Forty years ago, most people thought of adoptive parents as couples who could not become pregnant, and who adopted an infant to raise as "their own." Today, some adoptive families are formed in this way and for this reason, but there are many new ways in which adoption brings families together.

Adoption today may include infants born in the United States or abroad, or it may involve children joining their new families at any age before 18. Children may be of the same race as the family they join, or they may not. They may be placed individually or as part of a sibling group. Domestic adoption includes adoption through private adoption agencies, or independently with the assistance of an attorney or other intermediary, and adoption through public agencies. The latter involves children who are adopted from the foster care system, often by relatives, known as kinship adoption. In international adoption, children are placed from countries in Eastern Europe such as Russia, and from South American countries such as Guatemala and Peru. Many children are also adopted from Asia, where China and Korea are the leading countries sending children to the United States.

Adoption occurs for many reasons, such as the wish to expand families or to provide a home for children in need. Kinship adoption may include grandparents adopting the children of their children. More single people of both genders are adopting today than ever before, as are gay and lesbian couples. Increasing numbers of adoptive parents have opened their hearts and homes to children of races or cultures different than their own (known as transracial and transcultural adoption).  

The Decision to Adopt

Making the important decision to adopt may be one of the most challenging and difficult decisions a person or couple can make. If it is the result of infertility, it may mean giving up the dream of having a child by birth. This can be experienced as a very tragic loss. It is not unusual for any person grappling with this decision to experience a great deal of anxiety and fear, in addition to sadness. They may wonder, "Which type of adoption should I choose? What type of child? Which agency can I trust? Will the child be healthy? Will my extended family accept this?" The process of adoption itself can feel overwhelming, especially in terms of the paperwork involved and the home study that is required prior to approval for adoption. The stress on a marriage can be great, especially if one partner is ready to proceed with adoption before the other.

People who adopt from the foster care system have special concerns as well. Because many children in foster care have special needs, prospective parents are aware of the importance of financial support to provide medical, emotional, or academic support for the children. They may worry that services provided during foster care will end once the child is legally adopted. Kinship adopters particularly have concerns about how to handle future contact and relationships with the child's birth parents.

Whatever the circumstance, family therapists who understand the questions and concerns of prospective adoptive parents can provide the education, support, and counseling to help them through the decision-making process.

Adoptive Parenting and Children

Adoptive parenting is the same as, and different from, parenting children by birth. It is the same in that parents love their children and want what's best for them, and worry about their child's health and well being in the same way that biological parents do. It is different because adopted children face unique challenges and feelings related to being part of an adoptive family. These challenges include feeling different from children who were not adopted, feelings about why they were placed for adoption, feelings about birth parents, as well as concerns about handling questions by peers and adults about their adoption. Adoptive parents need to know how they can help their children to successfully handle those challenges.

When children are having trouble with feelings related to adoption, their behavior often reflects it. Communication about the impact of adoption, within families and also with others, is not easy to initiate.

The emotions can become quite strong and result in new behaviors: 

  • Withdrawal from others
  • Daydreaming in school, changes in school performance (falling grades, not completing homework assignments)
  • Angry outbursts, temper tantrums, or aggressive behavior with siblings, peers, or adults
  • Anxiety, fearful behavior, or difficulty being apart from parents
  • Changes in eating or sleeping patterns

These behaviors can certainly wreak havoc on family relationships and result in worry and conflict. The behaviors do not necessarily mean that the child is experiencing difficulty related to adoption, but only a therapist who understands post-adoption challenges can help decipher the problem.

It is important to note that post-adoption issues can also surface during adolescence, a life stage that can often be a challenging time for any family. Teens are trying to figure out their identities: who they are. As teens struggle to formulate their identity and figure out who they are, having two sets of parents can complicate this task because adopted teens must determine how they are like and different from both their adoptive and birth parents, whom they may have little or no information about. Adopted teens often have more anxiety about emotionally separating from parents, as well as leaving home.

The Important Role of Family Therapists

Family therapists can help the adoptive family to understand what impact, if any, adoption may be having, and they can help the parents to learn how they can help their child. Adopted children are sometimes reluctant to discuss adoption with their parents for fear of hurting them. If for example, they are wondering about their birth parents, such thoughts may make them feel disloyal when in fact they love their family very much. A family therapist can provide the support a child needs to open communication with his family. The therapist can also help parents identify other steps to assist their child. For example, both parents and children may need to learn effective ways to handle the many comments and questions they receive from others about adoption.

When school difficulties are involved, the family therapist can assist the family in correctly assessing what the child needs. In addition to emotional difficulties related to adoption, children may be experiencing learning challenges or other difficulties like Attention Deficit Disorder. The therapist can assist the parents in advocating for whatever additional services might be required of the school, such as educational testing and changes in school placement.

An area where family therapists can be particularly helpful to adoptive families is the array of new challenges arising from increased contact between birth and adoptive families. As families work through these relationships, and the way they may change over time, a trained professional can help to ensure positive communication and comfortable boundaries, which benefit the child and strengthen family relationships.

There are times when adoptive parents question whether they are adequately meeting their adopted child's needs. Whether it's anxiety related to talking with their child about adoption, discomfort related to some aspect of their child's personality or functioning, or issues related to relationships with extended family members, family therapists can provide parents with assistance in working out their concerns and strengthening family ties.

The text for this brochure was written by Debbie Riley, M.S. and Ellen Singer, M.S.W.


  • Child Welfare Information Gateway: Resources on all aspects of domestic and intercountry adoption, with a focus on adoption from the U.S. foster care system. Includes information for adoption professionals, adopted adults, expectant parents considering adoption, birth parents and relatives, and prospective and adoptive parents on a broad range of adoption topics.
  • North American Council on Adoptable Children (NACAC): Founded in 1974 by adoptive parents, the NACAC is committed to meeting the needs of waiting children and the families who adopt them.

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