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Direct Contact and Its Impact on Challenges Facing Adopted Children- a Literature Review

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Direct Contact and its impact on challenges facing adopted children: A Literature Review.

Table of content:

1) Abstract …………………………………………..3

2) Introduction and research question ………... 3

3) Methodology and Method……………………... 8

4) Key Findings……………………………………... 16

5) Analysis and Discussion………………………. 25

6) Limitations………………………………………... 28

7) Conclusion and recommendation…………….. 29

8) Bibliography………………………………………. 30

1) Abstract

This literature review explores the concept of direct contact, and what impact it has on the challenges that face adopted children. It begins by discussing adoption, contact and the meaning of these concepts. The key findings are then analysed and discussed in correlation to social work practice. From the literature analysed it would seem that direct contact has a positive impact on the challenges facing adopted children. These include, identity development,attachment development and reduced feelings of loss. Recommendation for future practice and research; although there is much to be learnt from research that has been carried out to date, simple formulas and rules cannot be applied; decisions made around contact require case by case assessment of the risks and benefits. Furthermore, long term, large scale research needs to be carried out to examine the effects of direct post adoption contact on children’s lives as they continue to develop and their needs change.

2) Introduction

Children in families formed by adoption have challenges, or ‘additional tasks’ (Neil,2002) to negotiate that do not concern families formed by birth (Brodzinsky, 1990; Triseliotis et al,1997, Neil and Howe,2004). These additional tasks primarily concern the formation of new relationships, adjustment to loss and the management of identity issues to name but a few. Recent years have seen an increase of openness in adoption, partly in response to research findings suggesting that the resolution of challenges is not helped and maybe impeded by a closed model of adoption practice that disallows contact (Triseliotis, 1991; Neil,2007; Fratter, 1996; Macaskill, 2002).Secondly, children are now placed for adoption at older ages than before having established relationships with birth family members. This study will consider what impact direct contact has on the challenges that face children in adoption.

The inspiration for this research stems from placement experience in a local authority Adoption and Permanence Team and from personal interest in the subject. Contact between children and birth families appeared to be a very contentious and problematic area, but also a crucial one in meeting the needs of adopted children. This review aims to answer the following question:

• What is the impact of direct contact on adopted children’s needs?

• What are the implications of these findings for social work practice?

(2.2) Key terms:

Adoption – the term adoption is used to describe a “process by which the legal relationship between a child and birth parents is severed and a new legal relationship established with adoptive parents” (Pierson and Thomas, 2002:14). This new legal relationship is similar to that of the birth parents and once the adoption is completed all legal rights, duties and powers transfer from the birth parents to the adoptive parents (Neil and Howe, 2004).

Birth family- within this paper this term refers to birth parents of the adopted child

Letterbox contact (‘post-box’/’indirect contact’)- is a term used to describe contact between the child and birth family members in the form of a letter.

Direct contact- this term is used to refer to face to face communication between adopted child and birth family members.

Older children- within this paper this term is used to refer to children placed with an adoptive family between the ages of four to eight.

Openness- is a term also used to mean ‘contact’ (Berry et al. 1998)

(2.3) Legal and Policy Context

Adoption of a child is currently granted by the courts through the Adoption and Children Act 2002, section 50 or 51 depending on whether it is a couple or single applicant. Adoption became recognised in English law in 1926 due to concerns children being brought up by adults other than their parents would be taken back to their parents (Pierson and Thomas, 2002).When adoption started the child’s origin was kept secret to avoid the child or adoptive mother being stigmatised. This secretive life was kept throughout the childhood and beyond for the adoptee (Neil and Howe, 2004).

In the early 1980s the nature of adoption began to change. Society’s beliefs as to what constitutes a family instigated an acceptance towards unmarried couples with children and single parents. This resulted in a reduction in the number of babies placed for adoption, going from around 20,000 a year in 1970 to 4,100 in 1999 (Brayne and Carr, 2003) this also meant that the traditional adoption cohort of babies declined (Macaskill, 2002). In their place were older children, who were increasingly being received into care as a result of social problems as opposed to being relinquished for example by single mothers (Neil,2000). In a sample of 168 recently adopted children, Neil(2000) found that 62% were required to be adopted by social services departments and the courts because all of them had suffered or were likely to have suffered significant harm. “Harm” as defined in the Children Act 1989 section 31(9), means “ill-treatment or the impairment of health or development.”

Placement of children for adoption at older ages meant that they often had established relationships with their birth families. Those working in child care arenas at the time began to question whether it was possible to successfully achieve attachment to new parents by completely severing ties with the family of origin (Neil and Howe, 2004:2).Some studies have indicated that it was not in the child’s best interest to experience a ‘clean break’ (Triseliotis,1989:23) with biological family and to be ‘cocooned in secrecy’, a change in the law was made to allow adopted people access to their records once they turned 18years of age under the Adoption Act 1976, section 51.

The term ‘contact’ can be used to refer to any form of communication between a child and their birth parents, siblings, relatives, previous foster carers, friends and significant others (Quinton et al,1997). Contact with birth family takes different forms; the most common types being ‘letterbox’ and ‘direct’ contact. Within each of these types of contact, how they work varies with regard to, regularity, which family members receive contact and how each contact is arranged. Within this paper the term contact should be taken to mean direct contact between adopted child and their birth parents.

Recent years have seen a change in contact arrangement to a situation where presumptions are held that contact should be ‘normal’ rather than an exception (Neil and Howe, 2004).There are two ways of setting up contact; gaining a contact order through the courts or through setting up of a contact agreement.

A Contact order is an order made by the courts under section 26 of the Adoption and Children Act 2002 or section 8 of Children Act 1989, which determines the frequency and type of contact the child will have with the person applying for the order. Only certain people are allowed to apply for this type of order and it is often used to settle differences of opinion regarding contact arrangements (Pierson and Thomas, 2002). A contact order imposes conditions about contact expectations with the weight of the law behind it. Courts are reluctant to make contact orders during the process of adoption, especially against the wishes of the adoptive parents (Argent, 2002) as they believe their autonomy over decisions regarding contact should not denied. Contact orders are therefore only made if it is felt contact is important for the child’s wellbeing and the adoptive parents are not willing to consider it (Smith, 2005).

A contact agreement involves everyone and is a voluntary exercise, having no support from the law. It gives consideration to content and purpose of the contact and requires a process of discussion and negotiation between all parties involved. For this to work long term commitment and agreement of all involved is required. The agreement is beneficial in comparison to the order as it has the flexibility to be evaluated and reviewed and provides the opportunity for contact to be altered without having to apply to the courts. As children grow and develop their contact needs change and the contact agreement allows this to happen. The difficulty with a contact agreement is that it is not legally binding so any party of the agreement could retract their agreement.

3) Methods and Methodology

The nature of my study is a critical review of the literature.By critically reviewing the literature and attempting to answer the research questions chosen, more informed decisions can be made as to whether children should have direct contact with their birth family and will allow a more child focused decision to be made.

A strength of this approach is that it strengthens the understanding of the subject by providing a comprehensive description of what research already exists. (Bryman,2004). Furthermore in assessing the merits of previous studies, one can learn from their research and identify gaps or where more research is needed (Gray,2004). Also, this approach would save a considerable amount of time by building on what is already known as opposed to having to carry out new studies (Hart,1998).

One limitation of this approach is the lack of service user participation. One of the social work values is to promote service user involvement. The British Association of Social Workers also sets out a duty “to ensure that service users are involved in practice and policy development and in the evaluation of services” (2002,3.3.2(f)).Furthermore Article 12 of the UNCRC (1991) provides for children’s rights to express their views on all matters that affect them. Interviewing adopted children and asking them about their views on direct contact admittedly would have offered more depth to my study. In not conducting an empirical research, I am aware that this study limits itself somewhat. However given the time constraints and other competing pressures a literature review was found to be the most appropriate approach.

Carrying out a literature review results in inevitable bias that manifests itself throughout the research process right from when a topic is selected to the researchers understanding of the topic to the conclusions drawn. Fink (1998:210) also points out that a danger when reviewing literature is the possibility of adding bias through interpretation. Human rights and principle-based approaches to research promote true reflection of author’s views through their policies of fair treatment and truthfulness and honesty. Furthermore to reduce this weakness as far as possible continual reflection of the approach will occur by asking such questions as: why has this material been selected? and why eliminate this particular literature?

This review involved a detailed search of relevant literature. Many of the texts selected for this dissertation contain qualitative studies and draw upon service user led experiences making it interesting and more accessible to a larger audience. In order to eliminate risk of producing a poor critical review, each resource should be checked to ensure that it is authentic, credible and representative (Bryman, 2004).Therefore when analysing the research findings attention was paid to whether the article was peer reviewed, who the authors were,etc. This also helps to ensure that a certain standard is kept. Difficulties were had with obtaining some of the articles and although every effort was made to obtain these it was sometimes necessary to discount them on the basis of accessibility.

Had time not been a factor, it may have been useful to combine the literature review with other research, possibly a longitudinal study involving participatory research. Using observations and semi-structured interviews with children having direct contact. A benefit of this approach is that it emphasises the importance of context in understanding events and meanings and takes into account the effects of the researcher and the research strategy on findings (Bryman, 2004).

To locate relevant research articles an advanced search was carried out on:
• Databases: Applied Social Sciences Index and Abstracts, Social Care Online, SCOPUS,
• Library resources and catalogues, including inter-library loan service: Universities of Sussex and Brighton
• Electronic journal articles, books.
• Internet sources: Google and Google Scholar, the British Association for Adoption and Fostering website and the website for the Department of Health.

Using Boolean operators like; “AND” “*” “OR”

Word searches were carried out, these included words like; • ‘post-adoption and contact’ • ‘contact’ • ‘contact and outcomes’ • ‘child’ and variations of the term ‘adoption’ • ‘contact OR adoption’ • “development* and adoption”

These generated hundreds of articles. In order to determine the suitability of the articles, abstracts were read; those referring directly to post adoption contact were included in the literature review automatically. Those articles which did not make the topic clear were read briefly to determine whether they had any relevance. After scanning the literature it became apparent that most of the articles focused on all forms of contact but mainly letterbox contact. An exclusion criteria was introduced that limited inclusion to: articles focusing on direct (face-to-face) contact, peer reviewed journal articles. This generated about forty articles. Each article was screened a third time to identify the best literature using an adapted template (Appendix A). In the end *fifteen articles were selected for the review.

A bibliography search on the articles was then carried out; five text books were found to have been cited in eight articles. To determine the suitability of the text books the index and contents page of each book was read, as well as the introduction and those referring directly to the topic direct post adoption contact were included.

On further evaluation of the literature acquired, it became apparent that research on this topic dated back to the early 1990s. This meant that the findings in this review could be viewed as authentic although it could also be argued that the findings are not varied and were just confirming the already existing opinions of the researchers.

Once relevant material had been identified it was critically analysed in order to answer research questions. Qualitative studies made up the majority of the articles selected for review. It could be assumed qualitative data is more suited to the topic of direct post adoption contact as it is aiming to get at the words used rather than quantification during the analysis of the data. A strength of collecting qualitative data is that the point of view of the participants can be gained and theories are able to emerge, whereas quantitative data collection can only gain the point of view of the research and can only test theories which have already been developed (Bryman, 2004).

However Denscombe (2003:281) warns that qualitative research is by nature of its small studies, not very representative. For example, if a number of small scale interviews are held within an organisation or even within a small community it is difficult to know if the findings can be applied to other settings or whether the results only reflect the situation in the environment the research was carried out in. This literature survey aims to partially negate this criticism by comparing small studies with large, research studies without distorting the findings by stretching them inappropriately (SCIE,2005). Also, it can often be difficult to identify what the researcher actually did with regard to the process and how they actually came to the conclusion they did. For example, it is not always clear how the researcher chose their participants, making it difficult to know whether a wide range of people were included (Hart,1998).Therefore an implication for using this approach could be misinterpretation of the information, which is caused by the researchers limited knowledge of the subject or if the researcher holds different beliefs to the author. There is the chance of the researcher putting a higher slant on the information they believe to be of importance due to biases they may have. In both situations misinterpretation could lead to the wrong conclusions being made (Marshall, 1998).

Taking a qualitative approach allows for interpretation by the researcher and allows themes to emerge through the understanding of the topic. This interpretive approach falls within an epistemological assumption and is the type of approach used within this literature review. Epistemology is a theory of knowledge and what knowledge is acceptable within a discipline (Bryman, 2004; Marshall, 1998). The theory analyses the nature of knowledge and how it links with similar ideas, attempting to address the questions including ‘what is knowledge’? and ‘how is knowledge acquired? (Denscombe,2002). An interpretative approach believes that humans are independent and “free to follow their will as part of the world, in relationships with other human beings, so they cannot be objective.” (Payne, 2005:55). This approach requires the reader to interpret what the author is saying, using their knowledge of the subject in order to gain further knowledge and understanding. Taking an interpretive stance can allow interesting findings as long as the researcher places themselves outside the social context of the subject and it can allow the researcher to interpret the social world from the author’s perspective (May, 2001).

To analyse the data found an open coding process in Strauss’ grounded theory was used (Gray,2004). This theory provides a framework for analysing qualitative data through reading texts, generating theory and reading further literature to either confirm or disprove the theory.

3.1 Ethics

Contact in adoption is a very emotive topic. Therefore care was taken to ensure not to take a stance that is either ‘for’ or ‘against’ direct contact in adoption, as this attitude could get in the way of critical research and introduce bias to my research (Hammersley, 2000).

As the approach of this research is a critical literature review rather than an empirical study, no permission is needed to carry out the research as all the literature being used for the review is already in the public domain (Biaxter et al, 2001).However it is necessary to take into consideration all possible ethical issues and also comply with the university’s ethical guidelines for research.

The ethical approach taken with regard to writing this paper is a human rights and principle based approach. The United Nations Convention on the Rights of the Child (UNCRC) (1991)states that all children have “the right to live in a family environment … and to have contact with both parents wherever possible”. Therefore it would be important to research whether promoting direct contact is an effective way of meeting adopted children’s needs to contribute to available literature, which may also go a long way in assisting and informing practitioner’s having to make decisions regarding contact.

Protecting the interests of participants in research is important. When working with children these include issues like, welfare of the child, informed consent from both parents and young people and confidentiality. Research analysis will explore whether the author has given adequate consideration to the ethics involved in researching with children.

Standards 4 and 5 of the University of Sussex’s Standards and Guidelines on Research Ethics are relevant to my research. The fourth standard is to “develop the highest possible standards of research practices”, which was done by identifying and considering existing literature and ongoing research and selecting appropriate methods (University of Sussex, 2007:28) The fifth standard is to “consider the consequences of [the] work or its misuse for…interested parties” (University of Sussex, 2007:28). I will try and address this by keeping in mind that research is not only written with social work professionals and academics as the audience but also the general public and service users as well. I would also need to be aware that the language I used is likely to influence the way my results are interpreted (Usher, 1997:27).

This research could also have an impact on professionals decision making regarding direct contact for a child and it may impact on adopters’ decision as to whether contact should occur. For this reason care was taken when reading the literature to ensure misinterpretation was avoided where possible.

It is recognised that due to the research used it is not always going to be possible to apply the findings to all races, ethnicities, cultures and abilities. This means the information is not always transferable to every situation (Bryman, 2004). Where research has failed to consider these things the research findings transferability will be questioned.

(4)Key Findings

The following challenges facing older adopted children were identified in the literature (Harris and Lindey,2002, Neil and Howe,2004, Quinton,1997);

• identity development • forming new attachments • adjustment to loss of birth parents.

In the following chapters I will consider the findings from reviewed literature.

4.1. Is direct contact essential for adopted children’s identity development?

The need to know where we come from and to understand as much as we can about our background is fundamental to our sense of identity (Feast and Howe, 2004: 28).Identity, a person’s sense of self, the real them, is developed through their many social relationships and personal influences (Marshall, 1998). Identity is something everybody has to create; we all have to work out who we are and how we fit with the people around us.

The Framework for Assessment of Children in Need and their families lists identity as one of the developmental needs of a child (DoH,2000).It is well documented in literature that adopted children can have difficulties in achieving a satisfactory sense of identity because they lack information about their family history (Feast and Howe, 2004; Trinder et al, 2000 and Howe et al, 2000). Research also indicates that it is important for adopted people to have information about their birth families in order to know who they are themselves (Fitzhardinge, 2008). Fratter (1996) argues that for children who are separated at a young age they may have no conscious knowledge or memories of their birth families and therefore will be entirely dependent on other people to convey important information to them.

Erikson (1982) developed a theory of development consisting of eight stages. The fifth stage of this theory of development was called ‘identity versus role confusion’ and although Erikson believed children had a sense of identity prior to adolescence, he felt adolescence was a time when identity formation takes place through the persons own decisions. Erikson suggested having difficulties with this stage may cause the person to become stuck and confused about who they are, he called this situation identity confusion (Gross, 2004).

Adopted people have to create their identity with the additional task of working out who they are, incorporating the knowledge they are adopted and once had different sets of parents (Neil, 2000), causing a feeling of difference. Research now suggests that just knowing they are adopted is not enough to assist the child in developing a complete sense of identity and that knowing the details of their birth family leads to a feeling of completeness in relation to their identity (Fratter,1996;Neil et al, 2003). Furthermore Neil and Howe (2004) comment that the ability of the child to understand birth family members depends on the amount, type and accuracy of information they are given, linking back to the child’s ability to form a secure self identity. Fitzhardinge (2008:66) supports this argument and suggests that building a coherent narrative and complete sense of self is made more difficult “by lack of facts and reluctance to share information within adoptive families. Similarly Ryburn (1996) argues that children need information which is continuously updated as they go through life. As they grow children become increasingly curious and ask more questions and Ryburn feels “static accomplishments” (Logan and Smith, 2005:9) including life story books and photos cannot meet these needs.

The reviewed literature suggests that contact increases access to background information which can help children with identity development. In the study by Fratter (1996), meeting identity needs was found to be a major benefit of face to face contact. Sykes (2001) suggests gaining information through contact gives a child feelings of ownership over their past, makes their history seem more real and gives them vital information about medical history.

Logan and Smith (1999) report adoptive parents as supportive of direct post adoption contact and participants felt it prevents potential identity problems occurring later on. Triseliotis (1991) suggests that contact enables a child build their developing personal, social and body identity on both psychological and biological parents.

Similarly, in a study by Harris and Lindsey (2002) in which professionals including judges, guardian ad litem, psychologists and psychiatrists were interviewed to explore their views on direct contact. Of the nine participants interviewed all the guardians and one judge placed particular emphasis on face to face contact as central to identity development. They linked ongoing contact with the maintenance of a sense of identity with the family of origin and consequently with the stability of placement. However the applicability and transferability of these findings to social work is not as clear cut as other helping professions such as psychology subscribe to different professional values and codes of practice (John,1994).

Jardine (1999:156) argues that in transracial placements;

“adopted children grow into adults who have enough loss to contend with (by virtue of the fact that they are adopted) without having the additional loss of racial identity and cultural heritage”.

If the child is of mixed heritage or if their identity differs to that of their adoptive parents contact could also help the child to develop their ethnic identity to a further extent to which they could not without contact (Ryburn, 1996).

All this research seems to support Erikson’s belief that it is possible to become confused if identity is not developed as it should, which research seems to suggest cannot occur without contact with biological parents. However it is difficult to know whether the findings from this research (ie.Fratter,1996;Logan and Smith,1999;Ryburn,1996;Sykes, 2001; Triseliotis,1991) can be relied upon fully due to the small sample sizes. Most of the researchers have used samples from all over United Kingdom which is positive as it means it is not just a local behaviour but a nationwide one. Ethical issues also arise from Logan and Smith’s (1999) and Triseliotis’ (1991) study as they have not informed readers whether their sample consisted of children from different ethnic origins or whether transracial adoptions were included. For this reason it cannot be assumed their research is applicable to children of all races and ethnicities (Bryman, 2004).

Conversely, Berry et al (1998) argues against the notion of direct contact as essential for identity development. Berry et al (1998) suggests access to information can prevent genealogical bewilderment but there is no evidence to suggest children who have access to information have better adjusted or failed to develop a complete sense of identity. However, Berry et al (1998) findings are less applicable to United Kingdom as the study was conducted in America, where opinions could differ due to cultural differences meaning the information is less transferable (Mullender, 1992).

Most articles reviewed recorded that ethical approval had been obtained by a university or government/professional body. However, where consent had been obtained from clients (eg Triseliotis (1991)), no detail was given of whether consent was informed. Two articles (Logan and Smith 1999;Triseliotis,1991) did not inform readers whether their sample consisted of children from different ethnic origins or whether transracial adoptions were included. For this reason it cannot be assumed their research is applicable to children of all races and ethnicities

Those arguing for direct contact are saying that through continual contact with birth family member’s access to information is more readily available and this is felt to be beneficial to the child’s identity development. Those arguing against direct contact were saying that there is no evidence to suggest that children who have no access to information via contact have failed to develop a complete sense of identity. Identity development is a life long process and should be seen as a cycle. (Grotevant,1997; Logan and Smith, 2005). Most articles reviewed however seemed to be arguing in favour of direct contact promoting identity development.

2. Is continuing contact with birth relatives likely to promote/interfere with the child making attachments within an adoptive family?

Neil (2002) suggests that children’s capacity to make and sustain relationships in adoptive families is affected by previous poor quality care and discontinuities in care.

An attachment is a bond with another person which is long lasting, unique and interchangeable with no one. The first attachment formed is perceived as crucial for health development because it acts as an example to follow (Bowlby,1969). According to early attachment theory a child can develop a healthy attachment to one main caregiver and some of the earlier research suggests for this reason that post-adoption contact creates a negative affect on attachment development of the child (Goldstein et al, 1973).

According to Harris and Lindsey(2002) for children who know and remember birth relatives the loss, anxiety and guilt caused by having to relinquish important relationships may undermine the process of settling in a new family.

Goldstein et al (1973) supports the idea of severance of all contact, he suggests contact between a child and its birth parents should end once the child is placed for adoption on the grounds that the child would fail to bond if contact continued and the attachment process would be impeded (Mullender, 1991; Sykes, 2001).He supported this by suggesting a child is unable to attach to a psychological parent while still maintaining contact with biological parents (ibid). The reliability of this research is however questionable as it comes from an old book and is an interpretation of previous research.

Many of the children who are placed in adoptive families are likely to have experienced some form of maltreatment (Glaser and Prior, 2006; Logan and Smith,2005).These factors predispose them to exhibiting severe attachment difficulties when placed with substitute families (ibid). Recent research has shown that abuse is the most common reason for a child to be adopted (National Statistics, 2005). In a study of fifty eight children in care (Schofield et al, 2000), at least a third of the children appeared to be experiencing some stress and potential harm through their relationships with birth families around contact. It could be argued that further exposure by contact to such insecure relationships with birth family members would not benefit the child.

However more recent research has produced evidence that suggests the contrary;

Openness can help the child settle in the new family providing the adults are not hostile to each other or the idea (Lindley,1997; Lowe et al, 1999; Logan and Smith, 1999).

Bowlby’s attachment theory suggests that children are able to make multiple attachments and that seeking attachment to others is a basic drive (Howe,1996) therefore contact could not prevent a child from making new attachments to the adoptive parent. Triseliotis (1991) supports this by reporting contact does not prevent attachment to a psychological parent. Similarly Fratter’s (1996) study found that such contact, even at a high frequency, was not reported to have interfered with the relationships between adopters and the child in any case of children placed under the age of eight years.

Bowlby’s early work also suggests that depriving a child of its mother in early childhood can cause many negative affects in later life including separation anxiety, feelings of loss and eventually disturbed behaviour. It could therefore be suggested that a child being adopted, who already has a primary attachment to a member of the birth family should be provided with contact to prevent the child from experiencing these adverse effects (Payne, 2005).

Many children placed for adoption experienced life with their birth families prior to being adopted. For some this experience includes witnessing their parents struggle with mental health issues and often created feelings that their parents were unable to cope. This can cause children to feel responsible and places them in a role of caring for the parent. For these children, severing contact may remove the burden of having to care for and witness this struggle but it does not take away the worry that child often has about the parents well being (Thomas et al, 1999). In a report written by Morgan (2006), consisting of 201 adopted children, 85% said that is was fairly or very important to be given news about their birth families and 49% wanted to be kept up to date with what their birth families were doing generally. In contrast only 3% stated that they did not want it. Similarly research studies by Ryburn (1996) and Beek (1994) recognised contact as creating a sense of well being in the child who perceives birth mothers and other birth family members are alright. Beek’s study found that in two cases the parents spoke of the contact meeting offering reassurance to the child that their birth mother was ‘OK’ (Beek, 1994:40). An argument put forward in favour of direct contact is that it can offer the child reassurance about the well being of their birth parents which would inturn allow them to feel free to form relationships with new carers. Lindley for example, argues that contact with birth parents assists a child to feel free to attach to their new family as they are able to see their birth family are well and acceptant of their adoption (Lindley, 1997).

Most of the articles reviewed concluded that contact can promote children forming new attachments in the adoptive family. However they also recommended that decision making around contact requires a case by case assessment of the benefits and risks (Logan and Smith,1999; Fratter,1996) .

Another emerging theme was ‘loss and separation’. Looking at whether openness facilitates or impedes adopted children’s grieving (Logan and Smith,2005). Other themes related to this were; whether direct contact heightened or reduced children’s feelings of rejection and abandonment or “confusion/divided loyalties.”(Ryburn,1996). However due to word limit it is not possible to cover this theme in depth.

5) Analysis and Discussion

When contact is seen as intrinsically right or good, this can result in bad practice (Neil and Howe,2004). It would be wrong to conclude that contact has either a negative or positive impact on adopted children’s lives because care needs to be taken not to quantify adopted children’s personal experiences of direct contact. Furthermore this would not be in congruence with the social work value of individualisation which acknowledges the uniqueness of individual experience.

The findings strongly suggest that direct contact can promote a child’s identity development by providing them with important information about their backgrounds, aid the establishment of a relationship and secure attachments to new caregivers and help to reduce feelings of separation, loss and rejection that the child is likely to feel.

From the literature analysed more positive effects of post-adoption contact on the challenges facing adopted children were found than negative effects. One thing all these articles have in common is the conclusion that not enough long term research has been done and not enough is known about post adoption contact to know whether it really does benefit the child. Logan and Smith (2005) were more sceptical as they thought that not enough has been done to differentiate between contact types and frequency, the conditions under which contact is arranged and members of the birth family involved. Similarly Quinton et al (1997:411) claims that it is misleading to think that what we know about contact is at a level of sophistication to allow us to make confident assertions about the benefits to be gained from it regardless of family circumstances and relationships. No research has yet concluded a connection between post-adoption contact and subsequent adjustment of the child (Berry, et al, 1998).

5.1.What are the implications of these findings for social work practice?

Research into long term effects of post adoption contact for the child, including developmental outcomes is limited (Neil, 2003). In light of this, Neil (2003) suggests practitioners need to develop a framework for thinking about the child’s needs when considering contact with birth family members. The new Children and Adoption Act 2002 goes some way to support this, with practitioner guidance suggesting they should consider the wishes and feelings of both the child and birth parents and any advice given by adoption panel when considering whether a child should have contact (DFES, 2005).

Social workers are very powerful in influencing contact arrangements (Dance and Rushton,1999; Sykes,2001). A recurring theme of the literature reviewed was that where contact arrangements are foisted on children, adopters and birth parents without a level of consultation or negotiation, the contact arrangements are at greater risk of being problematic (Neil and Howe,2004). The review has highlighted many issues on the subject of direct contact that are relevant to social work practice. The main key issues in relation to direct contact which social workers need to consider in order to promote a positive outcome for adopted children are;

Preparation:

Central to the debate around contact in permanent placement is the idea of belonging to two families. Social workers may experience complexities in managing their own personal values- of the traditional, private family unit versus their professionals values- protect the rights and promote the interests of service users in this case children (GSCC,2004). However the reality of the situation is that the adopted children do belong to two families. Therefore social workers need to anticipate issues and prepare adoptive parents for the social and emotional challenges that they will face in “sharing” their children with birth families over time. In formulating contact plans the aim should be to create a scenario which feels safe to all, is emotionally manageable for all, logistically do-able for all and is going to work for everyone at every stage of the child’s childhood and hopefully beyond. It needs to be a plan that is well-considered, well-resourced, well-managed and constantly under review. A plan that meets the needs of a five-year-old will not meet that of a 15-year-old.Logan and Smith (1999) suggest practitioners need to prepare adoptive parents further than they are and found negative experiences of contact occurred due to confusion of planning and perceived demands. Similarly Neil and Howe(2004;237) point out that direct contact is “insufficiently planned, supported and monitored for older children” (the complexity of the task for all three parties is underestimated).

Support Services:

Findings suggest that social workers were much more concerned with negotiating contact arrangement at the time of placement but that after adoption they were left to adopters and birth relatives to work things out (Logan and Smith,1999; Neil and Howe,2004). Arrangements for direct contact cannot be approached as a one-off event. Support, consultation and mediation needs to be available to adoptive parents and birth parents as and when they need it (Sales, 2002).

Children’s wishes and feelings:

Social work discipline upholds and promotes key values some of which are to ensure service user involvement in planning and decision-making processes in order to empower service users (BASW, 2002: 3.1). By viewing the children as the ‘experts’ of their own needs and consulting children on a regular basis about their views and wishes and ensuring that these are taken into account, social workers would be practising in an anti-oppressive way (Banks,2006).

(6) Limitations

A weakness of this paper is that most of the literature analysed is literature based studies, with limited empirical evidence to make comparisons to. Two articles reviewed reporting empirical research, were by Beek (1994) and by Fratter (1991) both consisted of small scale research in United Kingdom and both conclude their research to be too small scale to suggest post-adoption contact is beneficial in all cases or in fact at all. They both consider race and ethnicity within their research which could mean the findings are transferable to some races and ethnicities (Bryman, 2004). Furthermore both researchers suggest it would be beneficial to complete further research to either strengthen or disprove their findings.

Most of the research studies were restricted to small sample sizes, which makes it questionable whether the conclusions can be attributed to the general population. In addition, most articles specified the ethnicity mix of their case samples. However in two articles, readers were not informed whether sample consisted of children from different ethnic origins or whether transracial adoptions were included. For this reason it cannot be assumed their research is applicable to children of all races and ethnicities (Bryman, 2004). It could be argued therefore that the articles are not representative of the general population.

Children have very different childhood experiences. Some coming from backgrounds where they experienced abuse and/or neglect, exposure to domestic violence etc. Whilst many of the articles reviewed attempted to control for some of these uncontrollable variables, their number and extent makes the ecological validity of any research in this field questionable.

7) Conclusion and Recommendation

From this review it would appear that direct contact has more of a positive impact on the challenges facing adopted children. However decisions made around direct contact require case by case assessment of the risks and benefits. Finding the right balance between the needs and wishes of all parties in the ‘adoption triangle’ but keeping the child’s needs paramount.

The overall finding from this literature review suggests that contact is beneficial to children in many areas, including helping with identity development, attachment development, providing access to information. However with those benefits also come negative affects including possibility of confusion, anxiety and distress.

Despite the limitations of this study, the findings contribute towards the literature on direct contact for adopted children which could also go someway to helping professionals see what children can get out of direct contact

Recommendations for practice are that practitioners need to ensure children needs are kept at the heart of all decision making processes with the long term needs of the child in mind.

Recommendations for future research, there is a gap in substantial research for this topic and if practitioners are expected to make the best decisions possible when considering direct post adoption contact, far more needs to be done in terms of long term large scale empirical research.

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...Synthesis and Critical Review* Joseph E. Gaugler The University of Kentucky Abstract The objective of this review is to critically synthesize the existing literature on family involvement in residential long-term care. Studies that examined family involvement in various long-term care venues were identified through extensive searches of the literature. Future research and practice must consider the complexity of family structure, adopt longitudinal designs, provide direct empirical links between family involvement and resident outcomes, and offer rigorous evaluation of interventions in order to refine the literature. NIH-PA Author Manuscript Keywords Family Involvement; Nursing Homes; Assisted Living Facilities; Family Care Homes; Family Caregiving; Informal Care NIH-PA Author Manuscript Over the past several decades, various research studies have demonstrated that family members remain involved in the lives of their loved ones following placement in residential long-term care facilities (e.g., Bowers, 1988; Maas et al., 2000; Rowles & High, 1996; Smith & Bengston, 1979; York & Calsyn, 1977; Zarit & Whitlatch, 1992, to name a few). These collective findings have helped debunk the myth that families abandon their relatives in nursing homes or similar settings to die in isolation (Rowles, Concotelli, & High, 1996). Although the roles of families in residential long-term care have continued to receive attention in the literature, the findings are diverse...

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