Responsive Aggression Regulation Therapy (Re-ART): An Evaluation Study in a Dutch Juvenile Justice Institution in Terms of Recidivism

• Author: Larissa M. Hoogsteder,Daphne Bonnes,Geert-Jan J. M. Stams,Eveline E. Schippers
• Published date: 01 October 2018
• Date: 01 October 2018
• DOI: http://doi.org/10.1177/0306624X18761267
• Subject Matter: Articles

https://doi.org/10.1177/0306624X18761267

International Journal of

Offender Therapy and

Comparative Criminology

2018, Vol. 62(14) 4403 –4424

© The Author(s) 2018

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DOI: 10.1177/0306624X18761267

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Article

Responsive Aggression

Regulation Therapy

(Re-ART): An Evaluation

Study in a Dutch Juvenile

Justice Institution in Terms

of Recidivism

Larissa M. Hoogsteder1, Geert-Jan J. M. Stams2,

Eveline E. Schippers1, and Daphne Bonnes1

Abstract

This article describes a quasi-experimental study of the effectiveness of Responsive

Aggression Regulation Therapy (Re-ART) in terms of recidivism for 16- to 21-year-

old juveniles with aggression problems and high risk of recidivism. In a Dutch juvenile

justice institution, an experimental group received Re-ART (n = 63, Re-ART group)

and a waitlist control group received Treatment as Usual (n = 28, TAU group).

Results indicated that Re-ART is significantly more effective than TAU in reducing the

juveniles’ recidivism risk for violent offending. Compared with the TAU group, the Re-

ART group showed significantly less violent crimes after 2 and 3 years, less property

crimes after 2 years, and less general recidivism after 2 and 3 years. There was no

significant difference between groups in recidivism of property crimes with violence.

Ethnicity, mild intellectual disabilities, substance abuse, and age did not moderate the

effects on recidivism outcome, which indicates that Re-ART was equally effective for

various groups.

Keywords

aggression problems, adolescents, behavioral intervention, high risk of recidivism,

juvenile justice institution

1de Waag Forensic Outpatient Treatment Center, Utrecht, The Netherlands

2University of Amsterdam, The Netherlands

Corresponding Author:

Larissa M. Hoogsteder, Head Treatment, de Waag Forensic Outpatient Treatment Center, Postbus

1362, 3500 BJ, Utrecht, The Netherlands.

Email: lhoogsteder@dewaagnederland.nl

761267IJOXXX10.1177/0306624X18761267International Journal of Offender Therapy and Comparative CriminologyHoogsteder et al.

research-article2018

4404 International Journal of Offender Therapy and Comparative Criminology 62(14)

A large part of crime in the Netherlands is recurring crime committed by recidivists,

individuals who have previously been in touch with justice. The government strived to

reduce general recidivism by 10% (Ministry of Security and Justice & Ministry of the

Interior and Kingdom Relations, 2007). Therefore, Dutch juvenile justice institutions

invested extensively in effective treatment of (aggressive) behavior problems by

developing and offering various behavioral interventions. Responsive Aggression

Regulation Therapy (Re-ART; Hoogsteder, 2014) is one of the accredited behavioral

interventions in The Netherlands (The Netherlands Youth Institute, 2016), and it is

designed specifically for adolescents from 16 to 21 years old with severe aggression

problems and an IQ over 70. Hoogsteder, Kuijpers, Stams, Van Horn, and Hendriks

(2014) showed that, when compared with a control group, Re-ART significantly

improved aggressive behavior, coping abilities, responsiveness, and cognitive distor-

tions (with the exception of negative attitude) with medium to large effects. Following

the Hoogsteder et al.’s (2014) study, the present study examined whether or not

Re-ART leads to reduction of (risk of) violent recidivism. In addition, we investigated

for whom the intervention works best (La Greca, Silverman, & Lochman, 2009) by

investigating possible moderator effects of ethnicity, mild intellectual disabilities, age,

and substance abuse on treatment outcome.

Between 2006 and 2010, there was a small decrease (1.4%) in general recidivism

of juvenile offenders (from 59.2% to 57.8%; Wartna et al., 2012). In 2012, however,

recidivism rates slightly increased compared with the previous year (Wartna et al.,

2014). Remarkably, the number of violent crimes increased among adolescents,

whereas the number of property crimes decreased (Tollenaar, Van Dijk, & Alblas,

2009). It remains unclear why (only) the rate of violent recidivism did increase. It is

clear, however, that a large proportion of adolescents in juvenile justice institutions

show aggressive behavior problems (Brand, a’Campo, & van den Hurk, 2013).

Aggression is defined as the inadequate expression of anger, by means of hitting, kick-

ing, swearing, or mocking, threatening, or scaring someone, as well as purposeful

behavior that is intended to (physically) harm one other or benefit from (Anderson &

Bushman, 2002; Ferguson, 2015). The aggression problems of these adolescents are

often severe and persistent, and are influenced by various criminogenic risk factors

(Andrews & Bonta, 2010; Assink et al., 2015), including substance abuse (Plattner

et al., 2012) and psychological problems (Brand et al., 2013; Coccaro, Lee, &

McCloskey, 2014; Doerfler, Connor, & Toscano, 2011; Lobbestael, Cima, & Arntz,

2013; Vreugdenhil, Doreleijers, Vermeiren, Wouters, & Van Den Brink, 2004). Also,

notwithstanding the effect of treatment, detention can reinforce aggressive behavior

(Gatti, Tremblay, & Vitaro, 2009; Heynen, Van der Helm, Cima, Stams, & Korebrits,

2017). It is therefore safe to conclude that detained adolescents with severe aggression

problems have a (very) high risk of violent recidivism (Schubert, Mulvey, Loughran,

& Loyosa, 2012; Wartna et al., 2014). Therefore, reduction of aggression in detained

juveniles requires specific and professional treatment (Beerthuizen, De Wied, &

Orobio de Castro, 2011).

Re-ART integrates treatment components that decrease recidivism in adolescents

with (severe) aggression problems. For instance, the intervention is based on the risk,