|Common PAS include I&R, counseling, respite, training, advocacy, and support groups.|
Across the five states, the services most widely offered by PAS programs included information and referral, counseling, crisis intervention, respite, case management, training for parents and professionals, advocacy, and support groups. Some variation existed among the states. Texas was the only state to offer residential treatment within the PAS program; Georgia was the only state to offer tutoring; and Oregon was the only state that did not include counseling, crisis intervention, and respite.(6)
Information and referral (I&R). States used diverse strategies for information and referral services: 24-hour phone lines, websites, lending libraries, databases of adoption-competent professionals, printed materials (both about the program and about specific resources for families), and newsletters. Two states operated lending libraries (including books and videos), which were said to be well used, and one state was preparing to place regional advisors around the state.
As part of their response teams, the Virginia and Massachusetts programs used parent liaisons, who were themselves adoptive parents, to provide information and referrals. Parent liaisons in both states talked with the families who had contacted their agencies, identified their needs, and worked to locate needed resources.
PAS programs in the five states provided families with referrals to community mental health and other service providers. In Massachusetts, a subcontractor to the lead service agency provided families with free access to its extensive provider database.
Counseling and crisis intervention. In four of the case-study states, counseling and crisis intervention was available directly from the PAS providers or through referrals to community mental health agencies that were reimbursed by the PAS provider. A variety of approaches was used in delivering counseling and crisis intervention services, including multidisciplinary teams and in-home services. Providers did not expressly mention conducting comprehensive clinical assessments and testing, a need expressed by adoptive parents.
Respite. In four of the case-study states, respite was provided through the PAS program in several forms, including reimbursement or vouchers for a caregiver, sending a child to camp or on an outing, holding special events (e.g., annual parties), or art therapy. In Virginia, the Client Fund gave PAS providers the flexibility to fund an array of services identified by clients, including respite. Due to the high demand for caregiver respite, many programs limited the availability of respite funding. Finding respite providers who were acceptable both to families and to the state often was challenging. Only one state allowed adoptive families to use other family members to provide respite.
Virginia funded an effort to increase respite resources for adoptive families through the Virginia Institute for Developmental Disabilities (VIDD), an organization affiliated with Virginia Commonwealth University. The VIDD coordinator visited each region to discuss resource development and developed a resource guide for adoptive parents based on her experiences with respite for families with developmentally delayed children.
Case management. PAS providers in the five states engaged in varying levels of case management in conjunction with providing crisis intervention, counseling services, and/or information and referral. All of the states used client-tracking systems to assist staff in case management activities. Events that were tracked included incoming referrals, case openings, service use, and case status.
Parent training. State adoption program managers and PAS coordinators/providers reported providing training not only on adoption-specific issues (e.g., grief and loss) but also on child development issues relevant to adoptive families (e.g., fetal alcohol syndrome). While many of the trainings were one-session events, providers also reported offering workshops and a series of sessions on a particular topic. Providers also sent families to adoption conferences.
Professional training. In all five case-study states, state adoption program managers and PAS coordinators/providers also reported offering professional training on adoption-specific issues and child development issues. Training audiences included child welfare workers, mental health professionals, teachers and other school staff, court system staff, and medical practitioners. Topics offered to professionals included cross-cultural competency, transracial adoption, attachment in adoption, respite care for adoptive families, education law and advocacy, and openness in adoption. In several case-study states, PAS providers themselves also received training.
Advocacy. PAS providers described accompanying client families to meetings and conferences with schools and community service providers. Staff in one Texas region attended community review board meetings for cases where the childs needs extended to several state agencies. Parent liaisons provided advocacy for families in Virginia.
Support groups. PAS providers operated support groups for parents and/or children, either by leading them or through more limited assistance (e.g., offering a location, providing refreshments, mailing flyers). In addition to PAS staff, counselors, parent liaisons, and graduate students helped facilitate the support groups. Most often, providers formed support groups according to age and level of need (e.g., therapeutic support group). A regional PAS provider in rural Virginia started an online support group. Although providers considered support groups an essential component of PAS, recruiting and retaining families had been a continuing challenge. Many tried to increase and sustain attendance by, for example, holding child and parent groups simultaneously, offering child care for parent support groups, and providing transportation.