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This article was downloaded by: [Memorial University of Newfoundland]On: 10 October 2014, At: 04:27Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954Registered office: Mortimer House, 37-41 Mortimer Street, London W1T 3JH,UK
Adoption QuarterlyPublication details, including instructions forauthors and subscription information:http://www.tandfonline.com/loi/wado20
Preparing School Age Childrenfor AdoptionMichele D. Hanna PhD aa University of Denver, Graduate School of SocialWork , 2148 South High Street, Denver, CO, 80208,USAPublished online: 23 Sep 2008.
To cite this article: Michele D. Hanna PhD (2008) Preparing School Age Children forAdoption, Adoption Quarterly, 10:2, 1-32, DOI: 10.1300/J145v10n02_01
To link to this article: http://dx.doi.org/10.1300/J145v10n02_01
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RESEARCH ARTICLES
Preparing SchoolAge Children for Adoption:Perspectives of Successful
Adoptive Parents and Caseworkers
Michele D. Hanna, PhD
ABSTRACT. This paper presents the results of an exploratory study thatexamined the preparation of children for adoption from the perspective of55 adoptive parents and 26 caseworkers. Results indicate little consis-tency in practice and highlight the pivotal role of the adoptive parent.From the caseworker perspective, preparation for adoption is oftenseen as a process that ends at placement with the adoptive family. Adop-tion issues often arise at developmentally significant times in a child’slife and adoptive parents may need to continue working with the child,building on the foundation of preparation work done by the child’scaseworker or therapist. If the preparation work is insufficient or ineffective,adoptive parents may face greater challenges as they help the child resolveissues related to their past, present and future. doi:10.1300/J145v10n02_01[Article copies available for a fee from The Haworth Document Delivery Ser-vice: 1-800-HAWORTH. E-mail address: <[email protected]>
Michele D. Hanna is Assistant Professor, University of Denver, Graduate School ofSocial Work, 2148 South High Street, Denver, CO 80208 (E-mail: [email protected]).
Adoption Quarterly, Vol. 10(2) 2007Available online at http://aq.haworthpress.com
© 2007 by The Haworth Press. All rights reserved.doi:10.1300/J145v10n02_01 1
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Website: <http://www.HaworthPress.com> © 2007 by The Haworth Press. Allrights reserved.]
KEYWORDS. Adoption, adoption preparation, child preparation foradoption
INTRODUCTION
According to the United States Children’s Bureau, there are an esti-mated 114,000 children waiting to be adopted in the foster care system(USDHHS, 2006a). Recent trends indicate that approximately 50,000children are adopted each fiscal year (USDHHS, 2006b). According tothe most recent data available, 41% of the children waiting for adoptionin the foster care system are six years of age or older and 47% of thechildren adopted annually are six years or older at the time of the adop-tion (USDHHS, 2006a).
Rushton (2004) noted that “although preparation of children, espe-cially ‘life story work,’ has been described and promoted by practitio-ners, studies are lacking on how this affects the child’s development andplacement subsequently” (p. 93). According to Festinger (2005) the fewstudies that have considered the relationship between the preparation ofthe child for adoption and adoption disruption have produced conflict-ing results.
The tasks for caseworkers in the adoption process include legal andemotional preparation of the child; gathering social, medical, schooland other pertinent records of the child’s past; assessing the suitabilityof prospective adoptive families through training and the home studyprocess; choosing the family that will best meet the child’s needs; andassisting the family during the transition period to legal finalization(Downs, Moore, McFadden, Michaud & Costin, 2004). Throughoutthis process, the best interest of the child is paramount. Reitz (1999)stresses the need for quality research to provide guidelines for socialworkers in adoption practice. According to Reitz, guidance regardinghow social workers provide services in the best interest of their clientsas well as in compliance with current adoption policies and legislativemandates is needed.
Most practitioners will agree that the best interest of the child isserved in placement with a well prepared adoptive family; however,preparation of the child often translates to an assessment of the child’s
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behavior and stability in foster care. There is little evidence that toolsand practices designed to assist children with an understanding of theirpast and future, such as a life story book, adoption preparation groups,adoption specific counseling etc., are being used routinely or effectivelywith children in need of adoptive placement (Backhaus, 1984; Rushton,Quinton, Dance & Mayes, 1998). Currently, “there is no systemicmodel currently in practice to guide permanency work for those chil-dren living in out-of-home care within the child welfare system”(Henry, 2005, p. 197).
This paper presents a historical review of the literature related to thepreparation of school age children for adoption as well as an overviewof conceptual models of child preparation. The results of an exploratorystudy examining the preparation of the child from the perspective of theadoptive parents and caseworkers are also presented. Implications foradoption practice and future research are provided.
LITERATURE REVIEW
If the adoption of an older child is to be successful, the adoption pro-cess should include a thorough preparation of all parties involved (Bass,1975). As early as the late 1940’s, the need for good preparation of thechild for adoption was recognized by practitioners (Lyle, 1949). In dis-cussing preparation of the older child for adoption, the primary focus ofthe work has historically been on the child understanding his or her pastand the reasons for adoptive placement (Bell, 1959; Epstein &Heymann, 1967; Leatherman, 1957; McCoy, 1961). These early arti-cles were written by child welfare practitioners faced with the growingconcern of “foster care drift” (McKenzie, 1993). They provided practi-tioners with general guidelines for adoption planning and placement ofthe “older child.” Glickman (1957); discussed the importance of goodpreparation in relationship to the success of the adoptive placement,stating “[t]o sum up, the more thorough and skilled the workpreplacement. . . . the more stable and constructive will be theplacement” (p. 151).
Throughout the literature the term special needs adoption is used todenote the adoption of children, primarily from the foster care system,who have characteristics or needs that may present challenges or barri-ers to finding adoptive homes (Rosenthal, 1993). These special needsinclude older age, emotional problems, behavioral problems, siblinggroup membership, developmental disabilities, physical disabilities and
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minority group membership (Rosenthal). Adoption literature in the1970’s and 1980’s began to address the preparation and services for theadoptive parents of the more difficult children with special needs (Bass,1975; Gill, 1978; Katz, 1977; Meezan & Shireman, 1982; Proch, 1982).The literature continued to address the needs of these children in rela-tion to placement and permanency (Aust, 1981; Backhaus, 1984;Chestang & Heymann, 1976; Elbow & Knight, 1987; Jones, 1979;Kagan, 1980; Maluccio et al., 1980; McInturf, 1986; Neilson, 1972;Timberlake & Hamlin, 1982). Depending on the age of the child, adop-tion preparation ranged from the gathering of information to life storywork to adoption therapy or group work (Aust, 1981; Backhaus, 1984;Cole & Donley, 1990; Jones, 1979; McInturf, 1986). Over the years,different models of preparation of the older child for adoption weredeveloped to guide social workers as to how best to accomplish thistask.
Conceptual Models of Child Preparation for Adoption
Most of the conceptual models for child preparation for adoption areconsistent with the six major components of successful preparation out-lined by Epstein and Heymann (1967) and echoed by Chestang andHeymann (1976) which include: (1) letting the child know that everychild is entitled to a parent, (2) explaining the difference between fostercare and adoption, (3) having a trusting relationship with the case-worker, (4) helping the child understand their past, (5) involving thechild in the decision-making process, and (6) providing the child withfacts about adoption and the adoption process. Neilson (1972) providedan overview of how social workers could address each of these compo-nents in direct practice with the child including interviewing the child,collaboration with foster parents, the use of life story book, and visita-tion to places from the child’s past. Jewett (1978) presented a hypotheti-cal case study to guide practitioners through the adoption preparationand placement process with the child.
Most models of child preparation for adoption presented in the litera-ture are stage models (Henry, 2005; Jones, 1979; Kagan, 1980;McInturf, 1986). Although the number of stages varies, each of themodels included (1) helping the child to understand the facts of theirfoster care situation and why termination of parental rights is necessary;(2) helping the child to explore feelings of loss, anger and confusion;and (3) empowering the child by allowing them to be a part of the plansfor their future. Kagan’s (1980) model was designed to work with the
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child after placement in the adoptive family; presuming that the child isresistive to the new adoptive family and is exhibiting problem behaviorsin an effort to provoke rejection.
One of the most well-known models for child preparation is the onepresented by Fahlberg (1991a) whose guide for moving a child throughplacement recognized the importance of attachment and child develop-ment. Much like Epstein and Heymann (1949), Fahlberg stressed theimportance of helping the child to understand the past. Children beingplaced for adoption from the foster care system need to given accurateinformation about their birth family, why they came into foster care,why subsequent moves were necessary, if applicable, and why adoptionis necessary. Fahlberg agreed that a child needs to understand the differ-ence between birth, foster and adoptive parenting; however, in a timewhen many children were being adopted by their foster parents,Fahlberg added the need for the child to know whether or not they willremain with the current foster family for adoption or be faced with yetanother move. Fahlberg’s model also differed from other models in thatit highlighted the importance of helping the child through the grief andloss process with actual or symbolic goodbyes. These goodbyes, ac-cording to Fahlberg, enable the child to be accepting and optimisticabout the future. Lastly, Fahlberg stressed the importance of a positivetransition for the child moving to a new home. This includes a series ofpre-placement visits, formal, ritualized good-byes with the foster fam-ily and celebratory welcoming activities such as a party or a formalannouncement marking the child’s joining to the new family.
Child Preparation in Practice
Despite these models and guidelines Henry (2005) noted that “a re-view of the literature shows no standard approach to preparing childrenfor permanency” (p. 199). There does seem to be agreement about theimportance of doing life story work with the child as part of the prepara-tion process (Fahlberg, 1991; Henry, 2005; Jewett, 1978; Jones, 1979;McInturf, 1986; Neilson, 1972). The primary tool for this work is thelife book. According to Jewett (1978), the life book is a tool that a prac-titioner can use to help a child understand the truth of “who they are andwhere they came from” (p. 72). Used therapeutically, the life book can“help children in placement connect their past and present life experi-ences, [and] can also be used therapeutically to reeducate children to amore positive self-image” (Aust, 1981, p. 535).
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It is unclear if life story work or other child preparation activities areconsistently occurring in practice today. According to Henry (2005), a2002 survey of 32 responding states showed that only five states hadinitiatives specifically focused on preparing children for adoption(Maine, Massachusetts, Missouri, Mississippi, and New Hampshire).
Backhaus (1984) was the first to conduct research regarding the useof the life book in practice. In an exploratory qualitative study Backhausinterviewed 15 social workers who all reported using the life book aspart of preparing children for adoption. Although the workers saw thebenefit in completing the life book, they found that it was a time-con-suming task. Time was needed to engage a child in the process, establisha trusting relationship, gather historical documentation and contactprevious foster parents and relatives.
Impact of Legislation on Adoption Practice
The impact of legislation such as the Multiethnic Placement Act of1994 as amended by the Interethnic Adoption Provisions of 1996(MEPA-IEP) and the Adoption and Safe Families Act of 1997 (ASFA)on adoption practice has recently been examined (deHaymes & Simon,2003; Mitchell et al., 2005; Smith, Howard, Garnier & Ryan, 2006).MEPA-IEP changed practice as it relates to transracial adoption andASFA implemented shortened timelines for permanency hearings andtermination of parental rights, placing a renewed emphasis on adoptionas a permanency option (Mitchell et al.). While neither piece of legisla-tion directly addresses the preparation of children for adoption, bothhave indirect implications for child preparation.
Prior to the IEP amendment of MEPA in 1996; adoption practitionerswere permitted to routinely consider several factors during the prepara-tion of the adoptive parent related to the family’s ability to meet thechild’s cultural, racial or ethnic needs (Hollinger, 1998). With the pass-ing of IEP such routine evaluation is no longer permitted. Preparatorydiscussion regarding prospective adoptive parents’ capacity to meetneeds of a child related to cultural, ethic or racial background may onlybe done in rare circumstances when the needs of the individual child tobe placed warrant it and in many cases, can be documented. A smallqualitative study of transracial adoptive parents; however, indicates thatparents would like more training and preparation to help them effec-tively deal with racism and other transracial issues (deHaymes & Si-mon, 2003). Given this interpretation of the law, it can be presumed thatspecific preparation of the child for a transracial adoptive placement
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would also need to pass the “strict scrutiny test” (Hollinger, p. 23) withworkers providing documentation that there is a need to be addressedand that it is in the child’s best interest to do so. Crumbly (1999) usescase studies to guide practitioners as to how to best prepare a child fortransracial adoptive placement focusing on the preservation of thechild’s racial and cultural heritage. Open communication with the childregarding the racial differences between the child and the prospectiveadoptive parents is encouraged. Compliance with MEPA-IEP would re-quire that such preparation be done after a child is placed in the homeand after it has been identified as a specific need of that individual child.
Of the recent legislative reforms aimed at improving child welfareservice delivery, ASFA has been found to have the most significant im-pact (Mitchell et al., 2005). Since the passing of the law there has been asteady increase in the number of adoptions of children from foster care(Mitchell et al.). Smith et al. (2006) found that in Illinois, since the pass-ing of ASFA the disruption rate has decreased; however, childrenplaced for adoption after having been in care less than one year hadhigher rates of disruption. The authors speculate that one possible ex-planation for this finding is that placing these children so quickly afterthe removal from the birth family does not allow for sufficient time forthe child to “mourn the loss of family and make the emotional transitionto another permanent family” (p. 40). It could also be speculated that theexpedited time frames for permanency mandated by ASFA do not allowsufficient time for workers to provide supportive services to help thechild through the grieving process and prepare the child for thistransition.
Empirical Research on the Effectiveness of Child Preparation
There is very little empirical evidence of the effectiveness of childpreparation for adoption as outlined in the models or guidelines pre-sented. McInturf (1986) echoes the sentiment of most adoption practi-tioners stating that “to place a child in an adoptive home without properpreparation increases the chance of adoption disruption” (p. 385). With-out providing a detailed methodology, McInturf provides evidence ofthe effectiveness of his child preparation model stating that out of 100special needs adoptions in which the child was prepared according tohis model, only five disrupted. Those five children were reported to besuccessfully placed in subsequent adoptive homes.
Many researchers have explored the relationship between character-istics of the children needing adoptive placement and the predictors of
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placement disruption (Barth, 1988; Barth & Berry, 1988; Berry &Barth, 1990; Holloway, 1997; Rosenthal, Schmidt, & Conner, 1988). Ina study of 234 permanent family placements, Holloway (1997) foundthat most of the older child disruptions occurred with children betweenthe ages of 9-16 years. Children of this age can have considerable influ-ence on the success or failure of a placement. Children who have not ac-cepted the reality that they are not going to be reunited with their birthfamily can cause great stress on a new adoptive placement. Hollowaysuggests that these children need appropriate preparation for placementas well as continued support after placement.
As part of a study comparing intact adoptions to disrupted or dis-solved adoptions, McRoy (1999) interviewed twenty-two adoption su-pervisors in one state regarding their perceptions of the preparation ofchildren for adoptive placement. Although there appeared to be consen-sus among the supervisors on the activities and steps needed to preparea child for adoption, only five of the supervisors interviewed felt that thechildren had been adequately prepared for adoption. All of the supervi-sors agreed that adequate preparation of a child for adoption is asuccessful coping strategy for adopted children and families, and contrib-utes to the stability of adoptive placement; however, there is minimalresearch to support this belief. As cited in Festinger (2005), time spentpreparing the child (Boneh, 1979) and pre-placement visits between thechild and family (Boyne, Denby, Keetnering, & Wheeler, 1984; Fes-tinger, 1986) have not been found to be related to the eventual outcomeof the placement. According to Festinger (2005) study results have beenconflicting regarding the impact of having a “good-bye” session withthe child and current caregiver prior to placement. One study found thisprocess to decrease the likelihood of a disruption (Partridge, Hornby, &McDonald, 1986) while the other found these sessions to have no im-pact on outcome (Schmidt, 1986). In a subsequent study McDonald,Lieberman, Partridge, and Hornby (1991) found that group sessionswith the current caregiver reduced the likelihood of disruption whencontrolling for child characteristics known to increase the likelihood ofdisruption such as the age of the child.
The continuity or consistency of workers involved in the child’s lifethroughout the adoption transition period was found to be positively re-lated to the eventual outcome of the adoption (Festinger, 1986 as citedin Festinger, 2005). The risk of adoption disruption was decreased whenthe same worker who prepared the child for the adoptive placement alsosupervised the adoptive placement up to the finalization. The risk of dis-ruption also decreased when the same worker who prepared the child
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also prepared the family. In both cases, it is speculated that this positivecorrelation may be related to the fact that having the same worker is oneless change for the child during this transition period. It is also sug-gested that the worker’s comprehensive knowledge of both the childand family may be an asset to the worker as they help the family copewith and resolve difficult situations that may arise during the trialadoption period.
The importance of the therapeutic process during adoption transitionwas explored in a pilot study of nine children ranging in age from 4-15years old and their adoptive parents (Kriebel, Wigfield, Reilly, Krebs,& Marklin, 2002). The goal of therapy was to help the child understandthe adoption process as well as deal with fantasies about the birth fam-ily. Therapeutic interventions as well as additional services were indi-vidualized to ease the transition to permanency. The results varied withtwo of the children in finalized adoptions, four in pre-adoptive homes,one in long-term foster care and two refusing to be adopted.
After reviewing 120 cases of which 57 had disrupted (broken downprior to adoption finalization) Barth and Berry (1988) concluded thatagencies are not adequately preparing school age children for adoptionand need to provide more life planning services for children. Howardand Smith (2003) in a study of successful adoptive families found thatmost of the adoptive parents were satisfied in general with the prepara-tion their child received for adoption; however, in more than 50% of thecases, adoptive parents reported that many of the basic practices ofpreparation were not completed.
The only study found that explored the quality of preparation foradoption of the older child was done as part of a series of studies con-ducted by the Maudsley Family Research Team in London (Rushton etal., 1998). The study involved 58 placements of children between theages of five and nine who were placed in non-related adoptive homes.The level of casework provided to the children was categorized intothree categories: low, moderate and high. The researchers explored thepossibility of a relationship between the level of casework provided tothe child in adoption preparation and the severity of the child’s emo-tional or behavioral problems at one month and 12 months after place-ment. Taking into account child characteristics that might affect thelevel of preparation the child received, older children were found tohave received a higher level of services. Overall, there was no signifi-cant relationship found between the level of social worker input and thechildren’s problems across the year of placement. The researchers didhowever, find that children with the higher level of preparation had a
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lower mean number of behavior problems within the first month ofplacement than the children with low level of preparation. In discussion,the authors speculate that part of the explanation for a lack of relation-ship overall was the poorly formulated methods of child preparation,citing a lack of training, supervision and legitimization of the impor-tance of child preparation on the part of the social service agency.
In summary, the importance of preparing the child for adoptiveplacement has been cited in the literature since the late 1940’s. Prepara-tion of children for adoption was addressed sporadically in late 1950’sand 1960’s, most often addressed by child welfare practitioners in con-text of adoptive planning and placing the older child for adoption.During the 1970’s and 1980’s stage models using specific tools and tech-niques to help practitioners with the task at hand were presented. Theoverarching concepts and theoretical framework culminated into apractitioner’s guide, A Child’s Journey through Placement (Fahlberg,1991b) which has been used by many; however, there is little evidencethat the recommendations for preparation presented in the literature areconsistently being practiced by adoption professionals. There is also lit-tle empirical evidence that the recommended tools or activities utilizedin preparation are effective or have relationship to the successful out-comes of an adoptive placement. Henry (2005) most recently added tothe literature and is in the process of an empirical study of the effective-ness of her proposed 3-5-7 model of preparation.
METHOD
This study was a part of a project being conducted by The University ofTexas at Austin (UT-Austin) as part of the Collaboration to AdoptUsKids.This was an exploratory study that combined qualitative and quantita-tive research methods. A cross-sectional design was used to assess theperceptions of successful adoptive parents and caseworkers about childpreparation for adoption. Public and private adoption agencies locatedin forty-seven states and the District of Columbia were asked to assist inthe recruitment of a nationwide purposive sample of successful adop-tive families. Participating families were those whose adoption hadtaken place 18 months to five years prior to recruitment. An adoptionwas defined as successful if the adoption remained intact and the adop-tive parents remained dedicated to parenting the child even if the childwas currently in an out of home placement setting. Telephone inter-views were conducted with one adoptive parent per family using a
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semi-structured interview schedule. Adoptive couples were asked toidentify the parent who would remember the most about the details ofthe adoption experience for interview. Interviews with the adoptive par-ents averaged two hours in length, ranging from approximately 45 min-utes to six hours, with longer interviews often being conducted in twoparts.
A subsample of adoptive families was chosen for this study when theadopted child was age 6 or older at the time of placement into the adop-tive home. This age was chosen based on research that found that chil-dren do not recognize or understand adoption as an alternative means ofparenting until the age of six (Brodzinsky, Singer, & Braff, 1984). Fam-ilies were identified for inclusion in the subsample at the time the familyentered the larger study.
As a part of the interview for the larger study, adoptive parents wereasked to recall how the child was prepared for adoption. Specifically,the adoptive parents were asked if their child was the recipient of sixkey adoption preparation activities: completion of a life book, adoptionpreparation groups, pre-placement visits, discussion with the childabout the adoption plan or adoption, pre-placement therapy and post-placement therapy. Adoptive parents were asked if the therapy the childreceived, pre or post placement, specifically focused on loss and griefissues or the transition to adoption. If adoptive parents responded in theaffirmative, probing or clarifying open-ended questions were askedsuch as “please describe the life book.” Respondents were also askedwhich of these preparation activities they believed to be the most andleast helpful to the child. Adoptive parents were asked if there were anypreparation activities the child did not receive that they believed mighthave been helpful. These questions were open ended with probingquestions asked if needed.
Adoptive parents were mailed a survey that collected data aboutthe family’s pre-adoptive placement experience. The study presen-ted here utilized responses from seven questions from this surveyregarding the parent’s knowledge of the child’s history and back-ground prior to the adoption. This set of questions was adapted withpermission from the survey instrument used by Reilly and Platz (2003)in a similar study of successful special needs adoptive families. Of the55 families interviewed, 43 families completed and returned this sur-vey.
Telephone interviews were conducted with corresponding familyand child workers after the interview was completed with the adoptiveparent. Corresponding workers were workers identified by the adoptive
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parents as having worked with the child or family at the time of theadoption. In all 43 workers corresponding to the 55 families in this sam-ple were interviewed. For twelve families this included both a child andfamily worker. In those cases, the child worker was chosen for partici-pation in this study. In cases where only a family worker was inter-viewed, if the worker did not provide any information in relation to thechild’s preparation for adoption, the interview was not included in theanalysis. One worker was identified by two of the 55 adoptive familiesin the sample. The final sample of 26 workers includes 14 child workersand 12 family adoption workers identified by 27 of the 55 families ashaving worked with either their child or their family at the time of theiradoption.
As part of the interview for the larger study, corresponding workerswere asked twelve questions about the individual child’s preparation foradoption. Caseworkers were also asked what adoption preparation ac-tivities they believed to be the most helpful in preparing all children foradoption. The interviews with caseworkers averaged 45 minutes. All in-terviews for this study were conducted by trained members of theCollaboration to AdoptUsKids Research team, tape recorded and tran-scribed verbatim.
Sample
Fifty-five successful adoptive parents of children from the foster caresystem were interviewed as well as 26 corresponding caseworkers whoworked with the child or adoptive family at the time of the adoption.The adoptive families resided in 19 different states and represented 27different adoption agencies, both public and private. Forty-three (78.2%)of the adoptive parents were general applicants and twelve (21.8%)were foster parent or kinship adopters. Thirty-seven (67.3%) of the chil-dren were prepared for adoption by public agency workers and eighteen(32.7%) were prepared for adoption by private agency workers.
The majority of the adoptive parents interviewed were adoptivemothers. The average age of the adoptive parents was 48.37 years, andthe majority (83.6%) of the adoptive parents were White/Caucasiannon-Hispanic. Most (63.7%) of adoptive parents had a college or gradu-ate degree. The average annual family income was $60,000.
The average age at placement for the adopted children in the studywas 8.5 years with most having been placed between the ages of 8 and11. The current average age of the adopted children was 14.2 years withall being over the age of 10. The average number of years the adopted
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children had been placed in the adoptive home was 5.8 years with theaverage length of time for the general adopters being approximately 5.5yrs and for foster parent/kinship families approximately 6.6 yrs.
Over half of the children were of a minority race, and 29% of the 55children were in transracial adoptive placements. Most of the parentsindicated on their information sheet that their children currently had di-agnosed special needs such as Attention Deficit Disorder (with/withoutHyperactivity), Posttraumatic Stress Disorder, Reactive AttachmentDisorder and learning disabilities. All of the children had been removedfrom their biological families due to abuse or neglect. The majoritywere removed for physical neglect. On average the children had spent alittle over four years in foster care and had been placed in at least fourdifferent homes prior to being adopted.
The majority of the 26 workers interviewed were White females be-tween the ages of 30-49. Most (65.4%) worked for public child welfareagencies and most had between 3-15 years of experience in specialneeds adoption. Over half of the workers had a master’s degree in SocialWork.
Analysis
Content analysis of the interviews was conducted utilizing proce-dures identified by Miles and Huberman (1994) and Boyatis (1998). Astart list of codes was developed from the review of the conceptual liter-ature as well as an initial coding of a subsample of 13 adoptive parentinterviews. Twelve trained coders read the entire interview and codedfor the absence or presence of six identified preparation for adoption ac-tivities. When preparation activities were coded as present, descriptivecoding was done to explore the variation in the activities or task com-pleted (See Table 1). The primary researcher and one additional codercoded 80% of the family interviews and 69% of the worker interviews.The remaining interviews were coded solely by the primary researcher.Using percent agreement the average interrater reliability for the adop-tive parent interviews was 92% ranging from 85% to 97%. The code-book for the workers was patterned after the adoptive parent interviewcodebook with the addition of coding for demographic data provided bythe workers during the interview. The average interrater reliability forthe worker interviews was 92.5% ranging from 87% to 99%. During thecoding process, coders identified quotations from adoptive parents andcorresponding workers that might be used to illustrate findings in theanalysis.
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Four multiple regression analyses were conducted to explore factorsthat may explain the variation in the amount of preparation activities re-ported by the adoptive parent. The dependent variable represented thecumulative number of activities the adoptive parent reported the childparticipated in with each activity given equal weight (see Table 2 for listof activities). Independent variables for the analyses were conceptuallygrouped into four factors as the sample size was not large enough towarrant a regression model using all of the variables. These four factorsare system factors, child factors, child welfare history factors and adop-tive parent factors. System factors included the type of agency responsi-ble for preparing the child for adoption (public or private) and the typeof adoption (general or foster parent/kin). Child factors included age attime of placement, gender, race, total number of special needs identified
14 ADOPTION QUARTERLY
TABLE 1. Coding Matrix for Interviews
Activity Descriptors
Life Book Description of the Life BookWhen was Life Book Completed?Who was involved in the completion of the Life Book?
Pre-placement Visits Number of visitsWhere did visits take place?Type of visitsLength of pre-placement period
Therapy pre-placement Type of pre-placement therapyFrequency of pre-placement therapy
Therapy post-placement Type of post-placement therapyFrequency of post-placement therapy
Adoption preparationgroup
Description of adoption preparation group
Discussion with child Who discussed adoption with child?How did the child feel about being adopted?
Overall Preparation Which preparation activities were the most helpful to the child?Which preparation activities were the least helpful to the child?Which preparation activities did the child not receive or not par-
ticipate in that you think might have been helpful to the child?
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and total number of behavior problems reported. Child welfare historyfactors included the number of times the child was removed from the bi-ological family, the number of placements the child had in foster careand the length of time the child was in foster care. Adoptive parentfactors included the adoptive parent’s gender, marital status, race andincome.
Using the same four factors as independent variables, logistic regres-sion analyses were conducted examining differences in the probabilitythat a child might participate in an individual preparation activity. Dueto a lack of variability, analyses were not conducted for the followingactivities: discussion with child, pre-placement visits and adoptionpreparation group. Four separate logistic regression analyses were con-ducted for each of the remaining five individual preparation activitiesidentified in Table 2. For these analyses, the dependent variables repre-sented the absence or presence of the activity.
RESULTS
Overall Preparation Activities Reported
All of the adoptive parents reported that someone discussed adoptionwith the child at some point in the adoption process. All of the generaladoptive parents reported having pre-placement visits; however, asmight be expected only one foster parent/kinship adopter reported hav-
Michele D. Hanna 15
TABLE 2. Presence of Adoption Preparation Activities, n = 55
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ing had a pre-placement visit. Children are more often than not placed infoster care on emergency basis and pre-placement visits rarely occur.
Life books were said to have been completed for 60% (n = 33) of thechildren. Therapy that specifically addressed adoption issues was onlyreported to have occurred pre-placement by 47.3% (n = 26) and post-placement by 50.9% (n = 28) of the adoptive parents. Therapy that dealtwith loss and grief was reported to have occurred pre-placement by 60%(n = 33) and post-placement by 61.8% (n = 34) of the adoptive parents.Other types of preparation activities identified by some adoptive par-ents included sharing of information about the adoptive parents pre-placement such as sharing photos of the family, the home or the neigh-borhood (32.7%, n = 18); good-bye visits with biological parents givingthe child permission to move on to the adoptive family or biologicalfamily supporting the adoption through ongoing contact or visitation(32.7%, n = 18); and the adoptive parents having a prior relationshipwith the child other than that of a foster parents such as a volunteer ortherapist (21.8%, n = 12). Table 2 provides an overview of the presenceof adoption preparation activities reported.
Not all of the adoptive parents were aware of the amount of prepara-tion for adoption the child received. As illustrated by the quotations be-low, the perception for some adoptive parents was that the amount ofpreparation the child received was minimal:
No, none. Just the social worker talking to her in the car on the wayto visits . . . with me . . . she [the worker] would just tell me, she’dsay you know on the way here I explained this to her, on the wayback I explained this to her . . .
(Age at placement, 7)
And it’s funny that’s–I had asked him–we were actually watchinga show, and they were talking about adoption. And I had asked himif they said anything to him. And he said, no. He said that at notime during the 2 1/2 years was it ever discussed about them beingadopted.
(Age at placement, 9)
For others it was clear that the child was well prepared:
They did a life book, they had their goodbye meeting with their bi-ological parents, they had an adoption worker who was talking to
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them about being prepared for a permanent family you know tell-ing them how things would change, they wouldn’t need a team tomake decisions about them and that sort of thing and they wouldjust be in a family.
(Age at placement, 12)
Helping the Child to Understand Adoption
All of the models for preparation stress the importance of helping thechild understand adoption and what is happening to them at the time.According to Brodzinsky et al. (1984) a child’s understanding of adop-tion varies dependent on the child’s developmental stage. As previouslystated, all of the adoptive parents and caseworkers reported that some-one discussed adoption with the child, at some point. While most of theadoptive parents felt certain that a worker (89.1%, n = 49) or a therapist(69.1%, n = 38) discussed adoption with the child, most (92.7%, n = 51)talked about their own discussions with the child.
Many of the adoptive parents described the conversation as a discus-sion about the permanency of the placement, the child’s membership inthe new family signified by changing the last name or telling the childthis would be their “forever” family:
We kind of explained–she didn’t understand forever family. Andshe always thought that she would move again. So we were veryopen about–we took her with us when we filed the paperwork tothe court office. We talked about it and what it meant and what wasgoing to happen to her name.
(Age at placement, 6)
Just about what adoption means. We read books on the subject andhow that meant that she would be with us forever, that she’d al-ways be our child. And that didn’t mean that she couldn’t love herbirth family and that they didn’t exist. Of course, they exist, andwe valued that. And that basically–I mean, one of things that I’vealways said to my kids is that the worst thing that ever happened tothem was the best thing that ever happened to me. So it was reallytalking about how it changed her life, but it also changes our life,too.
(Age at placement, 8)
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. . . about the time she was going to move in with me she wouldwrite me notes like post-it notes and she would stick them in thecar and she would say, “Are you my friend? Yes or no, are you go-ing to adopt me yes or no?” . . . And when she moved in here shehad her own–you know I made a nice bedroom for her and she haseverything you could imagine but the first night she actuallymoved in with me for good she jumped up and down the bed,raised her hands up in the air and said, “Home, home finally I havea home of my own.”
(Age at placement, 7)
At least one of the adoptive parents reported having a more difficultconversation:
Depends on what day you ask her . . . I think that she was more re-signed than anything. It was one of those . . . this is going to hap-pen. I don’t really have a choice about it. So here I am, and I don’tnecessarily have to be nice to this person . . . she has told me subse-quently, that she was waiting for her chance to be able to run away.She was going back to [her town].
(Age at placement, 10)
For some families such as this one, the conversation evolved overtime. Children’s feelings of ambivalence about adoption and attach-ment issues were often apparent in the adoptive parent’s descriptions oftheir attempts to talk to the child:
[Child] let me know from the get go that I wasn’t going to adopthim. He told me he was staying with his foster family and that Icouldn’t be his mother and he didn’t have to listen to me and . . . Ididn’t force him and I didn’t push the issue. He knew what it wasabout, in that the desired end point was placement and then adop-tion. I don’t know if he knew what that meant but having been in somany different homes, I’m sure he thought he would just go backthere, regardless. . . he had no sense of what permanency wasabout. . . as he spent [more time] with me, he got closer. . . with thereactive attachment, that also made him want to run the other way,as he started to get close. . . We talked about it before we went tocourt, you know, and about the sense that we were adopting eachother and that I wanted him to say that he wanted to adopt me, that
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it needed to be a mutual adoption. Because he was adopting me ashis mom and that I was adopting him as my child. And he agreed toit the best he could. He said he wanted, but, it took a long time.
(Age at placement, 6 years)
Completion of the Life Book
Although that the life book is the primary tool recommended in theliterature for child preparation, only 60% (n = 33) of the children werereported to have had a life book completed. The corresponding workersfor 19 of these 33 families were interviewed. While none of these work-ers contradicted the adoptive parents’ report, only 10 (52.7%) could sayfor certain that a life book was completed for the child. A little over half(54.5%, n = 18) of the adoptive parents reported that the life book wascompleted prior to placement into the home. Twenty-two (66.7%)stated that the child was involved in the completion of the life book.Most described the life book as a photo album or a collection of photos(93.9%, n = 31) while only 3 (9.1%) reported that the life book wascomprehensive including photos, important documents, history andmemorabilia (see Table 3).
The importance of having or not having a life book to provide thechild and family with history was expressed by some of the adoptiveparents and evident in these comments:
I feel, going through the kids’ life books with them. . . very muchhelped me to see where these kids had come from, what seemed tobe important to them and be able to carry that over into, once I be-came their mom, that I was aware of their sensitive areas, their ar-eas of concern. Because the life books really do help walk youthrough some of those things as to what really the kids are thinkingor feeling.
(Age at placement, 6)
. . . he said something which is very true but you always forgetwhich is, he said, “I wish I had a baby picture of myself. I wish Iknew what I looked like.”. . . it should be mandatory cause theyhave to have something. How do you just erase your whole child-hood?
(Age at placement, 10)
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Consistent with Backhaus’ (1984) findings, one worker expressed anopinion as to why life books are not routinely completed on every child:
To be quite honest, that’s not one of those things that we–youknow, it’s something that’s really important, but how much timewe have to actually do it is pretty questionable ‘cause we got a lotof kids and a lot of paperwork and you know, the county doesn’tcome in–or the state doesn’t come in–or the feds come in and auditus on whether or not we did life books. They want to know if wedid all this other paperwork. So that sometimes gets put on theback shelf.
Child’s Worker (Age at placement, 8)
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TABLE 3. Adoptive Parent Report of Life Book (n = 33)
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Preparation for Transracial Placement
Twenty-nine percent (n = 16) of the adoptions in this sample weretransracial adoptions. Families were not directly asked if the child wasprepared for placement with a parent who was of a different race; how-ever, one parent discussed her African American/ Hispanic child’s sur-prise that she was white:
Well she did tell me when she met me and she knew I wanted [toadopt]–she was surprised that I was a white woman because sheknew white women but not intimately . . . I don’t think she thoughtabout all the differences and so I think that was, you know, oh, shewas surprised.
(Age at placement, 7)
Comparison of Adoptive Parent and Worker Perspectives
In response to open-ended questions regarding what preparation ac-tivities were most helpful to the adopted child, 46 of the 55 adoptiveparents identified fourteen different activities. The remaining nine par-ents either had no response or stated that all of the activities completedwith the child were helpful. Almost half of the responding adoptive par-ents (45.7%, n = 21) stated that therapy, pre or post placement, was themost helpful. Of the 26 parents responding to the question, “are thereany other preparation activities that [child] either did not receive or par-ticipate in that you think might have been helpful” half (n = 13) statedthat therapy, pre or post placement and specialized, would have beenhelpful. In comparison, workers were asked what preparation activitieswere most helpful to children in general. Nine (30.8%) of the workersidentified therapy, pre or post placement and specialized, as helpful tochildren in preparation for adoption.
The task most identified by workers (50%, n = 13) as being the mostimportant was discussing the adoption plan and involving the child inthe adoption process. Eight of the responding adoptive parents (17.4%)identified this as being most helpful. Adoptive parents saw discussingadoption with the child as being important but from their perspectivethis was primarily explaining to the child what was happening and howadoption would make them a permanent part of their family. Workers,on the other hand discussed involving the child in the decision makingprocess and getting their input as to the type of family they desire. Otheractivities identified by adoptive parents as most helpful included pre-
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placement visits (23.9%, n = 11); slow transition (8.7%, n = 4); comple-tion of the life book (8.7%, n = 4); and the foster parent being supportiveof the placement (8.7%, n = 4). Workers also identified adoption prepa-ration groups (23.1%, n = 6) as most helpful. Nine (34.6%) of theresponding adoptive parents stated that adoption preparation groupswould have been helpful to their child. Life books, pre-placement visitsand the foster parent being supportive of the placement were each men-tioned three (11.5%) times by responding workers.
The difference in perception of preparation pre and post placementwas apparent. Although there is often concern about possible adoptiondisruptions, when workers discussed adoption preparation they did notspontaneously talk about activities done after the child was placed in thehome. Most of the workers discussed preparation for placement and theactual move into the new home. Adoptive parents, on the other hand, pri-marily discussed activities completed either after the child was placed intheir home or after they began contact with the child. It may be thatadoptive parents are not often provided with detailed information aboutpreparation activities completed pre-placement. Workers, on the otherhand, may not consider the activities completed post-placement as partof the preparation process.
Significant Factors Related to Preparation
Multiple regression analyses were conducted to assess which of thefour factors (system factors, child factors, child welfare history factors oradoptive parent factors), were significantly associated with the amount ofpreparation a child received. Only one of the multiple regression analy-ses produced significant results. In the overall model, the systems fac-tors explained 16.3% of the variance in overall preparation (R = .40; F(2, 52) = 5.05, p < .05). Of these system factors, the type of adoption(general or foster parent/kin) was the only significant individual predic-tor of the amount of preparation received (see Table 4). Childrenadopted by general adopters received a greater amount of preparationthan those adopted by foster parents or kin.
Logistic regressions were conducted to assess whether any of thefour factors significantly predicted whether or not a child would partici-pate in any of these specific preparation activities: life books, pre or postplacement therapy focusing on loss and grief, and pre or post placementtherapy focusing on adoption transition. Logistic regressions using twoof the four factors, system and child welfare history, produced signifi-cant results.
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The overall models containing system factors, type of adoption andtype of agency, were found to significantly predict the likelihood of achild participating in pre-placement therapy focusing on loss and griefas well as pre and post therapy focusing on the transition to adoption(see Table 5). While the overall model was found to significantly pre-dict whether or not a child receive pre-placement therapy focusing onloss and grief (p = .029), neither individual factor was found to be a sig-nificant individual predictor. Using Nagelkerke R2 (an R2 estimate),system factors were found to explain approximately 23.9% (pre) and15.1 % (post) of the variance in whether or not children received ther-apy focusing on the transition to adoption pre and post placement re-
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TABLE 4. Summary of Multiple Regression Analysis for System Factors andTotal Number of Preparation Activities Reported (n = 55)
TABLE 5. Summary of Logistic Regression Analysis for System Factors andIndividual Preparation Activities (n = 55)
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spectively. These same system factors explained approximately 31.1%of the variance as to whether or not the child received therapy post-place-ment focusing on loss and grief. At pre-placement, children adopted byfoster parents were found to be 93.2% less likely to receive therapy thatfocused on adoption transition (p = .014). Post-placement, children pre-pared by private agencies were 74.7% less likely to receive therapy fo-cusing on adoption transition (p = .03) and 82.2% less likely to receivetherapy focusing on loss and grief (p = .009).
The child welfare history factors were found to significantly predictwhether or not a child was reported to have completed a life book andwhether or not child received therapy pre-placement that focused onloss and grief, explaining approximately one-third (37.4% & 30.7%) ofthe variation (see Table 6). For every removal from the birth family re-ported, the child was 59.8% less likely to have a life book completed (p =.021) and 47.9% less likely to have pre-placement therapy focusing onloss and grief (p = .032). The more placements in foster care reported,the more likely the child was to have a life book. For every placement
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TABLE 6. Summary of Logistic Regression Analysis for Child Welfare HistoryFactors and Individual Preparation Activities (N = 38)
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reported the child was 2.9 times more likely to have a life book com-pleted than not (p = .017).
DISCUSSION
Limitations of the Study
This study provides exploratory insight and understanding of howolder children in foster care are being prepared for adoption; however,there are limitations to this study that need to be addressed and consid-ered in future research. First, it was not possible to interview a corre-sponding worker for all of the 55 families in the sample due to a lack ofcontact information, turnover in agencies and in some cases, a refusal toparticipate by the identified worker. Also, given the parameters of thelarger study, it was also not possible to triangulate the data with accessto case records or interviews with the children; therefore the validity ofthe data presented are dependent on the recollection of the adoptive par-ents and caseworkers of events that occurred on average 5.8 yearsearlier. While on one hand this is a limitation, the detail in which respon-dents recall the adoption process provides some insight into the signifi-cance that participants assign to these events.
Sample size was a limitation for quantitative analysis. Although astatistical power analysis completed suggested that 55 was the minimalsample size needed for statistical power, (p = .05; r = .30; ES = .715), thelow response rate did not yield a full set of data on all 55 families. All 55families completed a telephone interview; however, not all 55 familiescompleted the mailed survey, therefore some regression analyses weredone using a smaller number (38, 37). Given this low response rate aswell as the amount of missing data, statistically significant findings arereported with caution and cannot be generalized to the larger popula-tion.
Multiple regressions used presumed that a child who participated in allof the identified activities was better prepared than a child who only par-ticipated in one activity; however, given that the quality of the prepara-tion activities was unknown, the analysis offered an incomplete picture ofthe relationship between preparation and the independent variables.
Despite these limitations, the adoptive parent interviews yielded arange of perspectives about preparation activities. Worker interviewsalso added to the understanding of how children are prepared and gaveinsight into the worker perspective of child preparation.
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How are Children Being Prepared for Adoption?
Preparing a child for adoption has traditionally been a process that fo-cused on getting the child ready for adoptive placement. A substantivefinding from this study is that adoption preparation for the child is a pro-cess that may begin before the child is actually placed in the home butextends beyond placement and sometimes beyond the final adoptionhearing. The 55 adoptive parents interviewed in this study supportGrotevant’s (1992) concept of adoptive identity and the life long schemeof identity formation for adopted persons. Adoptive parents reportedongoing issues related to adoption transition and the adopted child’s in-tegration into their homes. Rarely did a caseworker discuss the role theadoptive parent played in preparation. When discussed, it was in rela-tion to those adoptive parents who had a preexisting relationship withthe child prior to being considered as an adoptive resource. The resultsof this study suggest that adoptive parents play a pivotal role in the con-tinued preparation of the child for adoption beginning with the first timethey meet the child during pre-placement visits.
Most child adoption preparation models are theoretically based onthe need to help a child understand why they could no longer reside withtheir biological family and why adoption is now the case plan goal.Models emphasize permanency and the need for a child to understandthe difference between foster care and adoption. These models arephilosophically in line with current legislation such as the Adoption andSafe Families Act (ASFA) that mandates expedited times to perma-nency for children in foster care; however, the models require time andconsistency from social workers responsible for preparation. From theperspective of the adoptive parents, preparation ranges from minimal toextensive. The results of this study suggest that there is little consis-tency in the way school age children are being prepared for adoption.
Children adopted by general applicants were found to receive morepreparation than children adopted by foster parent/kinship adopters. It ispossible that these children are not seen as needing preparation giventhat they do not physically move from one home to the other. This studysuggests that foster parent/kinship adoptive parents feel that their chil-dren also need assistance understanding what is happening and whatadoption means. Many of the adoptive parents in this study, both gen-eral and foster parent/kinship, discussed how important it was for thechild to understand that adoption meant they were now a permanentmember of a “forever” family.
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Theoretically, the child’s developmental stage and age at time ofplacement should play a significant role in the way a child is preparedfor adoption (Brodzinsky et al., 1984). Rushton et al. (1998) found theage of the child at placement to be a significant factor in the level ofpreparation the child received. The results of this study did not supportthis finding. Age at placement was not found to be a significant predic-tor of the number of adoption preparation activities reported nor was itfound to be a predictor of the presence or absence of any of theindividual preparation activities.
Resolving issues of separation, loss and grief are paramount for chil-dren transitioning to adoption (Fahlberg, 1991); however, only 60% ofthe children were reported to have received therapy to address these is-sues either pre or post placement. Only 47% of the children werereported to have received therapy specifically addressing adoption tran-sition pre-placement and 51% post placement. It is possible that therapyboth pre and post placement focused more on stabilizing the child’s be-haviors and maintaining both previous foster and the adoptive home;however, it is also worth considering that many of the negative behav-iors children exhibit may be due to a lack of resolution of these issues.Children who were prepared by private agencies were found to be lesslikely to receive therapy that specifically addressed either of these is-sues. This is a significant finding considering that adoption and fostercare services are most often the first child welfare services contractedout when states move towards privatization (Freundlich & Gerstenzang,2003).
Many of the adoptive parents as well as the workers in this study re-ported a need for specialized therapeutic services for children related toissues of attachment. The child’s attachment style and ability to attachto a new family is often related to the number of placements the childhas had in foster care (D’Andrade, 2005; Smith & Howard, 1999). At-tachment may also be a major consideration for children who experi-ence several removals from the birth family. The results of this studysuggest that both of these factors play a role in the adoption preparationa child receives. Children with more removals from the birth familywere less likely to have therapy pre-placement that focused on loss andgrief. It is probable that the chaotic state of being reunified with the bio-logical family and then subsequently removed two, three or more timesmakes it difficult for a child to consistently receive therapeutic services.
Life books are the primary tool recommended for preparing childrenfor adoption (Fahlberg, 1991b; Jones, 1979; McInturf, 1986); however,only 60 % of adoptive parents reported that their child had a life book
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completed. Children with more placements in foster care were morelikely to have a life book completed, while children with more removalsfrom the birth family were less likely to have a life book completed. Onthe surface this may seem like a contradictory finding; however, whentaken into account the premise that the life book is primarily a tool tohelp maintain connections to birth family and the past, it is not surpris-ing that children who were returned home were found less likely to havea life book. Life books tend to be completed when children are not ex-pected to return home and are placed for adoption and therefore, maynot be seen as a priority for children who are going home. Also, fosterparents are often the ones responsible for completing and maintainingthe life book when the permanency plan is not reunification; therefore,it is not surprising that children in more foster care placements weremore likely to have a life book.
Surprisingly, a minority of the adoptive parents and workers consid-ered the completed life book a helpful preparation activity for the child.Life books as outlined in the literature (Fahlberg, 1991b; Jones, 1979;McInturf, 1986) are a therapeutic tool used in tandem with discussionwith the child about their past, their foster care history and their hopesfor the future. The majority of the life books completed for children inthis study were described as photo albums or scrapbooks. A small per-centage (33%) stated that the life book included information about thechild’s placement history or child abuse/neglect history. At least oneworker suggested that other case management responsibilities and man-dates take precedence over the completion of a life book. The results ofthis study suggest that agencies consider ways to support and foster thecompletion of life books for children prior to adoptive placement. Thismay include dedicating staff to preparing children for adoption whichincludes routine completion of the life book, providing staff with train-ing on the importance of life books and the impact on the child andadoptive family, internally auditing cases for life book compliance, orpurchasing services contractually for the completion of the life book.
CONCLUSION
The findings from this study suggest that adoption preparation ofschool age children varies widely. While quantitative measurement ofthe quality of preparation activities was not possible, the qualitativeanalysis of the data suggests the need for better, more consistent ser-vices. The review of the literature shows that adoption professionals are
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generally aware of the theoretical concepts that support the need forgood preparation for adoption. All of the adoption preparation modelsfound in the literature suggest that children need to process loss andgrief related to the removal from their birth families to ensure healthyattachment to the new adoptive families. Although not generalizablegiven the small sample size, the findings from this study suggest thatadoption agencies, both public and private, may need to assess the ade-quacy and effectiveness of how they are addressing these issues withschool age children.
This study also has implications for how caseworkers and otheradoption professionals define preparation for adoption. From the adop-tive parent perspective, preparation does not end at placement into theadoptive home and the adoptive parent plays a vital role in the contin-uum of preparation up to and including post finalization. As children arebeing transitioned into adoptive homes, workers may want to consider aredefinition of the role of the adoptive parent in the preparation process,seeing them as a member of the preparation team as opposed to simply arecipient of a child.
Findings from this exploratory study support the need for future re-search closely examining the concept of adoption preparation as a con-tinuum of activity beyond placement of the child in the adoptive home.The variation in preparation warrants further research on the effective-ness of preparation activities to provide practitioners with more sys-temic guidance as to how to best prepare children for adoption.
Adoption is a life long experience. The importance of the preparationa child receives as they begin this life long journey should not be mini-mized. Social workers and other adoption professionals should con-tinue to explore the relationship between adoption preparation andoutcomes not only for the adoptive family but also for the adopted adult.
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Received: 12/21/061st Revision: 06/15/07
2nd Revision: 08/17/07Accepted: 09/02/07
doi:10.1300/J145v10n02_01
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