Adoption Support Services are structured and co-ordinated to meet different levels of need
Why is this needed?
A graduated approach to service delivery:
- Ensures that a range of services exist to meet different needs as defined by eligibility criteria, rather than a one-size fits all approach
- Allows a degree of adopter choice (without this being the only determining factor)
- Enables an efficient use of resources – i.e. the more expensive and time-consuming provision is reserved for the higher levels of need.
NMS 15.2 When deciding whether to provide a service, or which service to provide, the agency has regard to the assessed needs for adoption support services, listens to the service user’s wishes and feelings, and considers their welfare and safety.
Adopters (and prospective adopters) want to know the nature and extent of the support services which an adoption agency provides, how they relate to each other, how access is determined and what choices are available.
This is an area where adoption agencies offer remarkably similar approaches. Appendix Seven provides schematic examples of how agencies commonly structure services. The most common approach is to group services into at least three categories, also known widely as a graduated approach:
- Universal/open access – generally accessed without an assessment with an emphasis on social and ‘fun ‘activities and designed to promote low level and peer- to-peer support.
- Targeted – usually available following an assessment, with an emphasis on group work and parenting development.
- Specialist – Usually appropriate to more complex situations, often but not always using externally commissioned therapists with funding from the Adoption Support Fund.
- A fourth category is ‘risk-based services’ where there is an assessed need for safeguarding, ‘edge of care’ or looked after services. These are generally provided by mainstream services outside of the adoption agency itself (see section 10).
Some agencies have aligned services around a common therapeutic model. E.g. Coram Kent uses an applied psychodynamic model of human development. AdCAMHS (East Sussex) is psychoanalytically informed. Most services which responded to the survey however, take a more eclectic approach. E.g. Birmingham CT (and others) train key staff in a range of attachment & trauma informed models of support including Secure Base, Theraplay, Dyadic Developmental Practice (DDP), Foundations for Attachment and Therapeutic Life Story work.
What might be broadly termed a neurosequential model (e.g. Perry 2206) is gaining increasing traction within adoption support where it has been most fully described by practitioners working within Family Futures - See McCulloch et al (2016), Vaughan et al (2016) and McCulloch and Mathura (2019). The Family Futures version of this is set out at appendix seven, which also includes a similar model used by Beacon House.
Possible future developments
Adoption Counts has worked to align the universal, targeted, specialist and risk-based levels of provision with the CAMHS I-Thrive model (see appendix seven).
This helps to unify the language which different professionals use but also makes clear that it is not necessary to have to pass through universal and targeted stages of help to access more specialist provision and that allocation of services should be appropriate to the level of presenting need.