Develop and Support Families

UCLA TIES for Families, California

This is one of 31 program profiles that appears in Support Matters, Lessons from the Field on Services for Adoptive, Foster, and Kinship Care Families (PDF – 2 MB), published March 2015.

Overview

The University of California at Los Angeles (UCLA) TIES (Training, Intervention, Education, and Services) for Families offers three phases of support: (1) preparation and support of prospective adoptive parents; (2) pre-placement assessment of children and consultation with families; and (3) early intervention during the first year of placement and beyond.

Population Served

  • Children birth to age 21 who are in the process of being adopted from foster care or have been adopted from care. Children and youth are most often referred by the Los Angeles County Department of Children and Families Services, but can be referred by others as long as they are in the process of or have been adopted through the foster care system.
  • The program serves about 150 children and youth each year.

Theory of Change

Effective support services — offered before, during, and immediately after placement — can promote the successful adoption, growth, and development of children and youth ages birth to 21 who have disabilities and other challenges, including prenatal substance exposure. Providing support during the vulnerable period during a child’s transition from foster care to adoption promotes opportunities for attachment, prevents problems from escalating, and supports parents through the potential challenges of adopting a child or youth who has experienced trauma.

Provider

The University of California at Los Angeles Departments of Pediatrics and Psychology, in partnership with the Los Angeles Department of Children and Family Servicesw

Role of Public Child Welfare Agency

The Los Angeles Department of Children and Family Services refers families and contracts with the University for the provision of services.

Key Service Components

UCLA TIES for Families offers services in three phases:

  1. Preparation and support of prospective adoptive parents — Prospective adopters receive nine additional hours of education before they are matched with a particular child or children. The training focuses on:
  • The challenges and rewards of parenting high-risk children and youth
  • The effects of prenatal drug exposure, abuse and neglect, and parental histories of mental illness
  • Parenting strategies for children and youth in foster care at highest risk for difficulties
  • Understanding addiction and building empathy for birth parents
  • Strategies for preventing substance abuse
  1. Pre-placement assessment of children and youth and consultation with families — Once a family is matched with a child or youth, TIES clinicians provide a multi-disciplinary review of social service, legal, medical, mental health, and educational records, and evaluate the child’s or youth’s development, strengths, and needs.

    The TIES team — usually a psychologist, pediatrician, clinical social worker, educational advocate, speech pathologist, and child psychiatrist, if necessary — present the assessment results in person with prospective parents and child welfare workers so parents can make informed decisions, learn about the child’s strengths and needs and recommended supports, and discuss the child’s or youth’s transition to the new home.
  1. Adoption-informed early intervention after placement — As a child or youth moves into the new home, TIES staff provide an array of preventive services, support, and education to the family. Services typically are offered for the first year after placement, but can be extended. The services include:
  • Developmental assessments and home visiting of infants — This service is designed to promote optimal parent-child interaction and child development, identify families under stress, and provide parenting intervention, support, and connections to additional services.
  • Monthly support groups for parents and older children, and parent-child groups for families with infants and toddlers — Each group provides parents or youth an opportunity to support one another and discuss key topics. Parent topics include coping with children’s or youth’s challenges and behaviors; maintaining contact with birth families; and talking with children about their histories. Older children discuss feelings of isolation, rejection from peers, feeling different from other youth, or missing birth or former foster parents. In the parent-child groups, participants discuss concerns about effects of prenatal substance exposure, feeding and sleeping problems, attachment, security concerns precipitated by birth parent visits and legal uncertainty, and issues related to adoption.
  •  Adoption-informed counseling — Mental health providers help families address issues such as understanding the fit between a child’s and parents’ temperaments; nurturing a secure attachment; coping with behavior problems associated with prenatal substance exposure or histories of maltreatment or neglect; understanding child identity development; dealing with child grief and loss of birth parents and past caregivers and divided loyalties; understanding issues related to transracial adoption and nontraditional families; and coping with stressors from legal and social service systems.
  • Interdisciplinary consultations and services — Staff from various fields work to address the family’s concerns. Educational consultants may attend individualized education program meetings or advocate for classroom accommodations to stabilize school placements. Other staff can provide in-home behavioral support, assess speech and language needs, or link families with medical professionals familiar with problems common in this population.
  • Mentoring of youth — Children and youth are matched with undergraduates or graduates of UCLA who have spent time in foster care or adoption.
  • Mentoring of parents — Parents who have adopted from foster care provide peer support to those who are going through the process or who need additional support.
  • L.I.F.T. Program (Loss Intervention for Families in Transition) — L.I.F.T provides short-term grief counseling and grief support group services to families who are facing the imminent loss of
  • a child or youth to reunification or have already had a child or youth reunified.
  • Psychiatric Medication Management Clinic — Board-certified child and adolescent psychiatrists perform evaluations and help families manage medication if needed.
  • Other evidence-based practices — The program can provide families with evidence-based therapies such as Parent-Child Interactive Therapy, Child-Parent Psychotherapy, and Trauma-Focused Cognitive Behavioral Therapy. (See pages 222, 213, and 232 of Support Matters (2 MB PDF) for more on these therapies.) 

Outreach Efforts

  • TIES staff attend the last session of adoption preparation training provided by the Los Angeles County Department of Child and Family Services and invite parents to attend additional training offered by TIES.
  • TIES staff make presentations and exhibit at adoption and other related events and encourage adoption professionals make referrals to the program.

Staffing

  • Licensed psychologists — 5.25 full-time equivalent
  • Social workers — 3.75 full-time equivalent
  • Mental health providers — 7 full-time equivalent
  • Psychiatrist — .6 full-time equivalent
  • Pediatrician — .3 full-time equivalent
  • Support staff and program administration — 4 full-time equivalent

Training Requirements

  • All staff receive 40 hours of training in issues specific to adoption and foster care in their first month with the program.
  • Staff are provided with eight additional hours of training each quarter on issues relevant to working with children and youth in foster care and adoption, including adoption-informed psychotherapy and evidence-based practices and multidisciplinary approaches to interventions with this population.

Evaluation and Outcomes

Evaluation Design

All parents complete a satisfaction survey. Program evaluators are conducting a longitudinal study of 82 families, collecting data two and 12 months after the intervention, and then every year until the children are five.

Key Findings

  • The vast majority of families surveyed report TIES was the most useful service received during the transition period.
  • Prospective adopters were more likely to be willing to parent a child who had prenatal substance exposure after attending the TIES training, and felt more confident in their ability to meet such a child’s needs.
  • The longitudinal study showed disruption rates of only 3 percent and parents reported less stress and more satisfaction over time.
  • During the first year of intervention, children in the longitudinal study showed increases in cognitive development and decreases in internalizing behavior problems.

Approximate Annual Budget for Services Described

 $2.5 million

Funding

  • Contracts with the Los Angeles Department of Child and Family Services and the Los Angeles Department of Mental Health.
  • MediCal for the therapeutic and medical services.
  • Foundation grants cover portions of the program not covered by the contracts. 

Partnerships Required or Recommended

  • The program relies on a strong relationship with the Los Angeles County Department of Child and Family Services. The child welfare department makes referrals and enables TIES program staff to conduct outreach during pre-adoption training.
  • TIES also works closely with local and national child advocacy organizations.

Challenges

  • Relying on public funds during tough economic times
  • Only being able to serve children and youth being adopted from foster care

Background and Future Directions

TIES began as a two-year program, originally funded by a federal Adoption Opportunities Program grant. Since its inception, the program has served more than 1,000 children and their caregivers, and about 2,000 families have received training.

TIES has created a manual to guide other practitioners in the use of its eight-module adoption-specific psychotherapy model (called ADAPT). A pilot study of its effectiveness is underway.

Learn More

Sources

  • Susan Edelstein and Audra Langley, interview, June 26, 2013.
  • Unique TIES Components fact sheet.
  • UCLA TIES website, accessed July 14, 2013.
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