Dosage is more than just counting program hours: The importance of role-playing in treatment outcomes

ABSTRACT

The risk principle directs correctional practitioners to provide greater amounts of correctional treatment to higher-risk offenders, while the responsivity principle directs practitioners to target criminogenic needs using treatment modalities that have been shown to be the most effective at reducing recidivism for offenders as a group. One such treatment modality is cognitive-behavioral treatment. Consequently, more studies are attempting to identify the most effective amounts of cognitive-behavioral treatment to provide to offenders of varying risk levels in an effort to maximize recidivism reductions. This article builds upon prior dosage research by examining whether time spent on a specific strategy commonly employed in cognitive-behavioral programs—the use of role-play—serves as a moderator of the risk–dosage relationship. It does so using a sample of 980 male offenders who received treatment in a community-based correctional program in Ohio. The results indicate that practitioners should continue to match treatment dosage to risk, strive to provide the optimal amount of dosage suggested by previous studies, and maximize use of behavioral rehearsal techniques such as role-play.

KEYWORDS:

• Community corrections
• correctional treatment
• dosage
• principles of effective intervention
• risk principle

Notes

The program defined a successful discharge as evidence that the program participant completed his prescribed dosage and maintained appropriate behavior throughout his stay.

Once we standardized for time in program, the variable role-plays per week ranged from 0–4.75. The mean was 0.90 and standard deviation was 0.93. If we used the mean +/− 1 standard deviation, then 84% of the sample would be in the first category, approximately 11% would be in the second category, with 4% and 1.5% in the third and fourth categories, respectively. The cutoffs would be 1.83, 2.76, and 3.69, which are similar to the cutoffs chosen for the analyses, and produced a similar pattern of results. Consequently, we elected to use a coding scheme that would be more easily interpreted and have practical value to practitioners.

While it appears that 200 or more hours of treatment produces the same recidivism rate as less than 100 hours of treatment for high-risk offenders, it should be noted that only six high-risk offenders received less than 100 hours. This combined with the drop in recidivism when going 100–199 hours of treatment to greater than 200 hours of treatment as well as previous cited research about effective dosage ranges for high-risk offenders led us to conclude that 200 or more hours are required to reduce recidivism for high-risk offenders.