1. Katelen Fortunati, LCSW Chestnut Health Systems
School Based Interventions for Children with Incarcerated Parents: Identifying and Treating Issues
Katelen Fortunati, LCSW
Amber Jennings, MA
Chestnut Health Systems
2015

2. Outline The Impact Characteristics of the Client
The Experiential Process
Categories and List of Treatment Areas
Scale and Treatment Plan
Therapeutic Messages and Themes
Overview of Intervention Programs
Change Maintenance

3. The Impact 2.7 million children nationwide Racial differences
Mother vs. father caregiving profiles
ACEs (
Long-term effects

4. Characteristics of the Client
Impact of trauma
Risks of parental incarceration
Economic
Family instability
Health disparities
Police/welfare contact
Child development
Case example

5. Ambiguous Loss
“…ambiguous loss is the most stressful kind of loss. It defies resolution and creates long-term confusion about who is in or out of a particular couple or family. With death, there is official certification of loss, and mourning rituals allow one to say goodbye. With ambiguous loss, none of these markers exist. The persisting ambiguity blocks cognition, coping, meaning-making and freezes the grief process.” (Boss, et al. 2003)

6. Types of AL Type 1: physical absence and psychological presence
Case example
Type 2: physical presence and psychological absence

7. Ambiguous Loss Characteristics of the construct Ambivalence
Traumatizing
Freezes the grief process
Closure improbable
Grieving the loss

8. Ambiguous Loss Core assumptions
Relational phenomena – not an individual condition
Positive psychology – assumed a natural resiliency
Occurs in multiple levels
Process occurs both linear & systemically  meta-recursive process

9. Ambiguous Boundaries Theoretical suggestions: (Boss, et al 2005)
Higher the boundary ambiguity in the family system, the higher the family stress and greater individual and family dysfunction.
If a high degree of family boundary ambiguity persists overtime, the family system will become highly stressed and subsequently dysfunctional.

10. Ambiguous Boundaries
Families with varying belief systems (e.g., mastery vs. fatalism) will differ in how they perceive their family boundaries, even after similar events of loss or separation.
The length of time a family will be able to tolerate a high degree of boundary ambiguity will be influenced by the family’s value orientation (e.g., mastery vs. fatalism).
The family’s perception (definition) of an event will be influenced by the larger community context.

11. Rando’s 6 “R” Process Model for Complicated Grief (Rando, 1993)
Avoidance phase
RECOGNIZE the loss
Confrontation phase
REACT emotionally to the separation
RECOLLECT and RE-EXPERIENCE the lost parent
Accommodation phase
RELINQUISH
READJUST to daily life
REINVEST or adopt new ways of being in the world
Meaning Reconstruction

12. Rando’s 6 “R” Process Model for Complicated Grief
Seek to provide new understanding of attachment (Klass et al, 1996)
Continued attachment does not equal unresolved grief
Disengagement and letting go of the past does not have to be a goal of grief
Enduring bonds can be healthy – they search for ways to maintain a connection
Each child’s response is unique
MEANING RECONSTRUCTION is the central process (Neimeyer, 2003)

13. Experiential Process Phases of Parental Incarceration
Initial Phase
Shock / confusion / avoidance
Need to recognize the loss
Denial
Need to recollect lost parent
Anger / Resentments
Need to react emotionally to the separation
Lower Level Acceptance / Accommodation
Realization of situation/family dysfunction
Need to relinquish and readjust

14. Experiential Process Phases
Advanced acceptance
Family member is working on own challenges
Letting go or forgiveness
Need to reinvest or adopt new ways of being
Possible re-unification of family unit
Restorative Justice
Parent takes responsibility
Parent apologizes

15. Variation of Individual Challenges
Vary depending upon the following factors:
Level of trauma
Level of attachment
Attitudes and core beliefs/schemas
Resiliency factors
Coping skills/self-regulation
Suppression/repression
Individual resources

16. List of Potential Challenges
Attachment separation/grieving issues:
Appears to be grieving the loss
Denial what happened
Acknowledges what happened, but emotionally negotiates
Harbors resentments and hostility
Feels abandoned
Hasn’t exhibited forgiveness
Doesn’t feel validated
Feelings of being loved and attachment with parent

17. List Of Potential Challenges
Attachment separation/grieving issues:
Emotionally refuses the reunification
Appears to blame self
Lacks friends (social networks)
Lacks a support system
Withdraws from people (isolates)
Appears depressed

18. List Of Potential Challenges
Regulations Skills
Anger management (has problems controlling temper)
Problem solving problems
Problems with coping skills
Goal setting problems

19. List Of Potential Challenges
Trauma Related Issues
Has anxiety and seems stressed
Traumatized (distressed about it)
Avoids conversations about the events
Appears in shock
Appears confused
Seems to dissociate (detach)
Has flashbacks
Appears easily startled
Can’t focus
Has nightmares/terrors

20. List Of Potential Challenges
Self Concept Related
Under plays strengths
Lacks confidence
Sense of identity
Doesn’t seem empowered
Insecurity/inferiority
Self-esteem (doesn’t feel good about self)
Self-worth (doesn’t seem to value self)
Doesn’t feel okay (adequate about self)
Personal hygiene issues

21. Therapeutic Messages and Themes
Key Therapeutic Messages
Core belief/schema
Empowerment
Sense of self–efficacy
Vision of hope
Acceptance of external realities

22. Therapeutic Messages and Themes
Key Treatment Themes
Understanding what happened
Dealing with shame and blame
Acknowledging trauma and grief
Dealing with feelings and managing anger
Building and reaffirming a positive identity
Building good relationships
Building good support systems
Planning for the future

23. Theoretical Assumptions
People have choices and are self-determined
All behavior has meaning
People have needs that can be met functionally or through dysfunction
Holistic view
The person consists of different experiential domains, including cognitive (thinking, beliefs), affective (emotions, feelings), behavioral, social, bio-physiological- body functions, spiritual, contextual (environmental, situational), senses.

24. Theoretical Assumptions
People can continuously learn.
People continuously change and develop.
Traumas can impact learning and development. Foundation disruption
Learning is complex, multi-leveled, and dimensional. A lot of learning involves “states.”
Change is creating a difference within functioning.

25. Dimensions of Self Multiple Experiential Domains of Self
Cognitive  thoughts, ideas, attitudes
Affective  emotions, moods, feelings
Behavioral  overt (motor) activities
Spiritual  connection to higher power/meaning
Biological-Physiological  organs, chemistry
Socially  attachment, relationships
Contextual  background, environmental
Sensory Modalities  perceptual modes
Core: Mind-Body Connection  Core Perceptual Belief System (State Dependent Memory Learning)

26. Holistic View: Mind-Body Connections
Social
Spiritual
Affective
Bio-Physio-logical
Behavioral
Contextual
Cognitive
Perceptual
Belief System
Mind- Body

27. Good Lives Model (Ward, 2002)
Fragmented/poor plan - leads to a chaotic meandering
Coherent plan - leads to a realistic plan tied to abilities, preferences, living environment.
In life - it is about how we meet our needs
People seem to fluctuate, however, the goal is to hopefully live mostly in a coherent life plan

28. Program Parameters: Manuals vs. Process
Programs need to be planned and documented via manuals
Manuals are the guidelines and program map
Therapist style  delivery of interventions and process variables account for large percent of successful outcome
Flexibility vs. rigidity
Common Factors – Dr. Sean Davis
Process is key
Experiential processes activated
Responsiveness

29. Key Factors in Successful Programs
Respect and Rapport
Therapeutic Connection
Hope
Encouragement
Directive – Structure and Guidance
Flexible with minimal chaos

30. Early Intervention with Children of Incarcerated Parents
Chestnut Recovery Values
Hope
Empowerment
Health and Wellness
Respect
Spirituality and Connectedness
Program Requirements
Comprehensive Services
Case Management (advocacy)
Therapy (individual, family, group)
Psychiatric Services
Caregiver Supports
Transportation
Grant Funded

31. Lutheran Social Services Curriculum: Session Structure
Psycho-educational group
CBT combined with positive psychology
Holistic approach
8 sessions
Currently piloted in a Chicago middle school

32. Sessions Dealing With Shame and Blame Acknowledging Trauma and Grief
Understanding What Happened
Instilling hope
Looking at the reality of the situation
Dealing With Shame and Blame
Bill of Rights
Ownership: Taking on the blame
Acknowledging Trauma and Grief
The impact
Identifying feelings
Grieving process of the loss and feelings

33. Sessions 4. Dealing with Feelings and Managing Anger
Identifying feelings
Range of feelings
The levels of feelings
5. Coping with Anger and Resentments
Managing anger
Coping skills
Letting go/ forgiveness
Coping with anger and resentments

34. Sessions 6. Building and Reaffirming a Positive Identity Feeling OK
Realizing and buying into the fact that “life isn’t fair but I’m OK.”
Using strengths
Building strengths
Affirmations
Validation

35. Sessions 7. Building Good Relationships and Good Support Systems
Respect self & others
Empathy
Boundaries
Developing good support systems
8. Planning for the Future
Instilling hope
Goal setting (immediate, medium, long range)
Realistic or not
Steps to complete goals
Keeping hope

36. Essentials of Change Maintenance
Change maintenance is based on a dynamic change process involving all experiential domains at varying levels
Self- determined
Restore and/or enhance resiliency
Coping skills
Reunification

37. Key Essential Elements
Change in core beliefs:
“Life isn’t fair but I’m ok”
“The past doesn’t control me, I control me”
“I’m ok and worthy”
“It is not my fault”
“I can do this”
Re-organizing the meaning of the experience into healthy/functional
Empowerment/mastery of problems
Acceptance of the situation for what it is
Normalizing the situational experience
Release of emotional energy and letting go of issues
Feeling connected to someone again

38. Concluding Thoughts
The impact of losing a parent to incarceration varies but is significant.
There is an experiential process - sometimes described as the ambiguous loss.
Treatment can be effective, thus reducing the impact.
Programs have been outlined, with clinical examples
Recovery is a dynamic process, often doesn’t follow a clean linear trajectory
There are key essential elements to the process of recovery (mastery, empowerment, letting go of issues, releasing energy,…)

39. Contact Katelen Fortunati, LCSW Amber Jennings, MA
Children’s book information
Amber Jennings, MA

40. References
Bender. J. M. (2010). My daddy is in jail: Story, Discussion Guide, & Small Group Activities for Grades K-5. Chapin, SC: Youthlight, Inc.
Boss, P., Greenberg, J. & Pearce-McCall, D. ( ). Measurement of Boundary Ambiguity in Families. Station Bulletin,
Boss, P., Beaulieu, L., Weiling, E., Turner, W. & LaCruz, S. (2003). Healing Loss, Ambiguity, and Trauma: A Community-Based Intervention with Families of Union Workers Missing After The 9/11 Attack in New York City. Journal of Marital and Family Therapy, 29,
Burgess, S.; Caselman, T.; & Carsey, J. (2009). Empowering: Children of Incarcerated Parents. Chapin, SC: YouthLight Inc.
Cassidy, J., Poehlmann, J., & Shaver, P. (2010). Introduction to the Special Issue: An attachment perspective on incarcerated parents and their children. Attachment & Human Development, 12,
Clopton, K. & East, K. (2008). “Are There Other Kids Like Me?” Children With a Parent in Prison. Early Childhood Education Journal, 36,
Dept. of social & Health Services, Washington State (Dec. 2009). A behavioral health toolkit for providers working w/children of the incarcerated & their families.
Geller, A., Garfinkel, I., Cooper, C., & Mincy, R. (2009). Parental Incarceration and Child Well-Being: Implications for Urban Families. Social Science Quarterly, 90.
Initiative Foundation (Date unknown) How to explain jails & prisons to children. Initiative Foundation, 405 1st dtreet SE, Little Falls, MN 56345,

41. References
Johnson, E. & Easterling, B. (2012). Understanding Unique effects of Parental Incarceration on Children: Challenges, Progress, and Recommendations. Journal of Marriage and Family, 74,
Klass, D., Silverman, P.R., & Nickman, S.L. (Eds.). (1996). Continuing Bonds. Philadelphia, PA: Taylor & Francis
Lander, I. Towards the Incorporation of Forgiveness Therapy in Healing the Complex Trauma of Parental Incarceration. Child Adolescent Social Work Journal, 29, 1-19.
McMurran, M. & Ward, T. (2004). Motivating offenders to change in therapy: An organizing framework. Legal & Criminological Psychology, 9,
Miller, K. (2006). The Impact of Parental Incarceration on Children: An Emerging Need for Effective Interventions. Child and Adolescent Social Work Journal, 23.
Neimeyer, R.A. (Ed.). (2003). Meaning Reconstruction & the Experience of Loss. Washington, DC: American Psychological Association
Newby, G. (2006). After Incarceration: Adolescent-Parent Reunification. The Prevention Researcher, 13.
Phillips, S. & Gates, T. (2011). A Conceptual Framework for Understanding the Stigmatization of Children of Incarcerated Parents. Journal of Children and Family Studies, 20,
Rando, T.A. (1993). Treatment of Complicated Mourning. Research Press
Reilly, K. (2013). Sesame Street Reaches Out to 2.7 million American Children With an Incarcerated Parent. Pew Research Center

42. References
Shlafer, R., Poehlmann, J., Coffino, B., & Hanneman, A. (2009). Mentoring Children with Incarcerated Parents: Implications for Research, Practice, and Policy. Family Relations, 58,
Sprenkle, D. H., Davis, S. D., & Lebow, J. L. (2009). Common factors in couple and family therapy: The overlooked foundation for effective practice. New York: Guilford Press.
Ward, T. (2002). Good lives & the rehabilitation of offenders: Promises & problems. Aggression & violent Behavior, 7,
Ward, T. (2002b).The management of risk and the design of good lives. Australian Psychologist, 37,