1 - (IOP 30) Feasibility and Acceptability of Adoption-specific Therapy (ADAPT) for Youth Adopted from Foster Care - A Pilot Study

In the United States, the average age of adoption for youth in foster care is 6 years. Importantly, youth who are adopted when they are older tend to have complex histories (e.g., abuse and neglect, multiple placements) that are predictive of behavioral challenges over time. Additionally, youth of color continue to be overrepresented in the foster care system and are likely exposed to increased racial/ethnic discrimination, which may exacerbate symptoms and behaviors. Unfortunately, evidence-based psychosocial interventions are not tailored to the unique clinical needs of youth adopted from foster care and their families, despite being overrepresented in mental health care and experiencing serious mental health challenges and negative outcomes. The current non-randomized pilot study investigated the feasibility and acceptability of an adoption-specific therapy protocol (ADAPT) in clinical settings. Informed by developmental-ecological and trauma-informed frameworks, ADAPT was developed as a manualized intervention tailored to improve the mental health and family dynamics of adoptive families for youth aged 5-14 years. The ADAPT intervention entails seven modules covering topics including trust building, coping strategies and behavior management, developmental understanding of the adoption experience, loss and grief in adoption, attachment to the adoptive family, identity development, transracial adoption, and trauma. In total, ADAPT consists of 20 therapy sessions involving individual parent and child sessions, as well as family sessions. At pre- and post-treatment, caregivers (N = 54) completed standardized measures, including emotional functioning (Emotion Regulation Checklist; ERC), family functioning (Family Environment Scale; FES), child behavior problems (Child Behavior Checklist; CBCL), parenting stress (Parenting Stress Index; PSI), and racial/ethnic socialization (Cultural and Racial Socialization Self-Efficacy Scale; CRSSES). On average, caregivers were 47.58 years old (SD = 8.64) and predominantly identified as female (60.5%) and White (55.3%). Based on caregiver-reported data, adopted youth in their care were 8 years old (SD = 2.92), 44.7% male, and 42.1% female (8% missing data). Youth were 50% Hispanic/Latinx, 29% White, and 21% Black. Paired-samples t-tests were used to compare pre- and post-treatment differences. Preliminary results of caregiver reports showed a statistically significant decrease in CBCL Total Problems scores (t = 2.07, p < .05) and an increase in CRSSES scores (t = -3.09, p < .01) at treatment completion. There were no differences in ERC, PSI, and FES. To explore factors potentially influencing post-treatment outcomes, multiple regression analyses were conducted to determine the effect of youth and caregiver demographic variables (e.g., age, race/ethnicity) on CBCL and CRSSES scores. Results were not statistically significant. An analysis of child outcomes measures (N = 54) and weekly family idiographic measures will also be discussed. This study highlights a gap in mental health services for adoptive families and emphasizes the need for more outcome studies on adoption-specific interventions for youth adopted from foster care and their families.