Law -Criminal

Article

The Effects of Prison Visits From Family Members on Prisoners’ Well-Being, Prison Rule Breaking, and Recidivism: A Review of Research Since 1991

Karen De Claire1 and Louise Dixon2

Abstract The effect of family visits on prisoner well-being and future behavior is an important consideration in the development of prison policy. This review systematically examines current research findings that explore the impact of prison visits from family members on three specific offender outcomes: prisoners’ well-being, rule breaking within the prison, and recidivism. The review focuses on visits by family and does not duplicate earlier reviews but rather extends them into current literature, through identification of empirical studies conducted post 1989, published since 1991. Ten studies met the stipulated inclusion criteria. All are case– control and cohort studies. The review of studies used a standardized quality assessment tool. Results show considerable var- iation in study quality, methods, and findings. However, studies consistently reported positive effects of prisoners receiving visits. Prison visits reduced depressive symptoms in women and adolescent prisoners. There was some evidence of reduction in rule- breaking behavior. One high-quality study suggested that visits reduced recidivism and increased survival in the community. Although there were positive outcomes associated with prison visits, it was not possible to draw strong conclusions for the outcomes of interest due to a lack of research, methodological discrepancies, and variability in outcome measures and results. The discussion considers the implications of the findings for policy, practice, and research.

Keywords prison visits, visitation, well-being, recidivism, rule breaking

Research has shown the existence and maintenance of strong

interpersonal relationships with friends or family reduces the

likelihood of re-offending and successful reintegration into the

community (Hairston, 1988; May, Sharma, & Stewart, 2008;

Niven & Stewart, 2005). Importantly, the maintenance of

‘‘good quality’’ relationships during a prison sentence has been

associated with the successful development of the relationship

post release (La Vigne, Naser, Brooks, & Castro, 2005). This

body of evidence, therefore, highlights the need to maintain

or develop supportive relationships during prison sentences

in order to reduce recidivism. Hale (1988) went so far as to say,

‘‘Since rehabilitation and re-entry of the offender into the com-

munity is the ultimate goal of the correctional system, it should

be obvious that the maintenance of the offender’s family sys-

tem is of vital concern’’ (Hale, 1988, p. 143).

Prison visits are an obvious means by which prisoners can

strengthen existing relationships: Indeed, they feature in prison

regimes on a general basis. Research suggests the benefits, in

addition to reduced recidivism (Bales & Mears, 2008; Hairston,

1988), include improved mental health of prisoners and other

family members, an increased probability of the family remain-

ing together post release (Hairston, 1991), and an improved

level of social adjustment during imprisonment and after

release (Casey-Avecedo & Bakken, 2002). This review aims

to search for and evaluate all of the studies published since

1991 that investigate the impact of prison visits from family

members on prisoner’s well-being, behavior, and recidivism

and to inform practice, policy, and further research.

Objectives of the Review

The role of prison visits in the maintenance of family relation-

ships and the reduction of recidivism has undergone some

research to date. Hairston (1988) reviewed the existing litera-

ture in relation to family ties and recidivism, which included

disciplinary infractions within the prison environment. In

1991, she further provided a review of family ties, well-being,

1 National Offender Management Service, School of Health Sciences/Applied

Psychology, Cardiff Metropolitan University, UK 2 School of Psychology, University of Birmingham, Birmingham, UK

Corresponding Author:

Karen De Claire, University of Birmingham, Edgbaston, Birmingham B15 2TT,

UK.

Email: kdeclaire@cardiffmet.ac.uk

TRAUMA, VIOLENCE, & ABUSE 2017, Vol. 18(2) 185-199 ª The Author(s) 2015 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1524838015603209 journals.sagepub.com/home/tva

and post-release success (Hairston, 1991). This review system-

atically investigates the impact of prison visits from family

members on three specific offender outcomes. Preliminary

investigation showed that all peer-reviewed, published papers

relevant to prison visits conducted prior to 1989 were included

in Hairston’s (1988, 1991) reviews. Therefore, this review

focuses on research that has been conducted post these

reviews. Specifically, this review aims to determine whether

family visits:

1. affect prisoners’ well-being (i.e., stress, depression, sui-

cidal/self-harm behaviors);

2. improve prisoners’ rule breaking within the prison envi-

ronment; and

3. reduce recidivism as measured by official records.

The Protective Role of Relationships

Arguably, the most important relationship disrupted by impri-

sonment for adolescents is with their parents and for adults with

their intimate partners or children. These primary relationships

allow prisoners to maintain their social identity and provide a

sense of security, well-being, and an assurance of worth (Hair-

ston, 1988). Hairston (1991) suggested that the maintenance of

these relationships throughout the sentence leads to decreased

recidivism and improved mental health and family reunifica-

tion after release. Although based on limited evidence, Hair-

ston concluded that there are strong social, economic, and

emotional reasons to develop programs that enhance family ties

and to change prison policies that inhibit family interaction.

Little research has explored the role of the parental relation-

ship in recidivism. However, the general offending literature

considers family relationships to be both a risk and protective

factor for delinquency (Stouhamer-Loeber, Loeber, Wei,

Farrington, & Wikstrom, 2002). Considerable research has con-

centrated on the risks and mechanisms associated with the paren-

tal relationship that influences adolescent offending behavior

(Rhule-Louie & McMahon, 2007). That antisocial behavior can

emerge through modeling from parent–child relationships sug-

gests that separation during incarceration may be beneficial.

However, a study by Ryan and Yang (2005) of juvenile delin-

quents in residential care found that those who received visits

had lower offending rates than those who did not.

Contact with children is viewed as having a positive effect

on a parent’s relationship with their child(ren), and many par-

ents work hard to maintain contact during periods of separation

(Hairston, 1991). Indeed, Poehlmann, Dallaire, Loper, and

Shear’s (2010) review found benefits of child contact for incar-

cerated parents in reduced distress levels and better parent–

child relationships for both male and female prisoners. How-

ever, this relationship is complicated. For example, Poehlmann

(2005) did not establish a relationship between visits and

increased relationship quality between mothers and their chil-

dren, although telephone contact did appear to improve rela-

tionship quality. Concerns for their children’s experience

may prevent prisoners from encouraging their visits. Although

a lack of contact with their child may have negative conse-

quences for the prisoner, bringing their children into the prison

environment may not feel appropriate and limit any positive

effects.

While for female prisoners, there is little evidence that adult

intimate relationships are protective the consensus is that they

are protective for male offenders. Segrin and Flora (2001) found

that possessing a satisfying marriage reduced loneliness during

incarceration. Carlson and Cervera (1991) demonstrated that

conjugal visits increased participants’ perception of closeness.

This demonstrates that contact between prisoners and their part-

ners through visits can improve prisoner well-being. However,

evidence is contrary concerning re-offending. Rhule-Louie and

McMahon (2007) found that individuals chose partners who sup-

ported their antisocial and criminal behaviors. However, Samp-

son, Laub, and Wimer’s (2006) longitudinal research with 500

young men showed that marriage was associated with a 35% reduction in the odds of an individual engaging in crime. If mar-

riage is a protective factor for men, then encouraging prisoners

to maintain their long-term relationships may be a useful tool

in reducing re-offending. Sampson et al. described four possible

mechanisms through which marriage could be causal in reducing

re-offending: Marriage creates social obligations that increase

the cost of crime; marriage causes significant changes in routines

and patterns of association; the female partner exerts direct

social control; and finally, marriage leads to a change in self-

identity to a more ‘‘responsible’’ person. If intimate relationships

are to continue to facilitate this, contact during a sentence is

important.

There are difficulties associated with maintaining visits

throughout a prison sentence. Although some prisoners may

see visits as the highlight of their time, their families can view

visits as difficult emotionally and practically and prison staff

see visits as organizationally problematic (Dixey & Woodall,

2012). Fuller (1993) identified a range of obstacles such as

work schedules, distance, and child care and health problem.

Comfort (2003) provided further examples describing the very

negative experiences of female partners visiting one American

prison as almost a secondary form of imprisonment. Indeed,

visitors need motivation to maintain contact and those setting

prison policies need reasons to support family members to visit.

Hairston (1988) suggested that without access to their family

prisoners lose hope that they can achieve more in their lives,

become more socially impaired, and their emotional resources

are depleted. As a result, they may re-offend at higher rates

than previously. If this is the case, then a review of research that

investigates the impact of visits on future positive outcomes is

necessary to provide information to shape future policy.

Method

Sources of Literature

The first author conducted preliminary searches using the terms

‘‘prison,’’ ‘‘visits,’’ and ‘‘recidivism’’ in databases that include

research within the fields of criminal justice, social sciences,

186 TRAUMA, VIOLENCE, & ABUSE 18(2)

and psychology. The search included papers post 1989 to cap-

ture research conducted following that date, not yet published

and considered in Hairston (1991). The initial search identified

the following databases as most effective in generating

research in the required area: Ovid MEDLINE(R) 2008–

2015, Ovid MEDLINE(R) 1988–1995, Ovid MEDLINE(R)

1980–1987, Ovid MEDLINE(R) 1946–1979, Ovid OLDME-

DLINE(R) 1946–1965, PsycINFO 1806–2015, Web of Science

1898–2015, EBSCO 1978–2015, and Science Direct May 2015

update. Together, these databases review over 8,000 journals

and cross all possible areas that could be relevant to this study.

A full literature review was undertaken using the English lan-

guage version (which includes papers translated into English)

in December 2011, January 2012, January 2014, October

2014, and May 2015.

Search Strategy

The reviewer searched the abstracts of relevant online data-

bases using a number of search terms related to the key con-

cepts. The reviewer developed search terms through a

number of exploratory searches using different terms and per-

mutations for each research question, with the terms prison*

AND visit* common to all research questions and searches.

Table 1 depicts additional terms considered for each specific

research question. All of the searches were rerun substituting

jail* and then incarceration for prison* and social support for

visit* until all permutations were used. The full search results

are available from the first author.

Study Selection

Selected studies were those that met the general inclusion cri-

teria (see Table 2) and the criteria pertinent to each specific

question investigated. To ensure that the studies would be

based on stringent methodology, the researchers also decided

that only peer-reviewed articles would be included (Smith,

Gates, & Foxcroft, 2006). This resulted in the exclusion of

26 dissertation abstracts and six books that had some relation

to the search criteria. The criteria were applied at three stages:

1. Initial sift to determine whether the study was related to

the subject of interest, at this stage many studies were

rejected that were not related to prisons or concerned

visits by professionals;

2. Consideration of the abstracts to determine relevance to

the questions being explored by the review, at this stage

many studies were rejected that were related to the pro-

cess of visits but not the effect, or the way visits affected

the family and children but not the prisoner; and

3. Reading the full text to establish if the papers met the

specific research question criteria.

Ten papers met the inclusion criteria. The reference sections

of these papers were also manually searched resulting in two

further papers. However, they did not meet the inclusion cri-

teria. Figure 1 provides an overview of the exclusion process.

Data Extraction

Data extraction from the articles used a standardized form. This

collated information on the studies and participant’s character-

istics, measures used for independent and dependent variables,

and outcome data for male and female prisoners and adult and

adolescent prisoners. The first author and a second researcher

reviewed the 10 studies separately to ensure reliability (concor-

dance rate 95%). Both researchers also assessed the quality of each paper using a quality assessment instrument, which was

adapted from the Critical Appraisal Skills Program tools for

reviewing randomized control trials, cohort studies, and case

studies (Public Health Resource Unit, 2006). This tool asked

raters to consider nine questions centered on the quality of pre-

sentation, design, and analysis. Table 3 includes a summary of

the specific questions asked and scores achieved.

Detailed questions are available from the first author on

request.

Quality Assessment

Each study was assessed on items such as a focused hypothesis,

quantifiable relationships between visits and outcomes of inter-

est, control groups, accounting for bias, number of participants,

and precision and presentation of results. After rating each of

the items based on presence or absence, an overall quality score

was calculated.

Table 1. Additional Search Terms for Each Research Question.

Question 1 Question 2 Question 3

AND self-harm* AND rule breaking* AND recidivism AND suicid* AND violence* AND re-offend* AND well-being AND rule violation AND offend* AND stress* AND depression*

Table 2. Inclusion Criteria.

Search strategy Studies conducted post 1989, but not published until after 1991 All questions

Prisoners had experienced prison visits with family members or partners

Studies that investigated relationships between visits and the stated outcomes of interest

Studies providing replicable, quantifiable, and objective measure of visits and outcome Experimental, quasi-experimental, controlled observational, and observational studies

Studies that controlled for confounding variables Studies subject to peer review

Specific questions Question 1: Studies with quantifiable measures of stress,

depression, suicide/self-harm Question 2: Studies with quantifiable measures of rule breaking in

prison Question 3: Studies with quantifiable measures of recidivism/

re-offending

De Claire and Dixon 187

Both researchers consistently reached the same overall

scores for each paper, achieving the same answer for each ques-

tion asked. Possible scores ranged between 9 and 18. The fol-

lowing are the codes assigned to each study:

� A: high quality (score of 16–18): All or most of the cri- teria met (90%) and if not. The authors judged that those criteria unmet are unlikely to alter the conclusions

reached (five studies scored within this range).

� B: medium quality (score of 12–15): Some of the criteria met (70%) and if not. The authors judged that those cri- teria unmet are unlikely to alter the conclusions reached

(three studies scored within this range).

� C: low quality (score less than 12): Few or none of the criteria met (less than 70%). The authors judged that the study quality alters the conclusion of the study (two

studies scored within this range).

Results

Table 4 provides an overview of each study and a summary of

the quality scores.

Research Question 1: Do Visits Affect Prisoners’ Well-Being?

Monahan, Goldweber, and Cauffman (2011). This study consid- ered how visitation from parents affected adolescents’ mental

health during the first 2 months of incarceration. The partici-

pants were 276 male adolescents between 14 and 17 years old

in one secure juvenile facility in North America. The compar-

ison is between those who received prison visits and those who

did not with differences in the groups for age, parental educa-

tion, and distance for parents to travel to prison accounted for.

The number of prison visits from parents was derived from

official records as the number from baseline to Month 2, calcu-

lated at number per week. Level of depression was assessed via

the Center for Epidemiological Studies—Depression Scale

(Radloff, 1977) during a 2-hr baseline interview and then

weekly 1½ hr follow-up interviews for the first 3 weeks and

then monthly.

The study used growth curve modeling to test differences in

the level of depression and change over time. During the first

week, there were no differences between groups on level of

depressive symptoms. Over the 2 months, those who were

receiving visits reported a more rapid decline in depressive

symptoms than those who did not. An increased number of vis-

its accounted for a more rapid reduction in depressive symp-

toms. Parental visits accounted for 8% of the variance in depressive symptoms. The effects of visits and relationship

quality accounted for 11% of variance, suggesting the effects of visits as independent from the effects of relationship quality.

This study scored 16 on the quality assurance measure. The

researcher defined a clear research question and measurable

hypotheses. The participant group was appropriate and com-

parison achieved effectively within the sample. Data collection

occurred from the same source and time period. Collection was

regular with some variables controlled for. However, they did

not account for other factors that may affect depression such

as relationships within the environment and withdrawal from

Initial sift of 235 studies identified through search terms across all questions

32 excluded as not peer reviewed

Full reading of the papers

13 excluded as not specific to the research questions

Full reading of the papers

43 excluded not specific to prison visits from family

Reading of the abstracts 127 excluded as not

relevant to the research questions

Reading of the abstracts 10 excluded as reviews,

discussions and no measurement

10 studies for inclusion

Figure 1. Flow diagram of the identification/exclusion process; initial sift to full review of the paper.

188 TRAUMA, VIOLENCE, & ABUSE 18(2)

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