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

26.1Service utilisation

There is limited evidence existing outside of the AIFS National Study (2012) and the Senate Inquiry report (2012) that specifically targets service utilisation by those affected by forced adoptions. This section of the literature review presents information regarding the use of services by those affected by forced adoptions as described most predominantly by Kenny et al. (2012).

The AIFS National Study (Kenny et al., 2012) reported varied experiences from the respondent groups in both the type of service used and levels of satisfaction with that service. The most predominant service types reportedly used by study participants were information, search and contact services, peer-support groups, and formalised counselling from a private provider. The study found:

more than half of adopted persons and almost 70% of mothers had used information and/or search/contact services;

mothers and adopted persons also used support from peers and one-to-one psychological counselling;

fathers had little support from formal services;

some relied on support groups and others relied on search and contact services only; and

other family members most commonly accessed formalised counselling services, as well as informal support from family and friends.

27Information, search and contact services

Numerous services exist nationally that provide assistance for people affected by past adoptions to access their adoption records. In addition, short-term counselling on the receipt of adoption information, and assistance with search and contact may also be provided.

For participants in the AIFS National Study who had used such services, varying levels of satisfaction were reported. While 76% of mothers in the study who had tried to find information about their son/daughter from whom they were separated said that they had used the services of an information or contact/reunion agency, less than 20% indicated that this type of service was one they had used as a source of support. Although most of this latter group found these services to be either somewhat helpful or very helpful, qualitative accounts of the use of information, search and contact services more generally, showed high levels of dissatisfaction with such services.

Almost 90% of adopted individuals in the study had tried to find information about their families; however, just over half (53%) indicated they had used information and/or search and contact services. The experiences of using these service types were generally more positive than those of the mothers in the study, however there were still significant issues reported by participants, some of which are highlighted below.

The Senate Inquiry (2012), the AIFS National Study (Kenny et al., 2012) and the NSW Parliamentary Inquiry (2000) outlined a number of barriers for those trying to access information, including:

cost—having to pay for information and copies of documentation about their own birth or the birth of their children;

long delays in obtaining adoption information;

difficulty in navigating the search and contact “system” (or systems), particularly when conducting searches in other states or territories;

encountering negative staff attitudes, inexperience, and lack of sensitivity and professionalism (suggesting significant workforce training and development is needed); and

lack of support for individuals trying to access records and lack of ongoing counselling support or guidance throughout the search and contact process, and afterwards—for example, before, during and after the reunion or connection.

The Senate Inquiry (2012) noted that this lack of support works against an individual’s rights to know information about their own family. They concluded:

Complicating factors surrounding access to information can include uncertainty about when and where the adoption took place, and the situation where an adopted person has two birth certificates that are sometimes not accessible to those conducting the search. (p. 273)

The Senate Inquiry report (2012) recommended that the Commonwealth extend the existing program for family tracing and support services to include adoption records and policies, with organisations such as Link Up Queensland and Jigsaw used as a blueprint (see p. 273).

28Counselling and mental health care services

According to the literature, counselling and mental health care services can perform a range of functions for those affected by forced adoptions:

a way of providing concrete reparation;

support for general difficulties, often described as “ongoing trauma”, which can be experienced continuously, periodically (in response to external events, or “triggers”), or at “random” and include clinical diagnoses such as depression, anxiety, and PTSD;

help clients deal with emotions such as grief, loss, guilt or loneliness;

support clients with forming and maintaining positive relationships with others, including partners and subsequent children, with family and relationship breakdowns, and with parenting difficulties;

support clients construct a positive personal identity;

provide support for clients dealing with feelings of loss, abandonment and grief;

provide support for clients presenting with physical health issues (including disabilities), and substance abuse; and

provide support for clients presenting with mental health problems or trauma “triggered” by contact/reunion processes.

Specialist post-adoption support services offer a range of services including counselling; however, the most common type of formalised support used by mothers as reported in the AIFS National Study was that provided by a registered psychologist or psychiatrist (29.1%) or a social worker or counsellor (22.2%). Just less than one-fifth of participating mothers reported the use of a registered adoption support service (18.6%). Adopted persons were likely to have used the support of a registered psychologist or psychiatrist (25.4%), relatively equally to that of an adoption support service (23.7%). Similar numbers of participants indicated obtaining support from a social worker or counsellor—around 21%. Of the mothers who had received support from a registered psychologist or psychiatrist, they were likely to have found these services to be either very helpful or somewhat helpful, and similar results were found for the smaller number of participants who had used a registered adoption support organisation for support. With high levels of formalised support services used among adopted individuals in the study, it was more commonly reported that services were somewhat helpful, rather than very helpful in most instances (Kenny et al., 2012).

Both the AIFS National Study and the Senate Inquiry identified that specialist training in adoption-specific grief and loss counselling for mental health professionals as an important service provision need for supporting people affected by forced adoption.

29Peer support

Peer-support groups are typically run and facilitated by members who have had a personal experience of forced adoption. The types of services that may be included are regular group meetings, online forums, information sharing and advocacy.

The Senate Inquiry (2012) provides a succinct definition of peer supports in the context of past adoptions:

Peer support groups are often formed amongst people with a shared experience of having endured particular suffering. These groups are attended and often facilitated by individuals who have experienced the same or similar trauma to those seeking help. Members have a special connection through their shared testimonies and can relate to each others’ life-story in a unique way that they feel counsellors and other trained professionals are not able to. Support groups also facilitate the giving of useful and practical advice borne out of real-life experiences and the wisdom of others who are on a similar path to healing. (p. 226)

Around one quarter of mothers who participated in the AIFS National Study reported that they had used a support group, and most were likely to have found the emotional support they received as being very helpful. Adopted individuals reported much lower levels of use of support groups—just under 13%, but similar to mothers, they found the emotional support provided in this setting to be predominantly very helpful.

Kenny et al. (2012) reported:

Many respondents from across the different participant groups saw the value of peer support. It can be a safe space where there are others with shared experiences. However, some of the issues people have had were if there were competing interests or needs within the group (particularly if both “birth” parents and adoptees were in the same group), the lack of regulation, quality of facilitation, and the distance of venues. (p. 177)

Both the Senate Inquiry (2012) and the findings from the AIFS National Study (Kenny et al., 2012) acknowledged that there is a role for peer support in the delivery of a service model for people affected by forced adoptions. The NSW Parliamentary Inquiry (2000) also noted the importance of support groups in offering a valuable service for people looking for support among those who have shared similar experiences.

However, in examining the role of peer support in the support service network, the Senate Inquiry (2012) concluded that:

Some individuals are greatly assisted by peer support groups, and others are not. The committee believes that, for counselling purposes, government funding should be made available only to qualified counsellors. It believes that it may be appropriate to fund peer support groups for other activities, such as information-sharing, documenting of experiences, or assistance with information searches and memorial events. (p. 231)

30Service and support needs

Having examined some of the experiences of those who have used support services to assist with the impacts of past adoptions, messages that were identified by the different respondent groups in the AIFS National Study (Kenny et al., 2012) in relation to their current service and support needs are summarised below.

Mothers

The key areas of service provision needs identified by mothers were:

access to appropriate and targeted mental and physical health services to deal with the consequences of trauma and other ongoing impacts of their adoption experiences;

opportunities to tell their story;

venues and forums for connecting with others affected by past adoptions—including peer-support options;

assistance with making contact with family—such as access to “Find & Connect” or similar style services staffed by trained and experienced professionals;

access to targeted and specialised counselling to assist with responses to making contact or trying to establish a relationship with their son/daughter from whom they were separated by adoption;

ongoing counselling provided by trained professionals that targets the specific needs of mothers including issues associated with trauma, identity as a mother, attachment, grief, loss, guilt, and loneliness; and

access to information about their child’s birth, including hospital/maternity home records, and original birth certificates.

Adopted persons

The key areas of service provision needs identified by adopted persons were:

access to their own information, such as original birth certificates (preferably through a national, centralised system) and medical histories of their family of origin, regardless of contact/information vetos;

opportunities to tell their story to increase public and service professional awareness of their particular experiences and subsequent needs;

venues and forums for connecting with other adopted persons as a means of validating and normalising their experiences;

assistance with making contact with family—such as access to “Find & Connect” or similar style services staffed by trained and experienced professionals;

supportive counselling while making contact, trying to establish a relationship with families of origin and navigating the complexities of such newly established relationships; and

ongoing counselling provided by trained professionals that targets the specific needs of adopted persons, including issues associated with identity, attachment and abandonment.

Fathers

The key areas of service provision needs identified by fathers were:

opportunities for their voices to be heard about their experiences, given the often overlooked/neglected recognition of their place in the adoption circle;

opportunities to connect and engage with other fathers who were disconnected from children through adoption;

establishment and promotion of peer-support groups for fathers in order to encourage engagement;

supportive counselling to assist with responses to making contact or trying to establish a relationship with their son/daughter from whom they were separated by adoption;

assistance with making contact with family—such as access to “Find & Connect” or similar style services staffed by trained and experienced professionals; and

making records accurate—including retrospective inclusion of their names on their child’s original birth certificate.

Other family members’ perspectives

The key areas of service provision needs identified by other family members were:

support to help them deal with traumatised family members;

assistance and support with contact and reconciliation with “the lost” relative;

public acknowledgement and greater awareness of past practices and their impacts; and

improved access to information about the family of origin—for example, medical history.

Service providers’ perspectives

The key areas of service provision needs identified by service providers were:

financial support for the development and conduct of training, materials and resources in adoption-specific issues, and to improve access to counselling services for people affected by past adoption practices;

greater awareness of the underlying issues caused by past adoption experiences and the services available;

greater awareness in the media, government and related agencies to validate the experiences of those affected by past adoption practices; and

the development of a system-wide network that connects people to counselling services, support services and related services.

The following section will now examine the literature as it pertains to treatment interventions that may be considered appropriate in addressing the psychological and emotional needs of those affected by forced adoptions.