Residential Treatment and Adoption: The Adoptive Parent Perspective

Purpose: Adopted children have long been found to be overrepresented in clinical populations. Most researchers would agree that the vast majority of the adopted children presenting in need of mental health services are behaviorally and emotionally challenged as a result of prior trauma, separation and loss. Adoptive parents often seek to address severe behavioral issues through the use of outpatient services; however, a higher level of care or residential treatment care is sometimes warranted. Approximately 12% of adoptive families nationally receiving an adoption subsidy have used residential treatment services for their adopted child. A recent study in a western state found that 17.5% of the children in residential care were adopted. This study was designed to explore the experience of adoptive parents who have placed an adopted child in a residential treatment center (RTC). Findings identify services and approaches families state worked well as well as areas needing improvement.

Methods: Twenty-four adoptive parents who placed an adopted child in residential treatment between 2007-2012 were interviewed using a loosely structured interview. Participants were recruited through various means including a non-profit organization that provides financial assistance to adoptive families who are struggling to cover the cost of RTC for their adopted child and three local residential treatment centers. Adoptive parents were asked to share the escalation of their child’s behaviors; their efforts to seek help from various systems, and the eventual decision to place the child in residential treatment. Interviews were analyzed with a primary focus on identifying key themes and strategies to help RTC professionals and staff working with adoptive families before, during and after the child’s residential stay.

Results: Qualitative analysis revealed several themes related to the experience of adoptive parents’ placing an adoptive child in residential treatment. One primary theme was a Paradigm Shift in Parenting. Adoptive parents revealed an evolutionary approach to parenting starting with an attempt to parent from a “normal” parenting paradigm to a recognition that the child may require more than “normal” parenting and the develop a new set of parenting skills including increased vigilance and precautions to secure both their own and additional family members’ safety.  As parents seek help and educate themselves they begin to parent through a trauma lens advocating for appropriate and adequate services for their child. Understanding this paradigm shift is important for professionals working with these families. Parents reveal challenges faced with the child welfare system, the mental health system, the educational system, and the juvenile justice system and provide recommendations as to how these systems can be more empathetic, consistent and supportive to all members of the adoptive family. Lastly, parents identify barriers to finding quality care for their children that is affordable, accessible and provides safety for the child, the family and the community.

Implications: This study has implications for child welfare, mental health, education, and juvenile justice systems. Implications for future research include a reevaluation of the need for residential treatment care for youth who are a safety risk to themselves, their families and their communities.