What is the Age Limit for Adoptive Parents in America

Infographic Text: What Is the Age Limit for Adoptive Parents in America?

The answer depends on where you live. Only 16 states list specific minimum age requirements for adoption.

These states require the parents to be at least 18 years old:

These states require the parents to be at least 21 years old:

These states require the parents to be at least 25 years old:

These states require the parents to be at least 10 years older than the adopted child (or 15 in Idaho’s case):

No states have an upper age limit for adoptive parents. So long as you are physically stable enough to care for a child, you can adopt from a government agency. Some private agencies, however, put a cut-off at the age of 40.

If you need help determining whether adoption is appropriate for your situation, consider speaking to a therapist.

References:

  1. Domestic vs international adoption. (n.d.). Retrieved from https://bit.ly/2TPAHRF
  2. Spence, V. (n.d.) Is there an age limit in adoption? Retrieved from https://bit.ly/2ST1HiY
  3. What are the top 10 requirements to adopt a child. (n.d.). Retrieved from https://bit.ly/2QQ7ZOw

Dear GoodTherapy.org,

My biological parents gave me up for adoption when I was born. I’m sure they had their reasons, and I am probably better for it since I grew up in a very loving family and turned out as well as could be expected. I’ve never wanted for anything. I have a great life, a great career, and a great family of my own now. I’m 45 years old. I don’t feel traumatized. I’m actually relieved my birth parents made the decision they did. I’ve never asked my adoptive parents about them.

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As I have gotten older, though, I have had more and more thoughts about my biological parents. I find myself wondering about the circumstances that led them to give me up, whether they’re still alive, and if so, what they’re like today. I wonder if they think of me, too. And I wonder what it would be like to meet them. I had never felt compelled to go down this road until recently, so I’m not sure what’s bringing these feelings to the surface.

I guess I just don’t know if it’s wise, from the standpoint of my mental health, to pursue this. Like I said, my life is great without them in it. Also, while I wonder if my life could be enhanced by knowing more about the people who gave me life and connecting with them after all these years, I am mindful of the possibility I will only learn upsetting things. Who knows? Maybe they wouldn’t even want anything to do with me.

What do you think? —Left Wondering

Submit Your Own Question to a Therapist

Dear Wondering,

It is only natural you would wonder about who your birth parents are, what they’re like, and why they decided to put you up for adoption. Who wouldn’t be curious? You write that your life, career, and family are satisfying, and perhaps you’d like them to know that. Maybe you also wonder what your life would have been like if you hadn’t been adopted. These days, there are numerous ways to look for people that may help you find your birth family—if you decide you want to.

Many years ago, adoption information was not recorded or, if it was, the records were closed, but since 1980 most adoptive records are open. If you decide to look for more information, you can use social media, genealogy websites, and open records that should give you access to your birth certificate and other information. I personally know one person who found her birth mother on Facebook.

You wonder what it might be like to meet your family of origin. Different people have different experiences, of course. You might find out you have siblings, for example. You might feel you have little in common with your birth family or, on the contrary, there is a lot you share. There is only one way to know the answer, but would the answer be worth the time and emotional energy you expend?

You are worried about how this would affect your mental health. That is a good question, and I suggest this is such a big question that you might want to work with a therapist or professional adoption adviser who could accompany you on your journey. You would be hunting down the past and bringing it into the present. Working out whether you really want to do that, and then how to proceed if you do, may be no simple task. Finding your birth parents and meeting them would likely necessitate a big adjustment on everyone’s part.

You may fear rejection. Many people do. You birth family may have the same fears about you, and you might also reject your birth family once you meet them; there’s no way to know. Your adoptive family could fear losing you. This delicate decision to find your birth parents requires a combination of wisdom and courage.

I don’t know if you ever watched the TV show This Is Us. It has many threads, but one of the important plot lines concerns looking for and finding a birth parent. You might want to watch the show and see what it brings up for you. Chances are, you have plenty of your own fodder.

I wonder if you know other people who have been adopted. If so, you might like to discuss your feelings with them and get to know how they understand their adoption. Talking to your partner is important, too.

It sounds like you never discussed this with your adoptive family. It may feel like a delicate issue to bring up, but they could be enormously helpful in your search and may even feel it is important for all of you.

You may fear rejection. Many people do. You birth family may have the same fears about you, and you might also reject your birth family once you meet them; there’s no way to know. Your adoptive family could fear losing you. This delicate decision to find your birth parents requires a combination of wisdom and courage.

Either decision—to know or not to know—is wise and brave. Only you can decide what is the right path for you. Whatever you choose, I admire your curiosity and your process. You are not taking this lightly, nor should you.

Good luck, and I hope you check back in and let me know what happens.

Take care,

Lynn Somerstein, PhD, E-RYT

Sepia-toned image capturing motion of child running up to parent and leaping into parent's armsThe adoption of a child is an event, fixed in time, with a beginning and an end. However, the impact of adoption is far-reaching and ever-changing—a process that continues throughout the lifespan of the adopted person and those connected.

It’s been my professional experience that many individuals who were adopted share similar symptoms, beliefs, and reactions in the present that stem from the separation trauma of parting from their biological mother at birth. Multiple placements, foster care, or time in an orphanage can exacerbate this trauma.

An infant or child separated from their birth mother will almost certainly experience some level of trauma, as they will perceive this event to be a dangerous situation. The sensations, sights, and sounds with which they were familiar are gone, and the mother is no longer available to soothe the child or help the child self-regulate. Because the only part of the brain fully developed at birth is the brain stem—this controls the sympathetic nervous system, which generates the “fight, flight, or freeze” response—babies are unable to use parasympathetic abilities, such as self-soothing. When this happens before the age of 3, it is encoded as implicit memory—like any event that takes place before the development of language. As noted trauma expert Bessel van der Kolk explains in his book The Body Keeps the Score, “We have learned that trauma is not just an event that took place sometime in the past; it is also the imprint left by that experience on the mind, brain, and body.”

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Eye movement desensitization and reprocessing (EMDR) is an integrative therapy originally developed by Francine Shapiro to alleviate distress associated with traumatic memories. When a traumatic event occurs or something happens that is perceived as traumatic, the associated memories may become stored in the brain and nervous system in a maladaptive way—frozen rather than processed. Current reactions are fueled by negative beliefs stemming from events that occurred in the past. People become stuck. In some cases, trauma that happened years ago continues to feel like it’s happening in the present.

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EMDR therapy targets the unprocessed memory as well as the emotions, beliefs, and body sensations associated with it. Bilateral stimulation (generally eye movements, tapping, or tones) activates the brain’s information processing system, allowing the old memories to be digested or reprocessed and stored in an adaptive way—even if the person doesn’t have an autobiographical account of the memory. For many adoptees, the trauma happened before they developed the language to explain the events, so the memory is primarily somatic in nature and stored in the nervous system.

Many adoptees have issues related to attachment ruptures. An adopted child whose parent is a few minutes late to pick them up from school may dissolve into tears. The internalized belief or negative cognition that child develops may sound something like “It’s not safe to trust” or “People I love leave me.” An adult who was adopted may unknowingly recreate abandonment scenarios in relationships, unconsciously choosing partners who are not truly available and do leave, fulfilling the negative belief “I am not worth it” or “I am not lovable.”

Using bilateral stimulation, EMDR helps integrate the early memories, body sensations, emotions, and negative beliefs the person has. Over a series of sessions, symptoms are reduced, and beliefs associated with the memories or experience are shifted to a more positive and adaptive state.

In both examples, the reaction in the present is disproportionate to the situation. This is useful information that some feeling, experience, or memory from the past is being triggered. A much younger “self” is running the show. The fight, flight, or freeze response gets activated in these situations, and the prefrontal cortex, the part of the brain in charge of executive functioning and decision making, goes offline. The person may feel disregulated, scared, and confused.

So what does a typical EMDR session with an adopted person look like?

After gathering history and establishing rapport, the therapist and person in therapy work together to establish target memories and present triggers that are causing suffering and/or interfering with daily life. The “targets” are the starting points of the session and a point of reference to trace the memory back in time. Using bilateral stimulation, EMDR helps integrate the early memories, body sensations, emotions, and negative beliefs the person has. Over a series of sessions, symptoms are reduced, and beliefs associated with the memories or experience are shifted to a more positive and adaptive state.

Rather than the belief “I’m not lovable,” the person may be able to recognize and have a felt sense of worth despite what happened in the past. In my work with adopted individuals, I combine various EMDR protocols, guided imagery, mindfulness practices, and visualization to create calm states and nurturing figures in the present to help heal the wounds of the past.

EMDR is safe, effective, noninvasive, and powerful. It does not involve medication or hypnosis, and I’ve found it a wonderful adjunct to talk therapy in my work with people who were adopted. If you want or need support on your healing journey, find an EMDR therapist in your area.

Reference:

van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. London, UK: Penguin Books.

Friends sitting in a circle at park“They say they understand, but how can someone who wasn’t adopted know what it feels like?”

Sixteen-year-old Lisa’s voice trails off as she explains the many frustrating conversations she’s had with her friends about adoption. The other teens sitting in the room nod their heads in agreement.

“I know, right?” adds Jake, 15. “How can they possibly know what it feels like to miss the mom who gave birth to you or why sometimes birthdays are really hard? Not to mention how uncomfortable it is to hear for the zillionth time, ‘Where were you born?’ because I’m a different race than my [adoptive] parents.”

More nods from the group.

“You guys get it,” laughs Adam. “That’s what’s so cool about this group. We don’t even have to explain ourselves.”

This conversation is one of many that seem to occur each time a group of adopted teens come together for the support group I co-facilitate in my community. In the group, teens can exchange stories and give and get support. Whether they are talking directly about adoption or not, the common thread of a shared experience puts them on a similar playing field and helps them “feel felt.”

Where Do You Belong?

[fat_widget_right]The experience of “not belonging” is common among those who were adopted. Coming together with others dissolves separations. Most teens come to the first group coaxed by parents, who often explain, “She probably won’t say too much” or “I don’t think he’ll want to stay, so maybe I’ll just sit outside.” That said, we have a 100% return rate so far! The teens who “won’t say too much” are frequently the ones who open up and expose their vulnerabilities as they share intimate details of their adoption stories to a group that welcomes each detail and listens attentively.

Participants in Teen AdoptCONNECT, our support group, include teens who were adopted transracially and domestically, as well as foster and former foster youth. Bringing together teens with varying stories and experiences allows teens to normalize similar issues on a bigger scale. It also further emphasizes the fact that they are not alone, that they belong to a “tribe.”

AdoptCONNECT is another unique group that invites all adult members of the adoption and foster care community to come together to give and get support. Adult adoptees, adoptive parents, former foster youth, first/birth parents, and waiting parents sit side by side, exchanging stories, fears, challenges, struggles, and wisdom. Members share thoughts and emotions openly and honestly without the worry of hurting someone’s feelings, all while coming to the realization they are not alone.

You’re Not the Only One

Support groups are an essential place to express feelings, give and get support, build lasting connections, and ultimately “feel felt.” The importance of sharing experiences with those who are walking a similar path as you cannot be over emphasized. It is pretty powerful to witness the exchange between an adult adoptee and adoptive parents of an adolescent.

“What did you need?” the parents ask.

The adult adoptee takes a few seconds and tearfully responds, “I needed my parents to realize that I thought about adoption all of the time growing up and that being curious about my biological family wasn’t a threat to them. I wish I could have shared my thoughts with them.”

An adoptive mom cries in relief after hearing another adoptive parent express similar feelings about sometimes not feeling good enough as a parent. “Wow, I thought I was the only one who felt that way.”

Why Support Groups Can Be So Important

My colleague and I started these adoption support groups to serve an unmet need in our community. The groups provide a place for the adoption and foster care community to come together and share stories, ideas, and concerns in a safe environment. Support groups are an essential place to express feelings, give and get support, build lasting connections, and ultimately “feel felt.” The importance of sharing experiences with those who are walking a path similar to yours cannot be overemphasized.

I encourage you to join a group or start a group if you are a member of this community. If you need help with this, please contact me for guidance.

little kid wearing a crown“Happy birthday!”

Colorful balloons are carefully tied to the picnic table as giggling 8-year-olds play hide-and-seek in the backyard. The pink and white frosted cake is about to be cut, but the birthday girl isn’t in sight. Her mom eventually finds her quietly playing alone in her room and gently asks, “What’s going on?”

Normally outgoing, the girl, adopted at birth, had been excited in the days leading to her celebration, helping with the plans and decorating invitations. Today, however, she awoke visibly upset and announced to her parents, “I don’t want a birthday party anymore!”

A member of a group I facilitate for adopted teens explains, “My birthday is an extremely hard day for me. It’s really bad. I feel sad and angry and just bad.”

“Me too!” another teen chimes in. “I’ve never liked my birthday, and Mother’s Day is sometimes hard, too.”

It’s not uncommon for adopted children, teens, and even adults to have conflicting feelings about birthdays and other dates of note. Small children may not even understand why and may need the adults in their lives to help put words to their complex feelings.

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Birthdays are often the day infants are separated from their biological mothers. This separation, an undeniably traumatic event, is stored in the brain and body as an implicit memory because the separation takes place before language develops. The memory becomes embodied and can later be triggered without conscious knowledge.

Mother’s Day can be difficult because while one mother is celebrated, the other may not be mentioned. Other holidays may be challenging as an adopted person thinks about his or her biological family. A 16-year-old adoptee shares, “I think about my [biological mom] a lot during Christmas. I hope she’s doing OK and celebrating. I wonder what her traditions are and I wonder if she’s thinking about me? I miss her even though I don’t know her.”

Difficulty navigating holidays and birthdays may be compounded for children and teens who have been in multiple placements or foster homes before they were adopted. Each year may mark a different memory and an additional loss.

Adoptive parents should be sensitive to their child’s experience and remember that their child’s history began before they became a family. This is also true for children adopted at birth or in early infancy. They, too, had a history prior to being adopted.

Parents can help put language to the felt experience for their child. They can empathically respond to a child who is visibly struggling by reminding themselves that their child is likely experiencing implicit feelings. They can make the implicit explicit by expressing curiosity and naming the feelings, which may include sadness, anger, and grief and loss. Parents might say something like, “Your birthday is the day you were born, and I wonder if part of you remembers this is also the day your birthmother made the difficult decision to have someone else raise you?”

On Mother’s Day and other holidays, parents can “say” what is not being said by celebrating and acknowledging their child’s birth mom and genetic relatives. They can ask their child about what they are experiencing and validate any and all feelings. Families might decide together to incorporate customs, traditions, and special foods of a child’s country of origin into their existing traditions. If the adoption is an open one, parents can make contact with their child’s biological family.

It’s OK for parents to give themselves permission to get creative and think outside the box. Most importantly, parents should strive to see the world from their child’s point of view and imagine how difficult it may be for the child to integrate the inherent split adoption creates. Adopted children and teens want and need their parents to be their advocates at birthdays, holidays, and every day, and to lead the conversations until they feel comfortable doing so.

file folder labeled "confidential" in filing cabinetThere is a question that has been asked of me multiple times over the past few months that I would like to answer. The question is: “Should a child’s foster parent(s) be granted access to their child’s psychotherapy notes?” The answer is not as straightforward as it may seem.

The short answer is: “No, a child’s foster parent(s) should not be granted access to their child’s psychotherapy notes.”

First, we must understand what the HIPAA privacy rule is, as it will ultimately answer the question. The Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, is a federal law which resulted in the establishment of the HIPAA Privacy Rule in December 2000. The HIPAA Privacy Rule is designed to protect information about individuals’ health care treatment. To understand privacy protections in the United States, you must start with this federally established framework and then consult state laws to determine whether there are any additional requirements to observe.

Second, we must understand what the HIPAA Privacy Rule has to say about “individual personal representatives.” An individual personal representative is any person with the authority to receive or access another individual’s protected health information (PHI).

In some cases, adults and emancipated minors have individual personal representatives, such as someone holding “power of attorney” or in a court-appointed adult guardianship or conservatorship. Otherwise, adults and emancipated minors do have uniquely boundaried privacy protections, whereas minors (children under 18 years old, with the exception of children—typically 16 or 17 only—who have been formally “emancipated” from dependency status by a court of law) always have at least one individual personal representative.

Children and adolescents in foster care tend to have many individual personal representatives, including representatives from Child Protective Services, attorneys, designated child-placing agency representatives such as case managers, foster parents acting as medical consenters, and, in some cases, juvenile probation officers. In rare cases, even court-appointed special advocates (CASA) may obtain status as medical consenters through a court and would, then, hold the distinction of an individual personal representative.

In addition, foster kids benefit from an extensive continuum of care including doctors, dentists, psychiatrists, clinical psychologists, school psychologists, school counselors, collaborative treatment team participants such as child-placing agency treatment directors (such as myself), and other consultants (at my agency, we have psychiatric fellows and residents as well as a program manager, intake coordinator, and, in some cases, a higher-level program administrator who all may participate in the ongoing treatment staffing related to a child’s case planning), therapists (individual, sibling, family, group), early childhood interventionists (speech, physical, and occupational therapists), and skills trainers. Each of these treatment providers freely accesses PHI of other providers in the course of treatment, which is necessary and beneficial for collaborative treatment.

Ultimately, these supports are beneficial, but often, along this stream of care, the “minimum necessary requirement,” a best-practices principle generally recognized and affirmed through the HIPAA Privacy Rule, is not sufficiently revered, and foster kids’ private and protected health information may not always be protected in practice with the same degree of diligence that it is in so many other sectors of health care. It is in this current that foster parents often believe that they, too, are entitled to the most private of health care information, their child’s therapy providers’ psychotherapy notes. I know this to be true from my own professional experience.

The third thing that you must understand to answer this question is that psychotherapy notes are given unique privacy protections within the HIPAA Privacy Rule, more so than all other protected health information (PHI), including purely diagnostic or evaluative information, case notes, other treatment services such as developmental therapies (speech, physical, occupational), as well as other treatment summaries or reports. Even reports via email from a therapist summarizing general or overall progress of therapy—or any other generalizing or summarizing report—are not given the same protections as psychotherapy notes themselves (U.S. Department of Health & Human Services [HHS], 45 CFR 164.508, 2006).

There is one final piece of this puzzle: The HIPAA Privacy Rule clarifies that, in certain circumstances, parents are not privileged to act as their minor children’s personal representatives—with respect to certain protected health information—and thus neither control the child’s health care decisions nor the protected health information related to that care:

  1. If no existing state statute or binding legal precedent requires a parent’s consent prior to a minor child obtaining psychotherapy treatment, and if the minor child then consents to his or her own psychotherapy treatment without the expressed consent of a parent, then, with respect to the minor child’s participation in that psychotherapy treatment, no parent acts as the child’s personal representative and, thus, the parent(s) will not be provided access to the psychotherapy notes without the child’s written consent.
  2. If a court grants or other law authorizes another adult to act as the personal representative for a minor child as it relates to the child’s health care, then the minor child may obtain consent for such psychotherapy treatment from another personal representative, as provided, without consent from a parent. Similarly, in this case, with respect to the minor child’s participation in that psychotherapy treatment, the parent(s) will not be provided access to the psychotherapy notes without the child’s written consent.
  3. If a parent provides a written and signed waiver expressly relinquishing his or her own right to participation in a confidential relationship between their minor child and a psychotherapist, then the privacy of the psychotherapy notes—as well as, in some cases, other protected health information—will remain boundaried and protected between the provider and the minor child, and parent access will be restricted unless the minor child provides written consent to the access of these protected records.

Further clarification in the Code of Federal Regulations (CFR) should be noted: “Even in these exceptional circumstances, where the parent is not the ‘personal representative’ of the minor, the Privacy Rule defers to state or other laws that require, permit, or prohibit the covered entity to disclose to a parent, or provide the parent access to, a minor child’s protected health information. Further, in these situations, if state or other law is silent or unclear concerning parental access to the minor’s protected health information, a covered entity has discretion to provide or deny a parent with access to the minor’s health information, if doing so is consistent with state or other applicable law, and provided the decision is made by a licensed health care professional in the exercise of professional judgment”(U.S. Department of Health & Human Services [HHS], 45 CFR 164.502, 2003).

Because foster children do not require the consent of foster parents before they can obtain psychotherapy services—and may obtain consent, if required, by way of other representative adults (such as child welfare caseworkers, child-placing agency case managers, etc.), whether the child independently consents or secures a nonparent consent to participate in such therapy, then, under the HIPAA Privacy Rule, the foster parent(s), for the purposes of this particular health care service, will not be provided distinction under the law as the child’s personal representative, and, thus, will not be provided the right to access documentation from the treatment record.

However, again, it is not that the HIPAA Privacy Rule expressly denies that foster parents have access to their children’s therapy notes, and, in fact, a “covered entity,” or provider (meaning, the child’s therapist) does retain prerogative to provide or deny a parent access with discretion if doing so is consistent with state and other applicable laws. Yet, this should be justified therapeutically.

In most cases, it is difficult to make a case that it is in the best interests of the child, therapeutically, to take away what is typically the only confidential outlet a foster child or teen has within the convoluted and institutional system in which they live and, thus, it is best practice in my state (K. Teutsch, personal communication, January 4, 2013) and in every state to preserve the therapeutic relationship by preserving the boundaries of confidentiality within that relationship and of privacy concerning the psychotherapy notes.

References:

  1. K. Teutsch, Division Administrator for Medical Services, Texas Department of Family and Protective Services, personal communication, January 4, 2013.
  2. U.S. Department of Health & Human Services – Office for Civil Rights (2006). HIPAA Administrative Simplification: Regulation Text [45 CFR 160, 162, & 164]. Washington, DC: US Government.
  3. U.S. Department of Health & Human Services – Office for Civil Rights (2003). OCR HIPAA Privacy: Personal Representatives [45 CFR 164.502(g)]. Washington, DC: US Government.

Close up of happy woman and babyYour social life, the quality of it, was wired into your gray matter by the age of 3, according to current thinking on child development. After a minute of contemplating that statement, the immense impact of early childhood caregivers becomes clear. This subject comes to mind after reading a recent news story about Artyom Saleviev.

Artyom was first in the news in 2010. He is the Russian boy who was adopted by a U.S. couple, the Hansens, 3 years ago. After being part of the Hansen family for 5 months, Artyom was put on a plane bound for Russia by his adoptive mother. Artyom carried a letter which stated the Hansen’s no longer wanted him because of his disruptive behavior related to psychological problems. The recent news article states that Artyom is now living in a foster home (in Russia) and his behavior there is not disruptive.

In the United States, the number of children in the foster care system is close to 500,000. One-quarter of them are infants when they enter the system; 15% are age 3 or younger, some only infants. The most common reasons for removing them from a parent or relative’s home are an absence of supervision (36%) and a failure to provide (31%). What affect does this have on a baby or toddler? Are they so young they will not remember neglect or abuse by early caregivers? If only that were true.

Caregiver Influence

To understand the effect early caregivers have on infants and toddlers, we can look at the implications of attachment theory. This theory, which has been substantiated by research, states that interactions with our initial caretakers determine our future capacity to build emotional bonds with others.

By the age of 3 years, children are either secure in their attachments to their caregivers or insecure. Children who are secure have the benefit of responsive caregivers that consistently meet their needs for food, safety, and affection. In adulthood, they can form lasting emotional connections with others.

There are three types of insecure attachment: avoidant, ambivalent, and disorganized.

When caregivers discourage expressions of a child’s distress or affection, an avoidant style of attachment develops. The child learns to discourage his or her own feelings, which damps down the child’s capacity to feel loved by others. Avoidant children typically withdraw from social interaction and grow into adults who are extremely uncomfortable with feelings and intimacy.

Ambivalent attachment occurs when early caregivers give comfort inconsistently. They sometimes respond to the child’s needs and sometimes do not. With this kind of care, children become unsure whether their needs will be met. As adults, they are slow to trust and at risk for mood and eating disorders.

When a child’s needs are not responded to, or the child is abused, a disorganized pattern of attachment can lead to delayed development, social withdrawal, and aggressive or disruptive behavior. Adults with disorganized attachment are susceptible to personality disorders and chronic mental health problems. Their relationships are often chaotic or short-lived.

Our attachment style sticks with us for life, although alternative behaviors and ways of thinking can be learned to improve relationships.

Not All Memory Is Conscious

When Artyom Saleviev arrived in the United States, was he secure, avoidant, ambivalent, or disorganized in relation to others? The Hansens painted a picture of a very disorganized child, although his current foster mother in Russia does not. Regardless, his experience with the Hansens, and the ill-conceived way he was sent back to Russia, are not stand-alone events. They rest on the foundation of interactions he had, or did not have, very early in life.

Even if a school-age child like Artyom is adopted or finds his way to a nurturing foster caregiver, a pattern of connection with others is already established. It begins before the child enters foster care, as a result of the child’s experience with his first caregivers, and the pattern continues after he leaves the system.

Around one-third of those 18 to 24 who age out of foster care are homeless within 18 months (in the U.S.). Up to one-half are unemployed within 4 years of leaving, and approximately 30% to 40% have a mental disorder and likely no health insurance. More than three-fourths will become parents.

Perspective

To keep these sobering numbers in perspective, we can consider that people with less than stellar starts in life can, and do, lead productive lives and find a share of happiness. Humans are highly adaptable and resourceful. It is also a fact that people from “good” homes enter adulthood with mild to severe attachment issues, usually the avoidant or ambivalent type.

Difficulty trusting and connecting with others is not just a single family issue. It is part of the human condition and drives the drama we call history.

The foster care system is imperfect, but it is a nested problem. Looked at as a whole, the problem begins with the child’s experience of insufficient early caregiving and is later aggravated by the lack of support for these children during the transition to adulthood. The system is situated in a disorganized world where, unfortunately, such institutions are necessary. The best we can do is to strive to keep making improvements based on what we continue to learn about the special needs of these children.

References:

  1. Child Welfare Information Gateway. Available from: http://www.childwelfare.gov
  2. U.S. Department of Health and Human Services, Administration for Children and Families. Abuse, Neglect, Adoption & Foster Care Research: National Survey of Child and Adolescent Well-Being (NSCAW), 1997-2010. Available from: https://acf.gov/opre/project/national-survey-child-and-adolescent-well-being-nscaw-1997-2014-and-2015-2024
  3. Radia, K. Adopted Russian boy rejected by U.S. mother adjusts in foster care. Available from: http://gma.yahoo.com/blogs/abc-blogs/adopted-russian-boy-rejected-u-mother-adjusts-foster-110037054–abc-news-topstories.html

Related articles:
Patterns of Attachment in Adults
Understanding Difficult Behavior – For Foster and Adoptive Parents

Daughter sulking in front of frustrated motherThe dreams we have for our families and children are full of deep expectations, some stated but many unspoken. This is true for families that have biological children and also for families who choose to foster and adopt. We want to make a difference in the world and love a child that needs us. We want to offer support, guidance, and opportunities to our children. The most frequent thing I hear from parents is, “I just want to help.” The best foster and adoptive parents know that helping a child involves more than just “wanting to”—it involves sticking in there when times get rough.

The Critical Point

In my experience, there tends to be a critical point in the journey of foster care and adoption when parents have to reconcile the difference between their initial expectations and their family’s current reality. I consider this the critical point because this is when placement disruption is likely to occur. Those of us that have experienced this firsthand understand that there is always a honeymoon period with a new placement. This time is filled with excitement and positive thoughts about the future. Though scared, the child may be on their best behavior: they are helpful with chores, follow the rules, attempt to build a relationship and may cheerfully fulfill their parent’s requests. For new parents, the placement may feel like bliss. The parents feel good about themselves and feel like they are making a difference.

Then comes the change—sometimes occurring slowly and sometimes what appears to be overnight. All of a sudden the sweet-natured child that you have grown to care about tells you that they hate you. They may leave the house unexpectedly and not tell you if they plan on returning, leaving you to worry and search through all hours of the night. They may refuse to follow the rules and start screaming hurtful remarks when you ask them to help with the dishes. They may tell you that you are an awful parent and that they want to move out. Some children may take this behavior to another level and resort to violence upon themselves or others. They may start attacking their siblings or getting aggressive with the family pets. They may make false allegations and tell their social worker that you are hurting them when you have done nothing of the sort.

At this time, it is incredibly important to make decisions about how to improve the situation and avoid a disruption in placement. Why do the children act like this? They are scared and lonely and testing whether you are going to love the “real them”—or kick them out like every other provider has in the past. Though it can be discouraging, all hope is not lost. Remember that there are peaks and valleys in behaviors and that these challenges will lessen over time given the appropriate support.

Before, during, or after this time of turmoil, it is common to have feelings of resentment toward the child you have chosen to bring into your home. You may feel exhausted and unable to manage their emotions in addition to yours. You may feel as though you are in over your head and are not skilled enough to manage what that child needs. Instead, you might feel as though this child screaming at you is not what you signed for and you worry about the impact on the rest of your family. It is also common to worry that your other children may pick up these behaviors and all of your hard work as a parent will be lost. You may realize that being a foster parent or adopting a child is not the same as what you expected it to be. You may think that you must be a glutton for punishment to do this work and you re-examine why you thought this would be a good idea. The worst part is that you are upset with yourself for thinking these things in the first place—all you wanted to do is “help,” right?

Working Through Resentment

The first step in working through the resentment is to acknowledge, truthfully, what your expectations were going into the process of becoming a foster/adoptive parent. Sit down and write out what your spoken and secret hopes and dreams were. Be honest about this because sometimes the secret and hidden expectations are the most important as they may reflect some core personal values that you hold about yourself, your family, and the world: What was the relationship you were hoping for? How did you envision the family dynamic?

Next, make a list of things that you felt blindsided by during this process: What has happened so far that you weren’t prepared for? What were you shocked by or scared of that you have seen your child do? What are your fears?

Third, you need to remind yourself why you are doing the work you do: What is your goal in becoming a therapeutic provider? How do you feel change is made?

Finally, re-examine your family goals with your revised understanding of your foster/adoptive child in mind and create steps you need to take in order to achieve your new and redefined vision of your family.

By doing these exercises you will gain insight into areas that you need help with in order to reconcile your feelings and get back on track with creating a therapeutic environment. You may identify areas or skills that could benefit from trainings, behavior coaching, support groups and/or therapy. You may also come to realize strengths in yourself that you never knew you had and may recognize your positive characteristics that led you to this challenging work in the first place. Remember that it is normal to feel resentment and that you are not alone. Most importantly, use these feelings to work toward being the therapeutic parent you are able to be.

GoodTherapy | Understanding Difficult Behavior: For Foster and Adoptive ParentsIt is common for children and adolescents in foster care and adoptive situations to exhibit challenging behaviors, some of which can be severe. It is equally common for parents providing care to these children to become upset and overwhelmed by what they see.

Before parents reach the point where they themselves may have a behavioral episode, I always remind them to remember the environment that their child came from. By remembering what this child was experiencing during their formative years, we can better understand the behaviors we are seeing now.

Understanding a Child’s History

Most likely, a child entering foster care is coming from a situation that may have consisted of severe neglect, physical abuse, sexual abuse, orphanage care, parental mental health issues, parents with addiction problems, or ongoing abandonment, to name a few. As a result, it makes sense that we see similar behaviors in children that they most likely experienced from their parents. These include:

Because these children did not have a comforting, loving, and secure environment as their “stable base,” they can appear lost, distrustful, and angry. These children are not “bad” or “damaged” like they may appear initially. Instead, they are simply having a normal reaction to the negative past experiences of their lives. Because of this, it is important to have a clear understanding of your child’s history in order to better understand what you are seeing now.

By gaining a deep understanding of your child’s experiences, you will be more competent as a parent and better able to work with the child in a calm and therapeutic manner. The good news is that these children can and will change with the security, warmth, and structure they can receive from a positive and therapeutic parent.

Creating a Therapeutic Environment

One of the most common burnout factors I experience with parents is lack of emotional reciprocity from the child, accompanied by destructive and targeted behaviors. We must remember that children and adolescents often “act out” when they are scared. This doesn’t necessarily mean they are scared of their foster parents, but it could mean they are terrified of being in a new environment and not knowing what to expect next.

Based on their history, it could make sense that the child would expect the worse and view everyone in their life as a potential threat. At that point, it doesn’t matter whether their foster or adoptive parent has the best intentions, a nice house with their own room, supportive siblings, or the best pet. What matters in that moment are the parent’s skills to create a therapeutic environment for that child to be able to succeed and thrive.

What does it mean to have a “therapeutic environment?” It does not mean you have a perfect family without any natural conflict. Instead, therapeutic in this context describes the positive and directed manner with which the parent is able to respond to situations. It is the response that determines the success of the intervention. In order to have an appropriate response, the parent must be self-aware enough of their own triggers and issues to be able to know whether they are responding to their children’s behaviors out of their own insecurities and fear or out of intentional positive parenting that will benefit the child.

This process of self-awareness can be quite a feat in itself. It is a critical step for parents to undertake when working with children that have trauma histories and need a little extra support. It may be necessary for the parent to take a self inventory of their own issues, parenting values, and childhood experiences that impacted who they are today. By taking this inventory, the parent can self-reflect on what responses they received from their own parent when they had a scraped knee, perfect report card, or just a bad day. By taking a self-inventory, the parent can understand where their own gut reactions come from in stressful parenting situations, and where some of their own learned behavior may have been developed.

Therapeutic parenting is about setting firm boundaries in a manner that is gentle enough to appeal to the child’s emotional needs and developmental stage, and strong enough to ensure felt security.

Basic Parenting Skills for Adopted and Foster Children

These basic therapeutic parenting skills are important in successfully responding to situations, as well as being proactive:

Therapeutic parenting is about setting firm boundaries in a manner that is gentle enough to appeal to the child’s emotional needs and developmental stage, and strong enough to ensure felt security. Following through with what you say you are going to do is also critically important. This teaches the child that they can trust what you say. They learn by your modeling that there are consequences for choices they make. By implementing positive and therapeutic parenting techniques, the parent will feel safer in their environment and so will the child. The hard part is implementation—it is much easier said than done.

In addition, there will inevitably be times you don’t implement these techniques as you would like to. When you slip as a parent it is important to acknowledge it. Apologize if you did something wrong or explain what happened. These “mistakes” are opportunities for you to demonstrate that you are human and you accept accountability—a social skill your child will benefit from having as well.

The best thing a parent can do when their child engages in this behavior is to remain calm and consistent. By doing so, the parent creates a safe space for the child to know that despite their behaviors, they are cared about in a consistent and structured environment. It is likely that a new foster or adoptive child will not show the love and affection that a parent is seeking. It is also likely that the child may be resentful of the situation and not act or appear appreciative of the parent’s efforts. When this occurs, it is important for you as the parent to remember, “It isn’t about me.” Use this as your mantra during behavioral episodes. Your job is not to save them, but to help guide them in their own journey of growth and self-awareness.

Persevering Through the Process

In the beginning period of a placement, which can last years, it is common for there to be steep peaks and valleys of behavior, usually quite frequently for the first year, at least. However, if the parent can stick with it and persevere through the difficult behaviors, the reward can be great. Over time, with consistency and warmth, a child can build trust and a sense of security with themselves and the rest of the world. The parent will start to see more mild peaks and valleys of behaviors, until a baseline is eventually reached—not without the occasional slip up, of course!

With a greater understanding and self-awareness on part of the parent, behavior will come to be an expected and natural part of a process, which can result in a child who has the opportunity for a life they wouldn’t have been able to live before. In my opinion, witnessing that type of positive change in a growing individual is one of the most rewarding things you can do. Good luck!

Parents who are struggling with managing the behavior of an adopted or foster child may find individual or family therapy helpful. Reach out to a licensed, compassionate therapist here.

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