The
Post-Adoption
Crisis Intervention Project, 1991-1993
Excerpts from the final report
to the U.S. Department of Health and Human Services
Administration for Children and Families, Children's
Bureau
Introduction Project Description Accomplishments Benefits Conclusions
For more than fifteen years, older and special needs children and adolescents have been placed for adoption as a result of permanency planning implementation nationwide. A logical consequence of this phenomenon has been the increased demand for post-adoption services. Older and special needs children who were hard-to-place because of their histories of physical, familial and psychological trauma would understandably also be hard to bring up. (Argent, 1984) Adoption workers placing these children have long agreed that, to insure permanence, support services must be available to families beyond placement. This need has been repeatedly borne out in research during recent years, where post-adoption services are positively correlated to higher satisfaction with adoptive experiences and preservation of adoptive relationships. These services must be available not only beyond finalization, but also at critical points throughout the life cycle for adoptees and their families. (Barth and Berry, 1988; Pine, 1991; Fales, 1985)
All adoptees, but particularly special needs children, have experienced loss and disruption of early affectional bonds. Many have suffered the added trauma of abuse, neglect and multiple moves. As a consequence, they bring to adoption and their new families the residual effects of grief, separation, attachment difficulties, identity confusion and family loyalty conflicts. (Brinich, 1990) In adolescence, these issues often intensify, exaggerating the adoptees' differences from their nonadopted peers. These exploding issues affect full integration into their adoptive families and increase their feelings of difference and isolation. Family life can become frustrating, confusing and stressful at best. Some parents find their adopted child's behavior so unmanageable or destructive to day-to-day family life that they may contemplate out-of-home placement or dissolution of the adoption.
According to 1992 statistics compiled by the Massachusetts Department of Social Services, 50% of the children waiting for adoption in this state are six years and older. In addition 72% of these children are part of a sibling group and 35% are children of color. (Breay, 1992) Given these statistics and the continued increase in the placement of older children, teenagers and children with special needs, a responsive support system is imperative. Although in Massachusetts and nationwide there is an increased demand for post-adoption services, they are in short supply. (Frey, 1986) Few adoption-sensitive resources exist to support families after legalization. In fact, the mental health community has historically been ill-equipped to address the unique issues surrounding adoption. Most mental health professionals are trained to assess acute psychiatric symptoms, parental abuse and neglect or family dysfunction. They are often not attuned to the complexities of psychological adjustment and family development that surface when integrating a previously traumatized child into an adoptive family. Many well-intentioned professionals alienate families by over-identifying with the adopted child, blaming the adoptive parents or devaluing the adoptive bond.
In response to this situation, Project IMPACT implemented a two-pronged postadoption project supported with federal funding. It included direct service to adoptive families (Post-Adoption Crisis Counseling Service) and generated an interagency and interdisciplinary Task Force to guide the development of adoption-sensitive training for non-adoption professionals.
Brief Description of the Project
The goal of the IMPACT project was to make a contribution to the continuum of post-adoption services in Massachusetts in two major areas: direct services to adoptive families and adoption-sensitive training for professionals. The direct service involved the provision of intensive crisis intervention services to seventy families with adopted children at risk of out-of-home placement. The training aspect involved the development of a sourcebook highlighting the knowledge, attitude and skills necessary to work successfully with adoptive families, the creation of companion training modules to address these competency areas and two site testings of the training.
The direct service piece was the core of the project and was designed to address the unique experiences and challenges of adoptive families by offering a select and specialized service. A short-term, intensive, in-home crisis intervention service was followed by referrals to after-care services which were part of the continuum of supports that many of these children and families would need either consistently or intermittently through life. The crisis intervention service responds to the growing number of families who require acute post-legalization support.
Since the goals of family preservation and placement prevention were paramount, the service was based on the Homebuilder model from Seattle, WA, a nationally recognized and highly successful intervention model. Homebuilders offers short term intensive, in-home crisis intervention and family education to families with a child at imminent risk of out-of-home placement. (Kinney, Haapala and Gast; 1981) Workers respond immediately to the family in crisis, keeping families together and addressing issues promptly. The model stands in contrast to many other intervention models that recommend separating family members during the initial assessment, and postponing the intervention until all reports are complete.
The goal of the Homebuilder model is to prevent out-of-home placement and to teach skills that family members can utilize to avert future difficulties. Crisis workers carry an active caseload of two to three families at one time, depending on whether families have requested a four-week or three-day intervention. Crisis workers are often in direct contact with families daily, with home visits frequently lasting for several hours at a time. All interventions take place in the family's home and involve all willing family participants as well as members of the family's support network. Crisis workers and supervisors are on call 24 hours a day, seven days a week. They are in charge of all aspects of the intervention, starting with the initial intake and continuing through termination. They develop strategies to maximize attainment of the family's stated goals. The workers also attempt to secure any ancillary services which increase the family's ability to sustain their progress beyond termination.
In response to the need for post-adoption services to address general life cycle issues in adoption, as well as the particular challenges of adopting older and special needs children, IMPACT's service is provided in a format which meets both the immediate and unique needs of this population. Its design honors the individual as well as the universal experiences, dynamics and expectations inherent to adoption. The issues are complex; the needs are often immediate and require a trained eye to recognize and respond to the sometimes subtle nuances of the adoption experience.
In addition to the program's specialty focus and its success both in preventing out-of-home placements and sustaining adoptive relationships, the crisis counseling program is also cost-effective. The approximate cost to provide a four-week family intervention is $3,600. Average costs of out-of-home placement options appear below, clearly demonstrating substantial savings when placement is prevented or even delayed for one, three or twelve months.
Cost of foster care in Massachusetts (approximate figure)
*one month=$1,000
*three months=$3,000
Cost of highly specialized Mentor foster care rate in Massachusetts
*one month=$2,250
*three months=$6,750
Cost of state-funded residential treatment program in Massachusetts
*one month=$6,000
*three months=$18,000
Cost of acute, in-patient psychiatric hospital in Massachusetts
*one month=$27,000
In conjunction with the primary aim of this project which was the direct service provided, a training component was developed in support of post-adoption service expansion across the state. The training aspect consisted of coordinating an Advisory Group and Task Force to guide the development of a competency-based training module for non-adoption professionals who work with adopted children and their families. Two site tests of the module were also planned. Progress on the training tasks is addressed in detail later in this report.
OBJECTIVE 1.
To provide post-adoption crisis services to at least 35 adoptive families a year (seventy families in 2 years) who are considering out-of-hme placement or adoption dissolution.
Under this objective, one full-time staff position and one part-time staff position were filled, and both staff members participated in adoption trainings on-site as well as Homebuilder trainings in Kentucky and in Washington state. A referral system was established to handle family intakes primarily from the Department of Social Services, the Department of Mental Health, mental health clinics, hospitals, health maintenance organizations and directly from families. The criteria for accepting referrals was: any adoptive family within a forty-mile radius of Boston whose child was legally adopted and which had at least one parent interested in preventing out-of-home placement for that child. In order to get the word out, the service was publicized in a variety of newsletters, and flyers were distributed to DSS, DMH, adoptive parent organizations, clinics, agencies, and families who had adopted through Project IMPACT.
In the early months of the project, referrals came in very quickly. Due to worker training, educating referral sources about appropriate referrals and temporary startup delays, full project capacity was reached in the third month. As the project progressed, a definite pattern regarding referrals developed. Referrals came in more slowly during the summer months when families were on vacation or kids were at camp. Also during the mid-winter months, referrals declined as families attempted to maintain the status quo until the holidays were over. Another reason for the inconsistent flow of referrals was staff turnover during a major reorganization at the Department of Social Services, the primary source of family referrals. However, despite the uneven flow, only once was an opening for service not immediately filled during the two-year grant. On average, referrals were received at two to three times program capacity.
Over the course of the two years, 142 referrals were received. The primary reason that a family could not be served was limited program capacity. Other reasons ranged from lack of urgency or imminent risk of placement, to geographic distance from the agency (beyond the forty mile radius), to pre-adoptive rather than postadoptive status of the child.
Sixty-two families were served, compared to a projected seventy families in the original grant proposal. The primary reason for the discrepancy is that the original figure was based on a larger projected number of three-day assessments or three-day interventions. Due to the skill of referral agents in identifying appropriate referrals, and the critical nature of the family situations being referred, neither three-day assessments nor three-day interventions were utilized as much as projected, which slightly limited the total number of families that could be served. However, based on the expected number of families to be served annually by Homebuilder therapists in the Washington agency, IMPACT's total of sixty-two families served is slightly higher than expected for one full-time and one half-time staff person over a two-year period.
A detailed outline of the statistics on these families appears in a separate section of this report. In general, of the adopted children and adolescents in the sixty-two families served, 94% were at home at the end of the intervention and 83% were still at home at the time of the three-month follow-up call. More importantly, the adoptive relationships were sustained in 100% of the cases at termination and 97% at three months, even when out-of-home placement was unavoidable. In a later section of this report, a comparison will be made of IMPACT findings and Homebuilder findings for both a typical Homebuilder population and a selected sample of adoptive families served by Homebuilders and Medina Children's Services under a prior federal grant.
Based on client satisfaction surveys immediately following each IMPACT intervention, the rates of preventing out-of-home placement and adoption dissolution were accompanied by a high degree of satisfaction with the service and the benefits to adoptive families. Copies of the intake application, case recordkeeping forms, client satisfaction survey and follow-up evaluation forms can be found in this report at Attachment A[not included in this article].
OBJECTIVE 2.
To link adoption support service providers, parents and public agency representatives in an ongoing taskforce.
This objective proved to be the most difficult to achieve during the first year of the grant. After several months of delays in meeting with the Advisory Group, which hindered the creation of the Task Force, the implementation of this objective began to take shape. A previously formed interagency group consisting of assistant commissioners of all the public children's' service agencies in the state and chaired by the Office for Children and the Undersecretary of Health and Human Services reconstituted as the Advisory Group. The group agreed to include IMPACT's project on their agenda and to discuss various routes to expanding specialized post-adoption services statewide. Through presenting both the direct service and training aspects of this project to the Advisory Group, the group identified several designees from their respective public agencies to participate on the Task Force being formed. Consequently, both public and private agencies were represented on the Task Force by staff in direct services, administration, policy and advocacy.
The Task Force also consisted of adoptive parents, adoption placement specialists, adoptive parent organization coordinators, child psychiatrists, school psychologists, school adjustment counselors, an adult adoptee, mental health professionals, clinic and agency administrators, a trainer/consultant, a social work professor, a probation officer, a residential treatment program executive director, child advocates and public agency staff from the Departments of Mental Health, Public Health and Social Services. Due to extensive reorganization and leadership changes in the Department of Social Services, consistent DSS representation on both the Advisory Group and Task Force was quite difficult to achieve.
The Task Force meetings generated lively discussions of adoption issues, adoption reform, policy changes and the serious need to promote adoption-sensitivity within the professional community. As energy on the Task Force evolved into action, a format for training non-adoption professionals emerged. The specifics of the training are discussed under Objective 4. The final product generated by the Task Force is a training sourcebook containing the competency areas that characterize professional sensitivity and increase successful interventions with adoptive families. The sourcebook accompanies this report as Attachment B [not included in this article] and includes a list of Task Force and Advisory Group members
OBJECTIVE 3.
To create a data base representing all families who request post-adoption services.
The design of the data collection plan was initially impeded by the reorganization at the Department of Social Services. At the time the proposal was written, DSS had committed in-kind services from its Research and Evaluation Unit, which was subsequently disbanded during reorganization. When it became clear that the Department could not offer consultation on research and evaluation at this time, a volunteer consultant was immediately located in order to stay within the boundaries of the project budget and timeline.
Collection of data on the families served commenced with the first referral and continued through the duration of the project. A variety of demographics, three-month and one-year follow-up statistics and client satisfaction information were all collected in order to determine the success of the services and guide expansion or future replication. A four-month no-cost extension on this project was requested in order to gather a larger sample of the families served by the crisis intervention service. By extending the project, staff was able to obtain three-month follow-up statistics on all sixty-two families served during the two years.
OBJECTIVE 4.
Introduce a training module for national dissemination that addresses the needs of adoptive families in crisis.
The fourth objective was to develop a module, initially intended to provide adoption-sensitive training to protective service workers, front-line child welfare and mental health staff in the public sector. Through the active participation and guidance of the Task Force, the focus of the module evolved into a broader training project, including but not limited to public agency staff. The end product emerged as a sourcebook to sensitize non-adoption professionals to the unique issues of adopted children and their families. Taking a competency-based approach, the sourcebook identifies the knowledge, attitudes and skills that affect the quality of services provided to adopted children and their families. The sourcebook can be used by professionals as a guide to orienting and educating themselves in order to provide more effective services this population. By selecting content from the sourcebook, an individual or group can request training from IMPACT designed to meet their particular needs. The modules selected can be tailored to social service and mental health professionals, administrators, educators, judges, attorneys, probation officers, clergy, etc.
Because of the Task Force's desire to reach a broader training audience, an annotated outline of the training components rather than an actual module has been produced for dissemination. The outline identifies several modules that could be further developed into a training design.
As a result of the work of the Task Force and the discussion about the need for adoption-sensitive training for public agency staff, the Massachusetts Department of Mental Health applied for and received a subsequent federal grant to train their case managers and the staffs of hospital units, intensive residential programs and emergency screening teams statewide. They have contracted with Project IMPACT and two independent child psychiatrists to design and implement the training. The modules outlined in the sourcebook serve as the foundation of this training, and the first two mental health training site tests are scheduled this month. DMH also has contracted with IMPACT for two years to provide intensive family stabilization services to 56 adoptive families with a child or adolescent at risk of psychiatric hospitalization.
The development of the Task Force and adoption-sensitive training sourcebook proved to be one of the extremely successful aspects of this project. The Task Force propelled the concept by providing a continuum of care to adopted children and their families by developing an adoption-sensitive training tool. Largely due to the Task Force and the training sourcebook, there has been significant expansion in such training opportunities for non-adoption professionals in the public and private sectors in Massachusetts, with a solid plan to continue its application to ongoing in-service training programs.
Reflections on Project Benefits
According to Robert Lewis, Executive Director and Principal Investigator of the Project, the grant program was highly successful for two primary reasons. First, in order to satisfy a growing need for post-adoption services, he feels a specialized approach to the acclaimed Homebuilder model addresses the unique issues inherent in the experience of adoption and meets the urgent need of some families for intensive intervention. Second, he sees a growing demand for mental health and other service providers to be educated about the culture of adoption. With the increased proportion of adoptees seeking mental health services, it is important that professionals be able to approach adoptive families with the same cultural competence that is required when treating other minority groups. This project expanded the view of what it means to be an adoption-sensitive professional, and then took it one step further to the development and implementation of training. Mr. Lewis hopes that through the efforts of this project, families will benefit from the least invasive and most effective services offered by professionals who truly understand adoption in all its complexity.
The accolades of adoptive families are the most powerful proof of the project's success. Client satisfaction surveys and follow-up evaluations consistently documented the benefits reaped by adopted children and their families. However, while positive, the family evaluations were also realistic. The service was not viewed as a panacea, and families looked cautiously down the long road ahead. They realized all too well that their children's pain from the past might well take a lifetime to subside. But given the tremendous challenges they faced, almost all of them continued to be a family, recognizing progress, renewing their commitment and feeling more hopeful about the future.
The findings of a study of 999 families who participated in intensive family preservation services in Oregon in 1988 seem to apply to the IMPACT group as well. The Oregon study found the adoptive families in their sample to be the most highly motivated, having the children with the most extreme behavioral symptoms and having the highest rate of success. Although no descriptions of symptomatology were formally categorized, there were an extremely high number of symptomatic children and almost no referrals of families receiving protective services. None of the families served by IMPACT were referred for child neglect, and in only two instances were there allegations of child abuse and protective service involvement. The vast majority of referrals were for children exhibiting extreme behavioral symptoms such as aggression, running away, delinquency and other self-injurious or high risk behaviors. These same children also had a history of previous out-of-home placements and a solid array of support services already in place. Consequently, the children served by IMPACT were at greatest risk of out-of-home placement in the future, and in some cases, temporary placement might be the only intervention that would preserve the safety and integrity of the family.
Although the purpose of the crisis intervention service is preventing a child from leaving the home or helping a child return to the home, each family is unique and no two interventions are alike. With the differing needs of families and the diverse approaches and perspectives of crisis workers, evaluating the results becomes a multifaceted activity. Sometimes the results of the interventions are immediately apparent, other times they only become visible over time. Sometimes growth can be measured by scaling goals, other times growth is more subtle and elusive. According to a review of case records, in 68% of the families' goals an expected level or greater than an expected level of success was achieved.
The following pages contain anecdotal accounts of other changes witnessed in the lives of children and families. Sometimes these changes are not necessarily unique to adoptive families but are congruent with outcomes similar to most any family referred to a family preservation program. In other instances the intervention strategies and the outcomes are clearly related to general issues of adoption or the specific realities of adopting children who have suffered early trauma. In all cases, however, the worker must be tuned in to the universal thoughts, feelings, hopes and fears of those whose lives have been touched by adoption. Despite their unique circumstances or the particular goals they set out to achieve, the experience of adoption is woven into the very fabric of each family and profoundly affects the whole of their lives.
One adoptive mother of five children found herself newly divorced and admittedly overwhelmed with increased responsibility and the daily stresses of single parenting. The crisis worker was able to help the mother develop chore lists with the children and systems for completing household tasks. The worker was also able to teach the mother to use behavior modification techniques to help manage her adopted son's chronic hoarding of food and temper tantrums. She learned to set limits and structure the lives of the children, making their lives more predictable and helping her to feel more in control. By the end of the four weeks, the mother had renewed hope and was no longer feeling overwhelmed. The success of the intervention was immediately apparent to both the mother and worker.
"(The worker) handled things so well. I thought (the counseling) would just be for the kids but I got a lot out of it which was wonderful. I learned a lot. " -Mrs. S.
In some interventions the parents may not even be focused on family issues because they have had to concentrate steadily on their child's behavior. One particular family had not identified the parents' planned separation as a factor that might be significantly intensifying the chronic behavioral issues with their child. As a result of the intervention, the parents began couples' counseling and postponed any separation. The home-based nature of the intervention also allowed the family to be more hopeful and trusting of other therapies.
"The service in the home setting was especially valuable. " -Mrs. D.
Some interventions have the specific focus of helping a child and family readjust to each other after an out-of-home stay. One very successful intervention of this sort occurred with the family of a fifteen-year-old girl adopted at birth. She had been hospitalized and was ready to come home but not without assistance. The theme of reintegration into the home became one of communication. The crisis worker was able to identify the teenager's preferred non-verbal style of communicating and promoted it through poetry and journal entries. The teen and her family began to recognize and appreciate each other's own individual styles and developed useful tools for communicating.
"We no longer pressure (our daughter) to share her feelings with us...and consequently, (she) is sharing more with us. " -Mrs. S.
At times, advocacy and networking are at the core of the intervention. In the case of a mentally challenged fifteen-year-old boy and an elderly adoptive mother in poor health, their needs went beyond the scope of four weeks. This African American family would need continuous services and a long-range plan in case the mother became more critically ill. Respite care, camp, a visiting nurse and a citizen group taking action on behalf of intellectually challenged individuals were all initiated during the intervention. The worker also provided a great deal of information, support and encouragement in helping this mother to decrease her son's negative and repetitive behaviors.
"I try to have a little more patience and to give (my son) healthier rewards (for good behavior)." -Mrs. T.
Sometimes family interventions bring pleasantly surprising results. The mother of a seventeen-year-old girl was at her wits' end. Her daughter appeared depressed, refused to go to school and was rarely compliant with house rules. Because of her age and her personal goals, the focus became independent living skills for this young woman. Working for her GED, finding a job and an apartment were all identified as goals. However, at the three-month follow-up, she was back in high school, receiving good grades, attending classes and easier to live with at home. Her message to the crisis worker was:
"Thanks for being there all the time. You helped me become a better person. Thanks for everything." -K
Her mother reported:
"It is so good to see K. going out with friends again, doing things and playing sports. You've accomplished something with K that medication and psychiatrists couldn't. Your caring but professional ways have helped us greatly and I can't fully express my gratitude." -Mrs. L.
Often the issues that arise in adoptive families are very different than those that challenge birth families. In the following examples, the families were best served by an adoption-sensitive perspective and the specialized training of the crisis workers in adoption issues and the implications of parenting a traumatized child.
In one situation, an adoptive family was perplexed by the particularly destructive behavior being exhibited by their child. Trying to find a therapist who would work with the child and team together with the parents had frustrated and infuriated this family. Other service providers had focused their attention on how they felt the adoptive family was escalating the destructive behavior. The crisis worker focused on the logic of this behavior given the child's early years of horrific abuse. Helping the family to understand the implications of early trauma and then helping them to find a therapist who also understood were invaluable. By affirming their capabilities they were empowered to set the necessary limits and structure without guilt.
"I learned to be more specific about my needs. I also learned that what I think is a priority is not necessarily a priority to everyone else. " -Mrs. H.
Yet another mother agonized over her teenager daughter who, adopted at two years old, had never developed a closeness with or even an acceptance of her as a mother. As the child grew into adolescence, this fragile bond gave way to acting out and fewer opportunities for connection. Instead of focusing on the teenager or the parent-child bond, the work was focused on the expression of the mother's grief. Grief caused by the one thing the mother had hoped for the most - a close bond with her child. The mother learned to keep a caring and attentive but self-protective emotional distance. As a result of working through her grief, the mother was more able to parent and to realistically appreciate some of the small signs of warmth in the mother-daughter relationship. With her need to connect reduced, she now felt more in control and able to set limits without undue pressure. When the expectations for mother-daughter interaction and affection were reduced, some of the hostility in the girl's behavior subsided.
"(The worker) was extremely flexible and helpful. We were feeling helpless and hopeless. The intervention gave us as parents tools and insight for helping our daughter and coping with our problems. " -Mrs. A.
Open adoptions where the adoptee keeps in contact with at least one biological relative after adoption are becoming more common. However, many adoptive families understand intellectually what open adoption means but emotionally find it difficult to live with. The crisis worker in the case of young girl who felt love and loyalty toward her birth sister helped the adoptive mother understand these intense feelings for what they were and not as she had feared, as a rejection of her and the adoptive family. Although this family would need to manage this open relationship both practically and emotionally for years to come, the intervention gave them a base of understanding, tools for negotiating and a positive experience on which to rest their hope.
"I feel that this is an important service and I don't see another one anywhere around out there. If funding stopped...I can't imagine... "- Mrs. L.
One of the stated goals of another recent intervention was for the family to understand and empathize with the loyalty issues their adopted son continued to struggle with related to contact with his birth brother and father. His acting-out behavior as described by the adoptive parents became obviously sparked by his guilt and confusion over split loyalties. The intervention enabled the parents to reduce their anger, anxiety and feelings of failure thereby relieving pressure on their son while he tried to make sense of his feelings.
"You don't understand, (the crisis worker) was amazing! She would meet us anywhere... truck stop, football field...if we had called her at 2:00 a.m. she would have been there for us." -Mrs. S.
When children are adopted cross-culturally and/or cross-racially, an additional set of challenges emerge. Even when family relationships have been satisfying and stable, as adolescents some of these adoptees face the stress of added identity issues and feelings of disconnection from their heritage and roots. In one intervention where these issues were prominent, the adoptive family was in need of cultural information, an adoptive parent support group and articles, books and any resource possible that could help them universalize their own feelings and experiences as well as those of their teenager.
"I now have a better respect for (my son) as an individual, and a better understanding of adolescent behavior and adoption." - Mrs. B.
The Post-Adoption Crisis Intervention Project demonstrated success on many levels. The Task Force furthered networking among professionals, developed an approach and a product to expand competency based training for non-adoption professionals and spawned a very productive public-private partnership between IMPACT and the Department of Mental Health for the purposes of expanding adoption sensitive services in Massachusetts.
The intensive, in-home crisis intervention service was quite effective in helping to stabilize families with an adopted child or adolescent at risk of out-of-home placement. Of the sixty-two families served, 94% of the adopted children or adolescents were at home at the end of the intervention and 83% of them were at home three months after the intervention. These are slightly higher success rates for placement prevention than in the Homebuilder adoptive sample. The percentage dropped to 59% at home at the end of one year, a figure unavailable from the Homebuilder study. It is important to understand this figure in light of the population being served. All children referred had experienced at least one family separation by virtue of having become available for adoption, and most had suffered repeated separations and multiple moves putting them at risk for more fragile attachments. Most children and adolescents referred had also had several prior out-of-home placements, putting them in a high risk category for subsequent out-of-home placements. In addition, most children had significant mental health issues and were highly symptomatic, exhibiting behaviors that could be classified as high risk and delinquent, identifying them as those clients with which it is hardest to intervene. Certainly the population served by this project represents the children and adolescents who are most at risk for out-of-home placement and adoption dissolution.
The fact that adoptive families consistently gave high ratings to this service for its immediacy and its specialized focus should be given careful consideration in the future development of post-adoption service continuums. Based on placement prevention, cost effectiveness, goal attainment and client satisfaction this service should be expanded in this state and replicated elsewhere in response to the demand for effective and informed supports to adoptive families. Notably higher percentages of out-of-home placements and adoption dissolutions for the families who were referred but not served should teach us that there is an important role for this type of service to play in preventing the return of children to the public child welfare system.
It is imperative that intensive, home-based services with a specialized focus not be billed as the ultimate answer to the range of post-adoption service needs. Although such programs should be much more widely available both in this state and nationwide, there must also be greater accessibility to less intensive postadoption services, ultimately preventing some families from ever reaching such a serious point of crisis. However, given the myriad of issues inherent in the adoption experience including the challenges of adopting a child who has survived multiple separations and traumatic experiences, it is expectable that some adoptive families may need to repeatedly access intensive services. They should be able to do so without judgment or blame, and their participation should be viewed as a strength and a demonstration of commitment. The concept of a service continuum for adopted children and their families should be examined carefully, addressing both normative crises and extraordinary needs for service as they present themselves to families. Even with the most comprehensive array of services and the most elegant of interventions, out-of-home placement will be unavoidable for some adopted children. It is then that helping families to sustain their adoptive relationships becomes most critical. Clearly the preservation of adoptions is the most valuable and lasting contribution of this service, for children, families, agencies and society in general.
Introduction Project Description Accomplishments Benefits Conclusions
NYS Citizens' Coalition for Children, Inc.
410 East Upland Road • Ithaca, NY 14850
607-272-0034 • fax 607-272-0035
nysccc@nysccc.org
9/11/02