ADOPTION AND RISK
This paper was presented to practitioners and academics from a wide international field at the International University Centre, Dubrovnik in 2004. Carole Littlechild is an Adoption Team Manager in Hertfordshire, a Local Authority in South East England, UK.
The profile of adoption in the UK has moved from a historically hidden activity reflecting the privacy associated with it, to relative prominence as a means of offering permanent family life for troubled children.
Adoption in the UK originated from the need for babies to be adopted when, commonly, the mother sought to hide her pregnancy for the shame associated with illegitimacy. Adoption offered relatively new born babies to childless couples with a severance of connection to the histories and origins of those babies, all the while scrupulously preserving the privacy of both the birth parents and of the adoptive parents.
While child protection as a social work activity has expanded and developed in England and Wales, with increasing numbers of children being removed from their parents formally for their safety through the Family Court system, the State has also been required to find stable alternative family care for those children.
In recent years the UK Government has become increasingly interested in adoption as a preferred solution for acquiring permanent alternative family life for children, as both a secure option for children and a cheap alternative from ongoing Government intervention.
In practice the challenges are considerable, and the raft of Government Regulations alongside the new Children and Adoption Act 2002 reflects both the complexity of children’s needs and the Government’s attempts to support and sustain those children and their adoptive families. It is an expanding and increasingly expensive activity that carries risk, as with the placing of children who are older and who have suffered a range of traumatising and abusive parenting experiences.
This paper looks at risks as they present themselves in the newer style of adoption particularly in England and Wales, a world in which we are developing specialist Adoption Support teams with a range of services available for adopters from the point of their approval as adopters by the Adoption Agency through the childhoods of the children they adopt, with accessibility of services at any stage of the child’s minority within the family.
What is risk?
The Oxford English Dictionary defines risk in the following ways
1. a situation involving exposure or danger.
2. the possibility that something unpleasant will happen.
Risk can mean exposure to danger or loss—an older dictionary version describes it as “exposure to mischance or peril”. In the Oxford Compact Thesaurus, other words for risk include chance, uncertainty, unpredictability, precariousness, instability, insecurity, and treacherous. Thus, embodied in the word risk is the concept of danger and warning.
There is an interesting debate to be had about the distinction between risk and uncertainty. The Oxford English Dictionary’s definition of uncertainty offers: “not known or definite”, “in the balance”, “undetermined”, “unsure”, and “fluctuating”. It seems to me that uncertainty suggests a more positive and enabling construct of risk in the tasks that face adoption work.
Life is about unknowns, uncertainties, risks
Creating new families is in itself a significant life risk artificially given to a relatively small number of individuals. This puts enormous pressure on systems, professional knowledge and expertise to seek good outcomes. What we then have to address is our definition of a “good outcome”, very often can be at the level of risking DOING vs. NOT DOING, or perhaps even “the least worst alternative”.
In Adoption, we set out to minimise risks
We do not want to expose children -or families- to danger or to the possibility that something unpleasant might happen. When children cannot be cared for by their birth parents, usually because they have suffered or are likely to suffer significant harm from them, we remove them from one set of Risks and present them with a different set of Risks.
Hertfordshire adoption agency- U.K.
Hertfordshire Adoption Agency framework
Two Social Work Adoption Teams for the county of Hertfordshire whose tasks include
1. Recruitment, training, and assessment of prospective adopters with reports to the Adoption Panel, subsequent support until placement of the child, and support while the child is placed through to the Court adoption application, the Adoption order, and for a year after Order. (Once the child is the subject of an Adoption Order, the adoptive parents become the sole holders of Parental Responsibility for that child, and the birth parents—and where it applies, the Local Authority—lose their shared Parental Responsibility and therefore any rights in respect to the child).
2. Family Finding for the older and harder to place children. This includes some specialist hours and is about to expand, aiming for a group of workers with this as their dedicated focus.
3. Adoption Standards posts created specifically to address skills and specialist knowledge shortages in the local area social work teams, and to assist in gathering all appropriate knowledge and understanding of the child for the Adoption Panel. These Senior Practitioner posts also assist in preparing children both for understanding what has happened to them and for major changes ahead, and in prevention of their drifting in the care system.
One Adoption Support Team that is newly expanding and aims to be multi-disciplinary in order to include social workers, a play therapist and a psychologist. This team also offers
1. Counselling for birth parents and for the adult adoptee seeking information and possible reunification with birth relatives.
2. A service of indirect contact, i.e., “letterbox” contact between the child and significant relatives, including birth parents, siblings, or grandparents. The service includes managing and monitoring information provided by birth relatives and administering information exchange between birth relatives and the adoptive families, along with active support for any birth relatives who may need ongoing assistance in writing and sending something to their now-adopted children.
An Adoption Panel nationally determined to include
-The Chairperson: a principal officer who holds no direct line of management responsibility for adoption workers or for social workers in the area teams. This is soon to be replaced by an independent person entirely outside the Local Authority.
- A professional social worker from the Fostering teams.
- A senior manager from within the overall Family Placement Service.
- Independent members including adoptive parents and adoptees.
- County councillors from local politics.
In addition there are professional Advisors
-Medical Advisor (community Paediatrician).
-Legal Advisor (Solicitor).
-Panel Advisor (Head of Adoption for Hertfordshire).
-Panel administrator and minute taker.
The work that comes to the Adoption Panel for their consideration falls into 3 categories
1. Children for whom the plan for adoption is regarded as being in the child’s best interests.
2. Prospective adopters seeking formal approval.
3. Proposed matches between named children and specific approved adopters.
The Agency Decision Maker has no line of management responsibility within the services for placing children, but is a senior manager and Head of Child Care Practice for the county.
.It is the role of the Adoption Panel to make recommendations in respect to the children, prospective adopters, and proposed matches of children with approved adopters, and it is the role of the Agency Decision Maker to make the decisions from the Panel’s work.
The legislative framework
The Children Act of1989
- Considers the interests of the child to be paramount.
- Emphasises the importance of partnershipbetween families and the local authorities.
- Expects robust efforts to reunite children with their families.
- Regards the least state intervention in family life as preferable, and provides a “tariff” of escalating Orders, starting with No Order as a positive choice, moving up to the Order which allows compulsory long term removal of the child.
- Provides some Orders which support relatives without State responsibility.
- Provides Parental Responsibility(PR) for all mothers, and for fathers who either married the child’s mother or who were given PR by the mother or by the Family Courts.
- Expects Local Authorities to promote continued direct contact between children and their birth families after permanent removal, unless the Court can be persuaded that ending direct contact is in the child’s best interests. If persuaded, the Family Court makes an Order granting specific permission to end contact.
- Offers the framework for Local Authorities to assume a major share of Parental Responsibility for the child, to enable planning for permanent alternative care to be made.
- Provides a Children’s Guardian appointed by the Court independently to convey the Child’sWishes and Feelingsand to evaluate all the evidence and to advise the Court on the direction of the planning in addressing the child’s best interests. The Guardian is given a mandate to inspect and evaluate all records and work of the Local Authority pertaining to the child.
The Children and Adoption Act of 2002
- Updates the Adoption Act of 1976.
- Broadens the role of the father who not married to the child’s mother.
- Introduces a range of national minimum standards of practice in adoption services, including prescribed timescales for work to be completed in the interests of speeding the processes of finding permanent placements for children.
- Requires Adoption Agencies to provide adoption support services for all concerned with the adoption—children, adoptive parents, and birth relatives—both practically and where appropriate financially, throughout the childhoods of those adopted.
- Will be introducing a new “middle way” option of “Special Guardianship” for older children who require more permanence than fostering allows, but want to stop short of the cut off implied in adoption.
- Currently there are a number of consultation documents being circulated with a range of proposals still to be decided.
The child’s journey....the planning process
The Family Court addresses instances in which the child has suffered significant harm (Children Act 1989) and scrutinises Care Plans proposed by the Local Authority.
During the Court processes, there must be parallel planning.
This means the Local Authority, while actively seeking to assess whether a child can be rehabilitated to her/his family, at the same time
must undertake a range of administrative steps required if the child is to be placed for adoption. These steps cannot include any meeting between a child and an adoptive family, but months of work can be in place so that if the Court
decides on permanent removal, the child suffers less delay in the plan being implemented.
The parallel planning programme includes
- Permanence Plan.
- Statutory Looked After Children Review with an Independent chairperson for decision.
- Adoption Plan.
- Adoption Support Plan for the child and for significant birth family to be written.
- Adoption Medical for the child.
- Obstetric Reports from the hospital regarding the child’s birth details.
- Assessment of the child (British Association of Adoption and Fostering, BAAF,
- Adoption Panel to consider if adoption is in the child’s best interests.
- Life story book, photograph album, and video for the child to be prepared.
- Life story work for children with language, age appropriate.
- Identification of the kind of family the particular child needs:
- Sole child or with others.
- Geographical areas to avoid.
- Contact arrangements.
- Particular emotional/physical/medical history/uncertainties/needs.
All these processes should take place before the Family Court proceedings have concluded.
Once the Court has made a full Care Order, if there is a family identified as a possible match, further immediate processes are required
- The child will have a “Wishing Her/Him Well” last face-to-face visit with birth parents (if ending direct contact is part of the plan).
- The selected adopters are given opportunity to
- Meet Medical Advisor of the Adoption Panel.
- Meet the child’s Social Worker.
- Meet the Foster Carers of the child.
- See photographs/video of the child.
- The child is shown an album of the family and read stories (age appropriate) to prepare for moving.
- A Matching Report is written for the Adoption Panel.
- The selected Adopters sign an Adoption Agreement form detailing what information they have seen/been given, with agreement not to use different names for the child before the Adoption Order and to inform birth parents in the event of the child’s untimely death.
- A meeting between the adopters and the birth parents may take place, and is
- The Adoption Support Plan is finalized, addressing the needs of all concerned—child, birth family, adopters.
The Adoption Panel considers the proposed match
- The Agency Decision Maker makes the decision (written within 7 working days).
- The Introductions Meeting is held, planning carefully detailed introductions tailored to the child’s age, needs, and particular circumstances.
- The child moves to live with adoptive family.
- A further life story book is compiled aimed for the child at the age of 9-10 years, posing questions and answers that anticipate likely worries for that child.
- A Later Life letter is written by the child’s Social Worker aimed for the child at 18 years (young adulthood).
- The adopters make an application to the Family Court to adopt.
- Statutory reviews continue to be held until the final Adoption Order is made.
-The Adoption Social worker writes part of the Court Report regarding the adopters, and the child’s Social Worker writes the other part of the same Court Report about the child. This is called a Schedule 2 Report.
- The Court appoints a Reporting Officer or Children’s Guardian, who provides a separate report for the Court.
- Dispensing with parental consent is addressed by the Court.
- The Adoption Order is made, removing PR from birth parents.
Functions/Tasks of the Adoption Teams
- Training/information giving.
- Medicals and Criminal Records Bureau checks.
- Group Assessment.
- Individual follow-up assessment.
- Written Assessment (BAAF ‘F’ Form) to present to Panel.
- Adoption Panel to consider approval of proposed adopters.
- Agency Decision Maker decides within 7 working days.
- Adopters placed on the list of in-house adopters with child’s age range approve details.
- Support for adopters while they await being selected.
-Adopters selected (see above).
- Older children or those with special needs that we can predict will not be placeable within our own “pool” of adopters are identified at the early stage of the Permanence Plan. If a Family Finder is allocated then, s/he may gather basic information and knowledge, but until the Family Court Care Proceedings are complete, s/he cannot meet the child or advertise.
Resources used when searching for families
- The Consortium; we have 7 adoption agencies within a geographical region of SE England, who have developed reciprocal arrangements with reduced fees when drawing on each others’ resources, either of children or approved adopters.
- The Regional “Swap Shops” —large events covering much of the south and east of England arranged like a “Fair”, with stalls by the adoption agencies that any other Family Finders and any Adopters can look into.
- National Advertising in local/national newspapers and specialist fostering and adoption publications.
- Specifically targeted evenings/days locally.
Adoption Support services
- Ongoing support, including financial if eligible.
- Letterbox (indirect contact) service.
- Counselling service for adoptees and birth families to make contact if wished once adopted children become adults.
- Workshops and training for adopters both when waiting to be selected for children and for those with children already placed.
- Parenting skills course [10 weeks, an evening per week]
- Play Therapy
- Individual work encouraging the development of attachments between children and their adoptive parents
- Crisis support for any adoptive family living in the County
At every level and at every stage of the process there are risks
- Risks for children.
- Risks for adopters.
- Risks of contact with birth relatives.
- Risks in assessment of adopters.
- Risks in family finding.
- Risks in timescales vs. risks of drift in planning.
- Risks in adoption support services.
- Risks of breakdown.
- Risks to the agency.
- Risks of stranger adoption vs. adoption by foster carers/birth relatives.
- Broken attachments.
- Attachment behaviour dysfunction.
- Siblings—if not placed together and sometimes because they have been placed together and their competing needs are overwhelming.
- Uncertainty of health/emotional/physical development, so that adopters and professionals do not know what the later developmental issues may arise.
- Inadequate preparation for moving on.
- Level of damage from original abuse/parenting experiences: physical and emotional neglect, sexual abuse, and trauma.
- Minimising of trauma by the adults/over optimism (can be by social workers, foster carers, and/or adopters).
When assessing adopters
- Smoking (in Hertfordshire the policy is that children under the age of 3 years will not be placed with a family in which a member smokes. This is because of the current evidence and belief that passive smoking can trigger cancer, and that small children are especially vulnerable—this caused an enormous stir in the groups in Dubrovnik in discussion).
- Desire to please affecting ability to assimilate information.
- Attachment history of the adopters.
- Capacity to absorb distressing history with appropriate empathy.
- Desire to control.
- Pregnancy of adopters during assessment.
- Timescales: measured assessment work taking longer vs. hasty and superficial evaluation of their strengths, abilities, and areas of potential vulnerability.
- Infertility/depression at different stages.
- Lack of parenting experience.
- Birth children (research indicates a significantly higher rate of disrupted adoptions where a child was adopted into a family with birth children).
- Child’s responses to past abuses.
- Pressures of society’s “norms” and how children are “expected” to be.
- Unrewarding parenting.
- “Support” which can feel intrusive, supportive, or can emphasize a sense of “failure” from the adopters’ perspective.
Contact with birth relatives
- Too much/too little.
- Inadequate preparation for any or all concerned.
- Unclear aims of protection and/or established means of communication.
- Changing needs over time; need for flexibility, renegotiation and mutual confidence for all involved—the adoptive parents, the birth relatives, and the child.
Timescales vs. Drift
Court Protocol 2003 requires court proceedings to be completed within 40 weeks. While this avoids drift for children, it risks parents feeling pressured/railroaded, and risks paucity of information on and for the child—on which so much meticulous planning depends, and ultimately on which the child will rely when accessing her/his records as an adult trying to piece together her/his own unique life story.
Adoption Standards timescales
Foster care providers who apply to adopt can expect to be assessed more rapidly than “stranger” adopters; this encourages security for the child but overlooks the possibility that such a change in the nature of such a placement can mean greater complexities to be examined, both for the long term interests of the foster family and for the child.
- Balance of full information.
- Ongoing risk assessment pre- and post-Adoption Panel for proposed match.
Support can come (or be accepted) too late, or may even have been resisted to the last minute. There may be devastating aftermath on the adoptive parents and other children, but exceptionally so for the rejected adopted child facing the ultimate second major rejection in her/his life.
To the agency
- Adoption Panels’ balance of appropriate checks and over-caution.
- Legal challenge: were adopters given sufficient information? (there have been recent legal challenges on that basis).
Stranger adoption vs. Foster carers/birth relatives
- “Least worst” alternative?
The Brighton and Hove Enquiry
This led to Hertfordshire, and many other Adoption Agencies, changing their assessment procedures to require the following
- A chronology of each prospective adopter’s significant life events and significant relationships, year by year from birth.
- Sufficient referees, usually four, to cover each prospective adopter’s lifetime, and to include one relative, with a minimum of two referees to be visited.
- Past spouses/significant partnerships to be contacted.
- Adult children from previous relationships to be visited.
- Employers to be contacted.
- Financial statements of all income and outgoings to be provided.
Adoption Support Services
- New and dedicated teams.
- Play therapists attached to the adoption support team.
- Proposed psychologist attached to the adoption team.
- Parenting skills courses pre- and post-placement.
- Workshops on Telling, Attachment, Attachment through Play, etc.
- Social events for informal contact between adopters.
- Contrived contact between specific adopters.
Robust Adoption Panels
These panels include a cross section of independent and professional membership able to scrutinise information and plans for children and make appropriate demands for good practice as well as recommendations for the future plans of the children
These groups seek regular discussion and feedback from adopters and from birth families to continually inform our social work practice. The groups also increase the partnership/joint working of adoption social workers with experienced adopters in running the training of prospective adopters.
This framework must include good practice standards and assistance in saying “No.”- .
We had many lively discussions over the week about how different organizations, cultures, countries, practices, policies and procedures influence the concept and understanding of risks in social work, and how they are translated into professional work. It was salutary to reflect upon how the UK in some ways appears to have the most sophisticated programmes and structures to support their work, juxtaposed with the challenge that they may have taken a step too far with Risk minimising having become risk aversive—food for thought.
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