[google2aab7242716fd830.html] Best Practice in Open Adoption by Jeanette Yoffe M.F.T.

Best Practice in Open Adoption: Repairing the Corrective Emotional Experience of Separation Trauma

Updated: Dec 10, 2019

Disclaimer- This best practice, is to be facilitated with the support of trauma informed, foster care and adoption competent, licensed psychotherapist, who is mindful of the child's best interest at all times and following there lead emotionally and psychologically.

Consider the shape of a circle. Make the perimeter high walls, impossible to see over or through and with no doors leading inside. Now, imagine you are standing in front of this walled circle, what do you see? Nothing but a tall curved wall. And from this perspective you don’t know what shape it is, and if there’s any entrance at all.

Now imagine that same high walled, doorless circle but this time you are hovering slightly above it, enabling you to see the whole shape and realizing that in order to get into the center you somehow must go over or even through those walls.

This is an analogy for closed vs.open adoptions. The walls are the trauma caused by the separation from the birth family. The center is a true connection with the adoptee. Standing in front, we get a limited perspective, uncertain of the entire shape of the situation, uncertain how to “get in” to the child’s experience and develop lasting bonds of attachment. Hovering above, we can see the entire shape of the situation, and knowing the only way in is over or through, can make intelligent decisions and strategies to enable strong, lasting connections.

This analogy describes the two most common modes of adoption in America today. The first is ‘completely closed’, also known as “confidential” - meaning there is no contact between the birth and adoptive families and usually little if any knowledge by their members about each other. (The first image of our circle analogy, standing outside looking at a wall) The second is ‘completely open’, also known as “fully disclosed”, in which there is ongoing contact among those involved, including the child. (This would be like hovering over and seeing the entire shape). A third mode is a hybrid form called “Mediated” adoptions that falls somewhere along the large spectrum between completely closed and fully disclosed. Usually, this means that the adoption agency facilitates the periodic exchange of pictures and letters, but they're typically is no direct contact among the affected parties and they do not receive identifying information about each other. This hybrid form leaves many questions unanswered and often creates more disquiet in the adoptee, tantalized by what they know, intensely curious about what they don’t - still unable to see the entire ‘shape’ of the situation.

In historical terms, ‘closed adoption’ with absolute secrecy is a relatively recent practice; it began in the U.S. in the 1930s and grew out of the prevailing attitudes of the day, primarily the desire to protect adopted children from the stigma of illegitimacy. As that stigma gradually evaporated over the ensuing decades, the number of agencies offering open adoptions grew rapidly and, by 1999, close to 80 percent offered that option. (*1)

Even though most agencies do offer open adoption services, they often lack the expertise (and perspectives) necessary to facilitate and nurture a successful bond between the adoptee and their new family. Just because you can see the entire shape and scope of the situation - doesn’t mean you can get over or through the walls to get inside the circle and make a true emotional connection. 

Making this connection is the most important objective in an open adoption process and should be the goal of all post-adoption services. The most effective tool to achieve this connection is to have a truly, non-biased approach to managing all the parties involved: the parent by birth, the parent by adoption, foster care or kinship families and extended relatives. Most importantly, these various factions must be managed and aligned toward "the best interest of the child” and to do this the facilitator must be able to hold the point of view, and empathy, of every party involved. 

Imagine the high walled circle again. On one side stands the parent by adoption, another the birth parent, another the foster parents - each group can only see their section of wall, they can’t even see each other. The goal of the Open Adoption Facilitator is to have an objective perspective that can see, know, and receive all angles. This person can then more effectively negotiate and manage the relational agreement, assist each party to process the "day to day", "week to week", "year by year" boundaries of the agreement, and monitor the steps of the agreement, so that all parties are held psychologically and emotionally well over time. This process will eventually elevate all parties high enough to not only enter the circle, but work together to make the strongest connection possible when inside. 
This is no easy task. And as it is a relatively recent development, not many social workers or adoption agencies have personnel trained in this approach and know how to be an effective ‘ Open Adoption Facilitator.’

As an adoptee myself, I grew up in a closed adoption. I had no information about my roots, except a vague story that "they couldn't keep me." I struggled with my identity and I was always looking backward, rarely ahead. I did not know anything about my cultural or ethnic background until I became an adult and searched. I later found and learned that my birth mother, Celia, was Argentinian and struggled with mental illness. I flew to Argentina as an adult, to have a reunion with her, and was able to get some understanding of what had happened. It gave me some clarity, a slightly better vision of my own walled circle and a deeper sense of connection, I felt a greater sense of belonging and felt closer to my adoptive family.  

That said, the reunion with my birth mother, even after all those years, still triggered my trauma - I felt overwhelmed by the loss of time, the realization of just how much of my life had this subtext of the unknown, the mystery of the truth of me. How all those gaps in my personal history became gaps in my psyche, manifesting in a loss of self-esteem and the constant questioning of why? And who’s fault was it? It became an almost constant wondering which culminated in various fantasies, especially as a pre-teen, as to who I really was and who my parents may be - Rich? Poor? Happy? Sad? I was living with a myriad of historical indexes and complex feelings, yet I had no words to explain it.

For many adoptees, the "not knowing anything about their parents by birth, leaves them in a constant state of captivity: of grieving, yearning, and remaining in a turbulent search for self. It's like walking into a mystery movie 15 minutes late and not knowing the who/what/when/where or how?”

Pauline Boss writes about this loss in her book, Ambiguous Loss: Learning to Live with Unresolved Grief. She says, "My basic theoretical premise is that ambiguous loss is the most stressful kind of loss. It defies resolution and creates long-term confusion about who is in or out of a particular couple or family. With death, there is an official certification of loss, and mourning rituals allow one to say goodbye. With the ambiguous loss, none of these markers exist. The persisting ambiguity blocks cognition, coping, meaning-making and freezes the grief process." I highly recommend her book to any clinician working in adoption.

This "stressful loss" is ambiguous for the adoptee and can turn into traumatic grief if left untreated. That is why knowing their birth roots leads to healing these unanswered questions, rebuilding continuity from past and present relationships, and creating a through line to their story, rather than an abrupt stop which doesn't yield the ambiguity. 

In a 2012 study called, OPENNESS IN ADOPTION: FROM SECRECY AND STIGMA TO KNOWLEDGE AND CONNECTIONS, the Evan B. Donaldson Institute depicts how extensively adoption in the U.S. has changed over the last several decades – from a time when it was shrouded in so much secrecy that birth and adoptive families knew nothing about each other, to a new reality today in which the vast majority of infant adoptions are "open," meaning the two families have some level of ongoing relationship. found intriguing results, that children who had reunion with their birth families were better off in the long haul. (*2)

The Evan B. Donaldson study found:

• 73% of most foster/adoptive parents that include birth parents, report positive experiences.

• Children are not confused, they develop more confidence and self-esteem knowing where they come from. They thrive knowing this information!

• Children report "It's nice having an open adoption because I know her and know what she's like. She's a friend, she doesn't have a parental role, because I already have that."

• Openness is linked to greater feelings of entitlement and reduced fears of birth parents.

• Parents report greater empathy and more positive attitudes about their children’s birth parents.

• 94% of parents, in relationships with birth parents, are generally satisfied with the level of contact and perceive benefits for their relationships with their children. 

• Birthmothers having contact report less grief, regret and worry, and more relief and peace of mind than do those without contact. (*3) 

• In addition, birthmothers who have the opportunity to personally shape the form of their children’s adoptions have a greater sense of self-efficacy and more positive adjustment following the placement. (*4) 

• Caring birthparents who establish and maintain a relationship with their children after adoption can gain a sense of contributing to their well-being and of being a supportive resource to them. 

Clearly, the evidence is there to promote truly open adoptions. And as an active ‘Open Adoption Facilitator' in my psychotherapy practice, I have experienced first hand the benefits of open, and well-prepared reunions which provide a "corrective emotional experience" for everyone. 

It was Alexander and French who enunciated the concept of corrective emotional experience as the fundamental therapeutic principle of all etiological psychotherapy. In their definition it means "to re-expose the patient, under more favorable circumstances, to emotional situations which he could not handle in the past. The patient, in order to be helped, must undergo a corrective emotional experience suitable to repair the traumatic influence of previous experiences." (*5)

So what is best practice as an open adoption facilitator? How is an agreement arranged? What is the structure of visitation? How much and how long? How close and how far?

Here is how I facilitate this process.

The first task is to work with each party individually and collectively to create a root template outlining a set of shared values and ethics, so we all know the rules and are working toward the same goal:

1. All parties agree to work at building compassion for the other, to talk with the open adoption facilitator (together or separately) to understand and process emotional triggers to help avoid any surface conflicts of misunderstanding. Success can only be achieved if each party has empathy with the other party and understanding what may be difficult and defining roles and expectations clearly. 

2. Stay open-minded to be less afraid, which will help demystify fears and embrace differences, in order to develop a genuine relationship with one another. 

3. Treat each other with respect and acceptance. Accepting people for who they are – for the good of the child and in the presence of the child.

4. Be open to learning each step of the way and always follow the child's lead when creating new changes and transitions.


5. The second step is to create the plan of action, which I demonstrate in the following steps, very concretely, so children can know what is going to happen. This is a typical step plan and every client is different depending upon their level of openness. Some children need more steps, and some kids want less. Always follow their lead.


Plan A - Letter writing, psycho-education with birth family:

1. Initially, the Open Adoption Facilitator develops a relationship with the birth parent via phone call or face to face, and listens, establishes a relationship and educates about the beginning steps of contact. This also includes processing feelings, thoughts, and concerns to arrive at Plan B- having a reunion via Skype/FaceTime and agreeing on ‘what to expect, what is the shared story that will be told to the child/teen’ as per the story of their adoption. Once a verbal agreement has been made about having a ‘positive reunion,’ which means each party agrees to share information with honesty, integrity and honoring the sensitivity and age of the adopted person, then Plan B or C can occur-having a reunion in person. This root template agreement can also include siblings. This beginning step can take a few months of preparation. Always follow the birth parents lead, not to force, but to process expected and unexpected "triggers" for all parties.

2. Inform the child/teen that you have made contact with their birth parent (only if the relationship has been established and they are on board with moving towards reunion). The child/teen can write them a letter with questions, photos, artwork or tell them about their life. Inform the child/teen, they will receive a letter in return from their birth parent. All letters are handled by the facilitator, in these beginning stages. When all parties are in an empathic relationship they can begin to exchange information via email or text. 

3. The facilitator helps the birth parent answer the child's questions, guiding them by answering what is asked. Keeping in mind, the child's age and maturity. However, never making up answers, but answering the best to their memory. Sometimes, answering "I don't know" is valued, if that is the truth. If there is something too personal being divulged, we discuss boundaries of information. Children don't need to know every detail, i.e. "at that time, we were young and inexperienced as parents, and did not feel we could parent any baby born on your birthday. It was not about you, it was about our level of confidence at that time, that we decided we couldn't provide you with all that you would have needed to thrive." 

When I help birth parents answer a child's questions, via letter writing, each story is different. There is never a blunt, cookie cutter answer. I need to really think about all sides of the story, and respect the mother's privacy to what is her story, and respect what the child needs to know and have answered.

4. When most questions have been answered and child/teen has processed feelings/thoughts with adoptive parent or therapist then Plan C can happen.

Plan B (if birth-parent is out of the state and face to face is not possible for some time)

1. Ask child/teen if they would like to Skype/Face Time with their birth parent and or siblings. I recommend child/teen Skype/Face Time with each family member individually. All media sessions, we recommend be gently supervised, which means you are present in the room while this is occurring. I usually create a phone call notebook, which has the date of call, a pre-written list of questions or things to talk about before the call occurs so to provide structure. With children/teens, a typical call lasts 20 minutes on average. The facilitator writes the answers to the questions in the notebook. When the call is over the child/teen processes how the call was for them emotionally and psychologically. We also plan questions for the next call. 

2. Talk with child/teen about feelings/thoughts they may have about a Skype/Face Time with a birth parent and or siblings.

3. Set up a time/length of the Skype session and be sure to inform the birth parent to not include any surprise visitors to the session without your agreement. Skype/Face Time can only be done with those honoring this full plan. This includes siblings.

4. Set up a regular Skype/Face Time session with time/length so child/teen can be reassured they will maintain contact. Please inform birth parents the importance of being consistent with the regular Skype’s as to not cause the child/teen to feel psychologically rejected by their birth parent.

Plan C - The Reunion

1. Talk with child/teen about feelings/thoughts they may have about a reunion face to face with the birth parent. I create a very structured day to day, hour to hour layout of what will happen so everyone is clear. 

2. Schedule with the birth parent a time/place (preferably a comfortable reunion room, or a park). We do not recommend a restaurant or a busy location. And decide the length of the reunion in advance i.e. 2-3 hours. If all is going well, you can have more time, however, keep in mind healthy emotional boundaries and help your child/teen say ‘goodbye for now’ in a healthy way. This will help them begin to repair their loss and grief and reassure them they will see their birth family again. TO NOTE- I create a non-verbal signal for the child to communicate to their parent, if they are overwhelmed, need a walk, breath of fresh air i.e. 2 blinks of the eye, 2 taps on the hand with 2 fingers. We need to allow children to take care of themselves emotionally. All children have thresholds of stress tolerance and we need to honor their window, so we do not cause secondary trauma.

3. Inform child/teen of when/where the/length of time the reunion will occur to give them preparation time. I advise at a minimum of 2-3 months in advance, to allow for the adoptee to process their thoughts/feelings/questions they may have.

4. When taking photos or videos of the reunion, the adoptee must be part of this planning process. Some may not want photos or videos and we need to respect that. When they feel ready and more comfortable, they will let you know.

5. I recommend bringing photo books of the adoptee’s life since birth for the adoptee to share with the birth parent. Have the child/teen be a part of choosing what is in the book so they can have a sense of control and repair their early sense of having no control in the matter because all the choices were made for them and they didn't have a say in the matter. This will also help focus the reunion on sharing their lives together.

6. If you can ask the birth parent to do the same and bring photos of themselves too, adoptees find this very encouraging because they usually see a lot of resemblances and feel a great sense of identity and connection with their heritage. 

Plan D - After Reunion Open Adoption Agreement Samples

1.  Visits- Face to Face- 3-4 visits per year at a mutually convenient, agreed-upon location and time. Always follow the child's lead. As all parties become more comfortable, more face to face visits can occur. Visits must be confirmed by both parties 48 hours in advance.

2.  Telephone/Skype/Face Time - 1x week on either a Saturday OR Sunday via a Skype account set up by parents, set time and length of the call. 

3.  Email- unlimited email via a Family email account set up by parents.

4.  Letter Writing- Letter writing back and forth is unlimited. This agreement is valid for one calendar year.

Perhaps most importantly, always keep in mind that " The foundation of the agreement is based on compassion and respect with an over arching principal of the best interest of the child. But what’s difficult about these agreements is you can’t contract behavior,” as stated by Carra Greenberg, J.D ., a lawyer who has worked in adoptions .

So the point is, each party must commit to the process and treat it with respect no matter how difficult it becomes and it is the Open Adoption Facilitator’s role to do their best to provide perspective, empathy, and support for every party involved, ultimately breaking down the walls of isolation and secrecy and allowing for fruitful and honest connections to be made and sustained. 

I hope this article helps in understanding the necessary steps of preparation, honoring structure and most important nurturing relationships. This can take years and that is ok. Facilitating an open adoption agreement is always a process of beginning, experiencing, stopping, slowing, sometimes stepping back, always moving forward, forgiving, learning, and enhancing the lives of all involved. Ultimately, all parties will rise up and be able to see the entire circle, settling comfortably inside where true happiness can grow. 

As said by James L. Gritter, author of Lifegivers: Framing the Birthparent Experience in Open Adoption says:
The birth family created the life.
The adoptive family sustains the life.
And together, they affirm the child's life.
Please learn more about Openness in Adoption shared by April Dinwoodie, Executive Director of the Donaldson Adoption Institute, an organizational leader in adoption.
References:

1. Hollenstein,, T., Leve, L. D., Scaramella, L., Milfort, R., & Neiderhiser, J. M. (2003). Openness in adoption, knowledge of birthparent information, and adoptive family adjustment. Adoption Quarterly, 7 (1), 43-52.  2. Deborah Siegel and Susan Smith Published: March 2012. OPENNESS IN ADOPTION: FROM SECRECY AND STIGMA TO KNOWLEDGE AND CONNECTIONS. Study by Evan B. Donaldson Institute. 3. Cushman, L.F., Kalmuss, D., Namerow, P. B. (1997). Openness in adoption: Experiences and social psychological outcomes among birth mothers. Marriage and Family Review, 2 (1), 7-18.  4. Sobol, M. P., Daly, K. J., Kelloway, E. K. (2000). Paths to the facilitation of open adoption. Family Relations, 49(4), 419-424. 5. Alexander, F.G., French, T.M . (1946). Psychoanalytic Therapy: Principles and Applications. New York: Ronald Press. 

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