Moral Reconation Therapy (MRT) is a systematic treatment strategy that seeks to decrease recidivism among juvenile and adult criminal offenders by increasing moral reasoning. Its cognitive-behavioral approach combines elements from a variety of psychological traditions to progressively address ego, social, moral, and positive behavioral growth. MRT takes the form of group and individual counseling using structured group exercises and prescribed homework assignments. The MRT workbook is structured around 16 objectively defined steps (units) focusing on seven basic treatment issues: confrontation of beliefs, attitudes, and behaviors; assessment of current relationships; reinforcement of positive behavior and habits; positive identity formation; enhancement of self-concept; decrease in hedonism and development of frustration tolerance; and development of higher stages of moral reasoning. Participants meet in groups once or twice weekly and can complete all steps of the MRT program in a minimum of 3 to 6 months.
| Areas of Interest | Mental health treatment Substance use disorder treatment Co-occurring disorders |
| Outcomes | 1: Recidivism 2: Personality functioning |
| Outcome Categories | Crime/delinquency Social functioning |
| Ages | 13-17 (Adolescent) 18-25 (Young adult) 26-55 (Adult) |
| Genders | Male Female |
| Races/Ethnicities | Black or African American White Race/ethnicity unspecified Non-U.S. population |
| Settings | Correctional |
| Geographic Locations | No geographic locations were identified by the developer. |
| Implementation History | MRT has been implemented in a variety of treatment settings in more than 45 States and in Australia, Bermuda, and Canada. Several States have systemwide implementations of MRT. It is estimated that more than 1 million individuals have participated in the intervention. |
| NIH Funding/CER Studies | Partially/fully funded by National Institutes of Health: No Evaluated in comparative effectiveness research studies: No |
| Adaptations | While MRT was first designed as a criminal justice-based drug treatment method, a host of other treatment adaptations have been made, including more individualized programs that deal with parenting, spiritual growth, anger management, juvenile offenders, sexual and domestic violence, and treatment and job readiness. Different workbooks based on the fundamental MRT concepts exist for each of these areas. |
| Adverse Effects | No adverse effects, concerns, or unintended consequences were identified by the developer. |
| IOM Prevention Categories | IOM prevention categories are not applicable. |
The documents below were reviewed for Quality of Research. The research point of contact can provide information regarding the studies reviewed and the availability of additional materials, including those from more recent studies that may have been conducted.
Deschamps, T. MRT: Is it effective in decreasing recidivism rates with young offenders? Unpublished master's thesis, University of Windsor, Windsor, Ontario, Canada.
Little, G., Robinson, K. D., Burnette, K. D., & Swan, S. Successful ten-year outcome data on MRT-treated felony offenders: Treated offenders show significantly lower reincarceration in each year. Cognitive-Behavioral Treatment Review, 8(1), 1-3.
Little, G. L., & Robinson, K. D. Effects of Moral Reconation Therapy upon moral reasoning, life purpose, and recidivism among drug and alcohol offenders. Psychological Reports, 64, 83-90.
Kirchner, R. A., Byrnes, E. C., Kirchner, T. R., & Heckert, A. O. Effectiveness and impact of program delivery: Evaluation of the Thurston County Drug Court Program--Part II. Annapolis, MD: Glacier Consulting.
Krueger, S. Five-year recidivism study of MRT-treated offenders in a county jail. Cognitive Behavioral Treatment Review, 3-4, 3.
Godwin, G., Stone, S., & Hambrock, K. Recidivism study: Lake County, Florida Detention Center. Cognitive Behavioral Treatment Review, 4, 12.
Little, G. L., & Robinson, K. D. Moral Reconation Therapy: A systematic step-by-step treatment system for treatment resistant clients. Psychological Reports, 62, 135-151.
Wilson, D. B., Bouffard, L. A., & MacKenzie, D. L. A quantitative review of structured, group-oriented, cognitive-behavioral programs for offenders. Criminal Justice and Behavior, 32(2), 172-204.
| Outcome 1: Recidivism | |
|---|---|
| Description of Measures | In some studies, recidivism was defined as the rate at which individuals were rearrested on new criminal charges, while other studies limited recidivism to a conviction of a subsequent crime(s). Data from each study were obtained from various databases, including Canada's Offender Management System (OMS), the Washington State Institute for Public Policy (WSIPP) Statewide Criminal History database, and computer-generated searches of local and national arrest records and jail records. |
| Key Findings | One study was conducted in Ontario, Canada, with juvenile male clients sentenced by a judge to an open custody facility, which is a midpoint on the continuum between prison and return to the community. In this type of facility, the offenders are not secured behind bars, and if the clients decide to leave, the staff are not required to intervene physically, but the offenders will receive a new charge when they are apprehended again. In this study, clients who participated in MRT had a conviction rate of 46% during the study period, compared with 57% of clients from a different open-custody facility that did not offer MRT. Further, the average number of reoffenses for the treatment group was 4.1, while the average number of reoffenses for the control group was 5.7 (p = .043). |
In another study, after 1 year of release, adult male felony inmates who participated in MRT showed a reincarceration rate that was two-thirds lower than that of a control group of inmates who had volunteered for the MRT program but did not receive it due to limited treatment funding. In all subsequent years (up to 10 years after the original incarceration), the treated group's reincarceration rate was approximately one-fifth to one-third lower than controls (p values ranging from .05 to .001). For example, after 10 years of release, MRT-treated subjects showed a 45.7% reincarceration rate compared with 64.6% in controls.
A fourth study examined the recidivism of adult male inmates of a short-term county jail. Inmates who participated in MRT had a 45% rearrest rate in the 4 years after being released from jail, compared with 67% for a control group who did not participate in MRT (p < .05).
| Outcome 2: Personality functioning | |
|---|---|
| Description of Measures | Participants responded to the short form (20 questions) of the Purpose in Life Questionnaire, which estimates perceived purpose in life. Participants also completed the Defining Issues Test, an objective paper-and-pencil test that yields percentile scores indicating individuals' capabilities for six stages of moral reasoning. Of particular interest in this study was the degree of "principled reasoning," represented by the sum of the scores for the two highest stages of moral reasoning. People who make their decisions from levels of principled reasoning tend to be guided by concerns of justice, equality, and basic human rights. |
| Key Findings | Among adult male offenders participating in the Drug Abuse Program (a closed therapeutic community operated within the prison compound), there was a significant positive correlation between the last MRT step completed at the time of the initial testing (after 6 months of program implementation) and the degree of principled reasoning (p = .03) and perceived purpose in life (p = .01). Further, there were significant improvements in universal-ethical principle (following one's conscience) levels (p = .01), the percent of principled reasoning (p = .02), and perceived purpose in life (p = .01) from testing conducted upon entry to retesting at the completion of MRT's Step 7. |
The following populations were identified in the studies reviewed for Quality of Research.
| Study | Age | Gender | Race/Ethnicity |
|---|---|---|---|
| Study 1 | 13-17 (Adolescent) 18-25 (Young adult) | 100% Male | 100% Non-U.S. population |
| Study 2 | 18-25 (Young adult) 26-55 (Adult) | 100% Male | 80% Black or African American 20% Race/ethnicity unspecified |
| Study 3 | 18-25 (Young adult) 26-55 (Adult) | 65.2% Male 34.8% Female | 92.1% White 7.9% Race/ethnicity unspecified |
| Study 4 | 18-25 (Young adult) 26-55 (Adult) | 89% Male 11% Female | Data not reported/available |
| Study 5 | 18-25 (Young adult) 26-55 (Adult) | 100% Male | Data not reported/available |
External reviewers independently evaluate the Quality of Research for an intervention's reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
| Outcome | Reliability of Measures | Validity of Measures | Fidelity | Missing Data/Attrition | Confounding Variables | Data Analysis | Overall Rating |
|---|---|---|---|---|---|---|---|
| 1: Recidivism | 2.0 | 2.0 | 1.0 | 3.0 | 1.5 | 2.0 | 1.9 |
| 2: Personality functioning | 3.5 | 3.5 | 1.0 | 1.8 | 1.5 | 2.0 | 2.2 |
Reliability and validity of the two personality functioning measures are well documented. The use of a treatment manual that incorporates milestones for program completion contributes to implementation fidelity. Missing data do not appear to have been an issue.
Length of stay at a facility was often too short for participants to have attained the recommended length of time in the treatment program; as a result, positive results from program completion may be confounded with the effects of longer incarceration. Additional "extensive" support services provided in aftercare programs may be another confounding factor. More information could have been gathered and reported on the intervention and comparison groups, allowing for more appropriate statistical analyses and the use of analyses to control for alternative explanations of effects. Reliance on statewide databases limits the accuracy of recidivism rates; recidivism may occur in other States without being documented. The use of the Defining Issues Test as an outcome measure may reflect participants' verbal ability in addition to moral reasoning; additionally, a significant percentage of scores on the Defining Issues Test were dropped from analyses, with no correction indicated. In several studies, type 1 error rate inflation of the multiple chi-square analyses is a concern.
Readiness for DisseminationThe materials below were reviewed for Readiness for Dissemination. The implementation point of contact can provide information regarding implementation of the intervention and the availability of additional, updated, or new materials.
Little, G., & Robinson, K. D. Moral Reconation Therapy: Counselor's handbook. Memphis, TN: Eagle Wing Books.
Little, G. L., & Robinson, K. D. How to escape your prison: A Moral Reconation Therapy workbook. Memphis, TN: Eagle Wing Books.
Quality assurance materials:
External reviewers independently evaluate the intervention's Readiness for Dissemination using three criteria:
For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.
| Implementation Materials | Training and Support Resources | Quality Assurance Procedures | Overall Rating |
|---|---|---|---|
| 2.0 | 3.8 | 3.0 | 2.9 |
Implementation materials are engaging and audience appropriate. The counselor handbook provides helpful hints for facilitating effective groups and addresses common intervention pitfalls. A comprehensive initial training package, coupling didactic teaching methods with extensive role-play, is available to implementers. Implementation checklists, video tape review, and other quality assurance tools help ensure implementation fidelity and therapist competence. Advanced training that addresses the appropriate use of quality assurance tools is also provided.
Given the complexity of this intervention, additional information is needed on the required training and skill level for group facilitators and administrators. Guidance is not provided on how to integrate this intervention with existing criminal justice and mental health systems. The level of ongoing coaching and consultation available to implementers is unclear. Little guidance is provided to implementers to support outcomes measurement.
The cost information below was provided by the developer. Although this cost information may have been updated by the developer since the time of review, it may not reflect the current costs or availability of items (including newly developed or discontinued items). The implementation point of contact can provide current information and discuss implementation requirements.
| Item Description | Cost | Required by Developer |
|---|---|---|
| MRT client workbook | $25 per participant | Yes |
| 4-day, off-site initial training (includes quality assurance tools and services) | $600 for first person, $500 for each additional person from the same agency | Yes, one initial training option is required |
| On-site initial training (includes quality assurance tools and services) | Varies depending on site needs | Yes, one initial training option is required |
| 2-day advanced training | $300 per person | No |
| On-site consultation | $450 per day | No |
| Video consultation | $150 per session | No |
Volume discounts are available.