Adoption-Informed Care: What Clinicians Need to Know

Background and Purpose: The need for adoption-informed mental health care is well documented, yet
there continues to be insufficient access to providers who understand the needs specific to adoptive
families. This especially affects families formed through transracial and transnational adoption as
language, race, and cultural issues are amplified for those families. Viewed through the lens of adoption
as a lifelong process, not a singular event, and with an emphasis on resilience and post-permanency
disruption prevention, this study adds to our knowledge of adoption through examining the stories of
adoptive parents to gain a deeper understanding of the facilitators and barriers to effective parenting,
building attachment, and maintaining post-permanency continuity for their families.

Methods: In-depth semi-structured interview data were coded using a thematic analysis. Thematic
analysis was a sound choice for this study because investigators were seeking the best way to identify
patterns within the data, organize and analyze the patterns into themes, and report on the findings in a
rich, detailed, and organized manner. Coming from a constructionist perspective, investigators used
thematic analysis to identify and evaluate themes from the person-in-environment perspective, allowing
for the inclusion of social and environmental aspects, minimizing individual motivations or pathologies,
while highlighting the “sociocultural contexts, and structural conditions, that enable the individual
accounts that are provided (Braun & Clarke, 2006, p. 85). While the larger study used a case study
method, for this study, we were less interested in individual cases and wanted to understand the adoptive
parents' aggregate experiences.

Results: Results highlight specific areas that practitioners working with adoptive families should pay
close attention to including (a) family systems related issues, which includes introducing adopted children
into a family with biologically related children, dynamics associated with transracial adoption, contact
with birth family, and limited access to support systems; (b) attachment and trauma related factors, which
examines the impact of unknown or unreported medical and trauma histories of adopted children,
unresolved mental health issues of adoptive parents and/or biologically related children, and unrealistic
expectations; and (c) grief and loss related factors associated with infertility, the loss of culture, family of
origin, language, and overall identity.

Conclusions and Implications: Adoption is common and touches many families. The risks of adoption
disruption, attachment issues, and other harms are well documented. A deeper understanding and
appreciation for what adoptive families experience while addressing those potential risks proactively and
effectively is essential. The stories of the adoptive families interviewed help to further flush out what
needs are most pressing, what remains unaddressed, and what adoption-informed care might look like. By
learning from adoptive parents’ experiences, needs, and hopes, clinicians can move towards becoming
more adoption-informed when treating families formed through adoption.