Keeping the Promise: The Critical Need for Post-Adoption Services to Enable

1. Keeping the Promise: The Critical Need for Post-Adoption Services to Enable Children and Families to Succeed

2. A Consensus among Professionals:We Need to Implement Real Change The Evan B Donaldson Adoption Institute’s “Keeping the Promise” report has stimulated enormous support in the adoption and child welfare community. Today, an extraordinary range of partners has coalesced for a movement to alter the paradigm of adoption in America so that it is not only about child placement, but also about enabling families to succeed. The partners include: Evan B. Donaldson Adoption Institute Child Welfare League of America North American Council on Adoptable Children Dave Thomas Foundation for Adoption Voice for Adoption American Academy of Adoption Attorneys National Council for Adoption Joint Council on International Children‘s Services Adoption Exchange Association Kinship Center Lutheran Social Services of New England Spence-Chapin Services The Cradle Bethany Christian Services Center for Family Connections Center for Adoption Support and Education New York State Citizens‘ Coalition for Children Wide Horizons for Children Adoptions Together Children‘s Home Society of North Carolina Adoption Resources of Wisconsin . . . and many more Keeping the Promise

3. Adoption in America Today:The Reality and the Need • 1 in 25 families in the U.S. with children have an adopted child, and about 100 million people have adoption in immediate family • The types of adoptions in our country have changed radically over the past 30-40 years • Most adoptees (not including by step-parents) come from backgrounds with elevated risks for developmental challenges • Here’s why . . . Keeping the Promise

4. Current Non-Stepparent U.S. Adoptions Keeping the Promise

5. International Adoptions into the U.S.

6. Number of Adoptions with Public Agency Involvement

7. Keeping the Promise:Principal Findings • Early deprivation/maltreatment = higher risks for challenges (developmental, physical, psychological, emotional, behavioral) • Most adoptees adjust normally, but a sizable minority struggle • Complexities are often not understood by adoptive parents or professionals (educators, pediatricians, counselors, etc.) • The help sought most is adoption-competent therapy, but most mental health professionals lack relevant training • Development of post-adoption services started over 30 years ago, but has slowed greatly in the past decade • Services are linked to parents’ greater willingness/ability to adopt from foster care, and parents whose children have special needs report more success /satisfaction when they get services • Many families report not being able to get needed services or endure years of escalating problems before finding them Keeping the Promise

8. Risk Factors for Ongoing Challenges • Prenatal malnutrition/ low birth weight • Prenatal substance exposure • Older age at adoption • Early deprivation & neglect • Physical, sexual & emotional abuse • Multiple placements • Emotional conflicts re: loss & identity • Genetic vulnerabilities Keeping the Promise

9. Bringing the Research to Life:Listening to Families 1. What were – and are – the primary challenges? 2. What was their impact on your family? 3. What was your experience in seeking help? Keeping the Promise

10. Good News in the Family:Closeness and Realized Expectations • Only 15% of parents report relationship with their adopted child is “more difficult” than they expected (National Survey of Adoptive Parents, 2009) • Most parents feel very close to their children across all types of families -- 83% who adopted from child welfare -- 87-90% of international, infant adoptees or of birth children (Howard, Smith & Ryan, 2004) Keeping the Promise

11. The Challenges • Adoptive families’ utilization of clinical services is triple the rate reported by birth families • Over one-third 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 are chronic, representing how they adapted to survive early traumas and get their needs met Keeping the Promise

12. Children 6-17 Receiving Mental Health Care (National Survey of Adoptive Parents) • 46% Foster care adoptions • 33% Private domestic adoptions • 35% International adoptions • 10% General population (National Survey of Children’s Health) Note: 10-15% of children who had damaging early experiences face severe issues Keeping the Promise

13. Child Welfare Adoptions: A Continuum of Needs • 55% Good attachment, behavioral scores within average range • 30% Some attachment issues, behavioral scores at level of youth in clinical treatment • 15% Very severe behavioral and attachment problems Note: Service needs differ for each category Keeping the Promise

14. What Services are Needed? • Information & referral • Education & training • Support services (support groups/mentoring) • Therapeutic counseling • Advocacy/crisis intervention • Respite care • Residential treatment Note: Service needs vary according to level of challenges Keeping the Promise

15. Barriers to Families Receiving Help • Mental health professionals lack adoption knowledge and competence • Effective treatments are just now developing • Can be hard to get effective, timely help because of complexity of problems & needs • Some states require guardianship to get residential care • Some problems cannot be remediated and need ongoing support Keeping the Promise

16. A Major Barrier: Inconsistent and Falling Funding • Some states have a range of post-adoption services, while others do not have any • Program capacity often does not meet demand • Cutbacks in subsidies and post-adoption services can have disastrous results • Some statewide programs have been decimated and others are up for elimination Keeping the Promise

17. When Needs Are Not Met:Major Consequences The human toll • Adoptions disrupt before finalization: around 10-15%, resulting in emotional damage to children and families • Some return to care: 2005 AFCARS data showed over 6,000 previously adopted children in foster care nationally • A significant number of families simply struggle every day The cost to society • High financial cost to states of children returning to care • Lack of post-adoption services is a deterrent to adoption • Lower costs in human services and reduced crime when children are adopted, estimated at about $302,418 per child Keeping the Promise

18. Early Intervention Makes a Difference • Can prevent many, if not most, adoption disruptions • Can help parents understand child’s needs and best approach to promoting healing, resilience • Can lessen compounding of problems and emotional pain • Can provide supports to continue parenting Keeping the Promise

19. More Consequences:Family Dynamics with Unresolved Problems • Severe power struggles • Mother takes brunt of child’s anger • Marital tension • Conflict thru family / sibs • Isolation • Running on empty/exhaustion • Parents feel like failures/hopeless • Difficulty connecting, empathizing with child Keeping the Promise

20. Rethinking Adoption • The Promise: the covenant between parents and children and also between agency and government and the adoptive family • Need for re-conceptualizing agency/state role in adoption to include a continuum of services • Post-adoption services are in desperate need of development, including knowledge base (research & training), continuum and funding • We need a paradigm change so adoption isn’t just about child placement but family success! Keeping the Promise

21. Now What?Policy Recommendations 1. Federal funding for post-adoption services should be enhanced and improved, including a dedicated federal funding stream that is flexible and sustainable allowing states to rely on future funding 2. Adoption-competent post-adoption services must be developed and be made available for all adoptive families in need & elimination of all state policies that force parents to give up custody in order to get services Keeping the Promise

22. Policy Recommendations (continued) 3. Enhanced research on post-adoption interventions and training for a “workforce” of post-adoption practitioners & evaluation components to enhance best practice and positive outcomes • Specific steps for Congress to take this session, to support children & families beyond placement include: • GAO report • Better data on adoption disruption • Direct current federal funding generated from adoptions into support for post-adoption services Keeping the Promise

23. Finally:What More Do We Need to Do? • After making considerable progress finding adoptive families, we need to assure they receive the supports that will allow them to raise their sons and daughters to healthy adulthood • Instigate broad-based efforts for change, including state and federal lawmakers, adoption and child welfare professionals, researchers and families • Develop national task force to lead strategic planning and implementation for services • Halt and reverse cuts in subsidies and services Keeping the Promise

24. For More Information Congressional Coalition on Adoption Institute www.ccainstitute.org 202-544-8500 Evan B. Donaldson Adoption Institute www.adoptioninstitute.org 212-925-4089 Voice for Adoption www.voice-for-adoption.org 202-210-8118  Keeping the Promise