Adoption-Specific Therapy

Children who are adopted at an older age through foster care and those adopted from overseas orphanages are at high risk of having behavioral problems and experiencing emotional distress. This important manual presents a structured, evidence-based protocol for providing mental health treatment to families adopting vulnerable children.

Drawing from their extensive clinical experience as members of premier national organizations that serve adopted children and their families, Jill Waterman, Audra K. Langley, Jeanne Miranda, and Debbie B. Riley describe common strengths and challenges of adopted children, as well as the underlying issues that uniquely affect adoptive families. These include concerns related to parent–child attachment, loss and grief, trauma, the child's understanding of his or her adoption "story," identity development, and birth family connections.

Therapy sessions deliver evidence-based child coping strategies and positive parenting approaches that are tailored to account for the child's past history, alongside resiliency-focused, trauma-competent, attachment-based treatment.

The clinician and practitioner resources provide free in-session handouts for practitioners.

Given the unique needs of this clinical population, this book is essential for therapists who treat adopted and foster youth and their families.

List of Online Handouts

Preface

Acknowledgments

Introduction

I. Foundations

1. Theoretical and Empirical Underpinnings of Adoption-Specific Therapy
2. Overview of Adoption-Specific Therapy

II. The ADAPT Curriculum

3. Module 1: Trust, Positive Coping Strategies, and Behavior Management
4. Module 2: Developmental Understanding of Adoption Experience
5. Module 3: Loss and Grief Issues in Adoption
6. Module 4: Attachment and Joining With the Adoptive Family
7. Module 5: Search for Identity and Transracial Adoption
8. Module 6: Adoption and the Outside World
9. Module 7: Trauma Treatment
10. The Termination Session

References

Index

About the Authors

Jill Waterman, PhD, is adjunct professor emerita in the University of California Los Angeles (UCLA) psychology department and for many years was coordinator of the UCLA Psychology Clinic, the training clinic for UCLA's top-ranked clinical psychology doctoral program.

She was one of the initial developers of UCLA Training, Intervention, Education, and Services (TIES) for Adoption (now called UCLA TIES for Families), an interdisciplinary program to support successful adoption from foster care of children with prenatal substance exposure and other at-risk conditions, and she has been with TIES since its inception in 1995. Much of the content of the adoption-specific prevention treatment (ADAPT) model was developed through her years of clinical work and supervision at TIES.

Currently, Dr. Waterman is the director of Infant Mental Health at UCLA TIES for Families, where she oversees the clinical and research components of the program.

Dr. Waterman's research involves various aspects of adoption and child trauma. She and her students have followed one cohort of children adopted from foster care for 15–20 years and are now following a cohort of infants with prenatal substance exposure who are in foster care with prospective adoptive parents. In addition, she has provided training and consultation both locally and nationally on issues related to parenting and treatment of children in or adopted from foster care.

Dr. Waterman has cochaired 21 doctoral dissertations and is the author of two books on child sexual abuse as well as an evidence-based group treatment manual for at-risk middle school students.

Audra K. Langley, PhD, is a clinical child psychologist and associate professor at the UCLA Semel Institute for Neuroscience and Human Behavior and the UCLA David Geffen School of Medicine Department of Pediatrics. She is the director of UCLA TIES for Families, an innovative multidisciplinary program for children in or adopted from foster care and their families in Los Angeles County.

Dr. Langley specializes in evidence-based treatments for children and adolescents with posttraumatic stress, anxiety, and related issues. Her body of work has sought to increase access to quality mental health interventions for underserved populations of children, including those in schools and involved with the child welfare system.

Dr. Langley has been the director of training for the Substance Abuse and Mental Health Services Administration-funded Trauma Services Center for Resiliency, Hope, and Wellness in Schools since 2003 and served for 7 years as chair of the Schools Committee for the National Child Traumatic Stress Network.

Nationally and locally, she provides training and consultation related to trauma-informed, child-welfare competent care to professionals in multiple fields and to parents and caregivers.

Dr. Langley recently developed and evaluated Bounce Back, an intervention for ethnically and socioeconomically diverse elementary-aged children exposed to traumatic events, which has since been disseminated nationally. She is the author of four treatment manuals and a proud parent of biological and adopted children.

Jeanne Miranda, PhD, is a professor in the department of psychiatry and biobehavioral sciences at UCLA.

Her major research contributions have been in evaluating mental health care for poor and minority women. She is evaluating an intervention her team developed for families adopting older children from foster care, adapting depression interventions for young women in Uganda, as well as evaluating governmental social programs there. She has developed and is evaluating a resilience intervention for low-income and minority lesbian, gay, bisexual, and transgender populations.

She was the senior scientific editor of Mental Health: Culture, Race and Ethnicity: A Report of the Surgeon General. She became a member of the Institute of Medicine, now the National Academy of Medicine, in 2005.

Dr. Miranda is the 2008 recipient of the Emily Mumford Award for Contributions to Social Medicine from Columbia University.

Debbie B. Riley, LCMFT, is a licensed clinical marriage and family therapist and CEO and cofounder of the Center for Adoption Support and Education (C.A.S.E.), an independent, nonprofit adoptive family support center in the Baltimore–Washington area.

A nationally recognized adoption expert and dynamic public speaker, Ms. Riley has 35 years of professional experience, including extensive health care management, administrative expertise, designing and developing nationally acclaimed adoption-competent programs, and direct delivery of specialized counseling services, which affords her the broad knowledge and nationally respected expertise needed to promote mental health training, child advocacy, and public policy development.

Ms. Riley created a continuum of innovative, culturally responsive, evidenced-informed programs to improve the behavioral outcomes of foster and adopted youth and their families, which has become a nationally recognized model.

Ms. Riley consults with national child welfare agencies on complex child welfare issues and systems of care enhancement. For over a decade, she has built and implemented a framework for training an adoption-competent mental health workforce nationally and is the founder of the Training for Adoption Competency curriculum currently taught in 17 states.

Through a recent federal 5-year grant awarded to C.A.S.E. from the U.S. Department of Health and Human Services, Administration for Children and Families, Ms. Riley serves as the principal investigator to establish a National Adoption Competency Mental Health Training Initiative (NTI). The initiative will build the adoption competency capacity of child welfare professionals and mental health practitioners who serve youth moving toward permanency as well as youth living in permanent adoptive or guardianship homes. The NTI will develop state-of-the-art, evidence-informed adoption competency web-based curricula for each group, with quality improvement components for use on a national basis.

Ms. Riley is coauthor of Beneath the Mask: Understanding Adopted Teens, contributing author of the article "Adoption Competent Clinical Practice: Defining Its Meaning and Development" (Adoption Quarterly, 16, 2013), and contributing author of Transracial and Intercountry Adoptions: Cultural Guidance for Professionals (edited by Rowena Fong and Ruth McRoy, 2016).

Waterman, Langley, Miranda, and Riley have created an invaluable clinical model for working with adoptive families. Adoption-specific therapy is theoretically grounded and combines evidence-based interventions with keen knowledge of and sensitivity to the child's trauma history and the unique dynamics associated with adoptive family life. This very readable guide is filled with clinical insights, suggestions, and activities that will intellectually stimulate mental health practitioners and enrich their work with adoptive families.
—David Brodzinsky, PhD
Professor Emeritus, Clinical and Developmental Psychology, Rutgers University, The State University of New Jersey, New Brunswick

This essential resource for clinicians, written by a team with a broad and deep understanding of adoption, provides hands-on, practical guidelines for conducting therapy with adopted children and their families. Both developmentally and culturally sensitive, their approach draws from the best available research about the unique needs of adopted children. Case examples bring the application of the approach to life and provide useful insights for adoptive parents, who will find reassurance that they are not alone. Any therapist wishing to be viewed as "adoption-competent" needs this book.
—Harold D. Grotevant, PhD
Rudd Family Foundation Chair in Psychology, University of Massachusetts Amherst

Welcome to the clinician and practitioner resources for Adoption-Specific Therapy: A Guide to Helping Adopted Children and Their Families Thrive. The treatment protocol presented in this book uses many handouts with both parents and children. These resources contain downloadable handouts to allow for easy reproduction and use with families.

These documents are offered for your personal and clinical use. If you reprint or adapt them for publication, permission is required from the copyright holder. All material is ©2018 by Jill Waterman, Jeanne Miranda, Audra Langley, and Center for Adoption Support and Education, Inc. unless otherwise noted.

• Summary of Handouts (PDF: 44KB)
• Handout A: Materials Needed for ADAPT Toolkit (PDF: 36KB)
• Handouts for Module 1: Trust, Positive Coping Strategies, and Behavior Management (Handouts 1–24) (PDF: 461KB)
• Handouts for Module 2: Developmental Understanding of Adoption Experience (Handouts 25–31) (PDF: 1994KB)
• Handouts for Module 3: Loss and Grief Issues in Adoption (Handouts 32–37) (PDF: 111KB)
• Handouts for Module 4: Attachment and Joining With the Adoptive Family (Handouts 38–43) (PDF: 244KB)
• Handouts for Module 5: Search for Identity and Transracial Adoption (Handouts 44–50) (PDF: 47KB)
• Handout for Module 6: Adoption and the Outside World (Handout 51) (PDF: 30KB)
• Handouts for Module 7: Trauma Treatment (Handouts 52–58) (PDF: 594KB)
• Handouts for Termination Session (Handouts 59–60) (PDF: 41KB)