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As a result of federal and state efforts, adoptions of foster children have increased sharply in recent years. Available data, while limited, indicate that most adoptions are highly successful. Disruption and dissolution(1) are relatively rare, and even adoptive families who have experienced substantial difficulties tend to report that they would adopt the same child again.
Yet many adoptions that do not experience disruption proceed under difficult circumstances. The long-term consequences of children’s early trauma and repeated disruptions may be manifested in significant functional impairments at home, in school, or in the community, which in turn creates stress for the entire family. To respond to these challenges, families draw on a variety of services. Many families would prefer that the service they use be tailored to the needs of adopted children and their families, and provided with sensitivity to the adoption-related aspects of their problems.
It is therefore not surprising that the federal government and state child welfare agencies have worked in recent years to develop strategies to support adoptive families. These supports initially consisted almost exclusively of the provision of state adoption subsidies, which now date back nearly 40 years. Post-adoption service (PAS) programs organized around the needs of adoptive families began to emerge in the 1960s, but their development accelerated in the last decade as a result of federal funding for demonstration projects, state efforts, and private agency initiatives. An infusion of federal funds from bonuses to states for increasing the number of children adopted and the Promoting Safe and Stable Families program has further facilitated both the establishment of new programs and the expansion of existing ones.
This report summarizes the findings of a project titled “Assessing the Field of Post-Adoption Services,” which addressed three research questions:
To address these questions, the study team engaged in four interconnected activities:
Methods and findings for each of these study components are described in greater detail in separate reports, cited above. These reports are available from RTI or at http://aspe.hhs.gov/hsp/post-adoption01/. This summary report presents findings from each component, with a concluding discussion of the current status of PAS and future directions for research and evaluation.
This project was funded by the U.S. Department of Health and Human Services (DHHS), Administration for Children and Families (ACF), under contract to the Office of the Assistant Secretary for Planning and Evaluation (ASPE). Research was conducted by RTI and the School of Social Work, University of North Carolina at Chapel Hill. Staff involved in the PAS programs participating in the case studies, as well as Susan Smith of the Center for Adoption Studies at Illinois State University, gave generously of their time and insights. We also appreciate the participation of the North Carolina Department of Social Services and the California Department of Social Services.
As the initial component of the assessment, the literature review describes information available from reports and professional literature, and gaps in the literature, with respect to the research questions guiding the assessment. The literature review also includes a discussion of the challenges to designing and evaluating PAS that provides guidance for subsequent activities within the assessment, including secondary data analysis and case studies of existing programs.(2)
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| Even with recent increases in adoptions, disruptions remain rare. |
Adoptions have generally been quite stable and successful despite the lack of PAS development. Relatively low adoption disruption rates reflect this success. This suggests that many families will not need PAS in order to keep their adoptions intact. Three federally funded studies completed in the late 1980s and one completed more recently used different methods and samples, but all arrived at similar conclusions about the approximate rates of disruption: for special needs children, somewhere between 10 and 16 percent of adoptions will disrupt (Barth and Berry, 1988; Goerge, Howard, and Yu, 1996; Partridge, Hornby, and McDonald, 1986; Urban Systems Research and Engineering Inc. [USR&E], 1985). This suggests that adoption disruptions are lower than disruptions of guardianships, which appear to occur with approximately equal frequency but within a shorter time frame, or long-term foster care placements, which occur at a greater than 20 percent rate over a 3-year time frame (Berrick, Barth, Needell, and Jonson-Reid, 1998).
As a result of federal and state efforts, adoptions of foster children have increased sharply in recent years, with an apparent growth from 24,000 in 1996 to 36,000 in 1998 (Kroll, 1999; U.S. Department of Health and Human Services [DHHS], 2000). There is currently substantial concern that this growth will increase adoption disruption rates. However, Goerge, Howard, and Yu (1996) concluded that since the passage of PL 96-272 (The Adoption Assistance and Child Welfare Reform Act [AACWA]) in 1980, the number of special needs children who were adopted increased, but “the percentage of failures from adoptions and adoptive placements has declined” (Goerge, Howard, and Yu, 1996, p. 6). Indeed, the proportion of adoption disruptions fell in Illinois from 21 percent prior to AACWA to 10 percent after permanency planning was implemented. This decline suggests that changes in policy that result in additional adoptions of foster children need not result in higher levels of adoption disruption.
| Subsidy policies vary widely, and their relation to PAS is not well understood. |
Our understanding of the relationship between adoption subsidies and other post-adoption services is limited. Several earlier studies and reviews have concluded that adoption subsidies are associated with adoption stability (Barth, 1993; Sedlak, 1991). Other assessments have indicated that the subsidies are set at least as much on the basis of geopolitical boundaries as on the family’s ability to meet a child’s needs (Avery and Mont, 1992). According to Bower (1995), the majority of adoption assistance administrators and adoption workers concluded that “services provided through adoption assistance programs were insufficient to meet the needs of special needs children and families who adopt them” (p. 25).
Adoption and Foster Care Analysis and Reporting System (AFCARS) data indicate that 88 percent of children adopted in 2000 received some form of adoption subsidy (DHHS, 2001c). Some of these children are not getting cash benefits and are receiving only deferred subsidy agreements that will allow families to obtain a cash benefit should they be able to document such a need at a later time. To our knowledge, there is no research on when and why deferred agreements are activated by families requesting a cash assistance payment.
States and localities are likely to vary in the assumptions that underlie design of their subsidy programs. Some will consider that subsidies should be set at a rate sufficient to provide general support for needed services. Others will set subsidy amounts at a level that can support only the basic care for a child, unless there are specific time-limited requests for subsidy funds to address specific problems. The range of state policies can be seen in the examples of Ohio, where the Post-Adoption Special Services Subsidy (PASSS) provides payments of up to $20,000 annually to adoptive families when there is a risk to the adoption; and Illinois, which limits its provision of cash assistance to meet exceptional needs, but offers a network of adoption preservation services.
There have been a few systematic efforts to keep track of the ways that subsidies support families. National Adoption Assistance Training, Resource and Information Network (1999/2000) survey data and a policy analysis by the North American Council on Adoptable Children (NACAC) show that states vary widely on key areas, including how special needs are defined and the provision of benefits including respite care, residential treatment, and nonrecurring adoption expenses (Bower and Laws, 2002).
More than half of the states indicate that they provide residential treatment as a post-adoptive service, according to the American Public Human Services Association (APHSA)/Interstate Compact on Adoption and Medical Assistance (ICAMA) survey (Oppenheim, Gruber, and Evans, 2000). Current IV-E regulations prohibit the use of funds for residential treatment for children receiving adoption subsidies. Although it might be possible for states to seek a waiver of this restriction, no state has yet done so. There appears to be substantial demand for this resource, yet there is no information available on its use, how it is funded in different states, and whether placements contribute to reunification.
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| Adoptive families are diverse in composition, often with relatively low incomes. |
Recent studies have improved our understanding of families who adopted children from foster care. Statewide surveys of families who adopted children through the child welfare agencies in Illinois (Howard and Smith, 2000) and Oregon (Fine, 2000) offer clues about the pool of families that are, or might become, post-adoption service users. About 40 percent of the Illinois families responding to the survey were single parent.headed households — a rate considerably higher than that in the Oregon samples. Similar proportions of households had one adopted child in Oregon and Illinois samples (ranging from 42 to 46 percent). In Illinois, many (42 percent) had birth children as well as adopted children. Foster children were present in 21 percent of the families, and 12.5 percent of families had other children, typically grandchildren or other relatives. About 40 percent of the children in the Illinois sample were adopted by relatives, which is a larger percentage than in the Oregon sample (18 percent). In both states, the typical age of the responding parents was about 46. The median age for adoption finalization in Illinois was 6 years.
Substantial proportions of families in both states have relatively low incomes, so that Adoption Assistance appears to be an important source of support for many families raising adopted children (Howard and Smith, 2000). These findings may indicate a substantial change in the material circumstances of adoptive families during the last decade in comparison to earlier research, which tended to describe adoptive families as more affluent than the general public (c.f., Barth and Brooks, 2000). This may be partly attributable to the growing rate of adoption by relatives who do have fewer financial resources (Magruder, 1994). Yet in Oregon, where only one in five adoptions is by relatives, 48 percent of families earned less than $40,000 a year (Fine, 2000).
School problems are consistently rated as the most significant concerns for adoptive families in both states. It is therefore not surprising that, in Illinois, support for tutoring was the reason given most often to explain the need for an increase in subsidy (by 29 percent of the families indicating the need for a higher subsidy).
Several risk factors for disruption have been identified in adoptive family characteristics. Being adopted by strangers or by families with no prior adoptive or foster care experience seems to heighten the risk for disruption (Barth, Berry, Yoshikami, Goodfield, and Carson, 1988; Berry and Barth, 1990; Partridge, Hornby, and McDonald, 1986; Smith and Howard, 1991). Several studies (Berry and Barth, 1990; Groze, 1986; USR&E, 1985) have found that younger adoptive parents are more likely to disrupt, but this conclusion is not unanimously supported. Partridge, Hornby, and McDonald (1986) did not find parental age to be a significant risk factor.
One of the more disquieting findings in the disruption literature is that adoptions by more-educated parents, particularly mothers, are more likely to disrupt (Barth et al., 1988; Brooks and Barth, 2002; Boyne, Denby, Kettenring, and Wheeler, 1984). Whereas Partridge, Hornby, and McDonald (1986) did not find education significant in predicting disruption, the studies that did find a difference theorize that this could be in part because of the heightened expectations that more educated parents may have for their children, as well as the lack of community resources equipped to handle children with special needs (Barth and Berry, 1991).
| Most adoptive parents report positive feelings about adoptions, even difficult ones. |
Most adoptive families have positive experiences, which vary somewhat with age, and do not use substantial amounts of services to achieve those good relationships (Brooks, Allen, and Barth, 2000). Howard and Smith (2000), in their general survey of families receiving adoption subsidies, found that 83 percent of families indicated feeling very close, 15 percent indicated feeling somewhat close, and 2 percent indicated feeling not at all close to their child. Even among families who experience an adoption disruption, 86 percent stated that they would definitely or most likely adopt again and 50 percent indicated that they would adopt the same child (but with more awareness of what adoption required of them at different stages in the adoption) (Barth and Berry, 1988).
Whereas most adoptions have been successful, there is a growing body of evidence
that they are also unusually challenging. Concern that adopted youth are
at risk for psychological disorders has persisted for several decades, although
there is certainly no consensus that adopted children have unusual levels
of problems (Bohman, 1981; Haugaard, 1998; Zill, 1996). The research on whether
children who have been adopted are at greater risk for emotional, academic,
and behavioral difficulties than nonadopted youth is widely discussed in
the adoption literature (Berry, 1992; Brodzinsky, Hitt, and Smith, 1993;
Haugaard, 1998; Lindholm and Touliatos, 1980; Warren, 1992; Wierzbicki, 1993).
| Age and behavioral/ emotional problems are the strongest predictors of disruption. |
Problems in adoptions — whether manifested in troubled behavior or adoption disruptions — are highly associated with certain characteristics of adopted children. The predominant factor influencing disruptions is the child’s current age. Numerous studies have supported the conclusion that the older the child, the more likely the risk of disruption (Barth and Berry, 1991; Festinger, 1986; Goerge, Howard, and Yu, 1996; Groze, 1986; Partridge, Hornby, and McDonald, 1986; Smith and Howard, 1991; USR&E, 1985). Older children, who are more likely to have been older when separated from their biological families, may have had more exposure to maltreatment, greater ties to their biological families, and experienced more disruptions in foster care (Barth and Berry, 1991).
Families in which children display behavioral or emotional problems are also more likely to disrupt, particularly when those problems are of an externalizing nature (such as violation of family norms, sexual acting out, defiance, cruelty, or physical harm of others) (Barth and Berry, 1991; Partridge, Hornby, and McDonald, 1986; Smith and Howard, 1994; Smith, Howard, and Monroe, 1998). One survey of states about their experiences with disruption found that children with emotional problems represented 19 percent of total placements but 39 percent of disruptions. This is in sharp contrast to the findings for children with physical or mental handicaps, who accounted for 21 percent of total placements but only 13 percent of disruptions (USR&E, 1985).
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A variety of needs assessments have identified a fairly consistent set of supports and services that are desired by adoptive families and recommended by agencies supporting them.
Parents in numerous studies have stressed the importance of full disclosure of information about their child, including the child’s social, medical, and genetic history (Barth and Berry, 1991; Berry and Barth, 1989; Brooks, Allen, and Barth, 2000; Commonwealth of Kentucky, 1993). In addition, parents requested literature in the form of pamphlets, books, and articles to help them better understand their adopted child and deal with issues surrounding adoption. Lectures, seminars, workshops, and classes were also mentioned as helpful.
Although many adoptive families indicated a desire for counseling for the child, couple, or family, few actually utilized these services. With the exception of the Commonwealth of Kentucky study, in which 50 percent of families reported using individual counseling for their child, only a small fraction of parents surveyed in any of several studies sought counseling for themselves or their children (Brooks, Allen, and Barth, 2000; Commonwealth of Kentucky, 1993; Howard and Smith, 1993; Walsh, 1991).
Parents often request respite care in general surveys of their needs, but they seem unsure as to how to access it in reality. Walsh (1991) found that although 26 percent of parents reported respite care as a need, only 6 percent actually used it. Findings from the Commonwealth of Kentucky (1993) can at least partially account for this discrepancy: parents either do not believe that respite care is available or cannot find someone willing or qualified to provide it. When provided, it has been lauded by parents and has reduced the experience of objective burden (Owens-Kane and Barth, 1999).
Parents also want material services for their children, such as adoption subsidies, medical care, and special education options. Adoptive families often struggle under the financial burden of another child in the house and request assistance to offset that child’s expenses (Berry and Barth, 1990; Brooks, Allen, and Barth, 2000; Commonwealth of Kentucky, 1993; Frey, 1986; Rosenthal, Groze, and Morgan, 1996). Berry and Barth (1990) compared stable to disrupted placements and found that the amount of the monthly subsidy check differed, with stable placements receiving greater subsidies. They also found that families who did not receive subsidies had a higher likelihood of disruption than other factors would predict. Children who are adopted often enter placement with special medical and/or education problems that require additional care and, by extension, additional money (Brooks, Allen, and Barth, 2000; Commonwealth of Kentucky, 1993; Howard and Smith, 1993; Howard and Smith, 1997; Kramer and Houston, 1998; Partridge, Hornby, and McDonald, 1986; Walsh, 1991).
Many adoptive parents utilize available support groups or rely on a more experienced adoptive parent as a mentor (Barth and Berry, 1991; Berry and Barth, 1989; Brooks, Allen, and Barth, 2000; Daly and Sobol, 1994). A growing number of support groups are available to adoptive families. Parent groups typically provide support in dealing with the variety of issues facing adoptive parents, including intercountry adoptions; special needs adoptions; future reunification with birth parents; and emotional, social, and educational assistance pre- and post-adoption. Parent support groups can be organized by parents or through support networks sponsored by community, state, and national-level public and private agencies. There does not appear to be any research that specifically evaluates the effectiveness of these support groups.
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| PAS may be provided directly by child welfare agencies or contracted out. |
In some areas (e.g., California), the adoption program includes an appropriation for post-adoption services as part of the reimbursement to the public agency for the completion of the adoption. In other states (e.g., North Carolina), Temporary Assistance to Needy Families (TANF) or Title IV-B Subpart 2 (Promoting Safe and Stable Families program [PSSF]) funds are provided to the public agency to underwrite post-adoption services activities. An apparent benefit of this approach is that a worker who knows the family and was involved in the original placement will provide the services in many cases. However, the worker might not still be with the agency when post-adoption services are needed, and he or she may not be a specialist in providing such services.
A second approach is to develop specialized post-adoption services units within the public agency to which cases can be referred. An apparent advantage of this approach is that these public PASS workers can collaborate closely with the adoption worker, have excellent access to the case history information, and have access to public agency resources (e.g., referral to intensive in-home services or temporary foster or group home care). Oregon’s Post-Adoption Family Therapy (PAFT) model and California’s Santa Clara County post-adoption services unit are examples of this model in action.
A third, and increasingly widely used, model is to develop interdisciplinary teams or provide training to other public and private agency personnel to improve the level of community response. These models typically involve contracting with service providers outside the public agency. El Paso County, Colorado, has developed more interdisciplinary support for adoptive families by engaging public community mental health programs and hiring a highly qualified adoption specialist, located in the DSS office, to serve as a single point of contact. In 2.5 years, only one of El Paso County’s 500 placements has disrupted before finalization, and only one completed adoption has not worked out after legalization (Berns, 2000).
The Arizona State Adoption Program’s Post-Adoption Services Project began a 3-year agenda in 1992 to address the problems of special needs adoption placement (Morse and Lussier, 1995). Training programs for mental health professionals and adoptive parents, as well as crisis prevention services, were developed and offered to adoptive families. Pre- and post-assessments of adoptive families’ satisfaction with support services indicated a modest improvement in satisfaction, although a low response rate at post-test complicates the interpretation of the findings.
In 1991, the Rocky Mountain Adoption Exchange received federal demonstration grant funding for a 2-year project to develop a collaborative model of interdisciplinary teamwork for serving families who had adopted children with special needs (Naylor, 1993). Teams were formed in Colorado, New Mexico, Nevada, and South Dakota. Mental health, social service, developmental disabilities/education professionals, and adoptive parents were incorporated into each team. A total of 168 families were served over the 2-year period.
Spencer (1999) describes what she considers to be an optimum approach to post-adoption services, involving comprehensive “Post-Adoption Service Centers.” The centers should be triad focused and equally address the long-term needs of all adopted children. The proposed centers would have enough service volume to support the delivery of quality services by trained staff. The centers would also provide training and technical assistance in remote areas of the state.
Alabama’s Department of Human Resources (DHR) has developed an approach to post-adoption services that involves the establishment of a system of family resource centers for adoptive families (NACAC, 2000). The project was developed during 1999 by examining other states’ post-adoption models and programs and by surveying Alabama families who had adopted foster children. The focus of the Alabama program is twofold: family support and family education and empowerment. A request for proposal was issued to locate a licensed child-placing agency to operate a statewide resource center and to manage a statewide network of post-adoption support services.
Other states implementing this model include Oregon, where a post-adoption resource center provides information and referral, library resources, and parent and professional training, Minnesota, where a post-adoption resource center is run by NACAC and the Minnesota Adoption Resource Network, and Louisiana, where services have included case management and subcontracted centers but now focus on respite (Karl Ensign, personal communication, February 12, 2001).
PAS programs have gained increased support in recent years by three federal legislative measures. The Promoting Safe and Stable Families (PSSF) program addresses a broad array of goals, including preventing unnecessary separations of children from their families, improving the quality of services, and increasing reunification and successful adoptions for children in out-of-home care (DHHS, 2001a). Under the terms of the PSSF, states are allowed to use Title IV-B, Subpart 2 funds for adoption support and preservation. A recent review shows that 15 percent of these funds have been used for this purpose nationally, with state allocations ranging from 0 to 25 percent of the funds received. This categorization does not allow identification of the extent to which funds were used specifically for post-adoption support (James Bell Associates, 2001).
| The Promoting Safe and Stable Families program and other recent federal initiatives have expanded funding for PAS. |
The Adoption 2002 Initiative set a national goal of doubling the number of children adopted or placed in permanent homes each year. Among the measures taken in response to this challenge was a system of cash bonuses for states increasing the number of children adopted from the public child welfare system. States may use their bonus funds to increase services, including post-adoption services (DHHS, 1996).
Finally, the Adoption Opportunities program, which amends Section 205 of the Child Abuse Prevention and Treatment and Adoption Reform Act of 1978, awards grants and contracts to public and private nonprofit agencies that improve permanency for children who would benefit from adoption (particularly children with special needs). The seven major program areas include post-legal adoption services for families who have adopted children with special needs (DHHS, 2001b).
| Advocates support PAS availability for all adoptive families, not only those adopting from foster care. |
At the December 2000 National Conference on Post-Adoption Services, there were repeated affirmations of the concept that post-adoption services should be universally available to all adopted children, regardless of any past involvement with the U.S. foster care system. Article 9 of the recently ratified Hague Convention on International Adoption requires participating countries to “promote the development of adoption counseling and post-adoption services in their States.” In this country, the Hague Convention is implemented by the Intercountry Adoption Act of 2000 (http://www.jcics.org/haguetop.html). New Child Welfare League of America standards will include provision of post-adoption services among its criteria for accreditation of private adoption agencies (including those providing international adoptions).
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Only five projects, described below, were identified as having formally assessed the performance of post-adoption services to prevent adoption disruption and dissolution. The small sample sizes and nonrandom sampling for several of these projects serves as a warning that the results should not be considered generalizable. The diversity of populations, services and evaluation methods represented by these evaluations makes it impossible to generalize any assessments except to note that while not all adoptions can be preserved, well-designed and evaluated programs can demonstrate positive effects.
| Few PAS programs have been formally evaluated. |
Although the available evaluation research is unable to offer precise estimates of the effectiveness of post-adoption services, some approaches have consistently been found to be more helpful than others. Contact with self-help groups or other adoptive parents who can provide respite and support is reported to be helpful (Commonwealth of Kentucky, 1993; Frey, 1986; Nelson, 1985; Walsh, 1991). In contrast, the disappointing results from the evaluations of brief, intensive adoption preservation services models suggests that they do not generally fit the needs of adoptive families (Barth, 1995; Howard and Smith, 1995). A less time-limited and more family-focused approach appears more suitable (Howard and Smith, 1995; Prew, Suter, and Carrington, 1990).
Illinois: Adoption/Guardianship Preservation Project. Beginning in the early 1990s, Illinois attempted to reduce disruptions to both adoptions and subsidized guardianships through its statewide adoption preservation program, which offers in-depth assessment, on-call support, therapy, support groups, and advocacy. The program currently serves approximately 600 families annually. The average case involves a total of 72 hours of work, including travel time and collateral contacts, and lasts for 9.7 months. Thirteen percent of children were out of their homes at the end of service, although nearly half of the parents of these children remained committed to their parental relationship. Satisfaction with the program was high; 92 percent of parents described themselves as satisfied or very satisfied with the services received. Children’s behavior was reported as improved by 74 percent of families and 70 percent of workers (Howard and Smith, 2001).
Oregon: Post-Adoption Family Therapy Project. In Oregon’s PAFT Project, an adoption worker and a family therapist (both of whom were licensed clinical social workers) teamed up to provide services to families struggling with post-adoption issues. Sessions were often conducted in the family’s home and focused on helping parents develop better ways of relating to their adopted child’s confused belief system, which may be the cause of the child’s inappropriate behavior (Prew, 1990). Only 8 percent of the 50 families served by PAFT disrupted by the end of the service period, the median of which was 3.5 months. Among 34 families referred to the program but not receiving services, 6 adoptions (18 percent) disrupted. There is no assessment of the comparability of these groups, however (Prew, Suter, and Carrington, 1990). The authors attribute PAFT’s success to the idea of co-therapists, as well as helping parents better understand their child’s behavior (Prew, 1990; Prew, Suter, and Carrington, 1990).
| Family-focused services and contact with other adoptive families are associated with effectiveness. |
Washington: Medina Children’s Services. In a collaboration between Medina Children’s Services (a well-established special needs adoption agency) and HOMEBUILDERS™ of Tacoma, Washington, 22 children and their adoptive families received 4 weeks of intensive in-home therapy (three to five sessions of 2 hours or more). Each full-time therapist handled a caseload of two families, allowing them to devote the necessary time to provide these services. One year after these special services were initiated, nine children remained with their adoptive families, nine petitioned for disruption, and four children were not living in the home (either in a group home or living on their own) but had not experienced disruptions. The disruption rate for this project ranged from 41 percent to 59 percent, depending on the status of the youth in transition (unpublished program documents).
Iowa: PARTNERS. Iowa’s Post-Adoption Resources for Training, Networking, and Evaluation Services (PARTNERS) program, piloted by Groze and colleagues, provided a continuum of services to adoptive families, including support groups, sustained adoption counseling, and intensive services (Barth, 1991; Groze, Young, and Corcran-Rumppe, 1991). Of the 39 families who participated in PARTNERS, 29 percent of the children were in out-of-home placements at the end of the service period. Groza cautions not to equate “displacement” with “disruption” and states that the children needed more intensive treatment than could be provided in the home at that time (Victor Groza, personal communication, May 18, 1999).
New England: Casey Family Services Program. CFS, based in Connecticut, offers post-adoption services in several New England states. Although structure and focus vary among the CFS divisions, the programs offer a broad array of services — typically including adoption information and education, counseling, advocacy, workshops, and facilitated support groups — open to any adoptive family. Services are generally short-term, with a median length of case opening of 5 months and a median of three sessions for families receiving family systems counseling. Based on a counselor’s assessment of family gains, strongest improvements were found in child behavior, understanding of adoptive issues, and effective communication, with less change in child-family attachment. Gains appear to be greatest among cases with longer duration and more counseling sessions received (Gibbs, Barth, and Lenerz, 2000).
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| PAS programs have yet to develop consistent service classifications or a research base for program effectiveness. |
The purposes and processes of PAS vary widely. There is no centralized source of information about which post-adoption service programs are operating with which populations and procedures. A classification scheme for PAS interventions must be established before significant strides can be made in studying the most efficacious approaches. This must then be joined with a consistent means to describe presenting problems of families who might benefit from post-adoptive services.
Families seek post-adoption services for many reasons, including crises that threaten the stability of the adoption; gathering general information about an adoption issue (e.g., open adoption or transracial adoption); normalizing the adoption experience; and searching for biological parents in closed adoptions. Families also bring many differing experiences to post-adoption services. PAS providers seem to have taken an approach to PAS that embraces this diversity and welcomes “all comers.” Whereas there is some evidence that adoptive families created from different circumstances are more alike than different (Groza and Rosenberg, 1998), there is also evidence that the problems of children adopted from foster care are the most substantial (Smith and Howard, 2001).
Child welfare administrative data is not likely to provide information about the impact of PAS. Assessment of post-adoption services will require more intensive and costly methods, involving direct assessments of the well being of children and families. Parent reports on their children’s well-being are insufficient because of the data indicating that adoptive parents have high standards for their children (Barth and Miller, 2000). Randomized clinical trials will be necessary and seem feasible, although they will not be easily achieved because the numbers of similarly situated cases served by most agencies is small and because the culture of PASS is generally distant from such rigorous research methods.
These trials would also need to be based on new developments in interventions on behalf of adoptive families. The adoption field has long been dominated by psychodynamic approaches like attachment theory, which has not received substantial empirical support as the basis for interventions with troubled children and families (Burns, Hoagwood, and Mrazek, 1999; Weisz and Hawley, 1998). Interventions that have demonstrated efficacy with other troubled families (e.g., Huey, Henggeler, Brondino, and Pickrel, 2000) also deserve testing with adoptive families.
(1) Disruption refers to the breakup of an adoption prior to finalization; dissolution refers to the legal abolishment of the adoption. Displacements refer to out-of-home care with continued involvement of the adoptive family.
(2) See Appendix for a complete list of references. (Note: Not all materials in the bibliography are cited in this condensed version of the literature review prepared for this summary report.)
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