The crisis of adoption disruption and dissolution

Pamela S. Bruning

Definitions

Disruption: after placement before adoption is finalised

Dissolution: adoption that ends after it has been legally finalised

Interchangeable use – basic description of a failed placement

Context: adoption aims to bring permanency to the life of a child and an exit from the state care system

Disruption: how often and why

Dissolution between 1-10% of time but stats are not perceived as accurate

10-25 % depending on some population and demographic variables Hispanic males are higher risk

Age: how older the child the risk increases Number of placements: more placements more risk Behavioural & emotion needs: more= more risk Agency staff turn over= significant Services: (After) less risk if services are provided

USA probability stats (older children)

6-10 years= 8% 11<= 16% 5.6 % when placed with siblings= lower 10.7% when placed alone 20.6% when placed apart 86% risk of placement in case of sexual abuse Of all disruptions any abuse abandonment or neglect

is present in 90% of cases Teenage girls’ placements are most difficult Previous disruptions increase risk More probable when in conflict with previously placed

or biological children

Swift case study

3 siblings 6-10 years from Russia Behavioural problems, sexual acting out,

highly manipulative Little services were rendered – permanent

placement failed- residential and psychiatric care

WAR ZONE for well intending parents faced with Attachment disordered children

? Handout- I’ll RUN- FC & POS implications

Challenges in Adoption

Inability to develop trust/engage with adoptive parents- resentment, unsafe, cant parent

Lack of history and background info: misinformation- NB HIV status developmental delays- court action disclose all even in utero

Denial or disbelief by ad par of the warnings: desire to parent overwhelming- present the material and risks but not believed? –writing?

Insufficient post placement support: medical dental psych care? How we place & how we support

Lack of skilled sw or therapists: trauma on brain edc attachment theory placement dynamics, stages of adjustment grief/loss and “normal” development

Challenges in Adoption

Limited community resources: judgemental service providers, community cultural taboos

Resistance to seek help: screening process expectation admitting there is something wrong- look for help too late

Lack of support from family/ friends: don’t know or don’t agree, slowly retracting support confirms isolation

Risk factors associated to the child

Failed adoption in an older child can be catastrophic Genetic heritage: traits personality abilities aptitudes

can clash with AP- get a history & collateral info In utero: substance-contaminated inadequate diet,

unwanted failure to thrive- get a history from the mom Early nurturing: pos quality of care, our responsibility Puzzle of missing pieces Seems that support staff is essential abroad most of the adoption service focus is after

placement

Attachment loss and trauma

Infant bonding process to develop basic trust nb- how long we take to place what support we give afterwards

Discomfort without care is very negative for a baby- all the attachment issues comes into play

Movements even in POS is to be avoided Critical that we do our screening intensively

but also quicker--------

RAD= reactive attachment disorder

Not able to form basic trust and cant replicate care and engagement in placement

Big big trouble: prognosis not good needs assistance on many levels

Individual counselling, bonding therapy, school support likely to be delayed

The body remembers Responsibility lies on us to look at the quality of care

of placements and to actively monitor it not just in terms of basic care but love warmth and contact-

Must train our pos parents in attachment soon

Impact of early abuse and neglect

Spend energy to transform adoptive home to something that is familiar to them

Children need to control test test test everything Milieu deprived children- under stimulated slow academic non

performer emotionally poor and prone to acting out, at risk of anti or a social behaviour with limited conscience development and difficulty with abstractions

Template for life is already established – good luck chuck to change it without many confrontations

Love is not enough- adequate parenting will entail long term therapeutic skilled interventions on all levels- school in family amongst peers and in child self

huge emotional and monetary cost to the adoptive parents

How to help children and families through disruption and dissolution Emotional hurt & disappointment child may loos all that is known and familiar- place

yourself in their shoes A parents guide to adoption disruption and dissolution

Laws & Ashe 2006 Therapy nondirective approaches has limitations-

avoidance RAD= diagnosis difficult for us but get to know the

signs Not only apply to adoption but to long term FC and

children’s homes

Therapeutic approaches

Adoption- after care NB nurse or EDC specialist Attachment therapies: Theraplay, holding therapy, re-parenting /

regression therapies Multi pronged approach when parents are still interested Individual therapy: play therapy sand therapy EMDR Conjoint therapy: mother child dyad attachment based therapy Family sessions focus on incorporating child in family: family

sculpting? Non verbal expressive play nondirectively directive no body

ever asked End of a chapter not the end of the book life story life map work is functional to use, scrap booking

Going bust Very threatening time for all involved- all their defences is

working Need a velvet glove and gritted teeth to work with a family at

this time Respectful sensitive approach: best interest of the child is

guiding principle Child may fantasise for biological parents misunderstandings

are frequent- explain over and over- draw pictures Always a very emotional charged time with the child and parent

walking out of the situation with a loss Parents feel devalued emotionally spent and at times cold/

detached after they reached their decision In some cases contact can be maintained but should be

packaged realistically as it can lead to delayed or compound losses- no false promises

Case study

Teenager- used a lot of reality testing Prospective adoptive mother was well prepared They stuck to their guns and kept respect in tact

while delivering some very difficult news. Acknowledging the cost of a disrupted placement is

difficult and is laden with feelings of failure guilt and disappointment

Not a lot of good feelings for the girl either Therapist acknowledge her own emotions Debriefing after you have spent a lot of time on a

case and deposited your own hope and emotions into a child/ placement is very important for remaining in the field