All study states except Oregon included counseling and crisis intervention in their array of PAS.(1) Counseling and crisis intervention were available directly from the PAS providers or through referrals to community mental health agencies that were reimbursed by the PAS provider.
|Crisis intervention and counseling were integral components of PAS in four of five states; in two states, teams comprising counselors, parent liaisons, and clinicians worked with families.|
The four states used a variety of approaches in delivering counseling and crisis intervention services, including multidisciplinary teams and in-home services. In Virginia, each region had a regional response team that consisted of a family counselor, a mental health clinician, and a parent liaison. In Georgia, the provider offering crisis intervention used teams consisting of counselors and clinicians located around the state. Providers in Georgia and Massachusetts reported that families received crisis intervention and counseling in their homes and in the providers offices. In Texas, the Department of Protective and Regulatory Affairs recently added in-home therapy to its list of allowable services. Counseling often was family-oriented and could have been offered to siblings and parents as well as adopted children. One provider noted that couples counseling also was provided if it was integral to the adopted childs well-being. Providers did not expressly mention conducting comprehensive clinical assessments and testing, a need mentioned by adoptive parents.
One PAS provider offering crisis intervention services felt strongly that these services were cost-effective by preventing family disruption. Its a lot less expensive to provide our services than to maintain a child in residential placement or [incur] the cost of a disrupted adoption. She noted that the intervention services need not be provided for long but should be available in a crisis, especially early in the adoption. The Georgia state adoption program manager asserted that crisis intervention was one of the most successful aspects of the program.
In Oregon, where the PAS program does not offer counseling or crisis intervention services, the state adoption program manager said that such services were supposed to be available from the county mental health system but acknowledged that the services provided may not have met the specific needs of adoptive families. However, she noted that discussions with the states mental health providers about funding adoption-specific therapies had led to increased information sharing about the needs of adoptive families.