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Telemental Health Services

COVID-19 inspired relational telemental health services for incarcerated individuals and their families

Dr Eman Tadros is an Assistant Professor at Governors State University in the Division of Psychology and Counseling. She is a licensed marriage and family therapist, MBTI certified, and an AAMFT Approved Supervisor. Her research follows the trajectory of incarcerated coparenting, incorporating family therapy into incarcerated settings, and the utilization of family systems theories within these settings.

The coronavirus has caused marriage and family therapists (MFTs) to alter how they provide clinical services. MFTs must determine how to deliver relationship-oriented services to underserved populations that are often forgotten during crises, including incarcerated individuals and their families. Relational telehealth - also referred to as online therapy or e-therapy - is the electronic modality utilized to conceptualize relationships and mental health systemically to support the well-being and functioning of individuals, couples, parent-child dyads, and families.

Relational telemental health (TMH) services for incarcerated individuals and their families can increase access to services and improve relational health. Many parents, partners, and siblings are left to face the burdens of having a loved one incarcerated, such as financial strain, residential instability, relationship dissolution, and stigma (Datchi & Sexton, 2013; Gueta, 2018; Tadros et al., 2020a, 2020b). Staying engaged with children is a challenge for many incarcerated parents (e.g., McKay et al. 2019). Without the ability to communicate directly with their children, incarcerated fathers often relied on children’s mothers to facilitate phone calls and visits with children, emphasizing mothers’ roles as gatekeepers of contact with children (McKay et al. 2019).

However, during the pandemic related to the COVID-19 illness, most corrections facilities have stopped in-person visits to decrease the spread of the virus, resulting in a reliance on phone calls or remote video visits, which can be expensive in corrections settings (Williams & Ivory, 2020).

To ensure the continued access to relationship-oriented services, recommendations on how relational TMH could be used in corrections during the COVID-19 pandemic are offered here. These also include advocacy for collaborative healthcare, recommended implementation practices, and ethical considerations. As such the recommendations are:

1) Increase access to care within corrections

- Implement relational TMH in jails and prisons already equipped with computers, tablets, and internet access for staff

- Offer relational TMH connections at low cost or free

- Integrate relational TMH with other family-oriented, parenting, or mental health programs

- Allow higher-risk individuals access to relational TMH

- Connect families living far from corrections facilities as a more routine process

- Communicate the convenience and other benefits for therapists to increase the number of professionals offering relational TMH

2) Provide collaborative care

- Practice unique skills for treatment planning in collaboration with other healthcare professionals

- Acknowledge established links among family relationships, physical health, and mental health

- Acknowledge established links among family relationships and reentry success

- Coordinate efforts to improve healthcare access and delivery across healthcare disciplines

- Combine efforts to increase health justice

3) Consider special issues when implementing relational TMH in corrections settings

- Identify or develop resources to treat incarcerated individuals and their families using relational TMH

- Access free TMH platforms

- Provide privacy for relational TMH for nonviolent offenders

- Protect client confidentiality in jail and prison settings

- Collect data to determine usefulness of relational TMH for institutional behavior, mental health, and recidivism

4) Ethical issues

- Address barriers to relational TMH in the criminal justice system including cost, technology, stigma, family conflict, and decreased family communication because of the pandemic

- Identify and implement informed consent as an ongoing process

- Help MFTs gain access to ethical and legal guides on technology usage in therapy

- Help MFTs access cross-state certifications


We thank Dr Eman Tadros for her submission!

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