Cognitive Behavioral Therapy: Cost Effective Treatment for Criminals and At-Risk Teens

In an experiment in Liberia, researchers took 999 of the most violent, high-risk criminals in their capital, and for only $535 of expenses per person (nothing to these kinds of programs or compared to the cost of crime and prisons), they bought 20-50% lower incidents of crime in that population for a year. The treatment was asking 1500 candidates if they wanted therapy – 2/3 of them said yes – and they ran a cheap cognitive behavioral therapy (CBT) course with them.

CBT was then brought to Chicago youths with similarly positive results in three separate randomized controlled trials. Graduation rates rose and crime rates fell, crucial in bringing a new generation out of poverty with access to better opportunities.

Image By Jty33 (Own work) CC BY-SA 3.0


In the two studies participation in the program reduced total arrests during the intervention period by 28–35%, reduced violent-crime arrests by 45–50%, improved school engagement, and in the first study where we have follow-up data, increased graduation rates by 12–19% […] These large behavioral responses combined with modest program costs imply benefit-cost ratios for these interventions from 5-to-1 up to 30-to-1 or more. 

If the improvements in participants’ high school graduation lead to other future benefits such as increased earnings or longer life expectancies, these estimates may understate the full value of the program’s social benefits
“Thinking, Fast and Slow?” Heller, et al

 

To investigate, we recruited 999 of the highest-risk men in Liberia’s capital, generally aged 18 to 35. Most were engaged in part-time theft and drug dealing, and regularly had violent confrontations with each other, community members, and police.

Men who received therapy reduced their antisocial behavior dramatically. Within a few weeks, for instance, drug dealing halved and thefts fell by a third, compared to controls. With therapy alone, these effects diminished after a year. When therapy was followed by cash, however, effects were lasting. For example, a year later, those who received both therapy and cash were 44% less likely to be carrying a weapon, 43% less likely to sell drugs, and reported lower aggression. In the control group, men reported stealing almost once per week on average, and with therapy and cash this fell nearly 40%—equal to 25 crimes per year, per person. 
Poverty Action Lab

Circumcision to Fight HIV Transmission

Voluntary male circumcisions (VMMC) in high-risk areas reduce HIV acquisition among men by approximately 60%, for only about $6 per treatment. The evidence is strong enough that the treatment has gotten heavy hitters like the CDC, WHO, the Gates Foundation, and the White House (at least the last one …) onboard.

Kenya made it its long-term goal to circumcise 80% of its male population in 2008. In the first couple years, they circumcised almost 400,000 people. Since then, 13 African countries have followed suit, getting 3 million done from 2008 to 2012, and doubling from 2011 to 2012.

Image Credit: UN AIDS Global Report 2013


Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa.
Public Library of Science

 

Kenya’s 4-year VMMC target is to circumcise 860,000 (80%) of uncircumcised males aged 15–49 years by 2013. During 2008–2011, trained clinicians performed 391,383 VMMCs for HIV prevention in Kenya, of which 340,958 (87.1%) were conducted in 260 MOH sites supported by CDC-funded partners, from which the data were obtained
The CDC

 

“Providing men with information about male circumcision and HIV risk can encourage safer sexual behavior among uncircumcised men, and fears that information will lead to riskier behavior among circumcised men may be overstated. The 2008 information campaign led uncircumcised men to adopt safer sexual behavior one year after a short information session, suggesting that VMMC information can have longer-term effects on sexual behavior.”
Jameel Poverty Action Lab

 

While challenges persist in preventing new infections, opportunities to dramatically lower HIV incidence have never been more promising. In recent years, evidence has emerged that antiretroviral therapies can reduce the risk of HIV transmission by as much as 96%, voluntary medical male circumcision by approximately 60% […]
The UN

 

The number of those responding positively is below the ages of 18. Maybe this is due to peer pressure. Once school children are circumcised, they tend to influence others to undergo the procedure. I think there is need to teach everyone a lot about these programmes.
VOA Zimbabwe

Peacekeeping is an Investment

Every year, the Institute for Economics and Peace Research puts out a report breaking out the status of peace and war over the last year. It’s the nerdiest and most amazing thing for political science nerds who obsess over data, so I highly recommend it.

One of the findings is that war costs the world economy over a trillion dollars per year. Peacekeeping cost less than 1% of that. Peacekeeping can be hard to motivate support for. It simultaneously seems scarily globalist, abusive, rapey, and ineffective, all at once. But that’s a shame. Because despite any flaws, it’s an incredibly productive investment. Crimes committed by the police very rarely result in calls for the abolishment of the idea of having police at all.

Cost savings from peacekeeping can be over 16 times the cost. 53% of peacekeeping activities are in active warzones, and the average length of an operation is only 31 months (with a few ongoing outliers). If the world could put the resources needed into peacekeeping in the next 10 years, the cost avoidance could be almost $3 trillion. And hidden behind those sterile dollars are a lot of real human lives. 

Image by Dawit Rezene, via Wikimedia Commons


IEP estimates show that the cost of violent conflict in 2013 was over 120 times higher than
peacebuilding and peacekeeping funding.
The potential benefits from investing further in peacebuilding are substantial. Based on IEP’s model of the cost-effectiveness of peacebuilding, the total peace dividend that the international community would reap if it increased peacebuilding commitments over the next ten years could be as high as US $2.94 trillion. 
Global Peace Index 2017

Walking Barefoot in Human Poop Held the American South Back for Centuries

Hookworm is a parasite that causes lethargy and lower performance. It is transmitted when human waste (used as a fertilizer on fields) comes into contact with human feet (barefoot field workers) in climates where it can survive (the American South).

Almost half of the American South was infected with this parasite as of 1910, causing stereotypes about lower-class Southern people being lazy and dumb. It was only around then, after centuries of lives held back from their potential, that someone thought to figure out why and discovered hookworm.

Despite some pushback from Southerners who were offended by the accusation that they were all infected by parasites, improving conditions and a big campaign by the Rockefeller Foundation eventually wiped out the parasites, but only in the mid 20th century.

Image Attribution: Marion Post Wolcott [Public domain], via Wikimedia Commons


[…] as recently as the 1950s, hookworms were an intimate and ever-present threat for those living in the South. It was nearly impossible for the rural poor—the majority back then—to avoid hookworms […] Because iron is critical for brain function, hookworm infection could also lead to irreversible cognitive and intellectual defects. A 1926 study of Alabama school children found that the greater the number of worms that students harbored, the lower their IQ. 
PBS

 

Areas with higher levels of hookworm infection prior to the RSC experienced greater increases in school enrollment, attendance, and literacy after the intervention. This result is robust to controlling for a variety of alternative factors […]
The NIH

 

Hookworms live in the small intestine. Hookworm eggs are passed in the feces of an infected person. If the infected person defecates outside (near bushes, in a garden, or field) of if the feces of an infected person are used as fertilizer, eggs are deposited on soil. They can then mature and hatch, releasing larvae (immature worms). The larvae mature into a form that can penetrate the skin of humans. Hookworm infection is mainly acquired by walking barefoot on contaminated soil.
The CDC

 

Southerners initially distrusted RSC efforts. Many were offended by accusations of infection and refused to accept testing and the treatment of Epsom salts and thymol. Others believed that the disease simply did not exist. Regional newspaper editorials also strongly criticized RSC employees and viewed them as a Northern imposition.
The Rockefeller Foundation

The One Economic Principle that Explains the Power of Lobbyists

Pay attention to politics at all, and you’ll come across the term “special interests” to describe lobbyists: the idea that a small minority of the population control Washington and politics in general.

There’s some truth to that idea. And it comes from an economic principle called “concentrated benefits and diffuse costs.” Say there’s a law that will take a dollar from a million people and give it to one person. How hard would you fight to save that dollar?  Would you fly to Washington D.C., hire a lawyer or lobbyist, and go to Congressional hearings for it? The person receiving the million dollars certainly would.

This simple concept explains why a small group of elites with time and money can often out-lobby millions of people, even in a democracy.

Image By Martin Falbisoner (Own work) [CC BY-SA 3.0
(http://creativecommons.org/licenses/by-sa/3.0)%5D, via Wikimedia Commons


“One reason for this lobbying imbalance was identified by the political scientist James Q. Wilson more than 30 years ago. He noted that many policies tend to concentrate benefits and costs on companies, while dispersing benefits and costs among citizens. The former motivates political action; the latter does not. This makes it much easier for a company like Citigroup to spend $5.3 million a year in lobbying expenditures but much harder for Citigroup customers to organize to, say, reduce fees.”
The Washington Post 

 

Many members explained their “no” votes by saying they were unwilling to sacrifice the subsidies to airports in their districts. “It’s that old problem of concentrated benefits with diffuse costs. The benefits are lavished on a few select communities, and the costs are diffused across the entire tax base,” McClintock said afterward. The beneficiaries, he said, are the only ones who care enough to fight.
The CATO Institute

 

Popular Opinion on War is Mostly Based on How Hard We’re Winning

The most important factor that statistically impacts the popularity of a war is whether we are winning. If we’re winning, we as a people tolerate pretty high casualties.

Dr. Feaver, the person who originally published these results from their conflict studies research heavily influenced the Bush administration in how it communicated the Iraq war (as reported by several journalists in 2005-6), and may have been responsible for the emphasis on winning quickly that Bush took with his speeches.

This same effect seems to have been picked up on in general by American politicians (e.g.: Mr. Trump and his fixation on repeating the words “win” and “lose;” Obama consistently downplaying the difficulty of destroying ISIS and repeating simple easy win conditions), so watch out for the impact of that analysis the next time you’re watching a speech.

Image By U.S. Department of Defense Current Photos
(101211-A-7125B-303) [Public domain], via Wikimedia Commons


Our core argument is that the U.S. public’s tolerance for the human costs of war is primarily shaped by the intersection of two crucial attitudes: beliefs about the rightness or wrongness of the war, and beliefs about a war’s likely success. The impact of each attitude depends upon the other. Ultimately, however, we find that beliefs about the likelihood of success matter most in determining the public’s willingness to tolerate U.S. military deaths in combat.
https://onedrive.live.com/redir?resid=5CBB7CBC784DB26C!385&authkey=!AOvcFBNMiNcM2JE&ithint=file%2cpdf (Success Matters: Casualty Sensitivity and the War in Iraq, Christopher Gelpi, Peter D. Feaver, and Jason Reifler, International Security, Vol. 30, No. 3)

 

He used the word victory 15 times in the address; “Plan for Victory” signs crowded the podium he spoke on; […] reflected a new voice in the administration: Peter D. Feaver […] They concluded that Americans would support a war with mounting casualties on one condition: that they believed it would ultimately succeed.
http://www.nytimes.com/2005/12/04/politics/bushs-speech-on-iraq-war-echoes-voice-of-an-analyst.html?_r=0 (Bush’s Speech on Iraq War Echoes Voice of an Analyst, Scott Shane, The New York Times)

 

[The administration] recognizes that flagging domestic support will translate into a strategic straitjacket […] The Feaver/Gelpi solution to this conundrum is to have the President spell out a clear definition for victory…
http://foreignpolicy.com/2005/12/06/political-science-enters-the-white-house/ (Political science enters the White House, Daniel W. Drezner, Foreign Policy)

 

These results suggest [given] substantial disagreement about the prospects for success, the public’s support is likely to remain low or even decline.
http://www.mitpressjournals.org/doi/abs/10.1162/0162288054894616#.V2tkO7grK70 (Victory Has Many Friends: U.S. Public Opinion and the Use of Military Force, 1981–2005, Richard Eichenberg, International Security)

 

As the Washington Post reported nine months ago, Bush’s domestic political spin on the war is guided by the work of two Duke University political scientists, Peter D. Feaver and Christopher F. Gelpi, […] Public support for the Iraq war has faltered because the American people cannot see progress toward a well defined goal and toward success.
http://www.salon.com/2006/03/23/civil_war/ (Civil War? What Civil War?, Juan Cole, Salon)

 

“We will have so much winning if I get elected, that you may get bored with winning.”
http://www.salon.com/2015/09/09/donald_trump_if_elected_well_have_so_much_winning_youll_get_bored_with_winning/

“Our objective is clear: we will degrade, and ultimately destroy, ISIL through a comprehensive and sustained counter-terrorism strategy.”
http://www.cnbc.com/2014/09/10/obama-us-will-lead-coalition-to-fight-isis-no-us-combat-troops-fighting-on-foreign-soil.html

“We Do Not Negotiate With Terrorists!” … Sometimes

It’s an old adage, and official policy of many governments. In fact, some upstart terrorist groups count on it in order to pump up their troops and escalate things with the governments they hope to agitate.

But while governments are hesitant to talk to them at first, the more terrorism a terrorist organization does, the more likely the government caves and comes to the table. That also may not actually be a bad thing when you crunch the numbers on it, as it tends to end conflict faster when everyone is able to get together and hash things out.

See the studies below for more details:

Image By BLAKE R. BORSIC, CIV, USAF [Public domain], via Wikimedia Commons


When the weakest rebels make demands from the government, they make large demands, ensuring that sufficiently weak types of government reject, preserving their optimism about their chances of victory. As these weakest rebels grow stronger, they are freed to demand less from the government, because the credibility of their threat to fight is no longer in question; they no longer need to believe that the government is very weak in order to credibly threaten to fight. Thus, we show that some common results from the standard approach to crisis bargaining, which assumes the credibility of threats, do not hold when credibility is an issue for uninformed players.
http://www.jakanathomas.com/uploads/2/7/1/6/27169143/final_rebel_credibility_dilemma_io.pdf (The Rebels’ Credibility Dilemma, Jakana L. Thomas, William Reed, and Scott Wolford, International Organization)

 

Using the conflicts in Northern Ireland and the southern Philippine region of Mindanao as illustrations, the article argues that the legitimation of `terrorist’ groups through talks can be a means to transform a conflict away from violence, while complexity may in fact open up new possibilities for engagement. The article concludes by examining how the naming of a group as `terrorist’ can and is often designed to forestall nonviolent responses to terrorism.
http://sdi.sagepub.com/content/39/4/407.short (`We Don’t Negotiate with Terrorists!’: Legitimacy and Complexity in Terrorist Conflicts, Harmonie Toros, Security Dialogue)

 

Using new monthly data on the incidence of negotiations and the number of concessions offered to groups involved in African civil wars, this paper demonstrates that rebel groups are both more likely to be granted the opportunity to participate in negotiations and offered more concessions when they execute a greater number of terror attacks during civil wars.
http://onlinelibrary.wiley.com/doi/10.1111/ajps.12113/abstract and https://www.washingtonpost.com/news/monkey-cage/wp/2014/04/22/actually-sometimes-terrorism-does-work/ (Rewarding Bad Behavior: How Governments Respond to Terrorism in Civil War, Jakana Thomas, American Journal of Political Science, reported on by the Washington Post)

 

Take a look at some of the most glaring – as well as some of the least well known – examples of U.S. negotiations with terrorists throughout history. [Iran Hostage Crisis, Iran-Contra Affair, Bill Clinton and the IRA, GW Bush and the Abu Sayyaf, Meetings with Hamas, Prisoner Exchanges in Iraq].
http://sotu.blogs.cnn.com/2014/06/07/timeline-of-u-s-negotiations-with-terrorists/ (Timeline of U.S. negotiations with terrorists, CNN)