Profiles in Permanence: What’s Being Done to Improve Adoptions and Guardianships

One of the most important and sometimes underappreciated challenges facing the child welfare system in the 21st century is addressing the unique needs of families formed through adoption or guardianship. Between 2000 and 2015 there has been an influx of children in adoptive homes.

The growth in adoptive and guardianship homes has led to a heightened awareness of the complex needs families can encounter at any point after permanence has been achieved. Many of the direct challenges stem from the maltreatment the children endured before being placed in their adoptive or guardianship homes. Children who have experienced trauma can demonstrate typical challenging child behaviors, but often at a frequency, intensity and duration that can stress families beyond their capacity to cope.

Such difficulties do not disappear spontaneously once an adoption or guardianship is finalized and new challenges can present over time. While some families travel a relatively smooth and uneventful path, for others, life post-permanence can be wrought with challenges that impact their functioning and overall well-being. The complex realities these families face call for innovative and practical solutions that have a proven track record of success. In an effort to meet these realities, the National Quality Improvement Center for Adoption and Guardianship Support and Preservation (QIC-AG) was created.

The QIC-AG is a five-year project designed to promote permanence when reunification is no longer a goal and improve adoption and guardianship preservation and support. Started in 2014, QIC-AG is funded by the Children’s Bureau and a through a five-year cooperative agreement with Spaulding for Children, and its partners The University of Texas at Austin, The University of Wisconsin-Milwaukee and The University of North Carolina at Chapel Hill.

The center was built on the premise that child welfare agencies need to provide a continuum of services to increase permanency stability, beginning when children first enter the child welfare system, and continuing after adoption or guardianship has been finalized.

Working with eight sites, the QIC-AG is implementing evidence-based interventions or developing and testing promising practices. Effective interventions are expected to achieve long-term, stable permanence in adoptive and guardianship homes for waiting children as well as children and families after adoption or guardianship has been finalized. After rigorous evaluation of the interventions, effective models of support and intervention can be replicated or adapted by child welfare systems across the country.

With all of this in mind, the QIC-AG is committed to learning what services and supports — when provided at the right time and intensity for a family’s level of need — will promote family preservation and avoid discontinuity. The center’s framework is comprised of eight intervals; the first several take place when a child is in foster care and are designed to move a child and family toward finalization. The next intervals occur after permanence has been achieved and are preventative in nature. The last two intervals focus on addressing intensive help and maintenance of permanence.

Each of the eight sites working with the center is implementing and evaluating a segment of this framework:

Texas and the Winnebago Tribe of Nebraska: “Focused Services,” aimed at helping address the emotional needs of children before permanence, and helping prepare adoptive/guardianship families before finalization. Texas is implementing Pathways to Permanence 2: Parenting Children Who Have Experienced Trauma and Loss.

The Winnebago Tribe of Nebraska is implementing Family Group Decision Making, adapted to reflect the Ho-Chunk cultural beliefs and practices.

Vermont: “Universal Prevention,” an intervention focused on the child welfare system’s ongoing outreach efforts and engagement strategies that are designed to keep families connected with available supports, to improve the family’s awareness of the services and supports available for current and future needs, and to educate families about issues before problems arise. Vermont has developed and deployed a post-permanency survey.

Illinois and New Jersey: “Selective Preventions” to assist families who are deemed to be at elevated risk for post-permanency problems. In Illinois, the Trauma Affect Regulation: Guide for Education and Therapy (TARGET) program which uses a strengths-based, psycho-educational approach to educate youth about the effects of trauma and to provide therapy for youth affected by trauma and exposure to adverse childhood experiences is being used.

In New Jersey, Tuning Into Teens (TINT), a six-session emotion coaching program designed to proactively increase parents’ capacity to understand and respond effectively to their child’s emotions, and thereby, help their child to develop and improve emotional competence is the focus.

Catawba County, North Carolina, and Wisconsin: “Indicated Preventions” for support services administered to families that request help with one or several issues. In Catawba County, Reach for Success, a two-part intervention designed to provide early outreach to families who are receiving adoption assistance and reside in the region is being implemented.

In Wisconsin, the intervention is called Adoption and Guardianship Enhanced Support or AGES. AGES offers families individualized assessment of emerging needs and their strengths, identification of family-specific goals, personalized assistance with navigation of pre-existing resources and services, and targeted advocacy in the areas as requested by the family.

Tennessee: “Intensive services” target families who are experiencing difficulties beyond their capacity to manage on their own, and therefore, are seeking immediate services. These families may be at imminent risk of experiencing a crisis or may already be in a crisis situation. This intervention focuses on the Neurosequential Model of Therapeutics developed by Dr. Bruce Perry at the Child Trauma Academy.

In forthcoming columns for The Chronicle of Social Change, I will describe the different interventions being tested at these sites in more detail. I’ll also share some of the major takeaways and trends identified during the course of the QIC-AG’s first five years.

April Dinwoodie is a transracially adopted person and host of the podcast “Born in June, Raised in April: What Adoption Can Teach the World!” She is the founder of Adoptment, a mentoring program that matches foster youth with adopted adults, and is retained by clients, including the QIC-AG, to help raise awareness of their work to support children and families.    

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