Season 1, Episode 22: Dr. Marta Santos Nunes describes the research on parenting stress among adoptive families. She identifies ways that parental factors, such as expectations and parental warmth, and child characteristics, such as behavioral challenges and age, interact in complex ways to predict parenting stress, attachment, as well as child emotional outcomes. She also highlights ways that expectations from others and stereotypes about adoption can contribute to parenting stress. She ends by emphasizing the uniqueness of each adoptive family system and the importance good pre-adoption preparation and high quality post-adoption supports to ensure the best possible outcomes for adoptees and their families.

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Routledge Handbook of Adoption

Transcript

Dr. Emily Helder: Hello. I’m Dr. Emily Helder and I’m here with Dr. Marta Santos Nunes who is a member of the Research Center for Psychological Science at the University of Lisbon.

Her research focuses on studying and working with individuals as a part of complex systems and she began her research on the topic of adoption in 2008 and has worked with adoptive families since that time. She and her co-authors wrote a chapter in the Routledge Handbook of Adoption, entitled, “Parenting Stress and Adoptive Families.”

So thank you so much for being here to talk about your work.

Dr. Marta Santos Nunes: It is my pleasure, Emily. So thank you also for your invitation and for all your work around this Handbook.

Dr. Emily Helder: Thank you. So in your chapter for the handbook, you begin by talking a bit about how parenting stress is actually somewhat of a normative experience, but at the same time, it can be associated with negative impacts for children and parents, when it reaches a particular level and that it’s really something to pay attention to and, and address. So given that parenting stress probably falls along a continuum, I wondered if you could say a bit about some signs that parenting stress has reached a particular level where, we would need, we would want to intervene and provide supports and services.

Dr. Marta Santos Nunes: So this is a beautiful question. It’s a super important question, but it is as important as difficult to answer. So let me try it: so it is important to answer in the sense that, and let me go a bit general… in general people, have this tendency, and I’m not saying that it’s everyone, but in general, we have this tendency to avoid asking for formal technical help to deal with our issues.

So people will reach to the psychologist or the social worker or whatever, when they are already over their limits. When they have tried a lot of things alone and they can not solve their issue. So they give a try with this technical help. When it comes to parents, what I have been observing is that sometimes we also observe this tendency that it’s hard for some parents to acknowledge and to assume that they need some kind of technical help to deal with their kid’s stuff. Let me put it like this. And when it comes to adoptive parents, there’s another layer that is added here for many reasons, but I would like to point out two of these reasons. So on the one hand, these parents, they are, if things are well done, they are extensively studied, before they got to be parents.

So when they are still candidates, they go through all of this, evaluation process. They have people analyzing if they are able to be parents, deciding on if they are able to be parents or not. So when difficulties arise, it can be hard to to assume that okay, “I am not able to deal with it, so I need some help.”

So this might happen. And what research has shown is that, parenting stress is a consequence from children’s behavioral problems, but it is also an antecedent. So this is why I consider so important that we make this reflection on the on the importance of identifying some signs.

Nevertheless each family, is a complex, is a world. So for me, it’s difficult to announce a list of signs because, what can be an alert sign for a person for a family, can be just something that another family, is aware of, is working on, but it’s not an alert sign. So what I can do, is based on research, talk about two big dimensions that have been associated with higher levels of parenting stress, and from there, try to identify some situations that can be assigned. So this two dimensions are: first, children’s difficulties – so whenever we have parents constantly with this perspective that, well, this child has much more troubles than they would expect to, or this child demands much more than other children that they observe or this child only does things that they cannot tolerate. And this is a constant perspective on their minds. Those could be some signs.

And the other dimension is related to the parent child relationship. So when parents hold this, this idea, this perspective that it’s super difficult to get along with a child, to get close to the child, to bond with their children.

When they have this idea that this child only does things to hurt them, and they can’t hold this anymore. This can also be some signs to call for help. Now one thing I’d like to make clear here, and it is the fact that any of these examples I gave can exist in other families and they are not necessarily a sign for help, for them to call for help.

Okay, what matters is, I would say the intensity of the impact of those factors in their daily lives, in their daily routines and also the consistency in time. So these ideas, these examples I gave, are not something that happened in a short period of time – it’s something that parents feel for a long time already.

So when this two factors come together, I would say that, yeah, it might be time to ask for help.

Dr. Emily Helder: Oh, that’s so helpful. I think in providing a framework, especially for clinicians too, as they’re talking with families. So yeah. As you think about focusing on the adoption context in particular, your chapter reviews a lot of research looking at adoptive parents and non adoptive families.

It’s pretty mixed actually, in terms of whether adoptive families have more stress than the non adoptive families or less, or the same amount. And so I wondered if you could talk a bit about, you know, what factors are driving those mixed findings. So, are there particular things, for example, in the studies that find that adoptive parents have more stress than non adoptive families that would help us understand why, why it’s so mixed?

Dr. Marta Santos Nunes: Yeah. So yeah, when, when we did this literature review, we find these very different results and we get to think, “Oh God, now what is the truth? Or what makes most sense or whatever.” So what I could understand is that the methodological particularities of the studies induced these different results.

And when analyzing all the studies, I could conclude that in fact, there are some factors that seem to be always present when the results evidence higher levels of parenting stress in adoptive families. And those factors are usually related to child’s characteristics or their previous story characteristics.

So one of the factors is children’s age at the time of adoption and also the current age when this study is being run. Okay, so usually, for instance, the school-aged children or studies that use samples of school aged children or parents of school aged children, usually present results with higher levels of parenting stress.

And we know that, this is a crucial moment in terms of the awareness of the meaning of adoption for the child. So it is understandable that we get these kind of results. And for instance, related to the age at the time of adoption. We have this study, but I’m not comfortable to identify this one as one of the factors, but actually there are some studies showing that the younger the child is the lower are the levels of parenting stress, so the better are the child’s outcomes and lower  are the levels of parenting stress. But this one, this particular factor is then informed by a lot of other factors, namely, the harshness of the previous life story of that child.

So the more traumatic, the more adverse that story is the worse usually are the outcomes of that children and the higher are the levels of parenting stress also associated. Then also the institutional care trajectories – so the more they were intermittent. So this is again the story of the child, right?

So the more intermittent, the poorer they were, the more we can observe also this worse outcomes in children and then the higher levels of parenting risks of stress. So all factors that are related with the child, but then we have something more related to the parents which are their expectations. So when there’s this mismatch between what parents expected to experience and what they are currently experiencing, we also observe this higher levels of parenting stress. So among many factors, I would refer to this related to the child and to the parents also.

Dr. Emily Helder: Yeah. Well, and let me ask you a little bit more about both of those things then. So if we start with the child related factors, one study that you talked about, that that was your own work that I thought was really interesting was looking at the interactions between parenting stress, attachment, well being, you know, child related factors. And I wondered if you could talk us through a bit of the model that you’ve developed among all those variables. It just would be so interesting to know more about how that unfolds over time. You know, what are some of the causal things and the outcomes, or maybe they’re mutually reinforcing.

I just would love to hear what you’re finding in your work.

Dr. Marta Santos Nunes:  What we were interested at the time was to understand the impact of some parenting processes and factors in children’s outcomes, in adoptive parents.

Okay. And particularly in the study and for what matters for this conversation we studied how children’s attachment patterns mediated the relationship between parenting stress and children’s emotionality, namely positive and negative effects. So we used here, we considered here three types of attachments, three patterns: so the secure, the anxious-ambivalent and the avoidant patterns. And what we found was that, the higher the levels of parenting stress, the lower were the levels of, or the evidence of, secure attachment and this influenced also the, the levels of affect [emotion] or positive affect [emotion] were lower and negative affect [emotion] were higher in children.

And another conclusion from that study was that parenting stress was also affecting reinforcing, anxious ambivalent pattern that then would, increase the levels of negative affect in children. It didn’t effect the positive affect in children, but the negative one. So we could conclude that because, like me add something here, from literature, from research, we already knew that parenting stress affected significantly children’s outcomes in terms of their behavioral problems, of their instability, emotional instability, but what this study adds is that, it affects also the patterns of attachment, then have an impact in this instability, emotional instability. So they work together, parenting stress and the attachment patterns, they work together as risk factors for increased emotional vulnerabilities for the kids so this was what we found with this model.

Dr. Emily Helder: I just think it’s so helpful to understand the, at least start to understand some of the complex interplay between all of those factors, it helps you know where you can target interventions then. So, thank you. If you think too a little bit about some of the parent-related factors that you mentioned I wondered if you felt like there were lessons that practitioners could learn from that research regarding ways that you might be able to either prevent some parenting stress or lessen parenting stress. Like, are there particular factors that you could target either pre or post adoption if you’re trying to, you know, work on parenting stress issues?

Dr. Marta Santos Nunes: Yeah, from that study, and from other studies that we also ran, what we found was that for instance  – research had already shown this, that working on parents’ expectations is crucial for then things to come out a little bit better. And we also ran this study, we found that when parents evaluate in a negative way the match between their expectations and what they are currently experiencing. This affects not only directly the child, the children’s outcomes, but also affects the levels of parenting stress and the levels of parental satisfaction.

And this, again, work as a cumulative risk factors for children outcomes. So, to put this in other words, when parents are facing or they evaluate what they are facing as being something worse than they expect, their levels of parenting stress are higher and the levels of parental satisfaction are lower and this affects children’s behavior, namely children’s behavioral problems.

So, again, as research has shown, and this study also confirmed, it is important in pre and also post-adoption services, always to work on the accurate  expectations of these parents and not only on their expectations, but also on the flexibility of their mindsets to embrace whatever unexpected difficulties and challenges that may come, may arise. So yeah, parents expectations would be one factor important to work on. And also in another study we found the importance of working on the parenting styles and practices, because we found that when they are characterized by emotional warmth, this has a particular impact in the levels of parenting stress.

It decreases the levels of parenting stress. And consequently has this good impact in children’s outcomes. And also, let me just try to remember, there was another result for this.. Oh yeah, so when parenting practices were characterized by control attempts, this reinforced the insecure patterns of attachment of children.

And this had also an impact in parenting stress. Because as I said before, parenting stress is both an antecedent, but also a consequence of children outcomes.

Dr. Emily Helder: Oh, that’s so helpful. Both for, I would think for agencies as they’re preparing families pre-adoption and for post-adoption service providers as well.

Yeah, I want to ask you more about the expectations piece. I mean, I think there can be probably parent expectations that are specific to that parent in that family system. But if you think more systematically, you know, do you see, that there are like societal expectations, either of parents in general, or of, you know, adoptive parents in particular that are feeding into some of the parenting stress, especially if maybe those expectations are internalized by the adoptive parent.

Dr. Marta Santos Nunes: Yeah, well, to talk about that, I need to talk about expectations, but also about some myths, some generalized ideas that we have on our societies that then end in some expectations that are internalized by parents and effect, research has shown, effects their levels of stress related to parenthood.

So, yeah. As I mentioned before, adoptive parents, they go through all this intensive process of searching their lives, evaluating their ability to raise someone, to have kids, to be parents. And also a lot of these parents, they have with them, they received these kids that have very hard stories and this reflects on their difficult behavioral and emotional difficulties.

So they have in their hands, on the one hand, this approval to be, as they are able to, to help these children to recover and to grow. At the same time, they have a lot of challenges to deal with the normative challenges of any child development, but also the specific ones due to the adoption status.

And a lot of times the report that I received from this parents is that they feel that they have the eyes of the society on them, on the work they are doing with all of this. So it’s an added pressure. It’s an added responsibility that they feel, they feel on their, on their shoulders. So this is one thing.

They feel that there are these eyes over them over their, over their work, but also Emily, when I ask people what movies do you know about adoption? People in general, not, not people that are working with adoption. Then I would receive different answers, but in general when I ask what do you know about adoption?

What stories do you know about adoption? Usually people associate adoption, to dramatic stories, to stories of children with lots of problems, with the stories of families broken due to the, the adoption of that child. So, there is this idea, this association of adoption and dramatic negative stories.

So this is one thing. Another thing is that myth about the blood ties, that the blood ties are stronger, that they reveal a more truthful, a stronger connection between child and parents. So, yes, there’s a lot of good stuff coming from society, but there’s also these generalized ideas. These myths that from what I heard from these parents, led to some pressure and their levels of stress might increase a bit because of this.

Dr. Emily Helder: Yeah. That’s you, it reminds me a little bit of a conversation I had with with Karen Garber who wrote a chapter for the Handbook on adoptive microaggressions and just talking about how the societal kind of stereotypes about adoption can contribute to stress for everybody.

Yeah. That’s so helpful. Last thing I wanted to ask you about was just, you know, in thinking about the fact that adoption is really not a one-time event, you know, it’s something that unfolds for the adoptee and their family, really over the lifespan. I wondered if you could say a bit about how adoptive parents might need different kinds of supports at different stages of the, you know, of the adoption or of their lifespan.

How does that change?

Dr. Marta Santos Nunes: Well, I’m not sure if this would be a matter of life stage I am more comfortable based on research to say that it depends on the stressor and the impact of that stressor. Because for the very same life-stage, I can have different challenges happening or different families can have different challenges happening.

And so different answers would be required. So for instance, and I go again to the school-age children, which is what I know best. So there’s this thing about communicating about adoption. Ideally the child is not discovered that she or he is adopted. So ideally we speak about adoption in the adoptive family since the beginning. It’s not that we have to speak every week or every month, but it’s a topic on the table, accessible to discuss. And when this time comes that the, when the children enters in school and they are in the face of their mates, their peers, families, and they gain this new awareness of the meaning of adoption.

There might be the need to talk again, to speak again about adoption, to explain again, the concepts around adoption, like relinquishment, et cetera. And for instance, story books, books made for children, can help parents with this communication, with this explanation of “what is adoption,” but of course, for an adolescent, storybooks would not work so well. So another thing like searching for the origins, searching for the adoption services to help them to talk about the origins might suit a little bit better. Okay, but another thing that can arise when we are, when we have this school-aged children is for instance, I don’t know some insecurities of the parents concerning their parenthood, and this might be solved with, a lot of times, this is solved with good conversations with other parents, adoptive or not.

Okay. Or the issue can be that these parents feel that they cannot reach the kids that something is going on with their child. And they are not being able to reach, that they are not being able to enter his or her world. So here maybe a technical help would be more, would fit better the situation.

So I don’t have a straight answer for this. Because I don’t believe in a magic pill or in the right answer for situation X and situation Z. What I believe is on the importance of parents having the knowledge of all the resources they have that are available, they have it and so they can pick they can choose one or two apply and see if they can get the answers they are in need of for that moment. And if not, they can try something else, but to have the information of what is available to help them.

Dr. Emily Helder: No, that makes sense. I wonder too, as you were, were talking, it made me think a bit about going back to the expectations piece that you talked about, that if parents, if adoptive parents had the expectation that, okay, we talk about adoption and it’s resolved, and then we don’t, it probably won’t come up again. Or we won’t have to, you know, it won’t impact my relationship with my child or be something we need to talk about. Then that could be you know, a problematic issue because really you could see how it would come, come up in different forms over time for each family. So, yeah. Yeah,

Dr. Marta Santos Nunes: Because it’s information that is disclosed in a way that the person, the child, the adolescent can digest, can understand. So we cannot deliver everything to a six or seven year old kid, but we can deliver a bit more to 10 year old and to a 15 year old.

So it’s something that should be on the table should be accessible to, to talk about.

Dr. Emily Helder: Yeah, that’s helpful to think about it not as a one size fits all approach. There’s not kind of one right way, each family’s different. Well, thank you so much for spending some time talking about your work and for writing the chapter in the Handbook.

It was really enjoyable to work with you on, on the project.

Dr. Marta Santos Nunes: Thank you. Thank you too Emily. So I’m glad to be able to, to participate also, thank you for the invitation again, and if you need anything else, I will be available. Thank you so much.

Dr. Emily Helder: Yeah. Thank you.

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