Good practice with adults in adoption

Gary Clapton (University of Edinburgh)

November 2018

Acknowledgements

This Insight was reviewed by Helen Allbutt (NHS Education for Scotland), Rena Phillips (independent practitioner and Coordinator of PACS, Post Adoption Central Support) Trudi Reid (Scottish Adoption) and Louise Wilson (Birthlink). Comments represent the views of reviewers and do not necessarily represent those of their organisations. Iriss would like to thank the reviewers for taking the time to reflect and comment on this publication.

Key points

- One in ten of the Scottish adult population has a direct connection with adoption.

- Adoption is much more than a one-off event. It is a lifelong process for all.

- The desire to find information about personal origins is ok and happens more often than not. Searching for birth family members is also normal.

- Birth mothers need services that address the persistence of loss and grief, and the undimmed desire to know how their adopted child has fared.

- Adoptive parents need a service that understands that the parenting they have done and do is of value, so as not to be upset by questions and activity related to family of birth and origins.

Introduction

Adoption has a long history as a way of providing a new family for a child that cannot be cared for in its family of origin by transferring parental rights from one set of parents to another. Prior to the 20th century this was often an informal arrangement, however, in more recent times adoption has been covered by legislation. In Scotland, adoption was made legal by the Adoption Act 1930 and since 1975 most adoptions are arranged by an official adoption agency.

Around 98,000 formalised adoptions have taken place in Scotland between 1930-2016 (National Records of Scotland, 2016). Some are ‘step-parent’ adoptions where a new stepfather or step-mother has joined with the child’s birth mother or father to adopt the child. There are also adoptions by other relatives, such as grandparents or aunts and uncles, but most adoptions involve a child being adopted by people that are not biological kin.

In the UK, the number of infants adopted rose to an annual peak of 27,000 in 1968 and, writing in the early 1990s, Howe and colleagues suggested that up to that point half a million mothers had had their children adopted (1992). In Scotland there were two annual peaks of adoption. The first after World War II in 1946 when 2,292 adoptions took place, and the second in 1969 when there were 2,268 adoptions (National Records of Scotland, 2016).

Throughout the 20th and 21st centuries, major shifts have occurred in UK adoption policy and practice, and recent history may be divided (with some reservations) into two relatively different periods. These two periods contain two different populations – prior to the 1980s when adoptions of babies was the most common form of adoption; and those after the 1980s since when there has been a marked decline in baby adoptions from the peak of the late 1960s, to the point where the majority of adoptions today involve children over one year that have spent time in local authority care. Indeed, in the post-1980s, 86% of adoptions took place as an alternative to birth family care for children between one and nine years (Thomas, 2013).

This Insight is concerned with the people and relatives relating to adoptions prior to the 1980s when the vast majority were relinquished by birth parents (as distinct from many of today’s adoptions from care which involve opposition from birth parents). As the title indicates, this publication is about adults (adopted people, adoptive parents and birth parents), and not about current issues concerning children.

Counting back eighteen years from now to 2000 at which point there was 90,000 adoptions in Scotland and the children of those adoptions would now be adults, it can be argued that some 450,000 adults – the adopted person, adoptive parents, birth parents – have a direct connection with adoption. This amounts to one in ten of Scotland’s estimated population of 4.5 million over-16s (National Records of Scotland, 2018).

If brothers and sisters, aunts and uncles, grandparents and spouses/partners are factored in, then it would be considerably more who have a connection with adoption. Added to this, not all will be alive or resident in Scotland, crossing borders between England and Scotland for example. Despite this and the rise of interest in genealogy, and the regular adoption-related storylines in the soaps, it is rare that mainstream social services promote support for adults in adoption and most support is left to charities. Why is this?

Adoption and secrecy

In the past, many adoptions were kept a secret, even within a family and sometimes children grew up not knowing the truth about their origins. When the information was discovered accidentally it was usually a shock (Lifton, 2009). To avoid this, for decades now, adopting parents are advised to tell children about their adoption when they are young and to talk about it when the children have more questions or if the subject comes up naturally. In order to help adoptive parents and their children, agencies are urged to pass on as much information as possible (first4adoption.org.uk). However, it can still happen that adoptive parents have very little information about birth parents or this is incomplete or inaccurate (Courtney, 2000). Sometimes adoptive parents were reluctant to talk about adoption for personal reasons such as acknowledging infertility or for fear of causing their son or daughter unnecessary distress (Miall, 1989). Such taciturn behaviour meant the subject was difficult to broach. Once adult, many adopted people curious about their origins, are afraid of seeming disloyal to their adoptive parents and so suppress this curiosity or conceal attempts to have it resolved (Schooler, 1995). However, there are often cases in which an adopted person’s search for their birth origins has been encouraged and accompanied by their adoptive mother or father (see Jackie Kay’s, Red Dust Road).

Though it is well-established that the desire for information is normative (Scharp and Steuber, 2014) and that for more adopted people than not, searching for birth family members is also normal (Wrobel, 2004) nevertheless, adoption-talk still carries some discomfort. Ignorance, mystery and sometimes deception are some of the feelings that swirl around for adopted adults (Baden, 2016). An emphasis that equates adoption solely with children, may also, it is suggested, tend to marginalise the needs of adults. However, the difficulties in finding out what records exist and where to find these can also foster feelings of neglect (Clapton, 2008).

Adoption and records

In Scotland, accessing information relating to original birth records has always been easier than in other parts of the UK because the first Scottish Adoption Act in 1930 stated that from the age of 17, adopted people who were born here could see and obtain a copy of their original birth certificate. In England and Wales this was not possible until 1975. The Children (Scotland) Act 1995 changed the age of right to access to original birth certification to 16, partly because this is the legal age of marriage and adopted people may need to make enquiries to be sure they are not too closely related to the person they plan to marry. Since 1930, it has also been possible for people who were adopted in Scotland to see the legal papers known as the ‘Court Process’ relating to their adoption. These papers are sealed when the Adoption Order is made and there are strict rules about gaining access to them (although these are straightforward compared to the rest of the UK where no right of automatic access exists).

Now that more adopted people are searching for information or hoping to make contact, the publicity around this has made it easier for birth parents to voice their needs, such as to know how their children have fared. Birth families do not have the right to obtain adoption certificates or to have access to the Court Process, but they may seek information from the agency that organised the adoption of their child. Since 1984 they have been able to register on the Adoption Contact Register for Scotland run by Birthlink. Sometimes social services agencies will keep messages on file from a birth mother for her adopted child and in a few cases, social service departments will contract with search agencies to help adopted adults and birth parents get in touch. Notwithstanding the various improvements in services for adults in adoption (the Adoption and Children Act 2007 required that adoptions agencies actively support adopted adults), adopted people continue to attest to the complexities of accessing information and searching for their birth families (Clapton, 2008). For example, access to records can range from an agency provided transcript of a page or two that may withhold the name of a birth father, to the full photocopied case notes. Birth parents’ access to their records is less well-established as a right, information ‘may’ be shared (Adoption (Disclosure of Information and Medical Information about Natural Parents) (Scotland) Regulations, 2009) and often it is the prerogative of the adoption agency as to whether and what it will share with them about the adoption of their child. Such constrictions contribute to the air of secrecy that can surround adoption and working through the consequent frustration is common. Finally, it is worth noting that the language of adoption has changed and decades-old records will contain quaint formulations, some of which are derogatory about young pregnant and unmarried women. Other case record entries will need care in deciphering, for example, legalistic jargon such as ‘putative father’ (the biological father but termed ‘putative’ because he may not be aware of his child’s existence). Sensitivity is also needed when phrases such as ‘surrendered for adoption’ are read, as are decoding skills with initials such as NAI (non-accidental injury) and RIC (reception into care).

What are the specific needs of those involved?

Adopted adults

“I don’t know what diseases come down my line; when dentist and doctors ask the old blood questions about family runnings I tell them; I have no nose or mouth or eyes to match, no spitting image or dead cert, my face watches itself in the glass.” (The Adoption Papers, Jackie Kay, 1991)

The curiousity that adopted adults have about their origins is an evidenced fact that has nothing to do with deficient upbringing and everything to do with an entirely natural need to know where we come from. Beyond curiosity, many adopted adults feel a need to meet their birth parents:

“Maybe I am looking for something I never had which I may never get, but until I meet her I will never know. I am hoping I can have a relationship with her. She is flesh and blood and there must be a tie… I’ve got lots of friends but I want somebody that is like me, that’s part of me” (quoted in Clapton, 2014)

The most common reasons given for searching include ‘getting information about me to help complete the jigsaw’ and ‘the need to know more about myself and make the picture whole’.’ (Howe and colleagues, 2001, p346).

Other answers are also needed. Neil suggests ‘it is important for adopted people to know not only the details of their biological heritage, but to explore the question of why they were adopted. This entails understanding the issues that led to the adoption, including the circumstances of the birthparents and the actions of social workers and agencies’ (2000, p303). Neil goes on to state ‘the need to know the truth is compelling’ (p304).

More practical information-based reasons also exist. Adopted persons often lack genetic and medical history, as well as other family information. A routine visit to the doctor’s office where the adopted person is asked to supply medical history, may make adopted persons acutely aware of how they differ from those who are not adopted. Those who find out only later in life that they were adopted as infants are sometimes put at risk by their long-held assumption of a family medical history that they later find is completely incorrect (CWIG, 2004). However, as previously noted, information about origins is often not readily or easily obtainable. For instance: ‘70% of searchers and 74% of non-searchers said they did not feel comfortable asking their adoptive parents about their origins’ (Howe and Feast, 2003). In Iredale’s accounts of adopted people’s meetings with their birth relatives, one adopted person feared asking her parents for information: ‘I was scared of upsetting the apple cart by broaching the subject’ (1997, p151), or for another, raising the matter was at the least a ‘guessing game’ (p152).1 Howe and Feast also note that adopted people who are not curious about their origins still have a need for services. Three quarters of the ‘non-searchers’ among the adopted people they surveyed felt that it was right for agencies to let them know that a birth relative had made an approach. Scharp and Steuber (2014) helpfully suggest a life-span approach to decisions and choices, ie a need to appreciate that preferences to search or not will not be static and may change with greater maturity or be affected by a major life event.

At the point of first contact, either by an adopted person or from a birth relative, people often need help with its impact. The speed at which it is possible to identify someone and collect information about them can make that person readily accessible, and so much care and thought is needed before sending a message or an email. Trinder describes the communication out of the blue as ‘an unexpected and unsolicited approach that is highly likely to be a considerable bombshell’ (2000, p20). Armstrong and Ormerod provide a comprehensive list of emotions that may be experienced, ranging from anger to ‘a mammoth shock’ (2005, p33). They also note that the search and contact process has been found to be more successful if an intermediary is engaged because this ‘does give a better chance of ongoing contact being established’ (2005, p7).

In the longer-term it has been noted that ‘People may need access to counseling over a period of years and not just at the point of contact’ (Feast and Smith, 1995, p23). Additionally, not all questions may be answered at once (nor might there ever be definitive answers) and as relationships proceed, new ones may arise, for example, concerning a birth father.

Overall, adopted adults may seek help with interpersonal relations, integration of adoption experiences, struggles around adoption, healing processes, grief and loss, and preparation for a reunion with a birth parent (CWIG, 2004). While ‘reunion’ is regularly used by professionals and academics, it is not a word in widespread use by adopted people. More importantly, it implies joining together again and imposes and raises expectations all round that may not be fulfilled (Clapton, 2003; Trinder and colleagues, 2004).

A frequent fear of adopted people that embark upon a search that might lead to contact with their birth family is that of rejection. Having once been relinquished, anxiety over being rejected again can be present. Good practice suggests that, on top of the other emotions sketched above, practitioners ought to be sensitive to this (after all, not all contact and meetings are positive).

Birth parents

Birth mothers need services that address the persistence of grief and undimmed desire to know of their adopted children. An early and influential Australian study of 213 women found that while not all women experienced ‘negative adjustment’, for others the effects of relinquishment could be devastating and long lasting. In particular, the study found that it was inappropriate to view mothers who give up their children for adoption as women who have put their problems behind them (Winkler and van Keppel, 1984). Subsequent UK studies underlined this message, for example, Bouchier and colleagues (1991) and Howe and colleagues (1992).

While UK research on birth mothers’ experiences seems to have peaked in the 1990s, elsewhere it has continued and a major US review of research concluded that ‘research on birth parents in the era of confidential (closed) adoptions suggests a significant proportion struggled – and sometimes continue to struggle – with chronic, unresolved grief’ (Evan Donaldson Institute, 2006, p5).

More recently in Australia, a Federal government-commissioned enquiry into past adoption practices took place. This encompassed testimony from birth mothers, professionals, adoption agencies and a wide-reaching review of world-wide research. The Enquiry heard hundreds of birth mother testimonies. These spoke to ongoing emotional damage, and feelings such as anger and disbelief that could not be resolved. The Enquiry observed that ‘the effects of forced adoption had had a severe and continuing effect on the lives of mothers and that these were life-long (Senate Community Affairs References Committee, 2012, p. 89):

“The pain never goes away, that we all gave away our babies. We were told to forget what happened, but we cannot. It will be with us all our lives. It has affected us in so many ways, by getting married so early, married, children, divorced. We are all trying to find or avoid that [which] will never be filled.” (Witness)

“I was told to go home and get on with life. I have had 20 years of psychiatric therapy for severe depression and panic attacks, I still take medication to this day.” (Witness)

The Senate Enquiry observed that ‘The witness accounts given as evidence to this inquiry greatly disturbed the committee. Most significantly, they point to ongoing health and welfare problems that need to be addressed’ (ibid, p94).

Alongside the Federal Enquiry, a study by the Australian Institute of Family Studies involving over five hundred birth mothers, concluded that there was a ‘higher than average’ likelihood of birth mothers suffering from a mental health disorder compared to the general population; that ‘close to one-third of the mothers showed a likelihood of having a severe mental disorder’ at the time of the study, and that ‘over half had symptoms that indicated the likelihood of having post-traumatic stress disorder’ (Kenny and colleagues, 2012, pxiii). The writers went on to point out:

“…significant implications for the workforce development requirements of those likely to be in contact with mothers affected by past adoptions, including primary health providers and those working in the mental health field, such as psychologists, psychiatrists and psychotherapists.” (Kenny and colleagues, ibid)

Social workers and other adoption professionals can be added to the list of those that would benefit from greater awareness of the birth mother experience. The birth father experience is much less known, however, what we do know suggests that birth fathers need a service that understands that for many men whose children have been given up for adoption, out of sight does not mean out of mind. Studies of birth fathers have pointed to the many similarities of experience between birth mothers and birth fathers. These include: continuing to mourn the loss of their child throughout their lifetime, tracking the milestones of their child’s life by imagining birthday parties, first days of school, graduation and more. Attention has also been drawn to feelings of guilt and shame regarding the adoption (Clapton, 2007).

Just as for adopted people, when birth parents are about to meet their adopted sons and daughters, good practice suggests that, on top of the other emotions sketched above, practitioners ought to be sensitive to the possibility that anger and rejection will be part of the process. Characterising contact and meetings as a process is an important approach because for birth parents, and indeed for adopted people, outcomes of meetings and relationships between adopted people and birth parents are provisional (Baden and Wiley, 2007). The potential for long-term relationships cannot be judged by the fizz and pop of first meetings, nor should early contact that meets with suspicion or rejection be deemed final.

There is a growing awareness of the needs of other birth relatives. Especially prominent has been work on siblings. As birth parents grow old and die, it is more likely that siblings may be the only living connection with family of origin. It has been argued that the more ‘horizontal’ connections between siblings can have less ‘baggage’ such as birth mother guilt and, paradoxically, the fact of having no knowledge of the circumstances of the adoption of a brother or sister (Curtis and Pearson, 2010). Additionally, according to Farr and colleagues (2016), siblings of an adopted person may be an important resource from which more rounded family information can be gleaned. On the other hand, for the adopted person, discovery of brothers or sisters may also invoke a feeling of ‘why was I the one that was adopted?’ All the more reason to highly value the importance to the adopted person of being able to know and own the story of their life and adoption.

Adoptive parents

The relationship between adoptive parents and their adopted (adult) children is under-researched. This is especially so in relation to an adopted person’s search, contact and any subsequent relationships with members of their birth family. Adoptive parents need a service that understands that the parenting they have done and do is of value and that adoption brings with it specific and unique challenges, many of which are about how to acknowledge the importance of roots with their son or daughter, and how to support them should they wish to trace their birth parents. Sometimes very caring and supportive adoptive parents can be unaware of the wish to talk or hear about the birth family. The silence of an adopted person on the subject of birth parents can be misinterpreted as a lack of interest, though as noted earlier, this can more accurately reflect a feeling that it would be disloyal to bring up curiosity about origins (Jones and Hackett, 2008).

Adoptive parents can experience a range of emotions when their adopted son or daughter begins to search for information or actively seeks contact with birth family members. Neglect is a powerful one, with most post-adoption services geared up to support what can be seen as the two primary parties in a reunion, the adopted adult and the birth mother. Anxiety that they may be replaced as parents is also present for adoptive parents, yet the vast majority of research suggests that rejection or replacement is not the case. A protectiveness that their son or daughter might be hurt has also been found (Petta and Steed, 2005). In their qualitative study of the experiences of twenty-one adoptive parents, Petta and Steed conclude that the overwhelming emotion was that of fear of losing their child and attendant emotions such as self-doubt. They recommend that: ‘adoptive parents need to be engaged as clients in their own right and be provided with opportunities to express and deal with their own emerging experiences’ (p240) and special attention be given to reducing ‘the sense of competition with the birth parent’ (ibid.). An empathic response to adoptive parents can sometimes be overlooked during the emotional rollercoaster of reunions between adopted people and birth parents, yet there is a crucial need for this too.

Finally, everyone directly concerned with adoption will probably have others in their lives. Spouses, partners, children, relatives, friends and other confidantes, will become involved. This is to be appreciated. More openness means less stigma and less stigma means greater understanding.

Fundamentals for social workers and other professionals

There is a considerable amount of advice available and countless websites. In their advice for ‘adoption-sensitive’ practice, Baden and Wiley (2007) suggest that the basic issues are:

- Identity (for adopted people)

- Search and reunion (for both adopted people and also birth parents)

- Well-being and mental health (both)

- Grief and loss (both)

The fact is that birth parents can experience identity crises too. An innocent ‘how many children have you got?’ question can be uncomfortable when the existence of a first, adopted-out, child has been a private matter. Moreover, adoptive parents may also experience any or all of the issues on Baden and Wiley’s list. However, the counsel to avoid over-pathologising anyone is a useful reminder that not every adopted person will experience identity problems, nor are all birth mothers incapacitated by grief, and adoptive parents regularly unsure of themselves.

Secondly, Baden and Wiley helpfully suggest that for practitioners, neither denial of difference between adoptive and birth families, or insistence on difference is helpful for adults in adoption.

A starting point for help is to appreciate these points but above all else, to understand that adoption is not an event but a life long process for everyone.

The ‘must knows’

There are a number of ‘must knows’ for those working in this area:

- Entitlements of people under law and policy

- Knowledge of the records that exist and where and how to access them

- Understand that case records can be misleading, incomplete, are at times hurtful to read and always generate high emotions

- Accurate information on services from local authorities and adoption support agencies

- Knowledge on the ins and outs of searching births, marriages and deaths

- Making contact is smoothed with the use of an experienced mediator or go-between

References

Armstrong S and Ormerod T (2005) Intermediary services in post-adoption reunion. New South Wales, Australia: Post Adoption Resource Centre

Baden A (2016) ‘Do you know your real parents?’ and other adoption microaggressions. Adoption Quarterly, 19, 1, 1-25

Baden A and Wiley M (2007) Counseling adopted persons in adulthood: integrating practice and research. The Counseling Psychologist, 35, 6, 868-901

Bouchier P, Lambert L and Triseliotis J (1991) Parting with a child for adoption, the birth mother’s perspective. London: British Association for Adoption & Fostering

Child Welfare Information Gateway (2004) Impact of adoption on adopted persons. Available at https://s.iriss.org.uk/2REiTb7 [accessed 1 September 2018]

Clapton G and Hoggan P (2013) Adoption and fostering in Scotland. Edinburgh: Dunedin Press

Clapton G (2003) Birth fathers and their adoption experiences. London: Jessica Kingsley Publications

Clapton G (2007) The experiences and needs of birth fathers in adoption: what we know now and some practice implications. Practice, 19, 1, 61-71

Clapton G (2008) The right to information in practice: adoption records, confidentiality and secrecy. In J McGhee and C Clark (eds.) Private and confidential? Handling personal information in the social and health services. Bristol: The Policy Press

Clapton G (2014) Birthlink’s adoption services for adults: what they are and why we provide them. Edinburgh: Birthlink

Courtney A (2000) Loss and grief in adoption: the impact of contact, Adoption & Fostering, 24, 2, 33-44

Curtis R and Pearson F (2010) Contact with birth parents: differential psychological adjustment for adults adopted as infants. Journal of Social Work, 10, 347-367

Evan Donaldson Institute (2006) Safeguarding the rights and well-being of birthparents in the adoption process. New York: Evan Donaldson Institute

Farr R, Flood M and Grotevant H (2016) The role of siblings in adoption outcomes and experiences from adolescence to emerging adulthood. Journal of Family Psychology, 30, 3, 386-396

Feast J and Smith J (1993) Working on behalf of birth families – the Children’s Society experience. Adoption & Fostering, 17, 2, 33-40

Goddard J, Feast J and Kirton D (2008) A childhood on paper: managing access to child care files by post–care adults. Adoption & Fostering, 32(2), 2

Howe D and Feast J (2003) Adoption search and reunion: the long-term experience of adopted adults. London: British Association for Adoption & Fostering

Howe D, Sawbridge P and Hinings D (1992) Half a million women – mothers who lose their children by adoption. London: Penguin

Howe D, Shemmings D and Feast J (2001) Age at placement and adult adopted people’s experience of being adopted. Child & Family Social Work, 6, 4, 337-349

Iredale S (1997) Reunions: true stories of adoptees’ meetings with their natural parents, London: The Stationery Office

Jones C and Hackett S (2008) Communicative openness within adoptive families: adoptive parents’ narrative accounts of the challenges of adoption talk and the approaches used to manage these challenges. Adoption Quarterly, 10, 3–4, 157-178

Kay J (1991) The adoption papers. Northumberland: Bloodaxe

Kay J (2017) Red dust road. London: Pan Macmillan

Lifton B (2008) Journey of the adopted self. New York: Basic Books

Miall C (1989) Authenticity and the disclosure of the information preserve: the case of adoptive parenthood. Qualitative Sociology, 12, 3, 279–302

National Records of Scotland (2016) Vital events reference tables - Section 2: adoptions and re-registrations. Available at: https://s.iriss.org.uk/2RCd8ut [accessed 1 September 2018]

National Records of Scotland (2018) Mid-year population estimates scotland mid-2017. Edinburgh: Crown Copyright

Neil E (2000) The reasons why young children are placed for adoption: findings from a recently placed sample and a discussion of implications for subsequent identity development. Child & Family Social Work, 5, 4, 303-316

Scharp K and Steuber K (2014) Perceived information ownership and control: negotiating communication preferences in potential adoption reunions. Personal Relationships, 21, 515-529

Schooler J (1995) Searching for a past: the adopted adult’s unique process of finding identity. Colorado: Pinon

Thomas C (2013) Adoption for looked after children: messages from research. An overview of the Adoption Research Initiative. London: British Association for Adoption & Fostering

Trinder L (2000) The rights and wrongs of post-adoption intermediary services. Adoption & Fostering, 24, 3, 19-25

Trinder L, Feast J and Howe D (2004) The adoption reunion handbook. Chichester: John Wiley

Winkler R and van Keppel M (1984) Relinquishing mothers in adoption: their long-term adjustment. Melbourne: Institute of Family Studies

1 Satisfying curiosity is not straightforward for adopted people. For instance it is not uncommon for adopted adults to be referred to as the ‘adopted child’. When they seek to gain access to information about their roots, they have to receive services from children’s services teams as if still children (Clapton, 2008).