A Scoping Review of Family Focussed Interventions to Prevent Prison Violence

Abstract

Violence is an ongoing concern for many people who live and work in correctional settings and yet relatively little is known about the effects of institutional violence prevention efforts. This paper reports the findings of a scoping review of recent research relevant to understanding the influence of one factor, contact with family, that potentially influences institutional violence in countries such as Aotearoa New Zealand where Indigenous peoples are over-represented in prison settings. A total of 15 different studies were identified that provided consistent evidence of an association between family contact and prison violence. The implications of this work for the development of evidence-based prison violence prevention strategies are discussed.

Keywords

family prison violence visits prevention

Introduction

Although fictional and media portrayals promote a stereotype of prisons as places that are largely defined by violence (Fleisher & Krienert, 2006), it is widely accepted that for prisons to serve their purpose in society they need to remain as safe and orderly as possible. Even though some of those who live and work in institutional settings may view aggression as a normal and inevitable—and, at times, even desirable—aspect of institutional life (Levan, 2012), the identification of policies and practices that can help to ensure good order and discipline nonetheless represents an important task for correctional administrators. And yet, as Wener (2012) has observed, correctional staff are often left to rely on their personal experiences and typically have limited access to research that might provide the foundation for their efforts to implement evidence-based practice. In practice, most administrations rely on multiple strategies to address what have been referred to as “importation” factors (characteristics that people bring with them into prison), “deprivation” factors (the impact of the prison experience), “situational” factors (circumstantial conditions of the physical and social environment), as well as “control” factors (how incidents are managed). Theoretically at least, intervention across each of these domains should prove effective in reducing institutional violence, with Ara Poutama Aotearoa (the Department of Corrections in New Zealand) recently developing a comprehensive strategy to reduce prison violence across each of these areas (Table 1).

Table 1.

Example Prison Violence Prevention Initiatives (Reproduced Courtesy of Ara Poutama Aotearoa).

Focus area	Example intervention
Importation factors	Domestic violence and anger management treatment programs; mental health and alcohol and other drug (AOD) treatment programs; random drug and alcohol tests; a mental health service focused on provision of mental health clinicians to work with both offenders and staff; a 5-year Gang Strategy.
Deprivation factors	Prison visits program, family days, access to phone calls and mail; mother and baby units; cultural needs programs; increasing Māori and Pacific people working within Corrections; vocational courses and work; prison-based educational courses.
Situational factors	Physical design to enhance engagement, multi-disciplinary teams, and a therapeutic approach to mental ill-health and aggressive behaviors; on-body cameras in high-risk units; a Prison Tension Assessment Tool; double bunking and modular accommodation; reduce illicit substances, including the use of sniffer dogs, X-rays and screening of visitors, random prison cell checks, as well as drug and alcohol screening; building capability and systems to operate in a fair, transparent and just culture (e.g., reporting mechanisms for concerns), Corrections Officer Development Program; recruiting corrections officers
“Recovery” or “mitigation” control interventions	Training to prevent or minimize potential physical harm such as Control and Restraint and de-escalation options, situational awareness, and risk assessment; Stab Resistant Body Armour; pepper spray; Post-Incident Response Teams at each site; staff welfare coordinators

Despite a reasonable body of published research describing the characteristics of those who are most likely to act violently in prison, and the range of organizational and systemic factors that are potentially relevant (see McGuire, 2018), there have been few attempts to systematically apply this knowledge to the design of interventions to reduce or prevent violence. In fact, there is only limited evaluation evidence to show that any specific intervention will be successful in reducing violence. A scoping review of this topic by Day et al. (2020) also showed that most of the available evidence comes from evaluations of programs targeted at those who have perpetrated violence. The specific focus of this review, however, is on the influence of a different set of factors—those that relate to engagement with family members outside of the prison walls and how this might impact on violence within the prison. What might be loosely referred to as “interventions” in this area (e.g., prison visits, family days, access to phone calls, video-calls, and mail) are often provided on the basis that they might play a key role in keeping people in prison invested in “doing their time without incident and working toward being reunited with family and (hopefully) prosocial friends” (Steiner & Wooldredge, 2020, p. 150). In short, it is assumed that they have the potential to relieve at least some of the stresses associated with the physical and psychological deprivations of confinement. The aim of this paper then is simply to review the body of research that exists that connects the level of support that people in prison receive from family and friends to the occurrence of violence inside prisons. This, it is anticipated, should be relevant to the further development of comprehensive and evidence-based prison violence prevention strategies. It is also timely in so far as one specific impact of the COVID-19 pandemic has been on the reduced availability of prison visits. For example, User Voice (2020) has reported that people in prisons in England and Wales have experienced severe lockdowns since start of the pandemic, with many people confined to their cells for 23 hours per day and face-to-face visits effectively suspended for lengthy periods. It is unclear whether these changing circumstances have had any substantive impact on rates of prison violence, but this presents as at least a possible hypothesis.

Rather than aiming to systematically review or synthesize the available evidence, this study uses a scoping review methodology to identify and map relevant studies. A scoping review determines the coverage of a body of literature on a given topic when it is unclear which other, more specific questions, might be answered by a systematic review or meta-analysis (Arksey & O’Malley, 2005). This methodology seems appropriate for this study given apparent the lack of published studies that have reported the association between support programs and prison violence. The review by Day et al. (2020), for example, identified only two relevant evaluations published in the last 20 years and both of these examined the impact of conjugal visits on subsequent violence (D’Alessio et al., 2013; Hensley et al., 2002). This may, of course, be because other forms of family contact (access to visits or phone calls with family) are not typically viewed as “programs” that require evaluation (or even as “privileges” to be earned—and that can potentially be withheld; see OHCHR, 2005). Nonetheless, it is clear that understanding more about the role that family contact has to play in preventing prison violence may help to inform decisions about the ideal availability, timing, and mode of contact. It is also—we suggest—in countries such as Aotearoa New Zealand where many of those in prison identify with cultural groups where interconnectedness between people plays a central role in identity. In this country, Māori make up 15% of the total population but account for more than 50% of the male and 60% of the female prison populations (New Zealand Department of Corrections, 2018) and, in 2019, a new strategy, Hōkai Rangi, was launched to guide the strategic direction for the department over the next 5 years. The concept of oranga, or wellbeing, is at the center of the strategy, with particular emphasis given to the ways in which the Department engages with whānau (a term used broadly to refer to family and extended family members¹), as illustrated in the following extract:

Where they are willing, whānau will be supported to walk alongside Māori in our care and management on their rehabilitation and reintegration journey. These whānau will be supported in this by our staff. Ara Poutama Aotearoa will proactively communicate with whānau Māori, involve them, and keep them close and connected to those in our care and management (Hōkai Rangi, 2019, p. 17).

In this sense, whānau are acknowledged in the strategy as being of paramount importance to the wellbeing of Māori prisoners, and the significance of proximity, continuity of contact, and wider notions of decision-making beyond that of the individual themselves is clearly recognized. Although Hōkai Rangi does not make any direct reference to prison violence, it can be inferred that the prison visits program, family days, and access to phone calls and mail components of the Ara Poutama Aotearoa violence prevention strategy (Table 1) might be expected to play at least some role in the ongoing development of the effective correctional practice in this area.

Methodology

Search Strategy

Eligible studies were identified through several search strategies designed to identify abstracts published between January 2000 and October 2020. The following databases were searched: APA PsycInfo; Criminal Justice Abstracts; Criminology and Criminal Justice; Social Work; Applied Social Science Index and Abstracts; and Academic Search Complete using the following keyword combinations were used: Prison* or inmate or jail or remandee or incarceration or incarcerated AND Family or families or spouse or partner or wife or husband or child* or baby or relative or son or daughter or parent or spouse or partner or visit* or staff or officer or social work* or psych* or custodial or guard or teacher or instructor or prisoner or peer or associate or friend*or “social support” AND Violence or violent or assault or attack or abuse or aggression or disorder or conflict or hostility or incident or misconduct or violation or social order or fight* or infraction or antisocial or prison order or riot or gang or victimization or discipline or rule-breaking or reoffending or recidivism or desistance or reintegration or re-entry or post-release or adjustment or stress* or suicide or loneliness or coping or substance use or substance misuse. Reference sections from previous reviews were then hand-searched, and a web search was conducted using the same keyword combinations to identify unpublished work or work in progress.

Studies were identified as eligible for inclusion as long as they contained text describing the study in detail. A total of 10,727 abstracts were identified using this methodology (Figure 1). A review of the titles and abstracts of these articles identified 164 articles for full-text review. Studies were retained if the following criteria were met: (a) studies were undertaken in a prison setting; (b) studies included participants over 18 years of age; and (c) studies examined the impact of support or interaction with family members including children, spouses, friends, partners, staff, peers (other prisoners), and/or significant others on one or more of the following areas: violence, misconduct, recidivism, substance use, adjustment, coping, mental health, and/or other aspects of emotional wellbeing. As the focus of this study is on the effect of family contact only those papers on this particular topic were retained following full text review. This led to a pool of 53 studies that were identified as eligible, of which 15 specifically considered the impact on prison violence, rather than other outcomes such as recidivism or mental health.

Figure 1.

Flowchart of the study selection process.

Results

Of the pool of 53 potentially eligible studies, only 15 directly examined the effects of family contact on institutional violence, with the majority of the others investigating the impact of family contact on other outcomes, such as reoffending or mental health. These 15 studies are listed in Table 2; grouped loosely into those that consider the impact of face-to-face visits, those that also investigated the value of phone calls, and those that examined support more generally. Only three of the studies explicitly used “prison violence” as the dependent variable, with the others using broader categories of recorded misconducts or rule infractions. All of the identified studies adopted quantitative research designs and had been conducted in the US, with the exception of one study which was conducted in the Netherlands (Bosma et al., 2020).

Table 2.

Eligible Studies.

Focus	Author(s)	Findings
Face to face visits	Reidy and Sorensen (2020)	This study provides mixed support for the restraining influence of visitation by family and friends on most serious forms of prison misconduct. A significant reduction in major violations was attributed to visitation but not to a subset of violent/injurious infractions. When violent and injurious infractions were considered apart from other major violations, only 1 out of 12 such violations proved significant, that is, assault resulting in physical injury to an inmate. Although other forms of violent/injurious infractions were not statistically significant, the visited group showed reduced levels of such misconduct, a 25% reduction in the number of these acts.
	Cihan et al. (2020)	Violent misconduct was not examined separately but high and early levels of visitation was associated with a lower likelihood of persistent disciplinary offending.
	Pierce et al. (2018)	No significant relationship was found between visitation or visitation frequency and minor misconducts. However, a significant inverse relationship was found for both visitation and visitation frequency with regard to serious misconduct (a category that included violence). Those with one and those with multiple visits had fewer acts of serious misconduct than those with no visits.
	Benning and Lahm (2016)	Those who received visits, both males and females, and mail (females only) were more likely to be written up and/or found guilty of rule violations (including those involving violence)
	Rocheleau (2015)	Prisoners who elicited both emotional and instrumental support from loved ones and other prisoners were less likely to be violent. Many of the prisoners’ counted on family to provide them with emotional support to withstand the stress and hardships of prison. However, they counted on other prisoners for support on how to handle hardships and deal with problems.
	Siennick et al. (2013)	The probability of an in-prison infraction declined in anticipation of visits, increased immediately following visits, and then gradually declined to average levels. This pattern was relatively consistent across visitors and infraction types but strongest for spousal visits and contraband infractions. More frequent visits were associated with a more rapid post-visit decline across all infraction types.
	Cochran (2012)	Four trajectories of visitation patterns were identified (non-visited, early visited, late visited, and consistently visited). Visitation effects varied depending on timing and consistency—those who were visited more consistently were less likely to engage in misconduct. Those who were not visited or who were visited early on but not in the later stages of incarceration were more likely to fall into a more regular pattern of misconduct.
	Casey-Acevedo et al. (2004)	The majority of the mothers do not receive visits from their children. Those who do were more likely to engage in both serious and violent infractions while in prison.
	Clark (2001)	Visitation by family and friends to incarcerated males was not found to be a significant predictor of inmate infractions.
Phone calls	Celinska and Sung (2014)	Male and female prisoners who received more phone calls from friends and family were significantly less likely to break prison rules. Number of visits from family members and friends in the past month predicted violations in female inmates—each visit decreased the likelihood of breaking prison rules by 6.0%.
	Jiang and Winfree (2006)	Although phone-calls to and from children led to lower rule violation per month for both male and female inmates, mail, visitation, and formal and informal support from prison did not affect misconduct.
	Jiang et al. (2005)	Phone calls made or received from children were negatively related to overall rule violations per month and violent rule violations per month. Family visitation was not related to overall rule violations per month or violent rule violations per month but was positively related to drug/property rule violation rate.
Conjugal visits	Hensley et al. (2002)	Conjugal visits did not have a significant effect on violent behavior.
Conjugal visits	D’Alessio et al. (2013)	States with conjugal visitation have a lower level of sexual offending in prison than states that do not allow conjugal visitation.
Support	Rocheleau (2014)	Emotional and instrumental support from others correlated with less misbehavior, including violence. Those who were able to turn to either family or friends in prison for emotional support and advice were less likely to be involved in serious misbehavior, including violence.

Discussion

Although the assessment of methodological rigor or of risk of bias is not part of the scoping review methodology, we would argue that there is sufficient evidence from this review to conclude that prison administrators who are concerned with the prevention of institutional violence should at least consider implementing—and evaluating—a range of policies and programs to promote contact with family members. Each of the identified studies offers at least some support for the general proposition that higher levels of family contact are associated with lower levels of institutional violence. The only exceptions to this were the study by Clark (2001) which did not identify visits as a predictor of subsequent violence and the Hensley et al. (2002) evaluation of the impact of conjugal visits. That said, there are some important limitations to the extent to which clear conclusions can be drawn. Not only is there a lack of consensus about the definition of violence (studies differed in whether or not physical assaults were analyzed separately or in combination with other types of infraction), but also grounds to question the reliability of prison violence data as a result under-reporting or inconsistent/inappropriate recording (McGuire, 2018). We also note that much of the work in this area relies on simple correlational data which fails to account for the effects of a number of other potentially important factors. For example, people who behave violently in prisons might well be expected to have entrenched patterns of violence prior to their conviction (their offenses may well involve violence) and this might be expected to result in damaged family relationships and estrangement. It would follow that those who receive fewer visits or have less family contact are those who are at the highest risk of institutional violence, thus potentially confounding any meaningful interpretation of correlational data. None of the studies that we identified controlled for such factors and this would be a recommendation for future research in this area. Furthermore, given that nearly all of the studies identified in this review were conducted in the USA any possible application of these findings to other jurisdictions, including Aotearoa New Zealand, will need to be established rather than assumed. It is, of course, also important to note that most of the included studies utilized data from male prisons. Of those that included female data, however, Benning and Lahm (2016) reported that visitation was beneficial for both men and women and Celinska and Sung (2014) reported fewer infractions for both men and women who had received more phone calls.

Perhaps the most interesting, and potentially important, questions for policy makers that arise from this review concern the way in which family contact might be employed as an intentional violence prevention strategy. No studies were identified that evaluated the impact of interventions that intentionally increased opportunities for family visitation (or indeed other forms of contact). Nor were there any evaluations of attempts to use face-to-face visits or phone calls as either a deterrent or as a punishment for those who had perpetrated institutional violence. Nonetheless, a plausible hypothesis would be that increasing the opportunities for people in prison to connect with family members will result in a reduction in prison violence.

Any judgments about the extent to which family contact can, and should, form part of a more comprehensive prison violence prevention program will, however, inevitably rely upon understanding how it is expected to influence institutional behavior. The study by Siennick et al. (2013), for example, pointed to only a short-term impact of visitation with a gradual average decrease in violent incidents in the prison during the period 6 weeks before a visit, but a rapid escalation in the week afterwards, followed by a return to the original “baseline” level. These findings require explanation. Mowen and Visher’s (2015) work on family contact, although concerned with post-release support, also reminds us that while contact with families may be beneficial overall, not all family support is equal or necessarily positive. They suggest that it is instrumental support, such as housing and financial support, that is more salient after release from prison than any emotional or interactional support. Jiang and Winfree (2006) did, however, note some gender differences in the type of support received (women in their study received higher levels of social support from children, whereas men received higher support from spouses), and the Rocheleau (2014) study also identified the particular importance of family contact for those who are held in segregation.

It is also quite possible that, for some, increased visits will lead to higher levels of violence. The Casey-Acevedo et al. (2004) study concluded, for example, that violence was more prevalent in those women who received visits from their children as they adjusted to imprisonment. Concerns have also been expressed about how the use of face-to-face visits can increase the contraband that enters prisons, with any subsequent illicit substance use and/or black-market trading of valued goods having implications for violence (Ellem, 2020). It is also the case, of course, that not everyone in prison will have equal access to their families. Not only will some be marginalized as a result of their offending (e.g., Van den Berg et al., 2018), but others will be geographically isolated (e.g., Casey & Wiatrowski, 1996), or have family members with only limited access to transport (e.g., Petersilia, 2003). Some families may also, of course, find the prison environment unwelcoming (e.g., Brodsky, 1975; Gibbons, 2011), leading them to feel stigmatized or degraded or not sufficiently comfortable to bring children to visit (e.g., Arditti et al., 2005; Comfort, 2003). Thus, although the focus of the studies reviewed in this paper is on the degree and type of contact with family members, what is clearly missing is any substantive commentary about the influence of the context and quality of the relationships.

More fundamental questions arise around when, how, and for whom, visits or phone calls might influence other triggers for prison violence, such as coping with threats of violence (Ricciardelli, 2014) or disrespect (Butler & Maruna, 2009). What is really needed then is a theory of prison violence that can account for the beneficial impacts of family contact and generate hypotheses and when this is might be most beneficial to violence prevention efforts. Consistent with this suggestion, Wooldredge (2020) has recently argued that there is a need to move beyond simple frameworks of deprivation and importation alone to integrate more general theories of crime and victimization, such as strain theory (Blevins et al. [2010], for example, considered how healthy family relationships might reduce the impact of “strains” such as an inability to obtain goods and services while in prison by promoting better coping). However, a potentially more useful approach may ultimately come from applying specific theories of violence rather than from more general theories of crime. One potentially useful theory here is the evolutionary theory developed by Gilbert (2020) which makes a key distinction between the concepts of “safety” and “safeness.” Safety, it is suggested, is biologically linked to how threats are recognized and responded to through the activation of two different systems: the behavioral inhibition system (increased arousal, focused attention) and the behavioral activation system (higher levels of goal seeking and positive emotions). Safeness, on the other hand, is triggered by cues that the environment poses a low level of threat. Applying these ideas to the prison environment might lead us to conclude that the current focus of many prisons is on promoting safety by ensuring they people do not behave in ways that stimulate conflict (e.g., prioritizing security and de-escalation strategies) such that a prison may appear stable but is, in reality, in an “agonic” mode where stability is achieved through threat and submissive wariness and defense. Gilbert argues that when people can trust each other to be supportive, the whole group settles into a different structure of attention and shared physiological arousal, called the “hedonic” mode. It may be that family contact, for many people in prison simply serves to increase the presence of safeness signals to suppress threat system processing (i.e., it promotes affiliative behavior). In this way family support programs might be expected (theoretically) to offer a useful supplement to other violence prevention interventions that are based around threat management (i.e., identifying ways to inhibit a behavioral response). Such theorizing resonates with current criminal justice approaches evident in trauma-informed care (see Oudshoorn, 2015) and prison therapeutic communities (see Akerman et al., 2017) where prison environments are created where threats are less prominent. Put simply, when people feel that they are safe (safeness), threat focused behaviors will diminish, and that this will then result in a decrease in the level of threat that exists in the environment. Gilbert’s theory thus suggests, perhaps, that the value of family contact in violence prevention may lie not just in terms of promoting safety (encouraging those in prison to inhibit violent responses to provocation by helping them to focus on longer-term goals), but also in supporting safeness (feeling able to behave in more affiliative ways while in prison). It would be quite possible to test these hypotheses empirically.

This is not to suggest that a focus on safeness is the only way forward when developing violence prevention strategies (operational budgets, procedural fairness, staffing, gang influences, the availability of programs, and a range of other factors are also clearly important; see McGuire, 2018), but simply that the concept might help to explain how family contact and other support programs can be optimally designed. Of course, in a context in which prisons have increased access to new technology that can be used to facilitate family communication (Arditti et al., 2005), there are considerable opportunities in this area. For example, in some jurisdictions, such as New South Wales in Australia, those in prison (post-COVID-19) have recently been provided with a tablet that allows regular communication to take place with family members (Ellem, 2020). For jurisdictions, such as Aotearoa New Zealand, the notion of safeness—and this can incorporate ideas of cultural as well as personal safety—will fit well with current prison violence strategies. The Hōkai Rangi strategy (see above) explicitly links family (whānau) connection with psychological well-being and the improved performance of prisons. Initiatives that engage family and community with those in prison are expected to influence the culture or climate of prisons and units with prisons in ways that result in fewer incidents of violence as well as better rehabilitation outcomes.

In summary, this scoping review has brought together evidence from the last 20 years to suggest that family contact and support has an important role to play in preventing prison violence. While there would appear to be grounds to conclude that family visits and phone calls do have a role to play in prevention efforts, further work is clearly required to understand how they might work and under which circumstances, and for which people, they are likely to work best. Of course, there are also other benefits arising from these interventions, with reasonably substantial evidence available to show that supporting those in prison to maintain, and even strengthen, ties with family improves a range of post-release outcomes (e.g., Draine & Solomon, 2000; Skeem et al., 2009; Swanson et al., 2013), as well as proving beneficial for the families of those who are incarcerated (e.g., Landreth & Lobaugh, 1998).

Footnotes

Declaration of Conflicting Interests

Work on this paper was supported by a grant from the Ministry of Business Industry and Enterprise.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Andrew Day

Notes

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