FAM-25-039 Attachment P DSS Post Adoption Best Practices Toolkit #2.pdf

Enhancing Adoption Competent Practices

Duke Storen, VDSS Commissioner

Toolkit #2: Findings from Evaluation ii Toolkit #2: Enhancing Adoption Competent Practices

Table of Contents

Purpose of the Toolkit

Brief overview of evaluation findings

Tools for incorporating learning from findings

Inclusion of lived experience

Cultural competencies and working with special populations

Crisis management and helping parents navigate the health care system

Workforce recruitment and retention

Coaching and training in child welfare

Additional Resources

Appendix A: Adoption competencies staff need

Appendix B: Post-adoption consultation findings

Correlates of adoption instability and protective factors

Use of services before and after RPAC

High needs areas for services

Staff competencies

3 Toolkit #2: Enhancing Adoption Competent Practices

Purpose of the Toolkit

The Virginia Department of Social Services Division of Family Services (VDSS-DFS) is committed to providing high quality, adoption-competent services and support to all post-adoptive families living in Virginia. To accomplish this goal, staff who provide post-adoption services and support (PAS) to families—including Regional Post-Adoption Consortium (RPAC) partner agencies, Local Departments of Social Services (LDSS), and other PAS agencies—must possess the values, knowledge, and skills required for adoption-competent practice. Competency topics include:

• Mental health and trauma-informed care

• Child development

• Relationship skill building

• Working with specific populations

• Case management

This toolkit, developed by Child Trends, provides information and resources on the current needs of adoptive families, the competencies required of staff— including values, knowledge, and skills to serve families—and the training necessary to enhance adoption competence.

Brief overview of evaluation findings

To understand how to best assist adoptive families, it is important to know the root causes of adoption dissolution and disruption. We reviewed literature on correlates of adoption instability and protective factors and analyzed data from the Adoption and Foster Care Analysis and Reporting System (AFCARS) and VDSS-DFS to understand the experiences of children and youth who were adopted and reentered the foster care system. We also gathered information directly from adoptive parents and staff who provide post-adoption services, regarding their challenges, needs for services, and experiences with accessing and using services. Finally, we surveyed staff about their level of competence providing services; knowledge, values, and skills related to adoption competence; and needs for training to enhance their adoption competence so they can best support families post-adoption. See Appendix B for more information.

Findings from the study informed the following recommendations, some of which are accompanied by related resources.

• Maintain or increase emphasis on finding potential kin placements, either as a guardian or adoptive parent.

o The Grandfamilies and Kinship Support Network has numerous resources to help systems enhance their engagement and service to kinship caregivers.

• Focus on services for children and youth who exhibit behavior-related difficulties, as these are a leading cause of adoption breakdown.

• Support adoptive parents following adoptions even if they feel confident in their parenting efficacy.

o Encourage service providers to continue to reach out and advertise their services in multiple venues and at multiple time points in the post-adoption journey of adoptive families.

VDSS Regional Post-Adoption (RPAC) Consortium Model

VDSS-DFS provides funding to private and a limited number LDSS agencies for post-adoption services and support (PAS).

In 2021 VDSS-DFS launched the RPAC approach to funding services, to ensure a consistent, comprehensive array of PAS to families across the Commonwealth. To understand how well the RPAC approach is working, Child Trends gathered data from adoptive parents, young adults who were adopted, staff at both public and private child welfare agencies on their experiences with PAS, as well as staff competency in providing PAS.

https://www.gksnetwork.org/

4 Toolkit #2: Enhancing Adoption Competent Practices

• Connect post-adoptive parents with one case manager who they can rely on and turn to when issues arise.

o Consider an enhanced case management model, like Success Coach Service or Solution-

Based Casework.

• Prioritize employing staff and peer supporters with lived adoption experience, either as a person who was adopted or as an adoptive parent, as parents appreciate having a service provider who understands their situation firsthand.

o In addition, engage adoptive parents and young adults who were adopted as program consultants to share their experiences and educate staff about the best ways to understand and engage families.

o Casey Family Programs offers resources on parent partner programs.

• Provide training to staff on adoption competence and how to work with diverse populations.

o The National Adoption Competency Mental Health Training Initiative (NTI)TM includes training on cultural responsiveness.

o Offer information and trainings in different formats, such as:

▪ Toolkits, guides, tip sheets, and other written materials;

▪ Live online trainings; and

▪ In-person trainings in convenient locations.

• Prioritize recruiting staff with master’s degrees and retaining staff as long as possible.

o The National Child Welfare Workforce Institute has a wealth of information about workforce recruitment and retention.

• Consider funding enhanced crisis intervention services with adequate staffing, as providing help during urgent situations is vital to averting escalation of problems to the point of breakdown. Two successful models include:

o Brevard C.A.R.E.S. Mobile Response Team (MRT) o Adverse Childhood Experiences Response Team (ACERT) – see ACERT Strategic Vision

Information in the toolkit is derived from a number of sources, predominantly from our initial report to VDSS-DFS,i and our second report .ii Staff can use this information to support their practice and further their skills as they provide the best services possible to families post-adoption.

Tools for incorporating learning from findings

All professions are based on a set of competencies practitioners are expected to master. The National Association of Social Workers and the Council for Social Work Education both endorse certain knowledge, skills, and values as essential components of professional competencies.iii See Appendix A for a table of adoption competencies expected from adoption service providers, as well as a list of references used in developing the table. During interviews, adoptive parents endorsed the importance of working with a provider who is well versed in these competencies. Adoption competent clinicians should engage all family members and propose activities that make sense to families and are easy to implement.

In our research, staff rated their knowledge, skills, and values as relatively strong across all competency domains. Staff had the highest knowledge about relationship skill building and the lowest knowledge about cultural competence and working with special populations. Parents, on the other hand, thought some staff lacked appropriate and adequate training in central concerns of families, such as attachment disorders, effects of trauma on behavior, and how to treat these problems. Adoptive parents expressed concern that when providers are lacking adoption competencies, parents have to spend time educating the providers when they should be receiving support.

https://www.cebc4cw.org/program/success-coach-service/ https://www.solutionbasedcasework.com/ https://www.solutionbasedcasework.com/ https://www.casey.org/parent-partner-topic-page/ https://adoptionsupport.org/nti/ https://ncwwi.org/ https://nam04.safelinks.protection.outlook.com/?url=https%3A%2F%2Fu3654171.ct.sendgrid.net%2Fls%2Fclick%3Fupn%3DQgp-2B7Biv-2F25N-2BCasHmwbET0T5ssXM4x7Qv2DxzsSU8pUWcn-2BsVfW0HclKKv5eal-2Bh-2F5B2ZXzDqC3lKMZtZ5kE-2F5pQ9cCwmGapnrQgj-2Fg4nupjql-2BowXVmWzKnyyHTlmjV-2FL6UN4JHG440OgKtjhEfXKn3v7LfWFfxTdRTQTahAFBrVCdtI9BgsLa1a4oXhj-2BSZsg3Tg-2BOKItJzadCPB3tl418iGKVUFMI-2FcUulYykQooMStq7jYvQ2tX44Exn4uCoH2zX6ess8nlhfuQHadPc00S-2FOHlLuZT5aWiDk04S-2FGtzbS1QcsEo-2BxPEzzB8AH76M3P2HP-2FrhShevH8RgvzCaacNE-2F0-2BSINzQG7VsFLYzwMw6mhPkR2F6Sj09FGWRkDXsRs11Kt-2BBmi6dk7b9o7bbvCxAFcS5OilnMKt3SJwQo-3Dmig8_eUXGhIKWNR-2FRdefc8cy5GwOI8tEv9zkDb0zkIFDqUXkkGIUpACenINlZBIzjcHSfGL0bKAmZZVRLcDqxX8pWmPtxG-2FnqGROsCKk-2BAGDHJbXy0fcFvzY5muDLvZTcko1sk5pluD22HOTH-2BWOIRfbjsrPxfhB5FHgpdH371pl6X-2F6ikQulXIPgpqVWfEBIzGfoCv7HmccDaWx0pyYJ8bmy0tPvL5IWe72tsKuKvKR4i2BDkIIzwQZcqK2i8YugwSJM1jzaIuuh9mM5TadRCJ2zyF7jBDRFHHm7nL3HH-2FKsUeWCZIntGOsaeB6nhLfVqWrYXwE7PHiesTqS3gAYdBlzYu7wlFiQD3PvMxmEeHRJDKKZ4QhV9qVvj-2BLw5MPVdh-2FSEweOR-2Bz0aQPblHBiObA32Q-3D-3D&data=05%7C01%7C%7C73d0d6b53e8d43f8acbe08dba7d6165d%7C380c6d8fdce34747b5fda656050bfd7f%7C1%7C0%7C638288310191875437%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=OPd7K86RfQyPIKtoVfe%2BbCdfysjpS4885O4UUmniJiQ%3D&reserved=0 https://www.amoskeaghealth.org/adverse-childhood-experiences-response-team-acert/#:~:text=The%20Adverse%20Childhood%20Experiences%20Response,been%20secured%20by%20the%20police.

https://schoolsafetyresources.nh.gov/wp-content/uploads/2021/06/ACERT-Strategic-Vision.pdf

5 Toolkit #2: Enhancing Adoption Competent Practices

In this toolkit, we offer additional resources to assist staff in providing post adoption services that are responsive to the needs of all adoptive families. The toolkit covers topics we identified as important to families and staff related to adoption competencies, including essential values, knowledge, and skills. We do not address issues related to service improvement, which are included in a previous toolkit. Toolkit #1 has tools to evaluate implementation and outcomes and maintain/improve effectiveness of the consortium model.1

For each topic, we describe the rationale behind its inclusion in the toolkit and offer resources for practitioners and staff seeking to enhance their practice around the topic. Topics include:

• Inclusion of lived experience o Resources for incorporating lived experience

• Cultural competencies and working with special populations o Resources around cultural competencies and working with special populations

• Crisis management and helping parents navigate the health care system o Children’s challenging behaviors o Resources related to mental health

• Workforce recruitment and retention o Resources related to workforce recruitment and retention

• Coaching and training in child welfare o Resources related to coaching o Different formats for training o Resources related to training

Inclusion of lived experience

Everyone involved in the child welfare system gains evident advantages when families and young people are involved at all levels. When families and young people are included in agency initiatives and given input over their own care, they can add the voice of lived experience, distinctive viewpoint on program development and policy, creative concepts that could enhance the results for children and families, and increased process accountability and openness leading to the provision of more timely and efficient services. The voice of lived experience can highlight discrepancies, communication breakdowns, and unmet service requirements in the child welfare system that may not be immediately noticeable to leaders and staff agency.iv

1 Please see Toolkit #1: Fidelity, Quality Assurance; Assessment; and Evaluation

Staff and Supervisor Training Child Trends provided two trainings based on information in this toolkit - one for staff on August 6, 2024, and one for supervisors on August 8, 2024. Staff provided useful insights into each of the topics listed below. This information is included in the toolkit throughout – please see sidebar notes formatted like this one under each topic.

6 Toolkit #2: Enhancing Adoption Competent Practices

Resources for incorporating lived experience expertise Topic Author Format Description

Staff with Lived Experience

Strategies for

Authentic

Integration of

Family and Youth

Voice in Child

Welfare

Capacity

Building Center for States:

Children’s

Bureau, Administration for Children and

Families

(CB/ACF)

Tip sheet Provides a list of essential activities for interacting with families and young people at the system and agency levels and gives child welfare managers pointers, tactics, and anecdotes from the field

Methods and

Strategies for

Engaging People with Lived

Experience

Capacity

Building Center for States:

CB/ACF)

Resource List Shares resources around how child welfare professionals can enhance their services and programs by seeking the input of individuals with lived experience

A Starter Kit on

Engaging People with Lived

Experience in Child

Support Programs

ACF Toolkit Highlights ways to involve those with lived experience to improve practices and services

Peer Supporters/Peer Mentors

Providing Peer

Support for Foster, Adoptive, and

Kinship Families

AdoptUSKids Tip sheet Reviews ways to use peer support to promote minimize isolation and get families connected to other beneficial resources

Inclusion of Lived Experience

• Staff with lived experience (either as an adoptive parent or someone who was adopted) may help families feel more seen and heard.

o Families believe staff with lived adoptive experience have greater understanding of what families are experiencing.

o Having an adoptive parent work alongside staff can help families feel safe and more comfortable to openly share their experiences and needs.

o Children who engage with staff with lived experience have more opportunity to see well-functioning and supportive adults who also were adopted.

• Recognizing a child’s lived experience helps better match children with adoptive families and post-adoptive support.

https://capacity.childwelfare.gov/states/resources/strategies-for-authentic-integration-of-family-and-youth-voice-in-child-welfare https://capacity.childwelfare.gov/states/resources/strategies-for-authentic-integration-of-family-and-youth-voice-in-child-welfare https://capacity.childwelfare.gov/states/resources/strategies-for-authentic-integration-of-family-and-youth-voice-in-child-welfare https://capacity.childwelfare.gov/states/resources/strategies-for-authentic-integration-of-family-and-youth-voice-in-child-welfare https://capacity.childwelfare.gov/states/resources/strategies-for-authentic-integration-of-family-and-youth-voice-in-child-welfare https://capacity.childwelfare.gov/states/resources/strategies-for-authentic-integration-of-family-and-youth-voice-in-child-welfare https://capacity.childwelfare.gov/states/resources/methods-and-strategies-to-engage-people-with-lived-experience-resource-list https://capacity.childwelfare.gov/states/resources/methods-and-strategies-to-engage-people-with-lived-experience-resource-list https://capacity.childwelfare.gov/states/resources/methods-and-strategies-to-engage-people-with-lived-experience-resource-list https://capacity.childwelfare.gov/states/resources/methods-and-strategies-to-engage-people-with-lived-experience-resource-list https://capacity.childwelfare.gov/states/resources/methods-and-strategies-to-engage-people-with-lived-experience-resource-list https://www.acf.hhs.gov/sites/default/files/documents/ocse/engaging_starter_kit.pdf https://www.acf.hhs.gov/sites/default/files/documents/ocse/engaging_starter_kit.pdf https://www.acf.hhs.gov/sites/default/files/documents/ocse/engaging_starter_kit.pdf https://www.acf.hhs.gov/sites/default/files/documents/ocse/engaging_starter_kit.pdf https://www.acf.hhs.gov/sites/default/files/documents/ocse/engaging_starter_kit.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-families-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-families-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-families-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-families-web508.pdf

7 Toolkit #2: Enhancing Adoption Competent Practices

Topic Author Format Description

Peer Support: A

Key Strategy for

Supporting

Resource Families in Tribal

Communities

AdoptUSKids Tip sheet Shares benefits, varieties, and implementation advice for peer support in Tribal communities

7 Characteristics of

Successful Parent

Support Group

Leaders

AdoptUSKids Tip sheet Provides guidance on balancing parenting and navigating the challenges of running a kinship, foster, or adoption support group.

This guide also outlines seven qualities of a leader who can manage the roles.

Opportunities for young adults and parents to be included

Engaging youth and caregivers in developing support services

AdoptUSKids Article Discusses key considerations, tips, and ideas on engaging parents, youth, and caregivers

Cultural competencies and working with special populations

According to the National Association of Social Workers, social workers have an “ethical responsibility to be culturally competent.” This applies to all staff who work with adoptive families, who represent diverse racial, ethnic, and cultural backgrounds; sexual orientations; life experiences; and behavioral and mental health challenges. RPAC staff need to be culturally competent to effectively provide services to adoptive parents and children, regardless of their backgrounds and areas of need. We highlight some specific areas requiring cultural competence below.

Equitable, Culturally Competent Practices. According to Substance Abuse and Mental Health Services

Administration (SAMHSA), organizations need to embrace cultural competence and allocate resources to promote and support their staff in providing culturally competent services. Staff need to understand the implications of their own race, ethnicity, and culture, as well as of those they serve, to be able to meet their clients’ needs effectively. To practice cultural competency, staff also need the support of their organizations at all levels of operation.

Transracially Adoptive Families. Approximately 30 percent of adoptive families in Virginia in 2017 were transracial families, where the child was a different race to the parents. 2 Adoptive parents of children of different races may struggle with supporting their child’s identity formation, among other challenges, and staff need resources on how to best help families navigate these challenges.

LGBTQUIA+ Youth and Parents: Gender Identity and/or Sexual Orientation. Staff may work with adoptive parents and/or their children who identify as Lesbian (L), Gay (G), Bi (B), Trans (T), Queer (Q), Undefined (U), Intersex (I), On the Asexual or Aromantic spectra (A), or Another identity which experiences similar forms of prejudice and/or discrimination (+) (commonly referred to as LGBTQUIA+).3 Staff can benefit from

2 Estimate of Population of Children Adopted from Foster Care and Under Age 18 in Virginia, as of 2017; Adoption and Foster Care

Analysis and Reporting System - Adoption Files 2000-2017 3 https://warwick.ac.uk/fac/cross_fac/academy/activities/learningcircles/transqueerpedagogies/keyterms/ https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-tribal-communities-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-tribal-communities-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-tribal-communities-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-tribal-communities-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-tribal-communities-web508.pdf https://adoptuskids.org/_assets/files/AUSK/Publications/Peer-support-for-tribal-communities-web508.pdf https://adoptuskids.org/_assets/files/AUSK/pro-hub/7-characteristics-of-successful-parent-support-group-leaders-web508.pdf https://adoptuskids.org/_assets/files/AUSK/pro-hub/7-characteristics-of-successful-parent-support-group-leaders-web508.pdf https://adoptuskids.org/_assets/files/AUSK/pro-hub/7-characteristics-of-successful-parent-support-group-leaders-web508.pdf https://adoptuskids.org/_assets/files/AUSK/pro-hub/7-characteristics-of-successful-parent-support-group-leaders-web508.pdf https://professionals.adoptuskids.org/engaging-youth-and-caregivers-in-developing-support-services/ https://professionals.adoptuskids.org/engaging-youth-and-caregivers-in-developing-support-services/ https://professionals.adoptuskids.org/engaging-youth-and-caregivers-in-developing-support-services/ https://professionals.adoptuskids.org/engaging-youth-and-caregivers-in-developing-support-services/ https://www.socialworkers.org/Practice/NASW-Practice-Standards-Guidelines/Standards-and-Indicators-for-Cultural-Competence-in-Social-Work-Practice

8 Toolkit #2: Enhancing Adoption Competent Practices expanding their competence and skills around working with LGBTQUIA+ families, and understanding the laws and policies that impact these families.

Children with Disabilities. Sixty-five percent of children who were adopted in Virginia in 2017 had some kind of special need, and 26 percent of those children had a medical condition or disability. This could be either a mental or behavioral health condition.4 Many of these children are older youth with behavioral problems, which can be very challenging for families to manage. Staff must have a high level of competence to stabilize difficult situations and help families stay together and thrive.

Guardianship Families. Many families assume guardianship of a child through kinship arrangements. Kinship caregivers often have less training and resources available to them than traditional adoptive parents, despite the challenges they often face caring for children who have experienced trauma. Kinship guardians need support from staff who understand the unique challenges of kinship care—such as how to manage relationships with birth parents and other relatives—and have adoption competence.

Children Who have Experienced Commercial Sexual Exploitation. Children who enter foster care and are subsequently adopted may have experienced sexual exploitation. These children are likely to struggle with trauma related behavior challenges, and their families need support in managing these behaviors. Staff can benefit from understanding and being able to identify commercial sexual exploitation and its effects to support affected children and families.

Undocumented or Refugee Status Families. This includes immigrant families who are either documented, undocumented, and/or refugees and children who came as unaccompanied minors and are being cared for by kinship or non-kinship foster families. These families have the same needs as other families, but also face unique challenges. Child welfare agencies and staff can implement strategies to support these families, including being culturally competent.

Resources. The table below provides a variety of resources that staff may find useful for themselves and/or for the families they work with. Topics include:

• Equitable and Culturally Competent Practices

• Transracially Adoptive Families

• LGBTQUIA+ Youth and Parents: Gender Identity and/or Sexual Orientation

• Children with Disabilities

• Guardianship Families

• Children Experiencing Commercial Sexual Exploitation

• Undocumented or Refugee Status Families

4 Estimate of Population of Children Adopted from Foster Care and Under Age 18 in Virginia, as of 2017; Adoption and Foster Care

Analysis and Reporting System - Adoption Files 2000-2017

9 Toolkit #2: Enhancing Adoption Competent Practices

Resources around cultural competencies and working with special populations Topic Author Format Description

Equitable and Culturally Competent Practices

Standards and Indicators for Cultural Competence in Social Work Practice

National Association of Social Workers

Document • Provides set of standards and indicators for social workers, encompassing:

o Ethics and Values o Self-Awareness o Cross-Cultural Knowledge o Cross-Cultural Skills o Service Delivery o Empowerment and Advocacy o Diverse Workforce o Professional Education o Language and Communication o Leadership to Advance Cultural

Competence

Improving Cultural Competence

Substance Abuse and Mental Health Services Administration

(SAMHSA)

Online Quick Guide for Clinicians

• Shares succinct, easily accessible information geared towards behavioral health clinicians and focused on culturally competent counseling skills

• The guide is based on Improving Cultural Competence, Number 59 in the SAMHSA Treatment Improvement Protocol (TIP) series.

• Consult TIP 59, for more information and a complete list of resources for improving cultural competence.

• The guide is free.

Cultural Competencies

• Staff need support to feel more confident in their ability to help families of different cultures to themselves.

• Staff can help families recognize differences in cultural practices and offer resources to address these differences.

• Staff should be aware of their own limitations around cultural competence and when they need to ask for assistance.

• Agencies can create a repository or inventory of resources to share with families, especially LGBTQ+ related resources.

• Staff need to know when a placement may not be appropriate for a certain child and listen to the child regarding their preferences and struggles.

• Staff also need to know when to support the potential adoptive parents to examine their own biases and see if they can come to embrace the differences and provide a loving home for the child, as well as support positive identity development for the child.

• Staff should advocate for parents when they need support and may be experiencing differential treatment because of their race, religion, gender identity or any other culturally based mistreatment.

•VDSS should enhance training opportunities for staff and families around cultural competence.

https://www.socialworkers.org/LinkClick.aspx?fileticket=PonPTDEBrn4%3D&portalid=0#:~:text=Cultural%20competence%20requires%20social%20workers,ethnicity%2C%20gender%2C%20class%2C%20sexual https://www.socialworkers.org/LinkClick.aspx?fileticket=PonPTDEBrn4%3D&portalid=0#:~:text=Cultural%20competence%20requires%20social%20workers,ethnicity%2C%20gender%2C%20class%2C%20sexual https://www.socialworkers.org/LinkClick.aspx?fileticket=PonPTDEBrn4%3D&portalid=0#:~:text=Cultural%20competence%20requires%20social%20workers,ethnicity%2C%20gender%2C%20class%2C%20sexual https://www.socialworkers.org/LinkClick.aspx?fileticket=PonPTDEBrn4%3D&portalid=0#:~:text=Cultural%20competence%20requires%20social%20workers,ethnicity%2C%20gender%2C%20class%2C%20sexual https://www.socialworkers.org/LinkClick.aspx?fileticket=PonPTDEBrn4%3D&portalid=0#:~:text=Cultural%20competence%20requires%20social%20workers,ethnicity%2C%20gender%2C%20class%2C%20sexual https://www.socialworkers.org/LinkClick.aspx?fileticket=PonPTDEBrn4%3D&portalid=0#:~:text=Cultural%20competence%20requires%20social%20workers,ethnicity%2C%20gender%2C%20class%2C%20sexual https://store.samhsa.gov/sites/default/files/sma16-4931.pdf https://store.samhsa.gov/sites/default/files/sma16-4931.pdf

10 Toolkit #2: Enhancing Adoption Competent Practices

Adoption Competency Training

Families Rising (formerly North American Council on Adoptable Children)

• A six-day training

• Either in-person, all virtual, or a mix of both in-person and virtual

• Covers the following objectives:

o Identify and define developmental issues and survival behaviors of children and youth o Build knowledge and skills for trauma-based parenting o Identify behavior and mental health issues that are impacted by time in care and prenatal exposure to substances o Identify relational difficulties and effective interventions o Build knowledge and skills for intervention on behalf of children with attachment difficulties o Discuss race and racism as they affect children and families in the child welfare system

• There is a fee for the training.

Adoption Competency and the Continuum of Services

Spaulding Institute for Family and Community Development

• Trainings

• Products and services

• Offers training programs and products in:

o Adoption of children from the public child welfare system o Cultural competency o Permanency and post-permanency services

• There is a fee for the training.

Services for Adoption Professionals

Adoption Mosaic • Keynotes

• Panel discussions

• Individual consultation

• Business consultation

• Adoption Mosaic is a BIPOC woman owned, adoptee-led mission-driven business.

• Offers services to develop adoption competencies in several areas, including:

o Transracial, international adoption and identity o Racial identity development and adoption

• There is a fee for their services.

Building Bridges:

Resources to Center Cultural Humility

The Racial Equity, Advocacy, and Community Health (REACH) Alliance; New York, NY

Toolkit for training

• Supports cultural competence of mental health service providers’ engagement with diverse clients

• Includes handouts, videos, and recordings

Cultural Diversity Resource Center

American Academy of Child and Adolescent Psychiatry

• Videos

• Frequently asked questions

• Links to training and education

• Raises awareness of diversity issues and assists clinicians with culturally responsive practice

• Some resources on the website are appropriate for a variety of audiences.

https://nacac.org/get-training/training-by-request/adoption-competency/ https://nacac.org/get-training/training-by-request/adoption-competency/ https://nacac.org/get-training/training-by-request/adoption-competency/ https://spaulding.org/professionals/spaulding-institute/training-curricula/ https://spaulding.org/professionals/spaulding-institute/training-curricula/ https://spaulding.org/professionals/spaulding-institute/training-curricula/ https://spaulding.org/professionals/spaulding-institute/training-curricula/ https://adoptionmosaic.com/business-services https://adoptionmosaic.com/business-services https://adoptionmosaic.com/business-services https://alcoholstudies.rutgers.edu/wp-content/uploads/Building-Bridges-Cultural-Humility-Toolkit.pdf https://alcoholstudies.rutgers.edu/wp-content/uploads/Building-Bridges-Cultural-Humility-Toolkit.pdf https://alcoholstudies.rutgers.edu/wp-content/uploads/Building-Bridges-Cultural-Humility-Toolkit.pdf https://alcoholstudies.rutgers.edu/wp-content/uploads/Building-Bridges-Cultural-Humility-Toolkit.pdf https://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/Cultural_Diversity_Resource_Center/Home.aspx https://www.aacap.org/aacap/Families_and_Youth/Resource_Centers/Cultural_Diversity_Resource_Center/Home.aspx

11 Toolkit #2: Enhancing Adoption Competent Practices

C.A.S.E. Training for Adoption Competency

(TAC)™

Center for Adoption Support and Education

A 72-hour curriculum:

• One online session

• Eleven classroom-based sessions

• Offered virtually or in-person

• Case consultations embedded in six classroom sessions

• Assessment-based certificate program for training mental health practitioners and developing adoption competency skills.

• Taught via classroom and remote instruction, as well as clinical case consultation

• Provides students with key clinical skills that support adopted children and their foster, adoptive, and kinship families

• Case consultations support the transfer of conceptual learning to real world practice.

• There is a fee for the training.

Transracially Adoptive Families – See Child Welfare Information Gateway for more information

Preparing Families for Racially and Culturally Diverse Adoptions

Child Welfare Information Gateway

List of resources, trainings, and other materials

• Resources for professionals preparing families to adopt children from racially or culturally diverse backgrounds

The Importance of Race and Culture in Adoption Permanency Decisions

AdoptUSKids Webinar • 90-minute webinar covering:

o The importance of considering race and culture when making adoption permanency decisions.

o Structural racism and its lingering effects on the child welfare system o The impact of disproportionality and racial disparities on child welfare practice and how this has led to the overrepresentation of Black and Brown children/youth within the system

• The webinar is free.

Strengthen capacity around racial equity to improve permanency outcomes for all of the children

National Adoption Association

• Recorded webinars

• Publications

• Resources and tips

• Partnership with:

o National Child Welfare Workforce

Institute o Dave Thomas Foundation for Adoption o The Center for the Study of Social Policy o Families Rising o The Center for Adoption Support and

Education o The Coalition for Children, Youth and

Families and Spence-Chapin

• All resources are free

LGBTQUIA+ Youth and Parents: Gender Identity and/or Sexual Orientation https://adoptionsupport.org/training-for-adoption-competency/ https://adoptionsupport.org/training-for-adoption-competency/ https://adoptionsupport.org/training-for-adoption-competency/ https://adoptionsupport.org/training-for-adoption-competency/ https://www.childwelfare.gov/topics/permanency/ https://www.childwelfare.gov/search/?search=transracial%20adoptions https://www.childwelfare.gov/search/?search=transracial%20adoptions https://www.childwelfare.gov/search/?search=transracial%20adoptions https://www.childwelfare.gov/search/?search=transracial%20adoptions https://professionals.adoptuskids.org/the-importance-of-race-and-culture-in-adoption-permanency-decisions/ https://professionals.adoptuskids.org/the-importance-of-race-and-culture-in-adoption-permanency-decisions/ https://professionals.adoptuskids.org/the-importance-of-race-and-culture-in-adoption-permanency-decisions/ https://professionals.adoptuskids.org/the-importance-of-race-and-culture-in-adoption-permanency-decisions/ https://professionals.adoptuskids.org/the-importance-of-race-and-culture-in-adoption-permanency-decisions/ https://www.adoptnaa.org/page/racialequity https://www.adoptnaa.org/page/racialequity https://www.adoptnaa.org/page/racialequity

12 Toolkit #2: Enhancing Adoption Competent Practices

Bulletins for Professionals:

Working With LGBTQ+ Families in Foster Care and Adoption

Child Welfare Information Gateway

Document

• A bulletin designed to help expand cultural responsiveness, competence, and professional skills when working with LGBTQ+ individuals and same-gender or gender-diverse couples.

• Examines laws and policies and provides tips to effectively engage this vital community

All Children – All Families (ACAF) Annual Certification Program

Human Rights Campaign

• Online self-assessment tool

• Webinars

• Peer-to-peer learning

• Foundational material

• Advanced content o For direct service professionals who work with LGBTQ+ children, youth, and families.

• Training of Facilitators program to build an agency’s internal training capacity o Three-part, customizable training series the ACAF's team of expert trainers provides for agency staff.

• Free webinars and resources

Children with Disabilities

Critical On-going Resource Family Education

Spaulding for Children

Training program for parents, including foster, adoptive, and kinship placements

Curriculum, publications, webinars, and competencies for parents to equip them with the knowledge, skills, and assets to effectively manage the behavioral challenges of older youth

Guardianship Families

Adoption and Guardianship Assistance by State

Child Welfare Information Gateway: based on a national survey conducted by AdoptUSkids and related research

Adoption and Guardianship assistance database

• Provides summaries of state policies on available programs and services in each state

• Reviews state guardianship assistance policies based on a national survey conducted by AdoptUSkids and related research

Guardianship Assistance, Resources, and Program Tools

Grandfamilies.org Summary, resources, and tools

• Provides a summary and analysis of guardianship

• Shares resources for families and professionals

• Includes tools for agencies implementing Guardianship Assistance

Children Experiencing Commercial Sexual Exploitation

The Commercial Sexual Exploitation of Children

California Department of Social Services

(CDSS)

Website with links to resources

Provides information to support awareness, identification, and prevention education of commercial sexual exploitation of children https://www.childwelfare.gov/resources/working-lgbtq-families-foster-care-and-adoption/ https://www.childwelfare.gov/resources/working-lgbtq-families-foster-care-and-adoption/ https://www.childwelfare.gov/resources/working-lgbtq-families-foster-care-and-adoption/ https://www.childwelfare.gov/resources/working-lgbtq-families-foster-care-and-adoption/ https://www.childwelfare.gov/resources/working-lgbtq-families-foster-care-and-adoption/ https://www.childwelfare.gov/resources/working-lgbtq-families-foster-care-and-adoption/ https://www.thehrcfoundation.org/about/all-children-all-families?_ga=2.259050890.1421290315.1706110998-395473606.1706110998&_gac=1.261511423.1706111011.Cj0KCQiAh8OtBhCQARIsAIkWb6_bwY856Uf6Ol8HoQdNJelV6aZB5fW8LbABOCQKNIWpBrzRHxHlHb0aAqd5EALw_wcB https://www.thehrcfoundation.org/about/all-children-all-families?_ga=2.259050890.1421290315.1706110998-395473606.1706110998&_gac=1.261511423.1706111011.Cj0KCQiAh8OtBhCQARIsAIkWb6_bwY856Uf6Ol8HoQdNJelV6aZB5fW8LbABOCQKNIWpBrzRHxHlHb0aAqd5EALw_wcB https://www.thehrcfoundation.org/about/all-children-all-families?_ga=2.259050890.1421290315.1706110998-395473606.1706110998&_gac=1.261511423.1706111011.Cj0KCQiAh8OtBhCQARIsAIkWb6_bwY856Uf6Ol8HoQdNJelV6aZB5fW8LbABOCQKNIWpBrzRHxHlHb0aAqd5EALw_wcB https://www.thehrcfoundation.org/about/all-children-all-families?_ga=2.259050890.1421290315.1706110998-395473606.1706110998&_gac=1.261511423.1706111011.Cj0KCQiAh8OtBhCQARIsAIkWb6_bwY856Uf6Ol8HoQdNJelV6aZB5fW8LbABOCQKNIWpBrzRHxHlHb0aAqd5EALw_wcB https://www.thehrcfoundation.org/about/all-children-all-families?_ga=2.259050890.1421290315.1706110998-395473606.1706110998&_gac=1.261511423.1706111011.Cj0KCQiAh8OtBhCQARIsAIkWb6_bwY856Uf6Ol8HoQdNJelV6aZB5fW8LbABOCQKNIWpBrzRHxHlHb0aAqd5EALw_wcB https://spaulding.org/professionals/spaulding-institute/core-critical-on-going-resource-family-education/ https://spaulding.org/professionals/spaulding-institute/core-critical-on-going-resource-family-education/ https://spaulding.org/professionals/spaulding-institute/core-critical-on-going-resource-family-education/ https://www.childwelfare.gov/adoption-guardianship-assistance-state/ https://www.childwelfare.gov/adoption-guardianship-assistance-state/ https://www.childwelfare.gov/adoption-guardianship-assistance-state/ https://www.cde.ca.gov/ls/ss/vp/commsexexploitationchild.asp https://www.cde.ca.gov/ls/ss/vp/commsexexploitationchild.asp https://www.cde.ca.gov/ls/ss/vp/commsexexploitationchild.asp https://www.cde.ca.gov/ls/ss/vp/commsexexploitationchild.asp

13 Toolkit #2: Enhancing Adoption Competent Practices

Evidence-informed, adult-focused child sexual abuse prevention trainings

Darkness to Light:

Stewards of Children®

In-person and virtual facilitator-led trainings

• Teaches adults practical actions they can take to reduce instances of child sexual abuse in their organizations, families, and communities.

• One of the only evidence-informed, adult-focused child sexual abuse prevention trainings in the United States proven to increase knowledge and change behavior

Undocumented or Refugee Status Families

Working With Immigrant and Refugee Families: A Guide for Child Welfare Agencies

Child Welfare Information Gateway

Bulletin Presents strategies that child welfare agencies can use at the systems level to improve case outcomes for immigrant and refugee children, youth, and families.

Crisis management and helping parents navigate the health care system

Children’s challenging behaviors

Most adoptive families successfully manage their children’s challenging behaviors; however, it is a commonly reported cause for adoptive family instability. More than a third of youth in foster care nationwide who have previously been adopted re- entered foster care due to child behavior problems.5 In

Virginia, child behavior is the primary reason for over half of adoption disturbances.6 The availability of appropriate, accessible services can help prevent adoption disturbances and protect family stability and well-being.

Accessing care during a mental health crisis is a major concern among Virginia adoptive parents.7 Parents experience barriers to accessing crisis services at multiple entry points, including while a crisis is occurring, when accessing crisis treatment services (e.g., hospitalization), and during follow-up to crisis treatment. An additional barrier to care is a lack of continuity in service providers across these multiple points. VDSS staff agree that mental health services in response to crisis are difficult to access and too expensive for families.

Staff also have concerns around the affordability of post-adoption mental health care services, including parents not being able to access funding if the child was not diagnosed prior to or at the time of adoption, lack of Medicaid coverage, and limited types of services covered through the RPAC model.

What is a crisis? The National Alliance on Mental Illness (NAMI) describes a crisis as “any situation in which a person’s behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves or function effectively in the community.”v Child behaviors that may precipitate a crisis include increased agitation; verbal threats; violent, out-of-control behavior; property destruction; and

5 Findings come from Child Trends’ analyses of data from the federal fiscal year 2021 Adoption and Foster Care Reporting System foster care file.

6 Findings come from Child Trends’ analyses of data provided by the Virginia Department of Social Services on all children and youth in VDSS custody at any point during the state fiscal year 2023 as the result of a disturbed adoption. Adoption disturbances include dissolutions and entries into foster care following adoption.

7 From parent interviews https://www.d2l.org/education/stewards-of-children/ https://www.d2l.org/education/stewards-of-children/ https://www.d2l.org/education/stewards-of-children/ https://www.d2l.org/education/stewards-of-children/ https://www.d2l.org/education/stewards-of-children/ https://www.childwelfare.gov/resources/working-immigrant-and-refugee-families-guide-child-welfare-agencies/ https://www.childwelfare.gov/resources/working-immigrant-and-refugee-families-guide-child-welfare-agencies/ https://www.childwelfare.gov/resources/working-immigrant-and-refugee-families-guide-child-welfare-agencies/ https://www.childwelfare.gov/resources/working-immigrant-and-refugee-families-guide-child-welfare-agencies/ https://www.childwelfare.gov/resources/working-immigrant-and-refugee-families-guide-child-welfare-agencies/

14 Toolkit #2: Enhancing Adoption Competent Practices abusive behavior to self and others, including substance use or self-harm.8 Such situations often exceed the capacity of parents to handle them alone or without training. In their description of their array of post-adoption support and services, VDSS-DFS lays out specific criteria to determine whether a crisis is occurring; these are situations in which 1) an external support (police, crisis unit, immediate hospitalization) is contacted and gets involved, 2) there is significant property destruction, 3) a child is actively suicidal/homicidal, or 4) anytime a child is taken to the emergency room for assessment and a possible temporary detention order.

Causes of child behaviors that can place adoptive family stability at risk. Trauma-related conditions that can cause challenging behaviors include post-traumatic stress disorder (PTSD), reactive attachment disorder

(RAD), and developmental trauma disorder (DTD).9 Trauma can also lead to behaviors that parents find very difficult to manage, even if the behaviors do not meet the criteria for a formal diagnosis. Often, crises among adopted children may have more than one underlying cause. They may be due to a condition common among children with trauma histories, such as oppositional defiant disorder (ODD), attention-deficit hyperactivity disorder (ADHD), depressive mood disruptive disorder (DMDD), bipolar disorder, autism spectrum disorder

(ASD), or fetal alcohol spectrum disorder (FASD).

Sometimes parents lack needed parenting skills and/or hold unrealistic expectations of young children, whose social and emotional regulation skills are minimally developed, and/or of teens, whose normative developmental inclination toward independence can be perceived by some parents as abnormal defiance. In such cases, parents’ developmentally inappropriate responses to children’s behavior can exacerbate problems.

Selecting appropriate interventions requires examining contributors to behaviors among children and family members that may lead or have led to crises, as well as contributors that can promote child and family stability. The involvement of professionals, family members, and children themselves will enhance this process. Knowledge that can inform this examination includes 1) children’s trauma, medical, and behavioral health histories; 2) biological parents’ mental health histories (particularly given that a propensity for mental illness can be genetic); and 3) adoptive parents’ understanding of child development, trauma, grief, and loss; parenting skills and behaviors toward their children; and their own trauma responses.

Post adoption support and services critical for supporting family stability

The Quality Improvement Center on Adoption and Guardianship is a federal effort aimed at testing promising approaches to promote family stability. The center elaborates that crisis in the context of adoption and guardianship can arise when children’s needs exceed parenting capacity and the necessary child welfare system resources or other support that could address the problems are not available.vi In other words, a comprehensive array of post adoption support and services must be available from the child welfare system or the community both for parents and for children. Important services include support with the prevention of and preparation for crises, immediate help during crises, and long-term intensive interventions to ameliorate the underlying causes of crises.

8 Please note: NAMI also describes signs of the risks of suicide. Many of these signs are “internalizing”—in other words, not involving aggression or threats toward family members, nor of property destruction. Clearly suicide risk is a crisis, but related behaviors signaling this risk do not seem to be a primary cause of adoption instability.

9 Not a formal diagnosis, but proposed to be such in the Diagnostical and Statistical Manual https://www.apa.org/monitor/2021/07/ce-corner-developmental-trauma https://www.apa.org/monitor/2021/07/ce-corner-developmental-trauma https://www.apa.org/monitor/2021/07/ce-corner-developmental-trauma

15 Toolkit #2: Enhancing Adoption Competent Practices

Prevention of and preparation for crises. Early assessment to identify risks or existing problems is critical to prevent and prepare for crises related to behavioral health. Appropriate interventions to address risks or problems can include parent psychoeducation or parent training; therapy for the family, child, and or parents; and, at times, medication. Caution with medication is critical, as the use of multiple psychotropic medications is disproportionately high among foster and adoptive youth. Warm lines—and even the sympathetic ear of a case manager—can help defuse tensions that could contribute to a crisis. Families at high risk may need guidance in developing a safety plan to guide their actions during a crisis. This includes not only de-escalation techniques to support parent and child emotional regulation—such as parent/child co-relation, rhythmic movement, or breathing techniques—but also a concrete plan for how to respond to a crisis in which any family member is in immediate danger of harm.

Immediate help at the time of a crisis. If anyone in the family is in danger of physical harm, immediate help is necessary. Depending on the level of risk, appropriate responses for parents could include calling a mental health hotline, visiting a crisis center than can assess risk and provide immediate counseling, requesting that a mobile crisis unit respond, or—in worst case scenarios—calling 911. Case workers should alert parents that if they call 911, the police (rather than an ambulance) will likely respond.

Long-term intensive intervention to prevent future crises. Adoptive families experiencing crises typically need not only immediate intervention to maintain the safety of all family members, but longer-term, intensive treatment to address the issues underlying the challenging behaviors.vii Treatment could involve child, parent, and family therapy; and/or medication (sometimes even for parents experiencing secondary trauma). Parents may also need help with educational advocacy, given that a child’s behavioral health needs may necessitate an individualized education plan to meet their education needs.

Children with severe mental health issues may benefit from an intensive outpatient program (IOP), partial hospitalization program (PHP), short-term (typically 30 to 60 days) residential treatment care, a wilderness program, a therapeutic boarding school (typically 12 to 18 months), or a higher-level residential treatment center (typically also at least a year). In such cases, parents need help determining the appropriate level of care for their child; identifying the appropriate modality of therapeutic intervention (e.g., broadly speaking, cognitive vs. experiential); identifying a specific, high-quality provider; facilitating access to care; planning and seeking the funding the care; and ensuring long-lasting and healthy family reunifications.