Exploring the Utilization of Structural and Medical Family Therapy With an Incarcerated Mother Living With HIV

• DOI: 10.1177/0306624X18821825
• Date: 01 March 2019
• Author: Eman Tadros,Natasha Finney
• Published date: 01 March 2019
• Subject Matter: Articles

https://doi.org/10.1177/0306624X18821825

International Journal of

Offender Therapy and

Comparative Criminology

2019, Vol. 63(4) 624 –640

© The Author(s) 2019

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DOI: 10.1177/0306624X18821825

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Original Manuscript

Exploring the Utilization of

Structural and Medical Family

Therapy With an Incarcerated

Mother Living With HIV

Eman Tadros1 and Natasha Finney1

Abstract

The incarcerated population is considered an underserved population, specifically in

regard to their ability to access and receive mental health services. There is a gap

in existing literature addressing the mental health needs of incarcerated individuals

who also suffer from chronic illnesses. The purpose of this case study is to provide

an exploration of how medical family therapy and structural family therapy can be

integrated to inform the treatment of incarcerated individuals and their families

who are experiencing a physical health illness. A case application will be provided to

highlight how the integrated approach can be utilized to conceptualize and treat those

incarcerated and their families. Treatment was shown to be effective as evidenced by

the outcomes of an incarcerated mother with HIV and her daughter.

Keywords

HIV, family therapy, incarceration, medical family therapy, structural family therapy

Introduction

Life While Incarcerated

By the end of 2014, an estimated 1.56 million Americans were incarcerated (Carson,

2015; Schelbe et al., 2018). Incarceration does not solely affect the individual behind

bars, but the entire family system as a unit. Studies have shown that incarcerated moth-

ers with a lack of contact with their children yield negative outcomes in regard to poor

mental and physical health (Foster, 2012). Children of incarcerated mothers are likely

1The University of Akron, OH, USA

Corresponding Author:

Eman Tadros, The University of Akron, 27 S. Forge St., Akron, OH 44325, USA.

Email: emantadros@gmail.com

821825IJOXXX10.1177/0306624X18821825International Journal of Offender Therapy and Comparative CriminologyTadros and Finney

research-article2019

Tadros and Finney 625

to live with a grandparent, with other relative, or in foster care rather than with the

other biological parent (Arditti, 2015).

In addition, having an incarcerated mother increases the likelihood of dropping

out of school, antisocial behavior, and intergenerational incarceration (Arditti,

2015; Dallaire, 2007; Huebner & Gustafson, 2007; Phillips, Burns, Wagner, Kramer,

& Robbins, 2002). Cho (2009) conducted the study “Impact of Maternal

Imprisonment on Children’s Probability of Grade Retention” which found that chil-

dren show a decrease in retention rates subsequent to their mother’s arrival to the

facility. The effects of an incarcerated child may not be outwardly stated; in fact,

they can be extremely resilient and well-adjusted. Ironically, the more disadvan-

taged a child is, the more likely they are to be perceived as “least affected” (Arditti,

2015). However, this does not excuse professionals to cease taking action to help

them, especially if the family is of an ethnic minority or of a low socioeconomic

status (SES) (Arditti, 2015; Rutter, 1987; Seccombe, 2002).

“Strong social networks and a high level of ‘social capital’ are essential for female

offenders to reintegrate successfully” (Collica-Cox, 2018; Reisig, Holtfreter, &

Morash, 2002; Rocque, Bierie, Posick, & Mackenzie, 2013, p. 525). Communication

between incarcerated individuals and their families have been shown to maintain or

improve their relationships while incarcerated (Song, Woo, Lee, & Cochran, 2018).

Family therapy services in this setting would ameliorate reintegration into the family’s

structure (Datchi, Barretti, & Thompson, 2016). A systematic literature review showed

that all studies analyzed were able to show benefits of family interventions within this

population (Roberts et al., 2017). Despite these results, there have not been substantial

changes in family services availability or accessibility in these facilities (Roberts

et al., 2017).

In an incarcerated facility, there is not one sole solution, rather it is a collection

of knowledge shared throughout the professionals that can benefit this population

(Gee & Bertrand-Godfrey, 2014). Interestingly, it has been recommended that

incarcerated facilities are the perfect contexts for presenting preventive measures,

information, and psychoeducational services to individuals who may not have

received this valuable information in the community (Abiona, Balogun, Adefuye,

& Anguh, 2015).

Life While Incarcerated With HIV

The human immunodeficiency virus, largely known as HIV, is a virus that weakens an

individual’s immune system by eliminating cells that fight off disease and infection

(Centers for Disease Control and Prevention, 2018). Living with HIV has a plurality

of accompanying issues. Over 20,000 of all individuals with HIV who are receiving

care were recently incarcerated (Nasrullah, Frazier, Fagan, Hardnett, & Skarbinski,

2016). Higher rates of HIV were reported among ethnic minority in the incarcerated

system (Feaster et al., 2013). In addition, within this population of HIV positive, eth-

nic minorities, most were of a low SES (Feaster et al., 2013). Thus, it is particularly