Caseworkers often perceive placement of a child in an adoptive family as the endof the work. Although placement may signal the end of the child's sojourn withinthe child welfare system, in reality it is the beginning of a life-long journey that,hopefully, will lead to overcoming the effects of whatever traumas led to the childentering the system as well as the negative impact of experiences he may have experiencedwhile in care.
Children who join adoptive families after experiencing abuse,either physical or sexual, neglect, parental separation and loss bring with thema legacy of failed family relationships. Their new family provides a new hope, andpossibility, for them to more successfully experience the intricacies and benefitsof family life.
Although previous life experiences may have led to emotionalinsults that may benefit from formalized therapeutic interventions, primary healing,if it is to occur at all, will occur within the contexts of day-in, day-out familylife. It is the result of the interface between the characteristics of the childand family that leads either to healing for the child or to disruption of the placement.According to Barth and Berry the characteristics of the child, his behaviors, temperament,habits, and academic skills are important only in relation to family characteristicsand patterns.
Children and parents alike come to adoption with some addedrisk factors when compared with children joining their permanent family at the timeof birth.
Child risk factors include
Parent risk factors may include:
Elbow identifies three facts in older child adoption that contribute to difficultyin mastering family developmental tasks.
Because of the nature of special needs adoption, involvement with post-placementservices and mental health resources should be considered a normative part of thisadoptive family's experience. Adopted children and their families are best servedwhen there is collaboration between the family, social service agencies, and mentalhealth resources. Each recognize not only what they, but also what the others, haveto offer.
Mental health professionals
Post-adoptive services need to be provided by individuals who:
Post-adoptive services may take a variety of forms:
Support services: Families who were prepared for adoption using a group processfrequently use other group members as an informal support system. Agencies may provideparent support groups; or help individual families connect with others who have hada similar problem; may provide parent education presentations. Even those familieswho need more intensive services, view support services as helpful. Respite carecan be a very useful service, but unfortunately families are frequently left to theirown devices in terms of providing it on a regular basis.
TRADITIONAL THERAPY APPROACHES ALONE HAVE NOT BEEN PARTICULARLY
SUCCESSFULWITH THIS POPULATION
Individual non-directive therapy with the child:
Traditional family therapy
Adoptive families, who represent the source of real change and remediation, mustbe actively involved in the healing strategies
BELIEFS IN FAMILY SYSTEMS APPROACH TO TREATMENT IN SPECIAL NEEDS ADOPTION
WHEN OUT-OF-HOME PLACEMENT IS NECESSARY:
Out-of-home placement may beindicated in a wide variety of circumstances ranging from brief respite to lengthyresidential treatment; from assessment to treatment. Special needs adopted childrenhave many reasons for possibly needing the most intensive therapeutic interventions.
Out-of-homeplacement should not be considered an adoption failure. Indeed, it may be a strongindicator of an adoption success when the family recognizes that their young personneeds more help than they alone can provide and they are willing and able to advocatethat their child receive this help.
Children who are not experiencing successin any of the major arenas of their life--family, school and peer relationships--arefrequently candidates for out-of-home placement. Family and professionals shouldalso be assessing the child's functioning within the community and his/her more personalfunctioning. Looking at these areas in detail frequently help determine the mostbeneficial type of placement.
Grotevant and McRoy in their research on adoptedchildren in residential treatment found that although adopted and non-adopted youthin residential treatment had similar behaviors and diagnoses, there were significantdifferences as well. When compared with the control population, the parents of adoptedyouth had less mental health pathology and more stable marriages. Of the 50 adoptedindividuals studied in 33 cases the adoption played a major role in their emotionaldisturbance; in 9 cases it played a minor role and in 8 cases it seemed to be playingno role.
The intensity of family life at the period when the young personis reintegrating earlier life experiences and redoing the tasks associated with individuationand identity formation may interfere with successful achievement of the tasks athand. Some youth are able to make much better use of their family when they are notliving with them. The family may be able to be more emotionally supportive, becausethey are less drained, in this situation as well.
Summary: The goal of allpost-placement services is to aid in maintaining the long-term commitment and accessibilityof the family as a positive influence in the adopted individual's life.
Barth, R., Berry, M., Goodfield, R. and Carson, M.L. OLDER CHILD ADOPTION ANDDISRUPTION. Washington D.C.: The Children's Bureau, April, 1987.Research findingson adoption disruption. Also contains an annotated bibliography and information ona residential treatment center approach to working with an attachment model.
Bourguignon, J.P. and Watson, K.W.: AFTER ADOPTION: A MANUAL FOR PROFESSIONALSWORKING WITH ADOPTIVE FAMILIES. Springfield, Ill. Illinois Department of Childrenand Family Services, 1987. Available from National Resource Center for Special NeedsAdoption; Crossroads Office Center; 16250 Northland Dr. Ste 120; Southfield MI 48075.Identifies how adoptive families differ from other families; the purposes of therapeuticintervention; seven areas in which adoptive families most often experience difficulties;a framework for a post-adoptive diagnostic assessment and interventions which lookat barriers to adjustment posed by child, parents, and the environment.
Brodzinsky, Schechter and Henig. BEING ADOPTED: THE LIFELONG SEARCH FOR SELF.New York, Doubleday, 1992.A developmental approach to the lifelong impact of beingadopted. The information is very useful in developing both supportive and preventativeservices for adopted individuals and their families.
Busch, L. editor: THE MENTAL HEALTH CHALLENGE OF SPECIAL NEEDS ADOPTION: A ResourceBook for Professionals Working with Adoptive Families. May be obtained by contacting:Adoptions Unit; Children's Services Division; 198 Commercial Street S.E.; Salem,OR 97310-0450. Contains some of the same articles as those in the book edited byPam Grabe plus some others. Donley's Post-Placement Services Analysis which is tobe used ahead of crisis time and which addresses the child's capacity for attachment;the child's resolution of separation and loss issues and the family stresses whichmay affect adjustment are of a size for easy duplication. I also found From Caregivingto Parenting: Family Formation with Adopted Older Children by Margaret Elbow (originallypublished in Social Work, Vol 31, no 5, 1986, pgs 366-370) to be excellent in lookingat how family issues are different in adoptive vs birth families and in identifyingthe developmental tasks of the adoptive family as a whole. Another additional, andhelpful article in this book is by Patrick J. Koehne and is entitled Adoption Processof Special Needs Children: A Family Therapy Perspective.
Grabe, P.V. editor: ADOPTION RESOURCES FOR MENTAL HEALTH PROFESSIONALS. New Brunswick:Transaction Publishers, 1990. Contains a variety of articles by many contributors.Helping Threatened Families by Donley and Blechner and Donley's Post-Placement ServicesAnalysis were particularly helpful articles when I was preparing for this presentation.
Groze, V.; Young, J; and Corcran-Rumppe, K. PARTNERS: POST-ADOPTION RESOURCESFOR TRAINING, NETWORKING AND EVALUATION SERVICES. WORKING WITH SPECIAL NEEDS ADOPTIVEFAMILIES. Available from Four Oaks, Inc.; 5400 Kirkwood Blvd, S.W.; Cedar Rapids,Iowa 52404. Presents a five phase treatment model comprised of screening, assessment,treatment planning; treatment phase and termination. Outlines a variety of supportservices; identifies adoption preservation services and on-going services. In thisproject a multidisciplinary Clinical Review Team was used in the treatment planningphase.Explains use of Placement Genogram which incorporates information not onlyabout birth and adoptive families, but also about child's placements in between thesetwo. This technique helps both family and therapists understand the uniqueness ofeach child's situation. Appendix includes a very complete assessment questionnaire;and formats for assessing family communication patterns; family cohesion and familyflexibility vs rigidity.
Prew, C; Suter, S; and Carrington, J. POST-ADOPTION FAMILY THERAPY. Another publicationavailable from the Adoptions Unit in Salem Oregon.Provides information from a projectwhich used a treatment team comprised of a family therapist and an adoption workeras co-therapists. Excellent, and fairly detailed, information on identifying commonproblem behaviors and on developing intervention strategies. Appendix includes usefulquestionnaires, especially an Adoptive Family Risk Assessment Scale and a Child BehaviorChecklist.
This paper developed for her training workshops for child welfare professionalsis related to material from Dr. Fahlberg's book AChild's Journey through Placement.
© Vera I. Fahlberg, M.D.
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