Trauma, Attachment and Family Permanence

Fear Can Stop You Loving

Caroline Archer

• Publisher: Jessica Kingsley Publishers
• Year: 2003
• Print ISBN:
  9781843100218
• eBook ISBN:
  9781846423871
• Topic: Psychology
• Subtopic: Psychotherapy
• Index: Psychology

Fostered and adopted children can present major challenges resulting from unresolved attachment issues and early traumatic experiences. In this much-needed book, the contributors provide a variety of complementary perspectives on the needs of these children and their families, focusing on ways of integrating attachment theory and developmental psychology into effective practice.

Examining multiple aspects of work with children who are unable to live with their birth families, the book includes contributions on the assessment, preparation and support needs of children and families, attachment and the neurobiological effects of trauma, effective management of contact with birth families and developmental challenges in school settings. The use of creative arts therapies, alongside developmental reparenting strategies as part of a long-term attachment therapy `package', are explored in some detail.

A fictionalised family, used as a working example throughout Part 2, brings

practical interventions to life: illustrating the Family Futures' inclusive approach, where adoptive and foster parents become pivotal members of the therapeutic team. In addition, contributions from real-life user families illustrate some of the challenges they face and demonstrate how the developmental attachment-based approach has worked for them.

Bringing together a rich and innovative selection of ideas for adoption and fostering practice across the disciplines, this book will be a valuable resource for all involved in supporting substitute families.

Part I

State of Play

Current Theory and Practice

CHAPTER 1

Adoption and Permanence Today

A Discussion

Adrian Briggs

Introduction

This chapter considers adoption and permanence today in order to set a social policy context for subsequent chapters examining ‘the Family Futures’ way’. It is divided into sections that will briefly discuss:

• how adoption has changed (and continues to change) because the needs of children requiring permanence are changing

• the many problems and issues currently confronting adoption and permanence services, whilst viewing adoption as an effective option on a continuum of permanence

• ways forward: new approaches to meet the needs of today’s children.

Unfortunately, the scope of this book and space do not allow discussion of the key needs of, and issues regarding, birth parents and adopted adults; in no way does this minimise their importance.

Adoption has Changed, is Changing

Research and various Government and Social Service Inspectorate (SSI) reports have confirmed that adoption has changed radically and continues to change (Department of Health [DoH] 2000; Performance Innovation Unit [PIU] 2000; SSI 1996, 2000a). The number of adoptions has reduced dramatically, from its peak of 22,502 in 1974, to around 4000 in 1999/2000 (Ivaldi 2000). The increased availability of contraception, abortion and acceptance of single parenthood has resulted in fewer babies being available for adoption, whereas the number of children adopted from care (around 2000) has remained fairly consistent (SSI 2000a). However, the decline in the number of children looked after by local authorities over the last thirty years, to the current figure of under 60,000, has resulted in a relative increase in the percentage of children adopted from care, from 1.5 per cent to around 4 per cent (SSI 2000a).

Older children (predominantly from the looked after care population) with complex care histories and a range of attachment and developmental difficulties now form a large proportion of children being adopted or placed permanently. The SSI has found that 80 per cent of children referred to adoption services were already in the care system; of these half were aged six years or older (SSI 1996). Of the 2200 adopted from care in 1999, 9 per cent were under one year old (not accounting for babies voluntarily relinquished), 57 per cent were one to four years old, 26 per cent were five to nine years old and 7 per cent were ten years and over (Ivaldi 2000). The largest group, one to four year olds, can be viewed as ‘early placements’. However, the increase in placement moves a significant number of these children have suffered, and the levels of the original abuse or neglect, renders this distinction immaterial. It should also be borne in mind that all adopted children are potentially vulnerable and may experience low self-esteem; a significant number will have difficulties developing a coherent sense of self (Archer 1999a, 1999b; Watson 1997).

As the majority of children now being adopted are older, it could be too easy to ignore the particular needs of children adopted as babies or infants. Verrier (1993) pointed out that adoption represents a dramatic emotional trauma for the child and mother, which resonates throughout their lives and must be addressed for healthy adjustment to occur. Too often social workers have assumed such children are ‘easy to place’. The myth of unproblematic early placement ignores pre-birth traumas, perinatal difficulties and evidence that young children may have suffered neglect and abuse from their birth parents at the pre-verbal stage which could lead to particular difficulties processing their traumas verbally (Archer 1999a, 1999b; van der Kolk 1996b). Currently there are increasing numbers of placements of children removed at birth or shortly after and placed for adoption against the wishes of their parents. In all cases the ‘explaining’ task continues to pose difficult challenges for adoptive parents and their children. Whilst these difficulties are not insuperable, the basic foundation of disadvantage, reinforced by the complexities of contemporary adoption, has to be taken into account in the provision of support services for adoptive and relinquishing birth families.

In the recent past, multiple placement moves and insufficient post placement support have exacerbated risks of disruption. Sadly, some of the damaging moves children suffer have resulted from a too strict interpretation of the Children Act 1989, with an increase in the number of additional late placements caused by ‘failed rehabilitations’ increasing the age of children at time of (eventual) permanent placement. Although earlier placement should be advocated and unnecessary delay avoided, the provision of effective support services would help to reduce risk to all placements. Whilst the numbers of children involved appear low, when disruption of permanent placements occurs it has a disproportionate impact on the families and agencies, especially if the crisis is dealt with by social workers inexperienced in adoption. The human and financial costs of adoption disruption are immense to the child, their adoptive family, birth family, social workers and agency and in the negative ripple effect it has on other child care agencies and the community. For example, disruptions involving older children may force social services departments to purchase alternative specialist agency placements, often very distant from children’s roots. Significantly, a major part of these agencies’ fees are earmarked to fund post adoption support services which they view as integral to maintaining ‘hard to place’ children in permanent placements.

The Prime Minister’s Review of Adoption recognises that children now being adopted from care are more challenging, and have experienced more placement moves, than previously (PIU 2000). As with social work with looked after children, an increasingly important part of adoption work is concerned with negotiating and maintaining contact arrangements over the lifetime of the placement. At least 70 per cent of adopted children now have some form of contact with their birth families. This further increases pressures and demands on adoptive families and staff (PIU 2000).

The incoming Labour Government of 1997 increased the sense of urgency about reforming services for looked after children, especially in the area of adoption and permanence. These concerns also helped to bring about the influential circular, Adoption – Achieving the Right Balance (DoH 1998a), which focused ‘attention on adoption as an important and beneficial option in the care of children and…intended to bring adoption back into the mainstream of children’s services’ (p.1).

The groundbreaking Quality Protects programme followed later that year, injecting substantial funding to local authorities to boost services to looked after children, with a particular emphasis on improving adoption services. These initiatives paved the way for The Prime Minister’s Review of Adoption in 2000, which in turn carried out significant groundwork for the Government’s White Paper culminating in the Adoption and Children Bill and the National Adoption Standards in 2001.

Historically, the secrecy associated with adoption suggested that adoptive families should be treated similarly to biological families and consequently specific services should not, or did not need to be provided after an adoption order. This perspective needed to be challenged and a culture shift had to occur. Essentially a ‘post adoption perspective’ was required which would recognise that adoption differs from other family situations and that social workers and other professionals need to work with adoptive and birth families and adopted persons and make flexible lifetime supports available (Burnell and Briggs 1995).

Major pressure for change came from service users and their organisations, especially Parent to Parent Information on Adoption Services (now Adoption UK), the Natural Parents Network (NPN) and the National Organisation for the Counselling of Adoptees and their Parents (NORCAP). With a number of progressive voluntary organisations, such as British Association for Adoption and Fostering (BAAF), the post adoption centres and Parents for Children, they campaigned to raise awareness about the changing nature of adoption. These groups maintained that children being placed were more damaged than many professionals recognised and that adoption was a lifetime project, needing lifelong support. Adoptive parents had to suffer (and still suffer, to a lessening extent) not being taken seriously by professionals or being made to feel that they and their family dynamics were at fault. Members of Adoption UK were particularly tenacious in the face of professional and political indifference: under their influence the DoH and social services gradually began to recognise that many adopted children were experiencing attachment difficulties which were having a huge impact on adopters and their families. Adoption UK’s journal, Adoption Today, has played an influential role in enabling struggling parents to gain a national voice and in giving them the confidence to campaign for reform.

Current Problems and Issues

Despite these changes, there are many issues remaining which cause unnecessary distress to children, adopters, birth families, adopted adults and professionals. The Government’s White Paper (2000) crystallised the concerns of service users, professionals, and the general public about delay, insufficient and inconsistent use of adoption, inadequate recruitment of adopters and the need to make adoption safer and more attractive to potential adopters, particularly by the provision of proper post placement/post adoption support (DoH 2000). The White Paper confirmed what many adopters and enlightened professionals had said for years, that ‘There is very little support available for adopters once a child has been placed for adoption’ (DoH 2000, p.17).

Proposed Government reforms include:

• investing £70m over three years in adoption services

• setting a target of increasing by 40 per cent, by 2004–05, the number of looked after children being adopted

• legislating to reform the legal framework for adoption, including a national adoption register, the right to an assessment for post placement support and aligning the Adoption Act 1976 with the Children Act 1989

• establishing national adoption standards

• developing innovative approaches

• exploring a range of powers against councils which consistently fail to provide a reasonable level of service

• reforming the court service to reduce legal delays (DoH 2000).

The application of the Children Act 1989 effectively marginalised adoption services. Raising the profile of rehabilitation considerably meant this option was often pursued beyond its usefulness to children and their families. Fortunately, political and professional changes have begun to shift ground and the perspectives of many senior managers in social services have been transformed. Stereotypical thinking does, however, remain in some quarters, putting obstacles in the way of providing essential services to children and families. It is vital to recognise that for children who are unable to return to their birth parents or relatives, adoption provides unique legal and psychological security and permanence. No other long-term placement option can provide this. Whilst for a variety of good reasons, some older children may have to remain in long-term foster care and will benefit from it, it would be misleading to say that this gives true permanence and lifetime family commitment (BAAF 1996). Although many problems remain to be overcome, adoption continues to be a positive, effective option on a continuum of permanence for children unable to return to their birth family or kinship network.

Currently, as a result of Government directives, the value of adoption is being recognised more consistently by social services’ senior management and, as it moves into the mainstream of child care services planning, it should provide a model for other aspects of child care. There continues to be a dynamic interface between adoption and the looked after care system, since adoption removes children from the formal system and, if consistent, adequate support is provided, the costly re-entry of vulnerable children with complex needs into the public care system could also be reduced. With the development of countrywide adoption support services the number of looked after children could dramatically decrease, in particular where more long-term foster carers are encouraged to adopt the children for whom they currently care.

Contemporary adoption of older children demands a different approach from the ‘closed’ practices of the past and ‘open’ adoption, with a range of contact arrangements, is becoming increasingly accepted. Adolescence may be a stressful time for many young people and their parents but is magnified for children separated from their birth parents (Archer 1999b). Again, adoption can play a more positive role than other care options (BAAF 1996), particularly if families are given appropriate preparation and support (Howe 1998).

From DoH statistics it is clear that adoption is an under used permanence option for many children, especially older children with specific difficulties and disabilities. A significant number of these children drift in ‘short’ and long-term care and do not return to their birth families. Expanding the use of adoption for older children and children with special needs unable to return to their birth families or kinship networks would create a less expensive permanency option than existing alternatives. Supporting adoption of ‘hard to place’ children over their lifetimes would still result in considerable economies for local authorities, making further funding available for the development of additional adoption support and child care services.

Residential placements in England and Wales cost on average £78,247 per year and foster placements £11,734, rising to £31,587 for an independent fostering agency placement (IPFA 2001). Although reliable figures are not available for the cost of adoption allowances in England and Wales, they are small compared to the huge costs of residential and foster care. Even with a significant additional allocation for post adoption support, adoption remains a cheaper permanence option. Given more prominence and credibility by the provision of consistent support services, more social workers would consider encouraging long-term foster carers to become adoptive parents and many foster carers would become more receptive to change of legal status if they believed they would have access to ongoing support. Clearly this should only be proposed where it was in the interests of the child and carers felt comfortable with the changes. The White Paper itself encourages this trend, proposing that assessment of foster carers should be fast tracked (DoH 2000). If followed through, this would have a significant impact in every local authority area, leading to a reduction in the numbers of looked after children. In the longer term, additional services could help to reduce the adoption disruption rate, since a number of studies of foster placements that have become permanent conclude that the disruption rate is lower in this group (Sellick and Thoburn 1996).

Although the statutory requirement to provide post placement/post adoption services will be underlined by new legislation, the nature of such service delivery should not be bureaucratic nor so bound by review and regulation. Post order adoption placements do not require statutory visits and reviews, thus would not demand the expensive quantity of professional and administrative time involved in supervising looked after children. Following an adoption order a more equal relationship between adoptive families and professionals should be developed. Adoption service users are themselves expressing the desire for a more accessible service, involving multidisciplinary co-ordinated inputs (Archer and Swanton 2000). Properly supported adoption would considerably reduce the risk of disruption and the huge human and financial ...

Table of contents

• Cover Page
• Other Books
• Title Page
• Copyright
• Contents
• Foreword
• Acknowledgements
• Introduction: A Tapestry of Colours
• Part I: State of Play: Current Theory and Practice
• Part II: State of the Art: Theory into Practice
• Part III: State, Community and Family: The Future
• Appendix: Family Futures Case Planning Matrix
• Glossary
• References
• Contributors
• Subject Index
• Author Index