Program Profile: Washington State Aggression Replacement Training

This is a group-based intervention for moderate- and high-risk juvenile court youth in Washington State. The goal is to reduce recidivism rates by teaching anger control, moral reasoning, and social skills. The program is rated No Effects. One study found treatment group youth were statistically significantly more likely to recidivate, compared with the comparison group. Another study found no statistically significant differences in recidivism rates between the treatment and comparison groups.

A No Effects rating implies that implementing the program is unlikely to result in the intended outcome(s) and may result in a negative outcome(s).

Program Goals/Target Population

Aggression Replacement Training (ART) is a cognitive–behavioral program that teaches youth to control impulsiveness and anger; to acknowledge the limitations in their current thoughts, emotions, and behaviors; and to learn new skills and coping mechanisms to promote future prosocial behavior. The program is targeted at moderate- and high-risk youth who have a history of serious aggression and antisocial behavior, assessed through a clinical instrument to examine the degree of problematic behavior. In Washington State, the program is implemented with juvenile court youth who are sentenced with local sanctions and is referred to as WSART. The main goal is to reduce recidivism rates in juveniles.

Program Components

WSART consists of a 10-week, 30-hour intervention administered to groups of 8 to 12 youth three times per week. The program relies on repetitive learning techniques to teach participants to control impulsiveness and anger so they can choose to use more appropriate prosocial behaviors. In addition, guided group discussion is used to correct antisocial thinking.

The program consists of three interrelated components, all of which come together to promote a comprehensive aggression-reduction curriculum: 1) social skills, 2) anger control, and 3) moral reasoning. Youth attend a 1-hour session each week for each of the three components.

• Social skills. In this component, trainers use demonstrations and practice sessions to help youth develop prosocial interpersonal skills.
• Anger control. In this component, trainers use role play to teach youth the skills to handle their angry feelings and provide them alternatives to aggression.
• Moral reasoning. In this values-oriented component, youth discuss responses to hypothetical moral dilemmas to identify the need for fairness, justice, and empathy toward others.

Additional Information

A study by Barnoski (2004) found no statistically significant differences on measures of recidivism between youth in the WSART treatment group and youth in the comparison group. However, a study by Knoth and colleagues (2019) found that youth in the WSART treatment group showed a statistically significant greater likelihood of recidivating (as measured by rates of any recidivism, felony recidivism, and violent felony recidivism), compared with youth in the comparison group.

Study 1

Barnoski (2004) used a pseudo-random assignment procedure to assess the effect of Washington State Aggression Replacement Training (WSART) on juvenile recidivism, at the 18-month follow up. The study sample included a total of 1,229 adjudicated youth (n = 704 treatment group; n = 525 comparison group) within 26 juvenile courts in Washington State.

All juveniles were assessed for eligibility by court staff, using prescreen and full versions of the Washington State Juvenile Court Assessment (WSJCA). This instrument determines a youth’s level of risk by prescreen scores on criminal and social history; the full assessment is then given to moderate- to high-risk youth only. The full instrument is organized into nine domains: 1) school, 2) free time, 3) employment, 4) relationships, 5) family (current and prior), 6) drug/alcohol, 7) mental health, 8) antisocial attitudes, and 9) skills (another score was developed to measure aggression). For each domain, a risk or protective factor score was computed. To be eligible for WSART, youth had to be considered moderate or high risk and have at least one of the following: 1) a criminal history risk factor score of at least 1 for a weapon, violent misdemeanor, or felony conviction; 2) an aggression risk factor score of at least 2 out of a possible 13; 3) an attitudes/behavior risk factor score of at least 7 out of a possible 28; or 4) or a skills risk factor score of at least 9 out of a possible 36. Youth who met these criteria were assigned to WSART until the program reached capacity (i.e., either all therapists had full caseloads, or all sessions were full). Court staff assigned the remaining eligible youth to the comparison group. The comparison group did not participate in WSART, but received the usual juvenile court services. Through this approach, the study authors created a sample with similar risk and protective factors.

The average age at adjudication across all courts was 15.2 for youth in the WSART program and 15.5 years for youth in the comparison group. The majority of the sample was male (80 percent in the WSART treatment group and 81 percent in the comparison group). Multivariate statistical techniques were used to control for systemic differences between the program and comparison groups on key characteristics from the WSJCA (such as gender, age, and domain risk and protective factor scores).

Outcomes of interest included recidivism, measured as felonies, violent felonies, and misdemeanor and felonies. Data on recidivism were collected from the state’s Administrative Office of the Courts and the Department of Corrections. To analyze the outcomes of interest, logistic regression was used to control for systemic differences between the treatment and comparison groups. Additional analysis examined how competent delivery of the WSART program affected the intended outcomes. A subgroup analysis was conducted to examine the effects on recidivism reduction by courts that were competently delivering WSART (n = 21), compared with courts that were not competently delivering the program (n = 5).

Study 2

Knoth, Wanner, and He (2019) assessed the effects of the Washington State ART (WSART) program on felony, misdemeanor, and violent recidivism in 13,070 juvenile court youth. Youth were identified through matches between the Juvenile Assessment Research Database and court cases from the Criminal History Database. Juvenile court youth sentenced with local sanctions were screened using the Washington State Positive Achievement Change Tool (PACT). For youth with multiple court cases who therefore received multiple PACT assessments, one of those assessments was randomly selected to be included in the analyses. If the randomly chosen assessment included youth’s WSART participation (but not necessarily completion) between January 1, 2006, and June 30, 2016, they were included in the treatment group. If it did not, the youth were placed in the comparison group. Youth were eligible for WSART if they were considered to be moderate or high risk and had one of the following: 1) a current or prior adjudication for a weapon, violent misdemeanor, or felony conviction; 2) a score of 2 or above on the Aggression domain; 3) a score of 5 or above on the Attitudes/Behavior domain; or 4) a score of 4 or above on the Social Skills domain. The comparison group was considered “treatment-as-usual,” as it included youth who were eligible for WSART but who did not start the program during the same 10-year period and may have started another evidence-based practice. The final matched sample included 6,535 treatment youth and 6,535 comparison youth.

To establish a sample that was similar on all characteristics (such as demographics, offense characteristics, and risk information), the authors used propensity score matching to identify youth in the comparison group who were most similar to youth in the treatment group and match them on observable characteristics, besides participation in WSART. The majority of youth in the WSART treatment group were 15 to 17 years old (77.0 percent) and male (74 percent). With regard to race/ethnicity, the treatment group was white (63.2 percent), Hispanic (15.9 percent), Black/African American (12.8 percent), Asian/Pacific Islander/Native Hawaiian (2.8 percent), American Indian/Alaska Native (3.7 percent), and other race/ unknown (1.6 percent). At the time of the assessment, most comparison group youth were also 15 to 17 years old (77.6 percent) and male (74.3 percent). With regard to race/ethnicity, the comparison group was white (63 percent), Hispanic (16.1 percent), Black/African American (12.8 percent), Asian/Pacific Islander/Native Hawaiian (2.8 percent), American Indian/Alaska Native (3.7 percent), and other race/unknown (1.6 percent). There were no statistically significant differences between the groups on baseline characteristics.

The primary outcome of interest was recidivism, including any recidivism, misdemeanor recidivism, felony recidivism, or violent recidivism. Outcomes were assessed through regression analyses using the matched sample. Recidivism data were collected from the Washington State Institute for Public Policy’s Criminal History Database, which combines data from several state agencies, including court data, residential confinement data, and incarceration in state prisons and community supervision data. Additional subgroup analyses explored the effects of risk level, gender, age, race/ethnicity, trainer competence, and program completion on program outcomes. For each of these subgroups, new models identified matched samples of treatment and comparison group youth with a similar likelihood of participating in WSART.

Washington State’s resident expert in Aggression Replacement Training (ART) worked with the state’s Juvenile Rehabilitation Administration on a half-time basis to train WSART instructors, who were funded by the Community Juvenile Accountability Act, and create a quality assurance process, a training curriculum, and a procedures manual (Knoth et al. 2019).

Re-review

In 2012, Aggression Replacement Training (ART) received a final program rating of Effective, based on a review of the studies by Coleman, Pfeiffer, and Oakland (1992); Barnoski (2004); and Gundersen and Svartdal (2006). In 2020, when CrimeSolutions conducted a re-review of the ART program, the new evidence base included studies by Barnoski (2004) and Knoth and colleagues (2019). This re-review resulted in a new final program rating of No Effects. In addition, because the studies by Barnoski (2004) and Knoth and colleagues (2019) specifically focused on the version of ART implemented in the State of Washington, the program name has now been changed from Aggression Replacement Training (ART) to Washington State Aggression Replacement Training (WSART).

Subgroup Analysis

Barnoski (2004) conducted a subgroup analysis by court competency ratings. Of the 26 courts, 5 were not considered competent in delivering WSART, and 21 were found to be either competent or highly competent. For the courts that were considered competent or highly competent at delivering WSART, there was a statistically significant reduction in felony recidivism for youth in the treatment group, compared with youth in the comparison group. In the courts considered not competent, there was no statistically significant difference in felony recidivism rates between youth in the treatment group and youth in the comparison group.

Knoth, Wanner, and He (2019) conducted multiple subgroup analyses; this CrimeSolutions review focused only on gender, risk level, and trainer competence. With regard to race/ethnicity, the results were mixed; however, there were some statistically significant findings demonstrating a negative effect of WSART on recidivism. For more information, see the article (Knoth et al. 2019) below.

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Following are CrimeSolutions-rated programs that are related to this practice:

Cognitive Behavioral Therapy (CBT) for Antisocial Behavior in Youth in Residential Treatment

Cognitive behavioral therapy (CBT) is a problem-focused, therapeutic approach that attempts to help people identify and change dysfunctional beliefs, thoughts, and patterns that contribute to their problem behaviors. This variant of CBT focuses specifically on youth in residential settings. This practice is rated No Effects for reducing recidivism, at the 24-month follow-up period.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Cognitive Behavioral Therapy (CBT) for Anger-Related Problems in Children and Adolescents

Cognitive behavioral therapy (CBT) is a problem-focused, therapeutic approach that attempts to help people identify and change dysfunctional beliefs, thoughts, and patterns that contribute to their problem behaviors. This variant of CBT focuses specifically on children and adolescents who have anger-related problems. The practice is rated Effective for reducing aggression and anger expression, and improving self-control, problem-solving, and social competencies.

Evidence Ratings for Outcomes

	Juvenile Problem & At-Risk Behaviors - Aggression
	Juvenile Problem & At-Risk Behaviors - Anger Experience
	Juvenile Problem & At-Risk Behaviors - Self-Control
	Mental Health & Behavioral Health - Problem-Solving
	Mental Health & Behavioral Health - Social Competencies

Psychological Treatments for Adults With Histories of Violent Offending

This practice consists of talk-based therapies aimed at reducing violent, aggressive, or antisocial behavior of adults with a history of violent offending. Therapies include cognitive-behavioral therapy, anger management programs, and violence reduction programs. This practice is rated Promising for reducing trait anger and impulsivity and for improving social problem solving, and general social skills. This practice is rated No Effects for reducing antisocial cognitions.

Evidence Ratings for Outcomes

	Mental Health & Behavioral Health - Trait anger
	Mental Health & Behavioral Health - Impulsivity
	Mental Health & Behavioral Health - Social problem solving
	Mental Health & Behavioral Health - General social skills
	Mental Health & Behavioral Health - Antisocial cognitions

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?