A Caregiver's Perspective: Service Needs and Barriers Among Families Formed through Adoption and Guardianship

Background and Purpose: The National Center for Quality Improvement on Adoption and Guardianship (QIC-AG) partnered with the Vermont Department for Children and Family Services to survey families formed through adoption and/or guardianship in Vermont. The Vermont Permanency Survey sought to learn about the experiences of families both pre- and post-permanence in hopes of identifying areas for improvement across the Vermont system of care. This paper explored (1) the services and supports that respondents identified as most important for families, (2) unmet service and support needs, and (3) barriers that limit access to those services and supports.

Methods: The Vermont Permanency Survey was developed and sent to all caregivers who were receiving an adoption or guardianship assistance agreement subsidy in Vermont (n=809, a 55% response rate). Caregivers were asked three open-ended questions about services for families formed through adoption or guardianship: (1) three most important services families received, (2) three services most needed but hard to get or not available, and (3) three barriers to accessing services. Using a content analysis, responses were organized into initial categories based on themes that emerged in the data using an open-coding approach. New codes were added when data did not fit the existing codes. Responses were coded independently by two trained coders. The coders met to review the themes, reviewed the codes that were different, and recoded the discrepancies until a consensus could be reached. Level of agreement between raters was 86% on important services, 84% on needed services, and 76% on barriers.

Results: A little over half of the participants identified at least one important service (54%), while close to one fourth of participants listed at least one needed but hard to get service (28%) and one barrier to accessing services (27%). The most important services fell under two broad categories: permanency/family-support services and mental health services. Classes, trainings, conferences and specific agencies were the most commonly reported permanency/family support services while counseling was the most commonly reported mental health service. The most needed but hard to get services included counseling (particularly trauma-informed and adoption-specific), support groups, respite, and child care; however, responses varied by district. In terms of barriers, caregivers commonly reported the location of services not being accessible, services or providers not existing, providers not being trauma-informed or knowledgeable about adoption-specific needs, and services not being covered by insurances; however, these responses also varied by district.

Conclusion and Implications: Because adoption and guardianship are complicated life-long journeys, it is important that families are able to access timely and relevant services. Overall, adoption-specific and trauma-informed mental health providers, accessible trainings, support groups, respite and childcare are needed services that are hard to get. Families often face difficulties in finding providers within their area that have the competence to meet their child’s needs, but these needs and challenges vary by location and urban or rural settings and should be addressed at the community level.