Kim Golding, DDPI Board Member, has written a Paper Review summary on our three research papers published in peer reviewed journals outlining the development and evaluation of the Neuro-Physiological Psychotherapy (NPP) treatment model. You can read more about the Paper Review on the DDP Network website here.
“These papers describe the developing evidence for the efficacy of an integrative, biopsychosocial intervention for adopted children who, on average, were within the mid-childhood age range at time of initial assessment. The model uses a synergy of therapeutic approaches, underpinned by DDP, and delivered using a wrap-around approach which supports parents, schools and the professional network.” From the Paper Review by Kim S. Golding, DDPI Board Member, 2020
Great to welcome Dr Dan Hughes, founder of DDP, at Family Futures to deliver DDP Level 2 training here (3-6 February). DDP is a treatment model for professionals working with traumatised children to improve attachment relationships. We have a few spaces left on our next DDP Level 2 training running in July 2020. You can find out more about DDP (Dyadic Developmental Psychotherapy) and our other training courses for professionals here.
Thank you to all who attended DDP Level 1 training here (27-30 January) with Julie Hudson. DDP is a treatment model for professionals working with traumatised children to improve attachment relationships. You can find out more about DDP (Dyadic Developmental Psychotherapy) and our other training courses for professionals here
Where is the support to make adoption a good option for traumatised children?
The Children’s Minister, Michelle Donelan, recently wrote to all Directors of Children’s Services urging them to consider adoption as a permanence option, stating: “we are determined to see adoption pursued whenever it is in a child’s best interests.” This follows a steady decline in the number of adoptions in the past four years, in spite of rising numbers of children in care.
Permanence and stability, whether it is in an adoptive home, special guardianship home or foster care is rightly what is needed for children who cannot live with their birth families but we are still missing the point. You can’t just transplant a traumatised child into a new family and think the child and family are going to thrive. Children who have suffered ‘significant harm’ through abuse or neglect in their early years need long term therapeutic support. The Adoption Support Fund (ASF) has been a welcome step forward for adoptive families to access support, but the capped level of funding means that those families who need more than a low level of intervention are still not getting their needs met. Without more support, over and above the capped ASF, adoption is setting many new families up to fail.
What is needed is a more systematic approach to assessing children in a multi-disciplinary way so that their complex needs can be addressed, and a streamed allocation of ASF funding would ensure these children and their families get the appropriate level of support. Our research shows the significantly improved outcomes for adopted children with complex needs who received holistic therapeutic support. As a society, we need to design an adoption system that works for the families who come forward to provide a loving, stable home to our most vulnerable children.
Contacting Family Futures over Christmas – please click here.
Family Futures will be closed from 5pm on Monday 23rd December 2019 and will re-open at 9am on Thursday 2nd January 2020.
If you are a family in treatment with Family Futures and have a serious emergency or crisis during this time and you think that the crisis requires the emergency services, we suggest you call them first. You can then ring into Family Futures on the main number 0207 354 4161.
On the days when the office is closed (Tuesday 24 December to Wednesday 1 January inclusive) a Duty Manager will be available between 10am and 5pm. On days when the office is open you can contact a Duty Manager between 5–9pm.
If when you ring in, you then press 3 as instructed on the answerphone message, it will divert your call to the Duty manager’s mobile.
Please leave a message with your name, number and why you are calling and the Duty Manager will call you back as soon as possible. We hope however that you have an enjoyable Christmas and New Year.
After 21 years at the helm of Family Futures, our co-founder Alan Burnell, retired in September 2019. You can read a Q&A with Alan which featured in Adoption Today magazine (October 2019) here, about the highlights of his career and his hopes for the future of adoption services.
Adoption Today is a magazine for Adoption UK members. If you are interested in more information about the magazine visit: https://www.adoptionuk.org/adoption-today.
New research by Family Futures, to be published in the Journal of Child Abuse & Neglect, November 2019, provides supporting evidence that a therapeutic intervention which is neuro-developmental and holistic in approach improved outcomes for children who had experienced developmental trauma and who had later been placed for adoption.
There is substantial evidence regarding the life-long impact of early maltreatment and adverse childhood experiences (ACEs) on health and social prospects, mental health, violence, criminality and poor engagement in education. Children who have been maltreated and subsequently fostered or adopted are more likely than others to have been subject to ACEs prior to their removal into care.
There is limited published research, however, that indicates what is effective in treating older adopted children who have experienced maltreatment and sustained trauma in their birth families. This study is the first to compare outcomes for adopted young people who received an integrated multidisciplinary treatment intervention with those who were recommended the approach at assessment but were unable to receive it (mostly due to funding restrictions).
Family Futures’ neuro-sequential and multidisciplinary treatment model, NPP (Neuro-Physiological Psychotherapy), is informed by neuroscientific research on the impact of maltreatment on the developing child and by therapeutic models such as Ayres Sensory Integration, Theraplay and Dyadic Developmental Psychotherapy (DDP). Alongside regular NPP family therapy sessions the model supports applications of its principles at home, school and in the wider family network. In doing this NPP provides wrap-around therapeutic support for adoptive families and children in alternative care settings.
Dr Elaine McCullough, author of the research said:
“This is currently the strongest evidence for a therapeutic intervention for adopted children who have experienced developmental trauma. The results indicate the potential far-reaching improvements the NPP model can have for adoptive families. However, the findings have also highlighted the detrimental consequences for some families of not receiving appropriate support.
Therapeutic interventions need to influence all aspects of the child’s system to improve outcomes and long-term impact. It is important that health, education and social care provide consistent and joined-up support for children and their adoptive families. This support should be informed by neuroscientific research on maltreated children and acknowledge the impact of developmental trauma on the underlying neurological and physiological aspects of their emotional, cognitive and behavioural presentation.”
These research findings are consistent with the recent Adoption Support Fund study (Gieve, Hahne and King, 2019) which concluded that although moderate improvements were found from interventions offered through the ASF, there is a need for wider support than traditional individual therapy, to support children with complex underlying difficulties. It is hoped that this research can inform policy and practice in effective support for children who have experienced maltreatment, abuse, neglect, and/or Adverse Childhood Experiences.
The full research article was published in Child Abuse & Neglect, 97, 104128: McCullough, E., & Mathura, A. (2019). A comparison between a Neuro-Physiological Psychotherapy (NPP) treatment group and a control group for children adopted from care: Support for a neurodevelopmentally informed approach to therapeutic intervention with maltreated children Child Abuse & Neglect, 97, 104128.
Thank you to the many families and professionals who have sent messages to Alan on his retirement. You can read a few of the tributes below.
“We feel a sense of pride, gratitude and hope as a Family Futures family. You’ve kept us on the right side of chaos. A big heartfelt thank you for the inspiration, innovation and hard work you’ve brought to us and others here.”
“Alan is remembered by adoptive families in difficulty for believing those difficulties they were facing (in many cases he was the first professional to do so), and for how hard he worked to get assessments for children who so desperately needed support, despite the lack of funding on offer for treatment. Years later those assessment reports continued to offer families validation and education for the child’s network.”
“The ripples have gone out throughout the UK and beyond, through the courage to bring in new people like Dan Hughes, to exploring different ways of being and ways of working with children who are deeply traumatised, including working with the whole body.”
“One of the most original thinkers in the field of adoption today. Alan has helped to shape the thinking to bring adoption practice and adoption support right into the 21st century. You have challenged the complacency and the status quo in the system.”
“We have learnt so much that is embedded in Family Futures. At the heart of all Alan has done is the belief that adoption is a lived experience in a most profound way. There’s not an end to the story. Our sense of gratitude for all you have contributed over the years cannot be underestimated.”
“Alan’s work has blazed a trail in the area of adoption. He and his colleagues at Family Futures have changed, for the better, the lives of many children and families.”
“That Family Futures is held in such high regard by families and practitioners across the UK – and beyond – is testament to your dedication to understanding and improving the lives of countless children.”
“The people who have been on the two-year adoption and attachment course set up by Alan have gone out and made transformative changes around the country. They’ve done that because of Alan’s pioneering and courageous approach.”
The recommendation to develop a multidisciplinary approach needs to encompass the whole adoption process, not just adoption support
We were delighted to read the APPG for Adoption and Permanence’s recent Investing in Families report as it had both a positive and constructive view of the Adoption Support Fund (ASF) based on the evidence collated. We can only endorse from our experience the recommendations of the report. The ASF (as it has been for the past four years) has to be seen as a first step in funding focused therapeutic support for the contemporary adoptive family. Like any first step a lot can be learned from it and we think the APPG report spells out those lessons very clearly and carefully.
The APPG’s recommendation 4 calling for an increase in clinical input is something that Family Futures have been advocating for some time now. The report recognises that for a significant number of families (56% if using Adoption UK’s Adoption Barometer as a guide) are still needing a longer and more significant specialist and therapeutic service. We know from our own clinical experience that at least half of the children placed for adoption today have high levels of complex needs that require therapeutic input and support, at varying intensities, throughout their childhood. Because of the complexity of these needs and the early ‘significant harm’ this group of children have experienced, the allocation of longer term therapeutic packages needs to be one that is assessed and evaluated by a panel of clinicians.
Currently it is difficult to obtain matched funding for the more complex cases and the annual re-evaluation can lead to unhelpful breaks in therapy while administrators resolve the funding issues. As a consequence the children with the highest level of need have been least well served by the ASF. This seems like ‘unfair access’.
One of the difficulties the ASF and adoption services in general are currently experiencing is the lack of a coherent and consistent theoretical approach to providing post adoption support. We don’t believe it can just be left to whatever the market delivers or to whatever parents think they need. There is now copious evidence on the impact of neglect and abuse upon child development. It is this body of knowledge that should form the basis for post placement support.
This body of knowledge combined with our experience of working with adoptive families has led us to provide an integrated multidisciplinary post placement service for adopted and fostered children. Family Futures’ approach has now been peer reviewed, evaluated and published and provides evidence of positive outcomes so we very much support the APPG’s recommendation for developing a multidisciplinary approach, not just to post adoption support, but to the whole adoption process. In this way children in foster care would be assessed more comprehensively, better matches made and post placement support programmes put in place using the expertise of a range of professionals.