Email Scott Mars to John Cameron

From: Scott Mars [Scott@americanadoplions.com]

Sent: Friday. August 03. 2007 12:07 PM

To: .John Cameron

Subject:  Counseling philosophies we can share with the staff.

Birth mother is wavering on her decision.

it is important to explore the reasons why the birth mother is wavering to make sure the birth mother has completely and thoroughly thought through her decisions. Sometimes birth mothers can be swayed by friends and family members towards a parentln decision they

really don't feel is the best decision  them or their baby. The pregnancy, the birthing process. and change of emotions can be very draining on many birth mothers and we need to support our cllents through this difficult time. Sometimes birth mothers can become frustrated at unsolicited family members who try to involve themselves in the parenting/adoption decision making process and this can add additional stress and confusion.

The  specialist should work with the hospital social work staff to provide a sale and emotionally secure environment for the birth mother. Once the baby born. birth mothers are particularly vulnerable both physically and emotionally to friends and famfly members‘ opinions even If they are contrary to their own opinion. Once the baby is bom. it is not uncommon for friends and family members to otter to help (when the birth mother knows this is unlikely), to try and guilt the birth mother into choosing parenting by talking about how much the child will hate her for choosing adoption. or to talk about how cute the baby is and how could you give this baby away to strangers who won‘! love himlher as much. These questionable practices by family members can unfairly and unjustly persuade a birth mother to parent when the birth mother does not really want to parent. It is the adoption specialists as well as the hospital social workers responsibility to make certain the parenting decision is not one made because of unethical influences by friends and family members.

You also want to be certain the birth mother is emotionally stable and mentally stable to make any decision. Prior to the hospital experience. the adoption specialist should prepare the birth mother for all the normal emotions that a mother will typically feel at birth. While considering an adoption plan, a birth mother will cflen experience the many stages of grief and loss and needs to understand these different stages prior to giving birth so that she may make sense of her own emotions during that vulnerable period. The adoption specialist should help the birth mother identify her emotions during the hospital experience by reminding her of the stages of grief and loss and inquiring if she feels she is experiencing one or more of those stages. The adoption specialist should also prepare the birth mother for the additional stages that may follow. The birth mother may feel adoption is the best decision for the baby but it does not mean the decision will be an easy one. lt is a decision that requires e lot of thought and emotional preparation to be sure this decision was made with great care and understanding for their baby and themselves.

It is often helpful to re-explore all of the factors why she was originally considering adoption. In this way. the birth mother can compare her pre birth thoughts and feelings with her present day thoughts and feelings. This often allows the birth mother to have a more lucid understanding of her decision making. It can also allow this birth mother to separate what are typical emotions ol grief and loss and what are her real reasons for choosing either adoption or parenting. It is also very helpful to ask the birth mother to identify which thoughts are more intellectually based versus emotionally based so that she can better gain insight into her own rationale. For example, prior to the baby being born. many birth mothers are thinking only from their head when making an adoption decision and after the baby is born are speaking only from the heart it is imperative that she explore both and not to shut off either when making her decisions. The adoption specialist should speak about the importance for her to pay attention to both and to make sure she puts a greater weight on whichever she truly believes should matter the most. It is also helpful to offer to the birth mother to take a break from all visitors including the adoption specialist in order to clear her head. This time can also be a good time to otter for the birth mother to have the baby return to the nursery so that she can truly make a decision without pressure. it is often helpful to suggest that the birth mother make a list of her pros and cons to both parenting and adoption so that she can see her own thoughts down on paper. All of this allows the birth mother to begin to sort through all of her confusing thoughts, input from family and friends. and her range of feelings. By helping her sort through, understand, and confront all her thoughts and feelings. this can better assure that her decision is a well thought out and responsible one.

For example, a birth mother who is in denial will likely not be making a healthy or good decision for her baby regardless of the decision she chooses. It is important to make sure birth mothers are working through their emotions and thoughts regardless of the decision she makes. It is very important to consider that alter the baby is born, most birth mothers experience many emotions. A social worker can help a birth mother make a well thought out decision on her own and the birth mother really does need a social workers assistance to help make sure she‘: considered everything before she makes any choice. A great example of denial is as follows: Imagine you go to a doctor's appointment and discover you are diagnosed with cancer. Let's say you respond by saying, I don't want to receive chemotherapy or any treatment because I am scared. If the doctor just responded 'Ok' and slowed you to walk out the door they would not know ll your decision to refuse treatment was based on fear/denial. If you then went home and if you remained scared (natural response) and in denial (natural response) you might avoid the doctor's calls and therefore not fully explore your treatment options. in essence. you would be making an uninformed decision and one based on denial. If the doctor didn't make sure you were making a well informed and thought out decision, he would be doing you a significant disservice because at a minimum you wouldn't know what no treatment would mean for you. You essentially could be making a decision out of fear without hearing all of the hard to hear questions the doctor should be asking to make sure that you are ultimately making a well thought out decision.

Another example would be a couple who is seeking marriage counseling and believe they want a divorce. Obviously if that was the final answer to every marriage then there would be no reason for marriage counseling. In some cases alter marraige counseling, divorce might be their choice but atleast through counseling they made sure it was a carefully explored and thought out process. In other words, if a birth mother says she has decided to parent. It is not the best policy to just reply ok. It is best to explore the reasons why she has changed her mind. is it normal grief and loss emotions? is it pressure from friends? Has some of her situation changed to where parenting would be a good plan? For example. one of the reasons a birth mother might initially be considering adoption is lack of family support. Once the baby is born. some family members may offer their support. What should be explored with the birth mother is does she believe this support will be genuine and be enough to help her be a good mom to her baby. It is a responsible way of counseling and necessary to ensure the home environment will be stable and adequate to raise a child. You don't want these birth mothers to put any child Into danger. You want to make sure the decision she chooses is emotionally and mentally explored so if she decides to parent she is fully prepared and able to be a good parent. it is also important that if she feels parenting is the best option that she has properly thought through all of the things she will need to do. Parenting can be a wonderful option but it should not be one entered into casually or without concern for the child's well being.

In no way should a birth mother be coerced or forced into either an adoption or parenting plan. The adoption specialist working the case should work with the birth mother to make sure she has developed whet the birth mother feels is the best plan for her and her baby. It is however important to make sure the plan is well thought out and is in the best interest of the child and the birth mother. if the birth mother ls making any decisions which might endanger the child in any manner, it should be reported to the proper authorities immediately as all adoption specialists are mandated reports and have a duty to report any child endangerment.

Times to take a consent

The consent can not be taken until 72 hours (changes with each state's law) after the baby is born. The consent then should be signed at the client's request and at their convenience. This means if the birth mother prefers to take the relinquishment after normal office hours. our staff will do everything possible to accommodate a client's request.

If a birth mother is ready to sign consents, any unnecessary delays on our staffs part is not healthy for the birth mother. Birth mothers often want to sign adoption paperwork when they feel they are ready to make the adoption decision. Many birth mothers feel signing the paperwork provides necessary closure to continue through their grief and loss process.

If a birth mother is stable and wants to sign consents, it is not appropriate for staff to delay taking consents to work around their own schedules. This delays the healing process. does not serve the client's wishes. and simply adds unnecessary emotional distress and frustration to the client.

Our staff should delay the signing of the consent paperwork if they don't feel the birth mother is mentally or emotionally stable enough to proceed. Additionally. If a clear state of mind been altered by medication, the staff should delay in the taking of the consents.

Taking a baby home:

When a birth mother makes the decision to take the baby home and continue making her adoption plan:

Birth mother. The adoption specialist should process the pros and cons of taking a baby home and assist the birth mother with preparing herself for the potential emotional difficulties that this choice could present for her and her decision making process.

Adoptive family- It a family is involved in a match. the family should be prepared by the adoption specialist that birth mothers who take the baby home are much less likely to choose adoption than to choose to continue to parent. Adoptive families must be told the realities of each situation so they are emotionally and mentally prepared for all possibilities including a  disrupted match. Faiure to properly prepare famllies for this reality can cause the family unnecessary distress and disappointment

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Judgment of birth parents backgrounds

The reasons why a birth mother is considering adoption should not be prejudiced by the social worker or adoptive family worker.

1. Birth mothers who choose adoption may be single. married. or widowed. Discrimination based on mental status is not acceptable. if for example a married couple is considering adoption, their adoption worker shouldn't push them to parent just because they are married. If the birth mother has had multiple sexual partners and can not identify the birth lather. discrimination is not tolerated. The worker should not pass judgment on what the couple or birth parent feels is the best decision for their baby.
2. Birth parents will range in ages from 10 years on up. Age discrimination is not acceptable. A worker for example should not judge a young teen for having premarital sex.
3. Birth Parents may be from varied religious or no religious backgrounds. We work with birth parents from any religious background and do not allow judgment of their religious affiliation.
4. Birth parents are not always financially poor as some are very financially stable but are considering adoption for reasons they feel are important to them. if for example, a couple is financially secure but feels they are too old to raise another child, then the worker should not judge this client
5. Birth parents are also of different ethnic and racial backgrounds. It is unacceptable to discriminate against the birth parent based on race or ethnicity. It is also not acceptable to push a birth mother to choose or not to choose a famiy based on their ethnicity or racial background.

Each birth parent has their personal masons for choosing adoption and we shouldn't pass unfair judgment on those reasons. The exception of course would be if the reasons were not mentally sound decisions

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Face to face and other services to clients

Ideally a client will be offered both face to face, phone, and internet services. By offering clients all three methods of services. clients can receive the beet services possible. it should be noted that some clients prefer services that best fulfill their needs or preferred communication style.

Is American Adoptions focused on trying to pressure the birth mother to receive a placement fee?

The simple and short answer is American Adoptions does not want birth parents pressured for any reason.

First and foremost. the board of directors presiding over the agency and staff members working the adoption would have trouble sleeping at night knowing birth mothers were being forced into an adoption plan. It also would be heart wrenching to know that forcing the birth mother into a plan caused an adoption to be overturned and feeling responsible for an adoptive family‘s and birth mothers pain would be unbearable.

Beyond ethics, forcing birth mothers to choose adoption would be a poor business practice for the following reasons.

1. Pressuring birth mothers would certainly lead to more contested cases therefore any additional revenue gained from such a foolish pradlce as pressuring birth parents would be consumed in legal costs in defending these actions.
2. Pressuring birth mothers would lead to additional lawsuits from adoptive families who had their adoption overtumed. This financial loss to a company would be immeasurable and could ultimately lead to an agency being shut down.
3. Hospital slaff and doctors would not refer dients to us and this loss in reputation would significantly impact referrals.
4. Clients would ultimately complain to licensing and licensing would not condone a practice of pressuring birth mothers, such a practice would ultimateiy lead to closing the agency via licensing.

In all, forcing a blrth mother to choose adoption is not an appropriate or ethical counseling strategy and it certainty would be a foolish business strategy as well.

Where does American Adoptions counseling philosophy come from?

It actually comes from two points of origin.

The executive director is an adult adoptee and he feels adoption often otters children an opportunity st a better life. in meeting his birth mother, the director was shown where he would have grown up and the challenges they would have faced in the town. financial struggles. and life without a lather. His birth mother knew then and knows now she made a decision that was best lor her child. it wasn't easy. it wasn't without some regret. In the end though. she knows her sacrifice allowed him to have everything in life she wanted for him and felt like he deserved. It was clear to him that in many cases adoption often affords a child an opportunity at a better life. This is the main reason why many birth mothers choose adoptionbecause they love their child enough to give him/hir a better life.

Every child deserves to have a life filled with lave. support from their family, and free of abuse and neglect. Adoption often offers a child those opportunities. in many cases. birth mothers are choosing adoption because they want a better life for their child so the child can live a happier and better life. The director feels it is our duty to help every birth mother fully explore her options to make sure the decision they make will be one that is truly the best for their child. in the end, if the birth mother chooses to parent or chooses adoption, with our counseling style it should be a well thought out decision. if however, our staff feels this child's safety or well being might be in jeopardy by a birth mother who is choosing parenting, we must report this immediately to the authorities.

The second area of philosophy our counseling practice comes from many social workers and counselors who have worked in slate foster care. They have seen hundreds of children in foster care where the parents abused and neglected their children until they were eventually removed from the home. it is vary disturbing that these parents did not choose adoption for their child many years ago because these children did not deserve such a life.

Our social workers do not want to be responsible for more children ending up in foster care because of the following:

• We did not prepare the birth mother for feelings of grief and loss.
• We did not prepare her for normal feeling and thoughts she will experience through the adoption process.
• We left her in a confusing time to be pressured by individuals who weren't truly concerned about what she felt was the best decision for her baby.
• We did not provide enough counseling and support to help choose the right adoptive family.
• We did not address concerns or fears she had about the adoption process.
• We did not provide enough counseling support to help her make the best decision for her baby.
• We did not provide enough support so if she chose parenting that she was well prepared and could adequately take care of her child.
• We did not carefully explore adoption so she could make an informed decision.
• We did not ask probing questions to make sure the birth mother has carefully thought through her decision.

What is a condensed version of counseling practice?

1. It is our job to make sure the child's safety is protected.
2. Our director feels it is our job to show to the birth mother what adoption offers a child to help them overcome any fears. doubts, as well as dispel any myths.
3. We want a birth mother to truthfully and carefully explore her options so she makes the best decision for her and her baby. Sometimes birth parents can be in denial and choose an option that is not carefully explored. This decision can ultimately negatively impacy the baby and the birth mother down the road.
   

While the parenting option should and must be explored, the reality is we are experts in adoption. Birth mothers are coming to us to learn about adoption to see if adoption is the best choice for their baby. We should help them explore their options carefully. We should however make sure we fully answer all of their questions and concerns about adoption. it is making sure the birth parents have property explored all options to be absolutely certain the choice they are making is the one they feel is best for their baby.

What happens if a birth mother stays in denial about adoption and parenting?

Ultimately. we can only otter our counseling and guidance. if they refuse to take it then we can not force it upon them.

Sometimes birth mothers are in denial about adoption meaning they won't fully process all of the emotions and thoughts necessary to grief through the adoption process. This makes the decision about adoption not as healthy as it can be. During the process. you should try as often as possible to help them process their emotions and thoughts in a healthy manner.

Ultimately though this is the client's choice to refuse such counseling advice. Do not however give up at first refusal as that is part of denial.

Sometimes birth mothers are in denial about parenting. This often manifests Itself once the baby is bom. Often the reasons they believe they should choose adoption have not changed but they can feel intense feelings of grief and loss or intense feelings of guilt from family members regarding adoption. Other reasons they may be in denial may be about a possible change in circumstances ; circumstances upon further exploration you might find they don't really trust

• A birth mother who is not prepared for grief and loss can often feel overwhelmed and confused. Sometimes the typical grief and loss can leave them in denial that suddenly they will be able to parent, that suddenly all of the reasons for considering adoption will change when in fact they know they will not. If the client will allow it. it is important to help them understand the stages of grief and loss, so they can help sort through their emotions. When possible. it is best to help them understand grief and loss in the early stages of working with this client. This allows the counselor to begin ideally helping the client acknowledge, recognize. and work through these emotions. it is also important so the client can understand other family members who will be experiencing these grief and loss feelings and how these family members might deal with these emotions (.i.e. anger).
• If a counselor does not discuss with a birth mother how to handle pressure from individuals who don't support the decision she feels it best for the baby. then these birth mothers are often more susceptible to unfair preaure from these individuals. Unchecked ooercision from family or friends can often cause a birth mother to make a choice she does not feel good about whether the choice is adoption or parenting. Birth parents should be prepared for coercision from any party. The birth parents should be able make the decision that they feet is ultimately best for the baby.
• Sometimes circumstances change or appear to change and the birth mother feels parenting would now be the best option. It is however important to explore with her how she truly feels about these changes to determine her trust in those changes. It also is a good time to help her prepare should these circumstances become unreliable so she has a good backup parenting plan in place. It also should be relayed to her that she can always consider adoption in the future in case the circumstances become so unreliable to where she feels adoption becomes the best choice.

Preparing your clients is the most important part of the counseling process. Asking the difficult probing questions is important to help make sure the birth parents have carefully considered their options. In the end. you should try and make sure they have carefully thought through

their decision. Ultimately though, it is the client's choice if they won't listen or engage in counseling.

It might also be stated that many birth mothers are struggling with their decision through out the process. it is our job in those cases to help them clearly review their options so they can make what they feel is the best decision for them and their baby.

Why is your disruption percentage lower than most adoption professionals?

There are actual several reasons we have a lower disruption percentage.

1. We work with birth mothers to determine the reasons they are considering adoption. We want to make sure they have explored all options and really feel like adoption is the best decision for their baby before matching them with an adoptive family. This policy helps reduce families from disappointments from birth mothers who never carefully reviewed all their options and carefully explored adoption emotionally and mentally.
2. We help birth mothers explore carefully the entire adoption process. We review what kind of emotions they will experience at various stages of the process so they are best prepared for how to cope and process through these emotions. This policy helps our birth mothers sort through their emotions so they can make a well thought out decision and be prmered for all of the ups and downs birth mothers will experience through out the process.
3. We help them develop an external support system that will truly support them in the decision they feel is best tor their baby. This helps reduce pressure from external sources that may try to push them into a direction they don't feel good about. We work with our clients on healthy ways they might redirect input from friends or family members who may not support them.
4. We prepare birth mothers from unfair judgment they might receive from doctors and nurses who might be against their adoption plan. We let them know that the hospital social worker can also help diminish this unfair judgement.
   
5. At the hospital. we help explore all of the conversations and thoughts we have accumulated as to why they were deciding on adoption or parenting. This allows them to sort through common ernotlons of grief and loss.
6. We encourage separate interaction with the hospital social worker who often is in concert with us regarding making sure the birth mother has carefully explored her options and is making a well thought out and emotionally explored decision.