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  • Effect of interventions targeting incarcerated parents and their children

Systematic review

Effect of interventions targeting incarcerated parents and their children

Published Updated

This systematic review indicates a need for more research about the effects of interventions on incarcerated parents and their children. In specific, there is a need for studies evaluating interventions targeting children with incarcerated parents.

This systematic review indicates a need for more research about the effects of interventions on incarcerated parents and their children. In specific, there is a need for studies evaluating interventions targeting children with incarcerated parents.


About this publication

  • Year: 2015
  • Authors Nilsen W, Johansen S, Blaasvær N, Hammerstrøm KT, Berg RC.
  • ISSN (digital): 1890-1298
  • ISBN (digital): 978-82-8121-966-3

Key message

Children with incarcerated parents may be at higher risk than other children for developing behavioural problems and poor mental health. This systematic review addresses the effect of interventions for incarcerated parents and/or their children. We included 22 studies. All the included studies were conducted in the USA. They examined three types of interventions: Parenting interventions, prison nurseries, and support groups for children. Only one study evaluated interventions directed at children with incarcerated parents.

The main findings of the report are that it is uncertain whether parenting interventions and prison nurseries have an effect on parenting attitudes and behaviour. It is also uncertain whether parenting interventions, prison nurseries, and support groups for children have an effect on children’s emotional and behavioural problems.

The uncertainty is a result of the interventions having insufficient evidence to allow firm conclusions. However, while we cannot draw firm conclusions about effect, this does not mean that the interventions do not have an effect.

The studies demonstrated some positive results. For example, parents who received parenting interventions had improved knowledge about child-rearing as well as acceptance and empathy for their children.

This systematic review shows that there is a need for more research on the effect of interventions for incarcerated parents and their children. Particularly, there is a lack of effect studies on interventions directed at children with incarcerated parents. Furthermore, there is a lack of effect studies on incarcerated parents and their children conducted in a Nordic setting.

Summary

Background

More than half of incarcerated persons in Norway have children. Children and adolescents with incarcerated parents may be at increased risk of poor mental health and criminal behavior. These mental and behavioral problems may be due to factors related to the parental incarceration itself, such as separation trauma, stigmatization, and changes in child care. In addition, these children and adolescents may be exposed to risk factors prior to the incarceration, such as low parental education and high family discord.

The Norwegian Knowledge Centre for the Health Services was commissioned by The Norwegian Correctional Services (NCS) to systematically review the effects of interventions to prevent adverse outcomes for children and adolescents with incarcerated parents. This is important in order to strengthen the opportunities for targeting this group with effective interventions. We have summarized quantitative effect studies to answer the following research questions:

1) What are the effects of parent-focused interventions for families with at least one incarcerated parent on prevention of problems among children and/or improving parents’ parenting attitudes and behaviors?

2) What are the effects of child-focused interventions for families with at least one incarcerated parent on prevention of problems among children?

Method

We systematically searched relevant literature databases up to February 2013. IN addition, we searched Google, reference lists,  and contacted experts. Two researchers independently screened abstracts and thereafter full texts using the following inclusion criteria:

Population: Parents and children (ages 0 to 18) in families with at least one incarcerated parent. 

Intervention: Parenting interventions and any intervention targeting children with at least one incarcerated parent.

Comparison: No intervention, wait list, other intervention. 

Outcomes: Outcomes related to parenting, the family or the child. 

Study design: Studies with control group.

Two independent reviewers assessed the methodological quality of the included studies. The quality of the evidence for each outcome was also assessed. The project coordinator extracted data from the included studies while one of the co-authors checked the correctness of these data. We summarized the results in accordance with the criteria described in the Norwegian Knowledge Center’s handbook.

Results and discussion

All in all, 22 studies from 19 publications met the inclusion criteria. These studies were published between 1999-2011 and included a total of 2500 participants. All of the studies were conducted in the USA. Fourteen of the interventions targeted mothers, while six targeted fathers, and one targeted both parents. Only one of the interventions targeted children (support groups for children with incarcerated parents). The study designs included randomized controlled studies (n=5) and non-randomized controlled studies (n=17).

The included studies examined the effect of three types of interventions:

1) Parenting intervention: courses on child-rearing strategies, communication- and problem solving strategies, knowledge of child development, and strategies to handle child separation. In some of the interventions, the parenting intervention also included play therapy, which involved playful interaction between the parent and the child as well as monitoring and guidance from a therapist.

2) Prison nurseries: the intervention meant that incarcerated mothers lived with the infant or child in a nursery after birth. In some cases, they also received offers of guidance on relevant topics for new mothers (e.g. nutrition and breastfeeding), family planning, employment, and substance abuse.

3) Support groups for children: interventions involving the interaction between the children and how they mutually could assist and support each other.

 

The summary of the results and quality assessments of the evidence allow us to draw the following conclusions:

  • It is uncertain whether parenting interventions have an effect on parenting attitudes and behaviour, and children’s emotional and behavioural problems. The quality of the documentation is considered to be very low.
  • It is uncertain whether prison nurseries have an effect on mothers’ attitudes and behaviour, and children’s emotional and behavioural problems. The quality of the documentation is considered to be very low.
  • It is uncertain whether support groups for children have an effect on children’s emotional and behavioural problems. The quality of the documentation is considered to be very low.

 

Most of outcomes concerned effect of the interventions on the parents. Only four of the 21 included studies that examined the effect of parenting interventions and prison nurseries examined the effect on children. However, some positive results must be noted: Some primary studies showed that mothers who received a parenting intervention had a significant increase in knowledge about child-rearing, empathy, acceptance of the child and had less stress in connection with child visits. Additionally, the children evidenced reduced problem behavior. Fathers who received a parenting intervention had a significant increase in child contact and reduced risk of criminal recidivism. A greater proportion of mothers from child nurseries was the primary caretaker after the intervention, compared to control mothers. There is uncertainty about the effect of parenting interventions, prison nurseries, and support groups for children with incarcerated parents. This uncertainty is a result of the primary studies being small (few participants) and suffering from high risk of bias. All outcomes were considered to have very low quality. 

Few controlled studies that have evaluated interventions for families with incarcerated mothers/fathers. This is surprising, considering the high number of children with incarcerated parents (especially in the USA), and the evidence that these children are particularly vulnerable to psychosocial- and health problems. The lack of effect studies within this area must be seen in light of the ethical requirements for conducting studies with vulnerable groups. Further, incarcerated parents and their children is a difficult group to investigate in large studies and there is a high risk of large drop out.

Conclusion

This systematic review indicates a need for more research about the effects of interventions on incarcerated parents and their children. In specific, there is a need for studies evaluating interventions targeting children with incarcerated parents. Only one study evaluated a child-focused intervention. Moreover, few studies on interventions for incarcerated parents evaluated the effect on childrens’ health and behaviour. It is essential to focus on the child-related interventions or outcomes to prevent the potential negative effect of having incarcerated parents. There is also a lack of effect studies on incarcerated parents and their children conducted in a Nordic setting.
 

Although we cannot draw firm conclusions about effect of the interventions evaluated in this report, it is important to highlight that this does not mean that the interventions do not have an effect. The results of the interventions are insufficiently documented (very low) to allow firm conclusions about effect.