Friday, February 22, 2008

Workshop 2.5: Supporting Adopted Children After Adoption: What are Their Post-Placement Needs?

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

Bullet points for discussion during Workshop 2.5:

  1. What are the most important needs of adopted persons after adoption – both in the short and long term?

  2. To what extent to current practices and policies respond effectively to these needs?

  3. What new services and supports are needed to ensure that the needs of adopted persons are met?


Carrie Kent is the Director of Research for Ethica, Inc. and an adoptive mother of two children, Jack and Desiree. She is active both locally and nationally in issues related to openness in adoption, as well as transethnic placement. She has been co-owner of the XcultureAdopt list for four years and has spoken at the 1999 Traverse City Open Adoption Conference, the fall 2000 LifeGivers Workshop at Higgins Lake, Michigan, and the 2003 Open Door Society spring conference. In her “day job,” she is head of Research Services at Harvard University’s Widener Library, and is an as-of-yet unpublished novelist.

Joyce Maguire Pavao, Ed.D., LCSW, LMFT, is the Founder and CEO of Center For Family Connections, Inc. (CFFC - est. 1995) in Cambridge, MA and New York. Dr. Pavao has done extensive training, both nationally and internationally. She is an adjunct faculty member in psychiatry at Harvard Medical School, and has consulted to various public and private agencies, schools, and the court system. She works closely with individuals and families created by adoption, foster care and other complex blended family constructions. She has developed models for treatment and training using her systemic, intergenerational, and developmental framework, The Normative Crises in the Development of the Adoptive Family. Her book, The Family of Adoption, has received high acclaim. Dr. Pavao has received many awards and honors, including the Adoption Excellence Award for Family Contribution (2003) and the Angels in Adoption award (2000).

Debbie B Riley is Executive Director of The Center for Adoption Support and Education, Inc. (C.A.S.E.), an independent post-adoption organization in the Baltimore-Washington area and co-author of Beneath the Mask: Understanding Adopted Teens. Since 1993, her work has focused exclusively on the field of adoption. She has created a continuum of post-adoption programs in the Washington, DC area and a variety of innovative and effective programs to address the complex needs of families with a variety of adoption backgrounds, including public and private, international and domestic. Ms. Riley presents both locally and nationally on numerous topics related to adoption and adolescent mental health. She serves on the Research and Practice Committee of the Evan B. Donaldson Adoption Institute, the Editorial Committee for the Adoptive Families Magazine, and the Children’s Agenda Advisory Committee of the Montgomery County Collaboration Council for Children, Youth, and Families. Ms. Riley holds a Master’s degree in Marriage and Family Therapy from the University of Maryland. She is the adoptive mom of a teenage son.

Indigo Willing OAM, is a doctoral student at The University of Queensland, Australia. Her research interests include transnational families and migration, as well as links among race, culture and child welfare services. Her thesis focuses on the experiences of Australian parents who have adopted children from Asia and Africa. Ms. Willing was adopted from Vietnam into a white Australian family in 1972, and as a young adult, she received a Medal in the Order of Australia in 2006, in recognition of her work in developing the Adopted Vietnamese International community network. This network is dedicated to assisting adopted people from the Vietnam War and their adoptive families to develop stronger connections to Vietnamese culture, history and surviving/missing relatives. The network works closely with a range of adoption groups in Australia.

Debbie Riley

  • When she thought about what are the most important needs of adoptees post-adoption and what extent current practices and policies respond effectively to the issues discussed by this panel, she came to the realization that adoption professionals know that there are normal but complex issues facing adopted persons, many of whom will seek professional services in charting their adoption journey.

  • Adoption is not a one-time event but a lifelong process that warrants specialized support upon the way.

  • Most important need of adopted persons is the funding, availability, accessibility and quality of adoption-competent mental health services. Current socio-political factors don’t ensure the availability of these services. It is the ethical and legal obligation of her field to ensure all adopted persons have access to competent mental health services. Why are the children with the most complex adoption and mental health needs being referred and seen by the least qualified experienced clinicians?

  • The Code of Ethics of the National Association of Social Work states that when generally accepted standards do not exist with respect to an emerging area of practice, then they should exercise careful judgement and take responsible steps with respect to education, training, consultation and supervision to ensure competency in their work and to protect clients from harm.

  • We must join together to expand the knowledge base of practitioners set the standards for competency through federal, state and local collaborations and advocate for flexible funding streams to sustain the services. Adoption competent providers can be instrumental in ensuring positive outcomes for adoptees and their families.

    It is our ethical responsibility to ensure that adoptive families have access to high quality adoption services.

Indigo Willing

  • Shared insight from the Australian perspective.

  • Since 2000 she has been working with adopted Vietnamese war orphans. She runs a search registry for people looking for relatives and notes the paucity of resources. Her doctoral studies focus on the identity construction of adoptive parents and how they negotiate problems of adoption.

  • Australia is undergoing several adoption legislation reviews at the state level and has just had a federal inquiry into the adoption process. People are speaking up and saying things need to be changed, but who are being heard?

  • Adoptees are highly experienced adoption educators and run excellent support groups among themselves, but they are rarely funded and rarely heard.

  • Most common issues adopted people are focusing on with respect to post-adoption needs:

    1. Representation – the need for adoption institutions, agencies and groups etc. to allow for adult adoptee perspectives to illuminate both the strengths and weaknesses of the practices. Also a push to call for adoptee inclusion on more boards, committees and forums.

    2. Administration – need for tighter record keeping, inclusive fees planning for services such as searching for birth parent assistance, return visits and counseling support. A lot of uproar in Australia at the moment for fees to adopt. None of those fee increases are covering post-adoption services other than 2,000 per year for a festival where children can dress in their national costume.

    3. Transnational planning – providing guidance and services relating to assisting adoptees who embark on return trips. A lot of adoptees travel independently and find themselves thrown in the deep end. They are left in an incredibly vulnerable place. If so much preparation goes into bringing these children overseas, surely some preparation could exist to help them return to explore birth countries.

    4. Cultural strategies – offering of programs dedicated to issues such as language and cross-cultural competency. For example, the documentary Daughter from Danang illustrated a cross- cultural collision.

    5. Ensuring emotional and psychological capital – relates to making sure there are suitable programs and appropriately educated counselors who can assist adopted people manage issues related to their emotional well being and mental health. There is no post-adoption training for people like psychologists and family health practitioners in Australia.

  • Education, if it does exist, generally consists of getting volunteer adoptees to speak about their life story. Would like to see stronger programs being built.

Joyce Maguire Pavao

  • What adoption is not: adoption is not a problem, illness or a bad thing though it stems from what many think are problems. Society tends to view adoption as a problem. It’s very important to realize that pathologizing leads to pathology and a lot of that goes on in adoption and is that ethical?

  • Adoption is taking on and extending or making of family by admitting others to the clan and claiming them as relatives as in marriage. It is a lifelong process and it affects the generations before and after in many direct and indirect ways. It is complex, it is never simple.

  • Cannot focus on post-adoption needs of the child without focusing on the parents. If you don’t take care of the adults, the child isn’t taken care of. We need to provide more support and services to foster families.

  • With respect to birth parents, it is important to pay attention not just in the moment, but post-adoption these issues go on. There’s a developmental process for birth parents. We are not doing enough for birth parents, they are hardly considered. If you care about the child, you care about all of their parents. This includes parents whose children were removed – the children are in permanent homes and messages they give those children will make a huge difference in the emotional stability of their child.

  • For adoptive parents, there are ongoing needs. Often it comes in the guise of the children’s needs, but parents have developmental issues, including in and out of doubt about feeling genuine.

  • Therapy is not the answer to everything. Need to provide consultations and programs and not necessarily be in therapy.

  • Developmental issues for children – many points in time where things will come up that are quickly pathologized. Under anger lies sadness or fear. Larger community needs to have education e.g., schools where learning disabilities diagnosed are in fact teaching disabilities; medical and health professionals – rampant medications and crazy therapies done in the name of attachment, bizarre overdosing of adult medications for kids is unethical. Need to have extended family educated

Discussion from Workshop 2.5

Question 1.A person from CASE raised concerns with other mental health professionals. Instead of pathologizing adoption, they minimize and fail to recognize normal reactions to adoption. They suggest other things are going on instead of validating what is happening is normal. Are there more ideas of how to educate other professionals?

Riley: It’s been a delicate balance for many years of how much to attribute to adoption. Education is important.

Willing: She is a sociologist by training, but sees attachment come up a lot. It’s important to remind parents to keep a critical mind and do research.

Question 2. An adoptive parent/adoption worker referenced developmental stages members of the triad undergo and requested references.

Pavao: A lot of the grass roots organizations can be helpful. For example Lee Campbell of Concerned United Birthparents put together material on developmental issues of birthparents; she has a long vision of birthparenthood. There is also Romanchik’s organization. For adoptive parents, there are wonderful adoptive parent networks. Always go to the elders, parents whose children are in 30's and 40's and who have kept up with the times. Some people are better at some stages than others. The family is an organism, so it is important to see how everyone is relating to each other. Adult adoptee groups are incredibly important for people to listen to. Find people who can reflect on things.

Willing: Sometimes the diagnosis of adult adoptees is wrong. For example, low-self esteem is attributed to being separated from mothers. That may be true, but a more well rounded approach needed, for example, an examination of what else is going on in their lives like racism. Look at studies by adoptees in addition to personal narratives.

Question 3. Another adoptive parent/adoption worker wondered how we can help better prepare families in adoption by saying that post-placement services are more likely than if they had given birth to a child because there will be an added layer of issues.

Pavao: People should be trained to provide them. Important the services not all be therapy, but often need consultation and support.

Riley: We need to start advocating for the funding and that these services are accessible.

Question 4. An adoptive parent and educator said he tried to start a club for adoptees at his high school but he ran into confidentiality laws. Doesn’t know how to go about it.

Pavao: Suggest normalize it by expanding it, for example, to kids who live in complex families. Emotional and psychological issues are the same even if the legal situation is different. The kids may feel pathologized if limited to adoptees.

Riley: Look at the environment. A lot of adoptive parents don’t want their children to share they are adopted because of the stigma attached to them. See how one can create adoption sensitivity among peers.

Willing: As a teen, there might be issues of gender. At an adoption camp in Australia they showed a video with stories by intercountry adoptees who were a little older. Accompanying that they showed the movie Transformers and lots of boys came. Adoptive father groups have football days.

Question 5. Someone from Open asked what if you have parents who are in denial or who are reluctant? How do you draw these parents in?

Pavao: Help isn’t help unless you want it. No one starts out gung ho understanding all of this, but opens up along the way. Pre-adoption, prospective adoptive parents may not be interested even if they attend pre-adoption education, but they will have the information to get more help when needed. Sometimes information doesn’t take seed for awhile.

Willing: There is a real need for this. Can’t adopt in Australia without going through a state agency. Reasonably good program in the pre-adoption stage where prospective adoptive parents needs to go through education sessions, provide a life storybook, and undertake home studies. Adoptive parents have to compete for children so they join networks to learn how to get through the system and make friendships that way and then are keen to learn more, but there are not enough professionals to do the training.

Question 6. A mother said she runs an online support group for individuals who worked with her network of agencies she lost her daughter to. So she is in a position to help even though she is not a professional. What other things can she do besides recommend books?

Pavao: Suggests reading, going to conferences and lectures, support groups. Worry about the word “support groups” sometimes. Some like the information but don’t like the name. Hearing other people normalizes experiences.

Riley: Something she has found useful is journaling.

Question 7. An adoptive parent/adoption social worker asked whether there is a need for more professional standards when it comes to adoption social work in schools of social work. Should there be more standards of practice across the board?

Riley: Yes, there should be. What is an adoption-competent therapist? There is no standardization of knowledge base or core competency. It is important that we come up with standards before an outside entity does.

Pavao: Post-graduate programs are great but they are not nearly enough. Supervision is a key factor, for example, in the child welfare system people often become supervisors if they are near retirement and are going part time. There should be a lot more done to make sure people are trained.

Question 8. Adoptive parent/adoption worker ask about the importance of providing services to siblings, both biological and adoptive.

Pavao: Siblings really need support. We don’t do enough work with siblings before a placement or before removal.

Riley: Do siblings get to be a part of the process? Doesn’t want to see the child as separate from everyone else and usually siblings are left out entirely.



  1. Usha, thank you for continuing to transcribe the sessions - this blog is a treasure trove of info from the ethics conference.

    I hope you and Desiree are doing well!

  2. Despite being called out about Desiree and David admitting that their children out cried to them that they were stolen just weeks after getting them transported from India, the did not go to India and try and get them back to their mother. This amounts to being part of their abduction and would not have been allowed by law even though they had gone through the "right" steps with their agency and goverment. They should have IMMEDIATELY gone over to India, hired a private investigator and returned the girls. I find it hypocritical that they fancy themselves sel-annointed adoption experts. My god.

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  4. Hi Emily

    We know what we lived and we know why we did and didn't do what we did and didn't do when we did and didn't do it. And frankly, though hindsight is 20/20 and knowing all that we know now (namely, the reality of corruption), we would have done things differently, hindsight also knows that the fact that we all made it through in as good as shape as we did was a miracle and not to be triffled.

    I don't mind answering sincere and respectful questions, Emily. But I don't like being messed with by someone who is simply out to attack me with insincere and disrespectful "questions" and criticisms of decisions made in my life--a life you didn't live--just to buttress her own adoption-is-always-ethical-and-wonderful belief system--a belief system that is under serious attack from reality.

    Wake up and smell the corruption, Emily. The evidence for it goes way beyond our own inconveniently true adoption story. The evidence is here on Fleasbiting in documented newstory after documented newstory after documented newstory after documented newstory.....

    A belief system that can't accomodate reality is a belief system that needs revising.

    We all start out as blind men standing at the trunk of the elephant of adoption.

    But an elephant is more than a trunk.

    Only those who refuse to listen to the perspective of other blind men continue to believe that an elephant consists only of a trunk.

    Scream as loud as you want, Emily, but those of us who have been stepped on by the elephant know that an elephant is not only a trunk, but also many other things.

    Many things can be true at the same time.

    The real reality of adoption, like all real realities, encompasses many realities and many perspectives at the same time, not just one.

    Those who want to grow and mature and understand reality as it really is, work to make their perspective on reality encompass as many perspectives as possible because they know only then will it be closer to an objective reality and not just a subjective belief system.

    The perspective that adoption consists of only a trunk is out there. What we have collected into one place here is evidence that the adoption elephant sometimes steps on those its meant to serve. Evidence that the elephant can be dangerous. Evidence that the elephant needs to be tamed and disciplined and made subservient to ALL who stand around it. Evidence that will lead to less people getting hurt, getting stepped on.

    As for our adoption and our decisions....

    Hindsight is always 20/20. Knowing what we know now about the reality of adoption corruption, we'd have done things differently. Back then we thought adoption consisted only of a trunk and so we listened to arguments such as Kevin puts forth--reasons that our daughters' allegations couldn't be true, arguments from others about how if we afforded our daughters' allegations credibility it proved we were bad parents, arguments about why our daughters were probably lying to make themselves feel better, etc. etc. etc. It was our agency's responsibility to investigate our daughters' allegations and so we asked them. Frankly, it took ALL of our energy and more 24/7 during that time just to keep our very, very, very traumatized daughters alive and work them towards daily functionality.

  5. No, Desiree,
    I appreciate your response.
    I am not davowing the corruption now or then.
    You are the girls second mother. It does not matter who did or did not help you. It was your resposibility to get on the plane and get them home. You can't pass it off on Kevin or anyone. If you, as a mother knew their mother was out there in agony, that she has tried and tried to find her children, you alone had the responsibility and the money and ability, no matter how crazy things were, to go to India and return them. Your story blames everyone else. That is where my beef is. It is a fairy tale that does not hold you accountable. You make it sound like you were the victim of the system yet you had the facts. They had names, they knew where they were from.

  6. Also, I hope that you ask for \god's mercy for putting your self above your daughter's out cries. Maybe there would have been no 24/7 trauma if you had listened and acted. Yes, you think it all worked out the best it could but I think some day, if they have not already asked, either out of respect or power differential, "Mom, why did you not take us home? Why did you make this about you and dad instead of rescuing us? Why do you tell the story as if it were not under your control? Why were you worried about what others were thinking and saying instead of listening to your own heart?" It may not be now, but it will come, it will come. And then you will know whereI was coming from.