Challenging Dogma - Fall 2007

...Using the social and behavioral sciences to improve the practice of public health.

Wednesday, December 12, 2007

Viewing Scared Straight as a Public Health Failure—Tyler James

Public Health interventions have failed to address the adverse health outcomes of adolescents vacillating back and forth between the criminal justice system. Research has documented that adolescent labeled as juvenile delinquents experience higher rates of illicit substance abuse, mental health issues, and higher rates of violent death than non-delinquent adolescents do(1-4). The philosophy behind these efforts suggests that reducing delinquency will improve the health outcomes among at risk adolescents. This paper will focus on the Lifer’s Juvenile Awareness Project captured in documentary “Scared Straight”, a prison-aversion program presented itself during the seventies as a possible method from deterring adolescents from criminal behavior and risky health behaviors. There have been mixed reports about the success of the Scared Straight program, this intervention represents a public health failure.

The Birth of Scared Straight
In 1978, Arnold Shapiro directed a documentary examining the “Lifer’s Juvenile Awareness Project,” implemented at the Rahway State Prison in New Jersey. The “Lifers Juvenile Awareness Program,” was offered as an alternative choice for adolescents who faced prison time for their involvement in criminal activity. The goal of this intervention was to give youth an experience of what life would be like in the prison system. The outcome that this intervention was hoping to achieve was to reduce adolescent’s risk of committing criminal or risky behaviors. The “Lifers Juvenile Awareness Program,” used real prisoners or Lifers to implement the intervention to adolescents. Lifers would “keep it real” and used excessive graphic language, violent images of men and women assaulted in prison, and role-playing to illustrate how engaging in delinquent behaviors ultimately leads to undesirable consequences, mainly landing in prison and suffering through its daily hardships.

Shapiro titled the documentary Scared Straight, and it aired nationally in 1979. In the finale of Scared Straight, Shapiro claimed that there was an 80% deterrent effectiveness among all participating adolescents and that there was 100% deterrent rate among the intervention participants during the filming of the documentary. With the lifer’s graphically demonstrating how their negative behaviors led to their imprisonment and the hardships they face inside of prison, rational thought suggests the intervention would discourage juvenile delinquents from continuing their destructive behaviors (5). This national exposure gave credibility to its effectiveness and it inspired 38 states to adopt prison-aversion programs modeled after the “Lifer’s Juvenile Awareness Project”, which due to the popularity of the documentary the public colloquially referred to as Scared Straight (6). State’s implementation of the program was very similar to the aggressiveness and intimidation tactics employed by the prisoners of the original documentary. Also, states used various criteria to determine eligibility for the intervention. Some juveniles participating in the intervention are first time offenders while others committed several criminal offenses.

Substance Use and Scared Straight
Scared Straight encompasses several of the Health Belief Model constructs used to inspire behavioral change in an individual. The behavioral outcome the intervention seeks to achieve is eliminating recidivism and encouraging adolescents to adopt more socially acceptable behaviors. According to the program, juvenile delinquents should have a high-perceived susceptibility since their behaviors led to their interaction with the criminal justice system. However, juvenile delinquents experience a high likelihood of illicit substance use and have difficulty making and maintaining a rational decision such as avoiding crime or remaining sober without assistance (1). Therefore, the co-occurrence of other issues among juvenile delinquents makes the rational thought process difficult to follow.

The glaring issue that makes this intervention a public health failure is that the intervention fails to recognize the importance of the co-occurrence of other issues among juvenile delinquents. Scared Straight fails to address the negative health outcomes such as illicit substance abuse or mental health needs of juvenile delinquents that cause them encounter the criminal justice system. Research has shown that recidivism coincides with more serious drug use—moving from marijuana to cocaine for instance (1). Studies have also shown that imprisonment negatively affects the health of individuals, particularly mental health (7-8). Solely relying on Scared Straight to address the co-occurrence of issues among juvenile delinquents represents a public health failure and evidence that treatment services need to be involved in reducing recidivism rates.

Scared Straight Fails to Provide an Effective Skills Set
Scared Straight consist of hours of Lifers talking to adolescents in an aggressive manner and use the role-playing exercises of the intervention to humiliate juvenile delinquents rather than help them learn how to perform more socially acceptable behaviors. The Scared Straight intervention fails to provide juvenile delinquents with an appropriate skill set for effectively avoiding recidivism and other delinquent behaviors. The co-occurrence of criminal behavior and illicit substance use suggests that juvenile delinquents need a new set of skills to perform more socially acceptable behaviors in mainstream society. Failing to address these issues will not engender change among juvenile delinquents because they lack the tools/resources to do so. Research supports the use cognitive-behavior therapy to change behavior successfully. Cognitive-behavioral treatment includes problem solving, negotiation, skills training, interpersonal skills training, rational-emotive therapy, role-playing and modeling, and cognitively mediated behavior modification (9).

Scared Straight Does not involve the Community or Positive Role Models
Research has shown that interventions seeking to combat recidivism prove to be more effective when the interventions are conducted in a community setting rather than institutions such as a prison (9-10). Lifers encourage juvenile delinquents to become socially responsible members within their community, yet the intervention excludes the community environment. There is a great disconnect between the goal of the intervention and the actual environments of juvenile delinquents. Not only does the intervention fail to incorporate the community within the program, juvenile delinquents do not receive information about the resources their communities or nearby communities have to offer. This is critical since the treatment services within the public sector are not easily available (1).

Unlike adolescents not labeled as at-risk or delinquent, juvenile delinquents have not experienced a decrease in illicit drug use. Prison-aversion programs such as Scared Straight have been unsuccessful in their attempts to decrease recidivism rates and negative health outcomes among juvenile delinquents due to their reliance on Health Belief Model constructs. Juvenile delinquents need additional resources and therapy to address co-occurring issues in conjunction with intervention leaders illustrating the negative consequences of their behaviors. This is the reason why independent evaluation of the Scared Straight intervention suggests the program is not effective. The intervention emphasizes the consequences of criminal behavior but fails to instruct juvenile delinquents from performing such behaviors. Once juvenile delinquents encounter the criminal justice system, they are aware of the consequences of their criminal behavior. Since states implemented the program with the same criterion and with the same expected outcomes stated in the “Lifer’s Juvenile Awareness Project,” they have not achieved their desired target goals in the reduction of youth coming into prison and reduction of recidivism among those that have been in the incarceration system.

Despite the promoted effectiveness of Scared Straight this interventions has failed to reduce recidivism effectively among juvenile delinquents. The structure of Scared Straight lacks the critical elements identified by research on efficacious methods of reducing recidivism. The major flaws of the intervention are it is not continuous, it inadequately addresses co-occurring issues such as substance abuse, it fails to provide juvenile delinquents with appropriate skills set for maintaining socially responsible behaviors, and it does not involve the community environments of juvenile delinquents.

With the dearth of public treatment services, linking juvenile delinquents with positive role models is critical to assist them in becoming socially responsible members of their communities. The Lifers serve as models of behavior for juvenile delinquents not to adopt, but, since the prisoners are removed from society, they fail to serve as an effective model for adolescents to emulate when they return to their communities. Positive community role models are imperative because not only do they serve as effective models for juvenile delinquents, but they also provide long-term assistance for juvenile delinquents as well. Juvenile adolescents need to interact with mentors who have reformed their criminal behaviors or maintained sobriety, and now behave as socially responsible individuals.

Since the program does not employ these crucial components, Scared Straight fails to combat recidivism and it reiterates what juvenile delinquents learned upon their first encounter with the criminal justice system; that is, their delinquent behaviors will result in negative consequences. Without this intervention teaching juvenile delinquents how they can combat recidivism and other co-occurring issues, Scared Straight will remain a public health failure.

1. Dembo R, Williams L, Schmeidler J, Drug Abuse among Juvenile Detainees Annals of American Academy of Political and Social Science 1992; 521: 28-41
2. Lennings CJ, Copeland J and Howard J Substance Use Patterns of Young Offenders and Violent Crime Aggressive Behavior 2003; 29:414-422
3. Teplin L, * McClelland GM, Abram KM, and Mileusnic D, Early Violent Death Among Delinquent Youth: A Prospective Longitudinal Study Pediatrics 2005; 115: 586-1593
4. Wiesner, M; Michael Windle Young Adult Substance Use and Depression as a Consequence of Delinquency Trajectories During Middle Adolescence Journal of Research on Adolescence 2006; 16:239-254
5. Petrosino, A; Carolyn Turpin-Petrosino, James O. Finckenauer Well-Meaning Programs Have Harmful Effects! Lessons From Experiments of Programs Such as Scared Straight Crime & Delinquency 2000; 46: 354-379
6. Buckner JC, Chesney-Lind M Dramatic Cures For Juvenile Crime An Evaluation of a Prisoner Run Delinquency Prevention Program Criminal Justice and Behavior 1983;10:227-247
7. Freedenthal, S., M.Vaughn, J. Jenson, and M. Howard Inhalant Use and Suicidality Among Incarcerated Youth Drug Alcohol Depend. 2007; 90:81-88
8. Teplin La, McClelland GM, Dulcan MK, Mericle AA Psychiatric disorders in youth in Juvenile Detention Arch Gen Psychiatry 2002; 59: 1133-1143
9. Pearson F, Lipton D, Cleland C, Yee D The Effects of Behavioral/Cognitive-Behavioral Programs on Recidivism Crime & Delinquency 2002; 48:476-496
10. Greenwood P, Zimring F One More Chance: The pursuit of Promising Interventions Strategies for Chronic Juvenile Offenders Santa Monica, CA:RAND, 1985)

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  • At December 17, 2007 at 3:46 PM , Anonymous Anonymous said...

    Tyler that was an awesome write up on the scared straight failure. I haven't heard much about this program since the early 80s. I think you encorporated the health belief model really well here as well as the incorporation of individual risk factors. The three reasons the program didn't work were well explained. Good Job!

  • At November 28, 2009 at 12:15 PM , Anonymous joejoe said...

    I loved the doc and I am not much aware of the present implications of a program f these characteristics into nowadays penitentiaries, I found this profound review on the doc lately here:

  • At March 7, 2013 at 10:13 AM , Anonymous Anonymous said...

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