Meeting the Mental Health and Developmental Needs Of Adopted Children

Beliefs & Principles Underlying Parent Preparation & Education

Adoptive parent preparation, education and support rest upon a core set of beliefs and principles related to children’s needs and rights, as well as the dynamics of the adoption kinship system. These include:

• All children have the right to a loving and permanent family
• When children cannot live with their biological families, adoption represents a positive and normal means of providing for their physical and emotional well-being
• Adoption is a lifelong experience, with the potential for influencing adoption kinship members at every stage of development
• Adoption involves the connection of children to at least two families
• Growing up in an adoptive family differs from growing up in a biological one, and can be more complex
• Adoptive parenting is associated with unique childrearing challenges
• Adoption is connected to the experience of loss, which must be understood, accepted, and respected
• Loss and grief in adoption are normal, not pathological
• Adopted individuals have the right to know about their origins and the circumstances of their adoptions
• Respect for the adopted person’s birth family is fundamental to his or her emotional well-being
• Birth family members should be seen as potential resources, whenever possible
• Children have the right to a meaningful connection with their racial, ethnic and/or cultural communities of origin and to take pride in their birth heritage
• Responsible adoptive parenting includes a realistic view of adoption
• Organizations and individuals facilitating adoption have a moral, ethical, and professional responsibility to ensure that parents are prepared, educated, and supported for the task of raising their children

Obstacles to Adoptive Parent Preparation & Education

It is widely accepted among professionals that adoptive parent preparation, education and support yield better adjustment outcomes generally and, in many cases, are critical for placement stability and long-term well-being of adoptive family members. So why is there such variability in the extent and quality of these services to parents, both before and after placement, as well as in the post-adoption period? Among the many reasons cited in the literature, as well as by the adoption professionals and parents interviewed for this project, are:

• Inadequate training of professionals – in formal schooling and on the job -- in areas related to adoption, mental health, child development, and family dynamics
• Insufficient money to support professional staff training at adoption-related conferences and seminars or to hire experts to provide in-service training
• Insufficient professional staff to meet the responsibilities of developing and implementing ongoing adoptive parent education and support programs
• Inadequate guidelines regarding the necessary scope and content for adoptive parent preparation and education programs
• High staff turnover, particularly in the public child welfare system
• Biases among some professionals who hold unrealistic views of adoption and, consequently, ignore, downplay, or dismiss the differences and challenges that can be associated with adoptive family life
• Under-representation of birthparents and adopted individuals in professional positions, which can result in a one-sided presentation of adoptive family life and adoption kinship dynamics
• Viewing adoption as a business focused narrowly on making placements, with too little attention to best practices that support those placements, or to other permanency alternatives for children
• Tensions between adoptive parents and professionals that undermine the parents’ receptivity to the information and support being offered
• Inadequate information about a child’s birth family and pre-placement history
• Inadequate post-adoption services in most communities
• Inadequate training of mental health professionals in areas related to adoption
• Obstacles to effective parent preparation are not only associated with the systems and organizations providing the education and support, however. They also are linked to the readiness of prospective parents to truly listen to what they are being told and to accept and integrate the information into their parenting attitudes and behavior. Virtually every adoption professional we talked to in developing this paper emphasized the role played by parental beliefs, expectations, and extent of openness regarding adoption-related issues. Some of the more frequently mentioned parent-related obstacles include:
• Lack of receptivity by prospective parents who are overly focused on the placement per se and simply not ready to hear about the issues, differences, or challenges associated with adoptive family life
• Lack of receptivity on the part of prospective parents because of unrealistic expectations associated with the adoption experience; for example, the belief that if they provide enough love and nurturing, their children will care little about their origins
• Lack of receptivity related to the parents’ emotional vulnerability, most often associated with infertility or other previous losses or traumas in their lives
• Failure of adoptive parents to utilize existing resources and supports because they feel judged by the professionals with whom they have worked or because of their own stereotypes, myths, or misconceptions related to adoption
• Failure of adoptive parents to utilize existing resources because of inadequate time, lack of awareness of their existence, or inability to pay for services

In summary, many of the obstacles to effective parent preparation and education are systemic and require, for instance, changing the way graduate training programs educate social workers and mental health professionals; others are organizational and have more to do with ensuring that adequate resources are made available to support both the continuing education of adoption professionals and the preparation and support of parents; and still others are interpersonal and are associated with the attitudes and values adoption workers bring to interactions with their clients, as well as the receptivity of parents to the information being presented.

Key Issues in Adoptive Parent Preparation

Based upon a review of the research and practice literature in this area, existing adoption education and training programs, and interviews with adoption professionals and adoptive parents, the Evan B. Donaldson Adoption Institute offers the following general recommendations as a foundation for best-practice guidelines for the preparation, education and support of adoptive parents regarding the management of their children’s mental health and developmental needs.

Educate Adoption Professionals

Preparation, education and support of adoptive parents begin with well-trained professionals. Every school of social work, along with graduate and post-graduate programs that train psychologists, psychiatrists, clinical social workers, and marriage and family therapists, should include curricula focusing on psychological issues in adoption and foster care. In addition, adoption professionals, including policymakers, agency personnel, clinicians, attorneys, and other facilitators, should regularly upgrade their knowledge and skills through continuing education in areas related to adoption and foster care practice. Fortunately, inroads in continuing education in this area are beginning, with a growing number of seminars being offered around the country, as well as regular in-service training for agency staff, online courses for professionals, and adoption certification programs geared toward social casework and clinical professionals.

In short, best-practice standards dictate that professionals ensure that they have the training, knowledge, and skills necessary to serve the needs of their clients. We recommend that all adoption professionals be broadly trained in areas relevant to child placement and family support, including but not limited to:

• Ongoing changes in contemporary adoption practice
• Laws associated with adoption policy and practice
• Awareness of personal values, attitudes, beliefs and stereotypes associated with adoption-related practice
• Managing client defensiveness, denial, and resistance
• How race, ethnicity, culture, gender, and sexual orientation influence adoption practice and adoptive family life
• Role of racial and adoptive identity in adoption
• Biological, experiential, social, and cultural factors affecting child development and adoptive family life
• Mental health issues in adoption
• Developmental issues in adoption
• Family life cycle and parenting issues in adoption
• Role of loss and grief in adoption
• Intervention strategies for supporting adoptive families
• Awareness of community resources relevant for parent preparation, education and support
• Impact of adoption on the life course of adopted persons
• Impact of adoption on birth family members
• Impact of openness on the adoption kinship network

Make Preparation and Education a Mandatory and Ongoing Process

Current efforts to prepare and educate adoptive parents focus primarily on the periods surrounding the application, homestudy, and placement of the child with the family. It is during these periods that professionals explore with clients their motives for adopting, the type of children they wish to adopt, the type of contact they desire with birth families, and their expectations regarding adoption – as well as their readiness to take on the responsibilities associated with adoptive family life in general, and the unique characteristics associated with the child’s history in particular (Farber et al., 2003). In most cases, preparation at this stage involves some effort to discuss the mental health, developmental and parenting challenges related to adoption, although the depth and quality of preparation is highly variable. Often, this type of preparation is tied specifically to the birth family history (if known), the child’s pre-placement experiences (if known), and/or the specific type of adoption the client is undertaking (e.g., across racial lines, from abroad, or with the intention of maintaining contact with birth family members). At other times, adoption professionals focus more broadly on the mental health and developmental issues that can be associated with adoption.

A potential problem associated with these early efforts to prepare and educate parents is their readiness to assimilate the information provided. The stress associated with infertility and the transition to adoptive parenthood can leave some feeling quite vulnerable emotionally (Brodzinsky & Huffman, 1988; Farber et al, 2003; Groza & Rosenberg, 1998; Kirk, 1964). Frequently, they have struggled for years to become parents and view adoption not only as a means of achieving this goal, but also as a way of resolving the deep-seated feelings of loss left by the experience of infertility or other previous traumas. As a result, there often is an urgency to adopt a child as quickly as possible, with the unintended consequence that parents sometimes pay too little attention to the adoption-related information presented to them. Furthermore, some of the information provided by professionals (e.g., the role of adoption in identity development) may not appear relevant to the immediate needs of parents who are adopting an infant or young child. In short, during this early period, prospective parents are often not ready to listen to, understand, and integrate important adoption-related information into their sense of self, their views of their children, and/or their representation and understanding of the nature of their family in general. Professionals must recognize and respect this reality. Although early parent preparation and education is critical, it cannot stand alone.

Best-practice standards require that adoptive parent preparation, education, and support not only be a routine part of the application and placement process, but also must be integrated into a well-developed and accessible post-adoption service program. For those professionals who are unable to provide appropriate pre- and post-adoption services, best-practice standards dictate that they be knowledgeable about relevant community and/or web-based resources and provide appropriate referrals to their clients.

Utilize a Multi-Method, Multi-Source Approach to Parent Preparation and Education

Most adoption professionals use a variety of methods and strategies for preparing and educating parents. Combining individual and group approaches appears to be most common and effective. Individual sessions allow professionals to explore the motives, attitudes, expectations, and personal histories of clients in a confidential, and hopefully, supportive manner. It also allows them to tailor the preparation and education process to the unique needs of clients, especially in relation to the specific background of the children to be adopted. However, adult learning theory suggests that most learn best through an active, multi-source, multi-method approach (Birkenholz, 1999; Knowles, 1987). Too often, the information provided by professionals, whether one-on-one or in a group-oriented lecture format, comes across as dry, irrelevant, and/or inaccessible. In contrast, the give-and-take of group process, during which prospective parents can share their hopes, fears, expectations, and experiences with each other – as well as with those who have parented adopted children for years – often is a richer, more relevant, and more credible experience.

In short, adoptive parent preparation should include a combination of individual and group-oriented approaches and, when possible, include opportunities to interact with both prospective and experienced adoptive parents, as well as with adult adoptees and birthparents. Utilization of role playing and other interactive exercises, visual media (e.g., videos and DVDs) and assigned readings on adoption also should be incorporated into the preparation and education process.

As noted previously, when practitioners cannot provide adequate preparation and education themselves, best-practice standards require that they refer their clients to other professionals and resources. One emerging resource is web-based programs. Organizations such as Adoption Learning Partners (www.adoptionlearningpartners.org), among others, now offer a rich array of training and educational materials. Although face-to-face preparation generally is preferable and more effective, it is not always possible or practical; the use of distance-education technology such as web-based courses therefore offers a very valuable means of helping parents develop the knowledge, skills, and appropriate expectations necessary to meet the challenges of raising their children.

In fact, this approach can have a number of benefits, both for agencies and other professionals, as well as for their clients. These include, but are not limited to: cost effectiveness; consistency of information presented; availability to parents for whom geography and/or transportation impede in-person education; and ability of parents to learn at their own pace. The greatest drawback to distance-education is the inability of clients to benefit from the give-and-take involved in interacting with professionals, other parents, and members of the adoption kinship network. In addition, distance-education programs typically are not designed to meet the unique needs of individual families. We believe, however, that it is quite possible to integrate such programs into more traditional parent preparation and education strategies, and we strongly encourage adoption professionals to do so. 

Provide an Objective and Balanced View of Adoption

One of the best predictors of placement stability and healthy parent-child relationships in adoptive families is the development of realistic expectations on the part of parents (Barth & Berry, 1988; McRoy, 1999; Smith & Howard, 1999). This is especially true when the child doesn’t match the family’s initial hopes and desires – e.g., when he/she fails to develop a secure attachment with the parents because of early traumatic experiences in the birth family or has significant difficulty in school because of a learning disability. The importance of developing realistic expectations by parents is a reoccurring theme in the adoption literature and every professional we contacted emphasized this point.

Facilitating realistic expectations in adoptive parents begins with providing an objective and balanced view of adoption. Parents need to be provided with information describing both the benefits of adoption for a child and also the differences, challenges, and risks that can be associated with children’s backgrounds and/or adoptive family life. They also need to recognize that growing up in an adoptive family is a different experience for a child compared to being raised in the family in which he/she was born (Brodzinsky et al, 1992; Kirk, 1964; Pertman, 2000). With the growing complexity of adoption practice today, this reality has never been truer or more important to understand and accept.

Besides being educated about the general complexities and challenges associated with adoption, parents need to be provided with as much information as possible about the unique history of the child they intend to adopt, including full disclosure of all available physical, medical, psychological, social, legal, and educational information relating to the birth family. Information about previous placements, including quality of care by extended family, foster parents, and/or staff from institutional settings also needs to be shared, when available. In general, the more information parents have about their children’s backgrounds, the better prepared they will be to meet ongoing child-rearing responsibilities.

Although professionals usually try to be truthful in sharing a child’s background information, they sometimes are concerned about creating excessive anxiety in their clients and potentially undermining the adoption. When this is the case, they may minimize the risks associated with the child’s history, which, in turn, can create unrealistic expectations in adoptive parents, potentially leading to significant family difficulties and even adoption disruption. In other cases, professionals may inadvertently overemphasize the risks related to the child’s background, which not only can compromise the parents’ sense of confidence in being able to manage their child-rearing challenges, but also may increase the chances of the child or birth family members being unduly stigmatized with pathological labels.

In presenting a balanced perspective on adoption to parents and in attempting to foster realistic expectations, professionals need to keep in mind -- and emphasize to parents -- the fact that research findings describing a group of individuals do not necessarily apply to any one individual in that group. For example, although research indicates that children who experience orphanage life are at increased risk for a variety of developmental problems (Chisolm et al, 1995; O’Connor et al., 2003; O’Connor, et al., 2000; Rutter, 2005), this does not mean all children who have lived in an institutional setting will have such difficulties; nor does it mean that problems will manifest themselves in the same way in every child. In short, it is very difficult to generalize from research data describing groups of individuals to the individual child who is being considered for adoption.

In summary, in providing a balanced and realistic perspective on adoption, professionals need to be guided by the following points:

• Help adoptive parents understand and manage their individual vulnerabilities, insecurities, and/or defensiveness, which can interfere with receptivity to the information provided
• Be thorough and objective when sharing background information
• Emphasize both the benefits and risks associated with adoption in general, and the child’s unique history in particular
• Emphasize that risk associated with specific biological and/or pre-adoption experiences only means that the child is more likely than the average to have adjustment difficulties; it does not necessarily mean that the child will have these problems
• Emphasize the high degree of variability found in children experiencing the same type of adverse biological and/or pre-adoption experiences
• Emphasize the role of high-quality care-giving in ameliorating early developmental problems

Create a Receptive Atmosphere for Parent Preparation and Education

Research and social casework practice suggest that the transition to adoptive parenthood can be a highly stressful process, regardless of the type of adoption undertaken (Brodzinsky & Huffman, 1988; Brodzinsky & Pinderhughes, 2002; Levy-Shiff et al., 1990; Pinderhughes, 1996). Consequently, it is extremely important for professionals to create a collaborative relationship with prospective parents so that they feel welcomed, valued, and supported. The relationship should focus not only on a mutual exploration of the clients’ motivation and intentions regarding adoption, but also should serve as the basis for adoptive parent preparation and education. Unless parents feel safe, respected, understood, and free of judgment, they can have great difficulty being receptive to the information provided.

Creating a receptive atmosphere for adoptive parent preparation begins with an assessment of the practitioners’ policies regarding the type of adoptions they support. There is considerable controversy in the field regarding various types of adoptions (e.g., transracial adoption, open adoption, gay and lesbian adoption, etc.). Practitioners need to be clear about their policies in their literature, on their websites, and in other marketing materials, and need to ensure that all staff are adequately informed about these policies and trained in ways that support them. But, clearly delineated policies, by themselves, are not sufficient. All adoption professionals – agency directors, casework supervisors, caseworkers, attorneys, independent facilitators, clinicians – need to do a self-assessment on where they stand regarding different types of placement practices. They also need to ensure that they have adequate training that will form the foundation for sensitive, respectful, and nonjudgmental adoption practice. Unless they create this type of environment, all their efforts to prepare and educate adoptive parents, both during the homestudy process and in the post-adoption period, could be compromised.

Educate Mental Health Professionals

Because adoption is a lifelong experience, education and support for families should not end just because the adoption has been finalized. Parents often need ongoing counseling and support about adoption issues during the years they are raising their children. Moreover, as adults, many adopted individuals will require counseling and support as they continue to integrate the adoption experience into their identities and, for some, begin an active search for birth family members. Birthparents also often require ongoing counseling well after the adoption placement has occurred.

Rather than returning to the agencies or other professionals that made the adoption placement, many adoptive parents, adult adoptees and birthparents seek guidance and counseling from mental health clinicians in their communities. Unfortunately, adoption-related training is not a routine part of most graduate training programs in social work, psychology, or psychiatry. Consequently, the vast majority of community-based mental health professionals are likely to be inadequately prepared to understand and manage the adoption-related clinical issues with which they are presented, which, in turn, could undermine treatment effectiveness (Brodzinsky et al., 1998; Porch, 2007; Smith & Howard, 1999).

A more concerted effort must be made to ensure that mental health professionals are better prepared to serve the clinical needs of all members of the adoption kinship network. In response to this need, we recommend the following steps:

• Encourage directors of graduate training programs in social work, psychology, psychiatry, and marriage and family therapy to incorporate information on the psychology and realities of adoption into their curricula
• Create readily available and well-publicized continuing-education programs focusing on developmental, parenting, and mental health issues in adoption that are geared toward all the helping professions
• Create web-based continuing-education courses on the psychology and realities of adoption to serve not only the general population of helping professionals but, importantly, also those who are geographically isolated and unable to attend conference workshops and community-based continuing-education programs
• Create adoption certification programs to support uniform standards of adoption clinical competence among mental health professionals
• Foster collaborative training in the psychology of adoption among all helping professionals

Content Areas for Adoptive Parent Preparation & Education

Adoption professionals are likely to raise a great many topics in preparing and educating adoptive parents. Here, we outline those topics to be covered with all adoptive parents, as well as those that typically apply to particular types of adoption (e.g., transracial placements).

Toptics for All Adoptive Parents

Mental Health Issues Associated with Adoption – Parents should recognize and understand both the benefits and risks associated with adoption (Brodzinsky et al, 1998; Brodzinsky & Palacios, 2005; Hoksbergen, 1999; Ingersoll, 1997; Juffer & Van IJzendoorn, 2005; McGinn, 2007; Van IJzendoorn & Juffer, 2005, 2006).

• Benefits for children include reduced chances of long-term adjustment problems compared to those who continue to reside in institutions, in foster care, or with parents who abuse and/or neglect them; in addition, nurturing care in an adoptive home often helps to ameliorate the impact of pre-placement biological and social adversity.
• Risks include higher representation in mental health treatment settings compared to non-adopted children, as well as greater likelihood of manifesting a variety of psychological and learning problems such as attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, substance abuse, and learning disabilities; for later-placed children and those placed from abroad, increased risk also is related to higher rates of depression, anxiety disorder (especially post-traumatic stress disorder), and attachment disorder.
• Adjustment outcomes in adopted children are associated with a variety of factors, including:
  • Genetics, including those traits leading to increased vulnerability and those that can serve as protective factors
  • Prenatal problems such as malnutrition, maternal disease, and drug/alcohol exposure
  • Pre-placement experiences such as postnatal malnutrition, neglect, abuse, exposure to parental psychopathology, exposure to domestic violence, multiple foster placements, and orphanage life
  • Post-adoption experiences such as children’s cognitive level, temperament and attachment security, as well as quality of home life and parenting in the adoptive family, and the nature of contact with birth family members

Normative Parenting Issues in Adoptive Family Life – Adoptive parents need preparation and education about the unique parenting challenges associated with adoptive family life (Brodzinsky & Pinderhughes, 2002; Brodzinsky et al., 1998; Pavao, 1998; Rosenberg, 1992), including:

• Pre-Adoption Period – coping with infertility and other forms of loss; coping with the stress of the homestudy; confronting adoption-related stigma; making an adoption plan and beginning to develop realistic expectations about adoptive family life; learning about the child to be adopted; meeting birthparents and developing a contact plan
• Immediate Post-Placement Period – integrating the child into the family; consolidating an identity as an adoptive parent; exploring thoughts and feelings about the birth family; finding appropriate role models; and maintaining realistic expectations about adoption
• Toddler and Preschool Years – beginning to talk to the child about adoption; creating open adoption communication; maintaining realistic expectations about adoption
• Middle Childhood Years – helping children understand the meaning of adoption; supporting them as they cope with adoption-related loss; fostering a positive view of birth family; fostering open communication about adoption; maintaining realistic expectations about adoption
• Adolescent Years – supporting children as they continue to cope with adoption-related loss; supporting the teenager’s adoptive identity development; supporting a positive view of birth family and the adolescent’s search interests and plans; maintaining open communication about adoption, as well as realistic expectations about the search process

Developmental Issues in Adoption – Adoptive parents need to understand the normal developmental changes that occur in individuals which impact on adoption adjustment (Brodzinsky, Schechter, & Henig, 1992; Brodzinsky et al., 1998), including:

• Infancy – children placed as infants generally develop attachments in much the same way, and with the same level of security, as non-adopted children; however, genetic vulnerabilities, adverse prenatal experiences, and adverse early pre-placement experiences can increase the risk of insecure attachments; the older the age at placement and the more severe the previous deprivation, the greater the risk of attachment problems
• Toddler and Preschool Years – most parents begin to share adoption information with their children during this time, and the children themselves begin to use adoption-related language; while cognitive immaturity prevents most children from understanding the meaning and implications of being adopted, theirs views of adoption at this time usually are quite positive
• Middle Childhood – as children develop cognitively, they become more aware of the meaning and implications of adoption, which, in turn, increases their sensitivity to related loss; children often display ambivalent feelings about adoption as they attempt to cope with adoption-related loss; interest in one’s origins generally increases as well; adjustment problems associated with adoption typically begin to manifest themselves during this period
• Adolescent Years – understanding of adoption deepens, as does sensitivity to related loss; ambivalence about being adopted is common during this period; teenagers begin to integrate adoption into their emerging sense of self; there is often greater interest in one’s biological origins at this time, as well as initial thoughts and plans related to searching; adjustment problems continue to be seen in many adopted individuals
• Adult Years – the role of adoption becomes more stabilized for many people; interest in one’s origins continues and often leads to specific plans for searching for background information and/or birth family members; plans for searching often are triggered by life events such as leaving home, getting married, having children, and/or the death of adoptive parents

Talking with Children about Adoption – Adoptive parents need guidelines regarding different aspects of the adoption revelation process (Brodzinsky & Pinderhughes, 2002; Keefer & Schooler, 2000; Komar, 1991; Melina, 1998), including:

• When and how to begin talking about adoption
• Validating and normalizing children’s thoughts and feelings about adoption information
• Translating emotionally charged information about the birth family, and pre-placement experiences, into more neutral and child-friendly language
• Strategies for handling the absence of information about the child’s origins
• Creating an environment that facilitates open and honest dialogue between parents and children about adoption issues
• Preparing children for questions from others about adoption

Loss, Grief and Adoption – Adoptive parents need to be exposed to an in-depth examination of loss and grief in adoption (Brodzinsky, 1990; Brodzinsky & Pinderhughes, 2002; Leon, 2002; Nickman, 1985), including:

• Nature and uniqueness of loss in adoption
• Developmental changes in children’s sensitivity to adoption-related loss
• Link between adoption loss, grief, and children’s adjustment problems
• Use of a grief model for understanding children’s reactions to adoption-related loss
• Strategies for managing children’s adoption-related grief

Identity and Adoption – Adoptive parents need to understand the relationship between adoption and normal identity development (Dunbar & Grotevant, 2004; Grotevant, 1997; Grotevant et al., 2007; Lifton, 1994; Wegar, 1997), including:

• The variability of the importance of adoption in the lives and identity of adopted individuals
• How identity development is influenced by the person’s own view of adoption, as well as the views of others and of society in general
• How adoption identity is influenced by adoption information and contact with birth family, as well as the quality of communication about adoption with others
• How adoption identity is impacted by racial, ethnic, and cultural issues
• Strategies for supporting children’s adoption identity development

Searching and Adoption – Adoptive parents need to understand the meaning and importance of the search process in adoption (Howe & Feast, 2000; Lifton, 2007; March, 1994; Sachdev, 1989; Schechter & Bertocci, 1990; Wegar, 1997), including:

• The universality and normality of searching
• The various steps involved in searching
• The variability in search interests and plans among adopted individuals
• The meaning of searching for adopted individuals
• Strategies for helping adopted individuals (both minors and adults) in the search process

Services and Supports in Adoption – Parents need to be apprised of the relevant services and supports available to them in relation to adoption, including:

• Post-adoption services in their communities (e.g., agency-based services, adoptive parent support groups)
• Adoption-competent therapists in their communities
• Web-based adoption sites and online adoption courses
• Adoption books, videos, and DVDs

Topics for Selected Adoptive Parents

Adoption of Children from Foster Care – Parents who adopt children from the child welfare system need additional preparation and training in the following areas (Barth & Berry, 1988; Gray, 2007; Hughes, 1997; Keagy & Rall, 2007; Levy, 2000; McRoy, 1999; Pinderhughes, 1996; Reilly & Platz, 2003; Sar, 2000; Smith & Howard, 1999):

• Impact of prenatal and postnatal trauma on children’s adjustment
• Parenting neglected, physically abused, sexually abused, and/or emotionally abused children
• Parenting children with attachment disorders
• Integrating the older child and/or sibling groups into the family
• Managing troublesome child behavior
• Supporting children’s acute grief in relation to known birth family
• Managing children’s connections with birth family members and significant others from the past (including previous foster parents)
• Developing and maintaining realistic expectations about their children’s behavior and functioning, and about their own capacity to help children overcome their problems
• Correlates and ways of preventing adoption disruption
• Knowledge and utilization of specialized services and supports, including those for self-care and marital/relationship supports

International Adoption – In keeping with the Hague Convention on Intercounty Adoption and its implementing legislation, individuals who adopt children from abroad are required to receive at least 10 hours of preparation and education. Although the specific content of the training is not specified, we recommend additional education, over and above that identified for all parents, in the following areas (Chasnoff et al., 2006; Dale & Myers, 2006; Gibble, 2007; Meacham, 2006; Rutter, 2005):

• Medical and developmental delays commonly observed in children adopted from abroad
• Impact of prenatal and postnatal trauma on children’s adjustment
• Impact of institutional rearing on children’s adjustment
• Parenting neglected, physically abused, sexually abused, and/or emotionally abused children
• Parenting children with attachment disorders
• Managing home and school life for children whose first language is not English
• Integrating the older child into the family
• Managing troublesome child behavior
• Supporting children’s grief in relation to known birth family and significant others from the past
• Maintaining open communication in the absence of much background information
• Managing children’s connections with identified birth family and significant others from the past
• Impact of race, ethnicity and culture on the child and family (see comments and recommendations below under Transracial Adoption)
• Developing and maintaining realistic expectations about children’s behavior and functioning, and about their own capacity to help children overcome their problems
• Correlates and ways of preventing adoption disruption
• Knowledge and utilization of specialized services and supports, including those for self-care

Transracial Adoption – Individuals adopting children of a different race, whether domestically or from abroad, need additional preparation and training (Baden, 2007; Baden & Steward, 2007; PACT, An Adoption Alliance, 2000; Register, 1991; Roorda, 2007; Simon, Altstein & Melli, 1994; Simon & Roorda, 2000). Our recommendation for racially sensitive education is in keeping with the Hague Convention and the Intercountry Adoption Act – but it varies from the Multi-Ethnic Placement Act (MEPA) and the Interethnic Adoption Provisions (IEP), which require that if training is provided related to transracial adoption, it must be offered to all families, not just to those adopting across racial lines. Our perspective is that best-practice standards require professionals to ensure that adoptive parents are adequately prepared and educated in ways that will support a strong and positive racial and ethnic identity, as well as healthy psychological adjustment, in their children. We believe these outcomes are best assured when parents receive training in the following areas:

• Promoting self-assessment regarding their perceptions, attitudes, beliefs and stereotypes of race, ethnicity and culture in society
• Fostering self-assessment of how adopting children across racial lines will affect their understanding of themselves, their children, and their families
• Assessing family, friendship and community support for transracial adoption
• Knowledge about their children’s race, ethnicity and cultural heritage
• Strategies for coping with prejudice and racism, and teaching their children to cope
• Awareness and respect for children’s views about having parents of a different race.
• Parenting children of a race different from their own
• Ways of supporting positive racial identity development
• Ways of making connections with positive racial, ethnic and cultural models in their communities, including with adult transracial adoptees

Open Adoption – Individuals who enter into open adoption placements need additional preparation and education in the following areas (Brodzinsky, 2005; Duxbury, 2007; Grotevant & McRoy, 1998; Melina & Roszia, 1993; Neil & Howe, 2004; Wrobel et al., 2003):

• Understanding the nature and implications of open adoption
• Differentiating between structurally open adoptions and communicatively open adoptions
• Understanding the benefits and challenges of open adoption, structurally and communicatively
• Strategies for managing contact with birth family members (including siblings), as well as with prior caregivers such as foster family members
• Coping with changes in the nature of openness over time
• Strategies for managing conflict related to contact with birth family

Lesbian/Gay Adoption – In addition to the issues noted in previous relevant sections, lesbians and gay men who adopt also need education and training in the following areas (see Boyer, 2007; Mallon, 2006; Martin, 1993):

• Assessing support for adoption in their families, friends and communities
• When and how to share information about sexual orientation with their children
• Helping their children cope with homophobia and heterosexism beyond the family
• Helping their children manage information about parental sexual orientation beyond the family
• Helping children cope with peer teasing about parental sexual orientation
• Helping children manage their feelings about parental sexual orientation

Final Comments

Adoption touches the lives of children and their parents in profound ways. Generally, it provides permanency, nurturance, emotional security, and a lifelong sense of connection for children who could not be raised in their families of origin for an array of reasons; for parents, it provides the deeply satisfying experiences of being a mother or father -- that is, to love, care for, guide, and support the development of one’s child. Even as it offers benefits and satisfactions, however, adoption also can bring challenges to the lives it touches. Historically, these challenges were either ignored or minimized. And yet we now know, both from research and casework practice, that unless parents openly acknowledge these challenges and are properly prepared to deal with them, the risk for adjustment difficulties for their children and families is substantially increased. Parents need to be educated and supported in their efforts to address the adoption-related issues in their lives and the lives of their children. This education should begin at the time of adoption application and continue into the post-adoption period. Responsible adoption practice dictates that all professionals involved in the placement process – agency personnel, attorneys, independent facilitators -- ensure that their clients receive appropriate preparation and education, either within their own organizations, by other qualified professionals in their communities, or through other means such as web-based courses. The Evan B. Donaldson Adoption Institute hopes that this policy and practice brief will encourage professionals to become better prepared to meet the needs of their clients and set more uniform standards for preparing, educating and supporting adoptive parents to meet the mental health and developmental needs of their children.

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This report was researched and written by Dr. David Brodzinsky, Research and Project Director of the Evan B. Donaldson Adoption Institute. Special thanks for their valuable contributions to Madelyn Freundlich, the Institute’s Legislation and Advocacy Director; Dr. Ruth McRoy, one of the Institute’s Senior Research Fellows; Spence-Chapin Services in New York; and Sharon Roszia of the Kinship Center in California. This Policy & Practice Perspective was edited by the Adoption Institute’s Executive Director, Adam Pertman. Send questions and comments to info@adoptioninstitute.org. All contents (c) 2008 by the Evan B. Donaldson Adoption Institute.