Girl playing game outside with her adoptive familyAdoption 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 stress and trauma due to difficulty with the foster care system, problematic placements, and neglectful or abusive foster parents and siblings.

Even when children are adopted into loving homes, they may have 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.

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. 

Many children who are adopted at an early age, especially those who do not know anything about their birth family or the circumstances that led to their adoption, experience significant stress, anxiety, and other issues as a result of not knowing who they are or where they came from. Children who live in happy homes with adoptive parents who love and care for them may still fantasize about their birth families and imagine what their parents and siblings might look like. As a result, children may become angry or oppositional.

Foster Care and Adoption Statistics

Currently, there are approximately 438,000 children in the foster care system in the United States, and in 2015, nearly 108,000 children were eligible for adoption. From 2006 to 2016, the rate of African American children entering foster care decreased while the rates of white and Hispanic children entering foster care increased.

  • Teens adopted in infancy were shown to visit mental health professionals and to have a behavior disorder at double the rate of non-adopted teens.
  • Compared to non-adopted people, adoptees are four times as likely to attempt suicide.
  • Twelve percent of children in foster care reside in institutions and group homes.
  • Studies report that anywhere from 20% to 45% of foster children attempt to leave the foster care system, running away from institutions or their foster homes at least once. Many of these stay with friends, but others become transient youth who face homelessness, unemployment, abuse, and imprisonment.
  • In 2016, over 20,000 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.

Foster children who run away often do so because they miss their friends or family. Generally, foster children who age out of the system are more likely to experience health problems and early pregnancy or become victims of sex trafficking.

Mental Health, Foster Care, and Adoption

Children who live in foster homes or with adoptive families may have attachment issues and developmental delays. They may also experience mental health conditions, such as significant anxiety, depression, 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:

  • Reactive attachment disorder (RAD): RAD is connected to withdrawn behavior in children. Adoptees or foster children with RAD may have a hard time showing affection.
  • Oppositional defiant disorder (ODD): Symptoms of ODD include anger, defiance, and aggression. People with ODD may appear to overreact or be easily annoyed.
  • Conduct disorder: Signs of conduct disorder often show from an early age and include violent or cruel behavior including physically hurting people and animals as well as bullying.
  • Posttraumatic stress disorder (PTSD): In adoptees and those in foster care, PTSD may be caused by past abuse, instability in living situation, or feeling abandoned. 

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 PTSD at twice the rate of veterans of the Iraq war.

Foster Care and Abuse

Children in foster homes may experience abuse or neglect at the hands of their foster parents: According to a 2010 study, 1 in 3 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 are abused or neglected 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.

Birth Parent and Foster Family Conflict

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.

Adoption and Attachment Issues

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

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.

Both adoption and foster care can increase the likelihood that a person may experience mental illness, but prospects look good. With therapy, many adoptees, foster children, those who have left foster care are able to improve their quality of life and well-being.


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