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

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.

In another example, a child, upon seeing a pregnant woman, may raise the question: “Did I grow in your tummy.” Parents’ response: “No, in your first mommy’s tummy.” Child: “But I wish I grew in your tummy.” Response: “I see that makes you sad.” The point is that as the parent you are validating your child’s feeling and letting the child know that adoption is easily discussed in the family. This encourages open communication and dialogue. The pre-school years are an ideal time to build a relationship with a trusted resource before a need for help arises. This is not unlike a call to the pediatrician when a child is ill. A decision to seek professional guidance in a supportive safe place and to get answers and guidance on dealing with a child’s questions is creating a safety net for the future.

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. For example, they may want to help teachers understand that not all families were built in the same way, and that projects such as creating family trees, Mother’s Day cards, and birthday cards may bring up feelings for adopted children. A professional will know how to guide adoptive parents to ask the right questions and learn to see through the “adoption lens” when appropriate.

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.


As the adolescent grows into adulthood, feelings and questions about adoption still percolate. Leaving home can stimulate feelings, and sometimes memories, of other good-byes, for example, losing and leaving birth families, foster families, or orphanages. The quest of finding the answer to that age old question “who am I” may be of particular importance to some young adult adoptees. This quest may propel some to search and find their birth parent(s). This is particularly true if the adoptive parents have died or the relationship is not close. For others, they have differentiated enough from their peer group, that they now feel freed up to explore their native culture, something that was only a piece of information they had gotten from their adoptive parents. Reuniting with birth families is an emotionally charged experience. Often, the support of an adoption sensitive professional can help prepare them for the various possibilities of that reunion.

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.

Resource Organizations » Adoption

In Massachusetts

Adopt Us Kids


877-236-7831 - En español

Email: info@adoptuskids.org

AdoptUSKids is a project of the U.S. Children's Bureau operated through a cooperative agreement with the Adoption Exchange Association. The project launched in 2002 with a two-fold purpose: To raise public awareness about the need for foster and adoptive families; and to support States, Territories, and Tribes in their efforts to find families for children in foster care, particularly the most challenging to place including older youth, those who are part of a sibling groups that need to be placed together, and children and youth of color, and to assist with placements across county and state boundaries.

Adoption Community of NE, Inc.


Email: acone@rfkchildren.org

The Adoption Community of New England, Inc. (ACONE) is a non-profit organization founded in 1967 in Massachusetts as the Open Door Society. ACONE is committed to the right of every child to a safe and permanent home and to helping all persons touched by adoption achieve full and equal participation in society. ACONE is not a child placement service. It educates, supports, and advocates on behalf of all members of the adoption triad: birth parents, adoptive parents, and adopted persons. It assists members through all stages of their adoption-related experience by means of seminars, workshops, support groups, policy statements, legislative advocacy, and other measures. ACONE also works cooperatively with adoption professionals and agencies and presents one of the largest annual adoption conferences in the country to accomplish these goals.

Adoption Resources


781-227-3060 - Text

Email: info@adoptionresources.org

Adoption Resources offers a variety of programs to assist individuals and couples pursuing adoption. Adoption Resources is licensed in Massachusetts to provide domestic and international adoption services, as well as a wide range of post-adoption services. Adoption Resources works with prospective adoptive parents from diverse cultural, ethnic, and religious backgrounds, making certain that each adopted child is placed in an appropriate, permanent, and loving home.

Adoptions With Love, Inc.


617-777-0072 - Text

Email: info@awlonline.org

Adoptions with Love, Inc is a private non-profit, licensed domestic adoption agency that has been helping build families through adoption for nearly 25 years. Their mission is to provide prospective adoptive parents and birth parents with professional, sensitive and confidential services to facilitate successful placements that meet the individual needs of all members of the adoption triad. Their website also offers a range of resources for birth and adoptive families. 


If you are thinking about adoption, please consider the difference you can make in a child's life. You can find more information here. This site provides an overview of adoption services, how to become an adoptive or foster parent, as well as support services.

Massachusetts Adoption Research Exchange



Email: web@MAREinc.org

The Massachusetts Adoption Resource Exchange (MARE) was founded in 1957 to find "a permanent place to call home" for children and teens in foster care in Massachusetts, including sibling groups and children who are traditionally harder to place.  They do this by recruiting, educating, supporting and advocating for families throughout the adoption process. MARE was then, and is now, the bridge between the state's Department of Children & Families, private adoption agencies, and adults interested in adoption. They recruit, educate, support and advocate for families throughout the adoption process while targeting recruitment efforts to attract potential parents for specific waiting children.  In addition, they are the Commonwealth's central clearinghouse for adoption information and referral, and work to identify potential matches between children and families.

Massachusetts Society for the Prevention of Cruelty to Children (MSPCC)


MSPCC is dedicated to leadership in protecting and promoting the rights and well-being of children and families. To prevent child abuse, MSPCC focuses on the needs of both the child and the parent. MSPCC’s work focuses on preventing or mitigating the effects of Adverse Childhood Experiences (ACEs) including physical, sexual, and emotional abuse, neglect, household substance abuse, household mental illness, and domestic violence.  By promoting social and emotional learning and supports for children as well as tools to improve parents’ skills, MSPCC employs a two-generational approach to improve outcomes for both children and parents. MSPCC combined with Eliot Community Human Services in 2016 to further strengthen the agency’s services and better address the needs of children and families.  Services provided include pregnancy and parenting support, clinical mental health counseling and care coordination, adoptive and foster parent support, and advocacy. The website allows guardians and/or providers to place referrals for clinical services directly as well.

Outside Massachusetts

Adoption Connection


Email: info@adoptionconnection.org

Adoption Connection, a non-profit, licensed adoption agency, is a non-sectarian program affiliated with Jewish Family and Children's Services (JFCS) of San Francisco, the Peninsula, Marin, and Sonoma Counties. Adoption Connection works with pregnant women and their families (often called birth parents) anywhere in the United States. They make sure all parties involved have a seamless adoption process from start to finish. While it can be a challenging journey at times, their seasoned professionals provide practical advice  and support – both on the birth, and adoptive parent side, of the equation.  



1-888-493-0092 (Talkline available M-Fri 10-1am, Sa-Su 10-6 EST)

(510) 817-0781 (Office)

All-Options (formerly Backline) promotes unconditional and judgment-free support for people in their decisions, feelings and experiences with pregnancy, parenting, adoption and abortion.  Their Talkline offers peer counseling and support to people throughout the United States and Canada. They are the only national talkline that welcomes calls at any point during or after pregnancy, whether callers are looking for options counseling, support before or after abortion, or a chance to talk about parenting, pregnancy loss, adoption, or infertility.


Center for Adoption Support and Education (CASE)


Email: caseadopt@adoptionsupport.org

Providing a safe place for adoptees of all ages to share their thoughts and feelings about adoption, C.A.S.E. is a private, non-profit adoptive family support center. Its programs focus on helping children from a variety of foster care and adoptive backgrounds to receive understanding and support which will enable them to grow into successful, productive adults.

Child Welfare Information Gateway


Email: info@childwelfare.gov

Child Welfare Information Gateway promotes the safety, permanency, and well-being of children, youth, and families by connecting child welfare, adoption, and related professionals as well as the public to information, resources, and tools covering topics on child welfare, child abuse and neglect, out-of-home care, adoption, and more.

National Council for Adoption


Email: ncfa@adoptioncouncil.org

Founded in 1980, the National Council for Adoption (NCFA) is an adoption advocacy nonprofit that promotes a culture of adoption through education, research, and legislative action. NCFA's mission is to meet the diverse needs of children, birthparents, adopted individuals, adoptive families, and all those touched by adoption through global advocacy, education, research, legislative action, and collaboration.

North American Council on Adoptable Children


Email: info@nacac.org

Founded in 1974 by adoptive parents, the North American Council on Adoptable Children is committed to meeting the needs of waiting children and the families who adopt them. NACAC promotes and supports permanent families for children and youth in the U.S. and Canada who have been in care, especially those in foster care and those with special needs.

The Donaldson Adoption Institute

(212) 925-4089

Email: info@adoptioninstitute.org

The Adoption Institute was established in 1996 by the Board of Spence­-Chapin Services to Families and Children (now Spence-­Chapin), which identified the need for an independent and objective adoption research and policy organization that addressed the needs of all those touched by adoption – first/birth parents, adoptees and adoptive parents.