Postadoption services help families cope with issues that arise after the adoption papers are signed.
By John Celock
After Barbara Dewey adopted three foster children into her Lincoln, Nebraska, home, a local postadoption support group was a lifesaver.
"[With a] history of abuse, and the number of placements, the behavior of the kids was berserk," she says, noting instances of insomnia, temper tantrums, property damage, sexual acting out, and a 4-year-old with no speech. "Other people had worse weeks than I did. There was a lot of comfort in that. We had one family where the kid tried to burn the house down."
A social worker referred Dewey to the group after the adoptive mother brought up some of the issues she was facing at home. During regular meetings, Dewey and her fellow support group members would discuss issues they were facing at home, along with how to navigate the Nebraska social services system. During these discussions, they would share common experiences and work on ways to deal with the issues.
In addition to talking and listening to each other for support, members would provide respite assistance, such as babysitting and doing chores, for other parents in the group who had taken ill. And each year, the group would sponsor a clothes collection for foster families.
Some of the families had been members for 22 years, and most of their children were now grown, so Dewey's group recently disbanded. But she still has many memories of the twice-monthly meetings, the pool parties, and the group outings, all designed to help the parents. "It [was] what you did the first and third Friday of the month," she recalls.
Postadoption services are a growing aspect of the adoption profession. Recognizing the issues facing adoptive families are often different from those facing biological families, many adoption agencies and private groups have come together to formulate plans to address these issues.
A recent CWLA survey of private member agencies, found 94% of respondents across 39 states provide postadoption services, including support groups, crisis intervention, child and family advocacy, adoption searches, case management, family therapy, mental health treatment, respite care, and targeted case management.
See "Survey Examines Postadoption Services Among Private Agencies."
"As adoptive and foster parents, all of the challenges do not stop because a child is adopted," says Judith Ashton, Executive Director of the New York State Coalition for Children, a postadoption advocacy organization in Ithaca. "Adoption is a lifelong process, and families and children need support throughout the process."
Children adopted from the foster care system--many of whom are adopted later in life and after suffering physical, mental, or sexual abuse--face far more difficult and complex issues. The most common include attachment and adjustment problems, along with explaining the reasons for adoption to the children. For children coming out of foster care, families commonly deal with kids acting out and trust issues because of the children's histories. Many of these issues are common no matter the form of adoption--open, closed, foster care, international, or kinship.
"For some of these kids who are special-needs, they will need counseling on and off the rest of their lives," says Ada White, CWLA's Director of Adoption Services. Working as an adoption manager for Louisiana a decade ago, White recalls families falling apart because they couldn't handle the stress and cost of the mental health issues facing their newly adopted children.
"We didn't know a family was in trouble until they were to the point of filing for bankruptcy or wanting to give the child back to the state," she says. "At that point, there was very little the state could offer, because the family was not only bankrupt and wanting to give the child back, their marriage was in trouble and it's very hard to mend an adoption then. What the family needed should have been provided to them ahead of time."
The largest share of funding for postadoption services, White points out, comes from the federal Adoption Assistance program through Title XIX, which provides not only some financial assistance, but also covers some mental health and most physical health care needs for children adopted from the foster care system.
Many private organizations have formed postadoption support groups to bring parents together. These groups are often peer driven and moderated by their own members. New members are routinely referred to the groups by social workers and adoption counselors.
"Families that have shared experiences can be a lifeline," Ashton says. "You never have to explain why you did such a thing. We don't judge families. Breaking down that sense of isolation can be tremendously affirming."
In addition to the local support groups founded by adoptive parents nationwide, state and national advocacy groups have made postadoption services a hallmark of their work. The Collaboration to AdoptUsKids, for example, has awarded 35 minigrants annually over the past five years to parent groups nationwide and in Puerto Rico to support new and existing adoptive parent organizations. AdoptUsKids is a federally funded initiative of the U.S. Children's Bureau.
Support in Stearns County
With eight birthchildren and 15 adoptive children, Paula Dunham is no stranger to the adoption process. Of Dunham's five adoption experiences, one was international, and the other four were through the foster care system. Throughout her adoptions, she has been involved with, and a moderator of, the Stearns County Adoption Support Group, a private organization in Minnesota.
At least 15 parents attend each monthly meeting. Members represent every type of adoption, but most have adopted through the foster care system. The group allows parents to express their personal issues and share mutual experiences. Attachment issues usually dominate the conversation, but other issues include lying, stealing, oppositional behavior, hoarding food, and smearing feces on walls.
"Often the children have no trust of adults," Dunham says. "Why should they? The adults in their lives have done horrendous things to them."
Members have adopted children ranging from toddlers to teenagers. Dunham notes that issues do change based on the age when the child was adopted, although some remain consistent no matter the child's age, and some carry through as a child ages. "Older children often are able to comprehend what's going on," Dunham says. "You can talk things out with the older children easier."
Dunham says her group also brings the children together to learn from each other and to get to know other children who have similar stories. A playgroup has been organized for the children, and parents have formed many friendships through discussing adoption issues. The teenagers also get together to hang out and share adoption experiences.
A Growth Area
Ashton notes the specialty of postadoption issues among social workers has lead several colleges to establish postadoption curriculums for social workers. The School of Social Work at Hunter College in Manhattan is the first school in New York to establish a postadoption certificate program.
Geared toward mental health professionals who work in adoption, the noncredit-bearing 12-week program teaches the issues common to adoptive families, focusing on those who have adopted children out of a public foster care system.
The Hunter curriculum includes classes on current trends in adoption and foster care, how to design a treatment plan for families, the effects of abuse and neglect on children, and how to handle adoptive children's questions about their birthfamilies and why they were placed for adoption.
"Working professionals cannot plop a biological family model on us and expect us to be a part of it," Ashton says. "I would like to see a version of the [Hunter] curriculum available to anyone in social work and where they are getting training."
In New York, a variety of public and private adoption agencies provide postadoption services. Many are funded by the state through its Temporary Assistance for Needy Families (TANF) grant from the federal government, which has been the focus of discussions between Governor George Pataki and the state legislature this year. According to Ashton, the services available in New York are not uniform and can differ from agency to agency across the state's 62 counties. She hopes Hunter's new program will bring uniform training and ideas to postadoption programs.
Families who adopt children from overseas also encounter a variety of postadoption issues. Philadelphia Children's Hospital has created an International Adoption Health Program.
According to program director Gail Farber, when children arrive from overseas, they bring a variety of mental and physical health problems with them, including nutrition and attachment issues. Following initial examinations, follow-up exams are scheduled to assess each child's progress in the United States and to address postadoption issues in the family.
"When we look at infants and toddlers, often they are developmentally behind their peer group," Farber says. "Even those who come out of foster care have a loss of a caregiver."
As a part of its program, Children's Hospital has developed support groups for parents and children so they can learn from each other. In addition, the medical staff works with the children to address issues of attachment, abuse, abandonment, and the effects of living in an orphanage.
Farber says her staff addresses all of the issues the children face, not just a portion, as some programs do. "Few places look at these kids holistically. We don't want to label the kids. They need services and an array of intervention. It's not all doom and gloom. We have been working with families who have been extremely resilient. International adoption produces families who are advocates. Some are bruised, but others will advocate for their kids."
Dispelling Myths, Building a Culture
"One thing I would like to do is dispel the myths of adoption," says New Jersey State Assemblyman Bill Baroni (R), himself an adoptive child.
Baroni's words ring true with many adoption professionals and adoptive parents. Some have said part of the postadoption process is to eliminate these myths to help children adjust into their circumstances.
Baroni, 34, was born to a young Irish woman who came to Florida to have him and place him for adoption. Adopted at the age of 6 weeks by a New Jersey couple, he has made adoption issues one of his priorities in the legislature.
Growing up, he says he has not faced many of the issues common among adoptive children, such as the desire to search for birthparents. He and his family did not participate in postadoption support groups, but did participate in other adoption-related events during his childhood.
"I remember going to adoption events with Catholic Charities," Baroni says. "It was important to my parents in the 1970s. It was something to be proud of, but not talk about. My parents were afraid my birthmother would come back."
Noting he does wish he had his birthfamily's health records, Baroni has been working to create a health registry system for adoptive families in New Jersey, allowing adopted children to access their health records without otherwise tracking down their birthparents. This would address privacy concerns of birthparents who don't wish to be in contact with their children.
In addition, Baroni says he would like to build what he deems a "culture of adoption" in New Jersey. This would include more services for families throughout the entire adoption process, along with support during the process. His proposals are similar to what adoption advocates nationally have tried to implement.
As Ashton explains, "[For] adoptive and foster parents, all of the challenges don't stop because a child is adopted. Adoption is a lifelong process, and families and children need support throughout the process."
John Celock is a freelance writer in New Jersey.
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