A Critique and Qualified Defense of “Correctional Quackery”

Concerns About Correctional Quackery

Correctional quackery is defined as correctional programming that has at its base the ignorant adherence to practices that have no grounding in the scientific literature (Latessa, Cullen, & Gendreau, 2002). The core of this argument is that some programs in corrections are not conceived or operated based on scientific evidence (so-called evidence based programming) in that they have an appreciable effect on recidivism. Those who critique programs as not having a discernible basis in scientific evidence, in terms of their effect on recidivism, are generally practicing a strict positivistic form of epistemology (Kraska & Neuman, 2011).

We recognize that hundreds of studies have documented many of the likely causes of recidivism (e.g., family, peer groups, criminal history) and the components of programs most likely to achieve reductions in recidivism (Knight, Simpson, & Hiller, 1999; Latessa et al., 2002; Lowenkamp, Latessa, & Holsinger, 2006; Pearson & Lipton, 1999). It is evident that the science on correctional programming is becoming more and more clear everyday, and, in large part, we are in complete agreement with Latessa and his colleagues (2002) when they claim that faddish programs such as boot camps, Scared Straight, and DARE have sucked precious research and programmatic dollars away from more viable and scientifically validated programs.

We do not advocate supporting programs that leave offenders untreated or increase the likelihood for future victimization. There is little defense that can be offered for such chicanery and we are not proposing to do so here. We do suggest, however, that learning more about what works best will require a healthy skepticism for both popularly supported “magic bullets” and will require a real openness to alternative perspectives as well as to research approaches beyond traditional positivism.

In addition, we think it is important to consider other metrics for measuring the “success” of programs. What if instead of using recidivism as the preferred program validating outcome, we evaluated correctional programs based on alternate outcomes such as reductions in violence or disruption in the prison environment, increases in the health or well-being of the inmate or offender, or the provision of opportunities for emotional growth as prosocial human beings? Many would counter such a proposal by pointing out that the public demands “crime reduction” as a programmatic outcome and we are not in a position to dispute this claim directly. However, we would note that there are likely real cost reductions, moral and ethical considerations, and even perhaps recidivism reductions associated with healthier inmates, calmer prisons and jails, and programming that allows humans to develop to their prosocial potential.

Problems With Judging Program Value Based Exclusively on Existing Models of Human Behavior

In this section, we argue that our current models of human behavior, and specifically the theories and research used to help understand offender rehabilitation, are not yet developed enough to consistently guide the design, implementation, and evaluation of effective treatment programs. Offering a qualifying statement regarding the current state of our knowledge about offender treatment programs aimed at the reduction of recidivism, Lipsey and Cullen (2007) point out that the “[r]esearch to date has been dominated by issues of whether anything works, with relatively little attention to questions of what works best, for whom, under what circumstances, and why” (pp. 14-15). They further state that “those treatments that show the largest average effects tend to be those based on better developed theory and research about their approach to bringing about change . . .” (Lipsey & Cullen, 2007, p. 16). Thus, is it likely that future progress in the area of offender treatment will be highly dependent on the advancement of systematic, theory driven research—a task that requires those working in the area to expand their traditional field-dependent worldviews and to draw on a wider range of theoretical perspectives and research approaches than presently employed.

Until quite recently, theorizing specifically focused on offender rehabilitation has taken place primarily within traditional disciplinary boundaries. This condition will likely need to change drastically to advance more complete understandings for how to design and implement effective treatment programming for the greatest number in need. For example, while psychologists seem well-suited to design programs aimed at helping clients adopt the type of attitudes, values, and beliefs that more prosocial behaviors likely require, most do not necessarily have the knowledge or expertise to know how to adapt these programs to the unique institutional conditions or the special needs of a wide range of correctional clientele. On the other hand, most criminologists have a good understanding of many of the social structural and process correlates of crime and criminality, but until quite recently have not paid much serious attention to the complex role of human agency in offending or desistance. And while some scholars trained in psychology have begun to focus their theory building and research on issues surrounding offender treatment programs (see Andrews & Bonta, 2006), and some criminologists have begun to build theory and conduct research in areas that have traditionally been “off bounds” such as biosocial, psychosocial, and life course theories of offending (Moffitt, 1993; Vaske, Gaylean, & Cullen, in press; Walsh & Ellis, 2003; Walters, 1990), this work is still the exception rather than the rule. To complicate matters further, there are vast and growing bodies of knowledge beyond the fields of criminology, psychology, and criminal justice, on which treatment specialists and rehabilitation researchers will need to draw as they work to design and implement effective correctional client interventions.

In addition to the more obvious relevance of findings on cognition and emotion being produced in the neurosciences, there are rich bodies of theory-driven research in fields such as developmental psychology and educational studies that will undoubtedly prove useful to future attempts to determine which types of treatments work best for whom. For example, over the past three decades, researchers from these two fields of study have produced independent findings that document the progression of cognitive and affective structures and processes that individuals grow through from childhood through adulthood (Hofer & Pintrich, 2002; King & Kitchener, 1994; Kuhn, 2005; Perry, 1968/1999). Current findings in areas such as the cognitive, affective, and neuropsychological correlates of learning processes will undoubtedly offer treatment program designers the type of knowledge necessary to structure more developmentally appropriate treatment/learning curriculum. These findings also have the potential to expose traditional rehabilitation researchers to a solid knowledge base focused on human growth and development.

As researchers work more actively across fields of study in an effort to examine offender rehabilitation from multiple theoretical perspectives and disciplinary frameworks, the organization and transfer of knowledge within and between different fields will need to take a higher priority than is it has in the past (see Cullen, 2011). Given the complexity of the challenge, more developed and integrated models of human behavior, as well as the adoption of metatheoretical frameworks, are likely to be employed to help orient researchers to multiple dimensions and layers of reality and guide the ongoing process of knowledge building. New theory construction and integration across disciplines may benefit from the use of various metatheoretical models that have been put forth by those approaching knowledge building from cross-, multi-, and trans-disciplinary perspectives (see, Barak, 2009; Bhaskar, 2002; Overton & Ennis, 2006; Poonamalle, 2010; Wilber, 2000).

Some international research teams have been working on the creation of methodologies for the construction of new worldviews that, in essence, encourage researchers to look at known facts and theories from another point of view (Aerts et al., 2007). Proposed methodological frameworks to construct worldviews that more consciously integrate facts and values could be adapted to help correctional rehabilitation researchers get a better sense for how their work might relate to work conducted in areas typically “walled off” from each other (i.e., social, behavioral, cognitive, physical, systems/informational/organizational sciences). More expanded, differentiated, and integrated worldviews may also help guide and sustain treatment program policy and practice, and serve as useful conceptual structures necessary to advance more effective pedagogical practices.

A summary of our current situation within rehabilitation research is such that we have both a strong and growing body of evidence that supports the effectiveness of certain correctional interventions and underdeveloped theoretical knowledge that lacks any coherent, metatheoretical structure to help orient or guide ongoing program design and research. Therefore, while framing the discussion around whether to adopt “evidence-based” programs or to rely on “correctional quackery” might have made sense at one time, and we acknowledge it may still make sense in certain practitioner circles, we suggest it makes must less sense at this point in time. Given the growth in knowledge bases from a wide range of disciplines relating to offender rehabilitation, we suggest that a very explicit recognition of the limits of our knowledge about why certain programs work, when they work, and for whom they work and under which conditions is just as essential as recognizing what works. Adopting greater precision in the way we think about and refer to programs and practices not only makes us more open to new discoveries but it can also help to minimize the tendency or temptation to oversell this state of knowledge and risk political consequences similar to those which occurred during Martinson’s day.

Importance of Opening to Alternative Research Approaches

As the field “opens up” to researchers from a wider range of disciplinary backgrounds, certain assumptions about various research approaches employed will also need to be brought much more explicitly into the foreground. Providing very direct, honest, and clear statements about epistemological and ontological assumptions that underlie theoretical frameworks and research approaches is likely to promote more effective communication and, hence, collaboration within and between researchers and fields of study. Because differing philosophical outlooks on such things as the nature of knowledge and what constitutes truth shape our views toward theory and evidence, not being explicit about these assumptions increases the likelihood for miscommunication. As a consequence of an “either/or” mindset, we can end up with situations where something that is considered “strong” theory or research from the perspective of one approach is perceived as “quackery” from another.

For example, while modern social sciences have traditionally adopted positivist methods of inquiry and relied on the observation and analysis of physical/behavioral phenomenon to understand and explain their object(s) of study, those attuned to the more subjective dimensions of meaning making and human understanding have generally employed more “interpretive” approaches, which typically deny any ability to make generalizations based strictly on empirical evidence (Crank, 2003; Kraska & Neuman, 2011). It is our view, however, that given the obvious complexity of the human condition, any significant advances in criminological and criminal justice theory (as well as research, pedagogy, policy, and practice), will likely depend on our capacity to explicitly draw on both positivist and interpretive approaches to support our knowledge building processes.

Kraska and Neuman (2011) use the term “critical social science” to refer to those research practices that tend to employ elements of both positivist and interpretive approaches to “doing” social science, and they provide a detailed discussion about how these approaches influence almost every step of the research process. They point out that each approach can be used in rigorous and systematic ways to uncover “what is” although key assumptions each approach makes about what constitutes valid knowledge, and hence the methods they typically employ, can differ. We view this type of direct discussion of the existence of differing philosophical perspectives, and hence theory building and research approaches, as essential for the advancement of a field that is learning how to more fully explore the potential of different treatment interventions from a wider range of disciplinary perspectives.

A real openness to both interpretive and critical approaches to social science, while keeping a “base camp” in positivism (or more accurately, “postpositivism”), seems essential for rehabilitation research to most effectively incorporate findings being produced from a wide range of related disciplines into the design, administration, and evaluation of treatment programs. Interpretive approaches offer major advances in our understanding of the human condition as they draw our attention to both structural power imbalances based on group differences such as class, race, and gender, as well as the more internal, less easily observable dimensions of our being (internal mental and emotional structures and states). They are known to employ theoretical frameworks and research practices designed to collect, analyze, and make sense of data derived from more subjective (first-person perspective) and intersubjective (second-person perspective) fields of our awareness, and to employ methodologies (e.g., phenomenology, ethnographic studies, and hermeneutics) that uncover different perspectives on reality. Positivistic approaches to social science research can build strong theoretical and analytical frameworks, employ highly developed tools to collect physical and behavioral data, and offer an invaluable means to examine phenomena from an objective, third person perspective. It seems evident, however, that a greater awareness of, and access to, internal fields of consciousness, such as those offered by the interpretive approaches, are indispensable as we build a more complete understanding of how the human mind, as well as of how our common and differing collective consciousness (cultures), influence behavior.

Furthermore, given that one of the explicit goals of the critical social sciences is “consciousness raising” and that its intended aim is to generate “liberating knowledge,” we contend that it too is worthy of serious consideration. Given the amount of misunderstanding about science in our society in general, and the role that findings produced from scientific studies can play to help guide decision-making processes in professional criminal justice circles specifically, a more explicit identification of the underlying philosophical perspectives on which theory and programs are being built, and research is conducted, offers a number of advantages. For example, rather than assume that research is or can be “value free” (or even neutral), or that all values are relative and therefore of equal worth, the critical social sciences bring to the forefront the point of view that all research has some normative, and hence political dimension (a claim that most researchers would have trouble denying). Given that a great deal of correctional decision making has historically been driven by normative positions alone, those who come from a critical social science perspective would encourage an open discussion of the relative merits of programs that have normative support versus those that have both normative and empirical support.

So incorporating some practices from the more interpretative approaches to social science does not mean that we are left in absolute relativity. Some may choose to use values such as the promotion of “social justice” as their decision-making criteria (as do most who identify with an interpretive approach) and focus on reducing prison populations, for example. Others may more generically identify those correctional programs and practices that are more inclusive of diverse worldviews and take a greater number of perspectives and needs into consideration as more valuable than those that address fewer perspectives and needs. Those who support a critical approach to social science value the explicit use of research findings to motivate and guide social action. Roger Matthews (2009b), for example, calls for an approach that links theory, methods, and intervention with the aim of going beyond what has been called “so what?” criminology.

Similarly, one assumption in rehabilitation programming that we argue should made explicit and challenged is the one that suggests that only treatment programs and practices that can produce evidence to demonstrate reductions in rates of recidivism are worthy of pursuit, and that all others constitute a form of “correctional quackery.” While making the case for evidence-based programs that reduce recidivism may be the easiest case to make in order to secure scarce program funding, we suggest that it is important to also support programs and practices directed at a wider range of outcomes. Specifically, as indicated in the foregoing, we argue that programs that have sound theory and/or evidence to demonstrate improved institutional conditions (for inmates, staff, and/or administration), and/or inmate conduct/behavior/health/growth while institutionalized are also worthy of serious consideration. Even while adopting a strictly positivistic research standard, there is overwhelming evidence to demonstrate the positive effects of a plethora of programs and practices when we broaden our scope beyond the goal of demonstrated reductions in recidivism, and consider the value of various less traditional correctional practices from a number of different perspectives.

Types of Outcomes We May Value in Addition to Reduced Recidivism and Why We Might Value Them

Correctional programming is imported from the larger community for application to inmates of jails and prisons and clients on probation or parole. This is fitting as the inmates and clients themselves enter facilities and supervision as products of that larger culture and with all of the health and welfare problems that are emblematic of it. In fact, because of their relatively impoverished state and their lack of access to health care, along with the abuse their bodies may have experienced due to drug and alcohol use, those inmates and clients are likely to have more health, psychological, and coping problems than is typical for their larger communities (Anderson, Rosay, & Saum, 2002; Marquart, Merianos, Hebert, & Carroll, 1997).

The managers and staff in correctional populations are responsible for addressing some of these problems, particularly when they make it difficult or impossible to supervise inmates or clients if these issues go unaddressed. In his classic book Hardtime: Understanding and Reforming the Prison, Johnson (2002, p. 83) discusses how a prison and its staff might be devised to assist inmates in “maturely coping” with some of these problems. He defines mature coping as

dealing with life’s problems like a responsive and responsible human being, one who seeks autonomy without violating the rights of others, security without resort to deception or violence, and relatedness to others as the finest and fullest expression of human identity. (Johnson, 2002, p. 83)

After acknowledging that many inmates of prisons might be “immature” due to debilitating substance abuse and life courses that went astray, he argues that prisons, or at least “decent prisons” that are by his definition free of most violence and able to meet the basic needs of their inmates, can be places where inmates in essence grow up. However, the prison (or correctional) environment must be such that inmates or clients are able to take responsibility for themselves, are able to engage in the world without having to employ lies or violence, and are able to form meaningful relationships with others. Thus mature coping both inside and outside of prison would appear to be a socially desirable outcome, distinct from recidivism—though likely related to it—that we might wish to nurture for inmates and clients of correctional entities.

Johnson (2002) places most of the responsibility and capability for maturing on the inmate of the prison, as one cannot impose this propensity on another. Notably, much of correctional supervision either inside or outside of institutions is about managing inmate and client time and activity. As such, there may be reduced opportunities for inmates/clients to act like responsive or responsible adults, or they may not have developed the ability to act without deception or violence in violence-prone institutions or neighborhoods. Thus Johnson (2002) notes that staff need to adopt a “human service” role in regard to correctional work, in which they undertake “goods and service” provision, “referrals and advocacy,” assistance with “adjustment,” and the formation of “helping networks” for the benefit of inmates (or clients; Johnson, 1996, pp. 229-245). As part of that human service perspective, the staff and management role is also to operate a decent prison where inmates might find “niches.” These niches might be places to which they might be classified to (i.e., living units) or in which they might seek out such programming as school, art, weight lifting, gardening, or other activities that keep them occupied with meaningful work and that provide them with the opportunity to “maturely cope.”

A collateral benefit of some such programs (e.g., yoga, gardening/nutrition, exercise), from a correctional manager’s perspective, and certainly from a taxpayer’s, is that health care costs are reduced when inmates engage in healthy eating and exercise or relaxation programs. From the staff and management perspective, then, the provision of programming that assists inmates and clients along the path to mature coping, that preoccupies them in prosocial and meaningful activities, and that may provide some collateral health benefits is all to the good, albeit with no direct effect on recidivism.

From an inmate’s or correctional client’s perspective, the need to develop life skills such as parenting, work expertise, and anger management might be viewed as valuable. Just the attainment of “how-to” knowledge related to these topics would appear to be a victory for some correctional clients who never had appropriate parenting modeled for them, or have never applied for or held down a job or, who have difficulty maintaining their temper when stressed. Certainly, if these programs are delivered to those who need them and have a cognitive component that requires behavioral modeling (in other words delivered with the “best practices” so often touted in the corrections literature), they are likely to have a greater positive effect on participants than otherwise. Should correctional clients practice such skills in their own lives, it is likely that they, and their families and communities, will benefit in numerous ways, perhaps related to reduced recidivism in a measurable way, but perhaps not.

From the perspective of what is of benefit to the larger societal good, one might argue, some programming (e.g., religious or spiritual) should be available to inmates and correctional clients. An ethics-of-care perspective and Maslow’s “hierarchy-of-needs” schema teach us that humans need to be provided with opportunities to use and develop to their potential whatever and wherever that track might take one (Maslow, 1961/1998; Pollock, 2004). Understandably, while under correctional supervision, such opportunities are constrained. However, if Maslow was correct that the need for respect, love, and self-actualization (beyond the food, water, safety, and security needs that correctional environments typically do meet) still exists, human beings will find some means to meet those needs. Better that the correctional environment provides prosocial programming or activities to meet those needs than that they avail themselves of antisocial activities that abound there (e.g., gang involvement, dealing in illegal goods). Are religious, educational, or other prosocial activities and programming related to reduced recidivism? The answer is not clear or always determinable in a positivistic fashion. Even so, there is some limited research that does indicate identifiable and beneficial outcomes, other than reduced recidivism, for inmates/clients (and indirectly correctional staff/management, and the larger society) that might be gained from correctional programming.

At this juncture we do know that some studies are suggestive regarding the increased health and other benefits that appear to derive from correctional programming that has nothing to do, directly anyway, with reduced recidivism. For instance, two medical doctors writing separate articles in a 2007 issue of the Journal of the American Medical Association recommended that yoga be used, among other techniques and practices, to reduce stress and strain on the heart (Torpy, 2007; Ziegelstein, 2007). One author recommended that more studies be done regarding the ability of yoga to reduce acute emotional stress.

The Niroga Institute, an organization devoted to delivering “transformative life skills” to underserved populations, assessed the effect of yoga classes on girls and boys incarcerated in the Alameda County Juvenile Justice Center. In a study they conducted of the effect of yoga on stress and self-control of these youth, the researchers found that the pretest and posttest study identified a decrease in stress and an increase in self-control among those taking the yoga classes (Matthews, 2009a). While not a study with an experimental design, the findings are suggestive of some positive outcomes for the youth and likely the facility, which may or may not be indirectly related to a reduction in recidivism.

Studies have documented the high levels of stress, anxiety, and depression experienced by incarcerated offenders (Buckaloo, Krug, & Nelson, 2009; Castellano & Soderstrom, 1997). Some research indicates that exercise programs can be used by inmates as a coping mechanism to reduce their depression, stress, and anxiety (Buckaloo et al., 2009) and aggression (Wagner, McBride, & Crouse, 1999). For those with serious mental illness, one study’s authors found that a residential mental health treatment program in a prison led to a decrease in psychiatric symptoms (Lovell, Johnson, Jemelka, Harris, & Allen, 2001). Moreover, educational programs provide a positive niche for inmates to retreat to and have been associated with reduced recidivism, though the effects might be particularly beneficial for those who are least advantaged educationally (Adams et al., 1994) and do not always hold true for vocational programs (Brewster & Sharp, 2002). As regards religious programs, there are some researchers who claim that these interventions provide solace to inmates and divert them toward more prosocial engagements with staff and other inmates and away from antisocial (e.g., gang) and self-destructive behaviors (Nielsen, 2003; Thomas & Zaitzow, 2006). The use of animals to help their human companions cope with illnesses, addictions, and disorders is a well-established practice in the medical community and is growing in usage among inmates (Furst, 2006). Whether this usage can be tied to later reductions in recidivism is doubtful, but it could very possibly serve some other purpose and lead to other beneficial outcomes.

Another type of programming that seems worthy of consideration is that which employs mental training to help individuals develop greater awareness of, and hence greater control or acceptance of, thoughts and feelings (e.g., negative emotionality, antisocial attitudes). This type of mental state training, which might have been dismissed as correctional quackery in the past, typically falls under the heading of “meditation,” and has been the subject of intense research on correctional populations for the past four decades (Chiesa, 2010; Lutz, Dunne, & Davidson, 2007). Positive health benefits such as reduced levels of stress, increased control over chronic pain, and enhanced regulation of emotion have been found in the general population (Kabat-Zinn, 2003; Lutz, Brefczynski-Lewis, Johnsone, & Davidson, 2008; Ospina et al., 2007). In a meta-analyses of 813 studies of the potential health benefits of meditation, the findings were inconclusive, though suggestive (Ospina et al., 2007). Most of these studies were poorly defined and there did not appear to be theoretical coherence in the meditation types offered (e.g., it included yoga, Qi Qong, and various types of meditation). However, although there were positive effects from meditation on hypertension and stress in this study, there was no effect found for substance abuse. The research concluded by calling for more rigorously designed and executed research (Ospina et al., 2007).

Studies specifically aimed at correctional populations, however, have found evidence to suggest positive outcomes, such as improved psychological well-being, as well as decreases in substance abuse and recidivism (Chiesa, 2010; Himelstein, 2011). Advances in brain imaging technology now allow researchers to examine relations between meditation states and cognitive and affective neuroplasticity, attentional stability, and self-awareness (Lutz et al., 2009; Raffone & Srinivasan, 2010), which may provide important insights for advances in correctional treatment interventions. In addition, as a new generation, or “third wave,” of cognitive-behavioral therapists adapt mindfulness-based meditative training into their clinical practices (Chambers, Gulloen, &Allen, 2009), it will be necessary to compare results of this form of cognitive-behavioral therapy with those produced from cognitive restructuring practices employed more commonly today by cognitive-behavioral practitioners (Brown, Gaudiano, & Miller, 2011).

It is still important to ask, however, whether some programs, no matter how well intentioned, should be abandoned when they show no relationship to recidivism or any other beneficial outcome. The answer has to be most assuredly, yes. For instance, a few studies of parenting programs indicate that at least for many substance-abusing female inmates, the programs did not have much effect on their attitudes toward parenting. This failure to change attitudes was attributed to the fact that many female offenders already have attitudes regarding parenting that largely mirror the general public’s, perhaps indicating that such programming may not be needed or that such programs need to be redesigned (Surratt, 2003). Moreover, as Craig (2009) notes in her historical review of mother and child programs in women’s prisons, such efforts ostensibly to bind the child to mother were often tangled up in efforts to control women’s minds and bodies, thus tainting the intent and exercise of such programs.

Conclusions and Recommendations

Correctional quackery is a term that can be appropriately tied to a few programs that yield no or little value for correctional entities, inmates/offenders, or the greater good. But it should not be applied to programs simply because they have no, or no discernible, effects on recidivism. If the identified goal of a program is reduced recidivism and that program does not achieve that goal, then certainly it should be cut. However, recidivism is a desirable, but not the only desirable, measure of correctional programming. Other socially laudable outcomes of programs might include reductions in stress, improvements in health, elevation in education or training, greater spiritual connection to other human beings, or just engagement in prosocial activities as alternative niches into which inmates might find refuge to cope with the reality of incarceration. As it stands, our theory building and methodology may be too primitive to illuminate the true value of programming that at first blush does not yield a drop in recidivism but, on closer examination, would reveal that it improves in important ways the lives of those imprisoned and those employed to watch and care for them.

Advancement in scientific inquiry requires an openness to alternate approaches and knowledge gained from other disciplines. For example, the connection between biology and criminal engagement is only now being accepted because there were some in criminology who resisted, and are still resistant to, this line of inquiry (Cullen, 2011). This resistance may have unnecessarily hampered our ability to see the true effects of the environment on biology, and vice versa. In short, theory and evidence are solid in some areas, but there is reason to believe we need to adopt broader theoretical frameworks to encourage knowledge building across traditional disciplinary boundaries, and incorporate valuable insights offered from both interpretive and critical research.

These considerations allow us to end by sharing four recommendations for enriching our understanding and the practical delivery of correctional programming.