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Meeting Bulletin #4: Community Based Responses to Violence

At Two Sessions in September, Working Group Highlights the Promise of Four Key Violence Reduction Strategies, Provides Guidance to Help Leaders Launch Programs Now

Members also began conversations about the broader Working Group research agenda, discussing topics such as retail theft, gun theft, and juvenile offending. The group considered the format and types of research products that would best equip policymakers and local officials to make informed, data-driven decisions on how to assess crime trends in their jurisdictions.

At its fourth and fifth sessions, the Violent Crime Working Group discussed community-based responses to rising violent crime. Consistent with the Group’s mission and its previous meeting, the sessions focused on community-based strategies that local decisionmakers can execute quickly to engage those people and places at the highest risk for violence. Group members will explore law enforcement strategies for reducing violent crime in upcoming sessions.

On September 15, the discussion featured presentations by Michelle Kondo, Research Social Scientist with the USDA-Forest Service, Fernando Rejón, Executive Director of the Urban Peace Institute, and Working Group member Daniel Webster, Bloomberg Professor of American Health at the Johns Hopkins Bloomberg School of Public Health and Director of the Center for Gun Violence Prevention and Policy.

On September 29, the Working Group heard presentations by DeVone Boggan, Founder and Executive Director of Advance Peace, Working Group member Paul Carrillo, Community Violence Initiative Director at the Giffords Law Center to Prevent Gun Violence, and Jens Ludwig, Edwin A. and Betty L. Bergman Distinguished Service Professor at the Harris School of Public Policy and Director of the Crime Lab at the University of Chicago.

Cognitive Behavioral Therapy

What We Know

  • Cognitive behavioral therapy (CBT) teaches people to manage emotions, address conflicts constructively, and think carefully before taking action. Typically conducted in a group setting, CBT can help even the highest-risk individuals improve their thinking and behavior in order to avoid crime and violence.
  • CBT is supported by a strong base of evidence that includes multiple studies using the most rigorous study designs as well as systematic reviews. In Chicago, randomized controlled trials have demonstrated that one CBT program reduced arrests for violent crimes among youth by half, while another reduced shooting and homicide arrests among high-risk individuals by 80 percent. A systematic review of 58 CBT studies found that such programs reduced criminal recidivism by 25 percent, with one of five programs cutting recidivism by more than half. Of the anti-violence interventions not involving law enforcement, CBT appears to have the strongest track record of success.

CBT in Practice: Results from Two Leading Anti-Violence Programs

  • Despite that track record, CBT is known mostly as a treatment for addiction, anger management, anxiety, and depression, and its application to criminal violent behavior has been less investigated. A small number of reputable providers, including Becoming a Man, READI Chicago, and Roca, use sports, street outreach, and subsidized employment to persuade those at significant risk for violence to receive CBT treatment. Unfortunately, the capacity to deliver such programming remains limited and the costs can be significant. While CBT “works” to reduce violent crime, access to quality providers can be challenging in many jurisdictions.
  • Bring quality CBT to your jurisdiction, then scale it up. Providing quality CBT to those at the highest risk for violence may be costly at first. But if successful, the benefits of CBT will greatly exceed the costs. Over time, look for ways to expand treatment while minimizing cost. For instance, if treatment is provided only by licensed professionals with advanced degrees, the prospects for scalability will be limited. Explore recruiting individuals who can deliver culturally competent services without an advanced degree.
  • Get training and technical assistance from experts in the field. While CBT is widely practiced in the U.S., few providers treat those at the highest risk for violence. Cities looking to implement CBT should engage experts with specific expertise in using it for violence reduction. Other CBT practices may be adapted for use in this area, but such adaptation must be done carefully and in consultation with experienced practitioners. READI Chicago and Roca both provide relevant training and technical assistance.
  • Fund research on implementation and scalability. While CBT is widely available, high-quality, cost-effective treatment for those at the highest risk for violence is not. Further research on how to scale successful strategies for this population is needed.

Street Outreach

What We Know

  • Outreach by “credible messengers” to individuals at the highest risk for violence is an important component of many models for reducing community gun violence. Also described as violence intervention or interruption, street outreach programs recruit frontline workers to mediate disputes and help those most at risk manage provocations and conflicts without resorting to violence. Outreach workers also connect individuals to social supports and services. Finally, some strategies use community events and media campaigns to promote nonviolent norms.
  • The evidence concerning street outreach is promising but mixed. Neighborhoods in Chicago, New York City, Los Angeles, and Philadelphia experienced significant reductions in shootings after implementing street outreach programs; evaluations in Baltimore and Pittsburgh, however, reported increases in gun violence. Careful attention to strong implementation is critical – when implemented properly, street outreach is a powerful anti-violence tool; when implemented poorly, it can have minimal or even negative effects.
  • Few evaluations of such programs have been published in peer-reviewed journals, and many studies lack the rigorous research designs and analytic methods needed to provide strong confidence in their findings.
  • Many street outreach organizations, such as Chicago CRED, Southern California Crossroads, UTEC, and the Nonviolence Institutes in Chicago and Providence, are well-managed and employ workers who are well-trained. Nevertheless, despite more than 30 years in existence, the field of street outreach can feel like it is still in the “startup” stage of development, as one Working Group member put it. A chronic lack of consistent funding has slowed the professional development of the field, limiting its impact. With additional funding, organizations must focus on improving recruitment, retention, training, management, and oversight.
  • A relatively new Advance Peace model for street outreach, first pioneered in Richmond, CA, uses conflict mediation, intensive mentorship, case management, and life skills training – combined with opportunities for travel, internships, and modest stipends – to reach those at the highest risk for violence. To date, the approach has delivered promising results including substantial reductions in firearm violence.
  • Use the Los Angeles and Chicago Models. When possible, cities should avoid placing all the burden of street outreach on a single provider. Instead, fund multiple organizations that are trained and organized centrally in partnership with local government. In Los Angeles and Chicago, street outreach is conducted in coordination with the Mayor’s office. In addition, LA’s Urban Peace Academy and Chicago’s Metropolitan Street Academy provide more than one hundred hours of training per worker, establishing protocols and professional standards to guide engagement as well as best practices to maximize impact. Cities should build the infrastructure necessary to sustainably support the practice of street outreach, not necessarily a single provider. The Richmond Advance Peace effort also benefited from strong leadership in local government.
  • Get training and technical assistance from experts in the field. Local jurisdictions should resist the temptation to “go it alone” on street outreach, launching organizations without consulting outside experts on best practices. When done properly, street outreach is a profession, and officials should consult professionals with expertise in multiple jurisdictions before implementing such programs. The Urban Peace Institute, CureViolence, and Advance Peace all provide valuable training and technical assistance.
  • Support outreach workers with the resources necessary to do the job properly. For years, street outreach workers have worked long hours with little pay, no benefits, and with minimal opportunity for upward mobility or advancement. Additionally, workers have not received sufficient support for addressing the trauma – direct and vicarious – that often comes with the work. That must change. Properly resourcing street outreach means creating viable career pathways over the long term and providing the mental health services needed by those who engage in the work.
  • Recruit talent with diverse perspectives. Street outreach workers must have credibility with the communities in which they work, and must be able to engage some of the most dangerous, deeply disconnected people in our society. Many successful street outreach workers draw on their own lived experiences, but there is no single formula for success. Working Group members with expertise in this area report that diverse workforces, with men and women from a variety of backgrounds, are often the most successful.
  • Manage and evaluate the work. The independence and confidentially of street outreach must be respected at all costs, but as with any professional field, there must be performance indicators with which to manage progress. Much has yet to be learned about how best to conduct this work, so partnerships with culturally competent researchers are encouraged to assess program outcomes and continue to learn what is necessary for success.

Hospital-Based Violence Intervention Programs

What We Know

  • Hospital-based Violence Intervention Programs (HVIPs) generally combine the efforts of medical staff and community partners to provide additional services and care to those at the highest risk for repeat injury. Typically, these programs aim to intervene during crucial “teachable moments” of an individual’s recovery from a violent incident, while leveraging the trust and goodwill afforded caregivers. Programs may provide conflict mediation, crisis management, home visitation, case management, mentorship, and other services.
  • The evidence for HVI is promising but more research is needed. There are several examples of highly successful HVIPs. In Baltimore, one such program provided repeat victims on probation or parole with intensive psychosocial services, family or group therapy, and substance use treatment. Participants randomly assigned to receive treatment were three times less likely to be re-arrested for a violent crime, four times less likely to be convicted of a violent crime, and were incarcerated for substantially shorter periods of time. While results like these are encouraging, too many HVIP studies suffer from selection bias, small sample sizes, and other methodological concerns.
  • There are a wide variety of HVIP models, many with differing approaches. Some simply focus on helping patients secure compensation and make referrals to outside service providers. Others directly provide more intensive and extended inpatient and outpatient services. Some are capable of working with the highest-risk patients, while others are not. HVIPs can benefit from additional collection and dissemination of standard and best practices.
  • Connect with key violence reduction stakeholders, particularly those in communities. Ultimately, most personal change occurs in the community, after release from the hospital. If HVIPs are not capable of working in that setting as well as the hospital, they must have strong relationships with organizations that are. By engaging and extending their efforts beyond medical settings to the broader community concerned with violence reduction, HVIPs can increase their impact.
  • Get training and technical assistance from experts in the field. As with other strategies, officials are strongly encouraged to consult with outside professionals before establishing an HVIP. The Health Alliance for Violence Intervention provides a wide variety of training and technical assistance.
  • Prioritize those at the highest risk for re-injury. In order to maximize their impact on violence prevention, HVIPs need to engage those at the highest risk for re-injury. These patients require additional services, and providers will need extra training to overcome the challenges associated with engaging this difficult-to-reach population.

Environmental Crime Prevention

What We Know

  • Environmental crime prevention strategies inhibit crime, violence, and disorder by altering the physical environments of locations. These place-based approaches involve addressing blight, adding streetlights, and changing foot and car traffic patterns, among many other measures. This bulletin focuses on strategies that can be implemented quickly by local jurisdictions.
  • The evidence concerning environmental crime prevention strategies is best described as mixed, depending on the type and focus of the effort. Some strategies, such as those involving the “cleaning and greening” of community spaces and the installation of street lighting, show promise. In Philadelphia, the removal of trash, the grading and seeding of land, and the planting of trees in vacant lots to create a park-like setting was associated with a 17 percent decrease in violent crime and a nine percent decrease in crime overall. In New York City, installing temporary streetlights corresponded with a 36 percent reduction in nighttime index crimes – a finding reinforced by systematic reviews of the strategy. Changing pedestrian and automobile traffic patterns has also succeeded in reducing violent crime.

    Other strategies, such as the installation of closed-circuit television cameras, have proven less successful in achieving reductions in violent crime (some show promise for reducing property crime). Overall, despite the relatively large number of studies in this area, few employ rigorous research designs and few focus specifically on reducing violent crime.

  • Finally, few environmental crime prevention strategies focus specifically on improving anti-violence outcomes in the highest-risk locations. Those that do are generally successful, while less-focused strategies generally provide weak, if any, anti-violent crime benefits.
  • Focus on the highest risk locations. To enhance their effectiveness, environmental crime prevention strategies should be implemented where rates of violence are highest. Priority should be given to the precise micro-locations – a certain liquor store, housing project, or roadway intersection – where violence concentrates most intensely.
  • Use in combination with other anti-violence efforts. Environmental crime prevention strategies are best used as complements to other place-based anti-violence efforts. Because they tend to be highly cost-effective, they can be carried out in addition to, rather than instead of, other efforts. One example is playing out in Los Angeles, where the police department established Community Safety Advisory Councils. Blending residents, police, and other city partners, the councils visit impacted areas to assess how the physical landscape can be improved as part of a broader anti-crime strategy.
  • Avoid “securitizing” public spaces. Some environmental crime strategies involving “target hardening” can inadvertently create fortress-like environments that negatively impact social cohesion. Care must be taken not just to discourage violent crime, but also to encourage pro-social activities in impacted spaces.
  • Rigorously evaluate the work, with attention to anti-violence outcomes. To advance understanding in this area, environmental crime prevention strategies should be rigorously evaluated, with a specific focus on concrete anti-violence outcomes.

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