Supporting Face-to-Face Birth Family Contact after Adoption from Care: Learning for Trauma-Sensitive Practice

Author(s):  
Mandi MacDonald

Abstract There are recent calls to consider face-to-face birth family contact for more children adopted from care. Given that the threshold for this authoritative intervention is significant harm, post-adoption contact should be sensitive to the possible impact of early childhood trauma, and be adequately supported. This article draws on adopters’ reports of face-to-face contact with birth relatives, and their evaluation of social work support to suggest an approach to practice informed by principles of trauma-informed care. Twenty-six adoptive parents participated in focus groups, and seventy-three completed a web-based questionnaire, all from Northern Ireland where face-to-face post-adoption contact is expected. Findings are structured thematically around principles of trauma-informed care: trusting relationships; physical and emotional safety; choice and control; and narrative coherence. Most families had a social worker attending contact, and help with practical arrangements. Less common but important practices included: deliberate consideration of children’s perspectives; safeguarding their emotional well-being; and facilitating communication outside of visits. Findings suggest that visits are a context in which trauma-effects may surface, and social workers supporting contact should be sensitive to this possibility. This article suggests a systemic approach to helping all parties prepare for, manage and de-brief after contact, attending to both adult-to-adult and adult–child interactions.

2017 ◽  
Vol 67 (1) ◽  
pp. 132-146 ◽  
Author(s):  
Rachel H. Farr ◽  
Yelena Ravvina ◽  
Harold D. Grotevant

2020 ◽  
Vol 7 (1) ◽  
pp. 222-232
Author(s):  
Denise Brend ◽  
Nicolas Fréchette ◽  
Arnaud Milord-Nadon ◽  
Tim Harbinson ◽  
Delphine Collin-Vezina

Objectives: This article presents the theoretical basis, initial deployment strategies, and resulting preliminary findings of a program implemented in residential treatment centres (RCs) in child welfare. “Program Penguin” aimed to help workers develop trauma-informed attitudes and implement trauma-informed practices, make the workplace more responsive to the well-being of RC workers, and reduce the use of restraints and seclusion among school-aged children in RCs. Methods: Informed by the theories of complex trauma (National Child Traumatic Stress Network Complex Trauma Task Force, 2003), polyvicitimization (Finkelhor et al., 2007), Attachment, Self-Regulation and Competency (ARC; Blaustein & Kinniburgh, 2018) and Positive Behavioural Interventions and Supports (PBIS; Sugai & Horner, 2002), Program Penguin was developed and deployed using the social innovation approach (Fixsen et al. 2005). The key stages of social innovation will here be used to describe the implementation process. Results: Changes in practices were observed, RC worker attitudes towards trauma-informed care were assessed and showed strong effects between multiple covariables. RC worker support needs were identified, and a reduction in the use of restraints and seclusions was shown. Key strategies towards the development and maintenance of buy-in and meaningful change in practices are also described. Implications: Changes observed at all levels of this implementation suggest Programme Penguin is a promising approach, despite local issues that arose and the challenges inherent to program deployment within child protection settings. It appears a trauma-informed program using positive behavioural approaches and leveraging existing organizational strengths may impact intervention strategies, worker attitudes, and the use of restraints and seclusions against children in RCs.


2020 ◽  
pp. 174462952091808
Author(s):  
Amanda J Rich ◽  
Nikki DiGregorio ◽  
Carla Strassle

Traumatic life events have pervasive impacts on health and well-being. A growing body of literature shows that people with intellectual and developmental disabilities are disproportionately impacted by trauma. Trauma-informed care (TIC) is a philosophy of service provision that is committed to preventing traumatization and re-traumatization and promoting healing. This study explores the perceptions of 130 leaders in the field of intellectual and developmental disabilities services on the adoption and practice of TIC through the analysis of quantitative data. Results indicated a disconnect between the level of TIC integration and perceptions detailing how well organizations are currently performing in aspects of TIC. Barriers to TIC included high staff turnover, lack of accessible mental health providers, lack of affordable training, stigma, and restrictive funding structures. Implications and recommendations for service organizations and educators are provided.


2018 ◽  
Vol 54 (9) ◽  
pp. 1179-1209 ◽  
Author(s):  
Kari Kokka

Using an ecological approach to trauma-informed care and radical healing, this case study explores how one Title I public middle school mathematics classroom offered students opportunities to engage in healing practices through the use of Social Justice Mathematics. Findings indicate that students identified their emotions, engaged in structural analyses of local social issues, and expressed plans to take action. This study suggests the possibility of using a Healing-Informed Social Justice Mathematics approach to support development of students’ sociopolitical consciousness, mathematics learning, and well-being.


2020 ◽  
Vol 7 (1) ◽  
pp. 154-165 ◽  
Author(s):  
Denise Michelle Brend ◽  
Ginny Sprang

Context: Rates of traumatization among residential child welfare professionals are alarmingly high. The well-being of these professionals is associated both with their intention to stay in their jobs and outcomes of children in their care. Several risk factors threaten the well-being of child welfare professionals, including primary and secondary exposure to experiences with the potential to provoke posttraumatic stress reactions. Objectives: This manuscript details experiences empirically shown to have potential negative impacts on professional well-being, discusses why these impacts are of particular concern for residential childcare workers, and describes the types of organizational cultures and climates that appear to mitigate these negative impacts. Implications: Trauma-informed care at the organizational level is proposed both as a means to reduce harm to child-welfare professionals and promote the rehabilitation of children within the child welfare system.


Author(s):  
Harriet Ward ◽  
Lynne Moggach ◽  
Susan Tregeagle ◽  
Helen Trivedi

AbstractThe chapter draws on data collected through responses to an online survey concerning 93 adoptees (44% of the cohort), completed on average 18 years after placement, and interviews focusing on 24 adult adoptees. Face-to-face post-adoption contact was a legal requirement. After placement with adoptive families, 93% of adoptees had contact with birth family members; at follow-up, 56% still saw at least one member of their birth family; 69% of both adoptees and adoptive parents thought contact was ultimately beneficial. There was minimal evidence of contact with birth parents destabilising placements. However, it introduced a ‘painful transparency’ for all parties and could be problematic. Over time, contact supported children’s identity needs by incorporating knowledge of their antecedents and could mitigate their difficulties with attachment, separation and loss. It forced all parties to engage with one another and helped adoptees achieve closure.


Author(s):  
Kimberly L. Hardner ◽  
Molly R. Wolf

The purpose of this qualitative study was to gather information about the experiences of staff at a non-profit agency in the United States as the organisation transitioned towards the implementation of trauma-informed care (TIC). In non-profit organisations, TIC (that is, safety, trustworthiness, choice, collaboration and empowerment) enhances the wellbeing of employees and clients by acknowledging the impact of trauma and reducing the risk of retraumatisation. Feminist theory was utilised to inform this study to empower participants to voice their experiences and to analyse the organisation’s commitment to the principles of TIC. Four focus groups were conducted (N = 17 participants in total) and all participants reported that the organisational culture was moving in a positive direction. Even in the early stages of the implementation of TIC, management reported feeling empowered and supported by the organisation; however, many participants noted that significant work will need to continue to enhance the emotional safety and empowerment of direct-line workers.


Author(s):  
Anna Elizabeth Sagaser ◽  
Betsy Pilon ◽  
Annie Goeller ◽  
Monica Lemmon ◽  
Alexa Craig

Purpose/Background: Therapeutic hypothermia (TH) is the standard treatment for hypoxic ischemic encephalopathy (HIE). We surveyed parents of infants treated with TH about their experiences of communication and parental involvement in the Neonatal Intensive Care Unit (NICU). Methods/Approach: A 29-question anonymous survey was posted on a parent support website (https://www.hopeforhie.org) and sent to members via e-mail. Responses from open-ended questions were analyzed using thematic analysis. Results: 165 respondents completed the survey and 108 (66%) infants were treated with TH. 79 (48%) respondents were dissatisfied/neutral regarding the quality of communication in the NICU, whereas 127 (77%) were satisfied/greatly satisfied with the quality of parental involvement in the NICU. 6 themes were identified: 1) Setting for communication: Parents preferred face to face meetings with clinicians. 2) Content and clarity of language: Parents valued clear language (use of layman’s terms) and being explicitly told the medical diagnosis of HIE. 3) Immediate and Longitudinal Emotional Support: Parents required support from clinicians to process the trauma of the birth experience and hypothermia treatment. 4) Clinician time and scheduling: Parents valued the ability to join rounds and other major conversations about infant care. 5) Valuing the Parent Role: Parents desired being actively involved in rounds, care times and decision making. 6) Physical Presence and Touch: Parents valued being physically present and touching their baby; this presence was limited by COVID-related restrictions. Conclusion: We highlight stakeholder views on parent involvement and parent-clinician communication in the NICU and note significant overlap with principles of Trauma Informed Care: safety (physical and psychological), trustworthiness and transparency, peer support, collaboration and mutuality, and empowerment, voice and choice. We propose that a greater understanding and implementation of these principles may allow the medical team to more effectively communicate with and involve parents in the care of infants with HIE in the NICU.


Author(s):  
Claudia Kustner

Acute inpatient mental health wards are characterized by constant change. The creation and maintenance of facilitated talking spaces for teams to reflect with each other is integral for both staff and service user well-being on these wards. There is a growing evidence base that supports the client-centred philosophy and principles of trauma-informed care whereby service users’ strengths are highlighted over pathology and skills building over symptom reduction. A systemic team formulation model is proposed as a useful, trauma-informed, staff support intervention that could be used on the wards, as it offers numerous intra- and interpersonal benefits for teams that engage in the process of shared formulations. A case example illustrating the methodology of systemic team formulation is explored. In addition, post-incident debriefing is also a necessary form of staff support, as a way of mitigating the negative emotional impact of serious untoward incidents and restrictive practices on staff.


Mindfulness ◽  
2021 ◽  
Author(s):  
Wendy Wrapson ◽  
Marlies Dorrestein ◽  
Jill Wrapson ◽  
Alice Theadom ◽  
Nicola M. Kayes ◽  
...  

Abstract Objectives Mindfulness is an evidence-based treatment for depression but has never been rigorously tested with stroke survivors with depression. This feasibility study examined several issues relevant to a potential trial of a mindfulness-based intervention (MBI) for improving mood after stroke. Methods In 2017–2019 in New Zealand, we recruited 20 stroke survivors with low mood to undergo a 6-week, one-on-one MBI course delivered by an occupational therapist experienced in MBIs. Pre, post, and 4-week follow-up assessments were completed. Results Fifteen participants completed all six sessions and a 4-week “booster” or top-up session. The 1-hour session duration was considered appropriate by participants and all enjoyed the face-to-face individualized format. Mean Beck Depression Inventory-II scores improved by more than one standard deviation and this was maintained at follow-up. However, the baseline assessment package was too long for some participants due to the cognitive component. Three participants indicated feeling emotionally challenged by some of the practices. These effects were managed by the mindfulness facilitator by adjusting the practice, so participants maintained their sense of agency, well-being, and overall benefit from the program. Conclusions MBI training delivered individually over six weekly sessions was acceptable to stroke survivors with 14/15 participants reporting improved mood. Three participants reported feeling emotionally challenged by some of the practices and we recommend MBIs for stroke survivors be provided by practitioners experienced in mindfulness, working with stroke, and trauma-informed therapy. It is important now to conduct rigorous randomized controlled trials to test the effectiveness and efficacy of MBIs for stroke survivors.


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