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September 2002 BEYOND CORRECTIONAL QUACKERY 43

Beyond Correctional Quackery—


Professionalism and the Possibility
of Effective Treatment

Edward J. Latessa, University of Cincinnati


Francis T. Cullen, University of Cincinnati
Paul Gendreau, University of New Brunswick at Saint John

LONG-TIME VIEWERS of Saturday vey of current correctional practices yields the snickers from the crowd—a case where hu-
Night Live will vividly recall Steve Martin’s disquieting conclusion that we are a field in mor unintentionally offers a damning indict-
hilarious portrayal of a medieval medical which quackery is tolerated, if not implicitly ment of the field’s standards of care.
practitioner—the English barber, Theodoric celebrated. It is not clear whether most of us In contrast to professionalism, quackery is
of York. When ill patients are brought be- have ever had that reflective moment in which dismissive of scientific knowledge, training,
fore him, he prescribes ludicrous “cures,” we question whether, “just maybe,” there and expertise. Its posture is strikingly over-
such as repeated bloodletting, the applica- might be a more enlightened path to pursue. confident, if not arrogant. It embraces the
tion of leeches and boar’s vomit, gory am- If we have paused to envision a different way notion that interventions are best rooted in
putations, and burying people up to their of doing things, it is apparent that our reac- “common sense,” in personal experiences (or
necks in a marsh. At a point in the skit when tion, after a moment’s contemplation, too clinical knowledge), in tradition, and in su-
a patient dies and Theodoric is accused of often has been, “Nawwwwwwww!” perstition (Gendreau, Goggin, Cullen, and
“not knowing what he is doing,” Martin This appraisal might seem overly harsh, Paparozzi, forthcoming). “What works” is
stops, apparently struck by the transform- but we are persuaded that it is truthful. thus held to be “obvious,” derived only from
ing insight that medicine might abandon When intervening in the lives of offenders— years of an individual’s experience, and legiti-
harmful interventions rooted in ignorant that is, intervening with the expressed inten- mized by an appeal to custom (“the way we
customs and follow a more enlightened path. tion of reducing recidivism—corrections has have always done things around here has
“Perhaps,” he says, “I’ve been wrong to resisted becoming a true “profession.” Too worked just fine”). It celebrates being anti-
blindly follow the medical traditions and often, being a “professional” has been de- intellectual. There is never a need to visit a
superstitions of past centuries.” He then pro- based to mean dressing in a presentable way, library or consult a study.
ceeds to wonder whether he should “test having experience in the field, and showing Correctional quackery, therefore, is the use
these assumptions analytically through ex- up every day for work. But a profession is of treatment interventions that are based on
perimentation and the scientific method.” defined not by its surface appearance but by neither 1) existing knowledge of the causes
And perhaps, he says, the scientific method its intellectual core. An occupation may lay of crime nor 2) existing knowledge of what
might be applied to other fields of learning. claim to being a “profession” only to the programs have been shown to change of-
He might even be able to “lead the way to a extent that its practices are based on research fender behavior (Cullen and Gendreau, 2000;
new age—an age of rebirth, a renaissance.” knowledge, training, and expertise—a tri- Gendreau, 2000). The hallmark of correc-
He then pauses and gives the much-awaited umvirate that promotes the possibility that tional quackery is thus ignorance. Such igno-
and amusing punchline, “Nawwwwwww!” what it does can be effective (Cullen, 1978; rance about crime and its cures at times is
The humor, of course, lies in the juxtapo- Starr, 1982). Thus, medicine’s “understandable”—that is, linked not to the
sition and final embrace of blatant quackery professionalization cannot be separated willful rejection of research but to being in a
with the possibility and rejection of a more from its embrace of scientific knowledge as field in which professionalism is not expected
modern, scientific, and ultimately effective the ideal arbiter of how patients should be or supported. At other times, however, quack-
approach to medicine. For those of us who treated (Starr, 1982). The very concept of ery is proudly displayed, as its advocates
make a living commenting on or doing cor- “malpractice” connotes that standards of boldly proclaim that they have nothing to
rections, however, we must consider whether, service delivery have been established, are learn from research conducted by academics
in a sense, the joke is on us. We can readily universally transmitted, and are capable of “who have never worked with a criminal”
see the humor in Steve Martin’s skit and won- distinguishing acceptable from unacceptable (a claim that is partially true but ultimately
der how those in medieval societies “could interventions. The concept of liability for beside the point and a rationalization for
have been so stupid.” But even a cursory sur- “correctional malpractice” would bring continued ignorance).
44 FEDERAL PROBATION Volume 66 Number 2

Need we now point out the numerous pro- the agency, and the community)? Often, no Notice, however, what is missing in this
grams that have been implemented with real choice is made, because agencies simply account: The failure to consider the existing
much fanfare and with amazing promises of continue with the practices that have been research on program effectiveness. The risk
success, only later to turn out to have “no inherited from previous administrations. of quackery rises to the level of virtual cer-
effect” on reoffending? “Boot camps,” of Other times, programs are added incremen- tainty when nobody in the agency asks, “Is
course, are just one recent and salient tally, such as when concern rises about drug there any evidence supporting what we are
example. Based on a vague, if not unstated, use or drunk driving. And still other times— intending to do?” The irrationality of not con-
theory of crime and an absurd theory of be- such as when punishment-oriented interme- sulting the existing research is seen when we
havioral change (“offenders need to be bro- diate sanctions were the fad from the consider again, medicine. Imagine if local
ken down”—through a good deal of mid-1980s to the mid-1990s—jurisdictions physicians and hospitals made no effort to
humiliation and threats—and then “built copy the much-publicized interventions be- consult “what works” and simply prescribed
back up”), boot camps could not possibly ing implemented elsewhere in the state and pharmaceuticals and conducted surgeries
have “worked.” In fact, we know of no major in the nation. based on custom or the latest fad. Such mal-
psychological theory that would logically sug- practice would be greeted with public con-
gest that such humiliation or threats are com- demnation, lawsuits, and a loss of legitimacy
ponents of effective therapeutic interventions by the field of medicine.
(Gendreau et al., forthcoming). Even so, boot TABLE 1 It is fair to ask whether research can, in fact,
camps were put into place across the nation Questionable Theories of Crime direct us to more effective correctional inter-
without a shred of empirical evidence as to ventions. Two decades ago, our knowledge was
We Have Encountered in Agency
their effectiveness, and only now has their ap- much less developed. But the science of crime
peal been tarnished after years of negative Programs and treatment has made important strides in
evaluation studies (Cullen, Pratt, Miceli, and the intervening years. In particular, research
Moon, 2002; Cullen, Wright, and Applegate, ⻬ “Been there, done that” theory. has illuminated three bodies of knowledge that
1996; Gendreau, Goggin, Cullen, and Andrews, ⻬ “Offenders lack creativity” theory. are integral to designing effective interventions.
2000; MacKenzie, Wilson, and Kider, 2001). First, we have made increasing strides in
⻬ “Offenders need to get back to
How many millions of dollars have been determining the empirically established or
nature” theory.
squandered? How many opportunities to re- known predictors of offender recidivism
habilitate offenders have been forfeited? How ⻬ “It worked for me” theory. (Andrews and Bonta, 1998; Gendreau, Little,
many citizens have been needlessly victimized ⻬ “Offenders lack discipline” theory. and Goggin, 1996; Henggeler, Mihalic, Rone,
by boot camp graduates? What has been the Thomas, and Timmons-Mitchell, 1998).
cost to society of this quackery? ⻬ “Offenders lack organizational These include, most importantly: 1) antiso-
We are not alone in suggesting that ad- skills” theory. cial values, 2) antisocial peers, 3) poor self-
vances in our field will be contingent on the ⻬ “Offenders have low self-esteem” control, self-management, and prosocial
conscious rejection of quackery in favor of an theory. problem-solving skills, 4) family dysfunction,
evidence-based corrections (Cullen and and 5) past criminality. This information is
⻬ “We just want them to be happy”
Gendreau, 2000; MacKenzie, 2000; Welsh and critical, because interventions that ignore these
theory.
Farrington, 2001). Moving beyond correc- factors are doomed to fail. Phrased alterna-
tional quackery when intervening with offend- ⻬ The “treat offenders as babies and tively, successful programs start by recogniz-
ers, however, will be a daunting challenge. It dress them in diapers” theory. ing what causes crime and then specifically
will involve overcoming four central failures ⻬ “Offenders need to have a pet in design the intervention to target these factors for
now commonplace in correctional treatment. prison” theory. change (Alexander, Pugh, and Parsons, 1998;
We review these four sources of correctional Andrews and Bonta, 1998; Cullen and
quackery not simply to show what is lacking ⻬ “Offenders need acupuncture” Gendreau, 2000; Henggeler et al., 1998).
in the field but also in hopes of illuminating theory. Consider, however, the kinds of “theories”
what a truly professional approach to correc- ⻬ “Offenders need to have healing about the causes of crime that underlie many
tions must strive to entail. lodges” theory. correctional interventions. In many cases,
simple ignorance prevails; those working in
Four Sources of ⻬ “Offenders need drama therapy”
correctional agencies cannot explain what
theory.
Correctional Quackery crime-producing factors the program is alleg-
⻬ “Offenders need a better diet and edly targeting for change. Still worse, many
Failure to Use Research haircut” theory. programs have literally invented seemingly
in Designing Programs ludicrous theories of crime that are put for-
⻬ “Offenders (females) need to learn
Every correctional agency must decide “what ward with a straight face. From our collective
how to put on makeup and dress
to do” with the offenders under its supervi- experiences, we have listed in Table 1 crime
better” theory.
sion, including selecting which “programs” theories that either 1) were implicit in pro-
or “interventions” their charges will be sub- ⻬ “Offenders (males) need to get in grams we observed or 2) were voiced by
jected to. But how is this choice made (a touch with their feminine side” agency personnel when asked what crime-
choice that is consequential to the offender, theory. causing factors their programs were target-
September 2002 BEYOND CORRECTIONAL QUACKERY 45

ing. These “theories” would be amusing ex- TABLE 2


cept that they are commonplace and, again, Eight Principles of Effective Correctional Intervention
potentially lead to correctional quackery. For
example, the theory of “offenders (males) 1. Organizational Culture
need to get in touch with their feminine side” Effective organizations have well-defined goals, ethical principles, and a history
prompted one agency to have offenders dress of efficiently responding to issues that have an impact on the treatment facilities.
in female clothes. We cannot resist the temp-
Staff cohesion, support for service training, self-evaluation, and use of outside
tation to note that you will now know whom
resources also characterize the organization.
to blame if you are mugged by a cross-dresser!
But, in the end, this is no laughing matter. 2. Program Implementation/Maintenance
This intervention has no chance to be effec- Programs are based on empirically-defined needs and are consistent with the
tive, and thus an important chance was for- organization’s values. The program is fiscally responsible and congruent with
feited to improve offenders’ lives and to stakeholders’ values. Effective programs also are based on thorough reviews of
protect public safety.
the literature (i.e., meta-analyses), undergo pilot trials, and maintain the staff’s
Second, there is now a growing literature
professional credentials.
that outlines what does not work in offender
treatment (see, e.g., Cullen, 2002; Cullen and 3. Management/Staff Characteristics
Gendreau, 2000; Cullen et al., 2002; Cullen et The program director and treatment staff are professionally trained and have
al., 1996; Gendreau, 1996; Gendreau et al., previous experience working in offender treatment programs. Staff selection is
2000; Lipsey and Wilson, 1998; MacKenzie,
based on their holding beliefs supportive of rehabilitation and relationship styles
2000). These include boot camps, punish-
and therapeutic skill factors typical of effective therapies.
ment-oriented programs (e.g., “scared
straight” programs), control-oriented pro- 4. Client Risk/Need Practices
grams (e.g., intensive supervision programs), Offender risk is assessed by psychometric instruments of proven predictive
wilderness programs, psychological interven- validity. The risk instrument consists of a wide range of dynamic risk factors or
tions that are non-directive or insight-oriented
criminogenic needs (e.g., anti-social attitudes and values). The assessment also
(e.g., psychoanalytic), and non-intervention
takes into account the responsivity of offenders to different styles and modes of
(as suggested by labeling theory). Ineffective
programs also target for treatment low-risk
service. Changes in risk level over time (e.g., 3 to 6 months) are routinely as-
offenders and target for change weak predic- sessed in order to measure intermediate changes in risk/need levels that may
tors of criminal behavior (e.g., self-esteem). occur as a result of planned interventions.
Given this knowledge, it would be a form of
5. Program Characteristics
quackery to continue to use or to freshly imple-
The program targets for change a wide variety of criminogenic needs (factors
ment these types of interventions.
that predict recidivism), using empirically valid behavioral/social learning/
Third, conversely, there is now a growing
literature that outlines what does work in of- cognitive behavioral therapies that are directed to higher-risk offenders. The ratio
fender treatment (Cullen, 2002; Cullen and of rewards to punishers is at least 4:1. Relapse prevention strategies are available
Gendreau, 2000). Most importantly, efforts once offenders complete the formal treatment phase.
are being made to develop principles of ef-
6. Core Correctional Practice
fective intervention (Andrews, 1995; Andrews
Program therapists engage in the following therapeutic practices: anti-criminal
and Bonta, 1998; Gendreau, 1996). These
principles are listed in Table 2. Programs that modeling, effective reinforcement and disapproval, problem-solving techniques,
adhere to these principles have been found structured learning procedures for skill-building, effective use of authority,
to achieve meaningful reductions in recidi- cognitive self-change, relationship practices, and motivational interviewing.
vism (Andrews, Dowden, and Gendreau,
7. Inter-Agency Communication
1999; Andrews, Zinger, Hoge, Bonta,
The agency aggressively makes referrals and advocates for its offenders in order
Gendreau, and Cullen, 1990; Cullen, 2002).
However, programs that are designed with-
that they receive high quality services in the community.
out consulting these principles are almost cer- 8. Evaluation
tain to have little or no impact on offender The agency routinely conducts program audits, consumer satisfaction surveys,
recidivism and may even risk increasing re-
process evaluations of changes in criminogenic need, and follow-ups of recidi-
offending. That is, if these principles are ig-
vism rates. The effectiveness of the program is evaluated by comparing the
nored, quackery is likely to result. We will
respective recidivism rates of risk-control comparison groups of other treatments
return to this issue below.
or those of a minimal treatment group.
Note: Items adapted from the Correctional Program Assessment Inventory—2000, a 131-item
Questionnaire that is widely used in assessing the quality of correctional treatment programs
(Gendreau and Andrews, 2001).
46 FEDERAL PROBATION Volume 66 Number 2

Failure to Follow Appropriate Assess- tified and addressed—such as possessing an- appropriate” category (Andrews et al., 1999).
ment and Classification Practices tisocial values—the prospects for recidivism But this failure to employ an appropriate treat-
The steady flow of offenders into correctional will be high. For example, a study of 240 (161 ment approach does not have to be the case.
agencies not only strains resources but also adult and 79 juvenile) programs assessed Why would an agency—in this information
creates a continuing need to allocate treat- across 30 states found that 64 percent of the age—risk quackery when the possibility of us-
ment resources efficaciously. This problem is programs did not utilize a standardized and ing an evidence-based program exists? Why
not dissimilar to a hospital that must process objective assessment tool that could distin- not select effective treatment models?
a steady flow of patients. In a hospital (or guish risk/needs levels for offenders Moving in this direction is perhaps mostly
doctor’s office), however, it is immediately (Matthews, Hubbard, and Latessa, 2001; a matter of a change of consciousness—that
recognized that the crucial first step to deliv- Latessa, 2002). is, an awareness by agency personnel that
ering effective treatment is diagnosing or as- Third, even when offenders are assessed quackery must be rejected and programs with
sessing the patient’s condition and its severity. using appropriate classification instruments, a track record of demonstrated success em-
In the absence of such a diagnosis—which agencies frequently ignore the information. braced. Fortunately, depending on the of-
might involve the careful study of symptoms It is not uncommon, for example, for offend- fender population, there is a growing number
or a battery of tests—the treatment pre- ers to be assessed and then for everyone to be of treatment models that might be learned
scribed would have no clear foundation. given the same treatment. In this instance, and implemented (Cullen and Applegate,
Medicine would be a lottery in which the ill assessment becomes an organizational rou- 1997). Some of the more prominent models
would hope the doctor assigned the right tine in which paperwork is compiled but the in this regard are the “Functional Family
treatment. In a similar way, effective treat- information is ignored. Therapy” model that promotes family cohe-
ment intervention requires the appropriate Again, these practices increase the likeli- sion and affection (Alexander et al., 1998;
assessment of both the risks posed by, and the hood that offenders will experience correc- Gordon, Graves, and Arbuthnot, 1995), the
needs underlying the criminality of, offend- tional quackery. In a way, treatment is teaching youths to think and react responsi-
ers. When such diagnosis is absent and no delivered blindly, with agency personnel bly peer-helping (“Equip”) program (Gibbs,
classification of offenders is possible, offend- equipped with little knowledge about the risks Potter, and Goldstein, 1995), the “Prepare
ers in effect enter a treatment lottery in which and needs of the offenders under their super- Curriculum” program (Goldstein, 1999),
their access to effective intervention is a vision. In these circumstances, it is impossible “Multisystemic Therapy” (Henggeler et al.,
chancy proposition. to know which offenders should receive which 1998), and the prison-based “Rideau Inte-
Strides have been made to develop more interventions. Any hopes of individualizing grated Service Delivery Model” that targets
effective classification instruments—such as interventions effectively also are forfeited, be- criminal thinking, anger, and substance abuse
the Level of Supervision Inventory (LSI) cause the appropriate diagnosis either is un- (see Gendreau, Smith, and Goggin, 2001).
(Bonta, 1996), which, among its competitors, available or hidden in the agency’s unused files.
has achieved the highest predictive validity Failure to Evaluate What We Do
with recidivism (Gendreau et al., 1996). The Failure to Use Effective Quackery has long prevailed in corrections
LSI and similar instruments classify offend- Treatment Models because agencies have traditionally required no
ers by using a combination of “static” factors Once offenders are assessed, the next step is systematic evaluation of the effectiveness of
(such as criminal history) and “dynamic fac- to select an appropriate treatment model. As their programs (Gendreau, Goggin, and Smith,
tors” (such as antisocial values, peer associa- we have suggested, the challenge is to consult 2001). Let us admit that many agencies may
tions) shown by previous research to predict the empirical literature on “what works,” and not have the human or financial capital to con-
recidivism. In this way, it is possible to clas- to do so with an eye toward programs that duct ongoing evaluations. Nonetheless, it is not
sify offenders by their level of risk and to dis- conform to the principles of effective inter- clear that the failure to evaluate has been due
cern the types and amount of “criminogenic vention. At this stage, it is inexcusable either to a lack of capacity as much as to a lack of
needs” they possess that should be targeted to ignore this research or to implement pro- desire. The risk inherent in evaluation, of
for change in their correctional treatment. grams that have been shown to be ineffective. course, is that practices that are now unques-
At present, however, there are three prob- Yet, as we have argued, the neglect of the ex- tioned and convenient may be revealed as in-
lems with offender assessment and classifica- isting research on effective treatment models effective. Evaluation, that is, creates
tion by correctional agencies (Gendreau and is widespread. In the study of 240 programs accountability and the commitment threat of
Goggin, 1997). First, many agencies simply noted above, it was reported that two-thirds having to change what is now being done. The
do not assess offenders, with many claiming of adult programs and over half of juvenile cost of change is not to be discounted, but so
they do not have the time. Second, when programs did not use a treatment model that too is the “high cost of ignoring success” (Van
agencies do assess, they assess poorly. Thus, research had shown to be effective (Matthews Voorhis, 1987). In the end, a professional must
they often use outdated, poorly designed, and/ et al., 2001; Latessa, 2002). Another study—a be committed to doing not simply what is in
or empirically unvalidated classification in- meta-analysis of 230 program evaluations one’s self-interest but what is ethical and ef-
struments. In particular, they tend to rely on (which yielded 374 tests or effect sizes)—cat- fective. To scuttle attempts at program evalu-
instruments that measure exclusively static egorized the extent to which interventions ation and to persist in using failed interventions
predictors of recidivism (which cannot, by conformed to the principles of effective in- is wrong and a key ingredient to continued
definition, be changed) and that provide no tervention. In only 13 percent of the tests were correctional quackery (more broadly, see Van
information on the criminogenic needs that the interventions judged to fall into the “most Voorhis, Cullen, and Applegate, 1995).
offenders have. If these “needs” are not iden-
September 2002 BEYOND CORRECTIONAL QUACKERY 47

Evaluation, moreover, is not an all-or- in corrections so as to build knowledge on alize, than simply visiting a library in search
nothing procedure. Ideally, agencies would “what works” to change offenders (Cullen and of research on program effectiveness (al-
conduct experimental studies in which of- Gendreau, 2001). Frequently, what guidance though this is often an important first step).
fenders were randomly assigned to a treat- criminologists have offered correctional agen- Information must be available in a form that
ment or control group and outcomes, such cies has constituted bad advice—ideologically can be used by agencies. As in medicine, there
as recidivism, were measured over a lengthy inspired, not rooted in the research, and likely must be opportunities for training and the
period of time. But let us assume that, in many to foster quackery. Fortunately, there is a provision of manuals that can be consulted
settings, conducting this kind of sophisticated growing movement among criminologists to in how specifically to carry out an interven-
evaluation is not feasible. It is possible, how- do our part both in discerning the principles tion. Much attention has to be paid to imple-
ever, for virtually all agencies to monitor, to of effective intervention and in deciphering menting programs as they are designed. And,
a greater or lesser extent, the quality of the what interventions have empirical support in the long run, an effort must be made to
programs that they or outside vendors are (Cullen and Gendreau, 2001; MacKenzie, support widespread program evaluation and
supplying. Such evaluative monitoring would 2000; Welsh and Farrington, 2001). Accord- to use the resulting data both to improve in-
involve, for example, assessing whether treat- ingly, the field of corrections has more infor- dividual programs and to expand our knowl-
ment services are being delivered as designed, mation available to find out what our “best edge base on effective programs generally.
supervising and giving constructive feedback bets” are when intervening with offenders To move beyond quackery and accomplish
to treatment staff, and studying whether of- (Rhine, 1998). these goals, the field of corrections will have
fenders in the program are making progress We must also admit that our use of medi- to take seriously what it means to be a profes-
on targeted criminogenic factors (e.g., chang- cine as a comparison to corrections has been sion. In this context, individual agencies and
ing antisocial attitudes, manifesting more overly simplistic. We stand firmly behind the individuals within agencies would do well to
prosocial behavior). In too many cases, of- central message conveyed—that what is done strive to achieve what Gendreau et al. (forth-
fenders are “dropped off” in intervention pro- in corrections would be grounds for malprac- coming) refer to as the “3 C’s” of effective
grams and then, eight or twelve weeks later, tice in medicine—but we have glossed over correctional policies: First, employ creden-
are deemed—without any basis for this con- the challenges that the field of medicine faces tialed people; second, ensure that the agency
clusion—to have “received treatment.” Imag- in its attempt to provide scientifically-based is credentialed in that it is founded on the prin-
ine if medical patients entered and exited interventions. First, scientific knowledge is ciples of fairness and the improvement of lives
hospitals with no one monitoring their treat- not static but evolving. Medical treatments through ethically defensive means; and third,
ment or physical recovery. Again, we know that appear to work now may, after years of base treatment decisions on credentialed
what we could call such practices. study, prove ineffective or less effective than knowledge (e.g., research from meta-analyses).
alternative interventions. Second, even when By themselves, however, given individu-
Conclusion—Becoming an information is available, it is not clear that it als and agencies can do only so much to
Evidence-Based Profession is effectively transmitted or that doctors, who implement effective interventions—although
may believe in their personal “clinical expe- each small step away from quackery and to-
In assigning the label “quackery” to much of rience,” will be open to revising their treat- ward an evidence-based practice potentially
what is now being done in corrections, we run ment strategies (Hunt, 1997). “The gap makes a meaningful difference. The broader
the risk of seeming, if not being, preachy and between research and knowledge,” notes issue is whether the field of corrections will
pretentious. This is not our intent. If anything, Millenson (1997, p. 4), “has real conse- embrace the principles that all interventions
we mean to be provocative—not for the sake quences….when family practitioners in should be based on the best research evidence,
of causing a stir, but for the purpose of prompt- Washington State were queried about treat- that all practitioners must be sufficiently
ing correctional leaders and professionals to ing a simple urinary tract infection in women, trained so as to develop expertise in how to
stop using treatments that cannot possibly be eighty-two physicians came up with an ex- achieve offender change, and that an ethical
effective. If we make readers think seriously traordinary 137 different strategies.” In re- corrections cannot tolerate treatments known
about how to avoid selecting, designing, and sponse to situations like these, there is a to be foolish, if not harmful. In the end, cor-
using failed correctional interventions, our ef- renewed evidence-based movement in medi- rectional quackery is not an inevitable state
forts will have been worthwhile. cine to improve the quality of medical treat- of affairs—something we are saddled with for
We would be remiss, however, if we did ments (Millenson, 1997; Timmermans and the foreseeable future. Rather, although a for-
not confess that academic criminologists Angell, 2001). midable foe, it is ultimately rooted in our col-
share the blame for the continued use of in- Were corrections to reject quackery in fa- lective decision to tolerate ignorance and
effective programs. For much of the past vor of an evidence-based approach, it is likely failure. Choosing a different future for cor-
quarter century, most academic criminolo- that agencies would face the same difficulties rections—making the field a true profes-
gists have abandoned correctional practitio- that medicine encounters in trying base treat- sion—will be a daunting challenge, but it is a
ners. Although some notable exceptions exist, ments on the best scientific knowledge avail- future that lies within our power to achieve.
we have spent much of our time claiming that able. Designing and implementing an
“nothing works” in offender rehabilitation effective program is more complicated, we re-
and have not created partnerships with those
48 FEDERAL PROBATION Volume 66 Number 2

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