Preparing Children and Youth for Adoption or Other Family Permanency

Children leaving out-of-home care for adoption or other family permanency require preparation and support to help them understand the past events in their lives and to process feelings connected to their experiences of abuse and neglect, separation, loss, rejection, and abandonment. Child welfare, foster care, and adoption agencies often assume that permanent families will provide the healing environment for these children and youth, and these agencies spend considerable resources to recruit, train, and support foster and adoptive parents to provide legal permanency and well-being for these children. While a high percentage of these adoptions are successful – in that they are not legally dissolved – both children and families often struggle or suffer from stress that might have been mitigated by better preparation practices for all parties.

Evolution of preparation for permanency

From the time that children and youth are removed from family care, they face numerous emotional stressors as they adjust to their ever changing status: for example, foster child, dependent child, former adopted person, delinquent, and various diagnostic labels, among others. They are challenged by new surroundings and must come to some level of understanding of what happened to them as well as affirm their own identity and allow themselves to create new relationships and redefine existing ones without protective adult relationships to support and guide them.

Achieving permanency is not just an outcome for these children and youth; it is a process. Whatever their legal status may be, at all ages, they are most interested in the relational permanency that they can find, create, maintain, or develop in the safety of a parent-child relationship. Ensuring that children and youth are ready for relational and/or legal permanency in what has proven to them to be a world that offers little stability is a critical step.

Traditional Preparation Practices

No specific practice modality has been established across the child welfare delivery system to prepare children and youth for adoption. Rather, approaches to this work have been agency and individually based, with some similar components and services. Traditionally, services to prepare children and youth have focused on getting children ready for the adoptive family, helping them to understand the legal process, and obtaining their consent for such a move, although the specifics of what this entailed could vary widely. This remains the practice in many agencies. Assessment of children’s readiness for a new permanent family generally focuses on their behavior in foster care, with input from social workers and mental health professionals. Decisions are based on the assumption that children will accept new homes and families once they understand that it is unsafe for them to live at home. Actual preparation activities may consist of several conversations with the child or youth to talk about the family who wants them and then plan for the placement. The emphasis on where the child is going, with limited mention of biological parents and possibly siblings.

Numerous states and private adoption and foster care programs use established curricula to provide content and materials to train and approve potential parents, generally in compliance with federal and state policies. In fact, much of the preparation work is done with the prospective family, who, after reviewing the background of the child, meeting him or her, and having pre-placement visits, determines that they want the child and can manage the behaviors of the child. In cases where a child is already living with a foster family and becomes legally free for adoption by that family, the change in legal status often occurs with little preparation for either the family or the child regarding other aspects of permanency.

The Adoption and Safe Families Act of 1997 (ASFA) brought about a number of changes in adoption:

  • Elimination of long-term foster care as a permanency goal
  • A shorter time-frame to termination of parental rights
  • Change in emphasis in public agencies to a focus on time-specific goals to permanency, specifically, risk and safety assurances
  • Shift in caseworker roles to case management functions
  • More specialized work with children and youth, based on assessments and mental health treatment services

While the goal since ASFA has remained permanency for children and youth, service delivery has shifted toward a behavioral health perspective for treating the behaviors of children and youth. These behaviors are often viewed from a perspective of pathologies related to the trauma that may have resulted from long-term foster care, group care, and impermanence in relationships. Thus, caseworkers and other important adults in the lives of children and youth may rely on therapists or behavioral specialists to prepare children for permanency. The focus often is on correcting behavior – to the exclusion of helping the child heal past hurts, resolve issues with past relationships, and prepare for relational permanency with the birth family, relatives, or adoptive parents.

Only a few models of preparation of children and youth have been developed.

Models of child Preparation for Adoption

Chestang & Heymann (1976)

  • Consider child’s relationship to biological parents
  • Help child to understand they are not in foster care because they were “bad”
  • Do not vilify biological parents
  • Relieve child of guilt for placement
  • Assure child of his or her right to caring and nurturing parents
  • Help child understand foster care is temporary and adoption is permanent
  • Worker should have consistent contact with the child – at least once a week
  • Worker should explore type of family the child wants and seriously consider the child’s wishes
  • Child’s participation may vary with age

Jones (1979)

Four stage process:

  1. Help child to understand legal termination of parental rights
  2. Help child understand difference between adoption and foster care
  3. Completion of the life story book
  4. Pre-placement visits with adoptive family

Kagan (1980)

Strategic therapy approach to be used after adoptive placement prior to finalization. Assumes child is resilient to placement and has problematic behaviors.

Child Has five tasks to resolve to successfully adjust to placement:

  1. Adjustment to current placement; learning the rules, expectations, roles, and norms
  2. Grieving the loss of parents and other significant individuals
  3. Expressing feelings of anger, fear, and sadness, preferably to new parents
  4. Developing a positive identity and self-image separate from previous parental figures
  5. Reattaching and forming primary bonds with the new adoptive parents

McInturf (1986)

Five stage process using the lifebook as the primary tool of preparation

  1. The facts
  2. The whys
  3. The feelings
  4. The goodbyes
  5. The plan for the future

Fahlberg (1991)

Identifies 14 tasks to be accomplished in transitioning child from foster care to adoption:

  1. Introduce adoption to the child
  2. Arrange first meetings
  3. Provide “homework” for child and family
  4. Share information
  5. Get commitment to proceed
  6. Plan subsequent pre-placement visits
  7. Discuss name changes
  8. Initiate the grief process
  9. Discuss the “worst of the worst”
  10. Obtain permission for the child to go and do well
  11. Facilitate goodbyes with the foster family and other people important to the child
  12. Provide ideas for welcoming ritual
  13. Facilitate post-placement contacts
  14. Arrange post-placement follow-up

Henry (2005)

The 3-5-7 Model – Three-step model with focus on involving the child in the process.

Step 1- Help the child integrate past and present

  1. Clarification of past and life events
  2. Integration of all family roles and memberships
  3. Actualization of being a member of the new family

Step 2- Help the child answer five questions

  1. What happened to me?
  2. Who am I?
  3. Where am I going?
  4. How will I get there?
  5. When will I know I belong?

Step 3- Critical elements of involving the child in the adoption process

  1. Engage with the child in the process
  2. Listen to the child’s words
  3. When you speak, tell the truth
  4. Validate the child and the child’s life story
  5. Create a safe space for the child as he/she does this work
  6. It is never too late to go back in time
  7. Pain is part of the process

Where the Field is Going

There is a growing recognition of the need to develop better practice models that guide children and youth toward permanency in relationships and connections. In response, many public and private foster care and adoption agencies, residential treatment facilities, and therapeutic treatment agencies have begun to offer adoption and permanency services for children focused on issues related to the trauma caused by abuse and neglect. These services often provide excellent support for children but may be fragmented when it comes to addressing all of the relationships within the child’s social network. Better preparation addresses all of the relationships – past and present – in children’s lies, supports their grieving, and helps them identify new permanency sources. The type of support that children need for this work is not exclusive to therapists, but can and should also be provided by other important adults in their lives. Agencies must develop and cultivate the skill and understanding needed by birth, foster, and prospective adoptive families who do this important work.

Promising Practices for Preparing Children and Youth for Permanency

Working with children and youth to guide them toward permanency in relationships should include both steps to address past traumas of loss and abuse and opportunities to five meaning to existing and future relationships.

Addressing Past Experiences in Preparation for Permanency

Those working with children and youth who have been in out-of-home care and are preparing for permanency need a basic understanding of the child’s point of view, including these common experiences:

  • Loss and grief. Children and youth who are placed in the child welfare system often have a long history of losses and unresolved grief. They may have losses directly related to the circumstances that brought them into care (abuse, neglect), and they may experience additional losses when they are removed from their family and caregivers. Each move can bring more losses of friends, siblings, supportive adults, classmates, pets, familiar surroundings, and more.
  • Confusion and anger. Many children are left to wonder what really happened that brought them into care, why their families may not be able to continue caring for them, and who will be there to take care of them and protect them. A child may experience anger, sadness, and even depression. Many children struggle with their changed role within the family system or sibling status when they are removed from their birth family. Unresolved grief, effects of feeling unwanted and unloved, and confusion about who they are and where they will live have been shown to lead to behavioral issues, psychological confusion, emotional stress, and difficulty in forming new relationships.
  • Divided loyalties. Many children, particularly adolescents, have conflicting feelings about being a permanent member of a new family. These children may have difficulty with their sense of identity, may lose connections to immediate and extended family, and may have very little information about their own personal history.

Caseworkers who understand the child’s experiences from the child’s point of view will be better able to help the child or youth address past issues and explore the possibilities of new relationships.

Foundational Principles of Preparation

A number of foundational principles can help agencies shape an overall approach to support and guide children and youth as they identify and establish permanent relationships:

  • All children and youth deserve relational permanency.
  • Just as adoptive parents and guardians need preparation for the new relationships they are entering, so do children and youth.
  • Readiness practices are needed regardless of the permanency goal or outcome.
  • Permanency is a process for a child, not just an outcome. It starts with birth family relationships and continues with reunification, adoption, or other permanent familial relationships. Establishing or maintaining connections to the birth family or important people from a child’s past may help to mitigate loyalty issues, whatever the permanency outcome.
  • Permanency work with children requires time, consistency, and honesty from social workers.
  • Work with children and youth should not be considered only in the context of therapy. Although behavioral health services may be appropriate for any individual child, engaging the child in activities, tasks, and conversations to prepare him or her for permanency can be the work of caseworkers, caregivers, social workers, family members, court personnel, and others. In some cases, birth parents or other birth relatives may be able to help the permanency process by giving their children “permission” to move on to a new family.
  • Work with children and youth is a process that begins before placement and can extend past final adoption. (Unfortunately, many efforts do not start until the child has been freed for adoption when termination of parental rights has occurred, and many agencies provide only limited supports and services after adoption finalization.)
  • Engaging children and youth in readiness activities must be developmentally appropriate. The cognitive and emotional abilities of the child or youth must determine the types of activities (e.g. lifebooks) and resources used in permanency preparation work.
  • Permanency planning (the legal process) is distinct from permanency preparation work (the relational process). Children and youth can be empowered by their participation in the planning process, including their involvement in recruitment and family finding activities. Although these activities may engage them in some of the emotional tasks of preparing for permanency, a more comprehensive preparation program may help them explore their feelings about life events and support their readiness for permanency.
  • The work of the child or youth is to grieve old relationships in order to move toward new ones. The work of the caseworker and other adults is to prepare and support the child through the entire process.

Agency policies and caseworker practices that take a holistic view of permanency preparation work, considering it from the perspective of the child and encompassing the resolution of past issues and readiness for new relationships, will be better able to help children and youth bring their own meaning to permanency.

Permanency Preparation Practices

Most models of child preparation follow three basic stages, and these general steps provide a good organizational structure and sequence for agencies and caseworkers responsible for preparing children and youth.

  1. Help the child to understand the facts of his or her removal.
  2. Help the child explore feelings of loss, anger, and confusion.
  3. Empower the child to be part of the plans for the future.

There are seven elements that identify the necessary philosophies and skills of those working with children and youth. The elements are just a few of the many skills that adults need as they support youth through their grieving and preparing for new relationships:

  1. Use engagement activities that encourage expression of feelings and thoughts about life experiences.
  2. Create a safe space for expressing feelings.
  3. Recognize that behaviors are based in pain and trauma.
  4. Respond briefly to the child or youth’s comments in order to provide space to grieve.
  5. Listen.
  6. Affirm their stories.
  7. Be present as they do the work of grieving.

While a guided approach can be woven into other child welfare practices, the application of concepts requires training, leadership, and effective communication skills. It also requires a time commitment by the caseworker so that the child or youth has continuity throughout the process. The worker and youth should meet at least once every 2 weeks, with interim phone calls.

Some youth may present barriers to adoption. Youth’s common concerns include:

  • Not understanding what adoption means
  • Not believing that anyone would want to adopt them
  • A worry that adoption would prevent them from ever having any contact with their birth family, including siblings
  • Feelings of disloyalty to their birth family
  • Worry about changing their name
  • Worry about moving far away

Most of these concerns can be addressed by providing factual information in a candid and sensitive matter, however some need more specific tactics to help ease the fear or anxiety surrounding these issues for the child or youth.

Youth engagement and empowerment is an important part of permanency preparation work, especially for older youth who may have experienced greater disappointments and have more reluctance to seek out a new family. Workers have used successful strategies to help youth overcome their lack of hope and distrust about achieving permanency, including:

  • Emphasize the advantages of adoption
  • Seek relatives and other connections to adopt
  • Be open and honest about the adoption process and possible outcomes
  • Empower youth throughout the adoption process
  • Address questions and concerns
  • Build a relationship with the youth

Conclusion

Helping children, youth, and families served within the child welfare system to prepare for permanent relationships offers greater opportunities for their improved well-being. Children and families often have both the strength and resilience to overcome hurtful life experiences and move on toward resolution of past losses. Models of intervention that establish these practices are beginning to demonstrate a practical and viable method to support successful outcomes with families.

 

Source: Child Welfare: www.childwelfare.gov

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