This Therapy Helps Formerly Incarcerated People Return to Society

In the mid-1980s Kendall Reese was arrested for a felony drug charge on the block where he lived in North Philadelphia and subsequently sentenced to federal prison. For reasons he never understood, Reese was sent to Holmesburg Prison to serve out his time. Nicknamed “the Terrordrome,” this maximum-security prison housed Pennsylvania’s worst criminals before it was closed in 1995. “At the time, it was filled with killers, 90 percent of which were never getting out,” Reese says.

From there, he served the remainder of his sentence at a Philadelphia detention center, where he says he spent 22 hours each day behind bars, confined to his cell. Reese says he felt the walls starting to close in. He no longer cared whether he was dead or alive. “The life expectancy of a Black male from my neighborhood was 25, and I was already 21,” he says.

But in 1990 Reese’s life took a new turn when he was let out of prison and came home to his mom, who was dying of cancer. On her deathbed, she asked him to go to college and take a step toward financial security by buying the family home. Reese still cared little about his future, but he wanted to honor his mother’s request, so he enrolled in a community college. In school, he spent hours poring through his behavioral health textbook, especially reading its description of major depressive disorder. He noticed that he had most of the symptoms on the bulleted list. “I didn’t realize until then how messed up I was,” he says.

In the following decade, Reese gradually began to turn his life around. He earned an undergraduate degree from Philadelphia University (now Thomas Jefferson University) and a master’s degree in counseling and psychology from Immaculata University. Today he provides therapy and guidance to formerly incarcerated people by volunteering with the Supervision to Aid Reentry (STAR) Program, which uses cognitive-behavioral therapy (CBT) and an approach called recovery-oriented cognitive therapy (CT-R) to help former prisoners reorient back into society and avoid recidivism. Reese says that training in this therapy also serves as a form of self-help, adding that it has given him the tools to make better decisions rather than act from a place of anger. “It teaches you to give yourself at least 10 seconds before you react and think about what could happen if you react in anger,” he says.

CT-R is a therapy similar to CBT but with a specific focus on motivating a person to make better choices. Rather than trying to change negative feelings and behaviors through CBT, CT-R helps patients access and enhance positive aspects of their personality and their existing skill sets, says Paul Grant, CT-R program director at the Beck Institute for Cognitive Behavior Therapy. The therapy was developed by the institute’s founder, the late Aaron Beck, who was considered the father of cognitive-behavioral therapy, several years before his death at the age of 100 in 2021. CT-R’s purpose is to motivate people to connect with others and embrace their own natural strengths. It proceeds by having the therapist first try to connect with a formerly incarcerated person by paying them a compliment and then asking them a related question. In one possible scenario, the therapist might ask, “I noticed that you know a lot about cars. What do you think about that?” This open-ended query guides people to notice their own positive attributes.

Rather than focusing on the challenges in people’s life, the therapy tries to motivate them to find their place in a society where many have always felt like an outsider. It’s directed at those who aren’t necessarily seeking help and don’t have a lot of hope in their life. The program was originally designed for those with major mental health problems, such as schizophrenia. People with schizophrenia typically live 15 to 25 fewer years than people without it. An October 2017 study authored by Grant and Beck that was published in the journal Psychiatric Services found that CT-R had profound effects on those with schizophrenia. The therapy decreased their negative symptoms (lack of motivation, aversion to socializing, inability to communicate with others) and enhanced their ability to function in society. Another study published in the December 2022 issue of Schizophrenia Research found that “CT-R can be a powerful tool to promote positive change in the lives of individuals with schizophrenia.”

In recent years the therapy’s use has expanded to help with reentry to society from prison. Some formerly incarcerated people are confronted with a shorter life span because of exposure to gang and gun violence. A December 2020 study published in the Journal of Preventive Medicine found an exceptionally high mortality rate among Black male gang members. According to the study, homicide was the top cause of death among Black male individuals aged 15 to 34 years, which is 11 times higher than that of white male individuals. Additionally, according to the Prison Policy Initiative, incarceration takes two years off a person’s life expectancy for each year behind bars. In fact, with more than 2.3 million people locked up, mass incarceration has shortened the American life span by nearly two years overall.

Research has also shown that the vast majority of people coming out of the prison system have experienced trauma in their life, whether it’s a result of generational poverty, a dysfunctional family or violence seen before or during their time in prison. A July 2017 report found 24 percent of male incarcerated people met the criteria for post-traumatic stress disorder (PTSD). Grant says that most of them don’t want to talk about their past traumas, and CT-R is a therapy that allows them to find motivation to start a new life without becoming mired in negative feelings. “They’re much more likely to want to talk about a life that they might want or aspire toward,” he says. With CT-R, a therapist approaches a formerly incarcerated person by trying to connect with them based on the things that they care about, such as sports, food or a hobby. It’s about finding what makes a person tick, Grant says.

Earle Brown, a West Philadelphia–based graduate of the STAR Program, endorses the benefits it brought him. He was just 22 years old when he was sentenced to 28 years in federal prison for gun and drug charges. In 2015, at age 49, he was released back into a world that was hardly recognizable. Smartphones were ubiquitous, social media had replaced social contact, and his infant daughter was all grown up. “Being away from my family that long, that’s trauma,” he says.

Today Brown works on carpentry as a hobby and has his own demolition and dump truck business. He says that CT-R classes he took at Drexel University have helped him to better understand how to take control over his life, make positive choices and not be reactive by thinking things out before taking an action. “If you stop when the light is yellow, you ain’t ever going to get in an accident,” he says. It’s about rebuilding your identity as someone who makes good choices.

The classes were developed by Drexel psychologist Kirk Heilbrun, along with Grant and Shelby Arnold, a staff psychologist at the Beck Institute, to incorporate and adapt CT-R therapy for those at a higher risk of reoffending. The two modules are 13 sessions each and focus on improving problem-solving skills, impulse control, decision-making and communication. Since 2015 163 reentry participants have been referred to the program, and 63 have completed all the modules. Twelve more individuals are currently in the program. Those who complete the modules can have their parole shortened by a certain amount of time. Many don’t think they need the program when they first start, but those who stick with it often remark that they can see results. “Many will say that they’ve adapted various aspects of it into their lives,” Heilbrun says.

The STAR Program has not been closely studied for its effectiveness, but there is, in fact, one measure of its success. According to the program’s annual 2022 report, only 13 percent of those in it reoffended, though not every participant took the CT-R portion.  Judge Luis Felipe Restrepo of the U.S. Court of Appeals for the Third Circuit in Philadelphia openly recommends it. “Over the last few years, I’ve become a big believer in the program because it really helps our participants readjust to life at home as opposed to being institutionalized,” he says.

CT-R, moreover, does not have to be delivered by a licensed psychologist or psychiatrist. Those who have done training sessions in the 15 or so reentry programs under the Beck model across the U.S. are then able to later act as counselors.

Earl Hunte of Philadelphia spent 20 years in federal prison for drug charges and completed the STAR program when he got out. He thinks it is more effective when people who have spent time in prison counsel formerly incarcerated people about reentry and mental health. Still, he thinks the program could have a greater impact if it began earlier, while participants were still incarcerated, because they would have more time to master what they learned in therapy. “Behind bars, prisoners have 24 hours a day to do nothing…. Once they get out, they have more distractions, worrying about rent and bills and other stressors,” Hunte says.

Over the past 20 years, Reese has worked to stem what he calls “a cycle of violence in his community.” In 2021 he was pardoned for his crimes—his felony record was wiped clean. “I no longer have to look over my shoulder every time they go to check my record,” he says. And for Reese, the lifting of this burden has been 30 years in the making.

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