Cognitive Behavioral Interventions: Scaling Success to Save Lives
By Thomas: Abt., Mills, M., Magori, G.
Cognitive behavioral interventions (CBIs) have emerged as a key evidence-informed strategy for saving lives and stopping violence. Despite a strong scientific track record, the capacity to scale these strategies remains limited. During Fall 2024, the Center for the Study and Practice of Violence Reduction brought together leading academics, on-the-ground practitioners, key government officials, and interested funders to discuss why. To implement CBI strategies effectively, six practices were identified as essential. First, successful CBIs employ practical tools and strategies that are proven to work. Second, they utilize street outreach workers with a high degree of cultural responsivity. Third, these organizations employ “relentless engagement” to connect high risk individuals to treatment and services. Fourth, they offer extensive training to their employees, both so they may utilize CBI tools and teach them to others. Fifth, they are flexible, adapting models to real world conditions. Sixth and finally, successful CBIs support and invest in their workers - their most valuable asset. Implementation best practices like these can be challenging for a number of reasons. First, those who are most in need are often the most resistant to these services, making it imperative that outreach workers leverage their credibility to find creative ways to connect with prospective participants. Second, negative peer influences can hinder participants from drawing on CBI tools in critical situations. Third, substance use and mental health issues pose significant challenges to program participants. Fourth, all elements of proper implementation are not yet fully understood. While a solid base of evidence supports CBI strategies, they still require further development and study. Trauma, if left unaddressed, can also impede the effective implementation of CBIs. Trauma Informed care can provide a basic framework for support while healing-centered engagement can further promote healing, a sense of belonging and self-determination, and empowerment to achieve post-traumatic growth. CBIs should focus not only on treating the trauma of program participants, but also that of program staff. To successfully scale CBIs, a number of strategies were recommended. CBIs must be cost effective, although even the most expensive approaches more than justify themselves in terms of social return on investment. CBIs must also secure consistent funding, increasing their capacity to access governmental and nongovernmental resources. Increased professionalization is necessary for sustainable and scalable CBI interventions. Finally, while a strong base of evidence supports CBI strategies, further research and study is necessary, especially with regard to implementation. In conclusion, CBIs continue to demonstrate effectiveness in reducing community violence, particularly when attention is paid to best practices. Continued investment is necessary to advance the field while growing it at the same time.
College Park, MD: Center for the Study and Practice of Violence Reduction University of Maryland, 2025. 25p.