ABSTRACT
Forensic mental health settings encounter challenges incorporating recovery-oriented treatment principles, a mandate for care since the President’s New Freedom Commission report. Some challenges are inherent to the justice system (e.g., length of stay, hierarchical decision-making), while others reflect a focus on legal constructs as markers of success rather than whole-person definitions of recovery (e.g., living one’s desired life). This chapter presents Recovery-Oriented Cognitive Therapy (CT-R) as an approach that improves care by operationalizing recovery principles for multidisciplinary teams in even the most restrictive forensic settings. Guided by Dr. Aaron Beck’s cognitive model, CT-R is an evidence-based practice that provides concrete, actionable steps to promote recovery and resiliency, providing efficient methods for risk mitigation through the reduction of evidence-based criminogenic risk factors (e.g., antisocial cognitions, lack of educational/vocational activities) and bolstering protective factors linked to recidivism reduction (e.g., increased connection, meaningful ways to spend time). Providers support these methods through strategies that lead to belief change, helping individuals view themselves as more capable, other people as worth connecting to, and the future as more hopeful. This chapter reviews the foundational principles and evidence base for CT-R, illustrating how it can be implemented in forensic settings to promote system change.
