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prisonvisitsAP1.pdf
Article
The Effects of Prison Visits From Family Members on Prisoners’ Well-Being, Prison Rule Breaking, and Recidivism: A Review of Research Since 1991
Karen De Claire 1
and Louise Dixon 2
Abstract The effect of family visits on prisoner well-being and future behavior is an important consideration in the development of prison policy. This review systematically examines current research findings that explore the impact of prison visits from family members on three specific offender outcomes: prisoners’ well-being, rule breaking within the prison, and recidivism. The review focuses on visits by family and does not duplicate earlier reviews but rather extends them into current literature, through identification of empirical studies conducted post 1989, published since 1991. Ten studies met the stipulated inclusion criteria. All are case– control and cohort studies. The review of studies used a standardized quality assessment tool. Results show considerable var- iation in study quality, methods, and findings. However, studies consistently reported positive effects of prisoners receiving visits. Prison visits reduced depressive symptoms in women and adolescent prisoners. There was some evidence of reduction in rule- breaking behavior. One high-quality study suggested that visits reduced recidivism and increased survival in the community. Although there were positive outcomes associated with prison visits, it was not possible to draw strong conclusions for the outcomes of interest due to a lack of research, methodological discrepancies, and variability in outcome measures and results. The discussion considers the implications of the findings for policy, practice, and research.
Keywords prison visits, visitation, well-being, recidivism, rule breaking
Research has shown the existence and maintenance of strong
interpersonal relationships with friends or family reduces the
likelihood of re-offending and successful reintegration into the
community (Hairston, 1988; May, Sharma, & Stewart, 2008;
Niven & Stewart, 2005). Importantly, the maintenance of
‘‘good quality’’ relationships during a prison sentence has been
associated with the successful development of the relationship
post release (La Vigne, Naser, Brooks, & Castro, 2005). This
body of evidence, therefore, highlights the need to maintain
or develop supportive relationships during prison sentences
in order to reduce recidivism. Hale (1988) went so far as to say,
‘‘Since rehabilitation and re-entry of the offender into the com-
munity is the ultimate goal of the correctional system, it should
be obvious that the maintenance of the offender’s family sys-
tem is of vital concern’’ (Hale, 1988, p. 143).
Prison visits are an obvious means by which prisoners can
strengthen existing relationships: Indeed, they feature in prison
regimes on a general basis. Research suggests the benefits, in
addition to reduced recidivism (Bales & Mears, 2008; Hairston,
1988), include improved mental health of prisoners and other
family members, an increased probability of the family remain-
ing together post release (Hairston, 1991), and an improved
level of social adjustment during imprisonment and after
release (Casey-Avecedo & Bakken, 2002). This review aims
to search for and evaluate all of the studies published since
1991 that investigate the impact of prison visits from family
members on prisoner’s well-being, behavior, and recidivism
and to inform practice, policy, and further research.
Objectives of the Review
The role of prison visits in the maintenance of family relation-
ships and the reduction of recidivism has undergone some
research to date. Hairston (1988) reviewed the existing litera-
ture in relation to family ties and recidivism, which included
disciplinary infractions within the prison environment. In
1991, she further provided a review of family ties, well-being,
1 National Offender Management Service, School of Health Sciences/Applied
Psychology, Cardiff Metropolitan University, UK 2 School of Psychology, University of Birmingham, Birmingham, UK
Corresponding Author:
Karen De Claire, University of Birmingham, Edgbaston, Birmingham B15 2TT,
UK.
Email: [email protected]
TRAUMA, VIOLENCE, & ABUSE 2017, Vol. 18(2) 185-199 ª The Author(s) 2015 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/1524838015603209 journals.sagepub.com/home/tva
and post-release success (Hairston, 1991). This review system-
atically investigates the impact of prison visits from family
members on three specific offender outcomes. Preliminary
investigation showed that all peer-reviewed, published papers
relevant to prison visits conducted prior to 1989 were included
in Hairston’s (1988, 1991) reviews. Therefore, this review
focuses on research that has been conducted post these
reviews. Specifically, this review aims to determine whether
family visits:
1. affect prisoners’ well-being (i.e., stress, depression, sui-
cidal/self-harm behaviors);
2. improve prisoners’ rule breaking within the prison envi-
ronment; and
3. reduce recidivism as measured by official records.
The Protective Role of Relationships
Arguably, the most important relationship disrupted by impri-
sonment for adolescents is with their parents and for adults with
their intimate partners or children. These primary relationships
allow prisoners to maintain their social identity and provide a
sense of security, well-being, and an assurance of worth (Hair-
ston, 1988). Hairston (1991) suggested that the maintenance of
these relationships throughout the sentence leads to decreased
recidivism and improved mental health and family reunifica-
tion after release. Although based on limited evidence, Hair-
ston concluded that there are strong social, economic, and
emotional reasons to develop programs that enhance family ties
and to change prison policies that inhibit family interaction.
Little research has explored the role of the parental relation-
ship in recidivism. However, the general offending literature
considers family relationships to be both a risk and protective
factor for delinquency (Stouhamer-Loeber, Loeber, Wei,
Farrington, & Wikstrom, 2002). Considerable research has con-
centrated on the risks and mechanisms associated with the paren-
tal relationship that influences adolescent offending behavior
(Rhule-Louie & McMahon, 2007). That antisocial behavior can
emerge through modeling from parent–child relationships sug-
gests that separation during incarceration may be beneficial.
However, a study by Ryan and Yang (2005) of juvenile delin-
quents in residential care found that those who received visits
had lower offending rates than those who did not.
Contact with children is viewed as having a positive effect
on a parent’s relationship with their child(ren), and many par-
ents work hard to maintain contact during periods of separation
(Hairston, 1991). Indeed, Poehlmann, Dallaire, Loper, and
Shear’s (2010) review found benefits of child contact for incar-
cerated parents in reduced distress levels and better parent–
child relationships for both male and female prisoners. How-
ever, this relationship is complicated. For example, Poehlmann
(2005) did not establish a relationship between visits and
increased relationship quality between mothers and their chil-
dren, although telephone contact did appear to improve rela-
tionship quality. Concerns for their children’s experience
may prevent prisoners from encouraging their visits. Although
a lack of contact with their child may have negative conse-
quences for the prisoner, bringing their children into the prison
environment may not feel appropriate and limit any positive
effects.
While for female prisoners, there is little evidence that adult
intimate relationships are protective the consensus is that they
are protective for male offenders. Segrin and Flora (2001) found
that possessing a satisfying marriage reduced loneliness during
incarceration. Carlson and Cervera (1991) demonstrated that
conjugal visits increased participants’ perception of closeness.
This demonstrates that contact between prisoners and their part-
ners through visits can improve prisoner well-being. However,
evidence is contrary concerning re-offending. Rhule-Louie and
McMahon (2007) found that individuals chose partners who sup-
ported their antisocial and criminal behaviors. However, Samp-
son, Laub, and Wimer’s (2006) longitudinal research with 500
young men showed that marriage was associated with a 35% reduction in the odds of an individual engaging in crime. If mar-
riage is a protective factor for men, then encouraging prisoners
to maintain their long-term relationships may be a useful tool
in reducing re-offending. Sampson et al. described four possible
mechanisms through which marriage could be causal in reducing
re-offending: Marriage creates social obligations that increase
the cost of crime; marriage causes significant changes in routines
and patterns of association; the female partner exerts direct
social control; and finally, marriage leads to a change in self-
identity to a more ‘‘responsible’’ person. If intimate relationships
are to continue to facilitate this, contact during a sentence is
important.
There are difficulties associated with maintaining visits
throughout a prison sentence. Although some prisoners may
see visits as the highlight of their time, their families can view
visits as difficult emotionally and practically and prison staff
see visits as organizationally problematic (Dixey & Woodall,
2012). Fuller (1993) identified a range of obstacles such as
work schedules, distance, and child care and health problem.
Comfort (2003) provided further examples describing the very
negative experiences of female partners visiting one American
prison as almost a secondary form of imprisonment. Indeed,
visitors need motivation to maintain contact and those setting
prison policies need reasons to support family members to visit.
Hairston (1988) suggested that without access to their family
prisoners lose hope that they can achieve more in their lives,
become more socially impaired, and their emotional resources
are depleted. As a result, they may re-offend at higher rates
than previously. If this is the case, then a review of research that
investigates the impact of visits on future positive outcomes is
necessary to provide information to shape future policy.
Method
Sources of Literature
The first author conducted preliminary searches using the terms
‘‘prison,’’ ‘‘visits,’’ and ‘‘recidivism’’ in databases that include
research within the fields of criminal justice, social sciences,
186 TRAUMA, VIOLENCE, & ABUSE 18(2)
and psychology. The search included papers post 1989 to cap-
ture research conducted following that date, not yet published
and considered in Hairston (1991). The initial search identified
the following databases as most effective in generating
research in the required area: Ovid MEDLINE(R) 2008–
2015, Ovid MEDLINE(R) 1988–1995, Ovid MEDLINE(R)
1980–1987, Ovid MEDLINE(R) 1946–1979, Ovid OLDME-
DLINE(R) 1946–1965, PsycINFO 1806–2015, Web of Science
1898–2015, EBSCO 1978–2015, and Science Direct May 2015
update. Together, these databases review over 8,000 journals
and cross all possible areas that could be relevant to this study.
A full literature review was undertaken using the English lan-
guage version (which includes papers translated into English)
in December 2011, January 2012, January 2014, October
2014, and May 2015.
Search Strategy
The reviewer searched the abstracts of relevant online data-
bases using a number of search terms related to the key con-
cepts. The reviewer developed search terms through a
number of exploratory searches using different terms and per-
mutations for each research question, with the terms prison*
AND visit* common to all research questions and searches.
Table 1 depicts additional terms considered for each specific
research question. All of the searches were rerun substituting
jail* and then incarceration for prison* and social support for
visit* until all permutations were used. The full search results
are available from the first author.
Study Selection
Selected studies were those that met the general inclusion cri-
teria (see Table 2) and the criteria pertinent to each specific
question investigated. To ensure that the studies would be
based on stringent methodology, the researchers also decided
that only peer-reviewed articles would be included (Smith,
Gates, & Foxcroft, 2006). This resulted in the exclusion of
26 dissertation abstracts and six books that had some relation
to the search criteria. The criteria were applied at three stages:
1. Initial sift to determine whether the study was related to
the subject of interest, at this stage many studies were
rejected that were not related to prisons or concerned
visits by professionals;
2. Consideration of the abstracts to determine relevance to
the questions being explored by the review, at this stage
many studies were rejected that were related to the pro-
cess of visits but not the effect, or the way visits affected
the family and children but not the prisoner; and
3. Reading the full text to establish if the papers met the
specific research question criteria.
Ten papers met the inclusion criteria. The reference sections
of these papers were also manually searched resulting in two
further papers. However, they did not meet the inclusion cri-
teria. Figure 1 provides an overview of the exclusion process.
Data Extraction
Data extraction from the articles used a standardized form. This
collated information on the studies and participant’s character-
istics, measures used for independent and dependent variables,
and outcome data for male and female prisoners and adult and
adolescent prisoners. The first author and a second researcher
reviewed the 10 studies separately to ensure reliability (concor-
dance rate 95%). Both researchers also assessed the quality of each paper using a quality assessment instrument, which was
adapted from the Critical Appraisal Skills Program tools for
reviewing randomized control trials, cohort studies, and case
studies (Public Health Resource Unit, 2006). This tool asked
raters to consider nine questions centered on the quality of pre-
sentation, design, and analysis. Table 3 includes a summary of
the specific questions asked and scores achieved.
Detailed questions are available from the first author on
request.
Quality Assessment
Each study was assessed on items such as a focused hypothesis,
quantifiable relationships between visits and outcomes of inter-
est, control groups, accounting for bias, number of participants,
and precision and presentation of results. After rating each of
the items based on presence or absence, an overall quality score
was calculated.
Table 1. Additional Search Terms for Each Research Question.
Question 1 Question 2 Question 3
AND self-harm* AND rule breaking* AND recidivism AND suicid* AND violence* AND re-offend* AND well-being AND rule violation AND offend* AND stress* AND depression*
Table 2. Inclusion Criteria.
Search strategy Studies conducted post 1989, but not published until after 1991 All questions
Prisoners had experienced prison visits with family members or partners
Studies that investigated relationships between visits and the stated outcomes of interest
Studies providing replicable, quantifiable, and objective measure of visits and outcome Experimental, quasi-experimental, controlled observational, and observational studies
Studies that controlled for confounding variables Studies subject to peer review
Specific questions Question 1: Studies with quantifiable measures of stress,
depression, suicide/self-harm Question 2: Studies with quantifiable measures of rule breaking in
prison Question 3: Studies with quantifiable measures of recidivism/
re-offending
De Claire and Dixon 187
Both researchers consistently reached the same overall
scores for each paper, achieving the same answer for each ques-
tion asked. Possible scores ranged between 9 and 18. The fol-
lowing are the codes assigned to each study:
� A: high quality (score of 16–18): All or most of the cri- teria met (90%) and if not. The authors judged that those criteria unmet are unlikely to alter the conclusions
reached (five studies scored within this range).
� B: medium quality (score of 12–15): Some of the criteria met (70%) and if not. The authors judged that those cri- teria unmet are unlikely to alter the conclusions reached
(three studies scored within this range).
� C: low quality (score less than 12): Few or none of the criteria met (less than 70%). The authors judged that the study quality alters the conclusion of the study (two
studies scored within this range).
Results
Table 4 provides an overview of each study and a summary of
the quality scores.
Research Question 1: Do Visits Affect Prisoners’ Well-Being?
Monahan, Goldweber, and Cauffman (2011). This study consid- ered how visitation from parents affected adolescents’ mental
health during the first 2 months of incarceration. The partici-
pants were 276 male adolescents between 14 and 17 years old
in one secure juvenile facility in North America. The compar-
ison is between those who received prison visits and those who
did not with differences in the groups for age, parental educa-
tion, and distance for parents to travel to prison accounted for.
The number of prison visits from parents was derived from
official records as the number from baseline to Month 2, calcu-
lated at number per week. Level of depression was assessed via
the Center for Epidemiological Studies—Depression Scale
(Radloff, 1977) during a 2-hr baseline interview and then
weekly 1½ hr follow-up interviews for the first 3 weeks and
then monthly.
The study used growth curve modeling to test differences in
the level of depression and change over time. During the first
week, there were no differences between groups on level of
depressive symptoms. Over the 2 months, those who were
receiving visits reported a more rapid decline in depressive
symptoms than those who did not. An increased number of vis-
its accounted for a more rapid reduction in depressive symp-
toms. Parental visits accounted for 8% of the variance in depressive symptoms. The effects of visits and relationship
quality accounted for 11% of variance, suggesting the effects of visits as independent from the effects of relationship quality.
This study scored 16 on the quality assurance measure. The
researcher defined a clear research question and measurable
hypotheses. The participant group was appropriate and com-
parison achieved effectively within the sample. Data collection
occurred from the same source and time period. Collection was
regular with some variables controlled for. However, they did
not account for other factors that may affect depression such
as relationships within the environment and withdrawal from
Initial sift of 235 studies identified through search terms across all questions
32 excluded as not peer reviewed
Full reading of the papers
13 excluded as not specific to the research questions
Full reading of the papers
43 excluded not specific to prison visits from family
Reading of the abstracts 127 excluded as not
relevant to the research questions
Reading of the abstracts 10 excluded as reviews,
discussions and no measurement
10 studies for inclusion
Figure 1. Flow diagram of the identification/exclusion process; initial sift to full review of the paper.
188 TRAUMA, VIOLENCE, & ABUSE 18(2)
T a b
le 3 .
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189
T a b
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.
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se lf -r
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n g
vi si
ta ti o n ’’—
ab o u t
1 to
4 ti m
e s
p e r
m o n th
, ab
o u t
e ve
ry o th
e r
m o n th
,a b o u t 4
ti m
e s
d u ri
n g
th e
ye ar
,a b o u t o n ce
th is
ye ar
, n e ve
r S tr
es s
a n d
d ep
re ss
io n : p ar
e n ti n g
st re
ss m
e as
u re
d b y
an ad
ap ta
ti o n
o f th
e P ar
e n ti n g
S tr
e ss
In d e x
(P S I;
A b id
in , 1 9 9 5 ).
V is
it at
io n
st re
ss w
as ad
d e d
to th
e P S I as
a 7 -i te
m sc
al e
b y
th e
st u d y
au th
o rs
an d
va lid
at e d
p ri
o r
to u se
(a ¼
.7 6 ).
A d ju
st m
e n t
w as
m e as
u re
d u si
n g
th e
d e p re
ss io
n , an
x ie
ty ,
so m
at iz
at io
n , an
d gl
o b al
sc al
e s
o f th
e B ri
e f
S ym
p to
m In
ve n to
ry (D
e ro
go ti s,
1 9 9 3 )
n ¼
3 6 2
fe m
al e
p ar
ti ci
p an
ts fr
o m
o n e
p ri
so n
in N
o rt
h A
m e ri
ca A
ge : 1 9 – 5 9
(M ¼
3 2 .6
ye ar
s, S D ¼
7 .4
)
A n al
ys is
o f in
d iv
id u al b
w e ig
h ts
fo r
e ac
h re
gr e ss
io n
an al
ys is
in d ic
at e d
th at
p ar
e n ti n g
st re
ss co
n ce
rn in
g vi
si ta
ti o n
w as
as so
ci at
e d
w it h
e le
va te
d an
x ie
ty .
V is
it at
io n
st re
ss (m
e as
u re
d th
ro u gh
th e
7 -i te
m sc
al e )
w as
al so
as so
ci at
e d
w it h
th e
gl o b al
sc o re
o n
th e
B S I
su gg
e st
in g
o ve
ra ll
e m
o ti o n al
ad ju
st m
e n t
d if fi cu
lt ie
s
B S co
re : 1 3
T u e rk
an d
L o p e r
(2 0 0 6 )
T o
e x p lo
re th
e as
so ci
at io
n b e tw
e e n
th e
am o u n t
ty p e
an d
fr e q u e n cy
o f
co n ta
ct b e tw
e e n
in ca
rc e ra
te d
m o th
e rs
an d
th e ir
ch ild
re n
an d
p ar
e n ta
l st
re ss
V is it s:
se lf -r
e p o rt
o f fa
ce -t
o -f
ac e
vi si
ts in
th e
la st
ye ar
P a re
n ta
l st
re ss
: th
e P ar
e n ti n g
S tr
e ss
In d e x
fo r
In ca
rc e ra
te d
W o m
e n
(P S I-
IW , H
o u ck
& L o p e r,
2 0 0 2 )
n ¼
3 5 7
fe m
al e
p ri
so n e rs
re cr
u it e d
as p ar
t o f a
la rg
e r
st u d y
in o n e
p ri
so n
in N
o rt
h A
m e ri
ca
T h e
re su
lt s
o f th
e re
gr e ss
io n
an al
ys is
d e m
o n st
ra te
d a
re la
ti o n sh
ip b e tw
e e n
in cr
e as
e d
p ri
o r
co n ta
ct s,
in cr
e as
e d
le tt
e r
w ri
ti n g,
an d
re d u ce
d st
re ss
. H
o w
e ve
r, in
cr e as
e d
vi si
ts w
e re
n o t
si gn
if ic
an tl y
as so
ci at
e d
w it h
a re
d u ct
io n
in p ar
e n ta
l st
re ss
C S co
re 1 0
(c o n ti n u ed
)
190
T a b
le 4 .
(c o n ti n u e d )
S tu
d y/
re se
ar ch
q u e st
io n
M e as
u re
s O
u tc
o m
e Q
u al
it y
R e se
ar ch
q u e st
io n
2 Ji an
g an
d W
in fr
e e
(2 0 0 6 )
T o
p ro
vi d e
q u an
ti ta
ti ve
d at
a to
e x p lo
re th
e d if fe
re n ce
s b e tw
e e n
so ci
al su
p p o rt
fo r
m al
e an
d fe
m al
e p ri
so n e rs
an d
th e
im p ac
t th
is h ad
u p o n
ru le
b re
ak in
g w
it h in
th e
p ri
so n
e n vi
ro n m
e n t.
V is
it s
fr o m
ch ild
re n
w e re
in cl
u d e d
V is it s:
se lf -r
e p o rt
o f vi
si ts
b y
ch ild
re n
ye s/
n o .
R u le
b re
a k in
g: th
e d at
a o n
p ri
so n
ru le
b re
ak in
g w
e re
co lle
ct e d
o n
ar ch
iv e d
d at
a fo
r th
e p ri
so n e rs
in 1 3
ca te
go ri
e s
o f ru
le b re
ak in
g. T
h e
n u m
b e rs
o f ru
le in
fr ac
ti o n s
w e re
d iv
id e d
b y
th e
ti m
e sp
e n t
in p ri
so n
to e st
ab lis
h m
o n th
ly ra
te
n ¼
1 4 ,0
0 0
(a gr
e e d
to ta
k e
p ar
t fr
o m
n ¼
1 ,2
6 9
m al
e , n ¼
3 ,1
1 6
fe m
al e )
C h o se
n fr
o m
a st
ra ti fi e d
sa m
p le
fr o m
2 7 5
p ri
so n s
in N
o rt
h A
m e ri
ca .
M e an
ag e
m al
e 3 3 .3
7 , fe
m al
e 3 4 .2
1
V is
it s
fr o m
ch ild
re n
re su
lt e d
in n o
si gn
if ic
an t
im p ac
t u p o n
p ri
so n
ru le
- b re
ak in
g b e h av
io r
A S co
re 1 7
S ie
n n ic
k , M
e ar
s, an
d B al
e s
(2 0 1 3 )
T o
e x am
in e
th e
e ff e ct
o f p ri
so n
vi si
ta ti o n
o n
th e
p ro
b ab
ili ty
o f
d is
ci p lin
ar y
in fr
ac ti o n s
E x p lo
ri n g
an ti ci
p at
o ry
e ff e ct
s o f vi
si ts
, th
e vi
si to
r, th
e ty
p e
o f in
fr ac
ti o n , an
d th
e fr
e q u e n cy
o f vi
si ts
V is it s:
o ff ic
ia l d at
a 1 . N
u m
b e r
o f vi
si ts
d u ri
n g
th e
p e ri
o d
2 . B ro
k e n
d o w
n in
to sp
o u se
, p ar
tn e r,
p ar
e n t,
re la
ti ve
, fr
ie n d .
In fr
a ct
io n s:
d is
ci p lin
ar y
in fr
ac ti o n , vi
o le
n t
in fr
ac ti o n ,
d e fi an
ce in
fr ac
ti o n , co
n tr
ab an
d in
fr ac
ti o n , an
d su
p e rv
is io
n in
fr ac
ti o n
ta k e n
fr o m
o ff ic
ia l re
co rd
s
n ¼
7 ,0
0 0
p ri
so n e rs
o f b o th
ge n d e rs
(p re
d o m
in an
tl y
m al
e )
re le
as e d
fr o m
p ri
so n s
in F lo
ri d a,
N o rt
h A
m e ri
ca , b e tw
e e n
N o ve
m b e r
2 0 0 0
an d
A p ri
l 2 0 0 2
A ge
: 1 4 .9
– 8 0 .8
at ad
m is
si o n
m e an
ag e
2 9 .7
3 G
e n d e r:
m al
e 8 9 .3
% an
d fe
m al
e 1 0 .7
%
In fr
ac ti o n s
ar e
si gn
if ic
an tl y
lo w
e r
in th
e 3
w e e k s
p ri
o r
to a
vi si
t an
d si
gn if ic
an tl y
h ig
h e r
in th
e 4
w e e k s
fo llo
w in
g a
vi si
t O
ve ra
ll vi
si ts
al te
r tr
e n d s
in m
u lt ip
le fo
rm s
o f m
is co
n d u ct
in si
m ila
r w
ay s
w it h
e ff e ct
s st
ro n ge
st fo
r co
n tr
ab an
d T
h o se
vi si
te d
b y
sp o u se
s h ad
th e
lo w
e st
o ve
ra ll
in fr
ac ti o n
le ve
l F re
q u e n tl y
vi si
te d
p ri
so n e rs
h av
e a
lo w
e r
b as
e ra
te fo
r in
fr ac
ti o n s
th an
ty p ic
al ly
vi si
te d
p ri
so n e rs
A S co
re 1 6
C o ch
ra n
(2 0 1 2 )
V is it s:
o ff ic
ia l d at
a 1 . N
u m
b e r
o f vi
si ts
p e r
m o n th
d u ri
n g
th e
p e ri
o d
M is co
n d u ct
ev en
t: ge
n e ra
l, vi
o le
n t,
se x u al
, p ro
p e rt
y, d ru
g o th
e r
ta k e n
fr o m
o ff ic
ia l re
co rd
s
n ¼
2 ,0
7 0
in p ri
so n s
in F lo
ri d a,
N o rt
h A
m e ri
ca , b e tw
e e n
N o ve
m b e r
2 0 0 0
an d
A p ri
l 2 0 0 2
A ge
: 1 5 – 7 4 , m
e an
ag e
3 2
G e n d e r:
m al
e
V is it a ti o n : tr
aj e ct
o ri
e s
fo r
vi si
ta ti o n
re su
lt e d
in fo
u r
gr o u p s:
n o n vi
si te
d ,
co n si
st e n tl y
vi si
te d , e ar
ly vi
si te
d , an
d la
te vi
si te
d M
is co
n d u ct
: tr
aj e ct
o ri
e s
fo r
m is
co n d u ct
re su
lt e d
in th
re e
gr o u p s:
h ig
h m
is co
n d u ct
, lo
w m
is co
n d u ct
, an
d n o
m is
co n d u ct
M o st
p ri
so n e rs
d o
n o t
e n ga
ge in
m is
co n d u ct
; h o w
e ve
r, th
e n o n vi
si te
d p ri
so n e rs
h av
e a
lo w
e r
p ro
b ab
ili ty
o f
n o
m is
co n d u ct
(6 6 .8
% ).
A n d
a h ig
h e r
p ro
b ab
ili ty
o f h ig
h m
is co
n d u ct
(5 .6
% ).
T h e re
is lit
tl e
d if fe
re n ce
b e tw
e e n
th e
vi si
te d
gr o u p s
o th
e r
th an
e ar
ly vi
si te
d h av
in g
th e
h ig
h e st
p ro
b ab
ili ty
o f b e in
g in
th e
h ig
h m
is co
n d u ct
gr o u p
(8 .1
% )
A S co
re 1 6
(c o n ti n u ed
)
191
T a b
le 4 .
(c o n ti n u e d )
S tu
d y/
re se
ar ch
q u e st
io n
M e as
u re
s O
u tc
o m
e Q
u al
it y
Ji an
g, F is
h e r-
G io
rl an
d o , an
d M
o (2
0 0 5 )
T o
p ro
vi d e
q u an
ti ta
ti ve
d at
a to
e x p lo
re th
e im
p ac
t o f so
ci al
su p p o rt
fo r
p ri
so n e rs
u p o n
ru le
b re
ak in
g w
it h in
th e
p ri
so n
e n vi
ro n m
e n t.
P ri
so n
vi si
ts fr
o m
ch ild
re n
w e re
vi e w
e d
as o n e
e le
m e n t
o f a
n u m
b e r
fo r
so ci
al su
p p o rt
an d
it s
e ff e ct
s o n
p ri
so n
b e h av
io r
w e re
as se
ss e d
V is it s:
se lf -r
e p o rt
o f vi
si ts
b y
ch ild
re n
ye s/
n o
R u le
b re
a k in
g: th
e d at
a o n
p ri
so n
ru le
b re
ak in
g w
e re
co lle
ct e d
o n
ar ch
iv e d
d at
a fo
r th
e p ri
so n e rs
in 1 3
ca te
go ri
e s
o f ru
le b re
ak in
g. T
h e
n u m
b e rs
o f ru
le in
fr ac
ti o n s
w e re
d iv
id e d
b y
th e
ti m
e sp
e n t
in p ri
so n
to e st
ab lis
h m
o n th
ly ra
te . R
u le
b re
ak in
g is
sp lit
in to
th re
e ca
te go
ri e s:
1 . O
ve ra
ll 2 . V
io le
n t
3 . D
ru g/
p ro
p e rt
y
n ¼
9 ,0
0 0 .
C h o se
n fr
o m
a st
ra ti fi e d
sa m
p le
fr o m
2 7 5
p ri
so n s
P ar
ti ci
p an
ts w
it h o u t
ch ild
re n
an d
th o se
se n te
n ce
d to
L if e
w e re
e x cl
u d e d
M e an
ag e
3 5 .0
5 (S
D 9 .4
4 )
P ri
so n e rs
w h o
re ce
iv e d
vi si
ts fr
o m
ch ild
re n
w e re
m o re
lik e ly
to e n ga
ge in
d ru
g an
d p ro
p e rt
y ru
le -b
re ak
in g
b e h av
io r
B S co
re 1 5
H e n sl
e y,
K o sc
h e sk
i, an
d T
e w
k sb
u ry
(2 0 0 2 )
T o
e x p lo
re th
e re
la ti o n sh
ip b e tw
e e n
th re
at e n e d
an d
ac tu
al vi
o le
n ce
w it h in
th e
p ri
so n
e n vi
ro n m
e n t
an d
co n ju
ga l
vi si
ts
V is it s:
p ar
t o f th
e co
n ju
ga l vi
si ts
p ro
gr am
o r
n o t
(n u m
b e r
o f vi
si ts
o r
th e
le n gt
h o f ti m
e re
ce iv
in g
vi si
ts w
as n o t
re p o rt
e d
o r
co n si
d e re
d in
th e
an al
ys is
) V io
le n t
th re
a ts
a n d
b eh
a vi o r:
se lf -r
e p o rt
b as
e d
o n
e ig
h t
q u e st
io n s.
F o u r
as k in
g sp
e ci
fi c
q u e st
io n s
ab o u t
th e
th re
at s
o f vi
o le
n ce
e n ga
ge d
in an
d fo
u r
ab o u t ac
tu al
vi o le
n ce
e n ga
ge d
in .S
e x u al
as sa
u lt
is in
cl u d e d
in th
e ac
tu al
vi o le
n ce
q u e st
io n s
n ¼
2 5 6
p ri
so n e rs
fr o m
lo w
an d
m e d iu
m se
cu ri
ty in
tw o
N o rt
h A
m e ri
ca n
p ri
so n s
in M
is si
ss ip
p i
n ¼
1 2 6
M al
e n ¼
1 3 0
fe m
al e
6 2 .6
% o f th
e m
al e
sa m
p le
p ar
ti ci
p at
e d
in co
n ju
ga l vi
si ts
1 8 %
o f th
e fe
m al
e sa
m p le
p ar
ti ci
p at
e d
in co
n ju
ga l vi
si ts
P ar
ti ci
p at
io n
in co
n ju
ga l vi
si ts
d o e s
n o t
h av
e a
si gn
if ic
an t
im p ac
t o n
p e rp
e tr
at io
n o f th
re at
s o f vi
o le
n ce
o r
ac tu
al vi
o le
n ce
to w
ar d
o th
e r
p ri
so n e rs
C S co
re 1 2
R e se
ar ch
q u e st
io n
3 B al
e s
an d
M e ar
s (2
0 0 8 )
T o
p ro
vi d e
su p p o rt
fo r
th e
as su
m p ti o n
th at
so ci
al ti e s
re d u ce
re ci
d iv
is m
th ro
u gh
te st
in g
th e
im p ac
t o f p ri
so n
vi si
ts o n
2 -y
e ar
re ci
d iv
is m
ra te
s
V is it s:
o ff ic
ia l d at
a 1 . O
n e
o r
m o re
in 1 2
m o n th
s p ri
o r
to re
le as
e 2 . F re
q u e n cy
in 1 2
m o n th
s p ri
o r
to re
le as
e 3 . S e ve
n ca
te go
ri e s
o f vi
si to
r ty
p e
4 .V
is it s
in m
o n th
p ri
o r
to re
le as
e re
ce iv
e d
h ig
h e r
w e ig
h ti n g
R ec
id iv is m
: re
co n vi
ct io
n fo
r o ff e n se
co m
m it te
d w
it h in
a fo
llo w
-u p
p e ri
o d
o f 2
ye ar
s p o st
re le
as e
n ¼
7 ,0
0 0
p ri
so n e rs
o f b o th
ge n d e rs
(p re
d o m
in an
tl y
m al
e )
re le
as e d
fr o m
p ri
so n s
in F lo
ri d a,
N o rt
h A
m e ri
ca , b e tw
e e n
N o ve
m b e r
2 0 0 1
an d
M ar
ch 2 0 0 2
M e an
ag e : 3 4 .5
P ri
so n e rs
w h o
w e re
vi si
te d
h ad
3 0 .7
% lo
w e r
o d d s
fo r
re ci
d iv
is m
th an
th o se
w h o
w e re
n o t
vi si
te d
F o r
e ac
h ad
d it io
n al
vi si
t, th
e o d d s
w e re
lo w
e re
d b y
3 .8
% F o r
e ac
h ad
d it io
n al
m o n th
vi si
te d
th e
o d d s
lo w
e r
b y
4 .8
% T
h o se
w h o
re ce
iv e d
vi si
ts b u t
d id
re -o
ff e n d
su rv
iv e d
lo n ge
r in
th e
co m
m u n it y
co m
p ar
e d
to th
o se
w h o
d id
n o t
re ce
iv e
vi si
ts H
ig h e r
fr e q u e n cy
o f sp
o u sa
l vi
si ts
w as
as so
ci at
e d
w it h
lo w
e r
re ci
d iv
is m
H ig
h e r
fr e q u e n cy
o f ch
ild vi
si ts
w as
as so
ci at
e d
w it h
h ig
h e r
re ci
d iv
is m
V is
it s
cl o se
r to
re le
as e
lo w
e re
d th
e lik
e lih
o o d
o f re
ci d iv
is m
fu rt
h e r
T h e se
e ff e ct
s w
e re
se e n
fo r
m e n
b u t
n o t
w o m
e n
an d
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192
substances. The detailed results included confidence intervals.
The authors addressed each hypothesis and explained the
results with all outcomes considered and explored. They
reported clearly on the limitations of the study. This study pro-
vides reliable evidence that prison visits affect well-being in a
positive manner.
Poehlmann (2005). This study attempted to determine whether early and current relationship disconnection is associated with
maternal depression. The participants were 94 mothers aged
between 19 and 44 years, from one female prison in North
America. The authors considered differences in the groups for
age, recency of sentence, and distance to travel for visits, with
none found. Self-report of face-to-face visits in the last 2
months identified type and frequency of contact. Assessment
through the Center for Epidemiological Studies—Depression
Scale (Radloff, 1977) provided level of depression. The results
of the multiple regression analysis demonstrated a relationship
between early relationship disconnection and depression,
which accounted for 6% of the variance. Fewer face-to-face visits with children related to an increase in depression, which
additionally accounted for 5% of the variance. This study scored 15. Although the complicated hypotheses
required simplifying, they were measurable. The participant
group was appropriate and comparison achieved effectively
within the sample. Data collection used the same source and the
same period for each participant. Data were collected regularly
and were current for all measures apart from past trauma. Con-
sideration was given to some controlling variables. However,
as with the previous study, the authors did not account for other
factors that may affect depression. More positively, the results
were robust and presented in detail. The authors explored all
the results reporting on and explaining each hypothesis and
considering all outcomes. This study further supports the view
that prison visits affect well-being in a positive manner.
Houck and Loper (2002). This study examined stress related to parenting among a sample of female prisoners and to determine
whether differences in the amount of parenting stress predicted
prison adjustment. The sample included 362 mothers aged
between 19 and 59 years, recruited from one prison in North
America. Frequency of visits was taken from self-report over
the last year. The authors used an adaptation of the Parenting
Stress Index (PSI; Abidin, 1995), adding visitation stress as a
7-item scale, validated prior to use (a ¼ .76). It measured dis- comfort felt by mothers regarding visit procedures and con-
straints. The depression, anxiety, somatization, and global
scales of the Brief Symptom Inventory (BSI; Derogotis,
1993) measured adjustment.
The authors added being part of a minority group as a cov-
ariate to the subsequent analysis when initial analysis sug-
gested that this affected the results. Analysis of individual
beta weights for each regression analysis indicated that parent-
ing stress concerning visitation was associated with elevated
anxiety. Visitation stress (measured through the 7-item scale)
was also associated with the global score on the BSI, suggest-
ing overall emotional adjustment difficulties.
This study scored 13. The researchers defined a clear
research question and measurable hypotheses. They attempted
to quantify relationships between stress and adjustment. How-
ever, in terms of this review’s research question, visits were not
well defined. Nevertheless, the participant group was appropri-
ate and comparison achieved effectively within the sample.
The authors compared norms for the general and psychiatric
populations. They collected data from the same source and
within the same period for each participant, although some par-
ticipants completed the questionnaires alone. The information
provided to participants would not have made the expected out-
comes obvious to them; however, introducing the incentive of
‘‘soda and cookies’’ may have introduced bias related to moti-
vation to fully engage.
The authors presented the results of multiple regression
analysis clearly and in detail. They explained the process of
attaining the results in a clear systematic manner. The strength
of this study was that the researchers created a measure related
to visitation stress that they developed from talking to the
prison population prior to its use in this study. Participants
involved in development of the measure were not involved in
this study. The authors were thorough in exploring the limita-
tions of the study and considering a number of variables that
may have influenced the results. The authors considered a num-
ber of options for the meaning of their findings and suggested
future research. They considered services that may help parti-
cipants in terms of their mental health issues. This study sug-
gested that prison visits affect well-being in a negative
manner for some women, as they add to adjustment difficulties
in the prison environment.
Tuerk and Loper (2006). This study explored the association between parental stress and the amount of prior contact, as well
as the type and frequency of current contact between incarcer-
ated children and their mothers. The sample included 357
mothers aged between 18 and 50 years, recruited as part of a
larger study in one prison in North America. Factors such as
age, age of the child, and criminal history were included in the
analysis. Self-report of face-to-face visits in the last year pro-
vided type and frequency of contact. The PSI for Incarcerated
Women (PSI-IW; Houck & Loper, 2002) determined levels of
stress. The variable of interest for this review, increased visits,
was not significantly associated with parental stress.
This study scored 11. The researchers had defined a research
question, but the results did not fully answer it. The hypotheses
required simplification; however, they were measurable
hypotheses. They attempted to quantify relationships between
parental stress and prison contact, but this was inconsistent.
Nevertheless, the participant group was appropriate. The
authors collected data from the same source and within the
same period for each participant, and the participants were part
of a larger study and blind to the purpose of the research. The
authors considered some controlling variables. However, they
did not account for other factors that may affect stress such
De Claire and Dixon 193
as victimization within the environment. This study suggested
that prison visits have no effect on well-being. However, con-
cerns over the quality of this study limit the value of the
findings.
Studies excluded post full review stage. Two further studies could have been included in this review, but on further analysis, they
did not explicitly state that the visits received were from fam-
ily. Pinese, Furegato, and Santos (2010) provided a medium
quality study with females incarcerated in Brazil. The results
of the analysis demonstrated a relationship between the
absence of visits and severe depression. The second study, by
Wooldredge (1999), was one of the few papers that considered
well-being in relation to adult males in prison. They identified a
significant relationship between prisoner well-being and
increased numbers of visits. However, there were many limita-
tions to this study. For example, the measurement strategies
were weak; there was no attempt to measure the number of vis-
its. The study was also reliant upon self-report using a question-
naire that prisoners with low reading skills could not complete.
Research Question 2: Do Visits Improve Prisoners’ Rule-breaking Behavior?
Jiang and Winfree (2006). This study attempted to provide quan- titative data to explore the differences between social support
for male and female prisoners and the impact this had upon rule
breaking within the prison environment. The authors conducted
interviews to collect data on internal and external social sup-
port. About 12,269 male and 3,116 female prisoners were cho-
sen from a stratified sample taken from 275 separate prisons.
About 1,100 prisoners refused to participate, resulting in over
14,000 participants.
Archived data for the prisoners who agreed to take part in a
nationwide study in the United States provided prison rule-
breaking behavior. The researchers hypothesized that social
support would affect rule-breaking behavior and that the effect
of social support would vary by gender. Visits by children were
one measure of social support. The study controlled for age,
race, criminal history, length of sentence, and drug use. Many
of the results were positive. However, in terms of visits from
children, the variable of interest in this review, there was no
significant impact upon prison behavior.
With regard to the quality appraisal tool, this study scored
17 and was rated at Level A ‘‘all or most of the criteria have
been met and if not the areas that have not been met would not
alter the conclusion significantly.’’ The researchers had defined
a clear research question and developed measurable hypoth-
eses. They attempted to quantify relationships between ele-
ments of social support and rule-breaking behavior. The
participant group was appropriate and the development of the
sample well constructed, achieving comparison effectively
within the sample. The authors collected data from the same
source for each participant, and all available participants within
a period were asked to participate resulting in a very large
cohort. Controlling variables were considered and included in
the analysis, and results for different groups reported sepa-
rately. A regression model generated robust and meaningful
results as a percentage of change on rule-breaking behavior.
The study reported on and explained each hypothesis consider-
ing and exploring the results. This study suggested that prison
visits have no effect on rule-breaking behavior within the
prison environment.
Siennick, Mears, and Bales (2013). This study attempted to exam- ine the effect of prison visitation on the probability of disciplin-
ary infractions. The study considered the anticipatory effects of
visits; whether the effects were dependent on the visitor, the
type of infraction, and the frequency of visits. The design was
a cohort study that was part of a larger longitudinal study. A
comparison of relationships between visits and prison infrac-
tions was extracted from using a within-subjects design. The
archived information for all 7,000 prisoners released from pris-
ons in Florida during a 5-month period provided the data.
Logistic regression analysis suggested that the odds of an
infraction are significantly lower in the 3 weeks prior to a visit
and significantly higher in the 4 weeks immediately following
a visit. Prisoners’ previsit infraction rate was significantly
lower than their usual risk, and the postvisit infraction rate was
significantly higher than their usual risk. Risk declined in the 3
weeks leading up to a visit, and just before the visit, it is 48% lower than baseline probability. In the week after the visit, it
was 58% above the baseline. It then declined to base rate 6 weeks after the visit.
Contraband infraction showed the greatest proportional
change in probability surrounding visits—77% lower the week before and 130% higher the week after. The proportional change in probability is smallest for defiance—36% lower the week before and 43% higher the week after. Proportional changes in violence and supervision are in between. Overall
visits alter trends in multiple forms of misconduct in similar
ways with effects strongest for contraband. Those visited by
spouses had the lowest overall infraction level, but the greatest
change pre and post visit, relatives had the second greatest
effect on change and friends the least. Frequently visited pris-
oners had a lower base rate for infractions than typically visited
prisoners did. When frequently visited prisoners went longer
between visits, their risk of infraction increased significantly.
This study scored 16 on the quality assessment instrument.
The researchers had defined a clear research question and
developed measurable hypotheses. They attempted to quantify
relationships between visits and infractions achieving compar-
ison within the sample, which effectively provided its own con-
trol. The study collected data from the same source for each
participant and from all available participants within a period.
Data collection period and follow-up period were the same. A
range of controlling variables, such as age, sex, prior criminal
history, and length of sentence, were included in the analysis.
The odds ratio results were robust and meaningful, measured
at an a level of .05 or less. Each hypothesis was tested and explained in the results and with all outcomes considered and
explored. However, there was no differentiation between
194 TRAUMA, VIOLENCE, & ABUSE 18(2)
results for each gender group. This study provided reliable evi-
dence that prison visits reduce rule breaking within the prison
environment.
Cochran (2012). This study examined the relationship between prison visitation and misconduct events. The study developed
a dual trajectory model for visitation and misconduct. The
design was a cohort study that was part of a larger longitudinal
study. The author conducted a comparison of relationships
between visits and misconduct using the archived information
of 2,070 prisoners incarcerated in prisons in Florida during a
12-month period. They then employed dual trajectory analysis
to test the relationships between groups.
Most prisoners did not engage in misconduct; however, the
prisoners who did not receive visits had a lower probability of
no misconduct (66.8%). The authors concluded that nonvisited compared to visited prisoners are more likely to misbehave in
prison. In particular, approximately 28% of nonvisited inmates fell in the low misconduct trajectory, compared to 21% of early visited inmates and late visited inmates and 23% of the consis- tently visited inmates. The nonvisited prisoners were more
likely to be in the high misconduct group (5.6%). Interestingly, the early visited prisoners were even more likely to be in this
group (8.1%), while the late and consistently visited prisoners essentially were never in the high misconduct group.
This study scored 16 on the quality assessment instrument.
The researchers defined a clear research question. They quan-
tified relationships between visits and misconduct, achieving
comparison within the sample, which effectively provided its
own control. The study collected data from the same source for
each participant and from all available participants within a set
time period. Data collection period and follow-up period were
the same. A range of controlling variables, such as age, sex,
prior criminal history, and length of sentence, were included
in the analysis. The odds ratio results were robust and meaning-
ful. This study provided reliable evidence that prison visits
reduce rule breaking within the prison environment.
Jiang, Fisher-Giorlando, and Mo (2005). This study attempted to provide quantitative data to explore the effect of social support
on rule breaking within the prison environment, with visits by
children as one measure of social support. Sampling, data col-
lection, and control variables were the same as those employed
by Jiang and Winfree (2006). Exclusion of participants without
children and those sentenced to life resulted in over 9,000 par-
ticipants. The researchers hypothesized that social support
would affect rule-breaking behavior. There were three cate-
gories of rule-breaking behavior considered: overall rule viola-
tions per month, violent rule violations per month, and drug
property rule violations per month. Visits by children were one
measure of social support.
Many of the results of the regression analysis were positive.
The significant results (ranging between p < .05 and p < .001)
for external social support were that married prisoners were
14% less likely to engage in overall rule-breaking behavior.
Those who received visits from children were more likely to
engage in drug and property rule-breaking behavior.
This study scored 15. The researchers defined a clear
research question and developed measurable hypotheses. They
attempted to quantify relationships between visits and rule-
breaking behavior. The participant group was appropriate and
the development of the sample well constructed, with compar-
ison achieved effectively within the sample and controlling
variables considered. The study collected data from the same
source for each participant. However, the authors did not
explain some of the exclusion criteria. The results showed sig-
nificant differences between rule-breaking behaviors when dif-
ferent variables applied. However, there was no differentiation
between results for each gender group, which limited the mean-
ing of the findings. This study provided evidence that prison
visits, specifically from children, can increase rule breaking
within the prison environment.
Hensley, Koscheski, and Tewksbury (2002). This study attempted to explore the relationship between threatened and actual vio-
lence and conjugal visits. The authors collected data from
256 male and female prisoners who volunteered to take part
from two prisons in Mississippi; they asked all the prisoners
in randomly selected units to take part. The response rate for
men was 30% and for women was 33%. The study considered two research questions: Do those who in engage in conjugal vis-
its have lower levels of threats of violence? and do those who
engage in conjugal visits have lower levels of actual violence?
The results of multiple regression analysis suggested that
those prisoners who engaged in conjugal visits did not differ
significantly from those who did not on their self-reported
threats of violence and actual violence.
This study scored 12. The researchers had defined a clear
research question and developed measurable hypotheses. They
attempted to quantify relationships between conjugal visits and
violence in the prison environment. However, the measurement
strategies were weak—there was no attempt to measure the
number of conjugal visits or the length of time participants had
been engaged in the program. The study was reliant upon self-
report for violence, and the questions asked did not capture
low-level violent acts. Sexual assault was also included, but
this was only one question and did not differentiate between
behaviors. The self-selected sample was small compared to the
population and differed from the general population. The dif-
ferences between those who engaged in visits and those who
did not could have accounted for the results. More positively,
the authors of the study recognized the limitations of the study,
presented the findings appropriately, and labeled the study as
exploratory. This study suggested that prison visits have no
effect on rule breaking within the prison environment, but qual-
ity concerns limit the value of the findings.
Research Question 3: Do Visits Reduce Recidivism?
Bales and Mears (2008). This study attempted to provide support for the assumption that social ties reduce recidivism, through
De Claire and Dixon 195
testing the effect of prison visits on 2-year recidivism rates. The
authors collected data from archived information for all 7,000
prisoners released from prisons in Florida during a 4-month
period. The study explored eight hypotheses that considered
a combination of the following ideas: Prisoners visited in the
previous 12 months were less likely to be reconvicted;
increased frequency of visits lowered or delayed recidivism;
visits from family, and most specifically a spouse, lowered or
delayed recidivism; visits closer to release were more benefi-
cial; and effects would differ dependent on the characteristics
of each prisoner. These characteristics were included as con-
trolling variables in the analyses.
The results of logistic regression suggested that those pris-
oners who received visits had 30.7% lower odds for recidivism than those who did not. For each additional visit that took
place, the odds lowered by 3.8% on average, although the effects of the first visits were higher. For each additional month
that visits were received, the odds lowered by 4.8%. Survival curves show that those who received visits but did re-offend
survived longer in the community prior to re-offending com-
pared to those who did not receive visits. When exploring the
differences between who visited and recidivism, the higher fre-
quency of spousal visits was associated with lower recidivism.
The higher frequency of child visits was associated with higher
recidivism, a result the researchers did not anticipate. As they
anticipated, visits closer to release lowered the likelihood of
recidivism further. These effects applied to men but not women
and were not significant for White men; also factors that were
not anticipated.
This study scored 17. The researchers defined a clear research
question and developed measurable hypotheses. They attempted
to quantify relationships between visits and recidivism, achiev-
ing comparison within the sample, which effectively provided its
own control. They collected data from the same source for each
participant and from all available participants within the period.
Data collection period and follow-up period were the same. A
range of controlling variables, namely, age, sex, prior criminal
history, and length of sentence, were included in the analysis.
The study presented the results as odds ratios and survival
curves. Results were robust and meaningful, at p < .05 and often
p < .01 or p < .001. The authors reported on each hypothesis
explaining the results and considering all outcomes. This study
provided reliable evidence that prison visits reduce recidivism.
Discussion
This review set out to evaluate the available literature and deter-
mine systematically the effects of prison visits on several offen-
der outcome variables, namely, well-being, prison rule breaking,
and recidivism. Together, the results of the studies scrutinized
found visits had significant positive effects on well-being and
recidivism. Prison visits reduced depressive symptoms in
women and adolescent prisoners, reduced recidivism, and
increased survival to re-offense in the community. Prison visits
had both positive and negative effects on rule breaking. How-
ever, the strength of conclusions drawn for the different outcome
variables varied due to the quality of the studies available for
review, the variability of the measures used, and the lack of spe-
cific research in each area. The following provides a brief sum-
mary of findings and implications for practice and policy.
Do Prison Visits Improve Prisoners’ Well-Being?
Four studies related to this specific research question. One
explored the relationships between visits from children and
depression, and the other explored child visits and stress in incar-
cerated mothers. Poehlmann (2005) found that those receiving
fewer visits from their children had significantly higher levels
of depression. Because this study is rated medium quality, scor-
ing 15, the finding that visits from children reduce women’s
depression in the prison environment can be viewed with some
confidence. In terms of stress, Houck and Loper (2002) found
that for some mothers receiving visits from children increased
their stress and anxiety, which affected their adjustment to the
prison environment. To the contrary, Tuerk and Loper (2006)
failed to support a relationship between visits and reduced par-
ental stress, while finding contact via letters did reduce stress.
Letter writing may reduce stress by allowing contact in an indi-
rect way, thus negating any parental stress caused by children
entering the prison environment. Relying on the results of this
study requires caution, as it was rated low quality. Nevertheless,
this conflicting evidence suggests that the effect of children’s
visits on stress is an important area for clarification.
One study showed that prison visits moderate the negative
effects of incarceration on depression for adolescents, improv-
ing their well-being within the prison environment. Monahan
et al. (2011) found that male adolescents receiving more visits
from their parents experienced a significantly quicker reduc-
tion in depressive symptoms than those who did not. Further,
when those relationships were of a higher quality, the adoles-
cents had significantly fewer symptoms of depression. While
only one study considered this, it is high quality resulting in
some confidence in the results.
Two studies could not be included; however, as they did not
explicitly state that the visits were from family members. Pinese
et al. (2010) provided further international support for the
research of Poehlmann (2005) that severe depression was signif-
icantly associated with mothers not receiving visits from their
children. Wooldredge (1999) explored the underresearched rela-
tionship between well-being and visits in male prisoners, but
several factors reduced the reliability of this study leaving the
effect of visits on male well-being unanswered.
Do Visits Reduce Prisoners’ Rule-Breaking Behavior?
Five studies explored the effects of visits on rule breaking in
prison. Jiang et al. (2005) considered the impact of visits by
prisoners’ children on rule-breaking behavior. In a follow-up
study, Jiang and Winfree (2006) considered the differential
impact on male and female prisoners. Siennick et al. (2013) and
Cochran (2012) considered the relationship between visits and
infractions, while Hensley et al. (2002) concluded that conjugal
196 TRAUMA, VIOLENCE, & ABUSE 18(2)
visits had no effect on prisoners’ violent behavior, although the
study was rated low quality. Although Cochran (2012) identi-
fied that prisoners who received visits had lower rates of mis-
conduct compared to prisoners who received early visits that
later reduced in number, more nuanced research identified
subtle differences when the relationship of the visitor was taken
into account. Prisoners receiving visits from their children were
significantly more likely to engage in drug- and property-
related rule breaking (Jiang et al., 2005). This result was coun-
terintuitive and may be related to increased visits providing
more opportunity to bring contraband into prisons, a factor
uncontrolled for in the study. Face-to-face visits between prison-
ers and their children do not provide protection from rule-
breaking behavior. Telephone calls, however, do appear to be
beneficial (Jiang et al., 2005; Jiang & Winfree, 2006), a finding
consistent with Poehlmann’s (2005) previous finding that rela-
tionship quality improves via contact through telephone calls.
The interpretation of these results can be made with a degree
of confidence due to their moderate to high-quality rating. The
study by Siennick et al. (2013), rated with the highest quality
score, did show an impact of visits on reduced rule-breaking
behavior, with those visited by spouses and those visited more
frequently having the least infractions. However, they also
revealed fluctuations in rule-breaking behavior, with reductions
before visits and increases after visits. Once again, the available
number of studies of high quality limits the confidence in con-
clusions that can be drawn from research in this area.
Do Visits Reduce Recidivism?
Only one high-quality study, by Bales and Mears (2008),
attempted to address this question. Generally, reconviction
research is difficult to conduct, as many confounding variables
are likely to affect the link between any one factor and recidi-
vism. This research attempted to account for these variables
and provided robust evidence to support the idea that an
increase in prison visits predicts a reduction in reconviction.
The results show that those prisoners who were visited had sig-
nificantly lower recidivism rates and lived longer in the com-
munity without re-offending than those who were not visited.
Further, as the number of visits increased, the likelihood of
recidivism significantly reduced. These results were not consis-
tent for all types of visits and prisoner. The number of visits
could not be isolated as a predictive factor for women’s recon-
viction. Visits from partners reduced recidivism for men, while
visits from children heightened the risk of recidivism for
fathers. Overall, visits appeared positive in terms of a reduction
in recidivism. However, these results may reflect only the
strength of the interpersonal relationships, with visits being one
measure of that. The researchers considered and ran a number
of controls for this but remained comfortable with their finding
that visits were a specific factor in their own right, as marriage
did not affect findings and relationships are also unlikely to
remain unchanged throughout a period of incarceration. The
findings of this study are robust, but the lack of other studies
in this area limits the ability to generalize conclusions.
Limitations of the Examined Studies
Many of the examined studies had sample limitations, which con-
founded the outcomes, creating difficulties generalizing results to
the wider population. The reviewed research only considered het-
erosexual intimate relationships. The participants were not con-
sistently the same age or sex. Only one study excluded because
it did not explicitly state that the visits were from family members,
and which had many methodological limitations, considered
well-being in relation to adult males in prison.
Methodological differences between the studies are likely to
account for the range of results reported. The main differences
noted were the definitions of variables measured and the tools
of measurement used. For example, ‘‘prison visits’’ is not in
itself a unified concept. Who visits, the type of visit, and the
length and frequency of visit were not consistent across the
studies. The studies chosen did not use the same measurement
methods, apart from two that considered depression. However,
these studies did not analyze the data in the same way.
Limitations of This Review
There were also limitations to the methodology used in this
review. In order to ensure the research included is ethically
sound only peer-reviewed papers were included, possibly limit-
ing its range. The reliability of the review findings is problematic
due to the limited number of studies included and the variety of
outcomes being measured; hence, the original research questions
cannot be answered with authority. Nonetheless, the findings of
this review are important because they highlight the need for
more high-quality research exploring the impact of prison visits
on well-being, prison rule breaking, and recidivism before firm
conclusions can be drawn and used to steer policy and practice.
Implications for Future Research
The review identified a number of areas that warrant future
research. Significantly, the relationship of visits to suicide and
self-harm could not be addressed in this review as no relevant
studies were identified. Future research exploring the effect of
prison visits on adult males’ depressive symptoms, self-harm,
and suicidal ideation may be useful considering men form the
largest incarcerated population.
There were a number of areas of conflicting evidence
throughout this review, notably the effect of children’s visits
on parental stress and rule-breaking behaviors. These are
important areas of clarification for men and women. The explo-
ration of rule breaking may benefit from more research that
considers different types of rule breaking and contact.
What happens during a visit is an interesting area to explore
further, as this may provide an insight into the conflicting
results. Fathers’ increased recidivism related to increased visits
from their children may be explained by a lack of shame related
to imprisonment. In other words, it is likely that this research
question results in a select sample of fathers for whom offend-
ing is a lifestyle, accepted by the family, who are more at risk of
De Claire and Dixon 197
recidivism than men who do not have this level of family
acceptance of criminality and imprisonment. To the contrary,
the evidence that visits from intimate partners reduces; recidi-
vism may be facilitated via the positive effects of relationship
bonds (Sampson et al., 2006). Visits maintain social obliga-
tions, self-identity associated with a relationship, and they
maintain a prisoner’s connection to their partner weakening the
influence of antisocial peers and allowing female partners to
continue to influence the prisoner’s behavior. However, these
results do not demonstrate effects for female prisoners, and
these sex differences require further exploration.
Implications for Practice and Policy
This review supports previous research and reviews that suggest
prison visits have positive effects on well-being and offending
behavior internationally. The results suggest that one promising
avenue would be for governmental and prison policy to support
prisoners receiving family visits. Indeed, this would seem a sim-
ple, cost effective, and fruitful step toward achieving goals set by
U.K. policy to reduce offending (Ministry of Justice, 2013).
Findings highlighted the importance of sex differences.
Prison visits were not associated with a reduction in women’s
recidivism in contrast to men’s recidivism. Furthermore, studies
suggested improvements in prisoner well-being for women who
received visits from their children, while it increased recidivism
for men who received children’s visits. This is significant to
practice, as it suggests clinicians and professionals should con-
sider sex-specific factors in the development of official policy
and practice. However, as the evidence related to recidivism was
limited to one study, the results are too preliminary for action but
rather flag the need to investigate these issues further.
Considering the findings related to children, special consid-
eration given to the benefits of helping prisoners manage their
visits with children is likely to be effective. This corroborates
the view of Poehlmann et al. (2010), who found that visits were
associated with positive outcomes for the child when the visits
occurred as part of an intervention, but negative outcomes
when the visits were not part of an intervention, thus highlight-
ing the need for well-structured and supported visits. Finally,
the review shows that those working with adolescents should
recognize that visits from parents are critical to the well-
being of young prisoners. The effects do not appear to be only
as a result of existing ‘‘good’’ parent–child relationships.
Sometimes, the view among professionals is that relationships
between young prisoners and their parents that are judged poor
quality should not be encouraged. However, in terms of well-
being, this review shows that adolescents can benefit from par-
ental visits irrespective of the quality of the relationship.
Conclusion
In summary, this review highlights the promising effects of
prison visits on a range of important variables related to pris-
oner well-being and offending behavior. The limited studies
and their range of quality suggest that future research is needed
to create a reliable evidence base from which sound policy and
practice can be derived. This point is supported by a recent
paper by Cochran and Mears (2013) that considered the ele-
ments required to develop a theoretical framework for prison
visits to support the guidance and assessment of research in this
area. This review recommends that future research should use
reliable outcome measures, control for confounding variables
where possible, use country-specific populations to inform
local policy, and investigate why specific types of visits have
different outcomes for prisoners.
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, author-
ship, and/or publication of this article.
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Author Biographies
Karen De Claire, DForen.Psy, is a practicing forensic psychologist
who has specialized in assessment and intervention with violent and
sexual offenders for 13 years. She is a psychologist in Forensic Psy-
chological Services, National Offender Management Service in Wales
with responsibility for supporting the Regional Psychologist to
develop and manage the service and the skills of the psychology team.
She is also an associate tutor with Cardiff Metropolitan University
with responsibility for supervising a number of trainee forensic psy-
chologists toward qualification.
Louise Dixon, PhD, is an academic and Forensic Psychologist who has
specialized in the prevention of violence for 15 years. She is a senior
lecturer at the Centre for Forensic and Criminological Psychology at the
University of Birmingham where she enjoys an active research profile.
She is currently working on an ESRC-funded project that aims to
explore the effects of prison visits on re-offending in the United King-
dom. She is the chair of the West Midlands branch of the national orga-
nization British Association for the Study and Prevention of Child
Abuse and Neglect (BASPCAN) and is on the Editorial board of Child
Maltreatment and Journal of Forensic Practice. Her coedited book series
on ‘‘What works in offender rehabilitation’’ was launched in 2013.
De Claire and Dixon 199
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