Forced adoption support services scoping study Daryl Higgins, Pauline Kenny, Reem Sweid and Lucy Ockenden Report for the Department of Social Services by the Australian Institute of Family Studies February 2014

128.6Individual vs systemic responses

Individual responses (trauma counselling; services to assist with finding and making contact with family)

vs

Systemic responses based on restorative justice principles (including implications for current adoption, donor insemination and surrogacy)

What proportion of the funding should go do redressing the harms for individuals vs advocacy to make systems change, and possibly prevent harms to future generations?

128.7Trauma model vs grief/attachment

Confronting or avoiding different fundamental views of past adoption and the conceptual underpinning of services: e.g., “adoption triangle” or “triangulated model” as it is sometimes termed by detractors (which is seen as part of—or sympathetic to—the current “pro-adoption lobby”).

vs

Seeing the separation of parent and child as an inherent trauma

Many of the current state-funded post-adoption services are seen to be compromised by some stakeholders, who have expressed reluctance to seek services from these agencies because they consider them as compromised and don’t want to risk being re-traumatised.

Accepting the view that separation is an inherent trauma (rather than “potential trauma”) excludes the minority (even though still a substantial group) of people who do not report having been traumatised by their adoption experience (e.g., around 1/3 of adopted persons who participated in the AIFS National Study (Kenny et al., 2012))

Some stakeholders present it as a divide between viewing the adoption experience as “grief and loss” (and thereby diminishing its fundamental impact on their lives) vs “trauma”. However, there were many examples of service providers, and other stakeholders who were able to accept the range of ways in which past experiences can affect present functioning (e.g., grief/loss, attachment disruption, and trauma), and that there is place for using different theoretical/conceptual tools for understanding harms (and formulating therapeutic responses), and recognising that even though different labels are used, many of the conceptual underpinnings actually have a high degree of commonality. The evidence in the literature favours service settings that address multiple or co-occurring conditions, for example mental health, trauma and substance abuse, through an integrated approach, rather than service settings that treat each symptom separately from the underlying experience—forced adoption—through the use of different professionals, treatment plans and service systems.

128.8Scope of knowledge translation/exchange functions

Basic, passive website (pointing to existing agencies and resources).

vs

An active knowledge translation/exchange service, which functions as a conduit for information, actively engages with stakeholders, and creates quality-assured, evidence-based materials and resources.

Unless the responsibility for hosting sits with an agency actively operating and networking in this space, the content is likely to become out-of-date, and it will rely on passive usage, rather than developing and implementing active stakeholder engagement strategies and communication plans.

Although needing to have expertise, such an agency would need to be seen as “neutral”. If the agency was involved in current service provision, it may be viewed as a conflict of interest. A knowledge translation/exchange may be better placed in the research/academic sector, but would need strong skills in research translation, and engagement with policy and practice (i.e., expertise and experience in knowledge translation and exchange).

Many of the other options either rely on, or would be enhanced by, a central web portal within an active knowledge translation and exchange service.

128.9Role of National Committee of Post-Adoption Service Providers

Confirm the existing role of the National Committee of Post-Adoption Service Providers—focused on state/territory departments and the NGOs they fund to provide Adoption Information Services (AIS).

vs

Seek to expand the membership and role of the National Committee of Post-Adoption Service Provides by providing funding and/or support (e.g., secretariat support) to play a more active and regular role in coordination and dissemination.

Could expand membership to include other adoption-support services not funded by states/territories (including peer-support groups), and other key stakeholders such as BDM registries and relevant Australian Government departments (Social Services, Human Services and Health).

Given the fragmented nature of the sector, the inclusion of peer-support groups would be highly contentious. It would massively expand the number of representatives and therefore the running costs if support was to be provided for travel, if training/conference opportunities were provided in conjunction with meetings, and if the frequency of meetings was increased.

However, to exclude peer-supports would also be contentious, and risk the entire service model being “rejected” by stakeholders.

A compromise might be to include peer supports in the local networks, and ask local networks to manage membership and attendance at National Committee meetings.

The National Committee (or more efficiently, a subgroup appointed to take on this task) could act as an expert advisory group to the KTE functions, and play a role in providing feedback and endorsing products and services that are produced or promulgated through the proposed KTE national web portal, and through the proposed local service networks (e.g., publications, training materials, evaluation resources, etc.)

For a copy of the current draft terms of reference that has been considered through COAG processes, see Attachment M.

128.10Organisational capacity vs service delivery

Aiming funding at direct service delivery for professionals engaging in evidence-based or evidence-informed services.

vs

Focusing funds on resources, training and supports to enhance the organisational capacity and skills of workers, including peer supports.

Currently, there is little focus on provision of services that can demonstrate an evidence base compared to other sectors such as veterans’ counselling, where there is a knowledge translation and exchange unit that synthesises the evidence base around what works in trauma-based therapies for PTSD and other mental health consequences of active military service.

Therefore, its hard to know whether simply providing more funding to current services to do what they already do will have the desired effect. In contrast, development and promotion of good practice principles, and synthesis/dissemination of the research evidence relating to broader therapies for grief, trauma, loss and attachment disruption will build the capacity of existing services—both mainstream and adoption-specific.