Can therapy influence criminals to stop violent careers?

In Liberia and other politically unstable countries, poor young men exhibit high rates of violence, crime, and other “antisocial” behaviors. In addition to their direct costs, crime and instability hinder economic growth by reducing investment or diverting productive resources to security. In fragile states, such men are also targets for mobilization into election intimidation, rioting, and rebellion. Governments commonly turn to policing and job creation programs, but these carrot-and-stick approaches take money, time, and capacity that Liberia, like many poor and fragile states, has in short supply. What is needed are rapid interventions that can target the highest-risk places, people, and behaviors.

Changing behavior

Christopher Blattman tests a different approach: rehabilitation, or changing behavior by shaping people’s underlying abilities and values. Together with Harvard Medical School, the US Consumer Financial Protection Bureau, and Innovations for Poverty Action, he applied principles from cognitive behavioral therapy to study whether interventions in the forms of therapy or therapy plus cash could influence at-risk men to foster skills of planning, goal-setting, reflection, deliberate decision-making, and controlling emotions and impulses. The therapy also aimed to encourage nonviolent, noncriminal behavior and lifestyles by fostering a change in the men’s social identity.

The team approached roughly 1,500 high-risk men, and 999 agreed to enter the study. In addition to the therapy, Blattman and his collaborators identified a simple economic intervention that could also help men avoid crime: a simple handout of cash to start a small business such as a kiosk or a shoe shine stand. To test both interventions, they divided participants randomly into four groups: a quarter who got cash only, a quarter who got therapy only, a quarter who got both, and a quarter who got neither—a control group. Therapy consisted of an eight-week program designed to affect economic performance and antisocial behaviors (including crime and aggression). Cash grants were $200—the equivalent of three months’ wages. Men were surveyed beforehand, a few weeks after the interventions, and a year later.

Families wait in line in the courtyard of a school in the Liberian capital Monrovia for rice rations distributed by local authorities June 28, 2003. About one million people, or a third of Liberia’s population, were seeking refuge in an already overcrowded Monrovia as UN Secretary General Kofi Annan called for the urgent deployment of a multinational force to the war-wracked nation to prevent a “major humanitarian tragedy.”

PHOTO BY Georges Gobet

Effects of incentives

Men who received therapy reduced their antisocial behaviors dramatically, by about 40 percent compared to the control group. Within a few weeks of therapy, for example, researchers observed large reductions in a huge range of behaviors, including stealing and drug selling. The therapy seems to have helped these young men become more future focused, emotionally self-controlled, and feeling accepted like normal members of society. At least for a time. With therapy alone, these effects diminished after a year, as men fell back into their old ways. But when therapy was followed by cash, the reductions in these violent and criminal behaviors were lasting.

Something about therapy plus cash helped young men focus more on their future and on a normal life, and stop crime and violence for at least a year. The evidence suggests it wasn’t the businesses and income, at least not directly. It turns out most of the men invested their funds in business or saved. This in turn helped them earn about a quarter more money than the control group, plus hold some savings for a rainy day. But life on the streets of Monrovia was risky, and they tended to be robbed or cheated every couple of months (in addition to other bad luck). A year later, the cash and businesses were gone.

While it lasted, however, the cash-driven businesses helped men practice the skills they learned in therapy and try to live out normal lives. This extended practice seems to have worked like an extended therapy, helping them cement their changes and avoid crime and violence for at least a year. From an average of 60 crimes a week in the control group, men in the therapy and cash group fell to 30 crimes on average. This is because about half left their lives of crime, and half did not. Relative to other, often more expensive programs, this was a huge improvement.

Ability to overcome

This study suggests something fundamental about human behavior—that we are all malleable and many if not most of us can come back from very severe circumstances.

The gains could have been even greater if the men had been able to keep up their economic success. Helping them protect their assets, shift to better neighborhoods, or choose better businesses are all approaches that hold promise. This belief is consistent with rural ex-combatants in Liberia, who shifted away from illicit activities when a much more intensive employment program raised their farm productivity (Blattman and Annan, 2015). Improving economic opportunities matters, and more experimentation and investigation is needed to find urban solutions that work for high-risk young men.

This therapeutic approach and its marriage with economic programs have promise beyond Liberia. The team kept the intervention low-cost and created a publicly available manual, curriculum, and training guidelines to ease adaptation and replication. And over time, it should be possible to develop qualified and effective facilitators in other countries. Blattman is currently collaborating with the University of Chicago Crime Lab to explore local opportunities.

American Economic Review (forthcoming)

Read Full Paper (PDF)

Still a Soldier.

CONGO TOWN, LIBERIA - SEPTEMBER 19, 2005: Lieutenant Joseph Kpayon Chea walks up stairs at the former uncompleted Ministry of National Defense building in Congo Town on the outskirts of Monrovia. Chea is still a soldier and earns $890 Liberian dollars ($14USD) monthly which he uses to support his wife and seven children. The “Pentagon,” named this way by its occupants, shelters 394 families totaling approximately 3,000 people who were booted out in May 2005 of the Barclay Training Center, which had been their home for the last two decades. Former soldiers, who fought for former Liberian presidents Samuel Doe and Charles Taylor, live in this building with no water or electricity, overcoming past differences. The construction of the building started in 1984 under Doe’s leadership, and the war interrupted the its completion and later served as a base for Taylor’s men.

 

GETTY IMAGES / Olivier Laban-Mattei