Cognitive behavior therapy reduces crime and violence over 10 years: Experimental evidence

In most societies, a small number of people commit most of the serious crimes and violence. Short-term studies have shown that cognitive behavioral therapy (CBT) can reduce such antisocial behaviors. There are some signs that these behavior changes may be temporary, however, especially from therapy on its own. This is unsettled, however, for there has been little randomized and long-term research on the question. We follow 999 high-risk men in Liberia 10 years after randomization into one of four arms: 8 weeks of a low-cost therapy; a \$200 cash grant; both therapy and cash; or a control group. Together, the two interventions cost just \$530 to deliver. We find that, a decade later, both therapy alone and therapy with economic assistance produce dramatic reductions in antisocial behaviors. Reported drug-selling and participation in thefts and robberies, for example, fall by about half. These impacts are greatest among the very highest-risk men. The effects of therapy alone, however, are somewhat smaller and more fragile. The effects of therapy plus economic assistance are more sustained and precise. Since the cash did not increase earnings for more than a few months after the grants, we hypothesize that the grant, and those few months of legitimate business activity, reinforced the learning-by-doing and habit formation embodied in CBT. Overall, the results suggest that highly-targeted CBT plus economic assistance could be an inexpensive and effective way to prevent violence, especially when policymakers are searching for alternatives to aggressive policing and incarceration.