We at the William James College INTERFACE Referral Service are keenly aware of the shortage of mental health providers of color and how racial inequities exist in medical and mental health care. The College’s Black Mental Health Academy, Center for Multicultural and Global Mental Health, and other programs and academic offerings are playing a critical role in reversing this trend. We invite you to read a statement from our Black Mental Health Graduate Academy Scholars, and to stand with us as allies to drive change and address systemic racism.

The Many Faces of Adoption: From Childhood into Adulthood

The Many Faces of Adoption: From Childhood into Adulthood


Adoption weaves itself through the different developmental stages from childhood into adulthood. Parents and/or professionals need to know whether a child is working through an age appropriate task or an adoption related one. In this article we will identify some of these adoption related tasks, what they look like, what behaviors might be seen, and why counseling might be needed. Awareness of the developmental process of adoption is a major reason why use of adoption sensitive therapists can be helpful to adoptive families.


The early years of pre-school are the start of a process of learning about adoption that will continue to develop over a lifetime. Children this age should not be bombarded with information as there is plenty of time for them to gradually understand who they are and where they came from. This is just the beginning. When pre-school age children see their friend’s mother pregnant, they first learn that they did not grow in their mother’s tummy. Pre-schoolers are confused about the meaning of adoption and therefore can easily distort information. They are concrete thinkers which makes it difficult for them to understand the abstract concept of adoption. At this age the child might become aware of obvious and noticeable physical differences within their families, such as in trans-racial adoptions. For example, in a trans-racial family, (such as a child of color with Caucasian parents), the child may ask “why do we have different skin colors?” The adoption sensitive parent may respond by referencing the child’s family of origin, ie, “the mommy in whose tummy you grew had beautiful brown skin just like yours.” This answers the question, and takes it a step further by helping the child build a positive self image relating to his culture and birth family. The earlier a family starts to integrate their child’s budding awareness of cultural, ethnic, and racial identity into their lives, the better.

Elementary School

Upon entering elementary school, children are old enough to begin to understand the difference between a birth family and adoptive family. As their identity is forming, it is important to communicate about their birth parents in a positive way - to set the stage for talking about an adoption plan that was made because they were cared about. As they go through their elementary school years, children who previously felt secure in their adoptive families begin to realize that being adopted also means loss. On some level, they may worry that they could also lose their adoptive parents. With this new level of understanding a child may go from security into turmoil, and mourn the loss of their birth families, a gradual and confusing process. An adoption therapist, especially one who uses creative arts and play, can often help children and their parents as they work through their grief.

From pre-school through elementary school (latency) age, acting out and challenging behaviors may appear in the form of tantrums, control struggles, withdrawal, anxious or clinging behavior, which may be related to the adoption experience. A loss of self esteem or confidence, feelings of inadequacy, guilt, shame, or even self blame may occur as children try to make sense out of their world. On some level they are trying to understand why they were “given up” for adoption - trying to figure out if there was something that they did, or didn’t do, to cause what they perceive as rejection or abandonment by their birth parents. Who are their birth parents anyway? Maybe they were “bad people”, or did something “bad.” A child may wonder “does this mean I am bad too? Is that why they didn’t want me?”

Even at these early years, children grieve the loss of their birth family, and this loss takes its form in a myriad of ways and shapes. The kinds of issues and behaviors one sees at this time are impacted by differences in the make-up of any part of the adoption triad (adoptive parent, birth parent and child). For example, the age at which the child was adopted, a cultural or ethnic difference, medical or mental health issues, or different learning styles, can complicate the issue further. Parents often benefit from support, information and help to become sensitive to the needs and feelings of their adopted children. They may need education or advice from an adoption professional on how to become more effective advocates for their children. 

A change in your child’s personality or behaviors may be a signal that the child is grappling with some of the above issues. An adoption sensitive therapist can help parents understand when these behaviors are “typical” to a stage of development, and when they may be a result of adoption experiences. Parents may also need support to understand and accept their own ambivalent feelings towards the behaviors of their children. Sometimes the help a child needs is best accomplished through providing counseling and support for parents, either individual or in groups that normalize the issues as happening in many adoptive families.


Children who have always known they were adopted often start to have different feelings as they become adolescents. Teens are now capable of having abstract thoughts, and understand that along with gain, they have loss in their life too. They wonder where they get their skills, abilities and general aptitudes from, and who they look like. Adolescents are involved in intensive self-reflection, and are often “super-sensitive” and aware of how others see them. A major task of adolescence is to become self confident and thus become independent, functioning adults.

Adolescence is a time that behavior is in transition, and not fixed. It is important to remember that what one sees today may be different tomorrow. It is the time of questioning everything about the world, their parents’ views, and developing their own. The adolescent may “try on” and choose different personas and seek different role models with whom to identify. They often express a reaction to loss by rebelling against parental standards and expectations. Teens may act out the behaviors they think reflect the values of their birth parents, as they test out different parts of themselves. This is a common way of trying to connect with their birth families, regardless of what is actually known about them. (What if they view the birth parent as promiscuous, or as poor, or as depressed- this may be a root of some risky behaviors). They also may not want to hurt their adoptive parents by asking too many questions, or alternatively, they may be angrily blaming them for the adoption and lashing out, while romanticizing their birth parents. And the behaviors that adolescents are sometimes drawn to involve danger and risk (such as drug and alcohol use/ abuse, self-harm, not doing school work, and fantasizing life with birth parents – perhaps even finding them and communicating via Facebook). This needs to be monitored and talked about.

There is often another layer of conflict in the adoptive family during adolescence that can be hard to differentiate from the usual adolescent conflicts. One may see rebellion over values and lifestyle choices. Parents and teens become angry and frustrated, and a split can occur, which can benefit from being addressed in a therapeutic relationship, sometimes most effective either individually or in family therapy or group or combination. It can also be helpful for teens and their parents to connect with others who are going through similar feelings, to feel less alone, and to have an understanding peer group as they explore these feelings in a safe environment. Open communication can smooth the process of growth. Again, an adoptive sensitive therapist can help parents distinguish between normal adolescent rebellion, how it looks with adoption and how integrate both identities.

In summary, adoption issues are reflected in all stages of life. Family dynamics are an important part of one’s good feelings and positive self-esteem. Communication, honesty and openness are just a few key ingredients to weaving the strong and healthy fabric of any individual’s life. We believe in fostering those values at every developmental stage.