[00:00:00] Speaker A: The challenge is that many fathers, they don't fully utilize these opportunities to connect with their children and family members. And for those fathers, it's often the shame and guilt associated with incarceration. They try to hide their situation away from their children.
[00:00:22] Speaker B: Welcome to the Emerging Minds Podcast.
Hi, I'm Jackie Lee and you're listening to the Emerging Minds Podcast. We would like to pay our respects to the traditional custodians of the land on which this podcast is recorded, the Kaurna people of the Adelaide Plains. We also pay our respect to all Aboriginal and Torres Strait Islander peoples, their ancestors and elders, past, present and emerging from the different first nations across Australia.
In today's episode, we're joined by Lin Nguyen to explore the strategies she's found helpful in supporting incarcerated fathers to rebuild their relationships with their children. Lyn is a Senior practitioner, mental health counsellor and accredited mental health social worker with a focus on anger management, behavioural change and skills training. In her work with CentreCare Catholic Country SA, she uses a variety of evidence based and trauma focused practices to equip fathers with the tools to overcome physical, mental and emotional barriers to connection. Connection. Lynn, thank you so much for joining us today.
[00:01:27] Speaker A: Thanks Jackie and Emerging Minds for having me today.
[00:01:31] Speaker B: To begin, can you tell us a bit about your role and what drew you to this work?
[00:01:37] Speaker A: Sure.
My name is Linh Nguyen and I'm a mental health counselor at Central Care, Catholic Country South Australia.
My role involves providing mental health service to communities and also to incarcerated individuals within reasons across Senecare service areas which includes the Far north area and the Riverland regions. And my practice focuses on depression and anxiety, anger management and behavioral change.
I started working with individuals in brilliance about, let me think about three years ago.
What struck me quite early on was that I often see there's a very high disengagement rate in this population compared to the other client groups in the community.
And at the same time, this population often presents with a high degree of complexity, frequently with a history of childhood abuse and significant exposure to drugs and violence since childhood. And this contrasts the high level of need for mental health care alongside a very low level of engagement really prompted me to try to understand how we could make mental health service more effective and more accessible to people in prisons.
[00:03:06] Speaker B: I Read that in 2023 over 40,000 Australian children were estimated to have a parent in prison.
What impact does parental incarceration have on a child's mental health?
[00:03:20] Speaker A: So I haven't had the opportunity to work directly with family members of incarcerated parents, but there has been Some evidence from the research in Australia and also in the other countries that discuss the impact of parental imprisonment on children and on their family members.
For example, I have a report in here. It's in. In 2023, it was done by a group of researchers in Monash University.
They did a study of 80 families of imprisoned parents. They felt that the most significant impact on the children was emotional distress and the difficulty in building a secure relationship with the parents in prison. And we all know how crucial secure attachment is for healthy child development. One family reported their daughters cry every night for their dad. Or another family state that their daughter shows anger that her dad isn't at home and misses things sheep achieved. And these comments in this study are similar to what I often hear directly from the incarcerated fathers that I am working with. I remember one father who was jailed for drug related offense. He was terribly sad when his teenage daughter said to him in a phone call, like dad, next time make sure that you choose your children over drugs. And that comment really seemed to indicate a deep seated belief in the girl that she was not important enough for her father to make him overcome the drug issues.
And of course, I know that there are many families out there. They are doing an amazing job taking great care of their children despite one parent being in prison.
However, the insight about those children who are struggling with emotional distress and a lack of secure bonding with one parent in prison, it really highlights the need for strengthening those parent and child relationships from prison.
[00:05:38] Speaker B: Absolutely. And that example that you gave really highlights the complexity in those relationships as well.
So what are some of the common barriers to incarcerated fathers connecting with their children and kind of building those relationships?
[00:05:57] Speaker A: Well, I want to be clear that we're focusing specifically on situations where it's safe for children and families to have those contact with the imprisoned parents. So we won't be addressing the case where there are intervention orders in place prohibiting that contact.
And at the same time, we have to acknowledge that because of safety reasons, there are inherent physical barriers to parent and child interaction when a parent is in prison.
So face to face visits can be quite limited, particularly when fathers are imprisoned hundreds of k away from their families. And the most common ways to connect with families from prisons are phone call, video calls and letters. And all those methods of contact come with a set of restrictions.
For example, my clients in prison, they typically get a few opportunities for phone calls each day, but actually each call is limited to 10 minutes only and only available within very specific time. And they often have to wait in a long line with other Inmates who are still waiting and are watching them during the call, urging them to finish quickly. The challenge is that many fathers, they don't fully utilize these opportunities to connect with their children and family members, even though they dearly meet their families and they are permitted to have the contact.
And for those fathers, it's often about emotional barriers. And I see that a key and frequent emotional barrier is often the shame and guilt associated with with incarceration.
Many fathers, they try to hide their situation away from their children because they struggle when their children keep asking again and again about dad, where are you and when will you come home? And there's another common barrier.
It's the internal conflict between the pressure of showing a strong man image in prison, to hide any signs of weakness in prison, and the inner need to be vulnerable sometimes. I have one client who avoided calling his parents and children because he cried almost every time he heard their voices on the phone. And he didn't want the other inmates waiting in the light to see him cry, which really, really sad. And finally, a really common barrier is the conflict with the children's caregivers. Most of the time they are their ex partners or sometimes can be their parents or parents in law. And there is a lack of skills in navigating conflicts. I have worked with several men who've cut off all the contact with their children because they feel unable to overcome the conflicts or the difficult conversations with the caregivers. For example, I have one client, one man had no contact with his children for an entire year because his wife had an affair shortly after he got imprisoned and he felt like he couldn't get over the resentment towards her. And some other men, they still contact the caregivers, but they struggle when the caregivers express their disappointment over the phone about their poor choices, when the matters they express their distress of being a single mom. And all of these emotional barriers can lead the fathers to avoid contact with their children. They often believe that it's better to just wait until they get released and then they can make it up to their families later.
[00:09:52] Speaker B: The physical and logistical barriers to building those relationships are so clear that all of those nuanced emotional barriers aren't as obvious.
So what approach have you found most helpful then when working to help incarcerated fathers to maintain positive relationships with their kids?
[00:10:16] Speaker A: Actually, there's a lot of approaches that can help. But to help my clients in prisons to overcome the emotional barriers that prevent them from engaging in meaningful daily routines, I find one approach cause distress exposure to be a significantly effective approach. So let Me explain distress exposure in psychotherapy. It refers to the approach where a person deliberately puts themselves in uncomfortable situations, allowing themselves to feel de stressed in a safe way with the aim of achieving a long term benefit.
So when you think about this approach, we actually do it all the time in our daily lives. We push ourselves at the gym, embracing the tiredness for better health. And we stay calm during a conflict with our clients or with our colleagues at work. We tolerate the frustration to maintain the professionalism. Or you can think back of the time when you was a kid, you see that when parents, they take their children to kindy, children often get anxious and cry in the first few days in kindy. Is that right? And when parents, what parents often do is that they comfort their children. They say things like, you'll be okay, I will pick you up in the afternoon. I love you. So by doing so, they allowed their children to experience the separation anxiety in a safe manner. And over time, after years of consistent practice, the child grows up and becomes more confident in handling more anxiety provoking situations like public speaking or attending a podcast interview.
That ability to tolerate distress is really a life skill that we've been practicing our whole life, so it's not something new at all. But now when we look at the fathers in prisons who struggle with emotional barriers, most of the time, the distress we are dealing with in the prison population is quite complex, much more complex than just the tiredness of going to the gym or the frustration from having conflicts at work. Now let's take an example of a father that I work with. We'll call him Chris, just a name that I'm using for this example.
So before he started counseling, even a hint of someone blaming him or refusing to take responsibility would make him incredibly angry. Of course, most people would feel upset in the same situation. But for Greece, even a very small comment like his ex partner saying he was irresponsible, something like that, it would escalate him into raising his voice on the phone. Or when his tennis partner made a mistake that caused them to lose the competition, he was extremely angry for days as he felt that the inmate wasn't taking enough responsibility.
So if we look at Chris's childhood experience, it sheds light on why the distress from being blamed or someone denied their wrongdoing was so deeply unbearable for Chris, because during childhood, Chris suffered severe neglect and was sexually abused multiple times by people in authority.
And the perpetrators keep blaming that it was his fault. And when he tried to tell his parents, they didn't believe him. They accused him of Lying, refused to believe that those in authority could sexually abuse their son, and denied their responsibility to protect him. And so that means that throughout his childhood, Chris, he just learned that blame, shame and denial attitude, immense danger. And these distresses were often associated with extreme physical pain. Not only emotional pain, but it's physical pain, nightmares, constant fear, and intense feeling of rejection. He didn't have enough opportunities to learn that distress, the frustration from being shame and blamed, actually it can also be tolerable and manageable in the other situations. So that's a very typical example of how we work with distress in the prison populations.
So how can this distress exposure approach help Reece and others with similar emotional barriers? Well, it helps my clients learn that some distress is safe and tolerable in the present.
And for those who suffer from past trauma, they start to understand that the distress they are facing here and now differs from the distress that hurt them or damaged them in the past and they don't have to avoid anymore.
[00:15:18] Speaker B: Sounds like really important work that we'll see them through once they do get to leave prison.
So what does this distress exposure work look like when you're working with this cohort?
[00:15:33] Speaker A: When I work with Chris, I broke down the distress tolerance exercises into very, very small and manageable steps. He starts with very simple activities, and each activity has two components. First, it needs to generate some kinds of emotional distress. And second, it needs to be beneficial for a person in the long run. And in counseling sessions, Chris learns skills for emotional regulation, positive communication, conflict resolution. And back in prison, he exposed himself to the distress provoking situations, Use those skills to navigate through the de stress. He practiced day by day, one distress at a time, until he felt confident in handling that specific distress and was ready to move on to a higher distress level.
The crucial principle of designing the exposure exercise is that the person makes a choice, not the practitioner. My clients, they always choose to start with something very simple, very simple tasks related to their daily life, not related to their family. Immediately, they choose some exercise, like they choose to go to the gym, drink more water, or reduce sugar in their diet. And these activities are immediately related to their daily need, something that they can do tonight or tomorrow.
Now, returning to Chris, he also practiced some simple distress exercises to tolerate boredom and procrastination before moving on to tolerate anger. Anger is really a big emotion. He practiced staying in a conversation with an inmate he disliked for 5 minutes a day, gradually increasing to 10 minutes, then 20 and 30 minutes. Let's call the inmate Jack. He didn't do anything harmful to Chris. At all. But what made Chris dislike Jack and avoided Jack was that Jack often bragged about himself. This really triggered Grace because unconsciously, Chris perceived extreme danger whenever he heard someone lying or denying their wrongdoing. And the plan was that whenever Chris heard Jack brag about himself, just calmly tell Jack, no, that's not true. I don't believe you. And then simply walk away without need to argue or raise voice or swear at Jack or force Jack to admit that Jack was wrong. So overall, we assist clients in learning skills to regulate negative emotions so that they can engage in a routine that is initially distressing but ultimately beneficial with the prison context.
[00:18:28] Speaker B: What effects have you noticed this work has had on the fathers that you work with and their relationships with their children?
[00:18:37] Speaker A: It's been really rewarding for me to observe the positive change in the fathers who've been engaging in the distress exposure exercises.
Initially, they often reluctant to undertake any activities directly related to family or to their past trauma, which is really understandable because those areas often bring bring up a lot of big distress. However, after several weeks of building their capacity to handle distress, they frequently started choosing to undertake activities aimed at reconnecting with their families. Take Grace's situation, for instance. He mentioned that his consistent effort should navigate those challenging conversations with Jack and with other inmates.
It sharpened his skills in active listening, showing empathy, and assertive communication.
And what was particularly encouraging was that these improvements made his phone calls with his ex partner much more positive. He was able to remain calm even during disagreements with her or when she said something that might have previously triggered him. And as a result, they begin communicating more often, which naturally lead to him having increased contact with his children.
And another truly impressive development that I witnessed in the individuals who started reading books in prison. I really like this exercise.
A lot of my clients in prison, they had never completed a book before in their life, and they didn't believe that they were capable of developing a reading habit.
However, when I provided them with a book related to their childhood trauma, just start with just a couple of pages each day, or even only one minute of reading per day, they became deeply engaged. They gradually progressed to reading for hours on a daily basis. And through reading, they learned a lot about how much their childhood traumatic experience might have influenced their behaviors and their relationships with family. And then they expanded their vocabulary for expressing emotions to their family, which is as beneficial as several counseling sessions. And these fathers have shared with me that the distress exercises made them recognize that negative emotions like shame, guilt or frustration, or even anger is just simply a normal part of relationships with skill learning, they can become much better at managing those distress through the consistent practice. And these examples really underscore how the practice of distress tolerance, day by day and through engaging in the very small and relatively simple, simple tasks, can result in substantial and long lasting improvements in family relationships over time.
[00:21:51] Speaker B: Absolutely. You're not just equipping them with the skills, but you're also building their confidence as well to tackle those relationships and perhaps more challenging conversations.
Of course, there's just so much to be exploring with fathers who are in prison to support their relationship with their children. Practitioners can also be curious about what a father's distress might say about what's important to them as a parent and the kind of father they want to be, even from within prison. If you're interested in having conversations with parents about what's important to them, check out our online courses, Practice Strategies for Implementation and Engaging Children Paving the Way with Parents. You can find links to these and other resources in the show. Notes now back to the episode.
Can you briefly explain the zone of proximal development for our listeners and how that relates to this work?
[00:22:53] Speaker A: Sure. It refers to the optimal zone for learning new skills where the task are challenging enough to promote learning but not so overwhelming that they become discouraging for the learners. And this zone is unique to each individual at each stage of learning and can be tricky to pinpoint in a short amount of time.
So coming back to the work that I'm doing with my clients in prisons so maintaining family relationships is a skill that requires learning and interaction with family from prison completely shifts the dynamics of relationships. Typically, these fathers show care and affection by playing with their children or by providing financial support.
But when they have to maintain the relationships from prisons through phone calls, video calls and letters, they are suddenly required to learn a brand new skill set of interpersonal skills, things like active listening or navigating through the difficult conversations and verbally express their emotions. And at the same time, they also have to cope with entirely new kinds of distress like shame, guilt, hopelessness, and even worthlessness. And it seems reasonable to think that incarcerated fathers, especially those who experience trauma during their childhood, or maybe they have chronic psychological issues, they might find it incredibly difficult to just immediately implementing all these new interpersonal skills, which means that these tasks are out of their optimal learning zone. The distress exposure approach breaks down these skills into really simple tasks that fall within the learning zone before gradually moving on into a more advanced task. So it might be a more effective way for them to learn those new skills.
[00:25:00] Speaker B: Makes Sense. What other strategies or approaches have you found beneficial when working with incarcerated fathers?
[00:25:07] Speaker A: So actually not every client, they need the counselor to explicitly give them the homework. Because for those who already have very good interpersonal skills, like actually listening, navigating difficult conversations, a skill that I just mentioned, usually I can see there's a quick process for them to try to rebuild their relationships with their families from prisons. And for these clients, even without therapy homework, they often proactively apply the skills that they learn in counseling sessions to adapt to their new environment.
So with these individuals, we found that the other approaches that require fewer sessions and minimal homework, like psychoeducation and cognitive restructuring, it can also be really effective and just for anyone who might not be familiar with these approaches. So psychoeducation is where the counselors just typically focus on educating clients and providing knowledge about the distress and cognitive restructure. On the other hand, we focus on helping clients to identify and challenge and change the negative or unhelpful thought patterns that contribute to their emotional distress.
[00:26:29] Speaker B: Do you work with incarcerated mothers as well?
[00:26:32] Speaker A: I haven't had it yet the opportunity to work with incarcerated mothers, but existing research, it does mention some difference between men and women in therapy homework. Like some studies suggested that women often engage more in therapy homework that fosters emotional connection and self exploration, whereas men tend to prefer behavior focused tasks and communication skills. And these findings are consistent with my experience with my male clients.
[00:27:08] Speaker B: You've mentioned that throughout in the case studies that you've shared that a lot of the fathers that you work with have coexisting mental health difficulties, substance use issues and experiences of trauma. What have you found helpful when working with clients with complex presentations like these?
[00:27:32] Speaker A: I have observed that progress can be particularly challenging with clients whose difficulties are compounded by substance use and maintaining focus during sessions. And adherence to practice, like distress exposure can be really difficult if clients are influenced by drugs or by addictive behaviors.
And in these cases, I believe that we need a strong collaboration with specialists experience in addictive behaviors, which is quite limited in my current area.
But on the other hand, I have seen more positive outcomes with clients who get significantly improved impacted by their childhood trauma. Consistent evidence show that trauma focus, cognitive behavioral therapy, or we call tf, cbt. It is a helpful framework. It seems particular.
It seems to me that the clients with very traumatic experience in the past, they can benefit a lot from this approach because in during this approach they have the chance, they have opportunities to discuss in details the memories that they have avoided for long time and they start to Explore the influence of their traumatic memories on their current behaviors and also on their family relationships. And with tf, CBT clients are supported to recall the traumatic memories in details and develop skills to regulate their emotional responses during the memory recollections.
[00:29:19] Speaker B: I wonder for how many of these men it might be the first time that they've ever talked about those.
[00:29:27] Speaker A: A lot.
[00:29:28] Speaker B: Yeah.
[00:29:29] Speaker A: Yes, a lot.
[00:29:30] Speaker B: Very powerful for them. So how can practitioners use these insights to support nature non incarcerated fathers who are looking to rebuild their relationship with their children?
[00:29:43] Speaker A: Of course, we all approach this work with experience, tailoring our intervention for the client populations we typically see. So that means that the approach that works for my clients may not be the best fit for clients from the other backgrounds. I'm a big believer in therapy home.
So when I say homework, I'm talking about a return plan that is tailored to the specific client. And the client agrees to stick on to that action plan on a regular basis, ideally daily or at least weekly. And the exercises need to be measurable and reportable. Then together the client and practitioner can track the progress and review the plan in each session.
And I have had conversations with other low intensity mental health practitioners in my area and there's sometimes a concern that being too structured with the therapy homework can make us seem like over directed. But let me share an example highlighting the benefits of therapy homework for behavioral change.
I had several clients who were restricted from visiting their children because of their problematic drug use.
They went to counseling for a year or two years. They learned about their triggers, they learned about their thought patterns and relaxation techniques for managing cravings. And they were never given any therapy homework aside the general skills. And then their drug use didn't change much during that time. I have worked with clients like that. One of my clients, I tried something a little bit different.
So initially he didn't recall much of the past experience that led to his problematic drug use. So I gave him a pocket size chart to track his smoking drugs for a week. He just need to tick a box whenever he smoke drugs. So we kept working on other therapy skills too at the same time. And after a month he reported a significant breakthrough. Seven days straight without drugs. He told me that when cravings hit, all the cognitive and relaxation technique seemed to vanish. But that little chart that he kept in the pocket, it kept him aware of his habit in the moment. And interestingly, the chart also helped him to explore the connection between his drug use habits and some painful memories that he hadn't thought about for a long time. And after that session we move on to explore his painful memories. And this really showed me that changing behavior is complex and so unique to each individual. And sometimes neither the client nor or the practitioner fully grasp the optimal learning zone of the client, all the underlying barriers to the learning, until we actually put a daily action plan in place and review it together.
[00:32:57] Speaker B: So it sounds like a very collaborative and iterative flexible process.
[00:33:03] Speaker A: Yeah.
[00:33:04] Speaker B: So, thinking about everything that we've discussed today, what, what societal and systemic changes do you believe are needed to better support parent child relationships within the justice system?
[00:33:17] Speaker A: There are some research suggested that parenting educational programs in prisons don't consistently lead to stronger family relationships without real opportunities for practicing new skills. It makes me believe that a helpful area for development would be increasing opportunities for incarcerated parents to interact with their children where it's safe to do so, only when it's safe to do so. And if increasing the opportunities for parent and child interactions from prisons might not be practical in the short term, particularly in the higher security prisons, perhaps we could initially focus on creating more opportunities for daily practicing the foundational skills that support healthy family relationships. My observation is that resources for cognitive learning in prisons tend to be more accessible to those who are already quite literate and have good comprehension and are either good at staying focused or maybe really good at socializing.
And this presents a significant challenge for me when I prepare therapy homework for individuals with low literacy learning difficulties or those from migrant backgrounds with limited English, and especially those with cognitive and intellectual disabilities. I remember having a client in prison who was a classic introvert. He comes from a migrant background and he didn't really engage in physical or social activities, but however, he was really good at drawing. Really, really good at drawing. And interestingly, after initially experiencing the depressive symptoms upon imprisonment, he gradually kind of started to recover when the other inmates discovered his painting talent and asked him to draw pictures of their family members, which is really interesting. And he socializes more. It creates more opportunities for him to learn socializing and positive communication skills. And this makes me wonder if we could really optimize how individuals in prisons can learn new skills by implementing more tailored resources and activities that take into account their diverse backgrounds, learning styles, their existing personal strengths for daily practice. Like imagine a daily painting workshop where people could come to practice drawing together every week or even send their artwork to their children.
[00:36:02] Speaker B: Absolutely. Thank you so much, Linh. This has been a fascinating conversation and I've really appreciated your insights into what I think is often a misunderstood and. And invisible population.
And yeah, thank you for joining us.
[00:36:19] Speaker A: Thank you for having me.
[00:36:23] Speaker B: Visit our
[email protected] au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The Centre is funded by the Australian Government Department of Health and Aged Care under the name National Support for Child and Youth Mental Health Program.
