Therapy for Adoption, Therapist for Adoption

Adoption / Foster Care Issues


Adoption and foster care can lead to positive outcomes for many children. However, thousands of other children and young adults placed in foster or adoptive homes may experience significant life stress and trauma due to difficulty with the foster care system, problematic placements, and neglectful or abusive foster parents and siblings. Even those children who are adopted into loving homes may experience conflicted feelings about being given up for adoption. Adoptive children may also experience stress or anxiety as a result of not knowing their background. These and other issues can often be explored through therapy.

Adoption and Foster Care Statistics

Currently, there are approximately 425,000 children in the foster care system in the United States, and nearly 115,000 of these children are eligible for adoption. More than half of the children who entered foster care in 2013 were youth of color, and nearly 25% of all children in the foster care system are African-American. 

  • Fourteen percent of children in foster care reside in institutions and group homes.
  • Twenty-two percent of foster children attempt to leave the foster care system, running away from institutions or their foster homes at least once. Nine percent of these report staying with friends, but many become transient youth who face homelessness, unemployment, abuse, and imprisonment.
  • In 2013, over 23,000 young adults aged out of the foster care system, and many of these also become transient.
  • Young adults who age out of care without a permanent home are statistically more likely to experience unemployment, homelessness, and incarceration as adults. In general, foster children who have left the system are more likely to experience health problems and early pregnancy or become victims of sex trafficking.

Understanding Adoption and Foster Care Issues

Many young parents who cannot afford to start a family or are otherwise unable to raise a child decide to give their infant or young child up for adoption, often with the hope of giving them a chance at a better life. Other children enter foster care after being removed from a neglectful or abusive home environment by Child Protective Services. Some of these children find long-term placements with caring and nurturing foster families, but others move from one foster home to another or reside in institutions or group homes until they age out of the system.

Children in foster homes may experience abuse or neglect at the hands of their foster parents: According to a 2010 study, one in three alumni of the foster care system reported experiencing abuse from an adult in a foster home. Many children experience abuse in multiple homes, and children who experience abuse or neglect multiple times often feel unable to trust any adult, or anyone at all. There are typically not enough quality foster homes to place all children who need homes, and often social workers have high caseloads and may not recognize abuse or neglect. In other cases, they may fail to report abuse or neglect in a foster home. Foster parents who are not equipped to handle children with special needs may also, in some cases, be inadequate foster parents without intending abuse or neglect.

Some children may be established in a foster home with parents who wish to adopt them, but the biological parents may not wish to relinquish their rights, hoping to find themselves in a situation where they can care for their child once again. A child who has been successfully placed with a foster family may experience stress and trauma from changing situations, should they become able to return to their biological parents.

Many children who are adopted at an early age, especially those who do not known anything about their birth family or the circumstances that led to their adoption, experience significant stress, anxiety, and other distress as a result of not knowing who they are or where they came from. Some children who live in happy homes with adoptive parents who love and care for them still fantasize about their birth families and imagine what their parents and siblings might look like. Children may experience anxiety or become angry or oppositional as a result. Therapy to explore identity and relevant issues may help, and opening the adoption may also be an option for some families. In most cases, adoptive parents may be able to help by providing children with as much information as possible and by answering any questions a child might have about his or her adoption.

Attachment Issues and Adoption

Due to the high number of placements and transitions a typical child may experience prior to finding a long-term home, attachment issues and related concerns are common. In addition, some children may exhibit serious behavioral issues as a result of early trauma and a lack of structure and consistency in their lives. These behavior problems can impact the entire family system and may also result in increased placement disruption in foster or adoptive homes.

International adoptions pose a unique set of challenges and difficulties for children to overcome, including behavioral, psychological, and basic health issues. In some cases, foreign orphanages do not provide the care, attention, and supervision necessary to support healthy attachments in the child’s early developmental stages. Early attachment issues can develop during this time, and these may have a long-lasting impact on a child’s ability to form positive relationships with family and primary caregivers.

These issues may be helped and/or resolved with intensive attachment-specific therapy, in addition to child and family trauma work. Skilled and loving caregivers who are able to self-regulate and provide the children with what they need developmentally may be successful at helping children facing these issues to adjust.

Psychological Issues Associated with Foster Care and Adoption

In addition to attachment concerns, children who live in foster homes or with adoptive families may have developmental delays, and they may also experience mental health conditions, such as significant anxietydepression, or social problems.Children who are eventually adopted by their foster families or by other families may also experience difficulty with trust and may not adapt easily to a permanent home.

Typical diagnoses associated with foster care and adopted children include:

Adults who grow up in the foster care system report experiencing conditions such as homelessness, addiction, anxiety, depression, and incarceration at much higher rates than the general population, and statistics show that they experience posttraumatic stress at twice the rate of veterans of the Iraq war.

Therapy for Issues Associated with Foster Care and Adoption

While counseling or therapy may be helpful for all children experiencing rehoming or placement into a group home, children who have experienced neglect, abuse, or significant emotional trauma may have a difficult time coping or adapting to a new home without the help of a therapist. Though a social worker may be able to offer help and resources to some children, heavy caseloads often mean that social workers do not have enough time to spend with each child under their care, and children who have been failed by a system multiple times may be less likely to place their trust in the system once again. When a child has been abused and experiences difficulty trusting a new family, family therapy may be recommended.

Therapy is generally recommended for families seeking to foster or adopt a child. In therapy, a family can prepare for any issues that might arise, and learn how to cope with a child's particular or special needs, including any behavioral or health issues. With the child, they can discuss any concerns about behavior or developmental issues and work as a family to establish bonds and trust. Families who adopt or foster a child with significant behavioral or developmental concerns may find their situation challenging and consider giving up the child once again. Some of these issues may be resolvable with work in therapy, preventing further disruption to the child's life.

Case Example

  • Neglected child receives therapy to succeed in foster care: Richard, 12, has had over 20 placements in the foster care system. He was born prematurely, due to his mother's chronic drug and alcohol use, and was significantly neglected by both parents and often left alone for long periods of time. Due to the lack of structure and poor boundaries within the household, Richard was often subjected to abuse from his siblings. Richard’s first-grade teacher noticed his dirty clothes and bruises and contacted Social Services. In foster care, he exhibited several challenging behaviors, such as hitting himself and others, banging his head when he was upset, and destroying property within the household. After multiple placements failed due to his behaviors, Richard began to be placed in group homes. He is eventually diagnosed with reactive attachment disorder and fetal alcohol spectrum disorder, and it is also believed that he also experiences some learning delays. A trained foster family reaches out to Richard's institution, indicating a desire to provide him a safe home, and they begin family counseling together before he leaves the group home. With the help of his foster family, Richard does well with attachment therapy and trauma treatment, and he begins to be able to accept love and compassion from his caregivers. After a few months, he demonstrates the ability to work toward stable relationships and, as his sense of safety and security within his family increases, Richard’s behaviors gradually decrease. His foster parents meet with his school guidance counselor to develop an IEP for Richard, and school and parental support allows for improvement in his learning. He continues in therapy with his foster parents, who remain committed to helping him succeed both in the home and in school, and after several months, Richard is able to demonstrate his own love and trust toward his foster family.


  1. #FliptheScript on #NationalAdoptionMonth. (2014, November 1). Retrieved July 10, 2015, from
  2. Barcella, L. (2014, November 13). Adoptees Like Me 'Flip the Script' on the Pro-Adoption Narrative. Retrieved from
  3. Foster Care. (2013). Retrieved from
  4. Luscombe, B. (2013, November 4). New adoption rules means more kids are left in orphanges. Retrieved from
  5. National Adoption Month: Foster Care Adoption Statistics. (2009, October 1). Retrieved from
  6. Stone, D. (2014, May 12). U.S. Foster Care: A Flawed Solution That Leads To Long-Term Problems? Retrieved from


Last updated: 09-15-2015

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