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Center for Advanced Studies in Child Welfare

Center for Advanced Studies in Child Welfare

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Last week the Donaldson Adoption Institute released its newest policy perspective titled, "A Need To Know: Enhancing Adoption Competency Among Mental Health Professionals. The report highlights the difficulty that adoptive families face when seeking clinical therapeutic services in finding practitioners who have a deep level understanding and training in permanency and adoption. While many therapists may say they work with adoptive families, surveys have found that knowledge about permanency and adoption are at best minimal. A study by Atkinson, Gonet, Freundlich and Riley (in press) found that of 485 respondents, fewer than 25% considered that the professional they worked with was adoption competent. Alarmingly, 26% of the respondents noted that none of the professionals they worked with knew much about adoption and many stated that working with these therapists actually caused harm to the family.

Findings from the report:


  • Successful adoption is tied to good preparation of all parties prior to placement and to the availability and utilization of effective supports and other help, including counseling, afterward. Adoption-competent therapists are high on - and sometimes at the top of - the list of services that members of adoptive and birth families want and need.

  • Genetic risk and early trauma (primarily for children adopted from foster care or institutions) do not inevitably undermine development. Two key factors that facilitate their recovery are comprehensive pre-adoption preparation and education of families, along with the availability and utilization of informed mental health services.

  • Graduate education in relevant fields does not usually include adoption issues. A survey of directors of clinical training programs in marriage and family therapy, social work or counseling found only about 5-16 percent offered adoption-specific coursework. Two thirds of licensed psychologists in a national survey reported no such graduate coursework; fewer than one-third rated themselves as well or very well prepared to treat adoption issues, and 90 percent said psychologists need more adoption education.

  • The limitations of medical insurance can pose significant barriers to accessing adoption competent therapists. Most insurance doesn't provide sufficient mental health coverage to cover the complex, long-term needs of those involved, particularly children who have suffered early trauma and other adversity; and few if any carriers take into account that adoption-competent therapists may not be on their lists of covered, in-plan providers.

  • Which practitioners are adoption-competent is not always clear or easy to determine, in part because adoption counseling has not yet been identified as a professional specialty in the health care fields, with clear guidelines for training, practice and credentialing.

  • Without an appropriate process, many individuals and families will continue to be treated by professionals who are inadequately prepared to understand and help them.

In addition, the Donaldson Instiute made the following recommendations:


  • Develop Certification for Adoption Clinical Competence. People want and need to know that the professionals they are working with have the requisite knowledge, skills and experience to meet their needs. This should apply in the adoption realm as much as in any other, so a certification for adoption clinical competence should be developed.

  • Expand Adoption Training Programs across the Country. Nearly all existing programs require training in classroom settings, so the number of available professionals is restricted to those who live within commuting distance of current sites. Training needs to expand through more programs and the use of technologies such as webinars, "flip teaching" and "massive open online courses."

  • Strengthen the Clinical Components of Existing Training Programs. This can be accomplished by increasing the number of required clinical courses for mental health practitioners; offering additional clinical courses as electives; and/or offering additional clinical courses as stand-alone, post-certificate, continuing education courses. All programs also should offer some type of clinical supervision.
  • Develop Outreach Efforts to Inform Mental Health Providers about the Need for Adoption Competency and Opportunities for Enhancing their Knowledge. Broad-based outreach initiatives should be developed to increase awareness on the need for adoption-competence, to identify opportunities for training among mental health professionals, and to explain the benefits of developing this specialized knowledge.

  • Educate Insurance Providers about the Unique Nature of Adoption Issues and Advocate for Expanded Coverage. Concerted efforts must be made to educate insurance providersabout the unique clinical needs of individuals and families affected by adoption-related issues. This process will be greatly helped if the mental health field overtly recognizes the value of adoption clinical certification and supports its development.

  • Encourage Graduate Training Programs and Post-Graduate Clinical Training Centers to Include More Information about Adoption and Foster Care in their Curricula. The better grounding in these areas that professionals receive while in training, the better prepared they will be to serve the needs of adoption kinship members and to seek to expand their expertise on adoption- and trauma-related issues.

  • Encourage Research on Training Effectiveness and Outcomes. To better serve the training needs of professionals and the well-being of adoptive kinship members with whom they work, the Institute recommends that researchers examine the effectiveness of training programs in terms of knowledge gained by participants, changes in clinicians' practices as a result of training, and clients' progress and satisfaction with services.

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At the University of Minnesota we are pleased to be part of a growing network of centers offering permanency and adoption competency education through our Permanency and Adoption Competency Certificate program (PACC), mentioned in the Donaldson Adoption Institute report. We also offer an elective course in our MSW program at the School of Social Work, Permanency in Child Welfare. You can learn more about our PACC program here and view professionals that have completed the PACC certificate on our PACC Professional Directory.

For the full report, you can download a pdf and learn more about the report at the Donaldson Institute website here.

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A couple of weeks ago, the Center for Advanced Studies in Child Welfare held its annual spring conference and the subject of this year's conference was the intersection of disabilities and child welfare.

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One of our speakers was Lupe Ortiz-Tovar, who along with her colleague Clay Fink, presented information on the National Resource Center for Youth Development's Making Healthy Choices: A Guide on Psychotropic Medications for Youth in Foster Care. This is a fantastic, youth-centric publication that I could see being a really helpful tool for workers or foster parents or adoptive parents to do along with a teenager who is currently taking psychotropic medications. I would encourage workers and agencies that work with this population to order your free copy of the guide!

The guide is available in English and Spanish.

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This morning as I was driving to work I heard a wonderful story by Sasha Aslanian on MPR about the Heartland Girl's Ranch. Heartland began as a group home for adolescent girls with behavioral issues and found over the years that more and more of the girls referred to them had a history of being exploited for sex trafficking.

Part of the therapeutic programming at Heartland Girl's Ranch includes equine therapy. Girls are matched with horses that they care for on a daily basis. They also have opportunities to learn how to ride and to participate in horse shows.

You can hear the story through the link below, or read the full story and listen on the MPR website.

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An article for The Republic and azcentral.com published late November highlighted the challenges that some adoptive families face that lead to a diruption or dissolution of an adoption.

The article highlighted one family whose adopted child struggled with mental health and behavioral issues so extreme, the family felt they had no other options but to "return him" to the system.

However, it is not just adoptive parents adopting from foster care who make these decisions. From famous adoptive parents like Joyce Maynard who announced this year she had dissolved the adoption of two Ethiopian adopted siblings to the case that made international news, Torry Hansen's "return" via sending her Russian born adopted child to Russia alone on a plane, adoptive parents often struggle to find quality and effective services for their children and themselves. Some parents, such as the ones in the The Republic article, "return" the child in order to get services that they could not access on their own.

With an increase in foster care adoptions in the U.S., the need for services will also need to increase in order to support these chlidren, many of whom have experienced a significant amount of abuse, neglect and trauma. With no way of tracking national disruptions and dissolutions for all adopted children, the scope of the issue is difficult to know. For the families who struggle, however, the impact of the lack of services is devastating.

The Republic article asks, "Who helps when adoptions unravel?" Another question we need to ask is "what can we do to prevent disruptions and dissolutions to begin with?"

What are your thoughts?

This morning NPRran a story, Helping Foster Kids Even After Adoption, about the types of post-adoption supports that families that adopt from foster care often need.

image001[1].jpgOne of the interviewees on this show is Debbie Riley, our partner at the Center for Adoption Support and Education (CASE). CASE's Training on Adoption Competency curricuum is the basis for our Permanency and Adoption Competency Certificate program.
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You can hear the podcast below, or click here to access it on the NPR site.

NPR Post-adoption support.mp3

For more information on our Permanency and Adoption Competency Certificate program, click here.

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MN Adopt is offering a training on August 6, 2012 on Working with the Mind-Body Connection: Understanding Stress and Trauma in Adopted and Foster Youth. The training will be presented by Lora Matz, LICSW.

From the description:

Increased levels of anxiety, depression and hopelessness are being seen in children from all socio-economic conditions, cultures and family life. Stress-related stomachaches and headaches in children of all ages are being reported as the number one health concern for children by physicians today. The principals and practices of Mind-Body skills are easily learned and empowering. Lora Matz offers Mind-Body skills that not only increase self-confidence, resilience and self-regulation but contribute to decreased disruptive behaviors often seen in children who have trauma histories. Participants will gain insight on how to talk to children of different ages about the stress response and how it impacts the body and emotions.

Lora Matz, LICSW is an internationally known health and wellness expert in the practices of Integrative Medicine. She currently serves as Clinical Education Specialist of Prairie Care and has a rich background as a psychotherapist, lecturer, writer and consultant in the areas of mind-body medicine and transpersonal development. Lora has many years of experience working with both children and adults in the areas of trauma and stress reduction strategies. She has served as Associate Director of the Center for Mind-Body Medicine in Washington D.C. and supervised the team who worked with the children who were on the school bus when the I-35W bridge collapsed. Addtionally, she has worked with adoptees and foster children as a foster mother, psychotherapist with both children and adults who have been adopted and their families. She also has worked as a psychotherapist and clinical supervisor with individuals struggling with issues related to failed adoptions.

For more information on this or other trainings, contact MN Adopt at:

trainings@mnadopt.org or

612-861-7115
612-861-7112 (fax)
866-303-6276 (toll free)

Webinar on helping children with sexualized behaviors

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MN ADOPT is hosting a webinar on July 25, 2012 on Helping Children with Sexualized Behaviors: What Parents and Professionals Need to Know with Jane Seymour, MSW, LGSW.

From the training desciption:
This webinar will review the common myths and facts about children who are exhibiting sexualized behaviors. Participants will learn about the characteristics of healthy and unhealthy sexual behavior in children. The presenter also explores the influence of early traumas, such as domestic violence, sexual and physical abuse and how it manifests with children who display sexualized behaviors. Parents and professionals will learn specific strategies and interventions for working with and helping these children.

Jane Seymour, MSW, LGSW is a Clinical Specialist with the MN ADOPT HELP program at Minnesota Adoption Resource Network (MARN). MN ADOPT HELP provides a Warm Line for adoptive families and connects adoptive families with adoption competent therapists. Prior to her work with MARN, Jane provided individual and group therapy to children who had experienced intra-familial sexual abuse. She also provided in-home therapy, education, and skill building to adoptive and kinship families. Jane has previously worked with families involved with Child Welfare, and with youth in residential and day treatment settings.

For more information on this or other trainings, contact MN Adopt at:

trainings@mnadopt.org or

612-861-7115
612-861-7112 (fax)
866-303-6276 (toll free)

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One of the practice issues that has been rarely talked about in academic, research or policy arenas that impact children that have been institutionalized or in foster care is the issue of eating behaviors.

It is quite common for children who have been neglected or for those who have experienced food insecurity, institutionalization in foreign countries or housing instability to have learned survival skills related to eating that may be difficult for foster and adoptive caregivers to manage.

Eating issues may be manifested in overeating, extreme pickiness, undereating, and hoarding. In addition, ideas about mealtimes may be very different for children who have had to learn to fight for food, were given limited options for food, or were not part of families or settings that had rules about eating (such as sitting at a table together, etc.).

Sometimes foster and adoptive caregivers end up inadvertently adding to the stress a child may have about food and mealtimes because they expect the child to understand that now food availability is no longer an issue or because meal time is expected (from the caregiver's view) to be a time of family sharing. Children that have experienced food insecurity or institutionalized meal times will not automatically understand the change, emotionally or behaviorally, once they move to a stable family setting.

Several years ago based on experiences as a case worker, I searched for research or practice guidance around this issue. At the time there was very little available. I finally wrote an article for Minnesota Adoption Resource Network (MARN) about this issue (click here for article), and I was excited to see that MN Adopt will be hosting a training on this topic on July 17, 2012.

From the training description:

Nurturing Feeding: Promoting Recovery from Eating Issues in Traumatized Children with Elizabeth Jackson, MS, RD, LD in Bloomington, MN

Children who have come from foster care or orphanages often have serious issues around found. This might take on the form of stealing or hoarding food, refusing to eat certain foods or developing a clinical eating disorder. Elizabeth Jackson provides participants a deeper look into food issues from infancy to adolescence. Topics to be discussed include:

  • Feeding during infancy and its impact on development of attachment patterns
  • Research on how trauma and neglect at all ages impact a child's eating habits and growth
  • Overview of Satter's Division of Responsibility that defines the optimal feeding relationship between adult caregivers and children of all ages
  • Treatment options for children and youth with habitual habits of hoarding and stealing food and eating disorders
Elizabeth Jackson, MS, RD, LD is an outpatient dietitian at Melrose Institute in St. Louis Park, Minnesota, a large, multidisciplinary eating disorder treatment facility with five levels of care. In January 2008, Elizabeth published her findings from years of successful group treatment of compulsive eating in the Journal of Nutrition Education and Behavior. She relocated to Minnesota in 2001 after 19 years in private practice in Michigan specializing in eating disorders and treatment of child feeding and eating issues. Elizabeth also developed curriculum and taught for eight years on eating disorders at Central Michigan University. Additionally, from 2002-2010, she was a clinical faculty member with the Ellyn Satter Institute, speaking and conducting workshops on child feeding and weight regulation throughout the U.S. and Canada.

For more information on this or other trainings, contact MN Adopt at:

trainings@mnadopt.org or

612-861-7115
612-861-7112 (fax)
866-303-6276 (toll free)

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MN Adopt is offering a training series, Beyond Consequences Training and Support - 8-part Series with Brenda Benning, MSW, LGSW.

This training series will provide insight into children's behaviors as well as hands-on skills to help parents work with children that have experienced traumatic histories. The series is based on the book "Beyond Consequences, Logic & Control" by Heather T. Forbes.

Dates begin Tuesday, July 10th. For more information on this or other trainings, contact MN Adopt at:

trainings@mnadopt.org or

612-861-7115
612-861-7112 (fax)
866-303-6276 (toll free)

Weekly news round-up

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Each Friday on the Stability, Permanency and Adoption blog we will provide a selection of news from the past week that you may have missed.

Today's news round up:

In Ontario, Canada, working parents who participate in foster-to adopt programs can participate in parental leave benefits. The Star online reports that even if the child is reunified with birth parents, the foster parent can receive parental leave benefits if they were willing to adopt the chils had reunification not been successful. In the past, foster-to-adopt families were only eligible to request parental leave benefits after they began the adoption process. To read the article, click here.


Children in New Jersey's foster care system will benefit from improved services as a result of a Silbermann Foundation grant awarded to the University of Medicine and Dentistry of New Jersey (UMDNJ) School of Nursing. From the article: "We are very excited to branch out into the field of child welfare nursing. It is our great hope that the curriculum developed at the UMDNJ-School of Nursing will attract qualified nurses to this important subspecialty. It is also our aspiration that this curriculum becomes the national standard in teaching and attracting nurses to this extremely important field," said M. Steven Silbermann, spokesperson for the Rosanne H. Silbermann Foundation, a non-profit charitable family foundation established by the late Rosanne H. Silbermann in 1998 that supports medical, educational and religious organizations." To read more click here.

Writer Dr. Suzanne Babbel, PhD., has written part two of a series, The Foster Care System and Its Victims. In Part I, Dr. Babbel describes what happens when a child is reported to have been abused. In Part II, Dr. Babbel describes how foster care can harm more than help an already vulnerable child. Both articles are available on the Psychology Today website.

In The Huffington Post, Kelly Kennedy writes about how several states are changing the way they consider recruiting foster parents. From the article, "Most jurisdictions end up being in a reactive mode because they don't have enough fosters parents so they're just focused on getting people into the fold instead of making sure standards for parents are elevated," said David Sanders, an executive vice president at Casey Family Programs, an advocacy organization in Seattle." The new focus is on recruiting foster parents that consider their job "parenting," such as Maritza Moreno who told the Huffington Post, who says a parent wouldn't rely on having the county worker take the foster child to doctor's appointments. Morento says foster children "really need a parent, not a caregiver." To read the whole article, click here.

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The Center for Advanced Studies in Child Welfare is pleased to announce that we will be co-presenting a webinar for the National Resource Center for Adoption tomorrow, Wednesday December 14th at 1pm CST/ 2pm EST.

Traci LaLiberte, Executive Director of CASCW and JaeRan Kim, Coordinator of the Permanency and Adoption Competency Certificate will join Christeen Borsheim, Director of Child Safety and Permanency Division at the MN Department of Human Services and Debbie Riley, CEO of the Center for Adoption Support and Education.

Meeting Description:
Adoptive parents, adopted persons and adoption researchers consistently tell us the mental health needs of adopted children and youth often go unmet, largely because there are too few adoption competent mental health professionals.

Recognizing that clinicians need quality adoption competent training, the Center for
Adoption Support and Education developed a 78 hour curriculum and case consultation process designed to provide practitioners with the knowledge and skills they need to provide quality mental health services for adopted persons, birth and kinship families, prospective adoptive parents and adoptive families.

Following a rigorous pilot test, the training is currently being replicated in three communities -- one of which is the State of Minnesota which has demonstrated stellar leadership in committing resources to ensuring that adopted children and adoptive families in both urban and rural areas of the state are served by adoption
competent clinicians. This webinar highlights the Minnesota program and the state leaders and university partners who have worked to develop, fund and fully implement this training and greatly expand the state's mental health treatment capacity.
This webinar is hosted by Natalie Lyons, Director, National Resource Center for Adoption.

To register or learn more about the webinar, click here.

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