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Conclusions from Cultivate: Adoption Clinician Alliance

We had the great privilege in 2021 of being one of six “emerging nonprofits” to be chosen to participate in the CULTIVATE program with Next Stage Consulting. The program is designed to help leaders of small but growing nonprofit leaders develop their ability to build effective nonprofits across six capacities – leadership & strategy, management, program development, human resources, financial resources, and operations & planning. Now that we are successful CULTIVATE graduates and our final business plan is developed, we continue with our series of blog posts to share with you what came out of the program. We hope that you will be as proud of it as we are and that you will feel excited to engage with us to move ASA into the future we envision.

The creation of the Adoption Clinician Alliance was our central “big idea” developed throughout the CULTIVATE program. The intent behind the Alliance is to enhance and broaden the counseling circle of support offered by ASA. Through the Clinician Alliance, we can walk alongside families as they enter the mental health system – as a trusted support who is able to meet their unique needs and can help them to effectively navigate mental health services.

The Clinician Alliance addresses several challenges within the broader mental health system for adoptive families:

  • When not served by an adoption-competent clinician, adoptees and their families can often find themselves in a maze of mental health services that are ineffective, as they rarely address the underlying issues common in adoption. This leads them to believe they are damaged or that counseling is not helpful, when the truth is they have not yet received the right kind of help.

  • There is a lack of awareness of which clinicians are truly adoption-competent.

  • It is difficult for families to find an adoption-competent clinician. Often the process involves multiple messages, lack of returned calls only to learn the clinician has no availability or does not take their insurance.

  • Adoption-competent clinicians operate as individual practitioners, often disconnected from like-minded colleagues and functioning as a business that needs to earn profit in order to stay open.

  • Children adopted from foster care, arguably the most vulnerable adoptees, have Medicaid insurance. The community is sorely lacking in adoption-competent clinicians who will accept Medicaid, as the reimbursement is relatively low, and the administration is relatively high.

Poor prenatal care, prenatal exposure to toxic substances, early childhood breaks in attachment, maltreatment and trauma, institutionalization and genetic vulnerabilities all contribute to children who are adopted requiring clinical intervention. Teens who are adopted are twice as likely to be diagnosed with a behavioral disorder as non-adopted teens (Center for Adoption Support and Education). Yet, despite the need, research also suggests that families have difficulties identifying adoption-competent clinicians.

Benefits of Shared Services

The Adoption Clinician Alliance will be a hub of adoption-competent services. Clinicians who are a part of the Alliance will have to meet specific experience and training requirements to demonstrate their competence in working with adoptive families. The Clinician Alliance will have a list of values and beliefs related to adoption of which clients will be aware when contacting the Alliance for services.

A goal for the Clinician Alliance will be shared expenses for key components currently missing in the field:

  • Intake Coordination – The Clinician Alliance will employ a single point of contact for the family. The Client Navigator will help the family to make a match with an appropriate therapist- based on location, age of the client, therapeutic approach, insurance and specific presenting problems. It takes the guesswork out of the process for the client and their initial experience with the mental health system will be encouraging rather than overwhelming. The process will be beneficial to clinicians because they receive referrals for clients with whom they want to work and are equipped to help.

  • Billing Support – The limitations of medical insurance can pose significant barriers to accessing adoption competent therapists. Most insurance does not provide sufficient mental health coverage to cover the complex, long-term needs of those involved, particularly children who have suffered early trauma and other adversity; and few if any carriers take into account that adoption-competent therapists may not be on their lists of covered, in-plan providers. A Billing Specialist will support the process of seeking payment from insurance and other payers.

  • Marketing – The lack of awareness about clinical support for adoptees and adoptive families is both a supply and demand issue. The Adoption Clinician Alliance aims to increase the availability of strong clinician support for families. Ensuring those families know they have options will require a commitment to marketing, working with referrers and increasing community messaging. Contractor/staff resources will be needed to ensure consistency.

As the family works with a clinician who is a part of the alliance, they will also have access to the circles of support that Adoption Support Alliance already provides – connection groups with other families, classes and community building events all centered around the commonality of adoption.

ASA has entered into a Memorandum of Understanding with the Center of Excellence for Integrated Care (COE), a signature program of the Foundation for Health Leadership and Innovation, to work in partnership to make this dream of an Adoption Clinician Alliance a reality! Download the link below to see our concept paper written for potential funders.

ACA Concept Paper
Download PDF • 173KB

We look forward to sharing with you soon the adoption-competent providers who will be a part of this work with us!

Have you had difficulty finding adoption

-competent services for your family? We’d love to hear from you. If you are willing for your story to be shared anonymously to demonstrate the need for this sort of network, please email your experience to Are you a clinician interested in being a part of this work? Please email for more information.


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