By Catherine Harris, MA

Catherine Harris is the post permanency manager for the Vermont Department for Children and Families, Family Services Division. She oversees the system of care for families formed through adoption and guardianship and coordinates the Vermont Consortium for Adoption and Guardianship. Her focus throughout her work has been on the well-being of children and ensuring that they have families who are able to meet the children’s social emotional needs. Catherine is an adoptive parent, guardian, and grew up with her uncle who was in kinship care with her parents. For more information about the risk and protective factors (including the manual or assessment mentioned below or a recording of a related training), email [email protected].

From Adoptalk 2021, Issue 1; Adoptalk is a benefit of Families Rising membership. 

Becky has returned to state custody at age 17. She was adopted at 7 and her family does not want to work on services to bring her home. They feel that they have done everything they could, they’re exhausted, and they don’t believe that Becky even wants them to still be her parents. Becky was adopted from the foster care system—what went wrong?

While we can’t change what has happened to Becky, we can learn from it and improve our work for other children. Taking time to reflect and review the risk and protective factors for Becky and her adoptive family can provide insight, but this by itself is not enough.

Shifting to use risk and protective factors when we make decisions about placement can move us from “seems like a good placement” to knowing what the child’s risks are, what a family’s risks are and then making an informed decision regarding placement. This doesn’t mean that you may not move ahead with what seems like a good placement, but that you plan for possible challenges and make sure the family has what they need to manage future struggles.

About Risk and Protective Factors

The risk and protective factors for adoption discontinuity have been well studied and the Quality Improvement Center for Adoption and Guardian­ship published a literature review of them in 2017. Adoption discontinuity is defined as post-permanency instability such as out-of-home placements. In Vermont, we found that a set of these risk and protective factors could be used to improve placement practice and a group of national and state adoption experts met to review the many factors and narrow this down to a set that we would focus on. The group began with more than 45 possible risk factors and focused on those that were both connected to discontinuity and could be tracked in Vermont. Thus we landed on 35 factors (see box below).

Vermont is in the process of implementing a Permanency Project Database that will be tracking these at the point of finalization and then follow the child from finalization until the adoption subsidy closes. Data will be collected through post-permanency services and through any future involvement with child welfare. Vermont will be able to improve its placement practices with this information and with a deeper understanding of what services appear to make the greatest difference in outcomes.

Risk and Protective Factors in Adoption Discontinuity

Child/youth risk and protective factors

  • Number of behaviors and severity
  • Capacity to attach
  • Number of placements
  • Number of previous custody episodes
  • Number of previous adoptions or guardianships that were dissolved
  • History of abuse and age at time of abuse
  • Abandonment
  • Prenatal exposure to substances (drugs, alcohol)
  • Child/youth exposure to substance use
  • Parental history of significant mental illness or intellectual disability
  • Child ACE score
  • Race
  • Older age at time of adoption
  • Cognitive disabilities
  • History of psychiatric hospitalization or residential treatment
  • Birth siblings outside of the adoptive/guardianship home
  • Engaged in social enrichment activities (sports, music, volunteering)
  • Siblings in the home’s acceptance of the child/youth
  • Peer acceptance of child/youth
Family risk and protective factors

  • Level of commitment to parenting and motivation
  • Both parents are committed equally
  • Realistic expectations of the child
  • Ability to adjust their parenting
  • Ability to accept help
  • Adequacy of natural supports
  • Understands the impact of trauma on a child’s behavior and development
  • Resolved trauma history
  • Flexibility of family
  • Positive parenting style
  • Capacity to cope with stress and challenges
  • Realistic expectations of themselves
  • Connected to their community
  • Kin
  • Relationship with child prior to placement
  • Acceptance/understanding of child’s identity and ability to nurture this
  • Communicative openness re adoption/guardianship
Community risk and protective factors

  • Access to quality adoption competent childcare and schools
  • Access to quality trauma responsive childcare and schools
  • Access to quality adoption competent medical and mental health services
  • Access to quality trauma responsive medical and mental health services
  • Community’s support for children who have been adopted/in guardianship
  • Community’s support for trans­racial/transcultural families
  • Experience of worker

Using These Factors in Placement

We knew children couldn’t wait until we had more information. Their futures depended on us making changes immediately! We began with adding this information to the training of all new child protection staff. We presented the risk and protective factors and gave them a case study to use those factors with. The case study is about three siblings who enter foster care and are not able to reunite with their parents. Parental rights are terminated, and the children move to adoption. In the training, participants work in small groups to look at and record the risk and protective factors for each of the children, for each family that may be a possible adoptive family, and to decide what other information or supports each of the families need in order to adopt. Staff like this part of the permanency training and have great discussions about the risk and protective factors as they work.

Our next step was to train Vermont’s resource coordinators, who manage the foster care system in each of our districts. They are also in charge of managing children’s placements and would be the key to making sure the risk and protective factors are used. We needed the resource coordinators to really understand how these factors could help them understand foster/kin/pre-adoptive caregivers’ strengths and challenges. We trained our existing staff and now train all new resource coordinators with other new child welfare staff.

At first the resource coordinators did not want to use the risk and protective factors. They felt that there were too many pressures on the foster care system, and too few options for children, to be able to use them. After they were able to do the case study exercise, the coordinators changed their minds. They saw that there are many times when thinking about whether a current placement or another placement option (such as kinship care, foster care, or home-studied family) that has been identified was best, took more thinking. They also saw that the risk and protective factors really helped them think about the strengths and challenges for each placement. Using the factors could help the resource coordinators come up with good service plans for families, both before and after children joined those families. And those plans could lessen the risks!

Vermont now has a manual for resource coordinators that includes a section about matching children with families using the risk and protective factors. For example, if you have a child who has significant behaviors you would want to identify a family who has realistic expectations of themselves, understands the impact of trauma on a child’s behaviors, and has the capacity to cope with stress and challenges. We are excited that this tool is now part of our regular practice and we think it will mean that children’s outcomes will be better from now on.

Using Risk and Protective Factors When Children Come Back into Care

Unfortunately, there are also times when an adopted child might come back into foster care. The risk and protective factors are also an important tool to use then. When this happens, the post permanency manager looks at the adoption finalization file to see the risk and protective factors that were included in the file. The manager and staff talk about how the factors can help them decide what support services may be helpful. What they learn from the review can also help them adjust and improve their practice in the future.

We have seen in Vermont that in almost every case the child had been neglected early in life and/or witnessed domestic violence, and that the discontinuity after adoption happened whether they were adopted at a very young age or at an older age. What this tells us is that early neglect and witnessing domestic violence are two factors that can make adoption stability more challenging. In these cases, we now know that we must provide extra support for the child and the parent.

When a child experiences early neglect they learn that parents can’t be counted on to meet their needs and that they need to look out for themselves. When children believe this about their parent, they have no reason to attach or even to listen to that parent. And this leads to real trouble in the new adoptive family. When children see domestic violence in the home, it changes their belief that a parent can keep them safe—again, leaving them feeling that they are really only able to rely on themselves. This is why we often talk about the idea of “felt safety” for children. They can often feel that they are not safe when there is no real danger.

Beginning attachment work right away, and continuing to work on it, can help children learn to trust their parents and, ideally, to experience felt safety. If we start this while the child is still in our care and living in their pre-adoptive home, the family has the guidance and support of both the child protection worker and the resource coordinator. If we wait until finalization to recommend this attachment work, we have lost a lot of important opportunities. There is so much information coming at a family during the finalization period that the importance of the attachment and healing work might only come up again as the family experiences challenges or a crisis.

Using the Factors in Providing Support

In Vermont, we know that using the risk and protective factors before an adoption helps to make stronger permanent placements for children. We also know that when adoptive families need services later on, the factors can be used to inform the support provided.

Vermont’s Permanency Project Data­base will give the post-permanency program direction about how often staff should reach out to individual families, knowing what the risks were when they finalized their adoption. (Unfortunately, the Permanency Project Database will only have data for families that were involved with the Vermont child welfare system so it doesn’t inform us about private or international adoptions.) The higher the risk, the more often post-permanency staff will reach out to a family with reminders about services that are available to them, as well as information about what can be expected as children in adoptive families develop and mature.

In Vermont there are three agencies who provide post-permanency services to adoptive and guardianship families even if the Vermont child welfare system was not involved. We hope that by reminding families of existing supports and services, and letting them know that it is normal to need support and use services during their adoption journey, they will use them before they have a crisis. This way we can reduce the number of families in crisis for whom we have to formally open for post-permanency services.

It can be hard for Vermont post-permanency workers to balance working with a family in crisis with helping them strengthen their protective factors. In Vermont post-permanency services are not made for crisis intervention, and the workers are not mental health clinicians. The job is to provide monthly in-home visiting where parents can learn to change the way they parent in order to help their children who have had experienced trauma or loss earlier in life. The workers also help them identify their own strengths and challenges and develop plans that help them grow as caregivers. In addition, the post-permanency team can offer:

  • consultation to treatment teams and advocacy,
  • education supports within schools
  • collaboration with treatment teams and referrals to community resources
  • general adoption/guardianship information, and
  • kinship placement support.

When they start their work with a family, Vermont’s post-permanency workers have the parent fill out an assessment that identifies areas of risk and areas of strength based upon the risk and protective factors. This assessment is completed every year once they come to the team and is used to plan what steps to take with the parents. Workers review the assessment and then work with the parent to identify goals that are about addressing the crisis work and will also build their protective factors. Some of the key areas are open communication about adoption, talking about race and culture, and building their natural networks of support.

When we first began using the post-permanency assessment workers seemed surprised that there were risks they hadn’t known about—especially with families they knew and had been working with. They asked for some additional training for themselves so that they could help families talk about adoption, race, and culture in particular. Over time the workers now use the information to make the service and support plans with families and track how they are doing. Our program uses the assessments to evaluate our post-permanency services: Are families talking about adoption with their children more often? Are they talking about race and culture more often? Are they finding and using more supports in their own network? Do more children have someone at school who they trust?

Conclusion

Vermont is committed to continuing this work and to growing it. Using risk and protective factors to prevent adoption discontinuity can be an important tool for making good decisions about the right family for a child as well as to make sure the services we provide after the adoption are what the family needs. We hope that this work will significantly decrease the number of children entering custody from adoptive homes, especially when they are 17 years old with a family who feels hopeless about being able to continue parenting.