Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Thursday, July 14, 2011

The Russian-U.S. Adoption Treaty: The Psychological Evaluation Issue

After a considerable period of discord, and a history of disasters for children adopted to the United States from Russian institutions, Russia and the U.S. have signed a treaty intended to address problems that have caused harm to adopted children (M. Schwirtz, “Pact on adoptions ends a U.S. Russian dispute”, NY Times, July 14, 2011, p. A12). In addition to improving the mechanisms for monitoring families after adoption, this treaty requires improved screening of potential adoptive parents and better information about the children’s medical and psychological histories.

How are people evaluated before they are accepted as adoptive parents? Psychological evaluations, often done through private sources or as recommended by the adoption agency, generally involve an open-ended interview less than an hour long, and may include a paper-and-pencil psychological test, usually the Minnesota Multiphasic Personality Inventory (MMPI). The MMPI provides an assessment of the individual on a number of scales (including whether they are so inconsistent that they are probably lying) as well as on some combinations of scales.

The MMPI does a good job of identifying individuals who are seriously mentally ill-- schizophrenics, for example. But most adoptive parents who harm or reject their children are not actually mentally ill. Instead, they have other personality characteristics, beliefs, habits, or social circumstances that culminate in child abuse or neglect, or even in the child’s death.

Can the MMPI identify those concerning personality characteristics and help to prevent adoptions that may lead to harm? Regrettably (considering how much people rely on this test), the answer is probably that it cannot. Of the thousands of studies done on the MMPI, very few have focused on the success or failure of adoptive parents, nor have most considered whether the responses of potential adoptive parents to the MMPI should be interpreted in any special way.

Almost 20 years ago, one researcher, J.E. Dalton, looked at a group of prospective adoptive parents and analyzed their scores on MMPI scales and on other personality tests (“MMPI-168 and Marlowe-Crowne profiles of adoption applicants.” Journal of Clinical Psychology, Vol. 50, 863-866). Dalton noted that there was a serious lack of normative data that would allow adoption applicants to be compared to other adoption applicants rather than to people who were free of the stresses peculiar to the adoption situation. He noted that the typical MMPI profile for the applicants he tested was “characterized by a high degree of defensiveness, particularly among females… the [average] female profile on the validity scale would be interpreted as follows: “This is a valid profile. Persons who obtain similar scores are often seen as naively defensive individuals who have a strong need to present an image of virtuousness or perhaps strong moral character. They tend to have little insight or awareness of their own stimulus value… “(p. 865). Dalton then went on to say-- and this is the significant part--- “Although it is possible that defensive people are more likely to apply to adopt children a more likely interpretation is that the [preadoption] screening process creates a defensive attitude” (p. 865). Dalton strongly advises comparing the MMPI scores of potential adoptive parents to those of other such people rather than interpreting them in terms of the larger population, in comparison to which the adoption applicants may appear to have some undesirable personality traits.

It is doubtful that preadoption psychological evaluations often do follow Dalton’s suggestion. Even if they did, however, there is little or no information to show us whether successful adoptive parents have different MMPI profiles than those involved in serious failures. Few evaluators who specialize in preadoption screening are research-oriented, and few potential adoptive parents would give permission to include their data in research reports. As a result of this lack of information, we may have a situation in which psychological evaluation can screen out seriously mentally-ill applicants, but fails to determine characteristics that may or may not fit a potential adoptive parent to do a successful job with a child.

I suggest that preadoption evaluators may do better to focus on certain personality and social characteristics that are not assessed by the MMPI but may be highly relevant to adoptive parenting. One of these is authoritarianism, a personality characteristic focusing on the issue of obedience to authority. Authoritarian persons are concerned with the obedience children owe to their parents and are simultaneously concerned with the obedience they, the parents, owe to persons in authority over them. Authoritarianism values obedience in and of itself, not simply as a means to an end; a nonauthoritarian parent may work to instill obedience in children so they will come out of the street or away from a hot stove when told, but the authoritarian parent sees child obedience as a goal in itself, independent of child safety or health outcomes. Some authoritarian parents consider child obedience to have special value in a religious context and consider obedience to a parent to be the foundation of obedience to God, while others want obedience as part of a secular value system.

A high degree of authoritarianism motivates a parent to require obedience of children even if they cannot do what is required of them or do not understand what is being ordered. When there are cultural differences which the parent does not understand or accept and which the child cannot articulate, there may be apparent intentional disobedience that an authoritarian parent finds unbearable. An example here might be the conflicts over pet animals so often noted in adoption blogs; poor or post-institutionalized children or those from the Third World may have had no contact with pets and may regard them as predators or vermin that should be killed, whereas an authoritarian adoptive parent may demand what he or she sees as appropriate affectionate behavior toward animals. More and more severe punishment may follow the child’s failure to comply.

Authoritarianism may also make adoptive parents especially susceptible to adoption counselors or therapists who focus on child obedience and parental control as the sole route to family success. Such semi-professional or professional advisors may advise physical restraint and control over food intake as appropriate means to achieve the obedience they have claimed as the key to positive development. These methods, or similar techniques like exposing the child to heat or cold or forced drinking or eating, all have very real potential for causing injury and even death.

Psychological evaluators, do your assessments consider authoritarian personalities as matters of concern for preadoption psychological evaluations? Do your interviews explore adoption applicants’ connections with advisors who may suggest potentially harmful paths to inappropriate goals? The U.S.- Russian adoption treaty will not tell you to do these things, but you may find them more genuinely useful in preventing adoption disasters than the MMPI’s standard textbook interpretation. The same goes for the post-adoption monitors required by the treaty.

2 comments:

  1. I have been very disappointed to see adoption agencies including fringe beliefs in their "Hague Convention-Approved" parent training.

    I hope the new Russian/USA adoption treaty provides meaningful guidelines for teaching safe and effective parenting methods.

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  2. Unless an independent monitoring group is established, I doubt that that's possible.

    Curious how harm can be done by teaching material that's not called for in addition to the required stuff.

    ReplyDelete