Why are these needed?

Whilst a coherent adoption support strategy will aim to maximise the impact of universal services and prevent the development of family stress, additional services will be required to meet the needs of some adoptive families in order to prevent crisis or breakdown situations.

Adopter's Perspective

Adopters have often complained of a lack of services which might prevent a crisis point being reached and more specialist services being required.

Exemplar Approaches

The following services are commonly available from the agencies which were surveyed. These services are either available following an assessment, or in recognition that universally available services are not sufficient for the family’s needs. These services are often delivered by in-house staff with the appropriate training or are commissioned, usually on a block purchase basis, from the third sector, utilising funding from the ASF.

Access to Therapeutic parenting groups including:

  • SafeBase
  • Introduction to Therapeutic Parenting
  • Nurturing Attachments
  • Foundations for Attachment
  • Ad0pt
  • Non-Violent ResistanceTraining
  • GroupTheraplay
  • Webster Stratton (adapted)
  • Parenting groups for teenagers
  • Positive Parenting Strategies
  • Emotional Well-Being for Teens
  • Safe, Stronger Families – a 14-week therapeutic parenting programme developed by Adopters for Adoption with a DfE grant.
  • AdoptionUK has developed the TESSA programme (Therapeutic, Education and Support Service in Adoption)

Life Story work is a well-established therapeutic approach with adopted children.  A recent new development has been the ARCBOX, a new bespoke, child centred, digital life story tool providing adopted and looked after children with the opportunity to contribute to and own their own personalised, fun to use, lasting digital record of their life. It provides a coherent narrative of their family history and their life journey up to the present day and allows significant people within a child’s life to contribute to their life story in real time.  It results in a ‘living’ chronology rather than a fixed historical document, which children and their family/carers can continue throughout their lives.

Inter-agency liaison, support (e.g. with health/education/schools)

Needs Based Direct work / Therapeutic Support – Direct work with children or parents provided by therapeutically trained Social Workers including Non-Violent Resistance, Dyadic Development Psychotherapy (PACE Parenting), Story stem assessments, Theraplay, therapeutic life story work.

Social communication groups to improve children’s relationships with their peers by building their confidence and sense of identity and providing them with functional strategies to support them in making and keeping friends and with regulating their emotions (CFAS).

Short break care/respite / Advanced Childminding - The Post Adoption Link Scheme (PALS), part of Adopt East Midlands, started in 2006 as a result of adopters reporting they had no respite and were unable to leave their young people with friends or family due to their support needs.  PALS work with approximately 30 young people annually with fortnightly sessions lasting for 2.5 hours.  There are about 20 PALS workers who come from a range of diverse backgrounds to meet the different needs of young people referred to the scheme.  They are supported by a Co-Ordinator (0.4 FTE) and an Administrator (0.4 FTE).  The focus is on young people who have complex needs or whose adoption is at risk of breaking down.  PALs enables adopted young people to build trust with adults outside a family context and over time they learn to reframe relationships with their parents and begin to allow themselves to be parented.

Adoptionplus delivers a Therapeutic Social Work Service for Adopted Teens in partnership with Hertfordshire and the North London Consortium which focuses on life story work and is DDP informed. The service has been evaluated by the University of East Anglia.

Possible future developments

Support services to adopted teenagers did not have a high profile in the survey (the two examples above being the exceptions).
  
Selwyn et all (2014) identified strain on adopter relationships as a key factor in adoption breakdown.  However, there was very little mention of specific support to adopters and support for their relationships in the survey (possibly because this is not available under the ASF).  The Tavistock clinic has developed and evaluated a psychodynamic approach of couple focused therapy by:

  • Offering a safe space to reflect on the impact of adoption on the couple’s relationship
  • Enabling better communication between parents
  • Supporting couples with difficulties they may be having with adopted children
  • Improving the overall quality of parental and couple relationships

An initial consultation to adoptive couples and parents is followed by up to a further 20 weekly sessions of 50 minutes duration. Parents showed improvements in measures of psychological stress, depression and relationships satisfaction. Parents ratings of children’s behaviour also improved.

Adoption Counts is piloting work with a Couples Psychotherapist who has adoption experience. This is being positively evaluated by adopters.

Adoption Counts and OAWY have both trialled block purchasing of group work services from the third section with funding from the ASF.  It has been challenging to ensure that every family attending has had the appropriate assessment and that individual applications have been made in the name of each participant.  Each agency has also been at a financial risk if families drop out at a late stage.  This approach also requires funding for a comprehensive and efficient administrative  system to be in place.

RAAs which work together to commission services should find opportunities to widen their service offer in a cost-efficient way.  Two or three RAAs could deliver training to adopters jointly, on a more frequent basis and with reduced risk of vacant places, than if delivered by one agency.  There is a clear co-ordinating role in this for Regional Adoption and Special Guardianship Leadership Boards.

Comment

Increasingly, statutory agencies are seeking to develop these approaches in-house rather than procuring from the third sector.  The rationale is two-fold.  First, some agencies believe that this gives them greater control over the quality of provision.  Second, agencies see the development of such services as an opportunity to develop their own staff with a positive effect on other aspects of their workload.  

Adoption Counts has made the following observations on its use of targeted services:

  • We often send adopters on a number of training courses, but we don’t focus on applying that knowledge but instead suggest another programme. Social Workers can help families review the lessons learnt and apply these to family life.
  • Sometimes the learning needs to be joined up with interventions and support from other agencies and professionals e.g. teachers