselves when faced with criticism, as is common in depressed clients. In fact, they may express little concern for the opinions of others or for how their actions affect others. Nor are they likely to overestimate and exaggerate potential dangers, as is common in clients with anxiety difficulties. Instead, offenders may underestimate danger, seeking out risky situations precisely for excitement. These are the patterns targeted in treatment for cognitive restructuring. By improving motivation for change and targeting the behavioral and cognitive patterns responsible for antisocial behavior, CBT can help prevent offenders from returning to the criminal justice system.

Damon Mitchell and Raymond Chip Tafrate

Further Readings: Bonta J., & Andrews, D. A. (2016). The Psychology of Criminal Conduct. New York, NY: Routledge. Bandura, A. (1977). Social learning theory. Englewood Cliffs, NJ: Prentice Hall.

Beck, A. T. (1976). Cognitive therapy and the emotional disorders. New York, NY: International Universities Press.
Ellis, A. (1994). Reason and emotion in psychotherapy (Rev. ed.). Secaucus, NJ: Birch Lane.

Milkman, H. B., & Wanberg, K. W. (2007). Cognitive- behavioral treatment: A review and discussion for corrections professionals. Washington, DC: National Institute of Corrections.
Tafrate, R. C., & Mitchell, D. (Eds.). (2014). Forensic CBT: A handbook for clinical practice. Chichester, UK: Wiley.