Supporting Children with Incarcerated Parents
From the Show: Bradley Hospital
Summary:
Air Date: 2/4/22
Duration: 10 Minutes
Dr. Margaret Paccione, the Director of Clinical Innovation at Bradley Hospital, joins us to discuss the struggles that children with incarcerated parents face and how they can be supported throughout the experience.
Transcription:
Anne Walters, PhD (Host1): Today's topic is an emotionally heavy one. Sometimes there isn't a cure and that can be a tough pill to swallow. With more than 2 million children affected by one or both parent's incarceration, it's important to bring this issue to light. Having a parent in prison can certainly impact a child's mental health, the inconsistencies in family life, coupled with the stigma that children face having a parent in prison often leads to emotional trauma. And children need support to deal with these circumstances. Children who have an incarcerated parent may experience financial hardship, that results from the loss of that parent's income. Further compounding trauma for the child is loss of parental rights, if the child requires state support or enters the foster care system. The trauma doesn't end there. Some children may have witnessed their parent's crimes or their arrest. They also may have had experienced witnessing violence in their communities or directly in their household or exposure to drug and alcohol abuse.
We're here to learn more about how to understand what children of incarcerated parents are experiencing and how they can be supported with Dr. Margaret Paccione, Director of Clinical Innovation who specializes in trauma informed care at Bradley Hospital. This is Mind Cast, Healthy Mind, Healthy Child, a podcast from the mental health experts at Bradley Hospital, leaders in mental health care for children.
I'm Dr. Anne Walters with my colleague, Dr. Gregory Fritz.
Greg Fritz, MD (Host2): So welcome Marge. We're really fortunate to have you today as the guest on the podcast. And we're interested in digging into this topic. Of course children experience trauma of all different kinds, but this one is especially intricate. As Anne mentioned, in many cases, parents in prison frequently had violence, drugs, inconsistent relationships and chaos in their lives and therefore, in their children's lives, before the eventual arrest that led to their incarceration. Families of incarcerated individuals have been referred to as the hidden victims in contrast to the direct victims of crime, because so little attention has been paid to their struggles. So, to get us started, could you just talk to us about some of the trauma that these kids face?
Margaret Paccione, PhD (Guest): Sure thing. Anne and Greg, it's great to see both, and thank you for inviting me to spend some time focusing on the special group of kids who are often forgotten. So, the number of adults in our state and federal prisons and local jails is right now about 1.8 million. The majority of those behind bars are Black and Hispanic and are incarcerated for non-violent offenses. I don't think we have to spend a lot of time talking about mass incarceration in our country. There is an awful lot written about that, and there's been a lot of discussion. But to what extent if any, our country is served by the imprisonment of so many, is unclear. What is uncontested however, is that millions of our kids is suffering the consequences of their parent's incarceration.
As Anne mentioned earlier, an estimated 2.7 million or one in 28 children under the age of 18, have a biological mom or dad who is incarcerated. Many more minors have a parent who has recently been released from the correctional system. Think about that. One in 14 kids will have a parent incarcerated before they're 18 years of age.
Host1: Marge that's a pretty sobering number. Can you tell us more about what we know about these kids?
Dr. Paccione: Sure thing. Although information about these kids has been slow in coming, we're learning more and more. The parental incarceration, when you look at a definition, involves the removal of an adult from the child's household or daily routine. This disruption of the parent-child relationship is painful and it's traumatic and may be accompanied by other corresponding traumatic experiences, such as witnessing the arrest of the parent, financial hardship, residential instability. These kids often move from place to place and school disruption. So, if we take this from about 50,000 feet, there are two main issues that come together for these kids. One, is the parental problems such as mental illness, substance use, financial stress or domestic violence that predate and may have contributed to the incarceration and coming together, the other theme, problems such as stigma, shame, grief, school disruption, parental repartnering, food insecurity, homelessness and change in financial status introduced as a result of the parental absence. So it becomes a pretty complicated set of circumstances.
Host2: So what types of behaviors are prevalent in these kids when one or both parents are incarcerated or in prison somewhere?
Dr. Paccione: Okay. So let's talk about these kids and school, as kids spend a large chunk of their day at school. A universal issue, that is once the parent is incarcerated, they're no longer involved with the school. So this absence often leads to lowered teacher expectations, stigmatization by educators and peers and increased special education placements. And once on that path, school absence, low achievement scores, grade retention, in and out of school suspensions. And sometimes even school expulsion may follow. And so more generally, behavioral problems such as the kids are withdrawn, they may be depressed, maybe some anxiety, attention deficit, which is often trauma that is perceived as attention deficit, reduced impulse control and increased violence toward themselves, and sometimes others, are common.
Host1: And in talking with kids about their parent's incarceration, what kinds of issues do you hear them bring up?
Dr. Paccione: So kids will talk about the stigma that they feel. There is a widely cited research study that concluded that kids of incarcerated parents are highly likely to be incarcerated themselves as adults. As this was one of the few research studies that was available on these kids, it was very, very widely distributed. In fact, there is no evidence to support this claim. It was just a poorly designed research study, but kids feel judged by adults in authority, as well as peers.
And often kids will say things like, I'm sorry. And, I'm sorry that all this happened and I'm tired of people feeling sorry for me, that just doesn't feel good. Another issue that comes up is, what we call parental role reversals. So think about that, the child is at home. The parent is incarcerated. And the child at home often winds up picking up some of the roles of the parent. For example, they're parenting siblings, or they're taking care of grandma, as the parent did prior to the incarceration. So there's a lot of that parental role reversal that takes place. Another issue is you know, that term, I think there's a phrase that says something like kids born to the same parents are rarely raised in the same household. You get that kind of situation happening here where one kid has a really strong relationship with a parent. And then next thing you know, the parent is gone and then the youngest sibling is just angry. They don't have the connection with the parent that the older sibling might have. So, there becomes some tension between the kids relative to each kid's relationship with the parent. It gets kind of thorny.
Host2: So you've got tons of experience with trauma informed care and it seems like no place would that be more relevant than with this group of kids. Talk to us about that, if you would?
Dr. Paccione: Sure thing. So. The concept called trauma informed care and essentially it's a shift in thinking, that has resulted in understanding the outcome of folks who have histories of trauma. The Substance Abuse and Mental Health Services Administration, usually referred to as SAMSA, has defined some of the components of a trauma informed organization. It could be a primary care practice. It could be a school, it could be a community. And some of the components are that the organization realizes the universal impact of trauma so that everyone in the organization has some background and education around trauma. That folks are familiar and recognize the signs and symptoms of trauma, and that they're able to integrate that knowledge into policies and procedures for the organization. And lastly, which probably should be right at the top of the list is that the organization seeks actively to resist retraumatization.
So a goal becomes, oh my gosh, whatever you do, don't retraumatize these kids. So once, folks are armed with education around trauma, they begin to see these kids a little bit differently. So if a kid is acting up at school, for example, rather than gee, that kid is kind of a jerk or that kid's a bad seed; once we understand the effects of trauma on behavior; we might say, hey, maybe that kid has some trauma in their background, which allows us to see the kid in a much more empathic and kinder light, kindler gentler way of viewing the world.
Host1: I know Marge that you've had so many venues in which you've looked at how trauma informed care can result in improved outcomes in the way that we talk to and care for children. Can you think of how this might apply to the children that you're talking about, for instance, in school or in other environments in their life, where those kinds of modifications in the way that people see that were going to be helpful?
Dr. Paccione: Yeah, that's a great question, Anne. I, I think that what trauma informed care does is allows us to become aware, aware of the impact of the trauma on all of the different functioning aspects of that child's life. And so social stigmatization by authority figures, as well as peers can be crippling. And once we folks begin to see the trauma and its effects; it allows us to see past some of the behaviors that these kids are presenting and to see the kid as a kid. And once the attention is drawn to the circumstances and vulnerabilities of these kids, adults can factor this in to the way they interact with these kids. An empathic, no fault environment is vital to helping these kids move to a better place.
Host2: A lot of parents, and I think professionals are also concerned with how do you bring these issues up to the child? How do you talk to the child about issues pertaining to their parent being in jail? What advice do you have for all of us in that regard?
Dr. Paccione: This is a question Greg, that comes up with so many adults who remain at home with these kids. So although it may be a difficult conversation. And this is one of those deals where honesty is the best policy. We often hear gee dad's on vacation or dad's working out of state and that's just not going to cut it in this particular case. So provide direct age appropriate information to the kid. For the really young kids, Sesame Street has a great video series out called Little Children, Big Challenges, Incarceration. Great videos and they can be so helpful to listen to the videos. And then also, experience them with the child. It's really, really helpful. Another issue that comes up with these kids, is to visit or not to visit. So, the parents are at home and they're faced with that question. Should the kids visit the prison or the jail? Should they visit the parent? And you can immediately see how wrought that is with issues.
And that's one of those situations where it's so individual, it depends on what the relationship that the child had with the parent. Does the child want to go to the prison? HOw comfortable would that experience be? How child friendly is the prison. And there's a lot of variability in terms of how welcoming they are to kids and families. So it's a big decision.
Host1: That's a tough one. My niece, when she was an undergrad at William and Mary did some work in Richmond in a program called Milk and Cookies, which in particular school systems in Richmond identified children who had parents who had been incarcerated and brought them together to do groups in the schools that were really designed to get the kids to talk about their experience. What are your thoughts about that?
Dr. Paccione: Oh, that's awesome. So, it's so important for kids not to feel alone, that they're not the only ones that are left in this situation, especially with the incredible stigmatization that they're experiencing. The opportunity for kids to talk about missing the parent, especially around significant events, graduations, weddings is so, so incredibly important. And just to be able to share that with other kids that are in similar situations, is incredibly helpful.
Host1: And would really reduce that feeling of isolation I'm guessing.
Dr. Paccione: Yeah, absolutely.
Host1: Marge, thank you. This was fascinating. And also heartbreaking. We really appreciate the time you took in talking with us today. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library at bradleyhospital.org/podcast for topics of interest to you. This is Mind Cast, Healthy Mind, Healthy Child, a podcast from the experts at Bradley Hospital.
Anne Walters, PhD (Host1): Today's topic is an emotionally heavy one. Sometimes there isn't a cure and that can be a tough pill to swallow. With more than 2 million children affected by one or both parent's incarceration, it's important to bring this issue to light. Having a parent in prison can certainly impact a child's mental health, the inconsistencies in family life, coupled with the stigma that children face having a parent in prison often leads to emotional trauma. And children need support to deal with these circumstances. Children who have an incarcerated parent may experience financial hardship, that results from the loss of that parent's income. Further compounding trauma for the child is loss of parental rights, if the child requires state support or enters the foster care system. The trauma doesn't end there. Some children may have witnessed their parent's crimes or their arrest. They also may have had experienced witnessing violence in their communities or directly in their household or exposure to drug and alcohol abuse.
We're here to learn more about how to understand what children of incarcerated parents are experiencing and how they can be supported with Dr. Margaret Paccione, Director of Clinical Innovation who specializes in trauma informed care at Bradley Hospital. This is Mind Cast, Healthy Mind, Healthy Child, a podcast from the mental health experts at Bradley Hospital, leaders in mental health care for children.
I'm Dr. Anne Walters with my colleague, Dr. Gregory Fritz.
Greg Fritz, MD (Host2): So welcome Marge. We're really fortunate to have you today as the guest on the podcast. And we're interested in digging into this topic. Of course children experience trauma of all different kinds, but this one is especially intricate. As Anne mentioned, in many cases, parents in prison frequently had violence, drugs, inconsistent relationships and chaos in their lives and therefore, in their children's lives, before the eventual arrest that led to their incarceration. Families of incarcerated individuals have been referred to as the hidden victims in contrast to the direct victims of crime, because so little attention has been paid to their struggles. So, to get us started, could you just talk to us about some of the trauma that these kids face?
Margaret Paccione, PhD (Guest): Sure thing. Anne and Greg, it's great to see both, and thank you for inviting me to spend some time focusing on the special group of kids who are often forgotten. So, the number of adults in our state and federal prisons and local jails is right now about 1.8 million. The majority of those behind bars are Black and Hispanic and are incarcerated for non-violent offenses. I don't think we have to spend a lot of time talking about mass incarceration in our country. There is an awful lot written about that, and there's been a lot of discussion. But to what extent if any, our country is served by the imprisonment of so many, is unclear. What is uncontested however, is that millions of our kids is suffering the consequences of their parent's incarceration.
As Anne mentioned earlier, an estimated 2.7 million or one in 28 children under the age of 18, have a biological mom or dad who is incarcerated. Many more minors have a parent who has recently been released from the correctional system. Think about that. One in 14 kids will have a parent incarcerated before they're 18 years of age.
Host1: Marge that's a pretty sobering number. Can you tell us more about what we know about these kids?
Dr. Paccione: Sure thing. Although information about these kids has been slow in coming, we're learning more and more. The parental incarceration, when you look at a definition, involves the removal of an adult from the child's household or daily routine. This disruption of the parent-child relationship is painful and it's traumatic and may be accompanied by other corresponding traumatic experiences, such as witnessing the arrest of the parent, financial hardship, residential instability. These kids often move from place to place and school disruption. So, if we take this from about 50,000 feet, there are two main issues that come together for these kids. One, is the parental problems such as mental illness, substance use, financial stress or domestic violence that predate and may have contributed to the incarceration and coming together, the other theme, problems such as stigma, shame, grief, school disruption, parental repartnering, food insecurity, homelessness and change in financial status introduced as a result of the parental absence. So it becomes a pretty complicated set of circumstances.
Host2: So what types of behaviors are prevalent in these kids when one or both parents are incarcerated or in prison somewhere?
Dr. Paccione: Okay. So let's talk about these kids and school, as kids spend a large chunk of their day at school. A universal issue, that is once the parent is incarcerated, they're no longer involved with the school. So this absence often leads to lowered teacher expectations, stigmatization by educators and peers and increased special education placements. And once on that path, school absence, low achievement scores, grade retention, in and out of school suspensions. And sometimes even school expulsion may follow. And so more generally, behavioral problems such as the kids are withdrawn, they may be depressed, maybe some anxiety, attention deficit, which is often trauma that is perceived as attention deficit, reduced impulse control and increased violence toward themselves, and sometimes others, are common.
Host1: And in talking with kids about their parent's incarceration, what kinds of issues do you hear them bring up?
Dr. Paccione: So kids will talk about the stigma that they feel. There is a widely cited research study that concluded that kids of incarcerated parents are highly likely to be incarcerated themselves as adults. As this was one of the few research studies that was available on these kids, it was very, very widely distributed. In fact, there is no evidence to support this claim. It was just a poorly designed research study, but kids feel judged by adults in authority, as well as peers.
And often kids will say things like, I'm sorry. And, I'm sorry that all this happened and I'm tired of people feeling sorry for me, that just doesn't feel good. Another issue that comes up is, what we call parental role reversals. So think about that, the child is at home. The parent is incarcerated. And the child at home often winds up picking up some of the roles of the parent. For example, they're parenting siblings, or they're taking care of grandma, as the parent did prior to the incarceration. So there's a lot of that parental role reversal that takes place. Another issue is you know, that term, I think there's a phrase that says something like kids born to the same parents are rarely raised in the same household. You get that kind of situation happening here where one kid has a really strong relationship with a parent. And then next thing you know, the parent is gone and then the youngest sibling is just angry. They don't have the connection with the parent that the older sibling might have. So, there becomes some tension between the kids relative to each kid's relationship with the parent. It gets kind of thorny.
Host2: So you've got tons of experience with trauma informed care and it seems like no place would that be more relevant than with this group of kids. Talk to us about that, if you would?
Dr. Paccione: Sure thing. So. The concept called trauma informed care and essentially it's a shift in thinking, that has resulted in understanding the outcome of folks who have histories of trauma. The Substance Abuse and Mental Health Services Administration, usually referred to as SAMSA, has defined some of the components of a trauma informed organization. It could be a primary care practice. It could be a school, it could be a community. And some of the components are that the organization realizes the universal impact of trauma so that everyone in the organization has some background and education around trauma. That folks are familiar and recognize the signs and symptoms of trauma, and that they're able to integrate that knowledge into policies and procedures for the organization. And lastly, which probably should be right at the top of the list is that the organization seeks actively to resist retraumatization.
So a goal becomes, oh my gosh, whatever you do, don't retraumatize these kids. So once, folks are armed with education around trauma, they begin to see these kids a little bit differently. So if a kid is acting up at school, for example, rather than gee, that kid is kind of a jerk or that kid's a bad seed; once we understand the effects of trauma on behavior; we might say, hey, maybe that kid has some trauma in their background, which allows us to see the kid in a much more empathic and kinder light, kindler gentler way of viewing the world.
Host1: I know Marge that you've had so many venues in which you've looked at how trauma informed care can result in improved outcomes in the way that we talk to and care for children. Can you think of how this might apply to the children that you're talking about, for instance, in school or in other environments in their life, where those kinds of modifications in the way that people see that were going to be helpful?
Dr. Paccione: Yeah, that's a great question, Anne. I, I think that what trauma informed care does is allows us to become aware, aware of the impact of the trauma on all of the different functioning aspects of that child's life. And so social stigmatization by authority figures, as well as peers can be crippling. And once we folks begin to see the trauma and its effects; it allows us to see past some of the behaviors that these kids are presenting and to see the kid as a kid. And once the attention is drawn to the circumstances and vulnerabilities of these kids, adults can factor this in to the way they interact with these kids. An empathic, no fault environment is vital to helping these kids move to a better place.
Host2: A lot of parents, and I think professionals are also concerned with how do you bring these issues up to the child? How do you talk to the child about issues pertaining to their parent being in jail? What advice do you have for all of us in that regard?
Dr. Paccione: This is a question Greg, that comes up with so many adults who remain at home with these kids. So although it may be a difficult conversation. And this is one of those deals where honesty is the best policy. We often hear gee dad's on vacation or dad's working out of state and that's just not going to cut it in this particular case. So provide direct age appropriate information to the kid. For the really young kids, Sesame Street has a great video series out called Little Children, Big Challenges, Incarceration. Great videos and they can be so helpful to listen to the videos. And then also, experience them with the child. It's really, really helpful. Another issue that comes up with these kids, is to visit or not to visit. So, the parents are at home and they're faced with that question. Should the kids visit the prison or the jail? Should they visit the parent? And you can immediately see how wrought that is with issues.
And that's one of those situations where it's so individual, it depends on what the relationship that the child had with the parent. Does the child want to go to the prison? HOw comfortable would that experience be? How child friendly is the prison. And there's a lot of variability in terms of how welcoming they are to kids and families. So it's a big decision.
Host1: That's a tough one. My niece, when she was an undergrad at William and Mary did some work in Richmond in a program called Milk and Cookies, which in particular school systems in Richmond identified children who had parents who had been incarcerated and brought them together to do groups in the schools that were really designed to get the kids to talk about their experience. What are your thoughts about that?
Dr. Paccione: Oh, that's awesome. So, it's so important for kids not to feel alone, that they're not the only ones that are left in this situation, especially with the incredible stigmatization that they're experiencing. The opportunity for kids to talk about missing the parent, especially around significant events, graduations, weddings is so, so incredibly important. And just to be able to share that with other kids that are in similar situations, is incredibly helpful.
Host1: And would really reduce that feeling of isolation I'm guessing.
Dr. Paccione: Yeah, absolutely.
Host1: Marge, thank you. This was fascinating. And also heartbreaking. We really appreciate the time you took in talking with us today. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library at bradleyhospital.org/podcast for topics of interest to you. This is Mind Cast, Healthy Mind, Healthy Child, a podcast from the experts at Bradley Hospital.