In February 2016, Beth Neil, Professor of Social Work at the University of East Anglia, wrote a piece for this website explaining that she and her colleagues at UEA, Professor Gillian Schofield and Dr Mary Beek had been working with colleagues from CoramBAAF and Great Ormond Street Hospital to plan a practice development project connected with supporting children’s moves to adoption.  Here is an update on the progress of this project.
Moving to Adoption: the development and piloting of a practice programme
The Moving to Adoption project started in September 2016, funded by the Sir Halley Stewart Trust.  The aim of the project was to develop and pilot a practice programme for social workers involved in supporting children’s moves to adoption.
The first stage included individual consultations with professionals, foster carers and adopters who had offered to share their experiences and ideas with us, along with focus groups for experienced foster carers and adopters and a stakeholders’ consultation group. 
This consultation process revealed national variation in practice connected with moving children to adoption.  Some agencies were more flexible around planning the move, particularly in relation to timescales and the role of the foster carer after the move.  Others were less flexible; moves were more rapid and the role of the foster carer limited, sometimes ending very abruptly. It became clear that managing separation and loss for the child in order to provide a good foundation for building trust in the adoptive family has often not been given the attention it needs. We concluded that there was a need to look in more detail at how practice can be developed and this led us to the second stage of the project:  the development of the practice programme.
The practice programme is designed to be used by adoption, fostering and children’s social workers.  It draws on theory, research and existing good practice and is underpinned by the Secure Base model https://www.uea.ac.uk/providingasecurebase/the-secure-base-model .
The practice programme identifies three stages of a child’s move to adoption.  These stages span the period before, during and after the move, suggesting a shift from the traditional focus on the introductions as the critical element of the move.  The three stages and some key issues for foster carers and adopters during these stages are as follows:
Stage 1: From placement in foster care to the link/match being identified
Foster carers

• Provide a secure base in short-term care – to maximise the development of the child
• Provide fully committed parenting and hold in mind that the child will move
• Manage uncertainty about the move – and help the child to do so

Adopters

• Understand the value of secure base relationships in the foster family
• Think about how to support children to manage loss and build trust
• Understand the significance of the foster family in children’s life stories

 
Stage 2: From the link/match being identified to the 4 month post placement review
Foster carers

• Provide full information about the child’s physical and emotional needs
• Sustain emotional warmth and availability and support the child to prepare for the move/build trust in adopters
• Tune in to child’s thinking and feeling and report back to professionals

Adopters

• Maximise their understanding of the child’s physical needs, thinking and feeling
• Build the child’s trust at a pace that is comfortable for the child
• Think about and respond sensitively to the child’s sense of loss but also parent with confidence

 
Stage 3:  From the 4 month review, onwards
Adopters

• Continue to build secure base relationships with the child
• Balance family life with professional involvement, as needed
• Recognise and support birth family and foster family connections

Foster carers

• Acknowledge and manage loss and grief, for all family members
• Cope with repeated loss without becoming detached

 
The practice programme promotes a flexible approach to planning each move to adoption, placing the child’s emotional needs at the centre, while also supporting the foster carers and the adopters. The programme suggests the following ‘key principles’ are held in mind when helping children to move:

• A positive relationship between the foster carers and the adopters is helpful to the child
• The timescale for the move should meet the needs of the child
• There needs to be overlap between the child’s current and new relationships, to enable trust to build gradually
• The child’s feelings should be held in mind and responded to sensitively
• Some continuity of environment and relationships will support the child in building trust

The practice programme is now being piloted in two Local Authorities and the pilot will run until July 2018.  The research team will hold four workshops in each agency to support implementation, and to gather feedback that will help to develop the practice programme.
At the end of the pilot we will have information on a complete cohort of adoption plans and placements for these two agencies, providing a much more detailed understanding of a wide range of children and the process of making the move to adoption.
 The aim is to influence practice both during, and after during project period.  A final report of the project will be prepared in 2018, including practice implications for all parties.  This, along with further consultation with stakeholders, will inform next steps regarding publications and further implementation and evaluation. 
We would like to thank, most sincerely, everyone who responded to Beth Neil’s request for innovative practice and ideas.  Your contributions helped to get the project started and will continue to feed in to the development of the practice programme.  We will provide a further update for this website in 2018.
Dr Mary Beek: m.beek@uea.ac.uk 
Professor Elsbeth Neil: e.neil@uea.ac.uk
Professor Gillian Schofield: g.schofield@uea.ac.uk
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Source: nomorethantwenty.wordpress.com/2017/04/01/the-final-insult/

I have a feeling I’m about to wade into an area that has nuances and textures that I don’t appreciate. In which case I’d prefer to position this post as an in-principle perspective. In other words, in an ideal world my position may be correct, but where ideal and real worlds meet the same position could not always be held. I should also state that our LO had only one set of foster parents from 10 months old to 3 1/2, and this will have skewed my perspective.

I had the great fortune to speak at conference for the Welsh National Adoption Service in Cardiff this week, and the even greater fortune to follow Lynne Cudmore, co-author of ‘The children were fine’: a report on the “complex feelings in the move from foster care to adoption”.

Not only was Lynne the most wonderful speaker, whose gentle but powerful style must have come directly from her Welsh forebears, but her subject matter filled me with the kind of passion only the righteous in a Merthyr Methodist chapel could have felt.

Lynne’s insight was on how the focci of the transition during introductions shifts subtly away from the child to the ‘process’, and how following that, in the ‘quadrat’ of adoption, the primary and defining relationship becomes between the birth family and the new adoptive family, with the foster carers moving from Mum and Dad to dutiful professionals. And how all these movements can deny the child the opportunity to grieve in a healthy way the pain of another severance.

I hated introductions. Everything about it felt wrong. It felt designed by a project manager with the goal to “get it all over with”. I didn’t get a sense that this process had been designed over many years with the extensive support of those who understood severance and grief. Just the well-meaning. I just couldn’t understand how you could read Dan Siegel or Nancy Verrier and then agree to move a child from their own hard-won precarious, sense of permanence to severance and then back to “permanence” within 7-10 days.

I couldn’t understand why the general consensus was that we should “leave it a few months” before seeing the foster parents again.  Just to make sure, I guess, that the child genuinely believed they were unwanted – as opposed to simply fearing it.

I couldn’t understand the language of “choice” in deciding whether to have future and on-going contact with the foster family.  As if it was our choice to make. As if the feelings that mattered in this were mine and my husband’s – and not our son’s.

I couldn’t understand how we could learn that feelings expressed were always better than feelings oppressed and then have it suggested by others that if contact with foster parents caused our LO distress we may consider stopping it. As though being able to say “Leaving the foster-parents seemed to have little effect on Jonny” was a good thing.

I still don’t understand how we can know that our children take each severance as a rejection of their very self and then accept it when we hear of a foster family who refuse contact with their previous wards because it “upsets them”. It makes me mad. Who cares how they feel.

In medical terms an insult is a physical or mental injury, and in many senses a trauma is also an insult to the brain – causing the formation of pathways that may not be beneficial to the child. Is the way we currently manage that transition simply the final insult?

I’m a nice person. I understand and empathise with the complexities of feelings this transition creates. However I’m not so liberal that I think that the feelings of the adults  affected by the movement into adoption matter that much.

I feel astonished that we have learned so much about neuroscience, trauma and attachment and yet design a process and make decisions that we must know deep down are more about adults and systems than children and feelings. I believe that as we learn more we will recognise that our good intentions in balancing the needs of all parties in the transition to ‘permanence’ we may in fact be harming again – but with our gentle hands.

Please don’t be offended if you have navigated this process with sensitivity and empathy and reached a different decision – fully in the interests of your child. Your child may have had multiple foster-carers, or those who fostered but didn’t care. They may have taken a brisk professionals who swept in and swept out. There are many reasons why contact may not be healthy, and I do not know your life. Forgive me if I make wild sweeping judgements on others – no two situations can ever be the same. But I do believe changing the way we look at adoption, and specifically this transition where we have an opportunity to be more intelligent, more informed and more child-centred, means we may need to accept that we have been part of the problem we spend our lives trying to fix – and that there is a better way.

​Please visit Jayjayell's website and Twitter account, as his post has had some really great feedback.

We were delighted to take part in CoramBaaf's Autumn conference, which was devoted to discussing ways of improving transitions from fostering into adoption.
The conference was lively and well attended and it felt as though everyone present shared many concerns about current practice,  and a desire for and commitment to change. Many new and innovative schemes and policies were discussed, as well as some very moving descriptions of the emotions involved from first-hand presentations from adopters and foster carers.

There was a spirit of hope and excitement about the future and a real commitment to improving this area of policy so that children's feelings are kept centre stage every step of the way. This is going to be a challenging task and there will never be a straightforward answer. Nevertheless it feels very positive that these things are beginning to be taken more seriously, and the complexities really taken on board. We are very glad that CoramBaaf devoted their conference to this topic,  and came away feeling much more hopeful about the future.

Here are some excerpts from recent feedback we have received. These contributors have asked to be kept anonymous.

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We had looked after our little girl for two years when she went to her adoptive parents. We requested if it would be possible for us to keep in touch with her. We were fortunate and lucky enough that her adoptive parents accepted this and the role that we had had in this little girl’s life. It is also with the clear knowledge that if it was detrimental to her that we would not continue with it. This was six years ago and we still meet up a few times each year to catch up swap birthday/Christmas gifts. She is now attached to her parents and is still happy to meet us and remind her mum about it too if too much time has passed.
 (Foster carer)
 
Please keep up this research. It needs to be proven that the foster carers have a significant role in these children's lives whether they are adopted or moved to other foster carers. There is bereavement for the child as well as the foster carers attached to each loss whether it be a positive or negative move. Anything done to salvage each bit of positive relationship is worth it in the long run building the child's resilience and more importantly trust in others. 
 (Foster carer)
 
Our little girl we always insisted that we would see her foster family and went against the social workers advice and saw them earlier (about 8 weeks) …  no dramas, and have seen them multiple times since.  In fact, she missed their son more as she was more lonely at home without someone to play with.  …. Not being able to go to her birthday party was just silly and a year later we have forged a more natural arrangement which again goes against the grain, so they see each other in holidays and go to each others parties etc. Like a normal family member rather than a formal arrangement.
(Adopter)
 
Sometimes I think adopters think more about themselves and not the wishes of the children. They are so busy in the "our family, go away now" mode, whether that be nervousness about being seen as their parents, a question of jealousy or burying head in the sand.
 
Best of luck with the research! Changing the attitudes of especially first time adopters is key so they aren't scared of the extended family, and realise what benefits it can bring.
 (Adopter)
 
 
Even before introductions foster carers are made to feel unimportant and are not allowed to know the address of adopters, despite introductions taking place in the home of the foster carers. We did not get to see our foster child for five months.  When we did meet up, he was overjoyed to see us and our children.  Unfortunately since then we have received no further contact. All foster carers are advised that they are not allowed to phone or email the adopters. The adopters have to make contact. 
 
We had no problems at all during introductions or during the meet up.  We can only presume that they feel insecure. However we would dearly love our foster child to know how precious they are to us! We loved her every bit as much as our own children, who have had to come to terms with the fact that they will not be a part of this little girl’s life and will probably never see her again.
 
Please please disseminate your research! Foster carers do an amazing job! Change attitudes, starting with the social workers and then move onto the adopters!!
 (Foster carer)
 
 
Before introductions my wife was very concerned that she would cry when the time came to say goodbye to the child. She did not want to upset the child. …  On the day the child left, the social worker commented how well the child coped.  It is only after reading your research, that I realise that she was just being compliant!  Heartbreaking!  no-one is looking after the emotional needs of these children, when they move from foster care.
 
I would be overjoyed if you could be some sort of catalyst for change.  As foster carers, we are powerless!
 (Foster carer)
 
 
We fostered a girl for nearly 3 years. ….It took a lot longer than expected to get an adoptive family and by which time she had become a very special member of our family. She met the adopting couple on a Monday and saw them for a couple of hours … every day for 5 days. There was no contact over that weekend and then they took her to see their home on the next Monday. On Tuesday they came and took her forever. We have more or less been 'dumped' and it’s like a death in the family. I rang her SW and was given the minimum of news and worry constantly that she is experiencing the same feelings as us and having a total ban on hearing anything about us. I'm totally in favor of the adoption and did my best to make the move go as smoothly as possible and I understand that she needs to be allowed to settle in but I cannot see how it can help either her, or us, to have just totally disappeared out of each others lives. Because of my experience I'll never long term foster again.
 (Foster carer)
 
 
I totally agree with further training and support with prospective adopters around attachments and the importance retaining meaningful contact.
 (Foster carer)

Lynne will be giving a paper at this study day being held by Tavistock Relationships (formally the Tavistock Centre for Couple Relationships) in London on 2 December. Entitled "From Private to Public: Pathways to Parenthood via Fertility Treatments and Adoption" , the day will focus on the experience of couples for whom the journey to parenthood has not been straightforward, and who have enlisted input from fertility experts and/or adoption agencies. Lynne and three other specialists in the field of fertility counselling, adoption work, child and couple psychotherapy will look at the experience of infertility, mourning, fertility treatments, adoption assessment and the process of becoming adoptive parents, and explore how these experiences impact on the couple relationship. The event will include information-giving, case examples and links to theory. 

More information
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A happier transition

Child psychotherapist Sophie Boswell talks to David Eggboro about research she and her colleagues carried out which highlights a serious problem with the way some children are moved on from foster care

A child who is quiet and compliant during a big change in their life may be not actually be fine – they may be hiding deep feelings of pain and loss which too often go unrecognised.

This phenomenon provided the foundation for a recent piece of research by child psychotherapists, Sophie Boswell and Lynne Cudmore, which examines what happens to some children when they are moved from foster care into adoptive families.

‘One group of children who caused concern were those who were settled and attached in foster care placements but approved for adoption,’ Sophie says. ‘There was anxiety about how painful this loss might be for the children, and how best to help them and their carers manage it.’

One of their first such cases was Kyle (not his real name): Kyle was placed with his carer, Liz, at a few weeks old. A deep bond grew between them, and he clearly felt safe and loved. When he was three, adoptive parents were found for him. However, amid the excitement, both Kyle’s social worker and Liz expressed great anxiety about how he would cope with the separation.

Despite these worries it was decided that Kyle would move just 10 days after meeting his new parents and, to avoid confusing Kyle or undermining the adoptive placement, he would then have no contact with Liz for three months.

Throughout his last night with Liz, Kyle slept with his arms clasped around her neck. However, when the time came to say goodbye, he was surprisingly quiet and compliant. His new parents were left to make the decision about whether he would ever see Liz again.

‘Situations like this gave us serious misgivings about the way children were being routinely faced with such abrupt losses,’ Sophie says. ‘We felt it would leave them bewildered, distressed and fearful of future losses.’

Avoiding the blind spots

This prompted Sophie and Lynne’s research, carried out with two social work colleagues. ‘The Children Were Fine’: Acknowledging Complex Feelings in the Move from Foster Care into Adoption was first published in BAAF’s Adoption & Fostering journal in March 2014.

The research found that adults involved in the adoption process, despite their best intentions, were unable to identify the children’s distress because the children usually withdrew into a compliant state which adults took as evidence that they were fine. Sophie explains: ‘This “blind spot” is particularly prevalent where the adults themselves are dealing with huge amounts of stress.’

Their recommendation is for current policies to be brought in line with attachment theory. Wherever possible, the relationship between child and carer should be maintained and supported throughout the transition, and at least until the child has begun to settle and feel safe within their new family. They believe that more thoughtful transitions will be less traumatic for children and provide a better foundation for new relationships.

In Kyle’s case the adopters did arrange contact with Liz and went on to build up a positive relationship with her which continues today.

Keep Connected is The Fostering Network’s campaign about the importance of maintaining relationships between looked after children and their former foster carers. We are calling on the UK’s governments to develop guidance and regulations to help fostering services support this bond when children move to another home.

Click here to download a PDF of this article.