Treatment Combinations: The Joint Effects of Multiple Evidence-Based Interventions on Recidivism Reduction

DOI10.1177/00938548211052584
Published date01 June 2022
Date01 June 2022
Subject MatterArticles
CRIMINAL JUSTICE AND BEHAVIOR, 2022, Vol. 49, No. 6, June 2022, 911 –929.
DOI: https://doi.org/10.1177/00938548211052584
Article reuse guidelines: sagepub.com/journals-permissions
© 2021 International Association for Correctional and Forensic Psychology
911
TREATMENT COMBINATIONS
The Joint Effects of Multiple Evidence-Based
Interventions on Recidivism Reduction
MING-LI HSIEH
University of Wisconsin–Eau Claire
KUAN-JU CHEN
University of Guam
PAK-SING CHOI
National Central University
ZACHARY K. HAMILTON
University of Nebraska Omaha
Evidence-based interventions have been implemented within penal institutions to reduce the propensity of postrelease reof-
fending across states. Traditional program evaluations explore these interventions and demonstrate treatment effects most
often for a single specific intervention. Although this process supports the doctrine of evidence-based research, little is known
of the joint effects of multiple program assignments. The current study examines the treatment effects of sequence combina-
tions of institutional programs on recidivism outcomes. Results demonstrate that correctional clients experienced incremental
improvements when receiving more than two interventions compared with those who participated in a standalone interven-
tion. Those who participated in three types of treatment combinations consisting of basic skills, vocational training, and
cognitive behavioral treatment were more likely to reduce postrelease reconvictions.
Keywords: multiple treatment effects; institutional programs; recidivism; propensity score matching; treatment dosage
INTRODUCTION
Evidence from meta-analyses has revealed a variety of interventions that have been
implemented within institutions that positively impact correctional clients’ postrelease
behavior (Andrews et al., 1990; Landenberger & Lipsey, 2005; Pearson et al., 2002, 2012;
Prendergast et al., 2013; Wilson et al., 2000). For instance, research on evidence-based
practices (EBPs) suggest that generic interventions such as, but not limited to, education
AUTHORS’ NOTE: Correspondence concerning this article should be addressed to Ming-Li Hsieh, Criminal
Justice Program, University of Wisconsin–Eau Claire, 105 Garfield Avenue, WI 54702; e-mail: hsiehm@uwec.
edu.
1052584CJBXXX10.1177/00938548211052584Criminal Justice and BehaviorHsieh et al. / Treatment Combinations
research-article2021
912 CRIMINAL JUSTICE AND BEHAVIOR
(Sedgley et al., 2010), vocational training (Callan & Gardner, 2005; Mohammed &
Mohamed, 2015), cognitive behavioral therapy (CBT; Duwe & Clark, 2015; Hollin et al.,
2008), risk-need-responsivity (RNR) supervision (Pearson et al., 2016), and prison-based
drug treatment (Duwe, 2010; Proctor et al., 2012) demonstrate as significant a recidivism
reduction as name brand programs in terms of public safety enhancement (Lipsey et al.,
2010).
While incarcerated, it is common for correctional clients to be exposed to more than
one generic program (Frölich, 2002), particularly prisoners in high-risk groups with crim-
inogenic needs. Correctional clients may first receive basic education training to obtain a
general educational development (GED) certificate. After that, they may attend a voca-
tional training program to build occupational skills, or begin a CBT to change antisocial
attitudes and to retain mental health, or receive other treatment combinations. One of the
primary reasons that these generic institutional programs seem to be consistently pro-
vided is that evidence-based programs often focus on dynamic risk factors in areas from
which change is more likely to result (Duwe, 2017) which helps prevent postrelease
recidivism.
Delivering several treatments simultaneously is necessary to address a correctional cli-
ent’s criminogenic needs (Andrews & Bonta, 2010a). Historically, there has been greater
focus on EBP’s ability to demonstrate the average treatment effects (ATEs) of single
interventions (Callan & Gardner, 2005; Duwe, 2010; Duwe & Clark, 2015; Hollin et al.,
2008; McNiel & Binder, 2007; Mohammed & Mohamed, 2015; Sedgley et al., 2010;
Somers et al., 2012), yet little is known about the joint effects of multiple program
assignments.
The current study attempts to assess whether correctional clients benefit incrementally
from additional programing, particularly whether additional programming reduces their
propensity to recidivate. This study also examines policy implications for program provid-
ers and correctional administrators related to the potential utility of program-sequence com-
binations in recidivism reduction for those correctional clients needing more rehabilitative
attention.
DELIVERY OF EVIDENCE-BASED INTERVENTIONS
It is common for states to fund correctional agencies to deliver multiple interventions,
hopefully delivering effective programs that possess recidivism reduction potential and
offer communities crime prevention (Taylor, 2017; Wanner, 2008). Most jurisdictions rou-
tinely provide evidence-based rehabilitation programs addressing the criminogenic risk fac-
tors derived from the General Personality and Cognitive Social Learning (GPCSL)
perspective (Andrews & Bonta, 2010a, 2010b; Bonta et al., 2013) that would lower a cor-
rectional client’s propensity for reoffending and maximize the likelihood of successful
reentry. For instance, interventions such as basic education, vocational training, and cogni-
tive therapy are not only promising generic options targeting general correctional popula-
tions (MacKenzie, 2006; Taylor, 2017; Wanner, 2008); they also provide “the behavioral,
cognitive behavioral, and social learning approaches” that could be further incorporated
into other programming and extended to the RNR model of crime prevention (Andrews &
Bonta, 2010a, p. 150).

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