Adoption Therapy : Finding Therapist, Part 2

by Child Welfare Information Gateway

(Page 4 of 4)

Interviewing prospective therapists. Using the recommendations that they gather, parents can call prospective therapists or schedule an initial interview to find out basic information. Some therapists will offer an initial brief consultation that is free of charge. Parents should start by giving the clinician a brief description of the concern or problem for which they need help. The following are some questions to discuss:

1. What is your experience with adoption and adoption issues? (Parents should be specific about the adoption issues that impact their problem, such as open adoption, transracial adoption, search for birth relatives, children who have experienced abuse or institutionalization, children with attachment difficulties.)

2. How long have you been in practice, and what degrees, licenses, or certifications do you have?

3. What continuing clinical training have you had on adoption issues?

4. Do you include parents and other family members in the therapeutic process?

5. Do you prefer to work with the entire family or only with the children?

6. Do you give parents regular reports on a child's progress?

7. Can you estimate a timeframe for the course of therapy?

8. What approach to therapy do you use? (See Approaches to Therapy above.)

9. What changes in the daily life of the child and family might we expect to see as a result of the therapy?

10. Do you work with teachers, juvenile justice personnel, daycare providers, and other adults in the child's life, when appropriate?

There are other practical considerations when choosing a therapist. Parents should be sure to ask about:

• Coverage when the therapist is not available, especially in an emergency
• Appointment times and availability
• Fees and whether the therapist accepts specific insurance, adoption subsidy medical payments, or Medicaid reimbursement payments (if applicable)

Working With a Therapist. If the child is the identified client in therapy, the family's involvement and support for the therapy is critical to a positive outcome for the child. An adoption-competent therapist will value the participation of adoptive parents. Traditional family therapists not familiar with adoption issues may view the child's problems as a manifestation of overall family dysfunction. They may not take into account the child's earlier experiences in other care settings and may view adoptive parents more as a part of the problem than the solution. Adoption-competent therapists know that the adoptive parents will be empowered by including them in the therapeutic process and that no intervention should threaten the parent-child relationship.

Parents' commitment to the therapy may also contribute to the success of the therapeutic process. For instance, parents are obligated to keep scheduled appointments. They should refrain from using therapy sessions as punishment for a child's misbehavior. Family members must communicate regularly with the therapist and ensure that the therapist has regular feedback about conditions at home. The success of therapy depends heavily on open and trusting communication.

Parents may want to request an evaluation meeting with the therapist 6 to 8 weeks after treatment begins and regular updates thereafter. Evaluation meetings will help all parties evaluate the progress of treatment and offer the opportunity to discuss the following:

• Satisfaction with the working relationship between the therapist and family members
• Progress toward mutually agreed-upon goals for treatment approaches and desired outcomes
• Progress on problems that first prompted the request for treatment
• The therapist's tentative diagnosis (usually necessary for insurance reimbursement)
• The therapist's evaluation of the chance that therapy can improve the situation that prompted treatment

Insurance Coverage and Other Funding for Therapy

The cost of therapy varies and may be covered in part by health insurance or the child's adoption assistance agreement. Some therapists, and most community mental health centers, provide services on a sliding fee scale based on income. Parents should ask about costs and when payment is expected (after each session, at the end of the month, or after reimbursement by insurance).

Insurance companies have different requirements for coverage of mental health treatment. Parents may have to choose from a list of approved therapists, and there may be a limit on the number and types of sessions covered. Parents should find out from the insurance company:

• The extent of coverage for mental health treatment
• Specialty areas of approved providers
• Company policies regarding payment for treatment provided by therapists outside the plan
• Whether insurance will pay for an out-of-plan adoption-competent therapist if such a therapist is not available within the network

If the child has an adoption assistance agreement, parents should see what the subsidy covers.

Conclusion

Members of adoptive families may encounter issues at different points in their lives that affect their behavior and emotional well-being and that require treatment from a professional therapist. Adoption-competent therapists, who understand adoption issues and adoptive family dynamics, are best suited to provide clinical interventions. With some research, parents can find the therapist best able to support their child and family.

About the Author

www.childwelfare.gov
Formerly the National Clearinghouse on Child Abuse and Neglect Information and the National Adoption Information Clearinghouse, Child Welfare Information Gateway provides access to information and resources to help protect children and strengthen families. A service of the Children's Bureau, Administration for Children and Families, U.S. Department of Health and Human Services.