Vermont's Cognitive Self-Change Program: A 15-Year Review
Powell, Thomas, Bush, Jack, Bilodeau, Brian, Corrections Today
There are few institutional environments more inclined to repeat past mistakes than the nation's prisons. Despite billions of dollars funneled into incarcerating 2 million men and women, the corrections profession has done little to advance the science of changing criminal behavior. Corrections often has scant resources to train or support staff in promising new methods. The age-old tension between programs and security continues to prevail, and security is still winning.
Symptoms of this "business-as-usual" approach are abundant. Psychologists are trained to be attentive to scientific innovation and research findings, but a recent survey indicated only 7 percent of psychologists working in prisons are members of associations dedicated to improving the practice of correctional psychology. Most still rely on the Minnesota Multiphasic Personality Inventory or Rorschach Inkblot Test, time-honored personality assessment tools with little relevance to offender risk prediction or treatment, while ignoring offender-specific tools, such as Level of Service Inventory Psychopathy Checklist, which provide far more relevant and valid data. Additionally, 60 percent of mental health treatment interventions occur in an individual, rather than group, format.  Given the sheer volume of mental health services in American prisons, this is an egregious waste of a very limited resource, based on traditional habits favored by clinicians.
This devotion to the past does not reflect best practices and yet it continues unabated, limiting access to effective treatment. U.S. prison policy tends to resist self-examination and change. Dedication to institutional security and order too often are seen as the only worthwhile goals, as we ignore the deleterious effects of the harsh prison environment on inmates and staff alike. Given the amount of political and economic attention lavished upon corrections, the taxpayer might wonder why there is so little "correcting."
In 1986, the authors of this article were involved in a critical review of the "business-as-usual" approach in the Vermont correctional system. In this small progressive state, we were aware that the old security-minded order was failing to address offenders' needs. In conjunction with the University of Vermont's Psychology Department, we began developing alternatives to traditional counseling and therapy methods. We identified a need for a much more explicit intervention, focusing on the specific cognitive structures, criminal self-image and anti-social attitudes. We wanted to introduce evidence-based practices and promising methods. We also wanted to move this intervention out of psychology staff offices and into the units, using uniformed officers and caseworkers as full participants in the treatment process. With the support and commitment of prison and central office administrations, the Cognitive Self-Change (CSC) program Was born.
CSC originally was based on techniques proposed by psychiatrist Samuel Yochelson and psychologist Stanton Samenow, both were researchers at St. Elizabeth's Hospital in Washington, D.C. It evolved to include established methods of cognitive restructuring, broadly similar to the methods of psychologist Albert Ellis and psychiatrist Aaron Beck. The premise of the program is that all people have acquired thinking and feeling habits, including underlying attitudes and beliefs, which direct and control their external behaviors. As William Healy described, "Bad habits of the mind" are more responsible for criminal conduct than social circumstances. Offenders have acquired habits of thinking and feeling that reinforce patterns of criminal or violent behavior. These ways of thinking are habitual and automatic; the offender "thinks without thinking." CSC aims to bring these automatic thinking habits under offenders' consciousness and deliberate control. 
The program proceeds through a series of steps. …