Working with Adoptive Parents E-Book

Virginia M. Brabender

• Herausgeber: John Wiley & Sons
• Kategorie: Geisteswissenschaft
• Sprache: Englisch

Seitenzahl: 794

Veröffentlichungsjahr: 2013

Beschreibung

Practical techniques for guiding parents through the stages of adoption and beyond Editors Virginia Brabender and April Fallon are clinical psychologists and also adoptive parents whose families are acquainted with both the uncertainty and joy of adoption. In Working with Adoptive Parents, they offer an in-depth treatment of the distinctive needs, feelings, impulses, expectations, and conflicts that adoptive parents experience through the stages of adoption and beyond. This volume offers a comprehensive picture of adoption through an exploration of the experiences and developmental processes of the adoptive parent. Featuring contributions from mental health professionals whose careers have focused on work with families through the adoption process, this unique book: * Covers the theory, research, and practice of adoptive parenting throughout the life cycle * Explores the issues unique to the adoptive mother and adoptive father as they traverse the stages of parenting * Offers a close look at families with special needs children * Acknowledges and explores the great diversity among adoptive families and the kinship networks in which they are embedded * Examines attachment issues between adoptive parent and child Providing a framework for therapists to conceptualize their work with adoptive parents, Working with Adoptive Parents clarifies and facilitates the journey that many of these families face.

Leseprobe

Contents

Foreword

Preface

Acknowledgments

About the Editors

Contributors

Chapter 1: Setting the Stage

Characteristics of Adoptive Parents

Serving the Needs of Adoptive Parents

History of Adoption

Contemporary Controversies

Practical Points

Conclusions

Notes

Chapter 2: Theoretical Contributions to the Understanding of Parent-Child Bonding in Adoption

Before the Family Becomes a Unit: Daniel Stern and Intrapsychic Reorganization

The Case of Dora

Bowlby and the Importance of Secure Attachment in Healthy Development

The Parallel Caregiving System: Contributions of George and Solomon

Ego Psychology and the Significance of Adaptation

Contributions of D. W. Winnicott

Kohut and the Development of Self-Esteem

Mentalization: Holding the Adopted Child in Mind

Separation-Individuation and the Contributions of Margaret Mahler

Practical Points

Conclusions

Notes

Chapter 3: Using Research to Inform Best Practices in Working With Adoptive Families

The History of Research on Attachment and Parent-Child Interactions

Research on Adoption

Attachment-Based Interventions for Use in Adoption

The Circle of Security

Practical Points

Conclusion

Chapter 4: The Adoptive Mother

The Eras of Adoptive Motherhood

Adolescence

Practical Points

Conclusion

Notes

Chapter 5: The Adoptive Father

Important Role Functions of the Father

Becoming and Being an Adoptive Father

Practical Points

Conclusion

Notes

Chapter 6: Recognizing Diversity in Adoptive Families

Identity Variables Within the Addressing Framework

Family Structure

Practical Points

Conclusion

Notes

Chapter 7: Adoption of Children With Special Health Care Needs

Three Approach Classes

Comparison to Children in the General Population

Disruption of Adoption for Children With SHCN

Who are the Families Who Adopt These Children?

Commitment

Preparation

Coping and Stress

Existential Issues

Posttraumatic Stress

Ambiguous Loss

Posttraumatic Growth

Marital Satisfaction

Practical Points

Conclusion

Chapter 8: Parenting the Young Child

Ghosts in Adoptive Families

Intervention With Adoptive Families: Developmental Guidance, Parent-Child Groups, and Parent-Child Therapy

Parenting Cornerstones for Adoptive Families

Enhancing the Parent-Child Relationship in Adoptive Families: Developing an Adoption Dialogue

Practical Points

Conclusion

Notes

Chapter 9: Adoptive Parenting of Teenagers and Young Adults

Developmental Themes of Adolescence and Early Adulthood

Individuation, Independence, and the Adoptive Parent-Child Relationship

Insights for Parents and Therapists

Identity Formation in International, Transcultural, and Transracial Adoptees

Practical Points

Conclusions

Chapter 10: Therapeutic Interventions With Adopted Children and Adoptive Parents

Introduction

Development of the Human Mind

Therapeutic Intervention in a Psychoanalytic Developmental Approach

Parent Problems and Child Problems in the Context of a Psychoanalytic Developmental Approach

Intergenerational Transmission of the Human Mind—The Missing Link

Evaluating the Parent-Child Dyad

Practical Points

Conclusion

Notes

Chapter 11: Adoptive Parent as Consultant, Educator, and Advocator

The Roots of Problems Facing Adoptive Parents

Action Implications

Practical Points

Conclusions

Notes

Chapter 12: Meeting the Needs of Adoptive Parents

Practice

Training

Research

Practical Points

Conclusions

Notes

References

Author Index

Subject Index

Praise forWorking With Adoptive Parents: Research, Theory, and Therapeutic Interventions

“With adoption, including those that across international boundaries, on the rise, the salutary impact of human kindness as well the tragic potential for developmental complications has greatly increased. Brabender and Fallon, the editors of this well-organized volume, are keenly aware of this. They have cast their net wide and brought together the perspectives of attachment theory, empirical research, and clinical experiences to deepen our understanding of the challenges faced by adoptive parents. Conceptually rich and yet unabashedly pragmatic, their book addresses the issues of parent-child bonding, the subjective dilemmas of adoptive mothers, the role of adoptive fathers, and parenting children with special health care needs. Attention is also given to the specific tasks involving the adoption of very young children as well as to the resurgence of difficulties during adopted children’s adolescence. This wide-ranging discourse consistently maintains a tone of respect, concern, and shared humanity of all of us. A most impressive contribution to the adoption literature indeed!”

Salman Akhtar, MD, Professor of Psychiatry, Jefferson Medical College, Training and Supervising Analyst, Psychoanalytic Center of Philadelphia

“This book is a tour de force, a must read for all involved in the world of adoption. A comprehensive history of adoption, including current controversies, sets the stage. Every chapter is a gem, but contributions on research to inform best practices, the role of the adoptive father, diversity, and adoption of children with special health care needs, help fill significant gaps in the adoption literature. Rich clinical material and the practical points summarized throughout, demonstrate the wisdom of seasoned practitioners.”

Jennifer Bonovitz, PhD, Supervising and Training Analyst, Psychoanalytic Center of Philadelphia

“This volume is a major contribution to our understanding of adoptive parenting. The book is thorough, full of helpful insights, case studies, and perspectives on the complicated dance involved for adoptive parents and their children. The portrait of adoptive parenting is both hopeful and realistic, and is framed with thoughtful attention to what we actually know from careful research. This book should be a helpful guide and resource for both mental health professionals and adoptive parents.”

Sam Osherson, PhD, Professor of Psychology, Fielding Graduate University, Cambridge, MA

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Library of Congress Cataloging-in-Publication Data:

Working with adoptive parents : research, theory, and therapeutic interventions / edited by Virginia M. Brabender, April E. Fallon.

1 online resource.

Includes bibliographical references and index.

Description based on print version record and CIP data provided by publisher; resource not viewed.

ISBN 978-1-118-41891-8 (ebook) — ISBN 978-1-118-41615-0 (ebook)

ISBN 978-1-118-61169-2 (ebook) — ISBN 978-1-118-10912-0 (pbk. : alk. paper)

1. Adoptive parents. 2. Parenting. 3. Parent and child. I. Brabender, Virginia II. Fallon, April.

HV875

362.734—dc23

2013000371

Virginia dedicates the book to two of her favorite adoptive parents, John and Rebecca Brabender, and to a very loving foster mother, Dona Aida Barrientos.

April dedicates the book to Hafeez and Theo Shaikh, whose generosity were instrumental in our adoptive process.

Foreword

Adoption, a gift to humanity, is the rescuing of humans, most commonly very young ones, who would otherwise be destined to a state of being unwanted or at risk in their environment unable to provide the basics needed for health and self-fulfillment. The complexity of adoption, its challenges, its rewards, and its heartbreaks, needs more attention than mental health has given to it to date. Those among us who have been drawn to adoption must record our findings, thereby opening them to further exploration, study, and dissemination among mental health professionals. In addition, and perhaps of greater importance, putting forward what we mental health professionals learn about the subject is a service that for many can and may be enormously helpful–for both other professionals who deal with the issue of adoption (such as pediatricians or those in the legal system) and the public at large, with its many adoptive parents, and I would add its adopted no-longer kids, as well as those who willingly or not give up their child for adoption. This book makes a significant contribution to both a greater understanding of adoption and its complex dynamic constellations as well as to serving those who are or come across adoption families, many of whom count on us adoption-informed mental health professionals to clarify and facilitate the challenges they face.

Multiple real-life characters play their part: the family of adoption, including especially the adoptive parent(s), the adopted child, and the birth parents, and the surround of each of these real-life characters.

The need to progressively learn as much as our clinical experiences with adoption constellations afford us has become increasingly recognized as we see the specific dynamics that adoption produces and as more and more adoptions seem to be taking place. Foremost, an unhappy percentage of women are unable to conceive; their experience of it is laden with pain—and more. Then, more teenagers than we like to think conceive due to compelling intrapsychic and external pressures, carelessness, or even against their will; for them, being pregnant causes them painful embarrassment, and giving up their infant can cause them great distress, both tending to lead to much uncertainty about what they should do, much self-doubt and internal conflict that may last a lifetime. In addition, as our world has evolved, lengthy education, the women’s liberation movement, and the march toward human rights progresses, given the added years needed by many to achieve yearned for goals of self-development and life-work, resulting in increasing numbers of women delaying their procreation plans. As mental health professionals have witnessed in and outside of the clinical situation, some among us believe that such delay has often led to failure in the ability to conceive among many an accomplished woman, now a professional who decides the time has come to have a child. Such failure to conceive, like with those who have tried and failed to conceive in their twenties, brings with it reactions ranging from anxiety and depression to distress and heartbreak. But like their young cohorts, for the now-professionals, whatever their field, commonly after years of trying, the self-disappointment, the shame, and the guilt experienced by many, the self-blame experienced by the failure to conceive gets slowly worked through and after debates between many a couple for or against the question, adoption is considered. The idea of adoption is met with a wide range of reactivities from trepidation and uncertainty to dedicated pursuit and hopefulness.

The decision to adopt brings with it a number of questions: How to proceed? What options do we have? Which channels to follow? From where? What age? A child in what kind of circumstance: A teenage mother’s newborn? A child in physical distress? A traumatized, abused child? Often, all this without, except in general terms, knowing critical characteristics and conditions of the circumstances of the birth mother and her environment.

And that is only the beginning of their labors.

This thoughtfully conceived and illuminating volume takes us into some of the many areas of concern and factors at play once the adoption is set in motion. It is fortunate that, as is the case with most innovations, research, and study, we come to issues that interest us vigorously, determined in large measure by our own formative experiences. What we experience gives us direct insight. We gather our own reactions and meanings of it, we find the key factors in the experience that make us feel as we do, and when we add formal study, research, and thought-laden consideration to the entire experience, we come away with experience-based plus acquired knowledge that qualifies us with down-to-earth expertise. This then we can offer to others similarly impacted by life. Driven by their own experience as adoptive parents and their clinical work with adoption constellations, the editors and contributors to this volume have produced a volume with real-life value: They have put down what they have learned and conceptualized, and have molded it to make it available to the many who treat real-life adoption characters, as well as those living with adoption in the hope that they can be better informed and that the challenges they face can be made more clear and their efforts at coping with the experience optimized.

It is especially important for those among us who work with adoption constellations as well as for adoptive parents to know that adoptive parents can truly rescue a child (not just a young one) not only from continuing trauma and/or neglect, but also that they can in good measure bring about the lessening of the effects of their adopted child’s past trauma, indeed foster healing from it, and prevent adverse consequences that can otherwise burden them for a lifetime.

Henri Parens, MD

Professor of Psychiatry, Thomas Jefferson University;

Training and Supervising Analyst, Psychoanalytic Center of Philadelphia

Preface

Adoption touches many lives. Most obviously, it profoundly influences the adopted child. According to some estimates, 2% of children are adopted within the United States each year, and 2% to 4% of all families have an adopted child (Child Welfare League of America [CWLA], 2005). Yet, these statistics apply only to formal adoptions. Informal adoptions exist in the absence of any legal process or in absence of recognition by any regulatory group, and are by no means uncommon. Adoption engages the parents, birth parents, and adoptive parents, as well as siblings and extended family members. Participants in the adoption situation are a range of human service professionals: social workers, psychologists, and psychiatrists who both evaluate prospective adoptive parents and monitor the family postadoptively; teachers who may witness the adoptive child’s efforts to master particular elements of the adoptive experience; therapists who provide assistance to different members of the adoptive family; and physicians who treat any special medical problems of the adoptive child. Hence, any strides made to understand more fully, or help more completely, any member of the adoptive family is likely to have positive reverberations far beyond the initial targets of such efforts.

OUR OWN JOURNEY

We became interested in adoption in the context of our own experiences as adoptive parents. Virginia and her husband adopted a baby girl from Honduras (now almost 18 years old), and April and her husband adopted a 4-year-old girl from Pakistan (now 14 years old). Prospective adoptive parents tend to consult the adoption literature, even the professional literature, on what to expect and we were no exception. For both of our families, the wait until a child was assigned to us was painfully long. In Virginia’s case, it took 3 years, and for April, 2. We struggled with a great variety of uncertainties, such as for example, having the host country close its doors to adoption. During this period, we found our immersion in the literature to be helpful in enabling us to summon patience. The literature ranged from professional books on attachment theory to our adoption agencies’ newsletters featuring stories of adoptive families to adoption blog posts. This material enabled us to form accurate anticipations about what we were likely to encounter and experience once our child entered our family. Our grade-school-aged sons, both nonadopted children, did not have the advantage of that resource, but relied on us and our spouses—both human service professionals—to contain their yearnings to get to know their new sisters.

During this period of waiting, each of us realized that over our years of practice as therapists, we had treated a number of adoptive parents and adults who had been adopted. It hit us like that proverbial ton of bricks that had we taken advantage of this literature at the time we were seeing patients or supervising our students’ treatment of patients, our work would have been deeper and richer. Since we have been acquainted with this literature, we have found that the valuable insights we derived have played a key role in informing the treatment of adoptive parents. Furthermore, we now had our own direct experience on which to draw in understanding our clients. A kind of synergy developed among the three elements: our clinical experiences, our reading, and our personal involvement in adoption.

At the same time that in our personal lives we were becoming interested in adoption, in our professional lives we were writing a book on the therapist’s pregnancy (Fallon & Brabender, Awaiting the Therapist’s Baby: A Guide for Expectant Parent-Practitioners, 2003). As part of that book, we interviewed a small group of individuals who were therapists and adoptive parents. From that sample, we learned a great about the experiences of being an adoptive parent. For example, we learned firsthand that adoptive parents are often unsupported by the systems in which they function. Our interviewees told us that their families questioned them about the decision to adopt far more than they would ever have felt entitled to do in regard to the decision to have a biological child (“Why would you want to have someone else’s baby?”). To learn more about adoptive families, but in particular, adoptive parents, we organized a group of mental health professionals and students from our two doctoral programs. Over the past 8 years, this group has collected data on adoptive and foster families, some of which is cited in the chapters of this book.

THE IMPORTANCE OF THE SUBJECT MATTER

Our work in this area has led us to believe that to achieve a complete understanding of adoption, the perspectives of all of the members of the kinship network but particularly the adoptive triad—the birth parents, the adoptive parents, and the child—must be taken into account. The adoption literature has addressed some aspects of the adoption situation intensively, such as the comparisons of the outcomes of adopted versus nonadopted children (Palacios & Sanchez-Sandoval, 2005). Yet, much remains to be done in achieving a comprehensive understanding of the viewpoints and psychologies of each of the major stakeholders. In many textbooks on adoption, often a chapter will be devoted to each of the members of the adoptive triad. A single chapter can provide the big picture, but it cannot offer an in-depth treatment of the distinctive needs, thoughts, feelings, impulses, fantasies, and conflicts that each of these triad members experiences through the stages of adoption and beyond. We believe that each member of the triad merits his or her own concentrated focus, but never to the neglect of a consideration of the other members. This volume seeks to contribute to the construction of a comprehensive picture of the adoption triad through a thoroughgoing exploration of the experiences and developmental processes of the adoptive parent.

The Influence of the Parent on the Child

An effort to illumine the behavior and internal life of the adoptive parent is important for three broad reasons. First, the parent has a crucial influence on the development of his or her child. Although this view may seem self-evident, it cannot be legitimately and fully accepted without empirical support. Furthermore, in some instances early trauma may be so great that the question of whether the best subsequent parenting could make a difference to the child is a reasonable one. In the past decade or so, researchers have demonstrated the importance of the quality of adoptive parenting in the well-being of the child.

For example, Simmel (2007) examined pre-adoptive risk factors and postadoption factors in the behavioral outcomes of adopted children in the child welfare system. In all, 293 families were studied. Simmel found that the parents’ self-perceived readiness was a more powerful factor in mediating short-term and long-term outcomes than most of the pre-adoption risk factors such as prenatal drug or nicotine exposure. In another study of children who were adopted at an older age, children’s adjustment levels were more affected by parental perceptions (for example, the capacity to see strengths in the child that others might ignore) than by child pre-adoptive behaviors (Clark, Thigpen, & Yates, 2006). Similarly, Smith-McKeever (2005) in a study of 83 African American adoptive families found that the child’s adjustment is more affected by the facets of the parent-child relationship (for example, how often the parent thinks of the child when separated) than pre-adoptive aspects of either the parent or the child. This trio of studies represents a small sample of the research showing the importance of the adoptive parent in the life of the adopted child. Kriebel and Wentzel (2011) found that highly responsive parenting can counter significant factors such as a pre-adoptive history of maltreatment in predicting adjustment in adopted children.

The Adoptive Parent’s Relational Context

The adoptive parent affects other individuals besides his or her child. Certainly, the adoptive parents’ happiness or misery influences the psychological status of all those close to him or her—spouses, other children, parents. What might be less obvious is that the well-being of the adoptive parents can also can bear on the quality of the other important member of the adoption triad, the birth parent. A variety of factors shape the adoptive parent’s stance toward the birth parent. One factor is the adoptive parent’s sense of security in his or her parental role. To the extent that the parent feels insecure or vulnerable or lacks a sense of entitlement to embrace fully the parental role, he or she is likely to view any interest in or contact between the adoptive child and his or her birth parent as a threat rather than a potentially enriching tie for all parties.

The Well-Being of the Adoptive Parent

A third reason is that the adoptive parent is a human being with his or her own psychological needs, a person entitled to the achievement and sustenance of a sense of well-being. Although adoptive parents are likely to have the range of problems that afflict all human beings, related to adoption are a particular set of problems. In contemporary society, many couples pursue adoption as an alternate means of building a family subsequent to difficulties with fertility. For some, a definitive diagnosis of infertility precedes their embarking on a course toward adoption. Fertility challenges and infertility are states known to induce a range of painful reactions and even psychological problems (Fassino, Pierò, Boggio, Piccioni, & Garzaro, 2002). Individuals may struggle with the psychological effects of infertility at the same time that they are considering adoption as a possible route to creating a family. In fact, for many, reactions associated with the loss of the dream of having a biological child continue to occur during the various stages of adoption and beyond (Bonovitz, 2006). As the adopted child develops, problems arise that evoke a range of internal reactions and behaviors in the adoptive parent. These reactions are often intensified by a social context that continues to see blood relations as pre-eminent, thereby attaching stigma to adoption (Carp, 2002). All of the aforementioned factors can affect the adjustment and life satisfaction of the adoptive parent.

Although in this book we talk about some of the challenges adoptive parents face, several points must be made in this regard. First, despite whatever difficulties surface, the pleasures and gratifications of adopting a child are enormous. Speaking as adoptive parents, we can say that having made the decision to bring a child into our families via adoption has been among the best in our lives. We simply cannot imagine our lives without our cherished daughters. From our professional and personal travels, we know that most other adoptive parents feel as positively as we do. Second, in describing the issues faced by adoptive families, we are not assuming that somehow such issues are greater in number or severity than other types of families. We do believe that within adoptive families, common challenges exist so that a family currently struggling with a problem may use strategies others have developed. Third, in identifying adoptive parents as having particular difficulties, we are not viewing the problems as residing within the adoptive parent. Rather, like many other writers in this area, we hold that the circumstances faced by the adoptive parent are inherently challenging. The adoptive parent’s particular psychological issues may intensify problems that erupt in the parenting of any child. Yet, the evidence suggests that adoptive parents are no more likely to have psychological difficulties than parents in other family structures. Moreover, adoptive parents appear to have a host of strengths that they bring to caregiving, and some of these we discuss in the first chapter.

INTENDED AUDIENCE OF THIS BOOK

Relative to the population at large, adoptive parents tend to use mental health resources when problems arise. The inclination to use available supports is one of the strengths adoptive parents have. Yet, do they get the help that they need? The answer to this question is a qualified “only sometimes.” As Pertman (2011) noted, at some point every adoptive family needs postadoption counseling. Only within the child welfare system are postadoption services consistently supported and even there, coverage falls far short of needs. In pre-adoption counseling, which also is under-supported, prospective parents are often not given the necessary education on what might signal the need for treatment. Hence, even though adoptive parents do seek treatment, they may not always know when treatment or consultation for one or more members of the family might be helpful.

Another significant obstacle to adoptive parents’ obtaining effective assistance is the serious lack of professionals who can competently address adoption issues. Certainly, an adoption specialist, a professional whose training and experience emphasize adoption, could treat such problems effectively (Child Welfare Information Gateway, 2006). Yet, for many reasons, adoptive parents may not seek the services of an adoption specialist in pursuing solutions to problems. The number of adoption specialists simply is not large enough to accommodate the needs of adoptive parents. In particular geographic areas, few or no adoption specialists may be present. Adoptive parents may pursue help for a problem that they believe is not related to adoption, but actually is. Adoptive parents may have an existing relationship with a mental health professional, and feel comfortable seeking help from that person. For example, a woman may have begun treatment with a therapist at the point when she was trying to cope with possible infertility. Now that she is experiencing some concerns in the context of parenting her adoptive child, her first instinct is to return to that trusted therapist.

The problem that we see is the lack of knowledge that the general mental health practitioner is likely to have in relation to adoption. Few graduate programs provide training in adoption, even as part of an elective curriculum. Furthermore, in the absence of training, this practitioner is likely to be vulnerable to some of the biases of the culture in relation to adoption. These biases are many, and this book identifies a good number of them. One bias is that adoption is a second-best way of building a family. Another bias is that adopted children have irremediable problems. Still another bias, which logically conflicts with the prior one, is that when adoptive children are having difficulties, it’s the fault of the parents. Those therapists who take any of these unrecognized prejudices into their work with the client may not merely fail to help him or her, but may exacerbate that individual’s difficulties. In Chapter 1, we illustrate how these therapist/societal prejudices may play out in treatment.

Our primary intended audience, then, is the generalist mental health practitioner. We believe that by a greater exposure to the array of issues with which adoptive parents grapple, the practitioner will be able to work with those parents more fruitfully. Part of competence involves recognizing its limits. An immersion in this material can help the generalist mental health practitioner to recognize that in some instances, securing the services of an adoption specialist is crucial. Finally, we would also like to believe that the book would stimulate interest in adoption and inspire the reader to delve into writings concerning the other members of the triad. We also expect that adoption specialists and child welfare workers will derive benefit from this book. We have synthesized fairly new research in the area of the adoptive parent (ours and others) and we believe that it is useful for professionals working in this area.

A secondary audience is adoptive parents themselves whom we know through our own research to be a highly literate group and who make frequent forays into the professional literature. For example, adoptive parents frequently read books on attachment written for a professional audience. We believe that prospective adoptive parents could be assisted in forming accurate expectations about their likely experiences, and that by doing so, their ability to adjust to the changing circumstances of adoption will be enhanced. One repeated finding in the literature is that correct parental anticipations contribute to the adjustment of all members of the adoptive family.

ORGANIZATION OF THE BOOK

In organizing the chapters of this book, we as editors work from the premise that no professional can make a helpful intervention in the absence of understanding. In consonance with this view, our next five chapters offer the reader the knowledge base to understand the adoptive parent fully. Chapter 1 looks at the literature to synthesize what we know about adoptive parents. It also offers a thumbnail history of adoption with an emphasis on societal changes in perceptions of the adoptive parent and his or her rights and responsibilities. The history leads to the current situation, which is defined by a set of controversies, the resolution of which will have great importance for many specific aspects of adoption such as who can adopt and access to information by members of the adoptive triad (adoptive parents, birth parents, and adopted child).

Chapters 2 and 3 respectively cover the theory and research related to adoption and the relationship between parent and child. We hope to convince our reader that each of the psychoanalytic theories covered provides a kind prism through which new facets of adoption can be illuminated. Although research is being done on many fronts, we home in most especially on the research in the area of attachment because it has such relevance for parent-child adjustment. Chapter 4 introduces the reader to the adoptive mother and her changing psychological states as she moves through the stages of preparenting and parenting. Chapter 5 focuses on the adoptive father, a topic far less covered in the literature. Both of these chapters feature some of our qualitative work.

The next seven chapters provide a more practical focus. Chapter 6 focuses on the amazing variability among and within adoptive families, particularly on those dimensions that reflect core elements of individuals’ identities. We attempt to give parents assistance in responding not merely constructively, but joyfully, to the differences within the family, such as differences in race between parent and child. Chapter 7 provides critically important information to the many families of adoptive children who have special needs, and their therapists. Readers within these families will, we believe, identify with the case material presented. They will also see that fostering connections with the broader special needs community—adoptive and nonadoptive—may be helpful.

The next two chapters form a couplet: Together, they cover the years of active parenting. Two contributors who have spent their professional lives working with families within the child welfare system wrote Chapter 8 on parenting the young child. They talk about the different stages of development and how these require a different pattern of response from the adoptive parent. They assist the therapist in seeing the kinds of supports parents need as they react to their child’s changing experiences and behaviors. For example, at some points the parent may feel that the child is rejecting him or her and be inclined to recoil. Our authors talk about the obstacle this parental behavior creates in the parent’s goal for an attachment to be formed between child and parent. Chapter 9 finds the adoptive child in adolescence and offers the adoptive parent wise counsel on how to assist the teenager through the developmental struggles of identity formation and separation, tasks that are somewhat different for the adoptive child.

Chapter 10 provides a framework for therapists to conceptualize their work with adoptive parents and recognizes that while many of the developmental tasks faced by both child and adult are universal, in adoptive families these tasks have unique facets. Chapter 11 recognizes that adoptive parents are called on to serve a range of roles on behalf of their own adopted child, and all adopted children. The chapter discusses the common situations that signal the need for the parent to engage in advocacy on the part of his or her child, and discusses some of the obstacles that the parent may have in successfully filling that role. This chapter is relevant to therapists in that it helps therapists to see that what may appear to the therapist as sensitivity is often a response justified by subtle biases in others, reflecting societal values, that parents discern.

Chapter 12 highlights some of the broad themes in the book. One section of this chapter looks at practice through a developmental lens by following an adoptive couple through the phase of contemplating adoption to that of having grown adopted children. This section shows the range of modalities and types of interventions that can assist the adoptive parent in achieving well-being and a high level of parental functioning. Another section addresses education. It recognizes that no one book—even ours—can do it all, and identifies the areas that therapists may wish to pursue to deepen their knowledge in this area. We encourage our readers to advocate for more adequate graduate and postgraduate training in the area of adoption. Finally, because we believe that some of the readers of our book are likely to be researchers as well as clinicians, important research directions vis-à-vis the adoptive parent are identified. Research on adoptive families is important not only to provide information that will help adoptive families but also to add to our understanding of such important processes as attachment and identity construction.

Acknowledgments

We have many people to thank. Our daughters add immeasurably to our lives and our gratitude to them is boundless for the continual inspiration they provide. We thank our spouses for being such wonderful fathers to our daughters and for sharing our view of the importance of the topic of this book. We recognize our sons who enthusiastically reached beyond their normal adolescent egocentrism to embrace the complexities and inconveniences that the adoptive process brought to family life. We thank the publishing staff at John Wiley & Sons, particularly Rachel Livsey, for her confidence in us and for her expert assistance throughout all of the stages of this project. We also want to express our gratitude to Amanda Orenstein for keeping us organized and on-task with such competence and good humor, and to Thomas Caruso for his expert management of the manuscript in the later phase of development. We also would like to thank the following colleagues who either reviewed the proposal or first draft of this book and provided valuable feedback: Naomi Chedd, licensed mental health counselor and educational consultant, Lexington, MA; Juliet Fortino, licensed professional counselor and registered play therapist, Tucson, Arizona; and Lawrence C. Rubin, PhD, professor, St. Thomas University. We acknowledge with appreciation the grant from Widener University that funded parts of this project. We are also appreciative of Henri Parens, who agreed to write the foreword for this volume. We are grateful for the research assistance of Jennette Von Bargen, Meredith Carter, Robert Eberwein, and Antoneal Swaby, and the secretarial assistance of Matthew Summerford. Above all, we thank the many adoptive parents who have been willing to share their stories with us, and have allowed us to share these stories with you, the reader.

About the Editors

Virginia M. Brabender, PhD, ABPP (Cl) is a professor at Widener University’s Institute for Graduate Clinical Psychology, where she served as director for 13 years. She has authored six books, including Introduction to Group Therapy. Five books are co-authored with April Fallon (see below). Virginia Brabender is a fellow of Divisions 12 and 49 of the American Psychological Association. Dr. Brabender is co-founder of the Widener-Fielding Universities Adoption Research Collective. Dr. Brabender has authored many articles including those concerning the development of the mental health professional. She serves on various editorial boards. She is a mother of two children, one of whom was adopted 17 years ago from Honduras.

April E. Fallon, PhD received her degrees at Allegheny College and the University of Pennsylvania. She is professor at Fielding Graduate University and associate clinical professor at Drexel College of Medicine. Dr. Fallon is co-founder of the Widener-Fielding Universities Adoption Research Collective. She has received numerous awards for her teaching of psychiatric medical residents and was most recently awarded the Psychiatric Educator 2012 from Philadelphia Psychiatric Society. She has researched and written on the development of emotion in both children and adults and bonding and adoption. She is the mother of two children, one of whom was adopted 10 years ago.

Other texts co-authored by Brabender and Fallon include: Models of Inpatient Group Psychotherapy; Awaiting the Therapist’s Baby: A Guide for Expectant Parent-Practitioners; Essentials of Group Therapy, and Group Development in Practice: Guidance for Clinicians and Researchers on Stages and Dynamics of Change.

Contributors

Bret A. Boyer, PhD

Institute for Graduate Clinical Psychology, Widener University

Virginia M. Brabender, PhD

Institute for Graduate Clinical Psychology, Widener University

Meridith C. Carter, MA

Institute for Graduate Clinical Psychology, Widener University

April E. Fallon, PhD

Fielding Graduate University

Drexel College of Medicine

Theodore J. Fallon Jr., MD, MPH

Chair, Child Psychoanalytic Program, Psychoanalytic Center of Philadelphia

Drexel College of Medicine

Elaine Frank, MSW

Co-Director of Parenting Services for Families & After Adoption, Philadelphia

Rama Rao Gogineni, MD

Cooper Medical School at Rowan University

Barbara L. Goldsmith, PsyD

Institute for Graduate Clinical Psychology, Widener University

S. Ileana Lindstrom, MDiv, MA

School of Psychology

Fielding Graduate University

Sanjay R. Nath, PhD

Institute for Graduate Clinical Psychology, Widener University

Alicia Padovano-Janik, PsyD, MEd

Prince William Family Counseling, Virginia

Henri Parens, MD

Professor of Psychiatry (Volunteer Faculty), Thomas Jefferson University Training and Supervising Analyst (Adult and Child), Psychoanalytic Center of Philadelphia; Director of Parenting for Emotional Growth.

Patricia G. Ramsey, EdD

Professor of Psychology and Education, Mount Holyoke College

Denise Rowe, BA

Co-Director of Parenting Services for Families & After Adoption, Philadelphia

Philip A. Rutter, PhD, LP

Human Sexuality Studies, Widener University

Hal S. Shorey, PhD

Institute for Graduate Clinical Psychology, Widener University

Amanda B. Swartz, PsyD

Counseling, Testing and Mental Health Center, Texas Christian University

Sonia Voynow, LCSW

Private Practice, Narberth, PA

Founder of Surviving and Thriving

Joseph D. White, PhD, LP

Private Practice, Austin, Texas

Antoinette Whitmore, AB, MEd

Consultant, Boston, MA

Mary E. Winzinger, PhD, LPC

Private Practice, Hackettstown, New Jersey

CHAPTER 1

SETTING THE STAGE

The Adoptive Parent in Context

Virginia M. Brabender and April E. Fallon

We begin our odyssey into the psychological life of adoptive parents by telling the tale of three couples.

Raina and Liam, parents of a 3-year-old daughter, had been trying for 2 years to conceive their second child. They had gone through some fertility testing and treatment. However, when further testing revealed that Raina’s husband had physical issues that made additional fertility intervention unlikely to be successful, the couple began to contemplate adoption. From their meetings with a counselor at an adoption agency, they formed a plan to adopt internationally. After an 18-month wait, they adopted a daughter from Ecuador, Lily, who entered their home when she was 13 months old.

Soledad and Roger, who had 7-year-old twin sons, had been foster parents for 4 years. The children who previously had been placed with them were preteens and teens who had stayed in the home 1 to 2 years. However, when baby Rose was placed with the couple, they discovered an ever-increasing desire for her to join their family permanently. When it became clear that the child would be unable to return to the home of the birth mother, they began to discuss with one another the potential of adoption.

Doris and Basil had spent 5 years trying to conceive a child. They had been told that the likelihood of pregnancy occurring was low. They decided to attempt domestic adoption because they desired both a newborn and a relationship with the birth mother. Doris herself had been adopted and after months of a protracted search in her early adulthood, achieved contact with her birth mother. After 8 months of having spoken with different birth mothers, a match was made and Doris and Basil were present at the birth of their baby boy.

These stories capture only some of the variability among adoptive parents and the circumstances of adoption. In these three cases, we see variation in how the child was identified, the conditions preceding the adoption, the amount of contact with the child and birth mother before the adoption. These differences create varied psychological experiences among parents. The longer waiting period for Raina and Liam may have been associated with a higher anxiety level. Soledad and Roger’s intimate knowledge of Rose may have reduced particular fears about their future child’s psychological and physical health. Doris and Basil’s waiting experience may have been laced with the fear that no birth mother would find them good enough for her child.

Yet, were these couples to convene as a group, many commonalities might they find. For example, despite the variation in their circumstances, they might identify some common ground in their motivations for adoption. They may share a worry that the child’s initial experience of loss may affect self-esteem, identity, and capacity for attachment. They might discover that all of them experienced concern about how their children would negotiate the interpersonal dynamics at school when peers, teachers, or both assumed that all children come from a traditional family. All six may have curiosity about aspects of their child’s background, although each type of parent may have access to a different fund of information. In the international adoption, the parents may have had no information about the child’s birth parents or early life, except perhaps to know that the child came from a particular orphanage. The foster parents may know the birth parents and a great deal about the child’s years prior to entering his or her home. In the domestic adoption, the adoptive parents may have been with the birth mother at the time of the birth and may have personal acquaintance with many of their child’s blood relatives such as the birth grandparents.

Both the commonalities and the differences among adoptive parents are critical for the therapist or other human service professional working with the family to grasp. Through sensitivity to differences and the unique characteristics of any adoptive family’s situation, the therapist can achieve a high level of empathy for what that family is experiencing. Without a conveyance of accurate empathy, nothing else that the therapist does is likely to hit the mark. The awareness of commonalities is also crucial because it enables the therapist to anticipate what the family is likely to need. For example, all of these couples will require a great deal of information about many aspects of the adoption prior to bringing the child into the family. This need is served by pre-adoption counseling. Once the child enters the family, and as the child moves through the developmental stages, myriad challenges will arise, some large and some small. To ensure that the challenges are met in a way that supports the psychological and physical health of all family members, postadoption counseling is also critical. Mental health professionals working with members of the adoption family, if not able to provide such postadoption counseling themselves, need to know how to help families access it. This book is intended to help the mental health professional work effectively with adoptive parents. We help therapists understand the adoptive parent, and from this understanding, advise and treat him or her. This book also may be of interest to adoptive parents themselves. Finally, we hope that students who may in the future work with adoptive parents read it.

The importance of knowing the adoptive parent well to provide competent service to him or her necessitates that we take a closer look at the characteristics of adoptive parents in relation to one another—the similarities and differences among them and the population at large.

CHARACTERISTICS OF ADOPTIVE PARENTS

To appreciate the diversity among adoptive parents and their circumstances, one must recognize the different types of adoptions that have informed their family’s lives. According to the 2007 National Survey of Adoptive Parents, inter-country adoptions account for approximately 25% of all adoptions; domestic, private adoptions 38%; and foster care adoptions, 37% (Vandivere, Malm, & Radel, 2009). Among domestic private adoptions, about 40% are by stepfathers, stepmothers,1 or other relatives. A domestic adoption by a biological relative is a kinship adoption and it can be formal or informal. The biological parent may even live in the home but not function in a parental capacity (Pierce, 1999c). This type of adoption has been increasing as the number of non-relative adoptions decline. Foster children are most commonly adopted by foster parents (U.S. Department of Health and Human Services, 2009). A relatively new form of adoption is the adoption of an embryo, and the literature base (e.g., Finger et al., 2012; MacCallum, Golombok, & Brinsden, 2007) for these families is only recently emerging. As later chapters reveal, each type of adoption has its own benefits and difficulties. In this respect, adoptive parents are similar to other types of nontraditional families. Although adoptive families predominantly consist of a mother and father, single parent adoptions are becoming increasingly coming (Haslanger & Witt, 2005), a trend reflective of the increasing societal separation of marriage and parenthood (Smock & Greenland, 2010).

Psychological Characteristics

Adoption is a lifelong process that can bring immeasurable joy to parents. Yet, the precursor to adoption is often loss. That is, adoptive parents frequently embark on adoption following a long and unsuccessful effort to have a biological child. The road to consummating an adoption can be perilous. Long waits, reversals of decisions by birth parents, and political upheavals in countries in which adoption applications are made are just a few examples of potential frustrations. Many adoptive children entering the adoptive family have a range of physical and psychological problems that become evident over time and affect the child’s adjustment at different developmental stages. Even in the absence of such problems, adoptive parents face the challenge of helping their children build healthy self-esteem, a task that can be more difficult in a society that values biological ties, and an identity that is inclusive of all aspects of the child’s background and denying of none. Those parents who embrace openness with birth parents, while reaping potential rewards for their child and themselves, take on an added layer of complexity. Some parents adopt children with special needs—children who have particular physical problems, autism, learning disabilities, or trauma—and their special needs require great parental sensitivity and responsiveness.

Despite this list of potential stressors, according to a recent survey, 86% of adopted parents reported that their relationship with their children exceeded or met their expectations (U.S. Department of Health and Human Services, 2011). Malm and Welti (2010) found that parents who adopted because of infertility reported finding happiness in adoption. Adoptive parents as a group have considerable resources for coping with whatever problems and challenges the adoption of their child might present. These resources are important for the mental health professional working with the parents to recognize so that he or she can mobilize them. Adoptive couples tend to show a high level of relational stability (Rijk, Hoksbergen, ter Laak, van Dijkum, & Robbroeckx, 2006). Although married couples tend to report a decrease in marital satisfaction on the entrance of a child into the family, the decrease is less for adoptive than biological parents (Ceballo, Lansford, Abbey, & Stewart, 2004). In general, adoptive parents show a high level of marital satisfaction (Leve, Scaramella, & Fagot, 2001). One study found that adoptive parents reported more positive expectations and experienced greater satisfaction on becoming parents than biological parents (Levy-Shiff, Goldschmidt, & Har-Even, 1991). Adoptive parents appear to have a lower level of psychopathology than the general population. They have lower scores on measures of anxiety and depression and higher on measures of positive affect than married women without children or biological mothers (Gjerdingen & Froberg, 1991). Adoptive mothers report significantly fewer physical problems than these same two comparison groups (Gjerdingen & Froberg, 1991). As parents, adoptive mothers report fewer parenting doubts than nonadoptive mothers (Cohen, Coyne, & Duvall, 1996).

Part of the reason may be that adoptive parents tend to be older than biological parents and thereby have more experience in coping with a range of stressors. They also tend to be better educated and more affluent. As one manifestation of the latter, relative to biological parents, adoptive parents are more likely to own their own homes (Teachman & Tedrow, 2008). A word of caution about these findings is in order. Studies to date are limited by small samples, lack of racial/cultural diversity among parents, and a focus on the mother only (McKay, Ross, & Goldberg, 2010). Also, the type of adoption has a bearing on parental characteristics. The subgroups outlined at the beginning of this chapter (foster, intercountry, private domestic) vary in terms of education and income. For example, those who adopt from foster care tend to have lower incomes than parents adopting privately, whether that adoption is domestic or international. Often, parents who adopted from foster care are more similar to birth parents than those who adopt privately (Gailey, 2010).

Motivation for Adopting

Parents’ motivations to adopt a child are varied, but, particularly in private adoptions, compensation for the inability to have a biological child is primary (Goldberg, Downing, & Richardson, 2009). Within the public system, altruism is the primary motive for foster care and adoption from foster care, and the desire to expand the family is second (Cole, 2005; Office of the Assistant Secretary for Planning and Evaluation [ASPE], 2011). Coping with infertility among individuals who adopt their foster children is only a tertiary reason (ASPE, 2011). Yet, to acknowledge fully the different driving forces in a parent’s decision to adopt, one must go back to the motives that any human being has in wanting to have a child (Langridge, Sheeran, & Connolly, 2005). These include, but are by no means limited to, wanting to be in the parental role, to create a family, to experience the pleasure of being with children, and to enjoy relational comforts in old age. Specific subpopulations of adoptive parents have these motives and others that reflect the values and emphases of that group. For example, first-time adoptive gay males identified their cardinal motive as being that of raising tolerant human beings (Goldberg, Downing, & Moyer, 2012). Parents in a kinship adoption are motivated often by the desire to keep a child within his or her broader biological family or out of the child welfare system (Child Welfare League of America, 2007). However, like other subgroups of adoptive parents, sometimes parents adopting their kin are motivated to do so because of infertility problems.

According to Malm and Welti (2010), adoptive parents generally select their particular type of adoption after investigating various options. Prospective parents select international adoption because they see domestic adoption as too difficult. Adoption within the foster care system is often chosen because it is a more affordable option. Zhang and Lee (2010) observed that parents adopting internationally see children adopted from other countries as presenting interesting challenges. Children available for adoption nationally are seen as merely having problems. Their study underscores the social construction element of adoption, that is, the shaping of behavior based on how a phenomenon is framed. By helping prospective parents to recognize the diversity of narratives available, therapists can facilitate them to make the best possible decision for their particular circumstance in the type of adoption they pursue.

Use of Treatment

One noteworthy finding is that adoptive parents seek psychological interventions for their children much more often than their biological parent counterparts (Howard, Smith, & Ryan, 2004). They seem to do so both because adopted children are more likely to present psychological difficulties but also because adopted parents seem to have a greater receptivity to psychological interventions. That is, they tend to be more comfortable with the idea of therapy and other mental health services. The unfortunate reality is that often the therapists whom they see are not familiar with issues related to adoption and how parents and children in this group may have differences from those biologically intact families. As we noted in our introduction, frequently parents when trying to obtain services for themselves (or their child) see multiple mental health service providers before they find someone who has the necessary knowledge base and skills to be truly helpful. In fact, it is precisely for this reason that the current text was written—to raise the level of knowledge of the mental health practitioner who provides psychological services to adoptive parents. In the next section, we see some of the problems adoptive parents may encounter as they pursue services through therapists lacking a background in adoption.

SERVING THE NEEDS OF ADOPTIVE PARENTS

Best practices in all mental health services demand that practitioners have mastered the accumulated knowledge from research and clinical practice for whatever problem or issue the client is seeking services. When mental health professionals are not adoption-knowledgeable, and yet provide services to adoptive parents, problems arise such as the following:

A prospective mother went to a psychologist for personality testing in conjunction with her adoption application. The assessor proceeded through the evaluation, at the end of which she asked the prospective mother her reasons for wanting to adopt. The mother explained that although she had three biological children, she wanted to adopt a child from a particular country for humanitarian reasons. Also, she indicated that she would love to have a fourth child. The assessor expressed the view that the mother could be taking on a great deal of trouble and should seriously consider the toll on other family members. She ended her comments saying that from her knowledge of adopted children “things didn’t tend to turn out well.”

This vignette calls to mind the truism “a little bit of knowledge can be a dangerous thing.” This psychologist’s comments designed to discourage the woman from adopting, were half-true, but half-false. Yes, adopted children do exhibit more problems than nonadopted children and these differences are due to the early history of the adopted child. However, what the assessor did not appear to know is that with the proper supports, and sometimes even in their absence, if particular protective factors are present, then parents and children do very well. This psychologist may have been competent to do an assessment, but she was not competent to do pre-adoption counseling. She went beyond the parameters of her role.

A second example concerns an issue of contact with the birth mother:

An adoptive mother, a single woman, had been seeing a therapist, a clinical social worker with a psychodynamic orientation, off and on for many years, even long before she contemplated adoption. The therapy covered a range of concerns including the mother’s relationship with her own mother, and the dissolution of her marriage. This adoptive mother’s daughter, Jill, was now 12 years old. The issue she was currently discussing in the therapy was the fact that the biological mother was lessening her contact with Jill, and it was painful to both adoptive mother and Jill. Jill had invited her to a number of school performances and the birth mother declined.

The therapist revealed that she had always been puzzled by the daughter’s capacity to have relationships with both biological and adoptive mothers, and she felt it could well be confusing to Jill. She said she believed that this development was positive despite the misery it caused because it would create greater clarity for Jill on who the authority figure is in her life. The mother was somewhat perplexed by the therapist’s comment because she did not believe that Jill was in any way confused about her adoptive mother’s distinctive role. The mother felt that the therapist failed to grasp that the lessened attention was a loss for both her and her daughter.

In this situation, the therapist uses her theoretical orientation as a guide to intervention without a full understanding of the phenomena at hand. She fails to appreciate the value that knowledge of and contact with birth parents can have in the lives of many adoptive children such as Jill, although certainly for some, contact is not indicated. In the absence of specific information about adoption, therapists naturally fall back on what they already know, cultural values or what theory dictates. Inevitably, circumstances will arise—such as those in the vignette—that demand more particular, adoption-related knowledge for an appropriate response.

Often clients will have developed a therapeutic relationship prior to their adoption of a child. Given the great importance of the therapeutic alliance, it is most reasonable that once a client forges a successful relationship with a therapist, he or she would want to continue with that therapist. We are not recommending that adoptive parents in a knee-jerk fashion abandon therapeutic relationships they already have formed. Rather we are encouraging that those therapists whose clients experience that life-altering event of adoption take the necessary steps to educate themselves about adoption. In some situations, however, the problems that are tied to adoption may be so complex and severe that they may necessitate calling on someone who specializes in adoption.

A third example concerns a circumstance in couple therapy:

A couple, a pair of adoptive parents, saw a couple therapist about conflicts they were experiencing about raising their three adopted sons, a sibling group from Haiti. The wife felt that the sons had no playmates who were adopted or who looked anything like them. The mother felt that as the children advanced in age, it was imperative that they had access to children whom they could perceive as like themselves. She suggested moving, or sending the children to a school that would provide a more diverse social landscape. Her husband thought that such changes were excessive. He pointed out that overall, the boys had done quite well: They earned good grades in school and had many friends. The mother argued that having friends who looked like them was vital to their development of a healthy sense of identity. The therapist attempted to assist the husband and wife in finding middle ground, for example, sending the boys to a camp that would accomplish the mother’s goals. Yet, the mother felt that the therapist had not heard her at all and was minimizing the issue she was raising.