Assessing the Field of Post-Adoption Services: Family Needs, Program Models, and Evaluation Issues. Case Study Report. 9.1.2 Service Needs Identified by Adoptive Parents

11/01/2002

The adoptive parents participating in the focus groups were vocal self-advocates. Although the single focus group held in each case-study state does not support generalizations about adoptive families in those sites, several themes about needed services emerged consistently across sites. These themes tended to converge with those identified in previous reviews of programs and related literature, although the emphasis on respite care was particularly keen in this study. This may reflect a change in the needs of adoptive families or a finding unique to the states or parents selected.

PAS programs offered valuable services to adoptive families, but unmet needs remained.

The parents who participated in focus groups in the case-study sites confirmed the usefulness of services offered by the PAS programs, especially information and referral, respite, advocacy, crisis intervention, and counseling. They also identified additional needs, including more usable information about their children, better information about supports available to them, and improved access to service providers of their choice. Although these needs might lie outside the boundaries of typical PAS programs, state adoption program offices could potentially address them.

Parents stated that having better information about their childs pre-adoption history and, consequently, a better understanding of the childs strengths and limitations, could have considerably lessened the difficulties the families had experienced. Two issues are involved in this assertion. First is the well-documented desire among adoptive parents to be provided with as much information on their child as is available at the child welfare agency. Although states have increased their commitment to preadoptive disclosure in recent years, parents in the focus groups might not have benefited from this change. It also is possible that parents eager to move forward with adoption listen selectively to what is disclosed. They need to hear it about three times, according to one adoption worker. In either case, parents indicated that they thought they would have benefited from the opportunity to review their childs history with an adoption worker as needed over the course of the adoption.

Parents needed assistance in understanding their childrens history and needs.

Information on the childs history is of limited value without interpretation of its implications for educational, perceptual, emotional, and behavioral functioning and future needs. Thus adoptive parents expressed a need for help in understanding and interpreting the information given them. They wanted access to cognitive, social, behavioral, and educational assessments for their child. They reported that this information would have helped them access needed services but that comprehensive assessments were expensive and difficult to obtain. As with needs assessment, review of this information must be an ongoing process, rather than a single prelegalization event, that can be revisited as the child matures.

Adoptive families needed information about available services before they were in crisis.

Parents also wanted better information about the services and supports available to them. Recruited for the focus groups by the PAS programs, these parents might have been expected to be highly aware of available resources. However, many were confused about what could be supported through adoption subsidies and how subsidies were adjusted. Only one state described a proactive effort to provide this information to adoptive families on a regular basis. Parents also maintained that they lacked information about supportive and preventive services and were directed to resources only after their needs had reached crisis proportions. Although all states made efforts to publicize the existence of their PAS program, it does not appear that information reached families with mild to moderate needs.

Access to professionals who understand adoption issues was particularly needed.

Finally, parents stressed the need for easier access to adoption-competent service providers. Some PAS programs were addressing this issue by offering training in adoption issues to mental health practitioners and other professionals. However, families access to these providers, or to those who already had the desired expertise and attitudes, may have been limited. Many providers, especially those with specialized expertise, did not participate in state Medicaid program or Medicaid managed care plans. Therefore, they were not available to parents who were unable to pay for their services out of pocket. States efforts to train professionals will not benefit adoptive families without efforts to allow families to access services outside their managed care provider or to reimburse services through subsidies.

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