Evaluation of a Family Wellness Course for Persons in Prison.

This research supports the value of maintaining the family ties of persons in prison. Family healing work will likely affect multiple relationships within the family, especially for the children of prisoners, and increase the possibility of healthy and productive life choices for all family members. The Family Matters course is grounded in family systems and attachment theories. It is designed to be used with persons in prison. The overall focus of the course is on family as a system with unique history, roles, rules, strengths, and challenges. The course teaches participants communication skills and how to manage conflict, change destructive behavior patterns by strengthening action over reaction, and heal relationships. Included is a focus on connection with family members, particularly children, and parenting from prison. Participants are asked to focus on improving one or two family relationships as part of the work to be accomplished during the course. Experiential exercises, roleplays, letter writing, and telephone calls are utilized to support this work. The course was evaluated on six classes, four in a men’s prison (n = 47) and two in a women’s prison (n = 26). Results suggest that the participants had a better understanding of themselves and their families at the end of the course, and showed increases in self-competence and self-esteem. Many participants reported more contact with one or more family members and improvement in important relationships, particularly relationships with children. A three-month follow-up suggests that these changes were retained or improved with time. The Journal of Correctional Education 66(1) • January 2015 Evaluation of a Family Wellness Linda G. Bell and Connie S. Cornwell 46 There are over 1.5 million men and women incarcerated in U.S. state and federal institutions (U.S. Census Bureau, 2009), creating 2.7 million children with parents in prison (CNN Report, November 26, 2012). It is not just incarcerated individuals who suffer from incarceration; family members are also affected. Parents whose own parents were incarcerated report being more depressed and having worse physical health than parents in families without an incarceration history (Kjellstrand & Eddy, 2011). Adolescents with a history of parental incarceration consistently exhibit higher levels of problem behaviors (Kjellstrand & Eddy, 2011). But these outcomes are not inevitable. Incarceration may act as a barrier that breaks families, or it may also act as a boundary that allows them to connect (Dyer, Pleck, & McBride, 2012). Using a family process perspective can be a powerful way to bring about healing by assisting families to work through past difficulties and transitions due to incarceration (Dyer, Pleck, & McBride, 2012). Family work is most important for the children of prisoners, but any family healing will likely affect multiple relationships, both within the family and with others outside the family, and even those relationships in prison. The negative effects on children of incarcerated parents (increased academic and behavioral problems, increased substance abuse) can be mitigated by visits with incarcerated parents, particularly if the visits are in a child-friendly environment (Poehlmann, Dallaire, Loper, & Shear, 2010). And stronger ties between inmates and families and close friends during incarceration lead to positive post-release outcomes (Visher & Travis, 2003). These outcomes include decreased recidivism, improved mental health both for prisoners and their family members, and greater likelihood that the family will hold together after reentry. Researchers find that family acceptance and encouragement, as well as perceived emotional support from family, are related to post-release success. People with closer family ties, stronger family support, and fewer negative dynamics in relationships with intimate partners are more likely to be employed after release and less likely to use drugs (Urban Institute, 2011). Method Development of a Family Wellness Course Family Matters: Family Wellness Education (Bell, Cornwell, Curran, & Gaston, 2011) is a family wellness course for the use with persons in prison to help them better understand, heal, and strengthen their family relationships while they are in prison. The Family Matters course was developed over a period of five years with input from various professionals, including those from family therapy, nursing, addictions recovery, and criminal justice. The primary theories The Journal of Correctional Education 66(1) • January 2015 Linda G. Bell and Connie S. Cornwell Evaluation of a Family Wellness 47 informing the course are family systems theory (Broderick, 1993; Guttman, 1991) and attachment theory (Bowlby, 1982; Karen, 1998; Mercer, 2006; Phyllis & Caffery, 2003; Wood, 2002). Both family systems theory and attachment theory are relationship based. Family systems theory has a historical relationship with general systems theory (von Bertalanffy, 1968). In general systems theory, a system has the following properties: (1) parts, (2) relations, and (3) interdependence. Thus a family system includes (1) family members with their individual motivations and traits, (2) interpersonal relationships with their characteristic patterns, and (3) interdependence among these motivations, traits, and relationships. Families are viewed as self-organizing hierarchical interactive systems that regulate themselves and their members’ behaviors through rules, values, and worldviews (Constantine, 1986; Cox & Paley, 1997). When we talk about family system, we are usually talking about a multigenerational family. Family relationships can be characterized by concepts such as affect, support, mutual respect, flexibility, conflict, communication, and problem-solving skills. The family system is seen as organized at different levels, from the biological nature of family members to interactions with the larger social system. The individual is viewed from a biopsychosocial perspective (Engel, 1977), and individual behavior is understood, at least in part, by the role or place of that behavior in ongoing relationship patterns. By helping participants in the course understand something about how family systems function, and also about some of the family systems’ properties in their families of origin, they can develop a deeper understanding of themselves. It also helps them be more effective when trying to create healthier patterns in their family. Attachment theory informs the course by helping participants learn about different attachment styles and methods for achieving more secure and healthy attachments with family members of all generations, grandparents, parents, spouses, and children. While Bowlby’s work originally focused on the motherinfant relationship, attachment has been found to be important in many relationships, particularly marriage. It’s also been found that through later life experiences, secure attachment can be “earned”; the attachment patterns developed earlier in life can be changed (Paley, Cox, Burchinal, & Payne, 1999). The course is divided into four main units with two to three classes per unit: (1) Family Systems, (2) Action and Reaction, (3) Healing and Hope, and (4) Precious Child. Family Systems introduces the strengths and the challenges represented by the different family cultures and ethnicity. It explains the importance of family history, family life cycle including grief and loss, and The Journal of Correctional Education 66(1) • January 2015 Evaluation of a Family Wellness Linda G. Bell and Connie S. Cornwell 48 family roles and rules. The participant begins to understand the family as a complex system with special relationships and reoccurring behaviors that become a pattern over time. As part of the course the participants are asked to think about the family relationship they would like to focus on improving. Action and Reaction introduces the thinking and feeling brain and supports the concept of taking responsibility for positive action rather than being reactive to one’s environment. Healing and Hope offers ways to break destructive patterns as identified in the Family Systems unit using skills such as effective listening, gratitude, and forgiveness. Precious Child focuses on attachment patterns, how to nurture secure attachment, and the importance of staying connected with family while in prison. It includes an extensive section focused on parenting from prison. As the course was being developed, it was taught to both men and women in prison, and to groups recently released from prison. By strengthening family relationships through an increased understanding of family patterns, more communication, and better parenting skills, it is likely that an individual will have more family support during reentry, thus increasing the possibility of success. Participants Forty-seven men and twenty-six women were included in the analyses reported here. All participants gave informed consent and completed the relevant questionnaires. Two-thirds (65%) of the sample were men. Seventy-one percent were white, 24% were African American, and 5% were other. These numbers are consistent with the Indiana prison population where 74% of the adult inmates are white (Bell, Cornwell, Curran, & Gaston, 2011). Men’s ages ranged from 24 to 60 with a mean age of 40; women’s ages ranged from 25 to 52 with a mean age of 36. Five percent of participants reported some high school education, 25% reported a high school diploma or GED, 39% reported some college or trade school education, and 31% reported being a college or trade school graduate. This sample represents a better than average education for prison populations: 41% of the U.S. prison population have less than a high school education (Educational Testing Service, 2006). Thirty-two percent of state prison inmates had at least a high school diploma and about 26% of state prison inmates said they had completed