In conjunction with National Adoption Month, which promotes the awareness of the need for adoptive families for children in foster care, Counseling Today spoke with Kara Holt about how to counsel adopted clients. Holt, an assistant professor in the University of Wyoming counseling program, is a member of the American Counseling Association, the Association for Child and Adolescent Counseling, the Association for Counselor Education and Supervision, the Association for Humanistic Counseling and the Association for Creativity in Counseling. She believes it is important for the adopted individual to understand his or her own unique story and for counselors not to pass any judgment until they have listened to and understood the client’s story.

Is there is more or less stigma for adopted children now? Why?

I do not think it is more or less as much as it is that the stigmas have changed. I think that adoption has become more commonplace in our society and that we do not often try to hide the fact that someone is adopted as frequently. However, I think that children who are adopted are often stigmatized [by mental health professionals] and given automatic diagnoses such as reactive attachment disorder without really getting to know the child.

 What are some do’s and don’ts for families with adopted children?

I think some of the do’s are to help the children understand their own unique story and learn how to integrate this into a coherent narrative of their life and sense of belonging.  It’s so important to celebrate the unique way that people create families. I think one of the don’ts, although very challenging, is to try to not take personally the struggles and resistance that some adopted children demonstrate.

What are some do’s and don’ts for counseling adopted clients?

I think it is essential to conceptualize the client within the framework of attachment dynamics, trauma and the effects that both of these have on brain development. It is essential to remain patient and remember the therapeutic power of safe and consistent relationships that involve a systemic approach. Remembering the difference between chronological age and emotional age is also key. Counseling should be geared toward the emotional and developmental age of the client, which is often younger than the chronological age. I would say it is important to not automatically label adopted children with a diagnosis without truly getting to know them and their experience and not to isolate treatment to only be between you and the client. I would also be cautious and remember that a behavioral change does not always equate to an emotional shift. This often takes time, and counseling can ebb and flow. It is also important to normalize [the client’s] experience and struggles. Often, adopted parents are reluctant to reach out for additional support and help.

Should parents be involved in counseling sessions with adopted children?

Absolutely, any time that this is an option.

What issues can the subject of adoption raise in clients? How about within clients’ families? What can counselors do to help?

This can often raise question surrounding belonging, abandonment and way to initiate and maintain healthy and supportive relationships. Families also experience anxiety about how to talk to their children about adoption and what language to use. Questions often arise about the open adoption, the status of the birth family or connecting with the birth family, and social situations. Counselors can help parents with activities that are developmentally appropriate to help them talk to children. Counselors can also help facilitate relationship-building therapies between parent and child and help serve as an advocate for the family. Counselors can also help parents understand the child’s behaviors and emotions within the context of the adoption experience that often includes some kind of attachment struggles even when the child was adopted at birth. Many times, parents do not expect struggles with an infant [adoption].


For more information, read Counseling Today’s March cover story, “Fitting together as a family,” which features an interview with Holt.

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