The Impact of Adoption of a Child with High Level of Care Needs on the Family System

Background and Purpose: Adoption presents challenges and changes for all members of the adoptive family. Research shows how adoption impacts children and parents, but less is known about how adoption influences the whole family system and overall family functioning. This study focused on the experiences families face post adoption due to the high needs of their adopted child and how this impacts the parental subsystem, sibling subsystem, and family system. This exploratory study was guided by the following research question: How do family systems and subsystems adapt after the adoption of a child with high level of care needs?

Methods: Data for this study came from the North American Adoption Study, a study that was conducted between April 2019 and June 2019. Through partnership with the North American Council for Adoptable Children (NACAC), adoptive parents who had at least one child placed in RTC were recruited for this study. An anonymous survey link was sent to the NACAC listserv. During this time, 119 participants completed the survey. Majority of the participants were white (92.4%) and female (94.1%). We conducted descriptive statistics to examine closed-ended questions, including respondent demographics, characteristics of adoptive youth, and Likert items related to the impact of adoption on the family subsystem. The open-ended questions were coded using thematic analysis. Themes were identified to explore families’ self-reported post-adoption experiences.

Results: Findings suggest a major impact on the parental subsystem via the parents’ relationship or marriage. Almost all participants who were in a two-parent household at the time of adoption (98.1%) indicated the adoption affected their relationship and 17.1% reported considering divorce, in part due to the stress from the adoption. The parental subsystem was further impacted based on the adoptive parent’s health issues. Since adopting, 50.4% experienced anxiety and 67% indicated experiencing secondary trauma. Only 4.3% expressed not experiencing any physical, mental, or emotional challenges. With regards to the sibling subsystem, the majority of participants had other children in the home, including biological children (48.8%) or other adopted children (84.6%). Themes emerged related to keeping other children safe and placing the child in an RTC as a last resort when all other alternatives failed. Ultimately, parents sought RTC placement in an attempt to maintain overall family safety. Themes further demonstrated families’ constant state of adjustment as the child cycled in and out of RTC placement.

Conclusion and Implications: Adopting a child with high needs presents a family with various challenges. This study suggests the adoption triad needs to be expanded to include the whole family system. Post-adoptive support needs to focus on the entire family unit and provide ongoing assistance throughout transitions. This study demonstrated families making placement decisions based on the entire family unit. Research needs to continue to explore the various effects adoption has on the family system while including voices from diverse families.