Not long ago in Baltimore, an angry young man in a neighborhood with many angry young men bumped into 23-year-old Cortez Scott — intentionally. He was, clearly, itching for a fight. And there was a time, in the not too distant past, when Scott would have given it to him — even, perhaps, taken it to the point of violence.

Instead, Scott took a pause to think for a minute. “Maybe this guy is having a bad day, he’s got personal problems,” he considered. “It’s not me he’s mad at — it was just me standing here in the moment. I can just ignore him.”

So he did. Scott walked away and lived (literally) to tell the tale. 

For that, Scott credits an intense, complex, and ultimately empowering and life-saving program called Roca that uses cognitive behavior therapy (CBT) to turn young men away from violence. Founded in Boston in the 1980s, Roca incorporated CBT into its work in 2014, with results that are hard to argue with. Among its Massachusetts participants — 94 percent of whom had arrest records prior to joining — 84 percent who stayed with the program for two to four years had no new arrests; 98 percent had no new incarcerations. In 2019, Roca expanded into Baltimore — the first time it moved beyond Massachusetts — and early results show the program is having a similar impact there, as well.

“We have all these programs to help people, but you really have to deal with what’s happening in the brain for any of them to work,” says Baldwin.

The idea of Roca is to interrupt the cycle of violence by helping high-risk young people change the way they react to situations, by — in effect — changing the way their brains work. They do this by teaching skills that, as with Scott, help people to slow down, think differently about a situation and plan a response that is measured and won’t lead to further confrontations. It sounds simple enough, but for young people who have lived with violence and trauma for most of their lives, that ability to think calmly often eludes them.

“What we’re doing is practicing the skills to build the muscle to learn to take the pause before they shoot someone, beat up their girlfriend, blow out of their job, tell everybody to fuck off, whatever the hell it is,” says Molly Baldwin, who founded Roca in Chelsea, Massachusetts, nearly 35 years ago. “We have all these programs to help people, but you really have to deal with what’s happening in the brain for any of them to work.”

Baldwin started Roca in 1988, originally focused on preventing teen pregnancy as a way to keep people from staying in poverty. Over the decade, Roca expanded its work to provide more services and educational programs to other under-resourced populations, including refugees. Eventually, the program began to focus on young people at risk of violence; in 2009, that focus narrowed even more, to high-risk individuals.

Somewhere along the way, Baldwin discovered the idea that there are “stages of behavior change,” which she describes as an awakening. “I remember thinking, this must be what the pilot feels when the lights go on the runway at night,” she says. That, eventually, led her to Luana Marques, PhD, a researcher and psychologist at Massachusetts General Hospital, who collaborated with Roca to customize a unique CBT approach that is non-clinical; can be delivered in simple skills; and can work with young people stuck in cycles of violence, without requiring classes or homework.

That is the program Roca now incorporates into its work, and which it took to Baltimore — a closer comparison to Philadelphia than Massachusetts — in 2019.

An innovative method to deal with rising gun violence

Like Philly and other cities around the country, Baltimore has experienced a chilling spike in gun violence over the last several years. In 2021, as in the six years prior, more than 300 people died from shootings in Baltimore, a rate for that small city that is even worse than Philadelphia, which also saw more homicides in 2021 — 562 —than any time in decades. (Nearly halfway through 2022, shootings in Philadelphia are basically on par with last year.) Victims these days are more varied than in past shooting sprees, with more women and children dying by guns, but it is still largely young Black men in Baltimore and Philadelphia who are at highest risk of shooting or being shot.

Roca’s theory of change is based on brain science that shows that healthy human brains are fully developed only at age 25, which is when the prefrontal cortex fully matures and impulse control and reasoning kick in. For people who have experienced trauma — like the continual trauma of ongoing violence — that part of the brain never entirely matures. Instead, people get stuck in a heightened state, their brains always in a fight, flight or freeze mode that non-traumatized people typically experience only in extreme situations. For people living with continued violence, extreme situations are a constant; that affects how many make decisions about their behavior.

Baldwin explains it this way: “When this happens, you are literally out of your mind; you can’t even access the thinking part of your brain. When you stare at me at the park, and I decide I have to kill you because that’s a threat to my existence, that, in my brain, is a rational response. It’s not ok; it’s not legal; I’m not absent responsibility. But it’s rational.”

Roca uses CBT to retrain the minds of young men at high risk of becoming shooters or victims of a shooting in Boston and Baltimore — to develop the impulse control and reasoning that will keep them from flying off the handle and firing a weapon. They do that through a series of seven lessons, what they call Rewire by Roca:

• • Be present
  • Label your feelings
  • Move it
  • Act on your values
  • Stick with it
  • Flex your thinking
  • Solve it

Locally, there are some organizations that incorporate CBT into their work in Philly, most notably Healing Hurt People, a hospital-based violence intervention program out of Drexel University that does trauma-informed and behavioral therapy for young adults aged 19 to 35. At Roca, though, every activity is about one thing: practicing CBT, in a classroom setting, at home, on the street, even in their jobs programs. They teach the skills over the phone, in groups, on doorsteps, wherever they find the young people and whenever they can.

“We want to get them to the point where if they have a thought, they do the pause thing, and think is that true? And is that helpful?” Baldwin says. “And then they act on that.”

That pause — like it did for Scott — is a moment filled with just enough thinking to prevent an action that can take a life. Baldwin recalls one participant who illustrated this point. He saw a guy looking at his girlfriend, and immediately became elevated. “I called my boy, was waiting for him to get my backpack, to get my gun and my mask,” he told Baldwin. “Then I started going through my skills and got to ‘flex your thinking.’ That’s when I thought: He can’t even see me.” Like Scott, he stood down and credits Roca for his doing so.

“It’s a sacred responsibility to help each of these young people live and not shoot each other,” Baldwin says. “We ask ourselves everyday: What should make me worthy enough to have the privilege of being in these young kids’ lives today? We should all get to that point, and we have to help each other.”

Roca’s participants are high-risk young men between ages of 16 and 24, who won’t be going to GED classes, or joining leadership programs, or doing job training, even if they have access to them. (“Is there a day when they might do those things? Yes,” says Baldwin. “They are not there yet.”) Roca identifies youth at risk, with criminal records, by referral from police, probation officers and community members; they have an after-shooting protocol to locate victims, shooters, their families and anyone else who might be at risk of another shooting.

And then, they go after them through what Roca terms “relentless outreach.” Youth outreach workers meet their charges wherever they are — in their homes, on the street, in a playground — and those charges are Roca clients whether they’ve chosen to be or not. “You’re in because we decide you’re in,” Baldwin says. “We’ll find you, stick with you, keep coming at you with CBT until you’ve built that muscle to choose.”

In Massachusetts, it takes on average about eight to 10 door knocks before a young man starts to listen; in Baltimore, it takes 12 to 14 tries before a real conversation even happens. (Amar Mukunda, Roca Baltimore’s assistant director, says the most door knocks it took for one young man was 96.) But slowly, the message starts to sink in and the work can begin. In Baltimore, Mukunda says his 10 caseworkers will have about 250 people on their caseload by the end of July, and Roca aims to serve 325 by the end of the year.

That is, admittedly, a small fraction of the people at risk of shooting or being shot in Baltimore, as in Philadelphia. Mukunda says his staff and the young men they work with hold two ideas at the same time: The need to prevent shootings now; and the need to invest in preventing shootings — and helping people heal — in the future. “This is a population that doesn’t get invested in, period, full-stop,” he says. “These are guys who deserve this effort, regardless of the immediate outcome. We can help them change their lives long-term.”

This is also not a quick fix to the problem. Brain science and Roca’s data shows it takes about two to three years to change behavior; often it’s four years before participants are ready to hold down jobs and truly live what they have learned. There is no way to speed it up, and Baldwin says there is no way to really scale the program more than they are, in a manner that also keeps workers and clients safe — which she stresses is not only necessary, but the only way to do this work responsibly.

Roca relies heavily on data, with staff members tracking every interaction with young people, logging every detail about their relationships and life events; they track who is onsite, and who they might have a beef with, so they can ensure they’re not in the same place at the same time. Supervisors carefully keep track of caseworkers, so they know how their employees are doing as well. The work is as much about healing — and not causing more — trauma as it is about ending violence.

“This is retail, not wholesale,” Baldwin notes. “It’s one special human being after the other. We can’t make it go faster. We have a really inequitable, racist world; we have poverty; we have a lot of people who have been hurt; there is no quick fix to this.”

Impact requires support

Roca has no plans to move into Philadelphia (or any other city) just yet; its launch in Baltimore was the result of intense planning and support from police and other public and private organizations. In fact, doing this work requires that support, something Roca may not easily get in Philadelphia.

Instead, Roca has worked since 2020 to spread its CBT training to a wider audience through the Roca Impact Institute, which works with juvenile caseworkers, police officers, and other community organizations, both as a way to give them the tools to train young people and also to heal themselves. In its first year, Roca worked with about 200 people in 15 different agencies across four states.

It’s police officers who Baldwin says are especially receptive. (In November, at the behest of a former Baltimore police major who works with Roca, the group started a program just for police officers.) They come in complaining that they have to be there; but they leave with a new understanding of how young people’s brains work, and how they can temper their own reactions when faced with volatile situations. They also, Baldwin says, reported feeling more hopeful that they now had a tool to share with the young people they encounter. 

That speaks to what Baldwin, and by extension Roca, has learned in 30-plus years of working to help young people overcome difficult circumstances: Things change, and we have to keep catching up to make sure the work is serving the people who most need it. 

“It’s a sacred responsibility to help each of these young people live and not shoot each other,” she says. “We ask ourselves everyday: What should make me worthy enough to have the privilege of being in these young kids’ lives today? We should all get to that point, and we have to help each other.”

Correction: An earlier version of this story misstated the number of caseworkers Roca has in Baltimore; it is 10. It also misstated the status of youth they reach out to; all of the young men in the program have criminal records.

Meet Molly Baldwin at

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