Holt’s clinical services director travels to Vietnam and the Philippines to teach social workers how to prepare older children for the transition to life in a family.
You’re 9 years old. You live in Vietnam. You grew up surrounded by other children, none of them siblings. You have never known what it’s like to have a mom and a dad. You don’t even understand the concept of parents, but all the grownups seem to think it is a good thing. You have no idea how you would respond to the actual love and affection of a family. You are fiercely independent and have learned to keep your emotions stuffed deep inside. All you’ve ever known is life inside an orphanage.
Now you live in a house in Minnesota. You have a brother and a sister and parents and grandparents. You have your own room that’s so quiet and dark at night, you can’t sleep. You grew up in heat and humidity, but here, a thick powdery blanket of snow covers everything in sight. Everything is foreign. The weather, the food, the language and most of all, the onslaught of love and attention from people you have known only a couple weeks.
This is your new normal. But everything feels new. And nothing feels normal.
When children join families through international adoption, their world is turned upside down. For older children, the transition is often significantly more challenging as they already have firmly established patterns, preferences and relationships. Even though they may desperately want a family and to live in a house with siblings and their own room, the shock of change can still be intense and overwhelming.
Five years ago, Abbie Smith, Holt’s clinical services director, recognized a growing need to prepare older children for the transition to life in a family. At the time, Holt was invited to participate in a “Journey of Hope” camp in China — a special program to advocate specifically for older children growing up in orphanages and foster families in several Chinese provinces.
“It is so vital for the well being of these kids to help them understand what their new life will be like as much as we can,” Abbie says. “It helps to reduce their anxiety about all the new things they will have to learn.”
In the summer of 2015, Abbie traveled to China to train Holt staff to lead a 12-week group support and education program designed specifically for older children. The children learned coping skills for when they get stressed. They learned cultural differences between China and the U.S. They practiced trust and cooperation skills to begin to understand and embrace the love and support of a family. They also learned how to say goodbye — an important though often overlooked step in their transition.
So often people want to avoid the sadness that comes along with saying goodbye,” Abbie says. “Unconsciously, we create circumstances that will allow us to leave without saying goodbye. Some people will just leave quietly, some may leave a note, and others may find something to get angry about and leave in a huff. These kids may never see their friends again and if they don’t say goodbye in a healthy way, it could be something that they regret for the rest of their lives.” Many children have also experienced abrupt moves from foster home to foster home or to and from the orphanage. By teaching children how to say goodbye, we help them to leave with bonds in tact and the possibility of future contact. In China, for example, children will often exchange qq email addresses before leaving the orphanage to join their families.
After the success of the Journey of Hope training, several orphanages in China applied the curriculum in various ways. One of the most positive outcomes of the program is that now, older children often Skype with their adoptive parents before travel and get to know each other in a deeper way than photos and letters can create. “The visual of a face reduces anxiety,” Abbie says. And when they meet their family, they have less information to process and can simply focus on attachment and bonding.
Last month, Abbie had the opportunity to expand the curriculum beyond China — traveling to Vietnam for a two-day training with roughly 25 social workers who work directly with children in care as well as a few government officials from the ministry that oversees the welfare of children.
Before teaching specific techniques and exercises, Abbie led with an overview of brain differences in children who have grown up without a family and how that impacts their development and functioning. “There are chemicals triggered from being well cared for,” she says. “If you don’t understand that, then you don’t get why you have to interact differently with these kids.”
Brain differences in children who grow up in orphanages occur at both a structural and chemical level. They typically develop smaller brains and their neurotransmitters can cause them to be either too active or too inactive. “In a nutshell, because their neurotransmitters are out of balance, nature cannot do its job of quickly calming their bodies after getting excited so they can get stuck being too excited,” Abbie explains.
To help children cope with the stress and excitement of their new environments, they learn calming techniques such as diaphragmatic breathing or guided visualization. During the training in Vietnam, Abbie taught these strategies to the orphanage social workers and government officials the same as she would lead a group of children through the exercises. They practiced holding a balloon steady with their breath, and pretended their fingers were birthday candles and blew them out one by one. They visualized a beach with waves coming in and out or trees blowing in the wind to mirror the rhythm of a calming breath.
For many children, lessons are even more fundamental. Before they can learn strategies to cope with stress, many children need to be able to recognize and understand their feelings. “In a care environment, there’s no time to teach children about their feelings,” Abbie explains. Games like Charades, in which children are asked to act out specific emotions, help caregivers assess their knowledge of feelings without putting them on the spot. Learning about feelings is a necessary step before children face the stress of transitioning to a new home environment — and a key part of the older child preparation.
Other exercises familiarize children with their new surroundings and give them practical tools — such as eating with silverware instead of chopsticks or learning about Western-style bathrooms. Often, confusion lies simply with the concept of “family.” Some younger children may think that they already have a parent because the orphanage director took them home over the weekend. An activity called the Sands of Time, in which children pour sand of different colors to represent different phases of their life, helps to clarify their story and develop their understanding of the distinction between a caregiver and a parent.
Following the two-day training in Vietnam, the social workers had an opportunity to observe Abbie in action as she led a group of children through the activities. About 25 children participated, ages 5-14. “Normally, we would group by age and development,” Abbie says. They practiced eating with a knife and fork at a Kentucky Fried Chicken near the orphanage. Hang Dam, Holt’s in-country Vietnam director, led the children through a breathing exercise that relaxed them so much, they fell asleep. Abbie also spread pictures on the floor and asked the children to pick the family they want. Most of them chose nurturing images of parents hugging children.
“By the end of the day, the kids were really engaged,” Abbie says.
Although these children are not yet matched with families, many of them expressed a great desire to be adopted. Two of them — Keian and Hudson — already have profiles on Holt’s waiting child photolisting. Once Keian, Hudson and the other children are matched with families, the social workers can work with them more in depth to prepare them for their transition home — which Abbie says will ultimately help ease the vital attachment and bonding process with their families.
“The more we can increase their confidence about forever leaving all they have known to go to a new land,” Abbie says, “the calmer they will be and this will improve the attachment experience from the get go.”
Next month, Abbie will travel to the Philippines to lead another training in older child preparation.
Robin Munro | Managing Editor