Helping Mental Health Clinicians Better Support Adoptive Families

Adopt­ed chil­dren and their fam­i­lies face a dis­tinct and ele­vat­ed risk of dif­fi­cul­ties. Too often, the sta­tus quo in men­tal health care has failed to meet their needs and — in some instances — even caused harm.

“Adop­tive fam­i­lies need spe­cial atten­tion, espe­cial­ly when the chil­dren who have been adopt­ed have suf­fered the trau­ma of enter­ing the child wel­fare sys­tem,” says Suzanne Barnard, direc­tor of the Annie E. Casey Foundation’s Evi­dence-Based Prac­tice Group.

For­tu­nate­ly, new research fund­ed by the Foun­da­tion has sin­gled out a spe­cif­ic train­ing mod­el — Train­ing for Adop­tion Com­pe­ten­cy (TAC) — that can help. TAC equips clin­i­cians with the knowl­edge and skills need­ed to bet­ter assess, care for and sup­port adop­tive fam­i­lies, accord­ing to the study.

About the model

TAC is a 72-hour adop­tion-spe­cif­ic cur­ricu­lum for licensed men­tal health clin­i­cians. Devel­oped by the Cen­ter for Adop­tion Sup­port and Edu­ca­tion, TAC can be facil­i­tat­ed in per­son or online and has four basic parts: 1) a 12-mod­ule cur­ricu­lum; 2) clin­i­cal case con­sul­ta­tion designed to rein­force the trans­fer of learn­ing to prac­tice, facil­i­tat­ed by advanced prac­ti­tion­ers; 3) a robust train­er cre­den­tial­ing and sup­port process; and 4) an ongo­ing exter­nal eval­u­a­tion that exam­ines train­ing deliv­ery, effec­tive­ness, and outcomes.

In 2019, the Cal­i­for­nia Evi­dence-Based Clear­ing­house rec­og­nized TAC as a pro­gram with promis­ing evi­dence of effec­tive­ness and high rel­e­vance to child welfare.

The TAC difference

The study com­pares the expe­ri­ences of adop­tive fam­i­lies who were treat­ed by a TAC-trained clin­i­cian to the expe­ri­ences of adop­tive fam­i­lies who were treat­ed by a sim­i­lar­ly qual­i­fied clin­i­cian minus the TAC train­ing. Fam­i­lies who part­nered with TAC-trained clin­i­cians report­ed the fol­low­ing advantages:

• more pos­i­tive treat­ment experiences,
• stronger rela­tion­ships with their clinician,
• more time in treat­ment (a dif­fer­ence of near­ly two sessions),
• few­er child-only sessions,
• more par­ent, fam­i­ly and group sessions,
• improve­ments in their child’s dai­ly functioning,
• greater par­ent sat­is­fac­tion, and
• improve­ments across a range of mea­sures, such as open com­mu­ni­ca­tion, adop­tion knowl­edge and par­ent­ing skills.

With these ben­e­fits on record, the study’s authors rec­om­mend expand­ing TAC to addi­tion­al clin­i­cians — a move that would make it eas­i­er for adop­tive fam­i­lies to access effec­tive men­tal health therapy.

“Even under the best cir­cum­stances, cre­at­ing a new fam­i­ly through adop­tion is a big adjust­ment,” says Barnard. ​“This study sug­gests that — with the right atten­tion and sup­port — adop­tive fam­i­lies will be in a strong posi­tion to succeed.”

Study specifics

The study’s par­tic­i­pant pool con­sist­ed of 159 fam­i­lies recruit­ed from 14 geo­graph­i­cal­ly diverse regions. Most of these fam­i­lies — 74% — had adopt­ed chil­dren from fos­ter care.

Of the 70 providers who com­plet­ed pro­files, 34 had TAC train­ing and 36 did not. The par­tic­i­pat­ing fam­i­lies also fell into two basic groups: Those who were treat­ed by a TAC-trained clin­i­cian (89 fam­i­lies) and those who were treat­ed by a clin­i­cian who had no TAC train­ing (70 families).

Inde­pen­dent eval­u­a­tor Anne J. Atkin­son of Pol­i­cy­Works, Ltd., con­duct­ed the study. She cau­tions that, although the research clear­ly links TAC with bet­ter ther­a­py out­comes and expe­ri­ences for adop­tive fam­i­lies, fur­ther eval­u­a­tion is need­ed to doc­u­ment the con­nec­tions between ther­a­peu­tic approach­es and results for families.

Read an exec­u­tive sum­ma­ry of the study