Abstract
With 1.7 million children in the United States with an incarcerated parent, the need to provide evidence-based programming, which helps incarcerated mothers re-establish healthy relationships with their children, is essential. This study examines Parenting, Prison, and Pups, a jail-based parenting course for incarcerated women, integrated with the use of animal-assisted therapy (AAT). Utilizing a mixed-method quasi-experimental design, the authors examined differences between mothers who completed a parenting course with AAT, compared with those who completed the same course without AAT; statistically significant lower rates of parental stress and higher rates of self-esteem and parental knowledge among the AAT group were found. Based on qualitative data, the presence of therapy dogs appeared to encourage communication, trust, and connectedness between group members. These results indicate the importance of using innovative tools to help incarcerated women, who often have long histories of trauma and abuse, to develop healthy bonds with their children.
“I was having such anxiety; couldn’t sleep. I’m not saying I was going to hurt myself but when those pups came in. . .I’m just saying—it saved me” (MCC).
Introduction
It is often difficult for mothers to maintain contact with their children while incarcerated (Greene, 2013). The separation between a mother and her child can contribute to her depression, self-harming behavior, and an array of mental health issues (Jasperson, 2010; Keaveny & Zauszniewski, 1999). Correspondingly, children may experience mental health problems, family instability, health issues, school failure, and increased involvement in the criminal justice system (Aaron & Dallaire, 2010; Christian, 2009; Mears & Siennick, 2016; Miller & Barnes, 2015; Purvis, 2013; Will et al., 2014). Maintaining healthy bonds between mothers and children, however, can mitigate these consequences (Purvis, 2013; Synder, 2009). With 1.7 million U.S. children having an incarcerated parent (Glaze & Maruschak, 2008; Maruschak et al., 2010), it is imperative that correctional facilities provide parenting programs, especially for mothers, whose absence often has a devastating effect on the lives of her children (e.g., children are relocated, there is increased child protective services involvement, and siblings are often separated) (Gifford et al., 2020; Harm & Phillips, 2001). Since jailed women receive fewer programs than jailed men, jails have an obligation to increase their gender-specific services as the proportion of women with criminal justice involvement continues to grow (Carson, 2020), especially when women tend to suffer from higher rates of substance use, mental illness, physical ailments, and trauma-based pasts, in comparison to their male counterparts (Clark, 2009; Collica-Cox & Fagin, 2018; Collica-Cox & Furst, 2019; Jasperson, 2010). Jails also have a unique opportunity; while their population is relatively transient, and incarceration stays are much shorter when compared with those serving time in prison (25 days compared with 2.6 years) (Zeng, 2018), incarcerated persons can learn skills that will be put into practice within a very short time (Collica-Cox & Furst, 2019). Since jails often struggle with difficulty implementing programming (e.g., short stays, lack of funding, and limited space), it is necessary to focus their limited resources on programs, which are effective and innovative (Collica-Cox & Fagin, 2018).
Animals are one innovative tool that can be used to increase the effectiveness of established correctional programming and animal programs are used in correctional facilities with great success (Allison & Ramaswamy, 2016; Furst, 2006; Kunz-Lomelin & Nordberg, 2020). Symbiotic relationships develop between humans and animals that can improve relationships with other people by encouraging empathy and growth. Engaging with animals can help in the healing process, especially for incarcerated women who have long histories of abuse or experience difficulties trusting others because of dysfunctional relationships in childhood (Collica-Cox & Fagin, 2018; Thomas & Matusitz, 2016). Combining an evidence-based parenting class with animal-assisted therapy (AAT) may increase the benefits of such programming for women and their children. Research on the effects of parenting classes for incarcerated persons is limited (Armstrong et al., 2017; Eddy et al., 2013; Hoffmann et al., 2010); the same holds true for studies that examine the effects of AAT with correctional populations (Mulcahy & McLaughlin, 2013). There are little to no studies that examine whether the two combined can beget beneficial outcomes. This study seeks to address this gap in the literature by exploring the benefits of the Parenting, Prison, and Pups (PPP) program, the first program of its kind, which combines an evidence-based parenting program with AAT for women, in two different jails, within the New York State metropolitan area.
Literature Review
Women’s incarceration rates continue to grow at approximately twice the rate of men’s rates (Carson, 2020; Kajstura, 2019). As of 2019, there were 231,000 adult and adolescent females incarcerated in the United States, with 101,000 of them incarcerated in local jail facilities; 60% of women in jail are pretrial detainees, and unlike men, more women are held in jails than in prisons (Kajstura, 2019). Recidivism rates are high and most releasees are rearrested within 3 years (Alper et al., 2018). Within that time frame, 60% of criminal justice-involved women are rearrested, 40% gain new convictions, and 30% return to a correctional setting (Deschenes et al., 2006). Most women are incarcerated for drug offenses and women with substance abuse issues appear the most likely to reoffend within the first few years of release (Heubner et al., 2010). Healthy family relationships can aid in moderating recidivism rates (Harm & Phillips, 2001). Jails, therefore, may reduce recidivism by providing gender-specific programming to help women restore healthy bonds with family members. Furthermore, women comprise only 15% of all jail residents and receive fewer programs and services than jailed men (Collica-Cox & Fagin, 2018; Minton & Zeng, 2016; U.S. Commission on Civil Rights, 2020).
When compared with incarcerated men, incarcerated women suffer from higher rates of mental health issues, substance use, and past abuse, in addition to lower levels of education and employment experience (Jasperson, 2010; U.S. Commission on Civil Rights, 2020). Addressing the mental health needs of women is a significant problem for correctional agencies—nationally, 65.8% of incarcerated women in prison have mental health issues (compared with 34.8% of men), and 67.9% of jail-based women have mental health issues (compared with 40.8% of men; Bronson & Berzofsky, 2017). Women also tend to feel the pains of imprisonment more harshly than their male counterparts due to the separation from their children (Collica, 2010). Since there are fewer women’s prisons (some states only have one), women are more likely to be incarcerated farther from home, making it difficult to see family, and they are more likely than men to have their parental rights terminated (U.S. Commission on Civil Rights, 2020). Women are typically the primary caregivers of children before their incarceration, and as a consequence of their mother’s incarceration, children may have to relocate, and in the process, be separated from their siblings (Collica-Cox, 2014; Harm & Phillips, 2001). These stressors are exacerbated when children are not able to have any contact with their mother, with children experiencing severe emotional (e.g., depression, anxiety, or low self-esteem), behavioral (e.g., poor school performance), and physical effects (e.g., insomnia or eating disorders), in addition to engaging in at-risk behaviors for criminal justice involvement (Aaron & Dallaire, 2010; Christian, 2009; Mears & Siennick, 2016; Miller & Barnes, 2015; Will et al., 2014). Nevertheless, the frequency and quality of contact with one’s mother can mitigate these negative effects for children (Comfort et al., 2011).
Carceral Parenting Programs
Most incarcerated women want to mend their relationships with their children, especially when actively working toward maintaining their sobriety (Kazura, 2001), but not all may be able to mend, maintain, and nourish those relationships. Parenting interventions not only help to mend relationships but they also can improve the relationship’s overall quality (Collica-Cox & Fagin, 2018). Generally, parenting programs for incarcerated persons increase parenting skills, parental knowledge, self-esteem, confidence, and communication with children/children’s caregivers, in addition to decreasing parental stress and negative attitudes regarding parenting (Gonzalez et al., 2007; Loper & Tuerk, 2011; Perry et al., 2011; Sandifer, 2008). According to Armstrong et al. (2017), parenting programs increased parental knowledge and enhanced the child–parent relationship but did not show a connection to parent well-being. Large effect sizes were found for parental knowledge, skills, and the quality of the relationship between parent and child; however, such effects did not exist long term. It is important to remember that many of the emotional and behavioral problems exhibited by children of incarcerated women began before their mother’s arrest (Christian, 2009); such behaviors are intensified by her incarceration. Women and their children could benefit from a parenting course that encourages healthy relationships with family members who are likely to offer support after her release (Nasher & Visher, 2006), especially since family members also experience hardship (e.g., anxiety and financial stress) during a loved one’s incarceration (Nasher & Visher, 2006). Although many correctional facilities offer parenting courses, rigorous program evaluations are scarce (Hoffmann et al., 2010; Skar et al., 2014). In light of the jail’s limited resources and difficulties in implementing programming, more studies are needed to determine which programs are most effective and thereby deserving of expanded implementation.
AAT Programs
Animals can serve as a tool to increase the effectiveness of established programming; AAT can be instrumental in this process. According to the International Association of Human-Animal Interaction Organizations (IAHAIO, 2018), AAT is:
“A goal oriented, planned and structured therapeutic intervention directed and/or delivered by health, education and human service professionals” (IAHAIO, 2018, p. 5). Animal-assisted activity (AAA), another effective tool, is similar to AAT, but it is provided for “motivational, educational and recreational purposes” (IAHAIO, 2018, p. 5). Overall, animal engagement can assist with the healing process and is as effective as any other reputable or well-known mental health intervention (Nimer & Lundahl, 2007). When used in programming, animals can serve as a positive attachment for participants, providing a secure base, allowing them to feel safe while communicating more freely. Unhealthy or insecure attachments in early childhood can affect both psychological functioning and relationship quality throughout one’s adult trajectory (Shorey & Synder, 2006). When someone is rejected by an attachment figure, it can create insecurities and negative perceptions of one’s self (Zilcha-Mano et al., 2011). As evidenced by attachment theory, an animal companion’s presence triggers feelings of safety in humans that can encourage class participants to explore their feelings in a protected environment. Animals can fulfill attachment functions, improving therapeutic outcomes by providing emotional security for clients (Zilcha-Mano et al., 2011). Once someone feels accepted and loved, they can communicate more freely, and it can be easier for them to relate to others.
AAT has numerous psychological and physiological benefits such as reducing stress, lessening anxiety, improving behavior, decreasing depression, and enhancing communication and reading skills (Dunlap, 2010; Geist, 2011). Human–animal interactions can increase social interactions, further social skills, create a willingness to participate in services and improve the quality of physical health by lowering blood pressure, heart rate, pulse and physical pain; furthermore, it can affect behavioral problems, emotional well-being, and perceived feelings of loneliness (Ambrosi et al., 2019; Barker & Dawson, 1998; A. Berry et al., 2012; Esposito et al., 2011; Fleishman et al., 2015; Morrison, 2007; Nepps et al., 2014; Nimer & Lundahl, 2007). AAT helps with overcoming trauma and substance abuse (Balluerka et al., 2014; Kelly & Cozzolino, 2015). Therapy dogs can be particularly helpful in motivating normally withdrawn and noncommunicative participants during counseling sessions (K. Brown et al., 2014; Chandler, 2001), in addition to encouraging patient compliance (Zilcha-Mano et al., 2011).
Prison Animal Programs
AAT benefits are observed in incarcerated persons who have psychiatric or developmental disorders (Koda et al., 2015) and correctional departments have been using some form of animal-based programming with varying degrees of success for years (Furst, 2006). Furst (2006) found that most states have some form of a prison animal program (PAPS), but they are commonly used with male populations and they are typically service-oriented. PAPS usually do not have a clinical or psychological counseling component, despite evidence that working with animals can provide incarcerated persons with psychological benefits (Strimple, 2003). Preliminary results indicate that PAPS are correlated with increasing self-worth, confidence, social skills, empathy, self-awareness, and engagement, while also decreasing infractions (Enders-Slegers, 2000; Fournier et al., 2007). Dogs can create a normalizing effect inside a correctional facility (Smith & Smith, 2019) and help reduce feelings of isolation (Allison & Raamswamy, 2016; Thomas & Matusitz, 2016). Programs that specifically use AAT can help incarcerated persons be more introspective because they form a connection to the dogs, making them feel loved and supported (Dell et al., 2019). The effects of therapy dogs may vary depending on the extent of the participant’s issues. In a study by Kunz-Lomelin and Nordberg (2020), incarcerated Texans who participated in AAT had decreased PTSD, anxiety, and depression, but decreases in anxiety were only significant with those who presented with moderate to severe scores, demonstrating that those with the most severe anxiety may experience the greatest benefit. Incarcerated women can also benefit from PAPs. These programs provide hope and growth, while increasing their feelings of value and worthiness, allowing incarcerated women to feel as if they are providing a valuable service to the community (Minton et al., 2015).
Dogs can help to mediate the relationship between adults and facilitate more open and useful communication. The expectation of complete confidentiality in a group setting is difficult and is exacerbated by the dynamics of the correctional setting (McClanahan, 2014). Consequently, it can inhibit participants from sharing personal information that limits the overall effectiveness of the group. Therapy dogs motivate incarcerated persons to not only attend class but also participate during classes and complete their program (Jasperson, 2010; Koda et al., 2015). It is evident that dogs can facilitate a connection of trust and acceptance (Brazier, 2014). Dogs can produce rehabilitative outcomes because they provide a secure environment to increase women’s comfortability, trust, and acceptance, helping to foster safe attachments (Silcox et al., 2014; Stetina et al., 2020; Zilcha-Mano et al., 2011) that is difficult to achieve in correctional settings. Those who participate in AAT programming tend to experience better moods and emotion regulation (Koda et al., 2015) that may mitigate institutional infractions. Dogs also provide a source of affection, as well as physical and emotional connectivity, that incarcerated persons lack due to a separation from their families (Dell et al., 2019; Silcox et al., 2014). Although more research is needed pertaining to the effectiveness of AAT within the correctional environment (Dell et al., 2019), there are studies that demonstrate promising effects (See Nimer & Lundahl, 2007), but there are also studies that demonstrate mixed results, revealing differing degrees of success (See Jasperson, 2010, 2013; Mulcahy & McLaughlin, 2013; Smith & Smith, 2019). Program measures can vary, complicating comparisons. When benefits are found, it is difficult to isolate the effects of AAT because many incarcerated persons often participate in multiple programs (Mulcahy & McLaughlin, 2013). One study found that both men and women benefit from AAT with improvements in emotional and social competencies, but women, especially those with substance abuse issues, benefited less than men (Stetina et al., 2020). The authors affirm that there is a lack of evidence on which programs are most effective for incarcerated women. Hence, this study adds to the limited scientific knowledge in this area.
Parenting, Prison, and Pups
The program in this study, which takes place at two separate jails—Metropolitan Correctional Center (MCC) and Westchester County Department of Correction (WCDOC)—is modeled after the evidence-based Parenting Inside-Out (PIO) curriculum that previous research has found to dramatically decrease depression, lower substance abuse, increase parental participation, enhance parenting skills, reduce parental stress, and reduce recidivism for participants throughout the Oregon Department of Corrections; study participants’ recidivism rate was found to be 27% compared with the control group’s rate of 48% (PIO, n.d.). In a study of PIO by Eddy et al. (2013), the field’s largest randomized controlled study, with over 350 incarcerated men and women within the Oregon Department of Corrections, researchers found that this program significantly affected parental adjustment, parental depression, parent-child interaction and the relationship between the parent and the child’s caregiver. To enhance the PIO curriculum, a stress management component (that includes meditation and yoga); a certification in cardiopulmonary resuscitation (CPR), First Aid, and automated external fibrillator for adults, children, and infants; and a Graduation/Reunification Day was added. In its first year, PPP was implemented without therapy dogs to understand how to best integrate the dogs into the curriculum. All classes after the first year were integrated with AAT. Women had the ability to engage with the dogs before, during, and after class (e.g., AAA). There are two therapy dogs per session and varying breeds of dogs are utilized (e.g., Labrador Retriever, German Shepard, Pitt Bull, Chihuahua, and Labradoodle). The dogs are integrated into the lessons and serve as examples to build upon more difficult concepts; the dogs also serve as a source of emotional support for women while discussing difficult topics, such as their separation from their children or past abuse (e.g., AAT). Parenting classes are offered to women at both jails twice per week, 2 hr per class, for approximately 2 months, for a total of 14 classes. The only exception is the CPR certification course, which is a 6-hr course offered on a Saturday. The same instructor teaches all classes with the help of college student assistants. Class topics include Effective Parenting Styles; Effective Speaking Skills; Effective Listening Skills; Effective Problem Solving; Child-Centered Play; The Child’s Job and the Parent’s Job; Giving Effective Directions and Encouragement; Rules, Rewards, and Consequences; Time Out With Backup Privilege Removal; Going Home, You and Your Children; Healthy Adult Relationships; Stress Management; CPR Certification; and the Reunification/Graduation Day. During reunification, children and other immediate family members are invited to the facility to spend a few hours with the PPP graduate. Food is provided by the jail, the visiting room is decorated, therapy dogs are present, activities are planned (e.g., games), and each woman receives her parenting certificate. Normal visiting rules are suspended, and women are allowed to have complete physical contact with their children. Although the parenting curriculum itself was studied previously, the integration of therapy dogs into this curriculum was not previously examined.
Method
The present study examined the impact of AAT on self-reported stress levels (both general and parenting-specific), anxiety, depression, self-esteem, and parenting skills knowledge among incarcerated women participating in an evidence-based parenting program. The researchers hypothesized that women participating in programs utilizing AAT would experience lower levels of stress, anxiety, and depression, in addition to increased self-esteem and parenting skills knowledge compared with women in programs not utilizing AAT. The study examined two groups of women from each facility. The only difference between the groups was the use of therapy dogs in the experimental group and the absence of therapy dogs in the comparison group; all other program components (e.g., curriculum and instructor) were identical.
Sample
At the time of the study, PPP was a partnership between MCC in Manhattan, WCDOC in Wescthester County, Pace University and The Good Dog Foundation. 1 The study included pre-trial detention and sentenced women housed at either MCC or WCDOC. MCC is a federal holding facility managed by the Bureau of Prisons with an average daily population of 800 residents; approximately 25–30 are women. WCDOC is the second-largest jail in New York; at the time of the study, they housed roughly 1,000 residents and approximately 65 of them were women. Criteria for program inclusion included being the parent or grandparent of a child under age 25, the ability to speak English, and have at least 2 months remaining on their jail sentence to allow them time to complete the program. Time-to-release for pretrial detainees was estimated by facility officials. Potential participants were informed of the program through announcements made in their housing area. Interested women were screened for program eligibility, informed of the voluntary nature of the study and selected in six waves occurring between 2017 and 2019, with data being collected in the fall at WCODC and in the spring at MCC each year. Although data collection continued into 2020, facility lockdowns due to COVID-19 necessitated the suspension of data collection until the pandemic passed. The full sample from both facilities included 60 women between ages 19 and 60, 28 from MCC and 32 from WCDOC, who completed the program. The sample included both pretrial detainees (73.3%) and sentenced offenders (26.7%; see Table 1). The sample was divided into an experimental group who participated in the parenting program that included AAT dogs (n = 40) and a comparison group who participated in the same program without the therapy dogs (n = 20).
Descriptive Characteristics.
Note. MCC = Metropolitan Correctional Center; WCDOC = Westchester County Department of Correction.
Demographically, the full sample was comprised of 28.3% White, 28.3% Black, and 36.7% Latinx women. Over a third of participants did not possess a high school diploma or GED (38.3%). A majority (71.4%) of participants at MCC were employed at the time of their incarceration, with an average income of US$22,950. In contrast, 81.3% of WCDOC participants were unemployed, with a considerably lower average income (US$7,603). Most of the samples (77.7%) were not married. Participants had an average of 2.6 children; 11.7% lost their parental rights prior to arrest and only 10% had an open case with a child protective services agency. In total, this group had very high rates of mental health problems and drug use, with the WCDOC group reporting higher rates for both. For WCDOC, 93.7% reported a drug problem compared with 42.9% of the women at MCC and 84.4% of WCDOC women reported mental health issues compared with 71.4% of MCC participants. Furthermore, WCDOC participants had much more extensive involvement with the criminal justice system. On average, all participants had 8.2 arrests, with the WCDOC women reporting an average of 11.9 arrests and the MCC women reporting an average of 3.8 arrests.
Measures
Quantitative and qualitative measures were provided for a mixed-method design. Pre- and posttest data were collected via interviews and included scales measuring stress levels (both general and parenting-specific), anxiety, depression, self-esteem, and parental knowledge. Stress, anxiety, and depression were measured through the Depression Anxiety Stress Scales (DASS) 21 Scale on a Likert-type scale from zero (did not apply to me at all) to three (applied to me very much or most of the time) (Lovibond & Lovibond, 1995). The scale has demonstrated validity (T. A. Brown et al., 1997) and reliability (Crawford & Henry, 2003). Self-esteem was measured using the 10-item Guttman self-esteem scale, “which has satisfactory reproducibility and scalability” (Rosenberg, 1965, p. 16) and can predict varying ranges of self-esteem levels (O’Brien, 1985). The 10 items are recorded on a four-point Likert-type-scale (0 to 4) from strongly agree to strongly disagree. Questions measuring parental stress and parental knowledge are adapted from J. D. Berry and Jones (1995); Korjenevitch et al. (2010); Kramer and McDonnell (2016) and Parenting Inside Out (2015). Each measure was created using five-point Likert-type items ranging from strongly disagree (1) to strongly agree (5). The scale measuring parental stress was created from 18 item questions to determine if women were happy, unhappy or under considerable stress in their role as a mother (e.g., I am happy in my role as a parent, having children has been a financial burden, the behavior of my children is often embarrassing to me, and I feel overwhelmed by the responsibility of being a parent). A 25-question test, comprised of information conveyed during the classes, was used to measure improvement in parenting skills knowledge (e.g., what is the preferred way to engage in play with children? when should privilege removal be used? and what is time out?). Group differences were measured to determine if changes occurred in stress (both general and parenting-specific), anxiety, depression, self-esteem, and parental knowledge in programs with AAT and those without AAT. All interviews were conducted in person by one of the researchers in a private room in the facilities. On average, pretests took approximately 40 min, while posttests, which took place within days of the course’s completion, took 42 min to administer.
All questions were read to participants to avoid any deficiencies with reading or writing skills. Responses were recorded in written format and transcribed (facility restrictions prohibited audio or video recording); quotes are verbatim transcriptions. Responses were then analyzed using content and thematic analyses and coded utilizing the open-ended approach (Glaser et al., 1967). Common themes in the respondents’ answers, using a framework analysis, managing data by case and theme were examined (Glaser et al., 1967; Miles & Huberman, 1994). Based on preliminary observations of the data, a codebook was developed, providing definitions for concepts; identifying themes emerged and succeeding concepts categorized (Glaser et al., 1967). Coding was a continuous process. Initial themes were organized into categories and reorganized during several transcription readings. Textual analysis was used to study similarities and differences in responses to the open-ended questions and interviews. Representative quotes were selected to describe categories and/or themes within categories. Frequencies and percentages were used to quantify responses from the closed-ended questions.
Results
Examination of the data revealed identifiable differences in outcome variables between the AAT and non-AAT groups and between the MCC and WCDOC samples. The AAT groups consistently demonstrated lower levels of depression, anxiety, and stress (both general and parenting-specific) and higher self-esteem levels and parental knowledge (see Table 2). Examining MCC and WCDOC separately, however, revealed some differences between the women housed within these facilities. Although participants in AAT programs at MCC demonstrated a change in the expected direction in depression, anxiety, and self-esteem; they also experienced higher (general and parenting-specific) stress levels compared with the non-AAT group. Between-group differences, however, were slight, indicating very little detectable variation in values (see Table 3). WCDOC participants, conversely, demonstrated the expected change in all measures with measurable differences between groups (see Table 4).
No AAT versus AAT Psychological Measure Descriptives.
Note. AAT = animal-assisted therapy.
No AAT versus AAT Psychological Measure Descriptives, MCC.
Note. AAT = animal-assisted therapy; MCC = Metropolitan Correctional Center.
No AAT versus AAT Psychological Measure Descriptives, WCDOC.
Note. AAT = animal-assisted therapy; WCDOC = Westchester County Department of Correction.
Having established the existence of group differences between the AAT and non-AAT groups, as well as differential program impact between MCC and WCDOC, two-sample t-tests were conducted to determine the statistical significance, if any, in the group differences. Separate analyses were conducted using the full sample (n = 60) as well as the MCC (n = 28) and WCDOC (n = 32) samples separately. Examining the full sample, two-sample t-tests revealed that the difference in mean scores for depression, anxiety, and stress were not statistically significant (see Table 5). Power analysis, however, indicated that the sample size was too low to reliably detect a significant difference for these measures. Offenders participating in the AAT parenting program did experience lower levels of parenting stress compared with those in non-AAT parenting programs; t(58) = 2.45, p < .05, Cohen’s d = .67. Participants in the AAT program also reported higher levels of self-esteem compared with the non-AAT group; t(58) = −2.21, p < .05, Cohen’s d = −.60. Finally, parental knowledge was significantly higher for AAT groups compared with non-AAT groups; t(58) = −4.8, p < .001, Cohen’s d = −1.70.
Differences in significant measures and effect sizes also existed between the MCC and WCDOC samples. Models examining the relationship between psychological measures and AAT revealed no statistically significant relationships between AAT and psychological stresses among the MCC participants (see Table 6). Models utilizing a WCDOC-only sample revealed statistically significant differences in all measures other than depression and stress with relatively large effect sizes (see Table 7). Anxiety scores among WCDOC participants in programs that included AAT reported lower anxiety compared with the non-AAT group; t(30) = 2.46, p < .05, Cohen’s d = .939. AAT participants experienced less parental stress compared with non-AAT groups; t(30) = 4.23, p < .05, Cohen’s d = −1.210. AAT groups, compared with non-AAT groups, reported higher self-esteem; t(30) = −3.17, p < .05, Cohen’s d = −1.21. Parental knowledge between the AAT and non-AAT groups was also significantly higher as expected; t(30), p < .001, Cohen’s d = −1.864.
Feelings Regarding the Class
Although the DASS 21 scores did not demonstrate a statistically significant difference in stress levels, the women verbally reported feeling less stressed as a result of the class. Ninety-five percent (n = 38) of the women in the AAT group reported feeling less stressed when compared with 75% (n = 20) of the non-AAT group: I have [felt less stressed]. It breaks the monotony and it gives us something to do. The dogs bring a lot of joy and you know you are accomplishing something (MCC). Before the dogs came here, I was very stressed out. It’s not easy to be here with all of these other women. They want everyone to feel better and we feel better when they are here. The dogs take our stress away (MCC).
Women in the AAT group (n = 40) reported that the dogs’ presence not only made them feel less stressed but also less anxious and safer. The women reported many different feelings regarding the presence of the dogs, such as the dogs made them feel happy, calm, supported, relaxed, or as if they were not in jail: We couldn’t have our kids, so [the dogs] made us feel comfortable, secure, and happy (WCDOC). Another woman mentioned: [The dogs were] so loving and I felt more comforted and relaxed (MCC). For one woman, the dogs reminded her of home and for the time she was in class, she was mentally able to remove herself from the jail setting: It made me feel like I wasn’t here. When I saw them, they took me away from here (MCC). The dogs also helped during the reunification/graduation day for those women who were unable to have their families, especially their children, attend (e.g., distance, orders of protection, caregiver was unwilling/unable to bring the child or the social worker would not bring the child): They were my company because my family was not here (MCC). For women who were able to have family, they wanted to introduce their family to the therapy dogs; they really felt that the dogs were an integral part of the class: It made me feel good that my kids could meet them (WCDOC). Another woman stated: They were a part of our community. I was proud to have them there and they deserved to be there. They stuck it through with us. They deserved to be with us (WCDOC).
Some of the women felt the dogs had a normalizing effect on the environment that made it more comfortable for their children to visit: It can be an uncomfortable setting and they make it feel normal. All the kids loved them. My parents loved them (WCDOC).
The PPP staff witnessed the majority of the children interacting happily with the dogs during the graduation/reunification day, and all of the women with young children reported that the dogs were beneficial for their children during this visit: I told them the dogs would be here. I wanted it to be a surprise. They couldn’t wait to see them. They love animals. They were laying on [one of the therapy dogs] and that made them so happy (MCC).
One beneficial interaction is represented by a case that involved a 9-year-old child who was waiting in the visiting room to be processed for the graduation; she seemed visibly nervous. The instructor approached the child and asked her if she wanted to meet one of the dogs. Her comfort level noticeably increased, and during the graduation, she made a picture for the therapy dog to thank him for comforting her.
The dogs’ presence might not only provide comfort but also affect behavior and remind participants they are not inherently bad. One participant claimed the dogs helped her to stay out of trouble: I looked forward to it. I didn’t want to get into trouble because then I wouldn’t be able to come to class (MCC).
Another woman said it made her feel like she was still a good person, despite her transgressions: Babies and dogs have instincts. I felt like a good person because they would come up to me. They know bad news when they see it, but they were calm and came right to me. They knew I wasn’t a bad person (WCDOC).
All of the women stated that the class met or exceeded their expectations and cited the following as their top three reasons: level of parental knowledge learned (48%; n = 29), ability to enhance parenting skills (20%; n = 12), and increased communication skills (8%; n = 5). One woman said: I didn’t expect to feel such a sense of accomplishment and so good about myself (WCDOC). Two other women noted: I learned more than I thought. I was able to make connections with my family and bond with them. I took it seriously (WCDOC). It helped me a lot. It taught me communication skills and how to deal with my kids. It helped me to be patient with my grandkids and my older kids (MCC).
A majority of the women said they felt comfortable sharing during the group (85%; n = 51), with 100% of the women stating that confidentiality was never broken; this was true for both the comparison and experimental groups. Examining observations of the groups, however, the AAT group appeared to share and disclose more freely earlier in the sessions when compared with the non-AAT group. At MCC, the non-AAT group did not begin to share until Class 3. When the therapy dogs were integrated into the group, women began to share personal information during the first or second class. The results were more extreme for the WCDOC group. For WCDOC, the non-AAT group did not share personal information until Class 10, while the AAT groups shared within the first or second class: I shared a little bit. I did disclose and I don’t usually say anything. This class brought up my self-esteem and made me feel as if I was part of something (WCDOC). In the beginning no. A lot of girls in here are not friends. You come here alone and you leave alone. They gossip. It’s like high school. There are two or three that I can talk to. I feel more comfortable because no one discussed anything outside of class (MCC).
Women in the AAT group appeared more motivated to come to class. In some cases, the instructor would have to find missing participants to encourage them to come to class but the number of attempted missed classes was lower for AAT groups (.175) compared with non-AAT groups (1.571). Utilizing a two-sample t-test, there was a significant difference between the AAT group and non-AAT group for attempted missed classes; t(59) = 4.94, p < .001, Cohen’s d = 1.33. These differences were consistent in both the MCC only, t(27) = 3.48, p < 05, Cohen’s d = 1.33, and WCDOC samples, t(30) = 3.44, p < 05, Cohen’s d = 1.31; see Table 8. For the majority of the women, the class was something they looked forward to weekly: I would have a hard day and I would look forward to them (the dogs). They put everyone at peace. Even people who were not in the class would ask about the dogs. Even the COs came to see the dogs (MCC).
Two-Sample t-tests, AAT versus No AAT.
Note. AAT = animal-assisted therapy.
Two-Sample t-tests, AAT versus No AAT; MCC Only.
Note. *All MCC participants taking the parental knowledge survey participated in programs with AAT. AAT = animal-assisted therapy; MCC = Metropolitan Correctional Center.
Two-Sample t-tests, AAT versus No AAT; WCDOC Only.
Note. AAT = animal-assisted therapy; WCDOC = Westchester County Department of Correction.
Two-Sample t-tests, AAT versus No AAT for Attempted Missed Classes.
Note. AAT = animal-assisted therapy; MCC = Metropolitan Correctional Center; WCDOC = Westchester County Department of Correction.
Skills Learned
When asked about the most important skills they learned and how they have improved, the women cited communication skills (60%; n = 36). All participants felt their communication skills were enhanced and would improve their relationships with their families. This was true for both the experimental and comparison groups, but the AAT groups reported more instances of utilizing these skills to the instructor during the actual parenting classes. Throughout the effective listening and speaking skills classes, women learned the skills needed to have more productive conversations. Such skills helped them talk to their children, their children’s caregiver, one another, and the correctional staff. Almost all of the women (97%; n = 58) said the communication skills helped or would help to improve their relationships with family members: My Communication skills are better. I think about what I’m going to say and what I’m not going to say and also how I am going to approach someone (MCC). Sometimes I like to run my mom around. I didn’t understand why she didn’t do what I asked her to do. I would call her and say mom, “do this for me’ and mom, ‘call my lawyer’.” Now I understand it’s not my world. I used to give orders, like “why didn’t you do this?” Now I know how to be more grateful. Now I just thank her and if I need to ask her to do something, I just tell her to get to it when she can and if she can’t, it’s OK (MCC).
Some women noted improved communication with their children: My communication skills (are the most important skill I learned). I talked with my daughter yesterday and I asked her if it was a good time to talk. Everything went smooth after that. I am talking to her more and not over talking her (WCDOC).
An overwhelming majority (92%; n = 55) said the communication skills they learned during class changed the way they handled disagreements or arguments, with 25% (n = 14) using emotion regulation, 22% (n = 12) trying to be more understanding of the other person’s feelings, 18% (n = 10) listening more, 9% (n = 5) looking at the problem from both perspectives, 7% (n = 4) not yelling, 9% (n = 5) talking through a solution and 9% (n = 5%) using other methods: [I changed] with my speaking skills. I will communicate instead of yelling and hollering and getting upset (WCDOC). [I learned] to be more calm and to breath in and out and don’t express yourself in anger, which makes it worse (MCC).
Respondents reported that the relationship with their children’s caregivers also improved (43%; n = 26), with 45% (n = 27) saying they took more time to show their appreciation for the caregiver’s efforts: It is so much better and we are talking again (WCDOC); We talk more and argue less (WCDOC); I am thanking her for everything now (MCC). For 82% (n = 49) of the women, the communication skills learned in the class helped to improve their relationship with the other women: Now I ask if they have time. Sometimes I feel I may have done something wrong to someone. Before I stayed quiet and I held it in but now I explain myself (MCC). I have connected with the women in here. I am not yelling or fighting with anyone (WCDOC).
About one third of the women (33%; n = 20) said it also helped their relationships with the staff. One woman said: It helped me to control my temper (WCDOC). Another woman claimed I have showed a lot more patience and because of it, I have not had any loss of privileges (MCC). Yet, many others (62% n = 37) said they never had a problem with the staff: I have no problems with staff. I respect them. This is jail and you should just shut up if you feel a certain way. I know how to respect my elders (MCC).
Changes With Their Children
Women in the AAT group reported increased contact with their children (48%; n = 19) compared with women in the non-AAT group (25%; n = 5). The ability to have visits with their children appeared to increase the most when compared with all other methods of contact (e.g., letters or phone calls). One woman used the problem-solving skills she learned to repair her relationship with her mom, who was also her son’s caregiver. She had not seen or spoken to either in several years. She was very anxious about speaking with her mother and felt that her mother always resented her; her mother often compared her to her dad, who died of an overdose. Once the lines of communication were open, she was able to speak with her son several times per week, followed by weekly tele-visits: [This class] already helped me. I got in contact with my mom and was able to see my son (WCDOC).
Ninety percent (n = 54) of participants said they would make changes to their relationships with their children after completing the parenting class. Twenty-seven percent (n = 16) said they would communicate more effectively with their children, 23% (n = 14) said they would utilize the parenting tools more consistently, 12% (n = 7) said they were focused on improving their overall relationship with their children, 28% (n = 17) cited an array of other changes (e.g., being more calm, confident, truthful, or appreciative), while 10% (n = 6) said they would not be making any changes to their relationship with their children as a result of what they learned (five of those six women were in the non-AAT group): I am listening to him more and because of that, he has been more forthcoming about his feelings about me being up here. He told me he didn’t like it and that he didn’t like my boyfriend. He opened up where he was quiet before (MCC). [I am going to] give them more support on their decision making and communicating with them (WCDOC).
Other women were focused on being more open and honest with their children: I will be more honest and open and not treat them as friends but on a different level. I’m the parent. I need to look at them as people with feelings, not just children. They worry about me and I want to be more open (WCDOC). I am more open with them. I use different strategies to keep them focused when I’m talking to them. I read books to them on the phone and I am helping them with homework on the phone (MCC).
To implement these learned skills, women need confidence in their abilities. At the beginning of the course, it was clear from group discussions that many of the women were not confident in their parenting skills and described themselves as “putty moms” (e.g., a mom without rules or discipline). By the conclusion of the course, 96% reported being more confident in their parenting skills: [I am more confident] with patience and I am more empathetic. I have to trust in the effective communication and listening skills I learned and believe that I will be successful in this new way of parenting (WCDOC).
Noticeably, women spent time reevaluating themselves. Eighty-two percent (n = 49) said the information learned in the class changed the way they thought of themselves as a mother: It drew out of me a certain level of confidence I forgot I had. It validated what I did well and in a way what I neglected about myself. I have to be loving and supportive to myself and as a mother; this class drew that out of me. I can find out what I’m looking for. I don’t have to shut doors. I have done things I thought were so terrible. They are mistakes and I don’t have to repeat them. They love me, I learned from this, and we can keep moving forward (WCDOC).
Ninety-five percent (n = 57) said the class changed the way they thought about parenting: I need to set rules and regulations. I have to be consistent and put him on a time out. I don’t want to be a putty mom (MCC). I need to be consistent with rules and discipline. I need to have better communication (WCDOC).
Eighty-two percent (n = 49) said the class changed the way they felt about themselves as a person: It helped me to want to value myself now. I have been reevaluating myself and getting into my spiritual being. I am trying to make a plan for myself. I take things one step at a time. I want success and love and I want so much to rekindle with my family and to let them know I appreciate them (MCC).
Discussion
This study demonstrates that there can be multiple benefits for incarcerated women in a jail setting who complete programs like PPP. The AAT group in this study demonstrated statistically significant lower levels of parental stress and higher levels of self-esteem and parental knowledge when compared with women in the non-AAT group. Participants reported feeling less stressed, anxious, and depressed as a result of their participation in the program, however, not all of these measures were statistically significant. Depression, stress, and anxiety may be difficult to combat, especially in a jail setting, where it is common. The majority of these women were unsentenced and newly incarcerated; they were adjusting to a new environment and new rules. They were dealing with court dates, as well as problems with spouses, children, their housing, bills, or what they would do when they went home. For many, they were sober for the first time in a long time. The impact of psychological measures might be more visible in a prison environment where there is more stability and fewer unknowns (2.6 years average incarceration compared with 25 days) (Zeng, 2018). It is important to remember that increased stress and anxiety are common in correctional environments and seem to be more heightened in jails.
Of the two AAT groups, the WCDOC women experienced statistically significant decreases in anxiety. WCDOC women presented with many more issues than the MCC women, such as higher rates of drug use, mental illness, and arrest rates. It is possible that those with the most severe rates of anxiety, as with the WCDOC group, are likely to see the biggest impact from AAT interventions (Kunz-Lomelin & Nordberg, 2020). MCC women appeared to have higher levels of stress when compared with WCDOC women. This could be due to differences in state and federal processes (e.g., it seemed the federal women were less likely to receive a plea-bargaining deal quickly and more likely to be housed at MCC for a longer period when compared with their WCDOC counterparts). The MCC women were more likely to be the primary caregiver of their children before incarceration compared with WCDOC women, resulting in additional stress. The AAT group also reported feeling happy, less anxious, less stressed, and safer because of the therapy dogs’ presence. Dogs can help to normalize the corrections environment (Smith & Smith, 2019), especially when their children visit. The dogs loved them and made them feel like they were still a good person, despite their crime. The human-dog relationship is incomparable to relationships with other humans because it is a relationship without words (Thomas & Matusitz, 2016). Although our words can offend others, dogs will never be offended by the language we use (Furst, 2006). Dogs are essentially nonjudgmental and loving (Cusack, 1988); you can tell them anything without fear of rejection. The women appeared to form an attachment to the therapy dogs because they felt supported (Dell et al., 2019), which, in turn, may have allowed them to communicate more easily with the instructor and with group members. AAT programs seem to help incarcerated persons develop a deeper sense of trust with others (Mercer et al., 2015).
Since incarcerated women have high rates of prior abuse (Jasperson, 2010) and often present with negative/dysfunctional childhood attachments, it is important for them to find a way to develop healthy attachments, so they can change the negative perceptions they possess, increase their self-esteem and increase their confidence (Zilcha-Mano et al., 2011). Healthy relationships with a therapy dog may initiate the process of developing healthy relationships with one’s self and then with others. Notably, all the women in the AAT group reported increased self-esteem and more confidence in their parenting abilities; both are important for postrelease success.
AAT affects mood and behavior. The AAT group was more motivated to come to class and it was possible that the therapy dogs gave them more of a reason to attend. Some women also reported that the dogs helped keep them calm, and they were mindful of their behavior outside of class; they did not want to engage in any trouble and lose their ability to participate. These women were also very introspective and they reported that the class itself helped to change their perceptions of self as a person and as a mother. The women in the AAT group disclosed personal information in the classes much earlier when compared with the non-AAT group, providing evidence that dogs may help to foster trust, communication, and a sense of connectedness between others. Women in the AAT group reported increased contact with their children. This is a positive finding since contact with one’s children and family is difficult to maintain while incarcerated (e.g., collect phone call costs, visiting procedures, or facility distance) (Collica, 2010).
Considering those in the AAT group appeared to share personal information earlier, there was the opportunity and willingness for them to try their newly learned skills with their children/children’s caregivers, providing for the facilitation of visits prior to the class’ conclusion. The therapy dogs may have made them more comfortable in regard to discussing relationship problems with their children/children’s caregivers within the first few classes with group members, which allowed the group to work toward potential solutions. This potentially made mothers more comfortable in contacting family members sooner, when compared with the non-AAT group, which accordingly, granted them more access to their children.
All of the women felt the class met or exceeded their expectations; the skills they learned, especially the communication skills, helped improve relationships with their children, children’s caregivers, family, and one another. Mending relationships while incarcerated can begin the process of postrelease success. Family stability is one of the “central eight” factors that correctional-based programs should target to help reduce recidivism (Andrews et al., 2006, 2012). Strong family relationships can preclude future criminal justice involvement, and parenting programs can help mend and re-establish these important relationships before a woman’s release.
Limitations
Due to the nature of the correctional environment, a controlled randomized evaluation is not practical. There are a limited number of women in both facilities who meet program eligibility at any given time. There are not enough women to organize both experimental and control groups and doing so presents an ethical issue—since jail-based women receive fewer programs than all other correctional populations, the authors did not want to deny this opportunity to any incarcerated woman who was eligible. The biggest hindrance to this program was the amount of time that the women had remaining on their sentence but providing two classes per week, rather than one, afforded the majority of women the opportunity to complete the program prior to their release. Even with providing reasonable estimates of the remaining time for unsentenced women, attrition was an issue for every class. Unlike prison-based classes, jail classes must be provided within a short time (<2 months) to increase the number of program completers. Jail stays are often unpredictable and many of the women were released directly from court (program staff never saw them again) or were sentenced and transferred to a different facility. An average of one to four women per session did not complete the class based on the above-mentioned factors, all of which were outside of the researchers’ and participants’ control. Moreover, threats to internal validity should be noted. Most participants also completed a drug program during their stay, and all were serving various lengths of time, making it difficult to contribute outcomes solely to the current intervention.
Implications and Future Research
Ideally, women, who are often incarcerated for nonviolent drug offenses, and their children, would fare better serving their sentence in the community where the possibility for engagement with one’s children is more easily facilitated. Distance and financial limitations are often cited as the most likely reasons women do not receive visits from their children while incarcerated, but some caregivers also feel that carceral facilities are inappropriate places for children to visit (Nasher & Visher, 2006). If the regularity and value of contact with one’s mother mitigate the negative emotional, physical, and behavioral effects for women and her children, including future criminal justice involvement, increased gender-specific parenting classes can provide ample benefits to two distinct populations (e.g., mothers and children) (Comfort et al., 2011). Since the use of therapy dogs can normalize the correctional environment and help to place children at ease, it may make it more likely for family to visit with younger children if correctional officials can implement this service. The contact between mother and child can mitigate negative effects for both (Comfort et al., 2011), enhancing outcomes for rehabilitative and reintegrative success, and providing an incentive for correctional facilities to consider utilizing therapy dogs more often. Once released, it is unfortunate that these mothers and their children will not have the benefits of the therapy dogs in their home environment. Services in the home is beyond what can be offered by the current program; however, future researchers may want to determine if dogs in the home environment can help ease the reintegrative process for the formerly incarcerated and serve to foster healing in familial relationships.
This study provides evidence that parenting programs, when used with incarcerated women in jail, may be more effective when integrated with AAT. If having therapy dogs twice per week can affect psychological measures, it stands to reason that increased hours with therapy dogs may affect these measures even more significantly. Future researchers should study whether increased time with a therapy animal begets more significant outcomes. Fortunately, this study found that as little as 4 hrs per week with therapy dogs can make an impact. Therapy dogs can be relatively inexpensive to implement if jails can form strong partnerships with agencies that are able to volunteer their services. Dogs are favored in the correctional setting, particularly jails; they are disciplined, respond well to commands, and are familiar. Limited space would make it difficult to incorporate larger animals, and dogs, unlike other animals, consistently have a moderately high effect size (Nimer & Lundahl, 2007).
The rise in mental health issues necessitates the use of innovative tools, such as AAT. Although jails often struggle with program implementation and maintenance due to limited funding and space restrictions, this study provides evidence that AAT programming works with incarcerated women and is a good candidate for implementation and expansion to other facilities. Researchers should continue to provide program evaluations for jailed women. Since they are often underserved, it is vital to use the jail’s limited resources for programming that is known to produce beneficial outcomes. Because these women are typically separated from their children for a short time, they can utilize their parenting skills at home soon after completing the program (Collica-Cox & Fagin, 2018). Future researchers should determine how parenting skills are implemented in the home environment and whether they can have a discernable effect on recidivism.
Footnotes
Acknowledgements
The authors thank The Good Dog Foundation for their initial partnership in programming, planning, and research, especially Renee Payne, Bruce Fagin, and Rachel McPherson. We would like to thank our current partner, Judy Audevard and Hudson Valley Paws For A Cause, for their commitment to PPP, in addition to the Westchester County Department of Correction, especially Nory Padilla, Leandro Diaz, Walter Moccio, Louis Molina, Frank Delgrosso, Marie Reyes, Eileen Sacharewitz, and Cassandra Tejada. Thanks to Commissioner Spano for his everlasting commitment to rehabilitation. Thanks to MCC, Thomas Volpini, Lee Plourde, and to Lisa Rae Johnson for her role in developing the initial pilot. A special thank you to all of our PPP therapy teams and Pace students. Finally, we would like to thank all of our moms for their commitment to parenting and for openly sharing their stories with us.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
