Research: Why take-up of support services for birth parents of adopted children is low

Take-up of support services by the birth parents of adopted children is low. Archie Maclullich reports on research as to the causes of this and how it can improved

 “Just because physically and emotionally I wasn’t capable of looking after my children, it didn’t mean I didn’t love them” – birth mother quoted in Helping Birth Families: Services, Costs and Outcomes

Take-up of support services by the birth parents of adopted children is low. Archie Maclullich reports on research as to the causes of this and how it can improved


Key words: Birth families Adoption Children’s services User engagement

Authors: Elspeth Neil, Jeanette Cossar, Paula Lorgelly and Julie Young, School of Social Work and Psychology, University of East Anglia.

Title: Helping Birth Families: Services, Costs and Outcomes, British Association of Adoption and Fostering, 2010, 239 pages.

Aim: The aim of the study was to provide more information about the practice of supporting the birth relatives of adopted children and the associated costs.

Methodology: The research was conducted through postal questionnaires and telephone interviews in the first phase followed by a more intensive interviewing programme. Four adoption support agencies, three local authorities and one voluntary adoption agency were consulted and an analysis of the costs of providing support to birth relatives was conducted.

Conclusion: The take-up of support services by birth relatives was low and showed wide variation across agencies. Those who used support services found them to be helpful and involvement was associated with positive outcomes for some; the costs of providing support were relatively modest.



The study is part of the Adoption Research Initiative, which consisted of seven major research projects. These focused on permanence planning, professional decision- making and the matching, supporting and costing of adoptive placements.

The research on support of birth families connects with other projects in the initiative and also feeds into the ­evidence-based policy agenda.

It is noted that very little significant research effort has been focused on the needs of birth relatives and the demanding life changes faced by them as the systems underpinning compulsory adoption affect their lives.

These challenges include the experience of the loss of the child, the impact of negative social attitudes directed at the birth parents suggesting they have failed as parents, concerns about the future welfare of the child, and difficulties in relating to the perceived complexity of adoption policies and procedures if no support in the form of advocacy is available.

Support services for birth relatives can take various forms: facilitating involvement in group support, providing counselling to help birth relatives cope with mourning the loss, access to an independent support worker, advocacy and support in attending meetings, and the provision of information about procedures and adoption policies as listed by Triseliotis et al (1997).


“[My support worker was] the first person I had ever spoken to about losing the children, who listened, who didn’t judge, who didn’t assume that because I had lost my children I was a bad person. She understood that just because physically and emotionally I wasn’t capable of looking after my children it didn’t mean I didn’t love them. She gave me back the most important thing that I had lost and that was self-respect.”

This statement by a birth mother provides a clear and explicit evaluation of the interaction between her and a support worker and, within the report, a range of similar statements from birth relatives add to accumulated data on this topic.

The comprehensive set of recommendations for service planning should be used to inform the development by authorities of services which connect more surely with the needs of birth relatives – one-third of birth relatives sampled had not used adoption support services and most of these had unmet needs, as assessed by interviews and questionnaires.

In situations where referral and engagement with support services worked, the overall level of satisfaction with the services expressed by relatives was nearly three-quarters (73%). This finding echoes the recurring theme of the research: how to provide effective referral and service engagement strategies to meet the needs of the target group.

The average cost of providing a service was £511 a case a year, based on 2007 figures. Given the improvement in personal circumstances which recipients reported, there is a strong case for further investment in practices that connect with, and engage, birth relatives who need support. A ­comprehensive list of implications for practice is presented in the publication and a brief selection is presented in the next section.


The report provides a comprehensive listing of recommendations under each section, and these form a strong set of guidelines for the development of support services. It should be noted that a number of these recommendations concerning the need for enhanced publicity and communication with the birth relatives can be put in place with relatively low cost.

The report places a welcome focus on the benefits for birth relatives associated with good networking, information-sharing and collaborative working between birth support service providers, local authority children’s departments, and professionals in other agencies. Birth support service providers could assist by improving marketing of services using websites and online information, through the provision of flexible venues and sound user-engagement.

Further, information-sharing regarding referral and uptake patterns with other providers can be improved by forming local consortia which would encourage the involvement of service users in the design, delivery and evaluation of services, and create social networks for users.

Focusing on collaborative working models with professionals from other agencies – for example specialist mental health units – would enhance assessment and referral processes with sharper identification of the specific needs of birth relatives.


In identifying the nature and extent of the challenges facing birth parents, and providing a systematic set of recommendations for the development of support services, the study makes a much-needed contribution to our knowledge of this dimension in adoption services.

It is based on a robust model, drawing data from a range of sources which facilitates triangulation of observations and it has also been framed on the basis of solid peer review and consultation.

The project locus within the overarching research initiative, with its emphasis on ­policy implementation, has added a welcome orientation which encourages formulating strategy and planning activity on research evidence.

The research team acknowledges that the views of adopted children and adoptive parents are not included within the span of the research and also that, in the long term, different models of support should be compared and evaluated when these are more fully implemented within authorities as direct services, or through independent bodies.

The report presents a range of recommendations and suggestions for project development derived from the research and it will be an invaluable handbook for practitioners and service planners in this field.


For practitioners:

● Improve publicity regarding support services and use birth relatives to plan services.

● Improve referral/uptake information systems and support practices which focus on partnership working with birth relatives before adoption.

● Address the contact gap and maintain structured information flow to birth relatives.

Increase the uptake of relative support services through effective monitoring and use of external agencies in their independent role.

For birth support service providers:

● Improve marketing of services via websites and online information and access through the provision of flexible venues and sound user engagement practices.

● Create information sharing regarding referral and uptake patterns with other providers by forming local consortia.

● Involve service users in design, delivery and evaluation of services and create social networks for users.

Further reading

● Neil (2004), Supporting the birth relatives of adopted children: a review of the relevant literature, University of East Anglia

● Sellick (2007), “An examination of adoption support services for birth relatives and for post adoption contact in England and Wales”, Adoption and Fostering 31-4 pp17-26

● Triseliotis, Shireman and Hundleby (1997), Adoption – Theory, Policy and Practice

● Also go to the Adoption Research Initiative 

 Archie Maclullich is a consultant psychologist with 20 years’ experience of social work management at directorate level.

This article is published in the 19 May 2011 edition of Community Care under the headline “Helping birth parents come to terms with adoption

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