THU July 12, 2018 THU July 12, 2018
10:30 am 10:30 am
International II International II

Debbie Riley

Chief Executive Officer, Center for Adoption Support and Education

Anne J Atkinson

President, PolicyWorks, Ltd.

Symposium: Improving Outcomes for Success: Building a Community of Adoption Competent Practitioners

Building a Community of Adoption Competent Practitioners

Access to adoption-competent mental health services is a well-documented critical need of children and families coming together through adoption to promote positive outcome and the long-term success of adoptions. Despite the frequency of emotional and behavioral issues that their adopted children present, adoptive families struggle to find mental health professionals who understand the impact of adoption and early compromised beginnings on their children and their families. Some families reported seeking therapy from as many as ten different therapists before finding one who understood adoption issues, if they find such a therapist at all. Meeting the diverse needs of adoptive families will require mental health providers to infuse knowledge gained through specialized adoption competency training which influence one’s assessment protocol, diagnoses, treatment planning and interventions

For 20 years, the Center for Adoption Support and Education (C.A.S.E.) has been providing adoption-competent mental health services to meet the complex needs of foster and adopted children, parents and families. In response to meet the needs of adoptive families nationally, C.A.S.E. first developed the Training for Adoption Competency (TAC), an evidenced informed 72-hour classroom based training curriculum to assure that mental health providers have access to high quality and standardized training to build awareness and increase their knowledge and skills in working with adoptive families. Subsequently, C.A.S.E. was awarded 5-year federal funding from the Children’s Bureau to implement the National Adoption Competent Mental Health Training Initiative (NTI) developing two state of art web-based training curricula, one to be infused in all child welfare agencies in the U.S and the other for community mental health professionals.

This presentation focuses on C.A.S.E.’s experiences with developing and implementing two adoption Competency training platforms. TAC training has been delivered to more than 1,500 clinicians in 17 U.S states, and included two foundational products: a set of specifically defined knowledge, values /attitudes and skills constituting adoption competencies in 18 domains, an expert consensus definition of an adoption competent mental health professional. Distinguishing features of the training model will be presented, including a final project and clinical consultation to facilitate the application and transfer of learning to practice, robust trainer support, and a rigorous evaluation that assesses training delivery and effectiveness and practice outcomes. The presentation will also provide a discussion and demonstration of the NTI asynchronous web based training for child welfare professionals including design elements, content development and evaluation of the pilot findings representing over 6000 users.

What We Are Learning and Need to Learn about Building Adoption Clinical Competence

All replications of Training for Adoption Competency (TAC) have been subject to ongoing, rigorous evaluation designed to assess training delivery, outcomes, and effectiveness. Findings from the evaluation will be presented with an emphasis on clinical practice changes reported by TAC participants whose responses have created a very large and rich body of data illuminating the nature of specific practices associated with adoption competence. In more than 1,400 responses every TAC participant has reported change in at least two of six defined aspects of practice; 59 percent report change in all five aspects at the individual clinician level; and 51 percent report change in procedures, programming and/or services at the organizational level. In more than 6,000 narrative responses identifying most important learning and it has been applied in practice, eight major themes were identified: 1) understanding of grief and loss and how it affects all members of the adoption kinship network; 2) how early trauma affects attachment; 3) understanding the critical role of the brain and neurobiology in behavior and relationships 4) the lasting/lifelong impact of birth parents; 5) understanding of adoption as a lifelong process; 6) awareness of new assessment tools and evidence-based interventions suitable for this population; 7) changing clinician preconceptions as outdated views are replaced by new perspectives informed by current knowledge; and 8) the need to address adoption issues directly (and greater clinician comfort in doing so).

While the ongoing evaluation of TAC continues to illuminate the nature of practices as described by training participants, there remains need to determine whether there is evidence of improved outcomes for adoptive families. Findings will be presented from a small pilot study that collected data from 19 families who worked with 7 TAC-trained clinicians and 16 families who worked with 8 comparably qualified non-TAC-trained clinicians. Although families were demographically comparable, adoptive parents served by TAC-trained clinicians registered very positive average ratings across all four dimensions measured (satisfaction, therapeutic alliance, adoption relevance of therapy, and family outcomes) and while those served by non-TAC-trained clinicians registered markedly less positive average ratings. A more robust study has been designed and proposed within the context of a single state and funding is being pursued. The presentation will examine implications of findings for policy, practice, and research and will engage with other symposium presenters and participants in a broader discussion of implications derived from all three presentations.