The act of adoption can be regarded as a happy ending, especially when a family and child have undergone a tortuous wait to find each other. This government is pressing ahead with a number of reforms to ease the adoption process in its determination to increase the number of children who end up in permanent placements. According to the latest figures, there were 4,734 adoptions in 2011 across England and Wales. But those figures are not the end of the story.
“A lot of people think once the child comes into an adoptive family, all problems are over, but actually it can re-traumatise a child,” explains Janet Smith, director of adoption support at Adoption UK. “The child can feel that the family has not turned out as expected, or the parent may feel they can’t be the parent they want to be – that is where extra support can be needed.”
There are no figures available on how many placements break down, although the government has commissioned the Hadley Centre for Adoption and Foster Care Studies at Bristol University to carry out research in this area. Smith suggests that overall, 20 per cent of adoptions may end in disruption, with some placements – such as older children or sibling groups – more likely to break down than others. However, she points out that disruption is a difficult thing to quantify. “When they become teenagers, children may walk out themselves, but that doesn’t mean the relationship doesn’t continue – the family still sees the child as their child and the child still sees adoptive parents as their parents, they just don’t live with them,” she says.
Most children who are placed for adoption continue to experience the neurological, developmental and psychological impact from their early histories even when they are in a supportive adoptive family. According to Adoption UK, 70 per cent of children adopted from the UK care system in the year ending 31 March 2011 had been removed from their families due to “abuse or neglect”. Adoption support services aim to help children work through their trauma and attach to their new family in a positive way.
Services can include financial support, which may help an adopter stay at home to parent full-time; mediation services to help children stay in contact with birth families; therapeutic services for the adopted child and the wider family; and training for the parents. Support groups can help parents and children get to know others in their situation, and benefit from their experience. These services can be delivered direct by local authorities or independent adoption agencies, or commissioned out to charities such as Adoption UK or the Post-Adoption Centre, or to individual therapists or other professionals. Where local authorities or adoption agencies do not provide services, they can signpost families, for example to mental health support.
Alistair is adoptive dad to nine-year-old Alex, who has a statement of special educational needs. A support plan agreed between the placing local authority, the home local authority and Alistair has resulted in a financial contribution for three years of family therapy, which Alistair describes as a “lifeline”.
“Without this support, we would have struggled,” he says. “The placement is going well overall, but there have been some sticky times. Alex needs quite a lot of help regulating his emotions. He hasn’t developed self-soothing skills, so he can get angry easily and his default mode is to think he can’t do things.” The therapist works with them to develop strategies to help Alex become more resilient, and also helps Alistair work through his own feelings: “It is easy to be drawn into Alex’s emotions, to feeling hysterical, and the therapist helps with that.”
Alistair feels he is fortunate in the amount and quality of support he has received, compared with other adoptive families. While local authorities are legally obliged to offer a needs-assessment to adoptive families, they are not obliged to meet any of the needs that are identified. Nor are they obliged to complete a full assessment of need where they are already providing information, counselling or advice. And even where the law requires it, the assessment does not always happen.
‘National scandal’
The government’s adoption adviser Martin Narey says many parents are in the dark. “The law requires that every adoptive parent can ask the local authority for an assessment of their support needs,” he explains. “I find quite a few adopters who don’t know that and are thrashing around for support.” A survey by Adoption UK early this year found that 62 per cent of adopters did not know about their right to request an assessment. Of those that had requested an assessment, only 63 per cent had actually received it, something the charity calls a “national scandal”. Eighty-one per cent of those who had an assessment were identified as needing support, with the greatest need being for therapeutic services, but only 56 per cent said their adoption agency agreed to meet their needs.
The amount and quality of support given varies, not only according to the local authority, but sometimes within an area depending on the confidence or “pushiness” of the adoptive family, the background or needs of the adopted child or the training of the individual social worker assigned to the family. Some local authorities are doing well – Smith cites the Adoption in the Black Country joint venture, and Swindon and Surrey (see box) as good examples. She also praises those councils that established adoption support teams using ringfenced money from the government-funded Adoption Support Grant, available between 2003 and 2006. However, others are not doing so well.
Difficulties can arise when agencies have to work together, as when a child is placed for adoption in a different part of the country, or when social workers attached to a case move on. Despite his own confidence in dealing with bureaucracy and a knowledgeable social worker from his own area “fighting his corner”, Alistair says he had to struggle to get the placing agency to honour the three-year commitment it made to fund therapeutic services for Alex.
There are no figures collected on how much each local authority spends on post-adoption support. Clearly, cuts are an issue for all local authority services. But Narey says he is not aware of any significant cuts to adoption support services. “I have seen no evidence of investment in post-adoption support being reduced through very difficult times – local authorities have maintained what they have, although it is still not all it needs to be in some areas,” he says.
Elaine Dibben, adoption consultant at the British Association for Adoption and Fostering, sees a varied picture. “There is some evidence of local authorities cutting posts in adoption support teams or having reduced budgets to deliver the services needed by adoptive families,” she says. “However, we are aware that some local authorities have invested in adoption support and increased capacity or services.”
Unexpected challenges
The Association of Directors of Children’s Services (ADCS) has proposed an “adoption passport” that allows families to ask for and receive support whenever and wherever they need it. “The support required is often not apparent at the time of the adoption and, as children grow, adoptive parents may face unexpected challenges,” says ADCS president Debbie Jones.
“Adoptive parents, like other families, move around the country making the provision of support more difficult. This means that while local authorities should make adoptive parents aware that they qualify for support at the point of adoption, the circumstances may have changed dramatically by the time this support is needed. What is required is a system that allows adoptive parents to ask for support whenever and wherever they need it, even some time after the adoption process.”
Smith says crucial times for support – apart from at the beginning of a placement – are the teenage years, when children can start to feel different from their peer group and show an interest in tracing their birth family, and ages seven to 10 when “the grieving process begins as they become more aware of what adoption means and what they have missed out on”.
There are no specific training requirements for staff working in support services. “Ideally, they should have experience of working with adoptive families, an understanding of the impact of trauma and neglect on children’s development and an understanding of the need for therapeutic parenting,” says Dibben. Such an understanding would also be welcome in schools, according to adoptive parents.
Adoption UK’s survey found 75 per cent of adopters feel their child’s educational needs are not being met. Looked-after children currently have more educational rights than those who are adopted, with virtual head teachers overseeing their education, personal education planning meetings and priority when it comes to school admissions – although from April 2013, adopted children will also be prioritised in the appeals process for school places.
“Alex’s school is very caring and because Alex has a statement, he has teaching assistant support, which has been great, but inevitably the school is still learning about adoption,” says Alistair. “School has made some allowances for challenges he has experienced in his life, but there have been some issues about understanding some of the pressures. More training for schools around adoption issues would be good.”
The inspection regime for post-adoption support services is about to change – from April 2013, there will be a three-in-one looked-after children’s inspection, combining adoption, fostering and looked-after children services. The idea is that this inspection will follow a child’s journey through care. “There is some concern about whether there will be sufficient time in the new inspection regime for all aspects of adoption work to be covered in depth,” says Dibben.
While there is good practice out there, it is clear that not all adoptive families are getting the support they need and, until they do, placements will continue to break down. Adoption UK is calling for statutory duties to be placed on education and health services in relation to the provision of adoption support and on the introduction of a statutory entitlement to adoption support services, not just an assessment. As one adoptive parent puts it: “It is daft that adopters have a right to have their needs assessed, but then no right to have those needs fulfilled."
SUCCESS IN SURREY
Surrey’s post-adoption support is “outstanding” and “excellent”, according to the council’s most recent Ofsted inspection.
Families have access to a range of professionals including educational psychologists, an adult psychotherapist, specialist occupational therapists working on sensory difficulties, and social workers trained in “theraplay”. A multi-disciplinary attachment panel, chaired by a specialist adoption worker, investigates the support needs of children and families, particularly those who may have more complex needs such as sibling groups or older children.
“We offer therapeutic support – life-story work and identity work seems to be the main area where people are struggling,” says Debra Hale, assistant team manager on the adoption and permanency team.
“We also run a drop-in service on the third Thursday of every month that is open to all adopters and special guardians. People come for a chat and a catch-up, but there are also appointments available with two educational psychologists that are attached to the team, and people can make an appointment with social services.” The team is hoping to replicate the service in another part of Surrey to make it accessible to families in other areas.
While some support services are delivered internally, families are also offered support from external agencies, including the Post-Adoption Centre’s contact surgery and Adoption UK’s “buddy scheme”, where experienced adoptive parents offer support, information and encouragement once a week by telephone or email. The council has recently signed up to After Adoption’s training programme for adoptive parents. Where the council does not offer a service, it is committed to “signposting” families to where they can be helped.
Work with schools is a priority – educational psychologists provide training in the particular needs of adopted children. “It is incredibly useful for schools that don’t always understand attachment and it’s a godsend for families,” says Hale.
Underpinning all of Surrey’s work is the philosophy that intensive support when needed means averting a crisis later on. “The idea is to shore up placements right at the beginning,” says Hale. “Families that run into difficulties are often those who didn’t have very intensive support at the beginning. Transition times are also important, such as moving school – some of our children struggle with change.”
ADOPTION SUPPORT: WHAT WORKS AND WHY
Dr Joanna North, adoption psychotherapist
My research into adoption support led to some straight-forward conclusions that, if put in place, could be remarkably helpful to adoptive parents. It is the worst-case scenario for children when they have been let down already by adults to then have their second chance at a family collapse on them. But this happens in a number of cases. It is too easy to blame adoptive parents when they give up. They will often have been put under an impossible strain without enough support to understand and pick up the complex emotional pieces of a child’s life. There are three key areas in which we can support new adopters.
1. Put adoption support in place from the beginning
Even the most complex cases will survive the early vulnerable years of adoption if adoptive parents are given support from the beginning – which means before the children arrive.
The most successful cases emerge when I meet the parents and we get to know each other before the child arrives at the new home. In these meetings, we can create a comfortable base together for exploring anxieties, confusion and crisis points that will inevitably arise. Once parents become confident of their capacity to steer their new family through a crisis, it builds competence and they become effective adopters. The flipside is where new adopters feel utterly defeated by the emerging behaviours of their new child and sometimes spend months getting help. Adoption support is like a secure base for the new parent while they build their parenting skills.
2. Help adopters deal with adaptation and change
New adopters become parents overnight, although they will have had a long run-in time with processing their fitness to be a parent. As one adoptive parent said to me: “It would have been easier and less exposing to be in the birthing room.”
It then takes about two years to comfortably build a secure base for the child and the family, during which time the adults are going through a process of adaptation to parenthood including changes in all aspects of their lives – social, financial, emotional and even biological. Adoption support is essential as a platform for supporting this adaptation. During this time, adoptive parents will move from their idealisation about parenthood to the reality of parenthood – but biological parents go through this too. It is exhausting, you will never have enough time for yourself, you will probably have to make financial and lifestyle changes that you did not expect, your relationship with your partner and friends will change, you might lose sleep, and so on. With some children, you may feel emotionally distraught for months as you learn to cope and help them with their emotional disturbance. Aside from all of that, it’s bliss and a great joy to bring up children and worth every minute of the struggle.
3. It’s all about a state of mind: kind, caring and calm
One of my adopters, whom I supported for two years with the process of caring for a very disturbed and troubled child, came up with three words for the best attitude that she found for raising a troubled child: “kind, caring and calm”. She found that whatever was happening in her home, if she maintained this stance she would always go round the cycle of difficult emotions and arrive in the right place. My adoptive parent’s findings are confirmed by the eminent neuroscientist Daniel J Siegel, who says that kindness in a parent, therapist or carer is one of the most powerful forces to help change the neurology of a frightened child (The Mindful Therapist, 2010).
But adoption triggers a massive adaptation for a child as well as the carer, however young that child is at the point of adoption. It is the state of mind of the parent that will support and assist the integration of the new experience in the vulnerable mind of a young child. It is the task of the adoption support agency and professional to support new adoptive parents in the task of keeping their own mind in a stable yet imaginative state and coping with their own fluctuating emotions as the new family builds their lives together. Given that this is a complex emotional process, it is of little surprise that people need support and can be vulnerable at this time. My call is to put in adoption support from the beginning. It is a much cheaper option – socially, emotionally and financially – than a failed experience of adoption.
Dr Joanna North runs an Ofsted-registered adoption support agency that is rated as outstanding. Her doctoral research investigated adoptions with children who have complex behavioural needs as a result of their traumatic experiences and culminated in the book, How to Think about Caring for a Child with Difficult Behaviour
