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2004 Jordan Institute
for Families

Vol. 10, No. 1
December 2004

Why Families Need Post-Adoption Services

“You are totally alone after you sign the papers for adoption.”
— North Carolina adoptive parent

“With all their problems we will probably have many, many more struggles for the rest of our lives.”
— North Carolina adoptive parent

* * * * * * * * * * * * * * * * * * *

Once upon a time it was not uncommon for child welfare agencies to leave families who adopted children from foster care alone to “figure things out” for themselves.

This probably was never a good idea. But today, when we talk so much about our concern for the permanency and well-being of children, this practice is indefensible. We simply know too much now about the challenges faced by adoptive children and their families. Here, briefly, are some of the chief reasons North Carolina strongly endorses the provision of post-adoption services.

Child Characteristics
The majority of children in foster care are there because of abuse or neglect. Past trauma, exposure to drugs and alcohol, and separation and loss cause many of these children to have developmental, physical, and mental problems (Berry & Barth, 1990; Lakin, 1992; Smith & Howard, 1994). Moreover, children in foster care are more likely than other children to struggle with chronic health problems, developmental delays, educational difficulties, mild to moderate mental health problems; and in some cases, severe psychological and behavioral difficulties (Avery & Mont, 1994; Simms, et al., 2000). These problems do not evaporate at the moment of adoption.

Older Children, Longer Foster Care Stays
Some children experience extended stays in foster care before they are adopted. For example, in September 1999, children in the U.S. who were waiting to be adopted had been waiting, on average, for slightly more than three years (Freundlich & Wright, 2003). Spending extended periods in foster care can have negative effects on children’s health, well-being, and ability to adapt to a new adoptive family (Freundlich & Wright, 2003).

Research also suggests that the older a child is at time of adoption—especially if the child is over age 10— the more likely it is that the child will have difficulty adjusting to his or her adopted family (Sharma, et al., 1996). In part, this may be because older children come to their adoptive families with specific expectations for how they and their adoptive family should behave (Pinderhughes, 1998).

Psychologist Katharine Leslie says that for some children who spend a long time in foster care, “living in a permanent family can be more stressful than anything else.”

As the overall number of children adopted from foster care continues to rise, so will the number of children who are older and/or who have had long stays in foster care.

Adoption Is A Process
In adoption circles it is commonly said that adoption is a process, not an event. Elinor Rosenberg provided support for this notion in her 1992 book The Adoption Life Cycle. According to Rosenberg, birth parents, adoptive parents, and adoptees face distinct developmental adoption-related challenges throughout their lives. Although it does not factor in the way abuse, neglect, and foster care can complicate adoption, The Adoption Life Cycle makes it easier to understand why stuggles between adoptive parents and adopted children often intensify during adolescence, and why adoptive families’ needs for services may actually increase over time (Groze, 1996).

Out-Of-Home Placement and Dissolution
Given what we know about the developmental, physical, and mental health needs of many of the children adopted from foster care, it is not surprising that some of these children are at risk of out-of-home placement, usually through placement in either foster care or residential treatment centers. For example, one study that followed 497 children adopted from foster care in New York in 1996 found that 3.3% of the children re-entered foster care at some time after the adoption (Festinger, 2001).

Dissolution (adoption failure after finalization) is also a concern. Although it is uncommon—in their study of children adopted in Illinois between 1976 and 1987, Goerge and colleagues (1997) found a dissolution rate of 3.3%—it is still very much to be avoided, given the trauma it causes children and families (Barth & Berry, 1988).

What Families Want
Although exactly what a family needs depends on the child’s characteristics (developmental age and stage, strengths and needs, etc.), family composition (number of children and parents), and other circumstances (e.g., family’s financial situation), there is a general consensus on what is useful to these families. The following list, which comes from Freundlich and Wright (2003), reflects this consensus:

  • Support groups, informal contact with other adoptive families, and help lines.
  • Accessible information about services, supports, and resources.
  • Parenting education, including practical help with children’s needs.
  • Respite care and babysitting for other children in the family.
  • Counseling, including assistance with children’s attachment issues; guidance in responding to their adopted children’s emotional, behavioral, and developmental issues; assistance in dealing with the impact of adoption on their birth children; and help with life planning for their children.
  • Crisis intervention services.
  • Advocacy services, including help negotiating the educational and mental health systems.
  • Educational assessment, special education services, and tutoring.
  • Counseling services for their children, including group services for older children.
  • Specialized children’s services, including mental health services, outpatient drug and alcohol treatment, physical therapy, and special medical equipment.
  • Adoption assistance (subsidies) and medical coverage.

What Families Get
Most families who adopt children from foster care in North Carolina receive some kind of financial assistance. Yet some adoptive families still have unmet support needs (NCDSS, 2004d).

There is tremendous variability across the country in terms of the supportive services that are available to adoptive families (Christian, 2002). The same is true within North Carolina. A handful of county DSS’s have their own post-adoption support workers. Others receive help from private agencies who work under contract with the NC Division of Social Services. Still others offer very little in the way of post-adoptive services.

This variability explains the fact that 23% of those who responded to a recent survey of adoptive parents in North Carolina said they had trouble receiving respite or therapeutic services and 20% reported difficulty finding support groups (NCDSS, 2004d).

What Works
There have been few empirical studies of the outcomes produced by post-adoption services. Most of these have methodological flaws (e.g., small sample size) that make it difficult to know what really works (Barth, et al., 2001). Yet new studies continue to appear that suggest post-adoption support does make a difference. For example, a recently published study out of New York reported that post-adoption services had a significant positive impact on families’ happiness and ability to stay together (Avery, 2004).

This shortcoming in the literature puts agencies in a tough spot: they do not have the luxury of delaying action until researchers know more. Children continue to be adopted from foster care each day, and there is no doubt some of their families need support.

While practitioners and agencies should be careful not to overestimate the impact their interventions will have (Barth, 2001), they must continue to do everything they can to support families after adoptions are final. The other articles in this issue suggest ways to enhance your efforts in this area.

Post-Adoption Services: Potential Benefits


Support for families after finalization is often provided in the hopes of achieving the following outcomes:

  • Preventing Dissolution and Out-of-Home Placement. Services after the final decree of adoption are needed to promote the well-being of families and minimize the possibility that adoptions will fail (Barth & Berry, 1988).
  • Promoting Family Well-being. There is evidence of a strong relationship between providing post-adoption support and the health, well-being, and stability of families (Groze, 1996; Smith & Howard, 1994), especially when counseling and other mental health services are provided (Winkler et al., 1988).
  • Recruiting Adoptive Parents. Knowing support will be available after the adoption plays a critical role in many prospective adoptive parents’ decisions to go forward with the adoption (Freundlich, 1997).

Source: Casey Family Services, 2002

References for this and other articles in this issue