The key to crime prevention may lie in a traditional therapy method.

Cognitive behavioral therapy (CBT) has become world-renowned for its impressive results in helping people change their behavior. Originally used to treat anxiety and depression, CBT is based on the idea that dysfunctional behavior results from dysfunctional thoughts, so the objective is to get participants to think differently about their lives in order to bring about real, actionable change. For example, if a smoker tends to grab a cigarette whenever they are stressed, CBT helps that person identify the mental connection they have between stress-relief and cigarettes. Once that connection is explicit, the person becomes better able to challenge the impulse the next time it arises, and pursue alternatives.

CBT advocates argue that once someone has become more cognitively self-aware of their own biases and actions, they can adopt strategies to help them refrain from problematic behavior and make wiser decisions. Such programs have been shown to reduce suicide attempts, teenage drug use, and, in some cases, anger. But the most dramatic use of CBT has been in the field of crime prevention.

Dr. Jack Bush is an Oregon-based therapist who runs a program called “cognitive self change.” He uses CBT techniques in group therapy sessions with offenders where they talk about and try to adjust the thoughts that drive them to criminal actions. In the over 35 years he has been administering the treatment program, he has seen countless offenders modify their behavior. One story that sticks out in his mind is about a man he refers to only as Ken.

Bush says Ken was a “career criminal” who grew up in 1980s Los Angeles. He started using drugs and committing armed robbery, and ultimately landed up in jail. Ken used to say he wanted to be the “baddest person” he could be. “By bad he meant criminal, without regard for other people’s rights.” Ken even wrote essays on why felons are morally superior to law-abiding citizens, arguing that by living according to a criminal code, he was more virtuous than other citizens who had no such code. He would “take a life sentence in prison rather than snitch on another co-criminal,” Bush says.

Success in changing the behavior of someone like Ken would prove to be difficult, given that he had such an intellectual and emotional commitment to breaking the law. But remarkably, the CBT intervention was successful. Ken has now been out of prison for 20 years and, according to Bush, has not relapsed into violent behavior.

A less aggressive way to fight crime

CBT’s participatory approach toward fighting crime differs vastly from the highly punitive rhetoric uttered by US president Donald Trump on the campaign trail. Trump has been quoted as favoring policies like “stop and frisk” and has signed a number of executive orders in which he vows to crack down on violent crime.

Policies such as stop and frisk often make people feel violated. The Center for Constitutional Rights found in 2012 that the policy had resulted in a range of abusive behaviors by police, including forcing citizens to strip to their underclothes in public, inappropriate touching, physical violence, threats, extortion of sex, and sexual harassment. This is particularly alarming in light of the fact that nearly nine out of 10 people stopped in New York since 2002 were completely innocent.

Compared to this, CBT looks more like a group-therapy session than a punishment. Bush’s version aims to tackle criminal reform and re-offense by getting participants to follow four steps:

Learning to pay attention to thoughts and feelings. This teaches them to be “objective observers of subjective experience.” Getting participants to recognize when their thoughts and feelings are leading them to break the law or hurt someone. Coming up with new ways of thinking that won’t lead to breaking the law—and that, crucially, still allow the offender to feel good about themselves. Practicing the new thinking in stressful situations.

Bush attributes the success of these programs to their non-confrontational nature. “Offenders, for the most part, don’t want to be labeled pathological—I guess nobody does,” he says. Offenders are also able to receive help without any stigma. By contrast, approaches that focus solely on incarceration tend to reinforce feelings of victimization within offenders. Once that point is reached, further punishment only fosters vengeful emotions against the system. Ultimately society ends up breeding “another generation of hard-core criminals”.

Sara Heller, assistant professor of criminology at the University of Pennsylvania, confirmed the efficacy of CBT in her research. When she conducted a study involving a randomized group of 2,740 at-risk-youths in Chicago, she found that compared to a control group, participants in the CBT initiative showed a 44% reduction in violent-crime arrests. Also, a review of 58 studies assessing the effectiveness of CBT programs around the country found that they cause re-offense rates to drop by 25%. CBT has since spread to many parts of the criminal-justice system, and has even been recommended by the National Institute of Justice as a particularly effective tool for treating juvenile offenders.

Paying the price for law enforcement

Considering that at any given time, approximately 1 in every 45 adults in the United States is under some form of community correctional supervision, CBT holds a lot of potential for reducing pressure on an already strained prison system. This is not only because of its capacity to bring down rates of reoffending, but also due to its cost effectiveness. In a 2004 research project that analyzed 14 studies investigating the impact of criminal-reform CBT programs, 13 were found to have positive cost-benefit outcomes.

Bush is under no illusions about CBT solving all of the problems facing the criminal-justice system: He thinks it should supplement other methods, not replace them. “There is nothing wrong with law and order in the sense of stopping criminals from offending by arresting them,” he says. “But if you follow that arrest up with more and more punishment, that will have a negative effect. It will not change their attitude toward the law and society.”