Journal of Child & Adolescent Mental Health

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Open adoption: a review of the literature with recommendations to adoption practitioners Loraine Townsend To cite this article: Loraine Townsend (2003) Open adoption: a review of the literature with recommendations to adoption practitioners, Journal of Child & Adolescent Mental Health, 15:1, 1-11, DOI: 10.2989/17280580309486535 To link to this article: http://dx.doi.org/10.2989/17280580309486535

Published online: 12 Nov 2009.

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Journal of Child and Adolescent Mental Health 2003, 15(1): 1–11 Printed in South Africa — All rights reserved

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JOURNAL OF CHILD AND ADOLESCENT MENTAL HEALTH ISSN 1728–0583

Review

Open adoption: a review of the literature with recommendations to adoption practitioners Loraine Townsend

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Department of Psychiatry and Mental Health, University of Cape Town, Groote Schuur Hospital, Observatory 7925, South Africa e-mail: [email protected]

As openness in adoption is still in its infancy, there has not been much systematic research on open adoption. This practice involves anything from sharing non-identifying information through an intermediary to regular face-to-face fully identifying information-sharing and contact between all members of the adoption triangle — the birthparent/s, the adoptive parents and the adoptees. Open adoption appears to offer birthparent/s the greatest benefits. Although adoptive parents express varying degrees of positive reactions to being involved in open adoptions, there are instances of discomfort and reservations expressed by some. With no studies investigating adoptees’ own perceptions around contact with their birthparent/s, the potential risks and/or benefits of open adoption for the children involved, is inferred from adoptive parents’ reports and theoretical perspectives. Adoption practitioners advocating openness in adoption, should be prepared for additional investments in time, effort and emotional energy in order to facilitate what is not a discrete event in time, but an on-going process.

Introduction Open adoption is increasingly becoming the mode of adoption practice in countries where adoption is one of established procedures for placing infants and children with person/s who are not that child’s biological parent/s. Over the past three decades, significant changes in adoption practice have occurred. Whereas before the early 1970s adoption was based on a model of secrecy, it is fast becoming based on a model of openness encompassing varying levels of contact and communication between the members of the adoption triangle — birthparent/s, adoptive parents and adoptees (Fravel, McRoy and Grotevant 2000). As open adoption is in its infancy and, given that there is relatively little information about openness among families involved in adoption (Frasch, Brooks and Barth 2000), the question that all those involved in any form of adoption are asking is whether it is a viable option as opposed to the traditional closed adoption practices and whether the benefits outweigh the risks, or vice versa, for all those involved. It is worth noting that the move towards openness in adoption was motivated by a surge of studies in the late 1970s and later, which identified the birth mothers’ ongoing distress after relinquishment of their babies as well as the call in the United States for opening previously sealed records to adoptees searching for their biological parents. Interestingly, in the United Kingdom, birth records were opened in 1975 for adoptees over the age of 18 years wishing to access information about their birthparents. According to Bagley (1993), five years later, only 2% of adoptees had availed themselves of this service and only 28% of these actually intended to seek their birthparents. This has led Bagley to conclude that, in North America, adoptees’ search-

ing process “has a basis seemingly rooted in ideology rather than in psychological need” (p. 7). Further, with the increasing decisions by birthmothers to keep their infants, the change in societal attitudes towards out-of-wedlock pregnancy and single parenthood, the increased use of contraception and the concomitant shortage of adoptable infants, birthmothers are increasingly becoming a major part of the decision-making process in adoption (Bagley 1993, Berry 1993a, Baumann 1997, Berry et al. 2000). The balance of power, according to Tugendhat (1992) seems to be shifting in favour of birthparents. The ensuing review will address a number of issues. Firstly, what are some of the theoretical perspectives that have informed closed adoption practices and what are those that now inform open adoption practices? Secondly, are there any inherent risks involved in open adoption for the members of the adoption triangle — the adoptees, the birthparents, and the adoptive parents? Thirdly, what are the benefits of open adoption for the members of the adoption triangle and finally, what levels of openness and what type of information sharing seem to be the most satisfying for each of the members of the adoption triangle? In order to clarify these posed questions, some of the most recent literature, during the past ten years, from academic journals, books by adoption professionals and anecdotal accounts from adoptees themselves have been reviewed. Some seminal works from the 1970s and 1980s have also been referred to. Few of the studies involve quantitative research, and most involve qualitative analyses from interviews and open-ended questionnaires. The data, thus obtained, are rich in variety and cover emotive issues often

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lost in purely empirical analyses. Most recent studies have been initiated in the United States of America and the following review draws heavily on these sources (Table 1). The discussion of the literature is limited to infant adoptions only (that is, children younger than 12 months old). Limitations of the research to date Before embarking on a discussion of some of the research to date, it is important to note that, because of the infancy of open adoption practices, there have not been many studies done around open adoption of infants (Siegel 1993, Gross 1997). Many of the recent studies have small samples and results are therefore not generalisable (Gross 1993, Alty and Cameron 1995). Most of the studies involve self-selected participants who may have already been predisposed to open adoption and therefore ‘skew’ the results in favour of openness (Grotevant et al. 1994, Alty and Cameron 1995). Some of the more recent studies have fairly high attrition/refusal rates in their follow-up studies, again suggesting a possible response bias (Berry et al. 2000). In spite of not having comprehensive records and representative statistics on adoption in the United States, a project conducted by the National Center for State Courts estimated that 118 779 adoptions occurred in the United States in the year 1990 alone (Watson 1996). Although these included intra-familial and older-child adoptions, it gives one a fair idea as to the volume of adoptions in the United States. Given this, the studies that have informed this report are tabled below and I would caution the reader at all times to consider that the samples in these studies range from as few as 21 adoptive parents with only one study investigating 1 268 adoptive families. By far the most important consideration to make is that research has been exclusively conducted with birthparents and adoptive parents (Gross 1993). To date, the author has not located any research findings reflecting adoptees’ perceptions of open adoption. Some of the reviewed studies are the beginnings of longitudinal research and the hope is that, in the near future, adoptees’ voices will also be heard (Berry 1991, Siegel 1993, Gross 1997). Much of the discussion around the risks and benefits of open adoption for adopted children is informed by theory and is largely speculative. Defining open adoption “Open adoption refers to both the practice of pre-placement sharing of information and contact between biological and adoptive parents of a specific child, and continued sharing and contact over the child’s life” (Berry 1993a, p. 231). Whilst most authors agree with this very broad definition, many acknowledge that openness falls more accurately along a continuum (Rompf 1993, Cushman, Kalmuss and Namerow 1997, Gross 1997, Sobol, Daly and Kelloway 2000) to the extent that the number of permutations is virtually limitless (Siegel 1993). Some authors have identified and focused on the type of information that is shared: either identifying information where both birth and adoptive parents share full names and contact/visiting details or non-identifying information where birth and adoptive parents may share only first names and do not have knowledge about each others’ addresses etc.

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Contact in the latter instance is maintained through the adoption agency/facilitator (Berry 1991, Sachdev 1991, Berry 1993a, Siegel 1993, Cushman et al. 1997). Some of the studies have operationalised levels of openness from where adoptive parents have limited if any contact with the birthmother, to where there is frequent on-going, face-toface contact between the adoptive parents, birthparent/s, and adoptees (McRoy, Grotevant and White 1988, Cushman et al. 1997, Gross 1997, Fravel et al. 2000). Others have acknowledged that open adoption is not so much a discrete event in time, but rather a long-term process (Berry 1991, Rompf 1993, Grotevant et al. 1994). More recent studies have focused on differing levels of openness when investigating their various outcomes of interest in open adoption (Berry et al. 2000, Frasch et al. 2000, Fravel et al. 2000). The risks and benefits of open adoption will be discussed from the position of each of the members in the adoption triangle. Levels of satisfaction amongst the various players in the adoption drama seem to depend on the amount and type of information-sharing as well as the degree of openness that is practised. Finally, adoption practices have been informed by theoretical perspectives, which may have continued relevance in the face of little empirical research. The birthparent/s Benefits of open adoption for birthparents Despite the earlier conception that birthmothers could relinquish their children (or even wanted to sever ties with their children) and continue their lives without a backward glance, it has been documented that this is a gross misconception (Sorosky, Baran and Pannor 1984, Baran and Pannor 1993). An Australian study (cited in Tugendhat 1992) reported that birthmothers were more likely to suffer illness and nervous disorders than the rest of the population. This appears to be the result of unresolved mourning and the consequences of living with unresolved stress. Noting that all mothers did not have the same reactions, some of these included post-natal depression and nervous breakdowns, feelings of guilt and low self-esteem and deteriorating relationships with their own parents. Tugendhat (1992) goes on to describe how the PAC (Post-Adoption Centre) in the United States started meetings for birthparents in response to “the litany of grief, anxiety, confusion and isolation” expressed by birthmothers. They believe that they experience bereavement that cannot be resolved because there has not been a death nor any rituals that accompany death. This was poignantly expressed by one birthmother (in Redmond and Sleighthorn 1982) — “A death heals over. But giving up a child, knowing its out there somewhere, it never stops” (p. xiv). Sorosky et al. (1984) describe their study where 36 birthmothers and two birthfathers were contacted and interviewed between one and 33 years after placement of their children in closed adoption situations. These findings showed that 50% of the birthparents continued to have feelings of loss, pain and mourning over the relinquished child; 82% wondered how the child was growing up, what s/he looked like and whether s/he was being well cared for; 80% hoped that the child was happy; 82% supported the idea of

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Table 1: Summary of primary source studies informing the review Author/s

Sample

Levels of openess

Design

Method

Area of investigation

Baran and Pannor 1993

764 adoptive parents

Half: no contact Half: some level of openness

Longitudinal

Questionnaire survey

Changes in openness over time. The relationship between openness and child and family adjustment 4 years postplacement.

Berry 1993a

1 268 adoptive families

Open, closed, intrafamilial, older child

Cross-sectional

Survey

Adoptive parents’ perceptions of, and comfort with open adoption.

Cushman, Kalmuss and Namerow 1997

171 birthmothers

All some level of openness

Cross-sectional

Interviews

Five years post-placement, social psychological outcomes among birthmothers.

Etter 1993

129 birthparents and adoptive parents in 56 open adoptions

All some level of openness

Cross-sectional

Questionnaire and open-ended questionnaire

Level of co-operation and satisfaction in mediated, written pre-placement agreements.

Frasch, Brooks and Barth 2000

231 adoptions foster care

42% having some level of openness 58% having no contact

Longitudinal

Survey

Child and family characteristics, openness and contact, views of birthparents, satisfaction 8 years after placement

Fravel, McRoy and Grotevant 2000

163 birthmothers

All some level of openness

Cross-sectional

Interviews

The relationship between levels of openness and differing levels of psychological presence of birthmothers’ relinquished children.

Gross 1993

1. 32 adoptive parents and 15 associated birthparents 2. 75 adoptive families

All some level of openness

Cross-sectional

1. Interviews 2. Questionnaires

Satisfaction with open adoption from birthparent and adoptive parents’ perspectives.

Gross 1997

41 adoptive families 26 associated birthparents

All some level of openness

Cross-sectional

Interviews

Variants of open adoption. Conditions for successful post-placement openness.

Grotevant et al. 1994

190 adoptive families 169 birthmothers

All some level of openness

Cross-sectional

Interviews

Variations in levels of open adoption as function of satisfaction for adoptive and birthparents.

McRoy, Grotevant, and White 1988

17 adoptive parents, 15 birth-parents, 24 adoptees

All except 2 having some level of openness

Cross-sectional

Semi-structured interviews

Satisfaction, advantages, disadvantages, concerns, difficulties from all three members of adoption triangle.

Sachdev 1991

76 adoptive parents, 28 birthmothers, 53 adoptees

All closed

Cross-sectional

Semi-structured interviews

Type of information wanted/ not wanted by all three members of adoption triangle.

Siegel 1993

21 adoptive parents in 24 open adoptions

All some level of openness

Cross-sectional

Interviews

Adoptive parents’ perceptions of advantages and disadvantages of open adoption

Sorosky, Baran and Pannor 1984

38 birthparents 2 of whom were fathers

All closed

Cross-sectional

Interviews

Between 1 and 33 years after placement. First opportunity for birthparents to express feelings and needs.

from

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a reunion although many envisaged a friendship rather than a parenting relationship developing; and 95% felt the need to provide up-to-date information about themselves to the adoption agencies considering the placement information not relevant to their present circumstances. Clearly, not only do birthparents continue to express grief, but also continue to be concerned for their children’s well-being. It is widely felt that open adoption may diminish birthmothers’ grief at the loss of her child, guilt or regret and sadness at having given up her child. In a 4-year post-placement study of birthmothers participating in some form of open adoption, Cushman et al. (1997) found that 84% of birthmothers were experiencing ‘a little’ or no grief at the relinquishment of their children; 78% were experiencing ‘a little’ or no regret; 74% were either not worrying or only worrying a little about their children; and 84% were either not experiencing any sadness or only a little. These results indicate that openness in adoption can be associated with positive, long-term psychological outcomes for birthmothers. Adding weight to the advantages of openness in adoption, McRoy et al. (1988) conducted qualitative interviews with 15 birth parents who were participating in either closed, semi-open or fully disclosed adoptions and were able to identify further benefits of open adoption. They found that pre-placement contact between adoptive parents and birthparents dispelled some of the negative fantasies that birthparents in closed adoptions developed about adoptive parents: curiosity about adoptive parents was fulfilled. Birthmothers also expressed great relief in the knowledge that their children would understand the circumstances of their conception as well as the reasons for the relinquishment. They felt relieved that their children would know that they were loved and that they had not been abandoned or rejected. These feelings of relief and peace were endorsed by the findings of Cushman et al. (1997) where a large majority of birthmothers expressed feelings of relief and peace over their open adoption arrangements (86% and 85% respectively). Additionally, a recent study by Fravel et al. (2000) found that there is clear evidence to suggest that despite no, some, or limited physical presence of a relinquished infant, “…adopted children are psychologically present to their birth mothers, not only on special occasions but also as the birth mother goes about her routine, day-to-day life” (p. 429). From comprehensive analysis of interview data collected from 163 birthmothers, these researchers explored the degrees and valence of psychological presence of their participant’s relinquished children. In every one of the 163 cases, the adopted child was psychologically present in varying degrees to the birthmothers. Additional findings suggest that, for many birthmothers, psychological presence is both positive (causing joy) and negative (producing pain). Although psychological presence was more positive for birthmothers in fully-disclosed adoptions, than for those in time-limited-mediated or closed adoptions, a remarkable finding was that overall negative valence did not occur in any of the levels of openness in the adoptions. Finally, it is interesting to note that Baran and Pannor (1993) suggest that adoption social workers may have been responsible for sustaining closed adoption as a practice pre-

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cisely because they were unable to “…deal with the continuing pathos and misery of the birthmothers in the post-relinquishment period” (p. 122). These studies provide evidence to suggest that birthparents (and in particular birthmothers) continue to think about their children. The ‘happily-ever-after’ myth (Reitz and Watson in Fravel et al. 2000) — a notion that birthmothers are able to forget about their relinquished children and continue with their lives — is clearly just that — a myth. For birthmothers, openness in adoption evidently reduces many of the discovered negative psychological consequences of relinquishing a child. However, there is also evidence to suggest that on-going contact between birthmothers and their adopted children may not always be a positive experience for them. Risks of open adoption for birthparents Contrary to the belief that ongoing contact with their children would dispel feelings of continued grief for birthmothers, Berry (1991) warns that continued contact may well prolong uncertainty and grief. In the McRoy et al. (1988) study, it was found that ongoing contact seemed to be very stressful for a number of birthmothers interviewed. These birthmothers reported that having to leave their children (after visiting) was extremely painful; seeing the adoptive parent as having complete control in their children’s lives was distressful and sadness and grief often characterised the termination of their visits or receipt of updated information about their children. Several of these birthmothers expressed a hope that their children would want to come to live with them when they were older. Also worth noting is a survey of a small number of birthparents involved in open and closed adoptions up to one year after placement done by Blaton and Deschner (cited in Gross 1993). Their findings suggest that birthmothers have greater grief responses in open adoptions than in closed adoptions. Once birthparent/s become involved in permanent relationships and go on to have families of their own, husbands, wives or partners may not share their partners’ wish and enthusiasm to continue a relationship with the adopted child (McRoy et al. 1988, Sachdev 1991, Grotevant et al. 1994). Conflict over this issue may cause friction between the parties in these newly established relationships. Berry (1991) describes how birthmothers (particularly adolescent birthmothers) may form an unhealthy emotional reliance on the adoptive parents. She goes on to suggest that emotional reliance of this sort may inhibit the young birthmothers’ emotional maturity and hinder her emotional and psychological development. Satisfaction with levels of openness for birthparents A number of features of openness in the Cushman et al. (1997) study were found to be associated with less feelings of grief, regret, worry and sadness and more feelings of relief and peace among birthmothers interviewed. These included being instrumental in choosing the adoptive parents, being able to meet the adoptive parents (pre- or postplacement), having post-placement contact (telephonic or face-to-face), and/or having received letters about and pho-

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Journal of Child and Adolescent Mental Health 2003, 15: 1–11

tographs of their children. For this sample of 171 birthmothers it appears that personal and on-going contact, whether face-to-face or indirect, was instrumental in their ongoing positive well-being. The data strongly suggest then that open adoption practices including identifying information can and does benefit birthmothers across a variety of psychological outcomes. In 1989, Etter conducted a study involving 129 biological and adoptive parents in 56 open adoptions, four and a half years after placement (Etter 1993). The salient feature of this pilot study was that all the open adoption arrangements “were mediated with written agreements delineating the parties’ desires for communication as well as other details” (p. 260). It was found that all the birthparents had kept to their original agreement and that 94% expressed satisfaction at the open adoption arrangements. Seventy-eight percent were satisfied with the mediation process and a similarly high percentage were satisfied with their contact with the adoptive family. It would appear then, that given the high levels of compliance and satisfaction, mediated written agreements worked best for this particular sample of birthmothers. Etter goes on to delineate three key ingredients that appeared to have made these arrangements successful. They were; 1) choice (the desired level of openness was chosen before matching, 2) thorough preparation (biological parents were prepared through counselling and support groups, and 3) written agreements (comprehensive, written agreement on all aspects of contact between the two sets of parents was established). If the parties did not agree on the basic issues, they were not matched and did not plan an adoption together. High levels of satisfaction are clearly due to both parties deciding on their basic needs and expectations before entering into an adoption arrangement and not having to make post-placement compromises. The need for pre-placement, firm agreements between the adoption parties is also strongly advocated by Siegel (1993). Unresolved grief and mourning As a proposed feature of birthmothers’ on-going psychological distress, the issue of unresolved grief and mourning warrants further mention. According to Wolfstein (in Kraft et al. 1985a), the capacity of an adolescent to mourn the loss of an object (in this case, her infant) is controversial. Informed by psychoanalytic theory, it is felt that successful resolution of the mourning process involves a detachment from the object and an acceptance of the finality of separation. For Silverstein and Demick (1994), this perspective assumes that “…healthy birthmothers are expected to separate from their children forever and to have no future knowledge of their well-being or whereabouts, to grieve this loss, and essentially to forget, disconnect from this troublesome episode in their lives” (p. 114). They go on to say that, to the extent that birthmothers are unable to do this, they are considered to be immature or even pathological and they are unlikely to be able to progress to full psychological maturity. On the other hand, Alty and Cameron (1995) argue that openness circumvents the need for a resolution of a mourning process. Because birthmothers have continued access to their children (albeit to varying degrees), there is no ‘loss’, no need for grief, no interference with their path to psycho-

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logical maturity. However, as noted earlier, in spite of continued contact with their children, some birthmothers do continue to experience on-going grief. The adoptive parents Advantages of open adoption for adoptive parents In 1989 Siegel conducted interviews with 21 adoptive couples who had participated in open adoptions, the levels of which varied from agency-mediated, non-identifying information exchange to frequent face-to-face meetings and resultant fully identifying information exchange. Despite some initial fears, anxieties and concerns about openness ranging from a reluctance to deal with the birthmothers’ pain, a fear of the possibility that birthmothers could reclaim their babies and a general fear of the unknown, none of the adoptive parents felt that open adoption had been a mistake. These adoptive parents listed a number of advantages to their open adoption arrangements. Specifically, they felt that open adoption gave them some control over which birthparents they wished to work with. Most noted that open adoption had helped them prepare for their roles as parents thus helping them to parent more effectively. Many felt that first-hand information about the birthparents was a distinct advantage. This, they felt, would help considerably in being able to answer their children’s questions adequately. Several parents expressed satisfaction in knowing that the birthmother had willingly chosen them to parent her child. It was comforting to know that through information about her child, the birthmother’s pain at relinquishment would be eased. Many of these perceived advantages were echoed in the study by McRoy et al. (1988) (described earlier). In this investigation, parents involved in semi-open adoptions (with exchange of pictures and letters and non-identifying information) felt that their arrangements had not only fulfilled their curiosity about the birthparents, but had also made the birthparents ‘real’ rather than fantasised people. Their chosen level of openness assisted them in explaining to their child the circumstances of his/her adoption and eased concerns for the birthparents’ need to be reassured about their child’s well-being. Those parents involved in fully disclosed adoptions with on-going and identifying information-sharing felt that their arrangement was in the best interests of the child and that the child’s relationship with its birthmother was a positive event. They also felt their adoption arrangement reduced the fear of reclaiming of their child by the birthmother, and provided them with accurate information about the birthparents. In a questionnaire study (Gross 1993), in which 75 adoptive parents participating in some degree of adoption openness were contacted, it was found that 95% had a basically favourable overall attitude toward open adoption; ninety-six percent of whom also expressed satisfaction with the level of openness in their particular adoption. In assessing some of the open-ended enquiries about the best aspects of openness, the greatest areas of comfort for adoptive parents revolved around control over information about, or access to the biological family that either they themselves or their children would have or need. Also mentioned were the comfort felt knowing that their child was aware of his/her biological

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parents’ love for him/her and knowing that the biological mother had some relief in having information about her child’s whereabouts and welfare. Another distinct advantage of openness, was proposed by Alty and Cameron (1995). Important medical information about the adopted child, particularly as it relates to inherited disorders and which may not be available to adoptive parents in closed adoption, could have tragic consequences. In open adoption, any ambiguous medical condition that threatens the adopted child, could be clarified immediately through on-going contact with his/her biological parent/s. These studies clearly enumerate a number of advantages of open adoption for adoptive parents. However, other research has identified a number of risks for adoptive parents. Risks of open adoption for adoptive parents Although all of the respondents in Siegel’s (1993) research felt that openness was not a mistake, 14 adoptive parents did identify some disadvantages. Some parents expressed concern about the (unknown) long-term impact that open adoption would have for their children. One mother expressed the strong need to distance herself from the birthmother’s pain, loss and regrets. She felt the need to limit contact with the birthmother, but felt she could not do so for fear of hurting the birthmother further. Another mother felt that the involvement of the birthmother had made her feel that the baby was not hers — she felt this had impeded her bonding with her child. One couple was struggling to break the intimate and reliant relationship that had sprung up between themselves and the birthmother despite a previous agreement to do so. Other couples noted that coping with their friends’ and families’ fears, was troublesome. Adoptive parents who participated in the McRoy et al. (1988) research also noted a number of disadvantages of open adoption. These concerned fears around meeting the birthmother. For example, fear that the birthmother may not like them and/or that they may not like the birthmother. There were also expressed concerns that the birthmother may become interfering and/or intrusive to the extent that some couples mentioned dreading the birthmother’s visits. Others mentioned resenting the additional time and effort required in maintaining the relationship between themselves and the birthmother. Witnessing the continued pain and distress that visiting caused the birthmother was also a cause for concern remarked upon by some parents. Many of the above negative experiences were echoed by the participants in the Gross (1993) study. When asked to identify some of the worst aspects of openness, adoptive parents most frequently replied ‘none’. However, other replies included; 1) persistent fears that the biological mother would want to reclaim her child, 2) the continued pain, grief and negative emotions expressed by birthmothers, 3) difficulties in arranging contact with the birthmother, and 4) lack of understanding or negative comments from others. Levels of satisfaction in open adoption for adoptive parents It is interesting to explore a study done by Sachdev (1991). Information was gathered through in-depth interviews con-

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ducted with 76 adoptive couples, 78 birthmothers and 53 adoptees who were all involved in closed adoptions. He was interested in exploring the types of information that birthparents, adoptive parents and adoptees felt they would like to have about each other. Almost 70% of adoptive parents favoured having identifying information released to adoptees. Non-identifying information provided to adoptees and themselves was chosen as the type of facts that almost 83% of adoptive parents favoured. Over 90% of adoptive parents favoured the release of medical information to adoptees and themselves. Whereas 75% opposed the release of identifying information about adoptees to birthmothers, over 80% favoured releasing information on adoptees’ well-being to the birthmothers. There was considerable opposition and ambivalence about releasing information about adoptees to birthfathers or half-siblings. This information has clear implications for the type of information sharing that may be most effective and satisfying in open adoption arrangements. In 1986, a Child Welfare League of America task force recommended that the amount of openness in any adoption should be based on mutual agreement (Grotevant et al. 1994). This was endorsed by both Etter’s (1993) findings (described in more detail earlier) and Siegel (1993), where there was surprisingly strong support from adoptive parents for a mediated, written, pre-placement agreement around all aspects of contact between the members of the adoption. A recent follow-up study appears to support the notion of firm boundaries for contact within open adoption arrangements (Berry et al. 2000). These researchers’ investigated over 700 adoptions, almost 400 of which were involved in one form or another of openness in their adoption arrangements. Amongst these open adoptions, parents report high levels of comfort with the contact they have, with 73% reporting feeling either very comfortable or comfortable with openness. Interestingly, comfort levels were also higher among those who felt they had a greater degree of control over the contacts. Grotevant et al. (1994) interviewed 190 adoptive couples whose adoption arrangements ranged from confidential adoptions to on-going fully-disclosed adoption. They identified ten variables (or elements) of the adoption situation and attempted to show how these varied as a function of the level of openness in the adoptions. In summary, it was found “…that parents in fully disclosed adoptions demonstrate higher degrees of empathy about adoption, talk more freely with their children, and are less fearful that the birthmother might reclaim her child than are parents in confidential adoptions” (p. 142). Berry (1993a) reports on a large-scale survey of 1 268 adoptive families. Those families involved in open adoptions who had planned and who did have subsequent contact with their adoptive children’s birthparents (n = 583), appeared to be overwhelmingly satisfied with their open adoption arrangements. Ninety percent of the sample were very satisfied with the adoption and 95% indicated that they would definitely do this type of adoption again. An interesting perspective on the temporal nature of satisfaction was reported on by Frasch et al. (2000). Six years after placement, adoptive parents (n = 57) continued to

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report high levels of satisfaction with their respective open adoption arrangement. On closer inspection, however, there is evidence to suggest that as time goes by, their levels of satisfaction decreased from 61.9% reporting being ‘very comfortable or comfortable’ with allowing contact between their children and their child’s biological parent/s in 1991 to only 55.4% reporting the same evaluation in 1997. The preceding account of some research concerning levels of satisfaction and dissatisfaction amongst adoptive parents in open adoption, points fairly strongly to positive perceptions and overall levels of satisfaction. Clearly though, it appears that these levels of satisfaction are mediated by the amount of control parents have over contact — certainly a function of pre-arrangements made. Attachment theory Two theoretical perspectives that have some relevance for adoptive parents’ parenting and decision-making, have been mentioned in the literature and bear mention. According to Ainsworth (in McRoy et al. 1988), the basis of secure attachment between a mother and child lies in the caregiver’s responsiveness to the needs of the infant. Attachment relationships in infancy are thought to have long-term effects on the psychological functioning of the individual child. In open adoption, if an adoptive mother’s sense of security is threatened by continued contact with the birthmother, the quality of her parenting may be negatively affected. The birthmother’s presence may make it difficult for the adoptive parents to interact wholeheartedly with the infant — secure attachment may be hampered. Also, if adoptive parents feel that they are expected to provide emotional support for the birthmother, this may detract from their task of developing a sense of attachment to their infant (Kraft et al. 1985b). Conversely, if adoptive parents know the birthmother and are reassured that she will not try to reclaim her baby, this may enhance the attachment process. Similarly, Baumann (1997) is of the opinion that knowing the birthmother and being with her during her pregnancy and birth, assists adoptive parents to begin to form an attachment to the child. She goes on to suggest that involvement with the birthmother’s pregnancy allows the adoptive parents time to prepare for their infant, which is not the case in closed adoption. “This preparation heightens (the adoptive mother’s) readiness to be a mother and enables her to move into an emotional space that begins to welcome her child” (p. 322). Cognitive dissonance theory Quite a number of authors have mentioned that adoptive parents may well agree to open adoption because, by refusing, they felt that they would either not be allowed to adopt a child or would jeopardise their chances of ever adopting a child (Kraft et al. 1985b, McRoy et al. 1988, Berry 1991). In fact, a full 15% of the Berry et al. (2000) sample reported having opted for openness for these very reasons. The oftreported overwhelming positive experiences of adoptive parents in open adoption could be explained by the assumptions underlying cognitive dissonance theory and therefore bears mention. According to this theory developed by Festinger, adoptive parents may agree to go along with open adoption even

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when they actually disagree with it and this situation creates dissonance (in McRoy et al. 1988). Once the decision has been made, adoptive parents may engage in dissonancereducing behaviour. Its entirely likely that they may vehemently advocate for open adoption to the extent of ignoring or not even considering the negative factors that they may be experiencing (McRoy et al. 1988). The adoptees As mentioned earlier, at the time of writing there were no known studies that assessed adoptees’, involved in open adoptions, opinions and perceptions about their experiences. Much of the literature deals with why adolescent and adult adoptees, in traditional closed adoptions, have felt the need to search for their birthparents. Gross (1993) does, however, cite one study known to her at the time of her writing in which children were old enough for their responses to open adoption to be considered. This study was conducted by Iwanek and, although she did not question the children themselves, they did show her pictures of their birthmothers and other members of their biological families. On the whole the children seemed at ease talking about them and the children’s responses to contact with their birthparents ranged from “enthusiastic” to “intermittent interest” with the opportunity to meet siblings highly valued (p. 274). Two studies did attempt to assess the comparative outcome of either open or closed adoption for adoptees by asking adoptive parents to complete a problem behaviour inventory (Berry 1991, Berry et al. 2000). Although, in both studies, the data relied (problematically) on parental perceptions of their children’s behaviours, the 1991 study found that children in open adoptions had significantly better behaviour scores than those in adoptions where there was no access to the birthparent/s. However, the four-year follow-up data reported on in 2000, found there were no significant differences in behaviour between children in open or closed adoption arrangements. Theories around identity formation/confusion, attachment, family romance, cognitive development and genealogical bewilderment, have informed many authors’ postulated risks and benefits of open adoption for adoptees. Each of these theories is briefly expanded on below. Identity formation in adolescence Erikson saw the essential task of adolescence as establishing a firm sense of identity (cited in Hjelle and Ziegler 1981). This sense of identity involves an integration of all the knowledge the adolescent has gained about him/herself (i.e. selfimages) into a personal identity that shows an awareness of both a past and a future that follows from it. This identity is partly established from an identity with the adolescent’s parents: they represent much of the adolescent’s past and are seen to be always present in their futures. To the extent that an adolescent adoptee has two sets of parents and, more importantly, one unknown to them, they may be particularly vulnerable to identity confusion (Sorosky et al. 1984). Knowledge of self includes knowledge of one’s biological family (Baumann 1997) and proponents of open adoption would assert that ongoing knowledge about one’s biological

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parents would necessarily prevent, or at least assist, in averting identity confusion in adolescent adoptees. However, critics of open adoption would stress that having to integrate everyone into his/her sense of self may overwhelm an adolescent adoptee to the extent that the child’s identity conflicts will be intensified and remain unresolved (Kraft et al. 1985c). Cognitive development Critics of open adoption have stressed that young children do not truly understand adoption until they are into their adolescent years (Berry 1991). According to Brodzinsky and colleagues, it is not until children are around eight or 11 years old that they begin to understand that being adopted is somehow different (cited in Berry 1991, Rosenberg and Horner 1991). Before this age, too, adopted children are more likely to fear that their biological parents may reclaim them and it is only in early adolescence that these fears are allayed (Rosenberg and Horner 1991). Berry (1991) suggests that openness and contact before adolescence should therefore be handled with great care and assurance to the young child. The family romance fantasy Anna Freud proposed that, as a part of a normal child’s development, there are times when the child doubts that s/he is the natural child of his/her parents (Sorosky, Baran and Pannor 1975, Rosenberg and Horner 1991). In a sort of ‘game’ the child often fantasises about the possibility of ‘alternative’ parents, particularly when the child is upset or angry with his/her parents. This fantasy is short-lived and is abandoned once the child realises that s/he can love and hate the same individuals. However, for an adopted child who is aware that s/he has two sets of parents, this fantasy is not a game, but part of his/her on-going reality. For a child in closed adoption the family romance fantasy is prolonged because s/he continues to fantasise about his/her alternative parents to the extent that “the fantasies will become the driving force behind detailed and persistent searches for biological parents” (Rosenberg and Horner 1991). Schechter warns that the ongoing fantasies and idealisation of the birthparents may cause the child to split images of his/her two sets of parents — attributing the good elements on to the one set of parents and bad on to the other (in Sorosky et al. 1975). Proponents of open adoption maintain that the family romance is not prolonged simply because the adopted child has access to reality and will not necessarily have the need for ongoing fantasising (Baumann 1997). ‘Genealogical bewilderment’ Sorosky et al. (1975) introduce us to Sants’ concept, ‘genealogical bewilderment’. The concept describes a state of confusion and uncertainty developing in a child who has either no knowledge or only uncertain knowledge about his biological parents. Particularly during adolescence and early adulthood, adoptees become increasingly interested in genealogical and hereditary issues. Adolescence is a time when children become aware of the biological link between generations and they begin to see themselves as part of a chain that stretches from the remote past, through the pres-

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ent and into the future. Through on-going access to their biological parents, children in open adoptions would develop healthy ‘genetic egos’ as opposed to a ‘heredity ghost’ (Sorosky et al. 1975). Attachment theory Mention has been made previously of how the presence of the birthmother may interfere with the bonding process and the resultant secure attachment between the child and its adoptive mother. It follows that, if the adoptive mother’s sense of security is threatened and the quality of her parenting is compromised, these will impact negatively on her adopted child. Postulated risks and benefits of open adoption for adoptees Most of the presumed risks and benefits that open adoption may have for adoptees, has come from reports from adoptive and birthparents. Interestingly, though, in an article discussing the results of a survey of 1 268 adoptive parents in California, Berry (1993a) came to the conclusion that there is a great deal of uncertainty among adoptive parents about the potential effect of openness on the adopted child. When asked, ‘what influence would/will contact have on the child?’, 18% of respondents suggested a positive effect, 16% posited a negative effect, 18% felt it would have little effect, and 48% were not sure what effect it would have. For the moment then, it seems wise to share Siegel’s (1993) view that “the true test of open adoption will come when adoptees who have been raised in confidential adoptions and various forms of open adoption can compare their stories” (p. 21). However, outside of the theoretically informed assumptions outlined briefly above, it is worth noting what researchers have suggested as some of the supposed risks and benefits of open adoption for adoptees. Adoptive parents mostly feel that open adoption would help them in answering their children’s questions more adequately (Berry 1993b, Siegel 1993, Gross 1997). The advantage here is that children will have adequate and sufficient knowledge about their biological heritage and the reasons for their adoption that would prevent identity confusion and diminish their feelings of genealogical bewilderment. Important medical information about adoptees’ biological parents and family may protect him/her from misdiagnosis or inappropriate medical treatment (Alty and Cameron 1995). Further, open adoption would preclude the adoptees’ need to search for their biological parents — a process that, in closed adoption circumstances, was often prolonged, painful and ultimately fruitless (Berry 1991, Baran and Pannor 1993). One mother in Siegel’s (1993) study mentioned that the birthmother’s presence had impeded the bonding process with her child and Kraft et al. (1985b) do argue that open adoption interferes with the bonding process between adopted child and adoptive parent/s, which may affect the adopted child’s healthy development. “Children do not understand relationships in open adoption, and direct contact with biological parent/s can weaken the bond between adoptive parent and child” (Berry 1991). As mentioned earlier, too, as time goes by and birthparents establish relationships unsupportive of continued com-

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munication with the child, contact between the child and its birthparent/s may decrease or stop altogether. Interestingly, in a four-year follow-up of adoptions, Berry et al. (2000) found that in 44% of open adoptions, contact had in fact decreased or stopped. Reducing or stopping contact was found to be initiated significantly more often by the birthparent and, although the researchers did not assess the reasons for declining and ceasing contact, it is entirely likely that it may have to do with unsupportive members in the birthmothers’ subsequent relationship/s. Of concern, however, is that the adopted child is faced with a second separation and possible negative consequences (Berry 1993b). Levels of contact The only information that is available regarding desired levels of contact from adoptees’ perspectives, comes from the previously mentioned study exploring what type of information adoptees would like to have about their birthparent/s (Sachdev 1991). Overwhelmingly, adoptees felt they would like identifying information and/or non-identifying information about their birthmothers. Many felt that identifying information should be available only once they had reached legal age whereas non-identifying information should be available to them at any time. Only a little over half of the respondents suggested that birthparents should have identifying information about the adopted child, but many were supportive of the birthparent/s having on-going information about the child’s well-being. Well over 90% of respondents supported the need for medical information. Although this study’s respondents were all involved in closed adoption arrangements, the implications for open adoption practice and information-sharing seem clear. Adopted children desire information about all aspects of their birthparent/s, but appear to be content to wait until adolescence for identifying information. Adopted children would not be enthusiastic about having identifying information about themselves released to their birthparent/s, but would want their birthparent/s to have knowledge about their on-going well-being. Reconceptualising adoption With the direction of adoption practices moving more and more towards openness, a number of reconceptualisations have materialised and are necessary in the area of adoptive and biological family systems and relations. As these have some impact on the way that these families are viewed today as opposed to when closed adoptions were the norm, some of these shifts are described below. Acknowledging the difference between biological and adoptive parenting Closed adoption practices, with their emphasis on secrecy, anonymity and confidentiality enabled the adoptive family to maintain the pretence that it was no different from a biological family (Etter 1993). According to Kirk, there is a need for adoptive parents to acknowledge that there is a difference between parenting a child by birth and a child by adoption (in Grotevant et al. 1994). This acknowledgement would enhance adoptive parents’ awareness of their children’s birth families. The bond that could then be forged between

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the adoptive parents and their adopted child would be based on ‘shared fate’ which, in open adoption would extend to include the children’s biological parents as well. This “would lead to communication both within and outside the family about differences and similarities and would ultimately benefit the adopted child” (Grotevant et al. 1994). Shared fate Kirk’s concept of ‘shared fate’ deserves elaboration. In 1963 Kirk published the first edition of ‘Shared Fate’, which was a sociological study of some 2 000 adoptive couples involved in traditional closed adoptions (in Watson 1996). The material from this study indicated that adoptive parents did perceive their families as different. Further, those parents who acknowledged this difference were more satisfied with their adoptions than those who rejected it. Closely allied to the concept of ‘shared fate’ is the notion of an adoption-kinship network proposed by Watson (1996), which also requires the recognition and acknowledgement of a child’s biological parents. In an adoptive situation, Watson believes that both sets of parents “must mesh themselves and the family systems in which they are embedded into the new adoption-kinship network” (p. 527). Self-in-relation theory Traditional psychoanalytic theory has been organised around the notion that healthy psychological development is essentially a process of ever-increasing separation of the self from others (Silverstein and Demick 1994). This is clearly seen in traditional closed adoption practices, which have emphasised separation of the birthmother from her child, separation of the adoptive child from his/her biological ties, and separation of the adoptive family from the biological one. Each of these separations were seen to be essential for the psychological health and maturity of all those involved in the adoption process. Empathetic awareness and continued connectedness were/are viewed as signs of immaturity and even pathology (Silverstein and Demick 1994). A self-in-relation theory, on the other hand, proposes an inherent human need to participate in reciprocal relationships with others, an innate potential to enhance the quality of these relationships by an empathetic awareness of the other. The implications for open adoption are great because, if connectedness and empathetic awareness are no longer seen as signs of pathology or psychological immaturity, but rather assets in complex human relationships, then openness in the adoption process no longer takes on pathological and dangerous undertones. From the foregoing then, it seems essential that a reconceptualisation of the adoption process as well as those involved in adoption be undertaken. Essentially adoptive parenting is not the same as biological parenting. This difference needs to be acknowledged for, only once this has been achieved, can adoptive parents and birthparents view their unique family systems as those that encompass the adopted child in a (positive) dynamic of ‘shared fate’. The changing role of adoption practitioners The move to openness in adoption practices will not only impact on the members of the adoption triangle, but will

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have far-reaching implications for adoption practitioners as well. Firstly, as mentioned in the introduction, open adoption is an on-going process rather than a discrete event in time. To this end, adoption practitioners should be available to provide on-going support and counsel to the extent that they must be prepared to remain an integral part of the adoption triangle or ‘adoption rectangle’ which includes social workers (Berry 1991, Berry 1993b). Given that the child’s best interests must be the paramount concern of adoption workers, Berry is also concerned that, once the relationship has been established between the two sets of parents (and the child), control may be relinquished to birth and adoptive parents and warns that, in such a new and unproven practice, this is disturbing. The on-going impact of openness in adoption on the child is still to be substantially informed by research and, as such, requires that adoption workers remain constantly alert to possible problems (McRoy et al. 1988). Secondly, writing from a position of 12 years as an open adoption facilitator, Baumann (1997) recognises that open adoption requires far more time, effort and emotional energy; more skills and time spent in facilitating relationship building. It is critical that adoption workers prepare and educate both the birth and adoptive parents, prior to adoption, about all aspects of the open adoption experience (McRoy et al. 1988). A considerable amount of time may be needed in preparing the terms and conditions of each open placement. A similar amount of time may be needed in aiding the parties to maintain or renegotiate these arrangements. Preplacement counselling would necessarily involve re-education of those involved as to the changing conceptions of adoption. Post-placement counselling and support services should be offered to all parties concerned (Baumann 1997). “Lack of counselling is a potential source of later disagreement and conflict among the parties” (Baumann 1977, p. 135). Finally, open adoption practices, which involve sharing of information through an intermediary (usually the adoption agency or facilitator), will require a life-long commitment by the agency/facilitator to act as an intermediary and will result in a greater workload as well as additional costs (McRoy et al. 1988). Conclusions and recommendations “The true test of open adoption will come when adoptees who have been raised in confidential adoptions and in various forms of open adoption can compare their stories” (Siegel 1993, p. 21). It is precisely this point that leads me to advocate for some caution in advocating for fully disclosed adoption — at this stage. Based on the preceding review, it seems appropriate to make a number of recommendations. Firstly, some form of openness should be offered as an option to every birthparent and prospective adoptive parent; openness should be optional and not mandatory (McRoy et al. 1988). Secondly, birthparents as well as adoptive parents should be made aware of the risks and benefits of open adoption as has been found in the various studies to date. As their initial decision will have a life-time impact on the adoptee, they should be made aware that there is little evi-

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dence as to the long-term effects of openness for adoptees. It would be the task of the adoption social workers to prepare both sets of parents thoroughly on these and all aspects of open adoption. Counselling and/or educative workshops should form part of the pre-placement process. Thirdly, it may be necessary to assess the degree of openness that the birthparent/s and the prospective adoptive parents can manage and to develop some specific assessment tools and procedures to evaluate their readiness for openness. Thereafter, exactly what form of contact and information-sharing should be worked out with both sets of parents, separately, prior to adoption. Closely related to this recommendation is that, besides other established criteria for matching of adoptee to adoptive family, matching in terms of similar requirements of contact and informationsharing should form a critical part of the matching process. The terms and conditions of contact and information-sharing as established by both sets of parents should form part of a pre-placement, written and binding agreement. Finally, the type of contact and information-sharing that seems appropriate to recommend to the birthparent/s and the prospective adoptive parents at this early stage of open adoption practice seems to be: • The birthparent/s should be able to select the prospective adoptive parents to parent their child. It seems that this is done most often with the aid of a photograph album and a biography of a selection of adoptive parents. Again, because of the life-time impact of this decision on the child, this should be done in consultation with the adoption social worker. • A pre- or post-placement meeting could be arranged between the birthparent/s and the selected adoptive parents. This would need to be mediated and should probably remain a non-identifying meeting. • Because of the unknown long-term impact, at this stage of openness — particularly in terms of the child’s ongoing developmental stages and cognitive abilities — non-identifying information and photographs should be shared (as a two-way process), via an intermediary, until the child is perhaps 16 to 18 years old. At this age, the child may choose whether to establish face-to-face contact with his/her birthparent/s and other members of his/her biological family. The foregoing has some important implications for social workers involved in open adoption. Firstly, they may need to extend their pre-placement workload to include counselling/educative workshops, more extensive pre-placement assessment, and assistance with pre-placement contact agreements. Secondly, they may need to extend their postplacement workload by being available for continued support, not only to both sets of parents but also to the adoptee. They should be prepared, as intermediaries, to assist with re-negotiation or re-evaluation of the existing degrees of contact and information-sharing should the need arise. Finally, in non-identifying open adoption, they will need to increase their workload by being available as conduits for the information-sharing process that has been established. To the extent that any form of open adoption seems to require a far greater and far longer commitment from adoption social workers, it is essential that they are quite pre-

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Kraft AD, Palombo J, Mitchell DL, Woods PK, Schmidt AW and Tucker NG (1985a) Some theoretical considerations on confidential adoptions. Part 1: The birth mother. Child and Adolescent Social Work 2: 13–21 Kraft AD, Palombo J, Mitchell DL, Woods PK, Schmidt AW and Tucker NG (1985b) Some theoretical considerations on confidential adoptions. Part 2: The adoptive parent. Child and Adolescent Social Work Journal 2: 69–81 Kraft AD, Palombo J, Mitchell DL, Woods PK, Schmidt AW and Tucker NG (1985c) Some theoretical considerations on confidential adoptions. Part 3: The adopted child. Child and Adolescent Social Work Journal 2: 139–152 McRoy RG, Grotevant HD and White KL (1988) Openness in Adoption: New Practices, New Issues. Praeger Publishers, New York Redmond W and Sleighthorn S (1982) Once Removed. Voices From Inside the Adoption Triangle. McGraw-Hill, Canada Rompf EL (1993) Open adoption: what does the “average person” think? Child Welfare 72: 219–23 Rosenberg EB and Horner TM (1991) Birthparent romances and identity formation in adopted children. American Journal of Orthopsychiatry 45: 18–26 Sachdev P (1991) Achieving openness in adoption: some critical issues in policy formation. American Journal of Orthopsychiatry 61: 241–249 Siegel DH (1993) Open adoption of infants: adoptive parents’ perceptions of advantages and disadvantages. Social Work 38: 15–23 Silverstein DR and Demick J (1994) Towards an organizational-relational model of open adoption. Family Process 33: 111–124 Sobol MP, Daly KJ and Kelloway EK (2000) Paths to the facilitation of open adoption. Family Relations 49: 419–424 Sorosky AD, Baran A and Pannor R (1975) Identity conflicts in adoptees. American Journal of Orthopsychiatry 45: 18–26 Sorosky AD, Baran A and Pannor R (1984) The Adoption Triangle. Sealed or Open Records: How they Affect Adoptees, Birth Parents and Adoptive Parents. Anchor, New York Tugendhat J (1992) The Adoption Triangle. Bloomsbury, London Watson KW (1996) Family-centered adoption practice. Families in Society 77: 523–534