Reshaping Adoption: Family Success Strategies for the 21st Century

1. Reshaping Adoption in the 21st Century:Progressing from `Child Placement’ to `Family Success’National Center on Adoption and Permanencywww.ncap-us.orgAdam Pertman, Presidentapertman@ncap-us.orgRuth McRoy, AdoptUSKids Evaluator NCAP Program Chair and Senior Fellowr.mcroy@mail.utexas.edu

2. National Center on Adoption and PermanencyOur Vision: Successful Families for All Children The National Center on Adoption and Permanency (NCAP) is a unique “one-stop” organization that provides a broad range of information, resources and multidisciplinary services relating to adoption, foster care and child welfare. NCAP’s mission is not only to achieve permanency for all children – in families of origin when possible and in new ones when necessary – but also to reshape policy and practice to enable those children and their families to succeed.

3. Our Strength is in Our People and Services NCAP is led by President Adam Pertman, former head of the Donaldson Adoption Institute; Executive Director Carol Biddle, former CEO of Kinship Center; and COO Allison Maxon, former Division Director of Kinship Center. Our work includes: • Research, evaluation, program & project development, consultation • Board development, consultation and/or executive transition planning  • Staff development and training to improve clinical and practice competence • Parent/caregiver training for families with children with histories of trauma • Communications: writing, editing, print, online/social media, related activities • Consultation on development and fundraising, as well as community relations • Conference/event consulting, including keynote speakers, other presenters • Executive training/coaching, policy development/analysis, practice protocols To learn more about our people and services, please write to Adam at apertman@ncap-us.org, call him at 617-903-0554 or go to: www.ncap-us.org.

4. A Few Books of Interest(to us, at least)

5. What We Know . . . About Everyone “In all of us there is a hunger, marrow deep, to know our heritage, to know who we are and where we have come from. Without this enriching knowledge, there is a hollow yearning; no matter what our attainments in life, there is the most disquieting loneliness.” – Alex Haley in Roots

6. What We Know . . . About Adoption • How many children are adopted in or into the United States each year? a). 85,000 b). 125,000 c). 175,000 • Of the three “categories” of adoption in the U.S., which one occurs most? a). International b) Foster care c). Domestic infants • How many people in our country have adoption in their immediate families? a). 45 million b). 85 million c). 100 million

7. Adoption in America: A Brief History • For generations, “formal adoption” meant unwed mothers, white babies, white married couples • Secrecy, stigma and shame characterized the process and all of its participants • Acceptance of single mothers, legalization of abortion, birth control instigate major changes • World events fill the gap, most notably Soviet Union dissolves and China imposes a one-child policy • Paradigm in foster care shifts to “best interests of the child” as defined by permanency

8. So . . . What Has Changed?

9. A Shift in Understanding and Practice 1950s . . . and . . . Today Secrecy “protects” members of the triad Birthparents told to go on with their lives as if nothing happened Adoptive parents feel entitlement and are protected from intrusion Adoptees assumed not to have adoption-related issues, so nothing to do More openness & honesty in all types of adoptions Most first/birth parents want openness and are usually helped by it With more openness, adoptive parents feel more entitlement and less fear Adopted persons benefit from knowing about and contact with birth families

10. Fitting a Square Peg into a Round HoleThen . . . and . . . Now Denial of difference between adoptive, bio families Match for race, physical traits > adoption undetectable “Chosen child” – it was a “win-win” for all parties! Agencies did not “interfere” after finalization Minimize importance of adoption in child’s identity Searching viewed as a sign of maladjustment Acknowledgement of difference is healthy Diversity in families makes adoption conspicuous Focus on helping deal with loss and other issues Professional support is important or even vital Adoption is recognized as part of identity Desire for information and connection seen as normal

11. A Result of the Adoption’s Greater Openness & Honesty: More Complexity • When do we tell our child she’s adopted? • Who are the members of your family? • Remember: Only adoptive families are complicated and have issues – as opposed to say … step-families, divorced families, grandparent-led families, single-parent families, families with two dads or two moms, families with children who have special needs … • To get the answer you’re seeking, you need to ask the right question; it’s about reality – and ethics.

12. Where We Are Today • Fewer than 1% of single women voluntarily place their children for adoption, and most become their parents. • Stigma, secrets, embarrassment and shame are lifting; we’re not there yet, but move is to greater openness and honesty. • Laws, policies, practices and attitudes shifting; we’re not there yet, but improving as we learn about adoption’s realities. • Adoption today is still commonly understood as child placement – so most people still don’t know much about the people involved (especially birthmothers), their needs, etc. • The adults adopting today are straight and gay, come in all colors, are married and cohabitating and single, young and old – and most children being adopted are not white infants.

14. Trends in Foster Care and Adoption: FY 2006-2015, AFCARS

15. Proportion of Non-stepparent U.S. Adoptions by Type 15 Non-stepparent U.S. Adoptions by Type

16. What Do the Families Look Like? The children being adopted – and all their parents – have changed over the decades; here’s what they look like today: • About 15,000 babies, many of color, placed each year with mainly white couples by mostly not-young or single mothers; an unknown, rising number are adopted by gay men/lesbians • About 6,000 girls and boys, mostly children of color who are not babies, are born in other countries and overwhelmingly are adopted from orphanages by white couples • About 50,000 children and older youth, who had been in foster care – a disproportionate number of color – are adopted alone or with siblings by gay, straight, single, married and cohabitating adults and couples of every age/race/ethnicity.

17. Historic Shifts, Systemic Impact • About 125,000 adoptions in U.S. a year * About 40% stepparent adoptions * 50,000 child welfare adoptions * 6,000 international adoptions (fell dramatically in last few years) * 15,000 domestic infants (decreased tenfold since 1970) • The real numbers: a far bigger population • Overall, 40% of adoptions in U.S. are trans-racial/ethnic * 28 percent from foster care * 21 percent of domestic infants * 84 percent from other nations • Reality on ground (records, LGBT, etc.) outpacing law, policy • And now … the internet is changing everything (more on this later)

18. Some Bottom Lines • Adoption has contributed to historic changes in perceptions and understandings of what families are, how they are formed, what they look like, etc. • Vast majority of adoptions today are of children who were abused, neglected or institutionalized before adoption (see pie chart). • There’s greater/growing openness and honesty in all types of adoption. Do laws, policies, practices and attitudes reflect and support that reality? • No. Most laws, policies and practices today still focus on “child placement” … and were created for a world that no longer exists. • Our focus has to be on progressing to a “family success” paradigm that genuinely serves all children … with a primary focus on the ones in society’s care, who were implicitly promised a better life.

19. Who are the Children and Youth Waiting to be Adopted from Foster Care? Of the 111,820 children waiting: • 53% = males • 47% = females • In continuous foster care an average of 31.7 months. • On average 5 years old when they entered foster care • Average age of waiting children =7.6 years • 62,378 of the waiting children have had their parental rights terminated. Source: AFCARS Estimates FY 2015 as of June 2016

20. Racial/Ethnic Background of Waiting Children • 43% White • 23% African American • 22% Hispanic • 2% Alaska Native/ American Indian • 0% Asian • 1% unknown • 8% Two or more races (Source: AFCARS Estimates FY 2015 as of June 2016) The 2011 Census estimates, however, the representation of children in the US is: • 54% White • 14% African American • 23% Hispanic

21. What are the Barriers to Adoption?

22. Wilson, Katz, & Geen, 2005: Summary of Findings on Adoption Barriers • Only 1 in 28 people who call seeking to adopt from foster care completes the process (i.e., adopts) • Most attrition occurs between time of application and commencement of the home study • Word-of-mouth is more important than media for finding potential adoptive parents • First call is generally not handled well by agencies (emotionally charged for many potential adopters)

23. Wilson, Katz & Geen (continued) • A strong personal connection with someone at the agency can make the difference, particularly during 1st call and during the home study • Agencies struggle to balance recruitment vs. screening • Potential adopters often confused about the process • Applicants frustrated by “secrecy” of matching process • Potential adopters struggle with how open to be during the training and home study process

24. REPORT TO CONGRESS ON BARRIERS & SUCCESS FACTORS IN ADOPTIONS FROM FOSTER CARE: PERSPECTIVES OF FAMILIES AND STAFF SUPPORTED BY THE ADOPTION OPPORTUNITIES PROGRAM 2007 U.S. Children’s Bureau Administration on Children, Youth and Families U.S. Department of Health and Human Services

25. Barriers Study: Family Perspectives Goal To identify actual and potential barriers to the completion of the adoption process from the perspective of a nationwide sample of 300 families seeking to adopt from the foster care system. • 102 (51%) discontinued the process • 98 (49%) finalized adoptions of 158 children AdoptUSKids: Barrier Study Methodology • Longitudinal Study (2003-2007) • Mixed methods • Nationwide Sample • 300 Adoption applicants • Multiple Interviews/Surveys • 382 Public and Private Agency Staff Surveys

26. Family Ethnicity

27. Family Structure

28. Motivation to Adopt through Foster Care: Five Most Common Responses From Finalized and Discontinued Families • Wanted to help a disadvantaged child/child with special needs/child waiting in foster care • Financial reasons – too expensive to do a private or international adoption • Didn’t want a baby • Wanted an older child • There are so many children in the U.S. that I do not want to do an international adoption

29. Understanding the Barriers • In which parts of the adoption process do prospective parents encounter the most barriers? • What are the most frequent barriers they encounter at different stages of the process?

30. Matching Children and Families "I think there has to be a better way to make the initial match to make it move faster. I think some of the caseworkers become so involved with some of these kids, and they’ve had them in their system for so long, that they almost look for too perfect a match, where there are lots of matches that would have worked, and the kids would have been in a permanent home sooner. We’re losing potential parents just because they can’t handle the wait time. ...”

31. Takes Too Long "It’s easier to go halfway across the world (laughing) in some ways than to do it [adopt] in our own state, which is frustrating to me 'cause I know there's a lot of need.“ ICPC Barriers “[The worker said], ‘We have plenty of children here in [state] that are in need of adoption’… I said, ‘We’re not looking in [state]; it’s just we’re looking everywhere.’ She said, ‘well, you know … these classes, of course, are state funded. … if you’re not going to adopt from [state], I don’t know if we can offer these classes to you.’ ” Lack of Follow-Up “We would get calls that ‘We have this child, are you interested?’ . . . and my answer was always, ‘yes’. I guess 5 or 6 times they called like that and I said, ‘what’s the next step?’ ‘Well, I’ll call you back with the details. But the call back never came.”

32. Disrupted Placement “When it came to reviewing the kids' files and everything, they lied to us. They didn't tell us, you know, the problems that these kids were having. And there wasn't anything in their files that we read about, some of the things that we found out later on after we had the kids. And so, we found out that the little boy had been sexually abused when he was younger…, which, you know, we did not know. So we didn't know how to deal with it when it started coming out. But it was probably the worst experience that we've been through in our lives. I don't think we ever want to go through it again.”

33. Finalized Adopters Encountered Barriers, Too (n = 98) • Process logistics (i.e., difficulty in getting through process, complexity of application, jumping through hoops, excessive paperwork/“red tape”) • Agency communication/responsiveness • Level of agency emotional support • Availability of non-financial services (i.e., therapy, support groups and psychiatric services) • Jurisdictional and interjurisdictional issues

34. FAMILY PERSPECTIVES Adoption Process Agency Communication Agency Emotional support Availability of Services Jurisdictional and Interjurisdictional Issues STAFF PERSPECTIVES Inadequate Pool of families Issues related to TPR ICPC placements Size of caseloads Availability of post adoption services Top 5 Agency Barriers

35. Incorporating Research Findings Into Practice at the Front Lines • Return phone calls to reduce families’ feelings of isolation and confusion • Increase attention to families waiting to adopt • Provide information and referrals on post-adoption services / help to identify future sources of support • Acquire knowledge about characteristics of the waiting children and families

36. Time to Move to a `Success Model?’ “We have to think outside of the box. It seems that we are recycling the same ideas whenever systems are restructured. It is important to build an entire community around our children, not just provide them with a temporary home."

37. Successful Adoptive FamiliesStudy Two: Success Factors Assess factors that lead to favorable long-term outcomes for families who adopt children with special needs Family Structure(N=161 families; 270 adoptive parents) • Married couples = 104 (65%) • Unmarried, same-sex couples = 2 (1%) • Unmarried, opposite-sex couples = 3 (2%) • Single females = 47 (29%) • Single males = 5 (3%)

38. Parent Satisfaction "I think very satisfied. She's a gift. … She sees things in a totally different way, as I suppose most kids who have MR do. You know, every day is a new day, and the smallest of things just makes her happy. Doesn't matter what it is, most of the time [laughs]. She is just refreshing because you can see things differently. She has a wonderful sense of humor, wonderful sense of humor. I can't say enough.“ ---------- "Well, I mean, there certainly have been rough periods. I'm not going to lie to you and say it's all been perfect, because it hasn't. But overall I think it's been a good experience for my husband and I, and for him too. I think we've all grown as individuals and as a family. I think we've all learned things about ourselves and each other. And I like the direction it's taken our lives."

39. What is a Successful Adoption? “… they come with all these diagnoses and it’s kind of overwhelming at first. … And when you get deep in the root of them, in who they are, it’s not so ‘special needs’ anymore. It’s just they’re your kid. And that’s who they are.” “ Raising a kid to maturity where they are self-supporting. And not giving up. And also meeting their needs no matter what those are. Hanging in there.”

40. What Does the Family Contribute To the Success of the Adoption? • Commitment to the child and adoption process (117 families; 73%) - “sticking it out through thick and thin” - “fully integrating the child into family/not treating them differently” - “giving the child unconditional love” • Effective parenting skills (48 families; 30%) - patience - consistent discipline - ability to provide routine and stability • Seeking resources (33 families; 20%) - advocating with public agency, schools, mental health system - seeking new information/additional training on effective parenting

41. What Advice do Adoptive Parents Give to Prospective Parents? • “Don’t think that love conquers all because it doesn’t. The kids’ needs are so great that it’s just not going to happen on love alone. It takes time and bonding.” • "It's going to take resources, and it's going to take time, and it's going to take effort.” • “IT CAN BE DONE!!”

42. To Overcome Barriers and Enable Families To Succeed, Give Them What They Need

43. Keeping the Promise:The Critical Need for Post-Adoption Services

44. Background and Context • Adoption is commonly understood as placement. • Vast majority adjust well; high family satisfaction. • These children were maltreated beforeadoption. • Vast majority meet “special needs” criteria. • Children’s issues often don’t manifest until school. • Many parents do not get preparation, resources.

45. The Good News from Parents Only 15% say relationship with children more difficult than expected. (Nat’l Survey of Adoptive Parents) Over 90% in any type of adoption are satisfied with their experience. (Howard & Smith, & Ryan, 2004; Rosenthal & Groze, 1994) Most feel very close to children: 83% CW, 87-90% biological, int’l, infant. (Howard, Smith & Ryan, 2004) 45

46. The Challenges Utilization of clinical services by adoptive families is triple rate reported by birth families. Over 1/3 of adopted children receive at least one type of counseling or mental health service. (National Survey of Adoptive Parents) Behavior problems for many of these children and youth are chronic. Underlying emotional issues drive behaviors. 46

47. Principal Findings • Most adoptees come to families with higher risks for a variety of challenges/problems. • Adoptive families utilize clinical services at a very high rate. Is that a bad thing? • The layers of issues and dynamics are often not understood by parents, professionals. • Adoption-competent therapy is most-often sought, but – like other services – is lacking.

48. The Right Thing for the Many Reasons We should be helping these children and families . . . well, because it’s the ethical and moral thing to do in a civilized society . . . but here are other arguments: • Each adoption from care saves governments an average of $143k. (Barth, et al, 2006) • Successful adoptions from care save money in human services and reduced crime, totaling $302,418 per adoption. (Hansen, 2007)

49. Primary Recommendations • National task force for post-adoption services. • Private/ public partnerships (including dedicated federal funding) to maximize services and access. • Public policy, child welfare officials use budgets, resources to focus on helping families succeed, with PA services part of the picture at all levels. • Funded research should increase significantly. • Curricula for professionals working with families.

50. Another Big Factor: How ProfoundIs the Internet’s Impact on Adoption?