The National Quality Improvement Center for Adoption and Guardianship Support and Preservation (QIC-AG) is a five-year cooperative agreement, funded through the Department of Health and Human Services, Administration for Children and Families, Children’s Bureau, designed to promote permanence when reunification is no longer a goal and improve adoption and guardianship preservation and support. For more information about this project, click here.
Writer April Dinwoodie is profiling each of the eight projects that are overseen by the center for The Imprint. Today, she explores the work being done in Illinois with Trauma Affect Regulation: Guide for Education and Therapy (TARGET).
Developed by Advanced Trauma Solutions (ATS) and copyrighted by the University of Connecticut, TARGET is a strength-based, psycho-educational intervention. TARGET is being implemented by the Illinois Department of Children and Family Services (DCFS) along with several existing adoption support and preservation providers. Illinois is providing TARGET to children and youth who, at the time of adoption or guardianship, had characteristics or exhibited behaviors that put them at increased risk for post permanency instability also termed discontinuity.
Decades of child welfare research provide significant insight into the characteristics of children and families who are more likely to face high risk for discontinuity. Previous research specific to Illinois found the risk of permanency discontinuity for children in adoptive and guardianship homes is most likely to occur when children enter their teen years regardless of the age they were adopted.
Based on this research, the Illinois QIC-AG initiative focuses on the young people between the ages of 10 and 17. Illinois offers TARGET to eligible youth with a finalized adoption or guardianship. To be eligible for TARGET, the youth must be living in the home of their adoptive parent or guardian. Once families who adopted or assumed guardianship of children — through the public child welfare system, private domestic or intercountry adoption — were identified, a series of outreach and communications took place including letters, postcards and phone calls.
TARGET is a series of 10 to 12 sessions in which a specially trained coach teaches seven essential skills called the FREEDOM steps: Focus, Recognize triggers, Emotion self-check, Evaluate thoughts, Define goals, Options and Make a contribution.
These skills are designed to help youth and adults deal with intense or shutdown emotions resulting from past trauma. TARGET teaches youth and adults about the emotional, behavioral and relational processes; and how the brain’s stress or alarm system — when stuck in survival mode — can impede the brain’s thinking and memory systems. The sessions are designed to actively engage participants to learn about how their brains and bodies react to stress and trauma and how to regulate their emotions and gain personal control over their lives.
The site team selected professional coaches who were experienced in working with families who had adopted or assumed guardianship. Coaches delivering TARGET receive an initial four days of training that teaches them how to deliver TARGET in an individual service delivery model.
To ensure fidelity and consistency, coaches are expected to closely adhere to the TARGET Individual/Family Manual. In addition, TARGET coaches’ videotaped sessions are monitored by the program’s developer, Advanced Trauma Solutions, and post-training protocols have been established.
TARGET was originally created for use in a group or residential setting therefore, in order to better serve the intended population, adaptations and modifications were made for use in a home setting. The team felt that the availability of an in-home option could eliminate potential transportation challenges, facilitate participation of multiple family members, and promote comfort. Another modification was to use a more inclusive approach that encouraged adoptive parents and guardians to directly participate in TARGET sessions with their adolescent. In addition, siblings and other family members were invited to participate.
And lastly, adoption competency language was utilized to overlay the TARGET manual provided by the developer to include information on adoption and guardianship. The overlay addressed understanding the impact of complex trauma on children and families, key elements of understanding the experiences of families who adopt via intercountry or the private domestic process, and the importance of recognizing the lifelong nature of adoption.
As of October 2018, 96 public adoptive and guardianship families have participated in TARGET through the QIC-AG, and 30 private or intercountry adoptive families have participated in TARGET. A detailed evaluation report is planned for September 2019.
QIC-AG is using a randomized controlled trial to test if children in the target population who receive TARGET will have better outcomes than similar children who receive services as usual. The expected short-term outcomes include:
- Reduced child behavioral issues
- Reduced school-based problem behaviors
- Increased level of caregiver commitment
- Reduced caregiver strain in the home
Several young people and parents have already shared their feedback about the program via case studies available on the QIC-AG website.
“TARGET taught me how to block out distracting thoughts about other things that were bothering me,” said one youth participant.
To learn more about the QIC-AG’s work with Illinois and TARGET, check out the full profile online. In future columns for The Imprint, I will continue to describe the different interventions being tested at the other seven partner sites in more detail.
April Dinwoodie is a transracially adopted person and a nationally recognized thought leader in foster care and adoption. Dinwoodie’s podcast “Born in June, Raised in April: What Adoption Can Teach the World!” helps to facilitate an open dialogue about adoption, foster care and family today. She is the founder of Adoptment, a mentoring program that matches foster youth with adopted adults, and is retained by clients, including the QIC-AG, to help raise awareness of their work to support children and families.