The programme aims to support a partnership approach across local authorities and integrated care boards to bring together the knowledge and expertise of different agencies and professionals specialising in adoption. The programme will run for a 2-year period.
Multidisciplinary approaches to assessment and support in adoption services
The Department for Education has made funding available to Adoption England to develop multidisciplinary and multiagency approaches to adoption assessment and support services to improve the process for adopted people and their families.
Why are multidisciplinary approaches in adoption needed?
The support needs of adopted children are often complex and multifaceted as a result of the early adversity and trauma they may have experienced. Being in care itself can be extremely difficult for children, especially those who have already experienced acute safeguarding issues, as a consequence of physical or sexual abuse; emotional abuse and neglect; domestic violence, drug and alcohol use (often during pregnancy); genetic factors, such as inherited learning disability; the impact of chronic instability and lack of permanence early in life. It is challenging to disentangle the causal relationships between the current situation and the child’s past experiences.
The evaluation of Adoption Support Fund (2022) showed that:
- the mental health and wellbeing needs of children aged 5-15 years about to receive ASF-funded support were significantly greater than those of the overall population of similarly aged children (As measured by the SDQ,).
- A high proportion of all children in the study (80% aged 1.5 to 5 years and 90% aged 6-18 years) had clinical or borderline clinical needs measured by the Child Behaviour Checklist.
The pathways within existing children’s mental health services, designed around diagnosable mental health conditions with very high thresholds, do not readily fit the higher level and complex needs that adopted children often have. To understand the needs and the corresponding support requires input and sharing expertise from a range of services and disciplines.
Development of multidisciplinary approaches in adoption
Adoption England has commissioned several regional adoption agencies to develop a collaborative working model within their local regions and bring together different professionals to provide improved services for adopted children and their families. We are supporting 7 new projects across the country as part of the programme, with the goal to form lasting partnerships between adoption agencies, the health and education sector and local authorities.
The projects will explore different ways to create multidisciplinary and / or multiagency models. The programme will be independently evaluated, so the learning from the programme can be shared across the sector.
The projects aim to:
- Offer timely specialist assessments and support and develop care pathways within the NHS
- Develop partnerships with Virtual Schools to improve the adopted children's experiences in education
- Develop multiagency and partner models across a larger region or wider group of adopted children and families
- Better meet the mental and physical health and wellbeing needs of adopted children
- Understand the needs and provide better corresponding support for adoptive families by sharing expertise from a range of services and disciplines
7 new projects across the country
- North East
Adopt North East, Adoption Tees Valley, Adopt Coast to Coast, in partnership with North East and North Cumbria Integrated Care Board.
The aim is to create a team of specialists with knowledge, skills, experience and interests relevant to the delivery of high quality multi-disciplinary assessment and support of adopted children and their families across three regional adoption agencies. The team will work with children who are between 4 - 11 years with a request for adoption support for neurodiversity and/or attachment and trauma behaviours which have resulted in difficulties with education, peer relations and at home that, without intervention, are likely to escalate in severity and complexity.
- Adopt South
Adopt South is working in partnership with Southampton University to create a multidisciplinary service to allow families to receive the correct timely service that holistically considers children’s needs and offers families specialist and streamlined support. The aim of the project is to find ways to share knowledge from the different psychology perspectives on supporting child development. By working collaboratively together, the project plans to strengthen the knowledge and resource across teams who are supporting pre and post order families, as well as birth families. This will include reflective supervision spaces, staff workshops and accessibility to a wide range of resources including podcasts, films, reading material and links.
- North West
Adoption Counts, Adoption Now, Together for Adoption, Adoption in Merseyside and Adoption Lancashire & Blackpool are working together to create a multiagency model with a North West reach to benefit children and adopters across four regional adoption agencies. The service will provide assessment, consultation and therapeutic CAMHS and educational psychology services for adopted children, their parents, carers, and social workers. The model will include support from an occupational therapist for children with sensory processing issues. The service sits alongside universal adoption services that support the child and their family and is primarily an assessment, training, and consultation service.
- Adoption East Midlands
Adoption East Midlands in partnership with local Virtual Schools, Education Psychology Services and Nottinghamshire Youth Services.
This project will develop a regional, multi-disciplinary team and service offer bringing together professional expertise in to assess the holistic needs of children, young people and families at the early stages of placement, families with more complex needs and young people on the edge of care. The services will provide a single referral, assessment and planning process as well as easier access to universal and specialist services. In addition the project will be working with a local youth service to provide a regional response to those young people who are at high risk of family breakdown or have other additional risk factors.
- Adoption Partnership South East
Adoption Partnership South East is working expand the existing in house therapeutic service from one local authority area across the whole reginal adoption agency. The therapy team works alongside the social work adoption support teams, providing multidisciplinary support for children and families. In addition, the project aims to improve the partnership between social care, education and health, to establish a knowledgebase and better understanding of the complex needs of adopted children.
- One Adoption South Yorkshire
One Adoption South Yorkshire is working in partnership with the local Integrated Care Board to develop initial support services for children who may be affected by foetal alcohol spectrum disorder including the provision of practical advice and assistance to schools and parents. The project will produce a specialist protocol for the initial assessment of children and an effective education plan, supported by our commissioned Educational Psychology team, to meet the specific needs of these children.
- Adopt Thames Valley
Adoption Thames Valley in partnership with Oxfordshire County Council ATTACH Team and local Virtual Schools.
The project will create a multi-disciplinary therapeutic team to provide services for complex needs including educational, psychological and sensory integration. The service will bring together the knowledge and expertise of different agencies and professionals to identify the individual needs of children/young people and their parents and carers, to provide support, and to triage mental health referrals where appropriate.
Project steering group
The steering group for developing multidisciplinary approaches in adoption represents key stakeholders and experts by experience and supports the delivery of the overall programme. Its vision is to enable the projects to achieve their objectives by identifying areas for improvement and removing barriers, to maximise the opportunities of the programme. The steering group members will influence their networks to establish and maintain effective multiagency partnerships and improve services for adopted children and families.
The steering group gives strategic direction, has oversight for the overall programme and reviews the regional projects progress against plans.
Key organisations and their roles within the steering group
| Organisation | Role in the steering group |
|---|---|
| RAA Leaders Group | Chair of the Group |
| National Association of Virtual School Heads | Education Lead |
| Manchester University NHS Foundation Trust | Mental Health Representative |
| Adoption England National Team | Adoption Strategic Lead |
| Adoption England National Team | Programme Manager |
| Department for Education | Department for Education policy lead for adoption support |
| National Health Service | Transformation of services |
| Department of Health and Social Care | Policy Lead for child health and safeguarding |
| Consortium of Voluntary Adoption Agencies | Voluntary Agencies representative |
| We Are Family | Adoptive Parent |
| Adoption UK | Adopter Voice/Independent Therapy Provision |
| Oxford Brookes University | Research Partner |
| Coram-Baaf | Director of Policy, Research and Development |
| Coram Advisory Group | Medical Advisor/Designated Doctor |
| Oxford University | Health Economy / Adopter |
Evaluation of multidisciplinary approaches in adoption
The evaluation of the 7 new projects and the existing multidisciplinary models in adoption support will help to assess the impact, benefits and challenges of these different approaches. The evaluation outcomes will help to understand the enablers and barriers to setting up integrated support services.
The Institute of Public Care (IPC) at Oxford Brookes University, partnered with Cardiff University and the University of East Anglia, have been commissioned to evaluate the projects and the benefits of existing and emerging multidisciplinary approaches to adoption support. The mixed methods evaluation aims to learn more about how multidisciplinary arrangements work, for whom, in what circumstances and why. It will also explore what the likely costed benefits are for organisations funding the arrangements and for the whole system of support for children and families’ health, education, and if there are broader outcomes.
The evaluation will explore these benefits from the perspective of both:
- Children and families who have received or are receiving multidisciplinary support through existing, mature models in both Adoption Counts and One Adoption West Yorkshire.
- Children and families receiving or about to receive multi-disciplinary support through up-coming models in the 7 funded projects in other regions in England.
What will the evaluation include?
The evaluation will need to be tailored to the different projects in each specific region but will also include a common core of activities, questions and methods including:
- A longitudinal survey of parents whose children are about to participate in multidisciplinary team supports, after the end of a period of support and 6 months after that.
- Follow up surveys of parents whose children have been the focus of multidisciplinary assessment and support in the past.
- Advice for existing or new projects about data capture.
- Secondary analysis by evaluators of data collected by each project site relating to their model, beneficiaries, and outputs / outcomes.
- Interviews with projects staff, and key stakeholders.