Overseas adoption represents one way for couples to become parents. Some adoptive parents have long, traumatic and ultimately failed fertility histories while others choose adoption over fertility-assisted treatments or surrogacy, preferring to parent a child to which neither has a genetic link. With the rate of local adoption at an all-time low as a result of a change in philosophy from adoption to fostering, for some couples international adoption represents the only way to realise their dream of becoming parents.
Various countries including Australia have programs in place for adopting overseas children. Adoption programs are in place between Australia and the following countries: China, India, Thailand, Taiwan, The Philippines, South Korea, Colombia and Chile. In 2012-13 there were 129 finalised overseas adoptions of children in Australia, representing 3 per cent of all adoptions (Australian Institute of Health and Welfare, 2013). Overseas adoption rates are likely to increase with the recent announcement by the Federal Government encouraging more overseas adoptions and easier pathways for prospective adoptive couples (see Report of the Interdepartmental Committee on Intercountry Adoption; Australian Government, 2014).
The suitability of prospective parents for overseas adoption is carefully assessed and frequently includes psychological assessment, providing a significant role for psychologists.
Selection process for involvement in overseas adoption
For a couple considering overseas adoption, the entry point in Australia is their local Adoption Service which is nestled within State/Territory Welfare Departments. These services liaise with the Australian Central Authority (located in the Commonwealth Attorney General’s Department), which holds overall responsibility at the policy and program establishment level to comply with Australia’s obligations under the Hague convention. The State services liaise with various international adoption services, conduct family assessments and undertake their own education, training and selection of suitable candidates. Some of these services undertake in-house psychological assessments while others sub-contract them privately. While each State shares information, psychological assessment decisions are made independently.
The process from an initial inquiry by a couple to allocation of a child is typically lengthy (up to and sometimes longer than four years), stressful and complex. Prospective parents undergo a raft of assessments including medical, financial, vocational and marital. There are decisions to be made about which country the couple should send their ‘dossier’. There is an in-depth family assessment made by one of the in-house social workers or psychologists, which examines in fine detail the couple’s psychosocial background, values, family relationship and cultural attitudes insofar as they relate to international adoption and reasons for adopting. These assessments are usually undertaken in the couple’s home, sometimes take 12-14 hours and the reports routinely run for 25-30 pages. No stone is left unturned.
In addition, the countries involved in the adoption process can change their ‘status’ for a variety of reasons. At one stage a couple may have decided to send their dossier to one country only to learn that this country has ‘shut its doors’ for reasons that are often unclear to local authorities. Military instability is an obvious reason for suspending an adoption program, but sometimes the reasons appear less clear and prospective parents are left with no recourse but to change their preferred country and in some instances, be re-assessed in order to adjust their dossier to the requirements of the new country.
Psychological assessment
Each country surrendering children for adoption has its own requirements for psychological assessment of prospective parents which form part of the overall assessment of parents ‘suitability’ for adopting. Some countries require lengthy psychological assessments complete with individual and couple assessments, and examination using psychometrically validated tools measuring personality and psychopathology, while other countries require only a simple statement of ‘sanity’. In addition, each State in Australia has some flexibility in deciding how they approach the complex task of assessing prospective parents for their suitability to adopt.
Regardless of whether or not assessment with specific tests is required, psychologists undertaking these assessments have a responsibility to reflect on the various requirements and provide an informed opinion about the questions raised by the local and international authorities governing international adoption. Such requirements include questions about mental and marital suitability, cultural awareness, social support, capacity to reflect on previous trauma and parenting awareness.
Some countries ask psychologists to assess both parents using specific tests to justify their opinions, including such tests as the Personality Assessment Inventory (PAI), the Minnesota Multiphasic Personality Inventory (MMPI) and the Parenting Awareness Survey Scale (PASS; see Bricklin (1990) for more information). Other countries require prospective parents to undergo a test of general personality such as the NEO Personality Inventory. But are such tests adequate and meaningful in this arena and do they ‘measure’ parental suitability for overseas adoption?
Consider the NEO, which is currently the predominant personality questionnaire based on the leading Five Factor model of personality. It has well validated scales and sub-scales that provide a wealth of potentially useful information about respondents. Is it, however, suitable for use in the context of adoption? Assessment for adoption, like any other assessment for a third party, carries a component of legality; to some extent, these adoptions are medico-legal. One party asks another party to make an assessment of a third party’s capacity to adopt. There should be a social desirability scale enabling the psychologist to assess the respondent’s honesty or otherwise in responding. There is no such scale in the NEO. Another term for social desirability is ‘positive impression management’. Impression management in test completion is a field all of its own and it is particularly relevant to psychological assessment for international adoption because applicants have very good reasons to portray themselves in socially desirable ways.
Consider also the PAI, with its extensive literature in clinical and forensic areas suggesting a fine pedigree well suited to the adoption arena. In addition, it has four validity scales, two of which measure components of positive impression management. But is the PAI a good test to use in assessing overseas adoption candidates? By the time couples reach the psychological assessment stage the adoption agency has done such a good job that most potentially problematic applicants have been excluded. As a result, most PAI profiles have T-scores in the normal range. More importantly they have validity scores comparable to analogue studies in which participants are instructed to fake-good, i.e., they are asked to provide an exaggerated favourable account of themselves. Such scores render these profiles invalid at the least and potentially misleading at the most.
Administering a specialised measure of positive impression management as part of the psychological test battery (such as the Balanced Inventory of Desirable Responding [Paulhus, 1998]) is one way to circumvent these validity problems. But experience shows that generally applicants ‘fail’ this test also. This does not necessarily mean they will be poor adoptive parents; the rigorous family assessment process itself is likely to exclude all but the most determined parents-to-be. However, it is possible that these well respected tests are not particularly helpful in this important area of assessment where positive impression management is a problem.
Qualities of suitable parents
In addition to the issue of positive impression management, assessors also need to know what qualities actually make good adoptive parents of children from overseas. The literature identifies a range of factors associated with successful overseas adoption (see Passmore, Feeney & Jordan, 2009 for a review). Such factors include having sound reasons for adoption, resolved grief over troubled fertility histories and associated losses, flexible attitudes towards parenting, and sensitivity and responsiveness to the needs of children.
Specific parent qualities associated with successful adoption include being open to new experiences and willing to consider whatever challenges an adopted child may bring. Likewise, flexibility in expectations about the child’s meeting of academic standards or societal norms is essential. Adoptive parents also need a high level of emotional stability and maturity to be able to set aside their own emotional needs and respond to the often complex needs of their children. All these qualities are particularly important given that some overseas adoptive children are brought into new families at an older age and with a history of pre-arrival adversity, posing some particularly challenging issues for adopting parents.
In addition, it is very clear that prospective adoptive parents of overseas children need to be culturally sensitive and culturally aware. There is an extensive literature demonstrating that children whose adoptive parents have a positive racial and ethnic attitude and go so far as to learn the language, choose culturally consistent schools, foods and medical providers and who actively teach their children strategies to anticipate and cope with racism (for example), adjust better than those whose parents do not have these attitudes (Lee et al, 2006). Betsy Vonk’s work (see, for example, Vonk, 2010) in this area has been an important source of information and her resulting questionnaires are useful for clinicians assessing prospective parents on their attitudes towards cultural awareness.
Conclusions
Clinicians undertaking assessments of prospective adoptive parents of overseas children need to think and read broadly in this area in order to provide meaningful and useful assessments. They need to understand the area of child adjustment and the associated parental factors. They need to understand the notion of cultural sensitivity and its importance in post-adoption adjustment. They also need to understand the various assessment tools they use and their probable lack of validity measures. They also need an understanding of the impression management field.
One recommended route for psychologists undertaking these assessments is to combine a well known mental health assessment tool such as the PAI or the MMPI with a general measure of personality such as the NEO. In addition to this, a measure of positive impression management such as the Balanced Inventory of Desirable Responding is recommended. Marital stability and parenting knowledge can be assessed by tools such as the Dyadic Adjustment Scale (see Spanier, 1976) and the PASS. Finally, the Transracial Adoption Parenting Scale (TAPS; Massatti, Vonk & Gregoire, 2010) provides a summary of parental attitudes to multicultural involvement and awareness. The use of the most suitable tools at our disposal, in addition to finely tuned clinical skills, provides the best path to reliable psychological assessment and to facilitating the best outcomes for adopted overseas children and their new parents.