Thanks to a federal grant, AFTER -
Kinship Center has provided 125 local therapists and social workers with
Adoption Clinical Training (ACT). These professionals live in your
community and have a variety of specializations. AFTER keeps a database
of those who have graduated from ACT and can help you find a therapist
who may be a good match for your situation. The following is
adapted for local use from the National Adoption Information Center.
Adoption is an event that has a
life-long effect on everyone involved. Adoption brings unique rewards as
well as challenges to families, and sometimes families will need or want
professional help as concerns or problems arise. Timely intervention by
a professional skilled in adoption issues often can prevent issues
common to adoption from becoming more serious problems that might be
more difficult to resolve.
The type (e.g., individual, family,
group) and duration of therapy will vary depending on many variables,
including the kinds of problems being addressed. Some families build a
relationship with a therapist over years, "checking in" for help as
needed. Other families might find they need a therapist's help only once
or twice. Sometimes a difficulty a child is experiencing is very
obviously connected to adoption, but sometimes the connection is not
readily apparent. On the other hand, issues that seem to be related to
adoption, after investigation, turn out not to be related to adoption at
all. Clinicians with adoption knowledge and experience are best suited
to help families identify connections between problems and adoption and
to plan effective treatment strategies.
Finding the right therapist can seem
like a daunting task, especially when parents may be feeling overwhelmed
or burdened by the difficulties for which they are seeking help. Parents
should take the time to shop around for a mental health provider who has
the experience and expertise required to effectively address their
family's needs. At minimum, a therapist must:
Be knowledgeable about adoption and
the psychological impact of adoption on children and families
Be experienced in working with
adopted children and their families.
Know the types of help available.
For a descriptive listing please click here.
Check on Insurance The search
for a therapist can be complicated by restrictions imposed by insurance
companies or health management organizations (HMOs); however, it may
still be possible to choose from a list of approved therapists. Check
with your insurance company to find out:
The extent of your coverage for
mental health treatment
Specialty areas of approved
providers
Company policies regarding referrals
to, and payment for, treatment provided by therapists outside the
plan.
You may be able to justify using a
therapist outside of the network for specialized services if the
insurance company does not have providers with the required expertise.
Although you might meet some resistance, persevere to secure the needed
services-you are your child's strongest advocate.
Some therapists accept Medicaid
reimbursement. The challenge is to locate a therapist who accepts
reimbursement and who has experience in foster care and adoption. Your
local public foster care agency may be able to give you referrals to
therapists they use for children's treatment.
Know the Types of Help Available:
Many different professionals provide
mental health services but not all may be available in your area. It
helps to know the training and credentials of various professionals
attain.
Pediatrician or Family Practice
Physician -
Medical doctor (M.D.) who
specializes in childhood or adolescent care and who typically treats
routine medical conditions; a primary care physician who refers a
child for additional lab studies or diagnostic procedures and who
coordinates referrals to other specialists.
Psychiatrist -
Medical doctor (M.D.) who
specializes in the evaluation of major mental or emotional disorders
which may require medication. Psychiatrists complete medical school
and follow with post-graduate training in psychiatric disorders and
perhaps subspecialties in child and adolescent psychiatry.
Psychiatry's primary focus is on medication consultation and
management, and only a few psychiatrists have formal training in
psychotherapy, counseling, or interventions that address child and
adolescent behavioral or emotional disorders. Rather, most work with
or refer to specialists in child and family evaluation and therapy.
Clinical Psychologist-
a clinical psychologist has
completed a doctoral degree (Ph.D. or Psy.D.) in psychology and
usually has completed advanced courses in general development,
psychological testing and evaluation, as well as psychotherapy
techniques and counseling. Many clinical psychologists develop a
subspecialty in child and adolescent development, psychological
testing, and family therapy.
Clinical Neuropsychologist -
Clinical neuropsychologists hold a
Ph.D. They complete undergraduate and graduate training in biological
and medical theories pertaining to human behavior and doctoral studies
in clinical neuropsychology, followed by post-graduate specialty
training in the assessment and treatment of neurodevelopmental
disorders, neurological and medical conditions, traumatic brain
injury, learning and memory disorders and the differential diagnosis
of organic versus psychiatric or psychological disorders.
Clinical Social Worker -
A clinical social worker (LCSW or
MSW) has completed a master's degree in social work with emphasis on
family structure and children's interactional strengths and
weaknesses. Social workers typically focus on social, educational and
family adjustment issues, but usually do not have professional
training in psychological testing. Many complete advanced training and
licensure in order to be qualified under state licensure requirements
to offer counseling to individuals and families.
Marriage and Family Therapist
-
Marriage and family therapists (MSW)
have a master's degree in counseling techniques that mainly focus on
family relationships and couples. Family therapists focus on
communication building and on family structure and boundaries within
the family.
Licensed Professional Counselor
-
A licensed professional counselor
often has graduate training in a specialty such as education,
psychology, pastoral counseling, or marriage and family therapy.
Licensed professional counselors focus on brief problem-solving
therapies with a focus on reorganizing the family, building
communication skills, and strengthening family relationships.
Pastoral Counselor -
A pastoral counselor has a minimum
of a master's degree (many have completed doctoral training) and
focuses on supportive interventions for individuals or families, using
spirituality as an additional source of support for those in
treatment.
Ask for Referrals Locating a
therapist does not have to be difficult. You may want to contact
community adoption support networks, use the Internet, and/or ask your
placement agency. Many adoption agencies have either consulting mental
health therapists trained in adoption on staff or referral resources in
the community. Public agencies may have a list of therapists who have
effectively worked with children in foster care and adoption. In
addition, there are independent social service organizations throughout
the United States that provide post-adoption services, which may include
parent support groups, individual and family counseling, children's
support groups, educational seminars, consultations and advocacy.
Check with the following resources for
therapist recommendations:
Agency social workers involved in
the original placement
State or local mental health
associations - most offer referral services and list specialty areas
for therapists
Using those recommendations, call
therapists for a phone or face-to-face interview. Many therapists will
offer a 15- or 20-minute initial consultation free of charge. In
contacting a community mental health center, parents should ask for
names of the center's family and child specialists and then leave
messages for those clinicians requesting a short phone interview.
Phone Interview Questions
Parents should start by giving the clinician a brief description of the
concern or problem for which they are requesting help. Listed below are
some questions to discuss.
What is the therapist's experience
with
Adoption, in general?
Infertility?
Special needs adoption?
Open adoption?
Transracial adoption?
Identity issues in the context of
adoption?
Search and reunion?
Adoptive families?
Adopted children?
Children who have histories of
loss, abuse and/or neglect?
Children who may have learning or
developmental disabilities?
How long has the therapist been in
practice, and what degrees, license or certification does he or she
have?
What continuing clinical training
does he or she have on adoption issues?
Does the therapist include parents
in the therapeutic process?
Does the clinician prefer to work
with the entire family or only with the child(ren)?
Will the therapist give parents
regular reports on a child's progress?
Can the therapist estimate a time
frame for the course of therapy?
What is the therapist's theoretical
orientation regarding treatment? Many therapists treat from one or
more of the following approaches:
behavioral therapy, which focuses
on treating overt behaviors
cognitive therapy, which focuses
clinical intervention on thinking processes, motivation, and reasons
for certain behaviors
family systems therapy, which
views family members as a unit and focuses on their interpersonal
and communications patterns
psychoanalysis, which is based on
psychosexual development theories, personality structure and
psychotherapy techniques pioneered by Sigmund Freud.
Other Practical Considerations
Most therapists or clinical practices have policies regarding late or
missed appointments, notice required for rescheduling appointments, and
filing for insurance reimbursement. Parents should ask for this
information.
What is the therapist's arrangement
for coverage when he or she is not available, especially in the event
of an emergency?
Are daytime, evening, or weekend
appointments available? What about after-school appointments?
Does the therapist offer discounted
or sliding scale fees if he or she is not an approved provider for
your health coverage?
Does the therapist accept adoption
subsidy medical payments or Medicaid reimbursement payments?
Does the therapist have experience
working collaboratively with school personnel including attending any
appropriate school meetings.
Working with a Therapist Parents
may request an evaluation meeting with the therapist 6-8 weeks after
treatment begins. This evaluation meeting will help all parties "take a
pulse" on progress of the treatment and to discuss the following areas:
Satisfaction with the "chemistry"
between the therapist and family members. (It is important for parents
to understand that a trusting relationship between clinician and the
child may take several weeks or longer to establish. This is
particularly true of children who have had histories of significant
loss and separations.)
Mutually agreed-upon goals for
treatment approaches and desired outcomes.
Progress on problems that first
prompted the request for treatment. Parents should realize that some
behaviors need extensive intervention before progress can be
identified.
A tentative diagnosis.
The therapist's evaluation of the
chances that therapy can improve the situation(s) which prompted
treatment.
Follow through by the family with
the therapist's recommendations. Practiced any "homework" assignments?
(Parents should know that most of the "work" in therapy occurs
between, not during, sessions and that it is a reciprocal process.)
The family's involvement and support of
the therapy is often critical to a positive outcome for the child.
Families must commit to keeping regularly scheduled appointments, and
parents should not use therapy as a tool for discipline.
Family members must communicate
regularly with the therapist and ensure that the therapist has regular
feedback about conditions at home. The success of therapy depends
heavily on open, honest and trusting communication.
Recognizing the need for outside
support and early intervention when problems arise will help adopted
children and their families navigate the challenges adoption presents as
they grow and develop.
In Summary You can locate a
therapist who has the experience and training best suited to your needs
by checking with local, State, and regional referral sources. This may
take more time but in the end, your research efforts should result in
finding the mental health service provider best able to work with you
and your child.
Adoption Clinical Training (ACT) is an eighty
hour course taught by master trainers, replicating the original training
developed by Kinship Center's Sharon Roszia MA and Deborah Silverstein
LCSW in Southern California. ACT is now funded by the Stuart Foundation
and is being provided to professionals in many counties throughout the
State.