|What treatment models are most effective in meeting the needs of adoptive families?|
What we know: Among the many interventions offered to adoptive families, there is no accumulated evidence regarding which approaches are useful, at what dose or desirable duration, and for which types of families. Disappointing results from early efforts to apply short-term, intensive family preservation models (Barth, 1991) suggest that service systems designed for biological families may not be effective with adoptive families. Only a few evidence-based interventions, such as parent-mediated training approaches (e.g., Fischer and Stormshak, 2000) and clinical models (Hoagwood et al., 2001; Weersing and Weisz, 2002), have been adapted for adoptive families.
Developing evidence-based approaches to treatment of adoptive families is fraught with unknowns (Schoenwald and Hoagwood, 2001). The greatest unknown is how adoptive families differ from other families that have benefited from evidence-based clinical approaches. Although the adoption field has long concluded that adoptive families are quite different from those formed by birth (Kirk, 1981), the importance of these differences to effective service delivery needs to be better understood. Although there is also much diversity among adoptive families, some have argued (e.g., Groza and Rosenberg, 2001) that adoptive families whether created via international, independent, or public agency adoptions are more clinically alike than different.
Moving forward: We need to develop a disciplined and strategic approach to advancing the quality and effectiveness of post-adoption counseling services. Promising approaches to development and dissemination of treatment innovations that begin with intensive training and supervision of homogeneous adoption populations and moves toward more naturalistic conditions of intervention with more heterogeneous adoption populations (Schoenwald and Hoagwood, 2001). Burns and Hoagwood (2002) have provided an important resource with their description of child and family services at various stages of testing. Yet we do not know how effective these efficacious interventions would be in the PAS context.
Questions that could be addressed by an expert panel and through an intensive review of existing research include:
- What interventions now being used with adoptive families are the strongest candidates for systematic assessment?
- Which evidence-based child and family mental health treatment approaches have the greatest promise for testing with adoptive families?
- What kind of adaptation might be needed to best assist adopted children and their families?
- Which subgroups of adoptive families should be the focus of initial assessments of treatment approaches in homogeneous populations?