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.
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.