Adopting Father

Adopting Mother

Counseling Information

Anticipated Counseling Costs:

How will you fund these costs:

Statement of Net Worth

Assets

Investments:

Liabilities

Cash Flow

Income (Please note net income is after taxes, 401K, healthcare and other witholdings)

Expenses & Payments

Housing:

Transportation:

By signing this form and submitting this application:

Please read closely and respond accordingly

1. We hereby give consent for Pathways for Little Feet to contact the provider/counselor named in this application for the purposes of determining adoption-competency. It is our understanding that information obtained will be used, in part, to determine our eligibility for this scholarship. We also understand and agree that Pathways for Little Feet is not obligated to provide financial assistance based on the willingness to accept an application.


2. If approved for a counseling grant, we understand, accept and agree to use any and all funds received exclusively for legitimate adoption-competent counseling expenses. We agree to provide verification of expenses upon request.


3. We understand, if approved for a counseling scholarship, that we will be required to answer a survey halfway through the scholarship in order to receive the remainder of the scholarship funds. We also agree to submit answers to a final survey at the completion of the scholarship. These brief surveys will help Pathways for Little Feet to tailor the Family Care program to help with post-placement care for more families.

Adoption-Competent Counseling

Here at Pathways for Little Feet, we are passionate about adoption-competent and trauma informed counseling because we place top priority on the best interest of the child and family. A great place to start looking for a provider would be the Trust-Based Relational Intervention (TBRI)® practitioners list available online at http://bit.ly/tbri-practitioner-list. While we cannot speak for every provider listed, we are confident in this training program from the Karyn Purvis Institute of Child Development at Texas Christian University (TCU). We also encourage you to connect with your church or local adoption support group for referrals to adoption-competent counselors in your area. Below we have compiled a list of questions and considerations to help you identify the right provider for your family*:

• Have you had extra training that is specific to adoption?


• Have you had experience with post institutionalized children?


• How does trauma impact a child’s development?


• What types of adoption have you worked with? Domestic infant? Intercountry? Foster to adopt? Transracial? Older child? Open adoption?


• How do you work with adoptive families


• What specific approaches have you found that work to help children cope with adoption, loss, and/or trauma related issues?


• What changes in the daily life of our child and family might we see as a result of the counseling?


• Be specific about the adoption issues that affect your family


• The psychological impact of adoption on children and families


• Loss as a core issue in adoption and how children process loss at different stages of development


• The impact of trauma on children and families (results from traumatic experiences prior to the adoption)


• The role and impact of attachment on the mind and body of the developing child

*Child Welfare Information Gateway; TBRI®; Creating a Family