Tuesday, October 23, 2007

Accountability to Families of Origin: Workshop 1.1--Birth Sibling Placement and Contact

Note: The following are detailed notes. They do not constitute the exact words of the speakers, but a--hopefully accurate--summary of the ideas of these presentations and questions. If any of the panelists or attendees take issue with any of these summaries, please let me know so that I can correct them.

Thanks,

Desiree

To order a audio CD of this presentation please click here: Purchasing Audio CD's of the Ethics and Accountability Conference

Ethics and Accountability Conference
Sponsored by Ethica and Evan B. Donaldson Adoption Institute
October 15-16, 2007



Panelists (for more detailed info on panelists, click on their names):

David Brodzinsky, Ph D, is Professor Emeritus of Developmental and Clinical Psychology and past Director of the Foster Care Counseling Project at Rutgers University. He is the author of five books and was a founding director and 10 year member of the Board of Directors for the Evan B. Donaldson Adoption Institute.

Joyce Maguire Pavao, Ed.D., LCSW, LMFT, is the Founder and CEO of Center For Family Connections, Inc. of Cambridge, MA and New York. She is also an author and an adjunct faculty member in psychiatry at Harvard Medical School.

Nancy Golden, LCSW, is the Co-Director of Midwest Adoption Center.

David Brodzinsky

  • Research on sibling relationship is recent; most has been done in the last 15 years.
  • What is so special about sibling relationships?
    • Sibling relationships are among the longest lived human relationships, forming early in life and continuing through the end of life. Sibling relationships generally run longer than relationships with parents, spouses, and children.

  • Sibling relationships, whether positive or negative, form lasting influences on children
    • Positively, siblings:
      • Can be companions and playmates
      • Can be models for appropriate attachment
      • Can be sources of cognitive stimulation; models for appropriate development; impetus for linguistic development
      • Can teach conflict resolution strategies, positive and negative
      • Can model for cultural relationship (socialization); model to how to relate to wider world (especially peers) in way that parents can't
      • Foster identity development (cultural, racial, gender, familial,etc.)

    • Negatively, siblings:
      • Often fight with each other; teach each other bad relational patterns
      • Can be sources of conflict,
      • Can, at the extreme, be sources of trauma and even abuse
      • Can model negative behavior (early sexuality, drugs, drinking)
      • Can model negative conflict resolution (physicality, torment, etc.)

  • Today virtually all major placement agencies have policies stating that siblings should be placed together. Despite this, siblings are too often not placed together. Why? What are the barriers keeping siblings from being placed together?
    • Sibling placement policies are not always well articulated
    • Problems in the translation between policy(on paper)and practice(in the field)
    • Lack of staff understanding/training in regard to the importance/role of sibling relationships
    • The belief that sometimes, when there is a history of difficult sibling relationships, it is a bad idea to keep siblings together
      • But keeping siblings apart also teaches conflict avoidance rather than conflict resolution
    • Lack of available families to foster/adopt sibling groups. Many feel they can't handle the responsibility of parenting large sibling groups with multiple children coming into the family simultaneously
    • Lack of training for parents who might consider larger sibling groups
    • Regulations about child placement that inadvertently preclude siblings from being placed together
      • Regulations regarding how many children can be placed in one family
      • Regulations about housing size in relation to number of children
      • Considering how important sibling relationships are, these rules should perhaps be bent

  • The separation of sibling groups is rightfully viewed by professionals using a "loss model"
  • Whatever WE think about the child's various losses, the child experiences his/her losses as major and significant.
  • Sibling loss must be viewed in the context of the larger context of the multiple significant losses a child has experienced. Foster/adoptive children have lost:
    • Parents, relatives, extended families, etc.
    • Significant non-biological relationships like foster families and foster siblings
    • Other positive relationships including caregivers, teachers, friends, community,etc.
    • Social "status"--foster/adoptive care carries the stigma of being "second best." No one wants to be in foster care or to be in a position where they need to be adopted.
    • Biological Origins. Adopted children, especially, lose genealogical continuity. They are cut off from their relatives, their biological origins, their genealogical identity, and from knowledge of relatives/ancestors. [No one who has not lost these things themselves can understand the significance of this loss.]
    • Identity. In many senses of the word
      • Loss of identity is especially prevalent in transracial adoption. The child loses his or her ethnic, cultural, and racial identities.
      • The transracially adopted child also suffers an inevitable and chronic loss of privacy. When a child doesn’t look like his/her parents then the fact that the child is being fostered or is adopted is no longer a private truth--the fact of "care" becomes public knowledge, available even to strangers.

  • Sibling loss is a serious loss for children of all ages, even infants.
    • Infants too young to be aware of their separation from siblings, do not escape sibling loss. Infants grow into children who ask questions and want to know about their lost siblings.
    • Older children also suffer from the loss of their infant sibling despite the fact that they have not had the chance to get to know them

  • It is a measure of the importance of the sibling connection that a sibling searches are often the first searches undertaken by those searching for their biological roots.
    • Sibling searches are considered "safer" searches. Siblings are perceived as less apt to reject the adoptee than parents.

Joyce Pavao
  • Began by discussing her own status as an adoptee who had six non-adopted siblings. It was a huge loss not to have known her siblings for all of their mutual lives.
  • Those who haven’t lost siblings can’t really understand the gravity of sibling loss
  • Siblings hold a huge amount of value and import to us. Sometimes sibling relationships are good; sometimes they are bad; but they are always very important
  • There are two recent books and a movie that artfully speak to the importance of sibling connection for adopted persons.

  • Placement decisions should not only take into consideration immediate concerns, but must also, and more importantly, take into consideration the lifelong importance of sibling relationships.
  • In the opening panel of the Ethics and Accountability Conference, Oronde Miller talked eloquently about loss of contact between the siblings in his family and the resulting loss of a medical history. That loss nearly meant the loss of life for one of his siblings. It was only finding each other that saved his sibling from an untimely death.
    • The surgeon general of the US talks about the need to know our family medical information, but how can fostered and adopted persons have that info if we do facilitate their keeping in touch with their families of origin?

  • There are numerous reasons why it is important that siblings remain connected to each other and that adopted persons should be allowed to retain connections with their families of origin.
  • There are numerous reasons why we must understand the value of sibling connections. It is incredibly important that people have an understanding about the importance of siblings. It is incredibly important that we discuss this importance with others (and share the information with the general public). This information has many practical day-to-day applications and implications.
    • For example, a child who is the only child in an adoptive family talks about his/her other siblings, and the uninformed teacher doesn’t understand--she thinks the child is "crazy" because, from her point of view, the child HAS no siblings because there are no siblings in the adoptive family. She doesn't stop to consider that the child's family connections extend beyond his adoptive family.

  • Incredibly, even today siblings and even twins are still being separated and some "professionals" are still supporting that separation.
  • Programs to preserve sibling relationships are needed--especially programs that can serve as models to be replicated elsewhere. It takes a lot of work to ensure that sibling connections are maintained when children are placed in different families.
    • If three families are raising three siblings, these three families may not have anything in common beyond the children they parent. Families may be culturally very different; they may have vastly different values and ways of doing things. It is hard without help to build relationships across all these difference.
    • Families who essentially have nothing in common but their children's connection to each other, may not WANT to build relationships. Without support and help to do so and a thorough understanding of the importance of sibling connections, the sibling connections may not be seen as worth the effort--and may get lost.
    • The adults (parents) involved need a chance to talk out and work out their differences in a way that honors and respects each other; they need understand how to agree to disagree about all sorts of things. There will inevitably be culture clashes between individual families and their own ways of doing things, seeing the world, etc.
    • Issues arise that don’t allow relationships to develop
    • Families need to be helped to understand boundaries and how to maintain them in the face of huge differences
    • Families need to be helped to find ways to make sure that relationships happen. Relationships must surmount values differences, geography differences, cultural differences, and surmount time pressures--all sorts of issues that don’t allow relationships to be valued enough to grow
    • Relationships can’t be legislated, but they must be given space to grow
    • This facilitation does not mean supervised visits most of the time, but might often mean clinical supervision of relationship between families.
  • What is a sibling? It is different to everyone and it is important to realize this and make allowances for these differences. Those who are siblings may include:
    • Biological siblings
    • Adoptive siblings
    • Foster siblings
    • Extended relatives
    • Others who are reside in the home for a time

  • We must give siblings of all sorts a place in order to help kids feel whole because we must realize what a huge and important impact siblings have on each other.


Nancy Golden
  • Sibling searches are the second most requested search in her practice. Requests for sibling searches typically come from adoptive parents of minors and/or from adult adoptees.
  • The single largest info exchange is the exchange of information between siblings
  • Ongoing sibling relationship may be represent complications for AP's, but sibling relationship is important to adoptees.
  • Sibling relationships are a matter of valuation.


Questions:
(from those present at Workshop 1.1)

Question 1. Can you speak to how kinship foster and kinship adoption affects sibling placements?

Pavao:
  • Honesty is extremely important. We have to help kids and adults understand their changing roles and responsibilities. People are playing roles different from their normal ones. [For example, a grandmother or an aunt or an older sister might function as a mother; others may also take on different roles too]
  • Secrecy is biggest problem
  • Kinship fostercare/adoption can be problematic because of the good sister/bad sister kind of dynamics that inevitably develop. There can be a lot of imposed guilt and shame.
  • In order for it to work, support is needed. And yet, generally, fewer services are available for kinship placement than for other placements.

Brodzinsky:
  • There is great complexity in kinship placement,but many times it provides the best opportunity to maintain sibling contact, even if children are placed in different kinship families. [Those families are naturally going to see each other simply because they are FAMILY to each other. Children placed in different kinship homes have multiple opportunities to relate to each other in a extended family setting]
  • It is true that services offered for kinship foster/adoption are much less, and that is a big problem. We definitely need to strengthen these services to support kinship placements.


Question 2. How do we balance between birthparent privacy and birthsiblings' need to know?

Pavao
  • Birthparents need to understand exactly what they are agreeing to in regard to privacy; the language needs to be clear
  • As important as privacy is, not enough is done to help birthparents understand importance of other aspects of connections. Birthparents might make different decisions if they understood the importance of connectedness.
  • Perhaps there might be ways for a birthparent to maintain privacy but also take care of the child’s needs for connectedness

Brodzinsky
  • This brings up an important question. How do you help a child when you don’t have the info you need to answer the child's questions and concerns. What do you say when the child asks, "Do you think I have siblings?"
    • Therapists are trained to not answer questions, but to explore the child's reason for and meaning in asking the question. Therefore they ask the child, "What do you think?" and explore the reasons the child is asking the question--what is in his/her head.
    • In IA often there is a dearth of information, so parents can't answer questions. AP's need to be taught how to talk to their children in situations where information is missing.
      • Must affirm normality of child's questions
      • Must affirm child’s feelings as appropriate; his/her feelings are not right or wrong
      • AP’s often simply say "I don’t know" to child's questions, and the conversation stops, but the conversation often needs to continue. Again it is important to understand what the meaning of the child's questions are. There is a need to know what's going on in the child's head.

Pavao:
  • Everytime anyone comes for therapy, we do a three generation genealogy for the adoptee. One third of the time we find that AP's know information that the adoptee doesn't. That means that 1/3 of the time AP's are keeping information secret from the adoptee. We end up spending time helping parents begin to tell adoptees the whole truth about what they know.

Brodzinsky:
  • What do you know that you haven’t shared? Is it the existence of siblings or a birthparent's name. Parents are afraid to tell their adoptive children. They are afraid that they'll "put ideas in the child's head."

Golden:
  • Parents should know that's there's a "continuum of connection." AP’s of minors should know that there are other ways to connect other than visitation. Contact can begin slowly. For example letters or emails can be exchanged first. Contact does not have to mean only visitation or physical contact--we can have a more sophisticated idea of openness.


Question 3: Can you speak to the situation when there is infant or toddler who is being adopted and the AP says well, the baby doesn’t know his/her sibling-—but yet they are not taking into consideration that older child already knows the younger child.

Brodzinsky
  • The baby will get older and will appreciate it if the siblings were kept connected; you can benefit from a sibling relationship at whatever age. It's not just important to keep siblings together who are old enough at the time of placement to be aware of each other. Sibling relationships are ongoing throughout life.
  • The reason why sibling are often not placed together is that it is too hard to find a family who will take both. Or sometimes it is that the professionals don't want to have to provide the additional services it would take to place the children together. More effort is required of both the caseworkers and the AP's if children are to have ongoing contact. But this is not OK. The needs of the children and the importance of ongoing sibling contact must remain at the forefront.

Pavao
  • People want things to be clean and easy, but sibling contact is often messy
  • Caseworkers don’t get training; supervisors don’t help; People get nothing but on the job training.
  • Still, it is important to understand worth of sibling connection. There is a term that I've heard--siblings who are connected through their mothers are "wombmates." That connection is incredibly important.
  • Adoption isn't just the needs for a moment in time; it is a moving picture, for a lifetime; not just for right now, but forever. We have to think in terms of metavision--in terms of a lifetime--not just for the needs of the moment
  • It is possible to maintain sibling connections even when one of the children is severely affected. It may mean extremely supervised visits, but children should be given the opportunities even in these circumstances.

Brodzinsky
  • If there is an unaware child--too young to know about siblings-- we use rationale that the child doesn't know the sibling anyway; we forget to think about down the line. Easy decisions in the shorttem come back to be more complicated in the longterm

Pavao
  • We should also think about sibling relationships in regard to alternative reproductive technologies. [This is another situation in which the short term decisions seem easy, but the long term consequences are more complicated]
  • We forget to think about these kids and their future need for needing to know about their genealogical heritage and their biological siblings; we need to have the info to give to them later
  • In terms of International Adoption, we had assumed that these kids would never have a connection with their birthfamilies, but there are now DNA studies from China and many adoptees have found siblings with DNA matches; We must recognize the importance of having those connections

Golden
  • When agencies have a child who comes into foster care, it is important to identify other any siblings the child already has in the foster care system.

Question 4. which is a comment:
  • AdoptUS kids has studied what increases a child's chances of being adopted and surprisingly, one thing is being a part of a sibling group—-the idea that siblings can’t be placed together is a myth. Things are changing in this regard and others.
  • In fact, a young caseworker recently told me that she had heard that "in the old days" siblings used to be placed in different homes. "The Old Days"... The younger caseworkers and professionals definitely have the ideal of placing siblings together.

Question 5. Can you tell me about assessment tools—for sibling evaluations?"

Pavao
  • It isn't so much tools that we lack as it is a lack of education of the professionals. If children are siblings, they are siblings. What assessment needs to be made?
  • An assessment of the professionals and other adults involved is more germaine. The adults have to be educated as to the value of ongoing sibling relationships. Especially, supervisors need to understand what they are doing and why.

Brodzinsky
  • Assessment does become important with history of past sibling abuse.
  • No formal assessment tools exist. Caseworkers and professionals have to apply other abuse models in these cases. The principles of contact should be the same as those applied with parents--children SHOULD be placed together with their siblings UNLESS traumatization would occur. If further traumatization is likely to occur, then the children should still have ongoing contact with the appropriate safeguards.

Golden
  • It may not be best in some cases that children not be placed together, but you still need to maintain contact between the children

Brodzinsky
  • The same models apply to sibling contact when there is abuse as to parent contact in the case of abuse. We should be following the usual rules of therapeutic contact between the two. We assess both the victim and the victimizer. The victim must accept responsibility and the victim should not be blamed for the abuse. Supervised and therapeutic contact occurs and the victim is kept safe.


Question 6: We have developed a multi-disciplinary team to take each sibling group and look at issues together. If it is necessary for the children to be placed separately, how can we best support the parties to build contact for a lifetime?

Brodzinsky:
  • Again, contact doesn’t have to begin with physical contact. Contact can be through email, letters, etc.

Pavao:
  • When a physical meeting does take place in the context of past abuse, it needs to be structured--carefully orchestrated and closely supervised--so that children feel safe together. [They can be doing something structured together.] As much as possible it's also important to know any possible trauma triggers and to avoid them during the meeting.

Brodzinsky:
  • There are no good assessment tools in these situations, so we try to think in terms of models—-attachment models, traumatization models, etc. We use these to try to understand what is going on in life of child and in these relationships.

Golden:
  • Sometimes the professionals are the ones who need to cultivate an open mind in these situations. We don’t understand the important value siblings have to each other. We shouldn't limit the solutions by the beliefs and bias which we bring to the situation. [Who are we to say that there is no value in contact between siblings in certain situations?]

Question 7: Any advice regarding the importance of International Adoption sibling placements?

Pavao:
  • Well, the adoptive parents (AP’s) get it, but professionals don’t. Most of the kids are NOT orphans. They have families. They have siblings.
  • In fact, I hate the title of Elizabeth Bartholet's book, NoBody's Children. Children NEED to know that there are people related to them IN THE WORLD. Eighty percent of the time kids have people related to them. It is rare that they don't.
  • There are many countires where open adoptions are happening; many countries where searches have been successful. Children can find their relatives.
  • Agencies need to have different ideas and an openness to these things. Yes, there can be language barriers and other barriers to contact, but we should not discount sibling/relative contact. We should not be pretending that the child's relatives don't exist. Anywhere--not even in IA.

Brodzinsky
  • Many internationally adopting familes don’t recognize that openness may be possible in the long run. We need to build and maintain the infastructure to facilitate it.
  • Even when all efforts to put the child in contact with relatives fail in an IA context, it is an important to maintain a dialogue, an openness with the child.
  • Communicative openness is predictive of better outcome in whatever context. The more open and honest, the better the outcome. It fosters healthier adjustment.

Pavao:
  • We also need to think about the impact on the other siblings(not just the adoptive child)left behind. To have opportunity to know their sibling is very important to them.


Question 8:(from US placement agency) How do we educate overseas partners who think that sibling connection is not important?

Pavao:
  • To some degree as the Hague is implemented in various countries, this will take care of itself. The Hague mandates that training/education must be provided to partners. When people get a longer view, they understand the importance of sibling and family connections. Right now they simply don’t understand the lifelong issues of adoption. Can they be blamed? The kids they place disappear and they don’t see what happens to/with them. Slowly education is changing things. Regulations will make a difference.

4 comments:

  1. Thanks, Desiree, for this incredible overview of this session. I attended a different session, and really appreciate your thoughts on this one.

    ReplyDelete
  2. Sibling relationship was mentioned in the Ethical Considerations in foster care too. Judge Thorne said that "children have rights to their siblings and extended families" and "terminating parental rights should not mean terminating the child's rights to extended family" including siblings.

    Great synopsis, Desiree. They matched my notes almost verbatim!

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  3. Thank you, thank you, thank you! My son from Vietnam was adopted at 5 months and desperately "misses" his brother who is 3 years older than him and he doesn't have a mature memory of. Children of all ages are affected by sibling loss. My son from Ghana has 3 siblings still in Ghana that were not available to us for adoption. Thankfully our Ghanaian son will at least have contact with his brothers (and other biological family) as he grows up.

    Anita
    www.gillispiefam.blogspot.com

    ReplyDelete
  4. My daughter was the only child placed out of her family and we know she has at least one older sister who stayed with her family and possibly younger sibs. She has gone from fantasizing about her parents to fantasizing about her sister, I believe, because her sister feels safer to her, though she also worries that her sister might have "wanted to get rid of her" just as she would like to get rid of her (adopted) brother from time to time. I don't doubt her sister feels the loss too.

    We did let a couple of potential intermediaries know that we are open to contact but it is slow going, and unknown whether the messages are or will ever be relayed.

    All that to say, siblings are not primarily noted in adoption ethics discourse and I am really appreciative of your summary here.

    ReplyDelete