The Goal of Reunification

System Challenges

The process by which reunification is sought tends to be highly mechanized. While states function from the premise that the biological parents and/or family of origin is the best place for a child, as evidenced by laws such as the Adoption and Safe Families Act (1997), the process toward reunification tends to be variable, stressful, and is not typically individualized on all levels to client and family needs (Allen & Bissell, 2004; Bonovitz, 2006; Freundlich, Avery, Gerstenzang, & Munson, 2006; Wulczyn, 2004). Commonly, the biological parents are not involved throughout the treatment process for a variety of reasons (location of the foster placement, resources for travel, parental substance abuse or mental health issues, etc.) and this lack of involvement in treatment can influence permanency outcomes (Andersson, 2009; Wulczyn, 2004). Often times, children in foster care are diagnosed with co-occurring mental health issues and are medicated at higher levels than children not experiencing an out-of-home placement (Crismon & Argo, 2009; Longhofer, Floersch, & Okpych, 2011). The foster care system in the United States typically seems to focus on quick placement, treatment, and reunification based on time tables as well as behavioral and psychotropic management of resulting disruptive behaviors that may be a response to trauma and transitional upset (Bellamy, 2008). This focus on individual, behavioral, and psychotropic interventions with children in care and lack of integrative planning can result in discouragement of foster parents, counselors, and families (Alpert, 2005; Alpert & Britner, 2009; Freundlich et al., 2006).

Discouragement and Behavior

“If anyone wished to make sure that children grow up to be failures in life, the method would be perfectly simple. There are only two things to do—systemically discourage children, and keep them isolated from other children” (Stone & Drescher, 2004, p. 30). This quote on discouragement comes from a translation of a lecture given by Alfred Adler and seems apropos given the sometimes discordant nature inherent to the foster care system. When children do not feel heard, valued, or that they have a role in developing their own future path, they become discouraged (Sonstegard, Shuck, & Beattie, 1997). As a result, children will attempt to get their needs met in ways that may not be useful for themselves or the family system; acting from a position of discouragement (Dreikurs, 1964). These discouraged behaviors are referred to by Dreikurs as mistaken goals. These goals result in behaviors that are attention seeking, involve power struggles, revenge, and displays of inadequacy. It is important to note that these goal-directed interactions are not isolated to the behavior of the child (Bitter, 2009).

Discouragement is a family system issue and parents have a primary influence on the family atmosphere; therefore, they also act from positions of discouragement (Bitter, 2009; Christensen & Schramski, 1983). This cycle of discouragement is present in families experiencing distress and children placed in foster care can transfer this way of being or way of coping to their foster placement and thus influence the stability of that placement (Cox, Orme, & Rhodes, 2003). A lack of stability in the family structure can lead to a multitude of mental health issues associated with trauma, distress, and general discouragement in all areas of life; therefore, methods for developing stability throughout foster placement and following reunification are essential (Bernardon & Pernice-Duca, 2010; Houston & Kramer, 2008). Foster parents and biological parents alike must be trained as family leaders in order to help encourage children and ensure positive outcomes (Bellamy, 2008; Bitter, 2008).

Finding Stability

To help support stability during foster care, it is important to advocate for continuity of care and parental involvement, when feasible (Alpert & Britner, 2009). Bonovitz (2006) highlights in his case account how essential a sense of continuity is in preventing ongoing distress as a result of trauma related to loss and separation as well as its role in facilitating attachment. In his account and reflections on his practice as a counselor with foster children, Bonovitz found it particularly “astounding to see how the child who reenters the foster care system is an unknown entity or blank slate. All continuity, all history, is ruptured” (p. 148). Interventions with the biological family, communication between the biological and foster parents, as well as visitation are all essential components in maintaining a sense of stability, continuity, and ensuring successful reunification and prevention of reentry into the foster care system (Bellamy, 2008; Brown, George, Arnault, & Sintzel, 2011; Edwards, 2007; Wulczyn, 2004).

Current research on foster care outcomes indicate that a variety of factors influence successful reunification. In an analysis of over 3,000 children in a Midwestern state, who experienced foster care from between 8 days and up to 42 months, Akin (2011) found that older children were more likely to be reunified and children with disabilities or serious mental health issues were less likely to be reunified. In addition, children who entered care as a result of physical or sexual abuse were more likely to be reunified with a biological parent than children who had experienced neglect (Barber and Delfabbro, 2009). Also, Akin found that children placed with other family members, children placed with their siblings, and only children were more likely to experience reunification. A lack of stability early in the foster care experience or runaway events during foster placement was found to inhibit reunification.

While Akin’s study did not consider the potential long-term effects of foster care, Berzin (2010) evaluated these outcomes in a propensity analysis of longitudinal data collected from the National Longitudinal Survey of Youth 1997 (NLSY97). In Berzin’s study, children who experienced foster care were compared with youth who shared similar pre-placement characteristics but did not experience a foster placement. Pre-placement variables included parent and child characteristics, family and home environment, and community characteristics. Results indicated that, generally, foster youth were less likely to have a high school diploma, had lower educational attainment, higher levels of homelessness, public assistance, and early parenting. However, the methodology used in this analysis could not account for parental substance abuse or incarceration as the data set used did not include these variables. Research indicates that parental mental health issues and substance abuse, access to supportive resources, and parenting skill also were important factors in successful reunification outcomes (Cheng, 2010; Miller, Fisher, Fetrow, & Jordan, 2006).

Adlerian Conceptualization of Foster Care System

Adlerians “assume that people are of equal value, but not the same” (Christensen & Schramski, 1983, p. 10), meaning that, in order for any system to work, it must recognize and believe that everyone has something to contribute and then endeavor to foster that potential. Chipungu and Bent-Goodly (2004) reported many challenges currently facing the foster care system. The data presented pointed to the need for family and case worker support as well as the development of policies addressing issues of cultural competency. Increasing case loads, counselor turnover, low foster parent compensation, lack of parental training and intervention, and the complexity of physical and mental health issues facing children placed into care all serve as difficult challenges that will need to be addressed systemically in order to improve outcomes following reunification. These challenges are indicative of a system that is overwhelmed and discouraged, much like the families involved with it and impacted by its decisions. When discouraged, individuals and families tend to act in disrespectful and devaluing ways. Adlerians perceive these internal family patterns to be “common to all others in their social and ethnic community” (Bitter, 2008, p. 97). Each level of a child’s world context is inextricably tied to the others.

In order for families to improve their style of interaction and for reunification outcomes to be successful over the long term, it will be necessary for the system to adopt policies that reflect the value that all individuals within a family, including children, are knowledgeable, have something to contribute, and are deserving of respect. Government systems, including the courts and the individuals that represent federal and state programs, must model a sense of courage and cooperation, as these things can “only be learned from those who are themselves courageous and cooperative” (Stone & Drescher, 2004, p. 35). Just as it is a mistake for individuals to display their superiority by acting in an authoritarian manner, it is inappropriate for a system whose goal is to promote family welfare to act in a way that is not cooperative, caring, and contextually appropriate in its action.

Purpose

In order to build a successful and cohesive family unit following a foster care placement, it may be helpful for family counselors to consider a model for conceptualization, action, and change that will facilitate the reunification process. This article is intended to present an Adlerian model for family counseling in order to provide a framework for counselors to follow when attempting to work in the highly complex system that dictates the parameters for foster care. Reunification is a process that takes time and requires systemic and therapeutic support (Wulczyn, 2004). Therefore, it is the responsibility of counselors to advocate for themselves and their clients in a planned and intentional way so that the support needed for successful treatment can be obtained.

Adlerian Family Counseling Model for Reunification

Alfred Adler was the first to develop child guidance and family systems approaches to counseling, beginning his community work in the early 1920s. Adlerian theory asserts that people are essentially social beings, motivated by a need to find belonging and purpose and, therefore, cannot be fully understood in isolation of systemic context. The family provides the setting in which children begin to define their place, purpose, and meaning, thus making family process an important focus for counseling intervention. The approach described was developed by the authors as a result of their time spent as counselors with children in foster care. This model is grounded in the perspective that “the primary unit of intervention is the family,” which includes both the family of origin and the foster families when the goal is reunification (Christensen & Schramski, 1983, p. 10). In the spirit of Adlerian family community counseling, we propose that family counselors should strive to develop ways in which all caregivers can be involved in family treatment throughout a child’s placement in care. Open forum variants of family counseling may serve to assist counselors and case workers in providing this integrative care while assisting many families at once—saving time while providing quality intervention that includes children, the family of origin, and foster families.

Keeping the Family Involved

In a qualitative study of parents, youth, and case workers involved in foster care in New York State, Freundlich et al. (2006) found that children typically reported a lack of involvement in their own permanency decisions, and when involved in planning, they stated that they were not made fully aware of their options or their opinions were treated as less important. Case workers and parents alike indicated a perception that the system in place did not allow for individualized planning, as well. Participants in this study felt restricted by “a formulaic process” (p. 369). While this investigation indicates issues specific to one state as related by a small group of participants (108 in total), a need for parental involvement in the mental health treatment of children and the lack of importance given to children’s involvement in decision making and goal setting tend to be common issues (Alpert, 2005; Chipungu & Bent-Goodley, 2004). When children are identified as “the problem,” a focus on individual counseling and goal setting by figures of authority can occur, especially given the cultural propensity to regard children as less than adults. Further, individualized treatment of children leaves the family system out of the equation, resulting from an internalized problem perspective rather than a systemic one. While individual counseling can be useful for both children and parents, the focus needs to be on the improvement of the family atmosphere; thus, family counseling should not be excluded in the treatment process.

Edwards (2007) indicated that maintaining parental involvement throughout the removal, treatment, and reunification process would assist in decreasing the time between a child being placed outside of the home and permanency by up to one year. Edwards’ model included a treatment modality that involved the family of origin throughout all decision-making processes, parent training, and continual family counseling. As the foster care system continues to become inundated with out-of-home placements, it is essential to find efficient methods to keep families involved with regard to the time constraints many counselors face in their day-to-day therapeutic responsibilities. Tying together individual counseling, family meetings, and community-based open-forum interventions could serve to address the needs of the family as well as the needs of the counselor. A model for this process is outlined in Figure 1. In following this model, it is important to be aware of how the counseling process stages will influence session focus and outcomes. In Adlerian family and individual counseling, there are four general stages inherent to the process: the development of the therapeutic relationship, assessment and psychological investigation, insight and interpretation, and reorientation and reeducation (Carlson, Watts, & Maniacci, 2005; Sweeney, 2009).

OPEN IN VIEWER

Figure 1.

An Adlerian model for reunification.

Assessment of Family Obstacles

In order to help parents and children become aware of their joint strengths and areas for change, it will be important to assess the lifestyle of the family. This includes evaluating their shared goals, beliefs, values, interactions, and individual ways of being (Bitter, 2008; Christensen & Schramski, 1983; Sherman & Dinkmeyer, 1987). It is important to note that “family interactions are mediated by values held in common, the negotiation of differences, and the interdependency among members for survival, development, and significance” (Sherman & Dinkmeyer, 1987, p. 300). Awareness of these values and their meanings from the perspective of each family member is a critical component in understanding the family atmosphere in relation to the family structure. In beginning the investigation process, the development of a genogram can serve as a starting point for assessing how each member of the family views the others. Having parents describe their children can reveal important information about sibling relationships, behaviors, and psychological birth order. In addition, it would be useful to have the identified client (usually the child in placement) provide at least three adjectives for each family member and discuss how they view themselves in relation to those descriptions (Bitter, 2008). Further, having the family talk about a typical day together may reveal additional information about member roles and obstacles that may impede successful reunification in the future. Taking steps to assess the family constellation, or each member’s sense of belongingness within the family system, will serve as a point of prevention.

Aspects of Counseling

Building social interest within the family is essential in rebuilding a useful interconnected process between each family member so that they can begin to work together toward common goals (Sherman & Dinkmeyer, 1987). In order to build social interest, parents must realize their roles as leaders in the family and accept their responsibility in shaping the personality development of their children through love, encouragement, and interest (Sweeney, 2009). It is the family counselor’s job to support parents as leaders, and thus, it may be useful to interview parents without the presence of the children (original caregivers and foster parents) prior to beginning any family counseling process (Bitter, 2008). This will serve to orient the parents to the expectations associated with the treatment process as well as provide them an opportunity to get to know the counselor working with their child or children.

In reference to the final piece of the Adlerian model presented in Figure 1, developing open forums for family counseling will not only assist parents and families in developing a stable home atmosphere, but it may assist in reducing case load responsibilities by allowing for efficient group intervention and may serve to build an encouraging community of parents. In developing an open forum model for the purpose of reunification, several options are possible. Counselors and agencies may develop forums specific for foster parents and their unique concerns, a mixed group of foster parents and those parents from the child’s family of origin, and a group specific to parents working toward reunification. In these forums, a counselor would work with a family openly regarding a specific issue while other families observed and provided feedback. As confidentiality could not be ensured, parents would be urged to self-monitor and the family counselor would need to interview the family prior to discussing topics they may not want revealed openly. This type of intervention may be particularly beneficial when working with families in the insight and reorientation phases of the counseling process.

Discussion

The realities of working with children in out-of-home placements are complex and often discouraging. Child care workers, counselors, and family advocates struggle daily with increasing responsibilities, little support, and little pay. A recent news report from New York City adds another layer of anxiety, as courts consider making counselors and other child care workers criminally responsible for a range of behaviors and outcomes considered negligent without regard for the systemic issues that may lead to these outcomes (Long, 2011). Given the many constraints, time restrictions, and responsibilities facing family counselors working with the foster care system, the development and implementation of different modes of addressing reunification can be difficult, overwhelming, and at times impossible to pursue. It is our hope that family counselors can use the information provided here as a springboard for change, as we all work toward improving the broader system and its approach regarding reunification.

As Adlerian theory lends itself to technically eclectic approaches (Watts & Shulman, 2003), family practitioners working from any theoretical framework could reasonably integrate the perspectives and techniques espoused here. Focusing on the relationship, actively involving children and their caregivers in counseling throughout their placement in foster care, and maintaining useful, goal-directed communication between all families and systems involved are essential in building a solid foundation for reunification. As family counselors consider implementation of this model, it is important to reflect on the level of child and parent involvement with regard to individual developmental and intellectual capacity and need. For instance, the reunification of an infant with her or his family of origin may involve more of an emphasis on parent training, whereas the reunification of an older adolescent may require a differing array of therapeutic focal points with regard to this model. In addition, children with emotional and behavioral problems may need special individual attention in order to ensure successful family outcomes (Balkin, Casillas, Flores, & Leicht, 2011). According to Bellamy (2008), caregivers with identified mental health issues may require individually based therapeutic intervention prior to reunification, as well. Family counselors may not be able to provide all of these services, nor should they be expected to. Rather, counselors should seek to refer children and parents for individual counseling services when specific needs arise as a supplement to the family counseling process.