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The support needs and experiences of newly formed adoptive families: findings from the Wales Adoption Study
Abstract
This article reports on findings from the Wales Adoption Study which used a sequential, mixed-method design to explore the early support needs and experiences of newly formed adoptive families. Ninety-six adoptive parents completed a questionnaire four months post-placement and a sub-sample of 40 parents was interviewed in-depth five months thereafter. The main support needs of the families fell within five key domains: promoting children's health and development; strengthening family relationships; fostering children's identity; managing contact with birth parents and significant others; and financial and legal assistance.
While the age and developmental stage of the child placed for adoption often influenced the nature of the support required across the various domains, the need for some form of support in every family was universal. Most, however, were not facing insurmountable difficulties. Arguably, many of the support needs identified could have been anticipated as they illustrate the complexities of ‘normal’ adoptive family life. The implications for social work practice are discussed.
... Financial grants and subsidies are currently a contentious issue in South Africa, with no clarity on their future implementation. In countries where financial support was offered at different phases of the adoption process, such as in Wales, this was done on a discretionary basis and not implemented consistently (Meakings et al., 2018). ...
... To help them prepare for the adoption process, parents mentioned accessing various resources such as workshops and conferences, and some conducted their own research on adoption independently of the adoption agency (Lee et al., 2018). Many parents sourced external information and resources, such as books, online sources, joining support groups and securing counselling to help them think through their general questions, parenting questions and specific questions related to adopting and raising a child categorised as having special needs and developmental setbacks (Denby et al., 2011;Meakings et al., 2018;Petrenko et al., 2019). ...
... The parents experienced a lack of communication from the social workers and felt that they were always too busy; this made the parents feel as though they were a burden (Lee et al., 2018). Poor communication by social workers in general and related administrative and procedural errors consequently heightened the levels of frustration and anxiety for the parents (Meakings et al., 2018). Administrative and procedural errors can include delays, or lead to lost paperwork and paperwork not being filled out by social workers and court officials (Anthony, Paine & Shelton, 2019;Meakings et al., 2018). ...
Prospective adoptive parents require a considerable amount of support from social workers as well as from other support systems during the adoption process. The purpose of this study was to explore and describe adoptive families’ experiences of formal and informal support during the pre-adoption phase. There is a dearth of empirical research in the South African context on prospective adoptive parents' experiences of support from social workers, family and friends, and the adoption community, particularly in KwaZulu-Natal. Using a qualitative research methodology, this study sought to explore the experiences of sixteen adoptive parents in the eThekwini region with regards to the support they received from social workers and other support systems during the adoption process. Non-probability sampling, more specifically, snowball sampling, was used to recruit the participants through the Durban Adoptive Families group. Thematic analysis was used to analyse the data. Several sub-themes emerged from the data analysis. The study found that the participants had varied experiences of support offered by social workers and organisations along with more positive experiences of informal support from family and friends and the adoption community. Keywords: adoption, adoptive parents, adoption process, social workers, support system
... Despite the substantial amount of research into adoption, little is known about the emotional and psychological impact of transitioning to parenthood from the perspective of the adopters (Meakings, et al., 2018;Selwyn, et al., 2006). This is likely to be significant as adoption disruption has been linked to parental factors at time of transition, such as adopters' unrealistic expectations, idealised view of adopted children, help-seeking behaviour and motivation to adopt (Goldberg, 2009;Palacios, et al., 2019;Randall, 2013;Rushton and Dance, 2004;Selwyn, Wijedasa and Meakings, 2014). ...
... More recently, UK researchers have emphasised the love felt by new adopters towards their child and the success of family adjustment, with expectations being more than met (Adoption UK, 2019; Lewis, 2018;Meakings, et al., 2018;Tasker and Wood, 2016). If problems do arise, they centre around different inter-generational parenting styles, a sense of continued uncertainty in the parental role (Tasker and Wood, 2016) and a lack of authority and support for well-being (Lewis, 2018). ...
... A longer time period has been used in two further studies. The Wales Adoption Study (Meakings, et al., 2018) surveyed 96 adoptive families at four months post-placement and 40 of them at nine months. The findings offered a comprehensive exploration of the support needs of adoptive families, particularly the value of short-term financial help, assistance with securing the adoption order and the need to be informed about the stages of the legal proceedings. ...
Objective
The objective of this study was to increase understanding of factors that influence adoptive mothers' psychological and emotional well‐being. The aims were to compare mothers' self‐reported emotional state 12 months after child placement to the time of the interview and to identify factors that challenge and support maternal mental health.
Background
Mothers who adopt children face unique challenges that put them at a heightened risk of negative mental health. There is a need for better understanding of the influences on their psychological and emotional well‐being.
Method
This qualitative study involved nine in‐depth semistructured interviews. Transcripts were analyzed using reflexive thematic analysis.
Results
The themes offered broad insights, including the consistency of negative mental health across time associated with demands of “extreme parenting,” strains within and across relationships , and deprioritizing self‐care . Factors associated with positive mental health included development of love; attachment and sense of family identity ; learning, competence, and “therapeutic parenting,” and the ability to “offload.”
Conclusion
The emotional and psychological well‐being of mothers who adopt children should be validated and recognized as important to the overall adjustment of adoptive families.
Implications
Adoption agencies should take a proactive approach to addressing the mental health needs of adoptive mothers, providing comprehensive information, ongoing support, and regular assessments.
... Most studies addressing specific parental difficulties focused on child-related stress, showing that adoptive parents perceived more difficulties related to their children's behaviors and the parent-child relationship than biological parents [18,19,23]. These results are supported by adoption studies that highlighted that adoptive parents frequently report parent-child attachment difficulties [13], concerns regarding their child's development [24,25], deviant behaviors [13], and emotional, behavioral or medical problems [24,26]. Adoptive parents also reported school-related challenges, namely with school staff or setting, and special education needs [13,24]. ...
... Previous research highlights a mixed picture regarding post-adoption support services [25]. They usually include educational, informational (e.g., seminars, support groups), clinical (e.g., crisis intervention services, counseling) and material (e.g., adoption subsidies, respite care) services [6]. ...
... Past research has shown that several families sought post-adoption services over time [13,24] and that, compared to biological parents, they seem to seek professional help more frequently [23,30]. However, although previous literature suggests that adoptive parents seek professional help especially to address their children's emotional/mental health needs [7,12,25,26], the specific parental difficulties associated with help-seeking remains understudied. ...
Effective psychological parenting interventions delivered to adoptive parents may prevent serious adjustment difficulties and promote a healthy functioning; however, less is known about adoptive parents’ specific parental difficulties and help-seeking behaviors and perceptions, the understanding of which is deemed necessary to design well-informed interventions. This study aimed to describe parental difficulties, help-seeking behaviors, satisfaction with, and perceived barriers to seek, professional help, and acceptability of psychological parenting interventions among Portuguese adoptive parents. Comparisons with biological parents (Study 1) and between adoptive parents that requested adoption-specialized and non-specialized support (i.e., adoption-specialized vs. non-specialized help-seekers) (Study 2) were explored. A cross-sectional online survey was conducted. Participants were 471 adoptive and 552 biological parents of children aged under 18 years who were recruited through schools, adoption agencies, and social networks. They completed measures assessing parental difficulties, help-seeking behaviors, satisfaction with, and perceived barriers to seek, professional help, and acceptability of psychological parenting interventions. Comparison tests between the study groups, Pearson’s correlations, analyses of covariance (ANCOVA) and multivariate logistic regressions (MLR) were performed. Parents’ well-being and normative parenting challenges were the most frequent difficulties in both groups, but only associated with adoptive parents’ help-seeking. Although difficulties related to a child’s problems/parent–child relationship were more frequent among adoptive parents, adoption-related difficulties were rarely reported. Adoptive parents sought professional help more frequently, regardless of parental difficulties. Knowledge-related barriers to seeking help were the most frequent among adoptive parents. Adoption non-specialized help was less satisfactory. Acceptability of psychological parenting interventions was high, but dependent on parental difficulties. Implications for post-adoption services’ development are discussed.
... This may include parents reducing their working hours and earnings to support and spend time with their child, as well as liaising with teachers, healthcare, and other professionals. [8]. Although evidence suggests that newly formed adoptive families might experience financial strain [8], to our knowledge, no studies appear to have examined the risk and facilitating factors that are related to change in employment and finances after adoption. ...
... [8]. Although evidence suggests that newly formed adoptive families might experience financial strain [8], to our knowledge, no studies appear to have examined the risk and facilitating factors that are related to change in employment and finances after adoption. To identify the support needs of and inform provision of services to families who adopt in the UK, we investigated child, parent, and family factors associated with change in parent employment and household income over 5 years following placement of a child from state care for adoption. ...
... Studies indicate that adoptees' mental health problems are, at least in part, attributable to their pre-adoptive history, such as their early experiences of adversity (in most cases, abuse or neglect, [21,22]) and instability in living arrangements [23], where children adopted later in childhood and in sibling groups are likely to experience more severe problems associated with spending more time with their birth family and in care [24][25][26]. Given adopted children's early experiences and support needs [27,28] and that, primarily, parents seek additional support with the aim of improving their child's emotional health and wellbeing [29], it is likely that some parents decrease their work hours (to the possible detriment of their financial situation) to meet the psychological needs of their child(ren) [8,24]. ...
We investigated risk and facilitating factors related to families’ change in finances and employment over five years following adoption of a child from local authority care in a prospective, longitudinal study of children placed for adoption between 2014 and 2015 (N = 96). Parents completed questionnaires at approximately 5-, 21-, 36-, 48- and 60 months post-placement. We used time series analysis to examine the impact of child (e.g. pre-placement experiences, mental health), family structure (e.g. number of siblings, parent relationship status), and parent (e.g. mental health) factors on change in household income and parent employment status after adoption. We also examined the tendency for parents to comment on employment and finances and the emotional valence of their comments to gauge their concern about their circumstances. Children’s mental health problems were associated with primary caregivers reducing their time spent in employment and parents’ tendency to comment on their financial and work circumstances. Children who experienced more moves in care were more likely to have a primary caregiver not in full time work, as were children with higher prosocial behaviour scores. Being in full time work was associated with parents’ symptoms of anxiety. We also detected associations between structural features of the family and changes in income and employment. This study represents one of the first empirical investigations of factors associated with the socioeconomic features of adoptive families’ lives and informs ongoing discussion regarding the support needs of families and the timing, nature, and delivery of post-adoption professional services.
... Despite the substantial amount of research into adoption, little is known about the emotional and psychological impact of transitioning to parenthood from the perspective of the adopters (Meakings, et al., 2018;Selwyn, et al., 2006). This is likely to be significant as adoption disruption has been linked to parental factors at time of transition, such as adopters' unrealistic expectations, idealised view of adopted children, help-seeking behaviour and motivation to adopt (Goldberg, 2009;Palacios, et al., 2019;Randall, 2013;Rushton and Dance, 2004;Selwyn, Wijedasa and Meakings, 2014). ...
... More recently, UK researchers have emphasised the love felt by new adopters towards their child and the success of family adjustment, with expectations being more than met (Adoption UK, 2019; Lewis, 2018;Meakings, et al., 2018;Tasker and Wood, 2016). If problems do arise, they centre around different inter-generational parenting styles, a sense of continued uncertainty in the parental role (Tasker and Wood, 2016) and a lack of authority and support for well-being (Lewis, 2018). ...
... A longer time period has been used in two further studies. The Wales Adoption Study (Meakings, et al., 2018) surveyed 96 adoptive families at four months post-placement and 40 of them at nine months. The findings offered a comprehensive exploration of the support needs of adoptive families, particularly the value of short-term financial help, assistance with securing the adoption order and the need to be informed about the stages of the legal proceedings. ...
This qualitative retrospective recall study utilised nine in-depth, semi-structured interviews with adoptive mothers involved with an online support group often used by adoptive parents facing difficulties. The aim was to explore their transition to adoptive motherhood. The study was unusual because it covered a lengthy period, from pre-adoption and the motivation to adopt to 12 months post child placement and used Reflexive Thematic Analysis to analyse the data. Findings include the mothers’ sense of misaligned expectation, uncertainty, powerlessness, isolation, and emotional and physical fatigue. The most prominent findings centred on the high level of mental health issues reported by the mothers which included post-adoption depression, anxiety and trauma. New insights are discussed along with implications for future research and practice, along with the limitations of the study.
... Life story work as "standard care". Seventeen articles (Brookfield et al., 2008;De Wilde & Vanobbergen, 2017;Hooley et al., 2016;Hoyle et al., 2020;Humphreys & Kertesz, 2012;Meakings et al., 2018;Murray & Humphreys, 2014;Murray et al., 2008;Neil, 2012;Pugh & Schofield, 1999;Ryburn, 1995;Steenbakker et al., 2016;Staines & Selwyn, 2020;Watson et al., 2015aWatson et al., , 2015bWilis & Holland, 2009;Wood & Selwyn, 2017) report evaluations of a range of LSW activity that was standard practice in the region or institution(s) with the populations studied during their time in care. ...
... Six studies (Brookfield et al., 2008;Meakings et al., 2018;Neil, 2012;Ryburn, 1995;Watson et al., 2015aWatson et al., , 2015b investigated perspectives of adoptive parents or adopted children and young people on the life story books (LSBs) that were passed onto families as part of normal practice in the regions of study. LSBs are a common part of LSW that can take a variety of forms, from a short book chronicling a child's history before care, to in-depth individual therapeutic work. ...
... In the six studies of adoptive families, some families highly valued their LSBs, but in other cases LSBs had not been received despite frequent requests to social work staff (e.g. Meakings et al., 2018;Ryburn, 1995), or were deemed to be of poor quality. Some families received only unlabeled photographs with no narrative provided around the CYPCE's entry to care (e.g. ...
This scoping review was undertaken to provide an overview of peer-reviewed empirical evidence concerning the undertaking of Life Story Work (LSW) with children and young people with care experience (CYPCE). Our search identified 1,336 potentially relevant publications. Of these, 24 empirical studies met our inclusion criteria and examined a wide range of practices in different countries. Using a thematic approach, key findings and characteristics related to current conceptualizations of LSW are explored and knowledge gaps identified. Our review shows that predominantly small-scale qualitative studies have been undertaken. These studies typically reported participants’ experiences and perspectives on pre-existing LSW practices (17 articles), or evaluations of innovative practices (7 articles). However, both lacked efficacy data. We identified numerous LSW practices that were consistently identified as providing “high-quality” experiences: young person-led approaches; consistent support to access and process personal information, including chronological facts, reasons for care entry and beyond; the use of artifacts; and assistance/training for carers supporting LSW. The included studies also identified practices that undermined LSW: rushed, incomplete accounts, using insensitive language that failed to include different voices from a young person’s past. The discussion appraises the findings through a critical lens and concludes that LSW is a clear priority for all and represents an intervention that has potential to help the unaddressed mental health needs of CYPCE. Unfortunately, without better evidence on how this intervention works best, for whom, over what period, and at what cost, practice cannot move forward. This paper challenges all stakeholders to realize this potential.
... The research evidence (e.g. Anthony, Paine and Shelton, 2019a;2019b;Meakings, et al., 2018;Selwyn, Meakings and Wijedasa, 2015) identifies a need for increased adopter recruitment which not only raises awareness and understanding of the therapeutic needs of 'priority' children but also the value of establishing an appropriate approach to adoption which ensures effective early intervention for both the child and adopters. More broadly, research findings have highlighted the psychological and practical support needs of families and identified gaps in the amount and quality of professional support received by parents, including during the early stages of an adoptive placement (Meakings, Coffey and Shelton, 2017;Meakings, et al., 2018;Selwyn, Meakings and Wijedasa, 2015). ...
... Anthony, Paine and Shelton, 2019a;2019b;Meakings, et al., 2018;Selwyn, Meakings and Wijedasa, 2015) identifies a need for increased adopter recruitment which not only raises awareness and understanding of the therapeutic needs of 'priority' children but also the value of establishing an appropriate approach to adoption which ensures effective early intervention for both the child and adopters. More broadly, research findings have highlighted the psychological and practical support needs of families and identified gaps in the amount and quality of professional support received by parents, including during the early stages of an adoptive placement (Meakings, Coffey and Shelton, 2017;Meakings, et al., 2018;Selwyn, Meakings and Wijedasa, 2015). Family law research and discourse have also drawn attention to emotive themes regarding human rights in relation to adoption, including relationships between siblings who are separated through the care system and the implications for adjustment across childhood to emerging adulthood (Doughty, Meakings and Shelton, 2019;Monk and Macvarish, 2018;Neil, Young and Hartley, 2018). ...
Significant concerns remain in many countries about the high numbers of children needing an adoptive placement relative to the low numbers of prospective adopters, the high level of long-term therapeutic support needs for many adopted children and their families, and whether there are appropriate services to meet them. There has been an increase in ‘priority’ children waiting over 12 months to find a family. These are often children aged four years and over, in care with siblings, with additional needs or developmental uncertainties and from minority ethnic backgrounds. The financial and emotional costs of long-term fostering when plans are changed are huge. This article describes a major development in child care practice in Wales that has occurred over the past two years. The Adopting Together Service (ATS) involves a unique, innovative and multi-layered collaboration between the voluntary adoption agencies (VAAs – non-governmental charities) and regional adoption teams (statutory agencies) to secure permanence for children who wait the longest to find families. It explains how the ATS has been developed and embedded, including an account of the referral process, the approach to recruitment, linking and matching, and therapeutic activity before, during and after placement. It also describes the process of securing sustainable social procurement under the guidance of the British Standard for Collaborative Working (ISO 44001; British Standard Institute, 2017), the creation of a Joint Relationship Management Plan between VAAs, and the implementation of service level agreements between the voluntary and statutory sectors. These developments are considered in the context of the Welsh Government’s implementation of the Well-being of Future Generations (Wales) Act 2015, which lays out collaborative expectations to the statutory sector as one of its sustainable development principles. The article concludes with an initial evaluation of progress, noting challenges to the service and the views of the social workers, foster carers and adoptive parents involved.
... Adoptive parent training regarding posttransition contact is also important. Although contact with birth parents and the degree of openness in an adoption is often now brought up with adoptive parents, some are not prepared for the idea of reverse visitation with former caregivers and are surprised when foster parents or caseworkers bring up the idea (Meakings et al., 2018). ...
A crucial aspect of designing transitions from foster care to adoptive homes is whether to facilitate contact between the child and their former caregivers after the transition, a practice known as reverse visitation. There is almost no research available on the use of this practice and its correlates, despite it being widely recommended based on attachment theory. In this exploratory study, surveys were completed by adoptive parents, foster parents, or caseworkers on 205 children moving from a foster home to a separate adoptive home in a convenience sample in the State of Oregon. Children were in some form of contact with their former foster parents in 70% of the adoptions. They had in-person visits with their prior caregivers 49% of the time. Associations between these forms of posttransition contact and other variables highlighted characteristics of the foster and adoptive parents as influential. Implications for child welfare practice and research are discussed.
... In a recent survey of English adopters, just 3 per cent had face-to-face contact with a birth parent, 25 per cent with a birth sibling . In the Welsh adoption cohort study (Meakings et al., 2018), none had a plan for face-to-face contact with birth parents. NI is somewhat different: face-to-face contact is the perceived norm in all but exceptional cases, recommended for more children and at higher levels than elsewhere (Featherstone et al., 2018). ...
There are recent calls to consider face-to-face birth family contact for more children adopted from care. Given that the threshold for this authoritative intervention is significant harm, post-adoption contact should be sensitive to the possible impact of early childhood trauma, and be adequately supported. This article draws on adopters’ reports of face-to-face contact with birth relatives, and their evaluation of social work support to suggest an approach to practice informed by principles of trauma-informed care. Twenty-six adoptive parents participated in focus groups, and seventy-three completed a web-based questionnaire, all from Northern Ireland where face-to-face post-adoption contact is expected. Findings are structured thematically around principles of trauma-informed care: trusting relationships; physical and emotional safety; choice and control; and narrative coherence. Most families had a social worker attending contact, and help with practical arrangements. Less common but important practices included: deliberate consideration of children’s perspectives; safeguarding their emotional well-being; and facilitating communication outside of visits. Findings suggest that visits are a context in which trauma-effects may surface, and social workers supporting contact should be sensitive to this possibility. This article suggests a systemic approach to helping all parties prepare for, manage and de-brief after contact, attending to both adult-to-adult and adult–child interactions.
... The Wales Adoption Cohort Study (WACS; Meakings et al., 2017;Meakings et al., 2018) used a prospective, longitudinal mixed-methods approach to understand the early support needs and experiences of 96 children adopted from state care and their adoptive families. Local authority adoption teams across Wales sent out letters on behalf of the research team to every family with whom they had placed a child for adoption from 01 July 2014 to 31 July 2015. ...
We examined how adoptive families manage and respond to contact with children's birth siblings living elsewhere within a nationally representative sample of 96 families who adopted a child between 01 July 2014 and 31 July 2015. We harnessed prospective , longitudinal data to determine the extent to which plans for contact between adopted children and birth siblings living elsewhere materialised over time. We present adoptive parents' views and experiences of the contact over four years, together with an analysis of factors that were thought to have prevented, hindered and/or enabled contact between adopted children and their birth siblings. The information shared by the adoptive families illustrates the challenges they faced in promoting sib-ling contact; in weighing up the complexities associated with managing contact in the short term against the anticipated benefit for their child in the longer term; of balancing a commitment to sibling contact with the psychological needs of their child; and of organising contact within the context of interactions with other families involved and social work professionals. On the basis of these findings, we make recommendations pertaining to the management of both letterbox and face-to-face contact and life story work, and underscore the importance of investing in sibling relationships.
... Better initial preparation and training for adoptive parents can normalize expectations about the need for support and increase willingness to seek help later on (Wind et al., 2007). A focus on a wide range of risk factors beyond age at placement is important, as the support needs of children placed as babies and toddlers can be overlooked (Meakings et al., 2018). Simplistic or deterministic predictions about children's development need to be avoided as sensitivity to risk varies and children's outcomes are diverse (Woolgar & Simmonds, 2019), but building a realistic understanding of potential challenges balanced with a sense of optimism is important ). ...
This study explored how child maltreatment, alongside a range of other variables, predicted adverse outcomes for children adopted from the foster care system in England. The participants were 319 adoptive parents who completed an in-depth online survey about their most recently adopted child. The mean age of children at placement for adoption was 28 months (range 0–11 years) and their ages at the time of the survey ranged from 0 years to 17 years (mean = 7 years). Detailed information was collected about children’s backgrounds, including their experiences in the birth family and the care system before adoption. Adoptive parents also reported on how well children were getting on in a range of areas of functioning and how well they felt the adoption was going overall. Child maltreatment and child adverse outcomes were modeled as two factors in a latent factor structural equation model. The relationship between these two factors was explored alongside a range of covariates. Associated with worse outcomes for children were potentially heritable factors (parental learning disability), the pre-birth environment (exposure to drugs or alcohol in utero) and the period between birth and moving to the adoptive family (higher levels of maltreatment, spending more than a year in care, having two or more foster placements). The child’s distress on moving from the foster home to the adoptive family was also highly significant in linking to poorer outcomes, suggesting the detrimental effect of poorly managed transitions. Implications for child welfare practices before and after adoption are discussed.
... Aspects of adoptive parenting shown to improve children's behaviour problems and well-being include child-centeredness (e.g., expressed warmth toward their children) [23,45,49], emotional availability [51], and perceived quality of adoptive family relationships [29]. Given that many adoptive families in the UK (especially those who adopted children aged 4 and over) call for more help to strengthen family relationships [52], further work that identifies pathways to better child outcomes is warranted. ...
We investigated the relationship between adverse childhood experiences (ACEs) and children's internalising symptoms and externalising problems in the Wales Adoption Cohort Study, a prospective longitudinal study that used case file records (n = 374) for a sample of British children adopted from care (M = 2 years, 55% male). Parents (n = 96) completed questionnaires at 3-5 months, 15-17 months, and 31-33 months post-placement. We hypothesised that: (1) children adopted from care would have experienced more ACEs than children in the general population; (2) the number of ACEs would be associated with higher internalising symptom and externalising problem scores; and (3) adoptive parental warmth would moderate the relationship between ACEs and post-placement internalising symptoms and externalising problems. Nearly half (42%) of the children experienced four or more ACEs. Internalising symptoms and externalising problems were significantly higher than the UK general population. The number of ACEs was associated with internalising symptoms 3 years post-adoptive placement but this relationship was moderated by adoptive parental warmth. This study profiles the experiences and characteristics of a national sample of adopted children and highlights the potential importance of parent warmth as a factor that ameliorates the impact of ACEs on poor child outcomes.
Little is known about adoptive parents’ experiences of and satisfaction with statutory child and adolescent mental services (CAMHS) in the UK, nor of parental concerns about their adopted children’s mental health and well-being. Ninety-eight adoptive parents completed an online survey about their satisfaction with services as well as their mental health concerns for their child currently and retrospectively at the point of adoption. Parental concerns were diverse, and many overlapped with issues that CAMHS could normally help with. Attachment was the primary concern initially, but this decreased over time in placement; while challenging behaviour was the highest rated current concern, along with aspects of general functioning such as peer relations, social skills and education. Unexpectedly, trauma was a relatively low concern at both timepoints. There were very high levels of dissatisfaction with CAMHS, evident across questions of access, engagement and quality of services, all at levels much higher than typically reported by general samples. Adoptive parents’ substantial dissatisfaction with CAMHS occurred despite an apparent fit between many parental concerns and the kinds of services typically offered in CAMHS. There remains a significant challenge to develop a shared understanding between parents and services of adopted children’s needs, especially given the absence of data about adopted children’s mental health and wellbeing problems.
Over the last century, changes in legislation, social constructs and the perceptions of what family life ‘should’ look like have significantly transformed the process of adoption in England. The role of adoption has shifted from providing orphaned children a stable new home to today’s regulated process mainly supporting children who have suffered early physical or social adversity. This provides significant challenges to adopters, paediatricians, child psychiatrists and teachers who can only support adopted children by understanding their needs.
Treatment Interventions include therapy for adoptive families or adoptive parents, individual psychotherapy, or psychodrama group therapy for adoptees, as well as self-help groups for adoptive families, adoptive parents, or adoptees.In psychotherapeutic processes with adoptive families, it is important to bring up the biological parents and to help adoptive parents and adopted children to reveal their (un)conscious fantasies concerning the biological parents.What adoptive parents, adopted child, and biological parents have experienced in common are losses or life events that have interrupted the continuity of their personal history. Working through the feelings associated with losses leads to an affectively shared togetherness and enhances the emotional bonds between adoptive parents and adopted children.Psychotherapeutic interventions with adoptive parents aim to strengthen their parental role and functions and to help parents expressing and processing critical experiences in their personal biography.Psychoanalytical psychotherapy helps adoptees to process their trauma, to reduce the intensity of emotional distress, and to elaborate meaning of their lived experience. Specific topics in the therapeutic process with adoptees are described.Placement agencies: The task of an interdisciplinary team, available for the adopted child, his parents, and the adoptive family is to ensure continuous care and support, before adoption, during the care relationship and after the legal adoption.KeywordsFamily therapyPsychoanalytical psychotherapyAdoptive parentsAdopteesPlacement agencies
This article explores the motivations and decision-making processes of parents who adopt older children from the UK care system. It draws on interview data from parents from 14 adoptive families to consider what influenced their decision to adopt an older child. Data were analysed thematically, and the analysis was theoretically informed by the concept of adoption as a ‘marketplace’. The study shows how prospective adoptive parents can be influenced in their decision-making by the information they have been given or perceive about the state of the adoption marketplace and indicates that making choices and decisions around the characteristics of future children is often an uncomfortable aspect of the process. The participants cited moral reasoning and notions of fate as key factors influencing their decisions. The article concludes by making recommendations for practice.
The question of how best to support adoptive parents has been attracting increasing attention in recent years. This paper aims to explore participants’ experience of a new online intervention for adoptive parents and toddlers, which was adapted from an existing psychoanalytic Parent-Toddler Group (PTG) model. Participants were recruited from the parents attending the intervention, and four took part in a semi-structured post-intervention interview, aimed at exploring their experience of the PTG. Findings showed that, despite difficulties with the online setting of this intervention, participants overall experienced it positively, and particularly valued the supportive element of the group and the improvements in the parent-child relationship. However, challenges included engaging toddlers in the online setting, and participants’ confusion over the expectations and outcomes of the group. Based on these findings, suggestions were made for further research and adaptations of this model for future adoptive parenting interventions and support.
Background
Life Story Work (LSW) is a biographical narrative approach used within health and social care settings that offers individuals an opportunity to talk and think about their lived experiences. LSW is embedded in government out-of-home care (OOHC) policy nationally and internationally. Despite this, little is known about how LSW is implemented in OOHC or the experience of key stakeholders. We conducted a systematic review and synthesis of qualitative studies to address these knowledge gaps.
Methods
We searched eight academic databases and reference lists (2006 to July 2021) for qualitative studies or those reporting qualitative data on LSW involving children aged <18 years in an OOHC setting.
Results
We identified 21 eligible studies from 706 records. The most popular LSW offering was life story books. Common OOHC settings for LSW implementation were adoption, home-based and residential care. OOCH was used to a lesser extent in family group homes and independent living settings. OOHC children valued LSW when it represented a comprehensive record of their lives, retaining their LSW in later years. Carers valued involvement in the LSW process and wanted a realistic life record. Facilitators and support workers viewed LSW as a beneficial adjunct but reported lack of training and support.
Conclusions
LSW is a valuable approach in OOHC settings. The process should commence early and continue with adequate support and training for carers and professionals. There is need for implementation in other OOHC settings, and controlled trials to establish the effect of the approach on social and emotional outcomes.
Key findings
• Rates of direct contact between birth families and adoptive families vary considerably across the UK from a low of 16% in Wales to high of 54% in Northern Ireland.
• In addition, there are differences in rates of direct contact with various categories of birth relative such as birth parents and birth siblings.
• A significant minority of adopters across all four nations are receptive to considering additional direct contact with birth relatives than is currently experienced, particularly, with birth siblings.
• The variations across nations in rates and types of contact suggest that decisions regarding a child’s best interests are open to considerable interpretation.
• Some opportunities for positive ongoing contact between adopted children and birth family members, especially siblings, may be being missed.
This small-scale study examines the experiences encountered by a group of parents in their endeavours to support their children to settle and thrive, both in family life and school. The study identifies how a ‘complex tapestry of relationships’ exists both within and beyond adoptive families, which influences children’s developmental and educational outcomes. Conflicting relationships emerged between: foster carers and adoptive parents, paired siblings, and adoptive parents and teachers. Enhanced understanding of the complexities and tensions which may exist will help school practitioners to identify approaches and strategies that can be used with children and families to promote adopted children’s self- identity, well-being and their capacity to function and learn inside classrooms.
The rights of children who are adopted in England and Wales, their birth parents, siblings and extended family, and their adoptive parents are considered in this article. This includes the rights of parents and children regarding consent to adoption; their rights to post-adoption contact; children's rights to develop an understanding of their identity as an adopted person; and adopters' rights to support in helping their children - in the framework of domestic law and human rights conventions. The article draws on findings from the Wales Adoption Cohort Study to inform the discussion. This study included a case file study of 374 children's adoption records, surveys of newly adoptive parents (96) and interviews with them (40). These findings included that, generally, adoptive parents had respect for the child's previous family ties. Adopters had a positive attitude toward helping their children with contact (especially with siblings) and making sense of their identity, but often struggled with a lack of professional support. There was a tendency amongst agencies towards a blanket policy on indirect contact, rather than planning more flexible individual arrangements.
For better or worse, the significance of the sibling relationship throughout the life course is widely acknowledged. This paper explores the ways in which sibling relationships, in their various forms, are affected by adoption. The case-file records of 374 children recently placed for adoption in Wales were reviewed. Questionnaires were completed by ninety-six adoptive parents, with whom a sample of these children were placed, and a sub-sample of forty adoptive parents were interviewed. Most children placed for adoption together with a sibling carried a shared history of maltreatment. Many had complex, often conflictual relationships. Nevertheless, birth siblings in the adoptive home also provided support and comfort for children. New sibling relationships, created by placing children into families with existing children, carried their own set of advantages and complications. Some children placed apart from birth siblings had plans for contact that had not yet materialised. Whilst adoptive parents were often determined to help strengthen sibling bonds created and affected by adoption, this commitment was not always championed through social work intervention. The implications for social work practice in adoption are considered and a family systems framework is proposed as a way of helping to understand sibling dynamics in adoptive families. © 2017 The Author. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved.
The current article provides a review of adoption research since its inception as a field of study. Three historical trends in adoption research are identified: the first focusing on risk in adoption and identifying adoptee—nonadoptee differences in adjustment; the second examining the capacity of adopted children to recover from early adversity; and the third focusing on biological, psychosocial, and contextual factors and processes underlying variability in adopted children’s adjustment. Suggestions for future areas of empirical investigation are offered, with an emphasis on the need to integrate research, policy, and practice.
Child sexual abuse is considered a modifiable risk factor for mental disorders across the life course. However the long-term consequences of other forms of child maltreatment have not yet been systematically examined. The aim of this study was to summarise the evidence relating to the possible relationship between child physical abuse, emotional abuse, and neglect, and subsequent mental and physical health outcomes.
A systematic review was conducted using the Medline, EMBASE, and PsycINFO electronic databases up to 26 June 2012. Published cohort, cross-sectional, and case-control studies that examined non-sexual child maltreatment as a risk factor for loss of health were included. All meta-analyses were based on quality-effects models. Out of 285 articles assessed for eligibility, 124 studies satisfied the pre-determined inclusion criteria for meta-analysis. Statistically significant associations were observed between physical abuse, emotional abuse, and neglect and depressive disorders (physical abuse [odds ratio (OR) = 1.54; 95% CI 1.16-2.04], emotional abuse [OR = 3.06; 95% CI 2.43-3.85], and neglect [OR = 2.11; 95% CI 1.61-2.77]); drug use (physical abuse [OR = 1.92; 95% CI 1.67-2.20], emotional abuse [OR = 1.41; 95% CI 1.11-1.79], and neglect [OR = 1.36; 95% CI 1.21-1.54]); suicide attempts (physical abuse [OR = 3.40; 95% CI 2.17-5.32], emotional abuse [OR = 3.37; 95% CI 2.44-4.67], and neglect [OR = 1.95; 95% CI 1.13-3.37]); and sexually transmitted infections and risky sexual behaviour (physical abuse [OR = 1.78; 95% CI 1.50-2.10], emotional abuse [OR = 1.75; 95% CI 1.49-2.04], and neglect [OR = 1.57; 95% CI 1.39-1.78]). Evidence for causality was assessed using Bradford Hill criteria. While suggestive evidence exists for a relationship between maltreatment and chronic diseases and lifestyle risk factors, more research is required to confirm these relationships.
This overview of the evidence suggests a causal relationship between non-sexual child maltreatment and a range of mental disorders, drug use, suicide attempts, sexually transmitted infections, and risky sexual behaviour. All forms of child maltreatment should be considered important risks to health with a sizeable impact on major contributors to the burden of disease in all parts of the world. The awareness of the serious long-term consequences of child maltreatment should encourage better identification of those at risk and the development of effective interventions to protect children from violence. Please see later in the article for the Editors' Summary.
We provide an overview of the National Adoption Service for Wales (NAS) which was launched in November 2014. Further to a 2016 briefing by John Simmonds, Director of Policy, Research & Development at CoramBAAF, on the regionalisation of adoption services in England, we outline the background and legislative changes that have been made in Wales and report on progress so far. We summarise the current position of NAS, drawing on a wide range of consultation and engagement events with adopted children, adopters and practitioners working in the sector. We conclude by identifying future priorities, challenges and areas for further development.
Young people in and leaving state care are more likely than the general population to become parents at a young age. Relatively little is known about the experiences and progress of care leaver parents and their children, but emerging evidence suggests an increased risk of intergenerational state intervention. Drawing on data from the XXX, this paper examines the prevalence and profiles of care leavers amongst birth parents whose children were placed for adoption. Findings showed that more than a quarter (27%) of birth mothers and a fifth (19%) of birth fathers with children placed for adoption were themselves care leavers. There were no significant differences between care leaver and non-care leaver birth parents in terms of involvement in crime or substance misuse, but carer leaver birth parents were distinguishable from other birth parents by their own experiences of abuse and neglect. Care leaver birth mothers were also more likely than their non-care leaver counterparts to have diagnosed mental health problems and were less likely to appeal the adoption plan. The profiles of children placed for adoption between care leaver and non-care leaver birth parents were similar. The findings presented in this paper strengthen the moral imperative to address the over-representation of care leavers amongst birth parents whose children are placed for adoption. There is an urgent need to revise how children and young people in state care are prepared for parenthood and supported as parents.
This article draws on the findings from a national adoption study to examine the characteristics and experiences of children recently placed for adoption. With a focus on relevance to health visiting, it considers the early concerns, support needs and experiences of newly formed adoptive families, and examines the role health visitors play in supporting these families, as part of routine health intervention for children.
In the UK, there has been an increasing emphasis in recent years on reducing the delay in making permanent placements for children who cannot remain living with their birth parents. Adoption is one such plan for permanence. This study examined those factors that predicted a lengthier care episode for a national sample of children recently placed for adoption. The data was drawn from the Wales Adoption Study. This is a mixed methods study that analysed information from the adoption reports of all children placed for adoption over a 13 month period during 2014 and 2015 (n = 374). Children were aged between 0 months and 6 1/2 years on entry into care. On average, the time between entering care and moving into an adoptive placement was 528 days. The results of the regression analysis showed that four child-related factors were associated with a longer wait in care before being placed for adoption. These were developmental delay, externalizing behaviour, serious and enduring health problems/disability and exposure to domestic violence. The procedural factors examined showed no association with length of time to placement. The findings from this study make a substantial contribution to further developing what is known about the timeliness of adoption within the current UK context. The implications for policy and practice are discussed.
Adoption can provide stability and improved outcomes for looked after children, but the support needs of adoptive families
range from financial support to managing difficult behaviours and attachment problems. This study looks at the use of services
and associated costs over a six-month period through data collected from nineteen adoptive parents six months after a child
(average age twenty-three months) had been placed with them for adoption and at the patterns of service needs, usefulness
of services and satisfaction with services, supplemented with data from twenty-seven families who were interviewed about their
experience of post-adoption support. In line with previous research findings, the core element of support was provided by
social workers and over a third of families received financial support from social service departments. Involvement of specialist
services such as mental health professionals and educational support was low, probably because of the children's young age.
Satisfaction with the support provided by social workers varied and depended on their relationship with the parents. The mean
public sector cost of services was £2,842 (range £980–£6,270) and most costs were borne by children's social services. These
support costs compare favourably with other placement options such as children's homes or foster-care.
When children move from foster care into adoption the transition tends to take place within a tight timeframe, usually between seven and 14 days, with no contact between the child and the foster carer for several months after the move, if at all. Very little attention or research has been aimed at understanding the rationale for these procedures. Together with social work colleagues in a Looked After Children’s team, two child psychotherapists carried out a piece of qualitative research, interviewing foster carers, adopters and social workers to analyse in detail five children’s moves into adoption. We found that the emotional experience of the child, particularly their experience of losing their foster carer, became less prominent in people’s minds during this transition. It is a highly anxious time for the adults and in the grip of these anxieties they can lose sight of what is happening emotionally for the child. The child’s outward compliance with the move and lack of obvious emotion at losing her or his carers can be interpreted as signs that they are ‘fine’. These research findings are explored in the light of our understanding of attachment and loss in childhood, and of individual and organisational defences against pain and loss. Implications for future practice are discussed.
Sociological and anthropological studies of kinship have examined adoption as a test case for understanding the complex combinations of biological and social ties that constitute kinship. Adoption sets up an ‘adoption kinship network’ between birth family and adoptive family members. Contact after adoption poses challenges for adoptive families and birth relatives in negotiating changing kinship ties. This paper examines the experience of post‐adoption direct sibling contact from the perspectives of adoptive parents and birth relatives, including adult siblings. Interviews were carried out with 51 adoptive parents, four long‐term foster carers and with 39 birth relatives. The analysis revealed the complex multiple family networks that exist between adoptive families and the families of the adopted child's birth siblings. These networks connect some siblings, but sever connections with others. Where direct contact occurs, infrequent meetings mean that regular, repeated interactions normally considered to constitute ‘family practices’ are absent, in some cases creating barriers to feelings of kinship. Implications for adoption and contact support services are discussed.
This paper reports on a follow-up to adolescence of two longitudinal prospective studies of children placed from public care with non-related adoptive families in the UK. Factors associated with outcome are presented for 99 children (one index child per adoptive family) who were between 5 and 11 years of age at placement. Information concerning the children's backgrounds and care histories was obtained shortly after placement (T1), from social workers. Adopters were interviewed at T1 and again at the end of the first year (T2). A further follow-up was conducted an average of six years after placement (T3).
Outcomes at T3 were classified as either disrupted, which was true for 23%, continuing and ‘positive’ (49%) or continuing but ‘difficult’ (28%). Bivariate analyses revealed a number of attributes, related to both the child and the adoptive parents, which were associated with differential outcomes. Logistic regression produced five predictors of placement disruption: age at placement, behavioural problems, preferential rejection, time in care and the child's degree of attachment to the new mother. Differences were found between ‘positive’ and ‘difficult’ outcomes in continuing placements as well as between continuing and disrupted placements. The analysis suggests that adoption should certainly be considered as an option for children over 5 years of age while recognizing the need for both preparation and post-placement support. Evidence of differential outcome in continuing placements provides support for efforts to reduce the number of placements and returns home that a child at risk experiences.
Background: Adopted children have been said to be difficult children, scarred by their past experiences in maltreating families or neglecting orphanages, or by genetic or pre- and perinatal problems. Is (domestic or international) adoption an effective intervention in the developmental domains of physical growth, attachment security, cognitive development and school achievement, self-esteem, and beha- viour problems? Method: Through a series of meta-analyses on more than 270 studies that include more than 230,000 adopted and non-adopted children and their parents an adoption catch-up model was tested. Results: Although catch-up with current peers was incomplete in some developmental domains (in particular, physical growth and attachment), adopted children largely outperformed their peers left behind. Adoptions before 12 months of age were associated with more complete catch-up than later adoptions for height, attachment, and school achievement. International adoptions did not lead to lower rates of catch-up than domestic adoptions in most developmental domains. Conclusions: It is concluded that adoption is an effective intervention leading to massive catch-up. Domestic and inter- national adoptions can be justified on ethical grounds if no other solutions are available. Humans are adapted to adopt, and adoption demonstrates the plasticity of child development. Keywords: Adop- tion, meta-analysis, catch-up, developmental plasticity, ethics, growth, attachment, behaviour prob- lems, brain damage, malnutrition, residential care, resilience, self-esteem. Adoption may be defined as the permanent, legal placement of an abandoned, relinquished or or- phaned child within a family of relatives (kinship adoption) or within an unrelated family (non-kinship adoption). Selman (2005) estimated the number of children adopted across the borders of countries (international, mostly non-kinship adoption) to be at least 40,000 in 2003, which is an increase of 100% since the late eighties. The number of adoptions within countries (domestic adoptions) is harder to estimate. In the USA alone, 120,000 children are adopted annually, their total number amounting to
Among the most sensitive tasks of our courts of law is dealing with disputes among parents over the best interests of children.1 The Illinois Supreme Court was recently faced with an unusual case in which one of the parties to such a dispute was a father attempting to save the life of a child critically ill with leukemia.2 The sick child was Jean Pierre, 12 years of age. He had been living with his father, Tamas Bosze, in Colombia, where his illness was misdiagnosed. A few months later, the boy and the father returned to the United States, and another . . .
A novel behavioural screening questionnaire, the Strengths and Difficulties Questionnaire (SDQ), was administered along with Rutter questionnaires to parents and teachers of 403 children drawn from dental and psychiatric clinics. Scores derived from the SDQ and Rutter questionnaires were highly correlated; parent-teacher correlations for the two sets of measures were comparable or favoured the SDQ. The two sets of measures did not differ in their ability to discriminate between psychiatric and dental clinic attenders. These preliminary findings suggest that the SDQ functions as well as the Rutter questionnaires while offering the following additional advantages: a focus on strengths as well as difficulties; better coverage of inattention, peer relationships, and prosocial behaviour; a shorter format; and a single form suitable for both parents and teachers, perhaps thereby increasing parent-teacher correlations.
Adopted children have been said to be difficult children, scarred by their past experiences in maltreating families or neglecting orphanages, or by genetic or pre- and perinatal problems. Is (domestic or international) adoption an effective intervention in the developmental domains of physical growth, attachment security, cognitive development and school achievement, self-esteem, and behaviour problems?
Through a series of meta-analyses on more than 270 studies that include more than 230,000 adopted and non-adopted children and their parents an adoption catch-up model was tested.
Although catch-up with current peers was incomplete in some developmental domains (in particular, physical growth and attachment), adopted children largely outperformed their peers left behind. Adoptions before 12 months of age were associated with more complete catch-up than later adoptions for height, attachment, and school achievement. International adoptions did not lead to lower rates of catch-up than domestic adoptions in most developmental domains.
It is concluded that adoption is an effective intervention leading to massive catch-up. Domestic and international adoptions can be justified on ethical grounds if no other solutions are available. Humans are adapted to adopt, and adoption demonstrates the plasticity of child development.
This article reports the findings related to adoption support of a Department of Health-funded study: Costs and Outcomes of Non-infant Adoptions. This is the first UK study to comprehensively examine the support provided by Social Services Departments (SSDs), Health, Education, and Child and Adolescent Mental Health Services (CAMHS) beyond the first year of the adoptive placement. The services provided to 80 children, before Adoption Orders were granted, were examined from SSD records. Interviews with 54 adoptive parents then investigated the services provided to 64 of the 80 children post order. Families were initially supported primarily by Social Services but, post order, Health, Education and CAMHS shouldered most of the support responsibilities. A high proportion of the children were seen by these professionals over the course of the adoptive placements but many adopters felt that the services provided had been 'too little, too late'. While there were assessments of children's difficulties, mainstream services typically failed to provide what adopters considered sufficient or effective support. This was also largely true of the services provided by SSDs and is an important message for practitioners if they are to succeed in improving adoption support services.
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