Kit Myers, a transracial adoptee, in his cover story for Gazillion Voices online magazine, states, “As we grow older … many adoptees slowly begin to understand the complexity of adoption and the violence of separation, secrets and racial difference that accompanies the loving parts of adoption. Rarely is there space for adoptees who have had a ‘loving childhood’ but choose to critique or question certain (or all) aspects of adoption.”

Professional counselors are often challenged with providing the “space” Myers describes to normalize, validate and encourage transracial adult adoptees to explore their pre-adoption histories, their racial identity development and their relationships with their adoptive and birth families. Although we do not have data on the current number of transracial adult adoptees residing in the United States, the 2010 U.S. Census reported 2.1 million adopted children under the age of 18 living in households. A 2007 survey of adoptive parents sponsored by the Department of Health and Human Services indicated that 40 percent of all adoptions, regardless of type (private domestic, foster to adoption or international), were transracial. Specifically, most transracial adoptive families are composed of white adoptive parents with children of color who eventually grow up to become adults. Counselors, possessing a foundation based on a wellness model, are particularly poised to offer multicultural and adoption-sensitive counseling services to adult transracial adopted persons. Even so, it can be easy for counselors to overlook, minimize or misinterpret common clinical presentations of this population.

 

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Tara (identifying information altered for the purposes of this article), age 26, is a biracial (African American and white) adult adopted person who sought counseling with me to address her ongoing symptoms of anxiety and for assistance with a potential reunion with her birth family. She had previously engaged in counseling services on multiple occasions but had found that although counseling temporarily aided her in times of crisis, the services generally were not helpful in addressing her longer term concerns. Specifically, Tara reported to me that in previous counseling attempts, her counselors had not inquired about her adoptive status or her racial identity. Consequently, she did not feel it was acceptable to bring those topics up herself.

I will describe Tara’s counseling process after each section of this article to better highlight the framework, techniques and structure of counseling that we utilized.

Frameworks 

David Brodzinsky, Marshall Schechter and Robin Marantz Henig’s 1992 book Being Adopted: The Lifelong Search for Self describes their research that yielded a developmental stage theory, similar to Erik Erikson’s stages, that is unique to adopted persons. The stages describe tasks such as attaching to one’s adoptive family in infancy, learning one’s adoption story during middle childhood, developing racial and adoptive identities in adolescence and considering a birth family search in adolescence and/or young adulthood.

Some tasks, such as coping with adoption grief and loss, permeate throughout the life span. Sometimes typical young adult and adult milestones, such as launching from the home for college or employment, developing intimate partner relationships, choosing a career or becoming a parent, trigger adoption-related tasks. For transracial adopted persons, launching into adulthood may mean moving away from their adoptive families, who are often white, and exposing themselves to racial/ethnic discrimination or microaggressions.

Amanda Baden, Lisa Treweeke and Muninder Ahluwalia’s reculturation model, published in the Journal of Counseling and Development in October 2012, is a particularly useful framework to assist this population in delineating and determining where they may fall on the continuum of ethnic, racial and adoptive identities. The model can also facilitate discussion on experiences of racial/ethnic discrimination. Reculturation is described as the unique process that some transracial and international adopted persons engage in to reclaim their lost original cultural, racial and ethnic identities. The model illustrates how many transracially and internationally adopted persons lose their connections to their original cultures and racial/ethnic groups when they are adopted and leave their first families. This is especially the case when they are adopted by white parents. The reculturation model includes a phase describing the process by which transracial adoptees seek information about their birth cultures in late adolescence, as young adults or as adults.

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Tara’s self-referral for counseling was ignited by new information about her adoption story and considerations for search and reunion. She described lifelong issues with anxiety, feelings of detachment from family and romantic relationships, and struggles with her racial identity. Tara indicated that she felt reasonably trusting that this newest counseling experience might prove more helpful than past experiences. Specifically, she cited my advertising materials and biographical information that used “adoption-friendly” and welcoming language.

Assessment

Assessment and evaluation of transracial adult adopted persons for treatment planning purposes requires the same ethical standards of practice that are applied when collaborating with any client population. Careful and thorough clinical interviews and consultation with former providers and current medical providers (with appropriate releases of information, of course) are crucial.

When considering the diagnoses, evaluations and assessments given by previous providers, it is important that counselors ascertain how, if at all, the client’s adoptive and racial/ethnic identities and background were incorporated into those evaluations. Unfortunately, far too often, mental health providers have misdiagnosed or overdiagnosed adopted persons on the basis of adoption stigma or a lack of adoption and multicultural competency. Counselors following best practices will strive to balance previous evaluations and assessments with their own knowledge of the context and background of the client’s adoptive, racial and ethnic identity status so that a pathological or inaccurate diagnosis is not maintained.

For assessment purposes, counselors also need to be mindful that many adopted persons, both transracial and same race, may have missing information regarding family medical and/or mental health histories, as well as prenatal and perinatal care and circumstances. For persons adopted after infancy, major gaps in childhood development information may exist. In such cases, it is important to acknowledge any grief, loss or anger the client feels regarding lack of access. It is also important to validate the social justice aspect of this person being deprived of basic information that most nonadopted persons have by default.

If the client does have information available — for example, child welfare records, orphanage/institution reports and/or foster family records — counselors should ask if the information may be reviewed together in session. Records and information from prior caretakers and institutions, although not always entirely accurate, can be useful guides in helping the client piece together a narrative of his or her early life history.

John Bowlby’s attachment theory is based on the trust developed in relationships between the parent(s) or caregiver(s) and the child. This theory is often utilized with adopted populations because it also examines the impact to the attachment process when a child is separated from his or her caretaker or parent. Unfortunately, along the way, some adoption professionals grossly mischaracterized this theory to endorse unethical and harmful therapeutic practices that are most often referred to as “attachment therapy.” Counselors should be alert to and aware of their clients’ experiences with any type of attachment therapy so they can assure these clients that they will not be subjected to this kind of treatment in their current counseling situation. In addition, counselors should determine the extent of trauma, if any, experienced by these clients during previous treatment episodes.

Despite the negativity associated with so-called attachment therapies, there remain valid and credible attachment-related clinical assessment tools that can be useful in counseling. In 1985, Mary Main and her colleagues developed a 19-item questionnaire, the Adult Attachment Interview (AAI). Later on they created a coding system that has been empirically validated to show that the AAI reliably determines a person’s attachment-seeking strategies. The questionnaire, which asks about a client’s relationships with family members, experiences with loss and trauma, and caregiving experiences from a young age to young adulthood, often can aid the client and counselor in determining how the client’s attachment strategies may be affecting his or her current relationships (usually intimate partner relationships). It can also identify incidents of trauma and loss that need reparation.

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Tara’s assessments included a clinical interview, multiple in-session reviews of her foster care records and the AAI. One of Tara’s previous providers had diagnosed her with reactive attachment disorder (RAD) during her teenage years. This diagnosis had not been explained to Tara previously, and it was uncertain how, other than Tara’s adoptive status, the clinician had arrived at that conclusion. The RAD diagnosis was not part of Tara’s current clinical picture because she did not meet the diagnostic criteria. Instead, it highlighted an example of a potentially inaccurate diagnosis that was likely based on bias or stereotypes of persons from foster care backgrounds.

During the beginning of Tara’s treatment, we reviewed her records from the child welfare system. This information provided Tara with the groundwork needed to develop her treatment plan. Her records mainly highlighted the neglect and poor quality care she had received from infancy until her first foster home placement as a toddler. They also described basic details about the challenges her birth mother experienced while attempting to parent Tara and provided information about possible older siblings of whom Tara had previously been unaware.

Finally, Tara’s responses to the AAI offered information on how her attachment strategies, characterized by intense anxiety and fear of losing important relationships in her life, developed throughout her lifetime. The AAI also revealed trauma she had experienced in relation to being one of the only persons of color in her community. These experiences included multiple incidents of racial teasing as well as more subtle microaggressions.

The beginning treatment sessions were powerful for Tara. They represented the first time she had been offered a nonjudgmental space in which to explore her adoption story, including those elements that did not fit with the dominant adoption narrative she grew up with that highlighted only the “happy” and “fortunate” aspects of her story.

Counseling goals

The assessment process offers valuable data when the counselor and client collaborate to develop a counseling plan. When working with a transracial adoptee, these goals may center on:

• Further exploring adoption-related developmental tasks for review and repair purposes
• Examining racial identity development through the lens of transracial adoption, which often requires incorporation of both adoptive and birth family racial/ethnic heritage
• Understanding and repairing early life trauma, including abuse and neglect, and the subsequent impact on attachment strategies
• Beginning or continuing the process of search and reunion

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Tara’s counseling goals reflected her assessment outcomes. Her goals included reviewing her development in the context of adoption-related tasks; examining her racial/ethnic identity using the reculturation model; exploring and repairing instances of neglect, trauma and attachment disruptions; and preparing for reunion with her birth family.

Counseling interventions

Psychoeducation: Effective interventions often start with basic psychoeducation on normative adoption-related developmental tasks using the stage theory from Brodzinsky and colleagues.

For transracial adoptees, the reculturation model is also valuable as a starting point in treatment. It offers a flow chart depicting an adopted person’s removal from his or her birth family and culture and subsequent adjustment into the client’s adoptive (often white) family. The model also offers descriptors of identity-seeking activities that many transracial adoptees engage in as adolescents and young adults to gain integration of their original birth culture and racial/ethnic heritage. Some examples of these activities include touring a birth country or having extended visits, learning their original language, attending college or living in communities with others who share their racial/ethnic heritage, and participating in religious practices related to their racial/ethnic background.

The model includes categories for transracial adoptees who:

• Have reclaimed their original racial/ethnic background
• Balance both their original and adoptive family backgrounds
• Remain identified with their adoptive family’s racial/ethnic identity
• Identify with the transracial adoptee culture

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Tara and I used the adoption-related developmental tasks to better determine which aspects of the stages she had completed and where she might need further exploration. For example, as a child, Tara experienced periods of grief related to her adoption and transracial identity. These periods often centered on birthdays, certain holidays or the rare occasions when she saw other families who reflected her racial background. She had not shared these feelings with her adoptive parents because she was afraid it would hurt their feelings and she would be considered ungrateful for having been adopted. While examining the reculturation model, Tara was excited to discover that her various activities to engage with the racial and ethnic group of her birth, such as attending a historically black college and moving to a more diverse community, were important parts of her racial identity development.

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Interactive timelines: Timelines that use large, floor-length paper serve as useful visual tools for the counselor and client to highlight significant events in the adopted person’s life. These events can be charted using drawings, words, symbols or photos. Significant events might include birthdates (actual or estimated), moves from foster care placements, times spent in institutions or orphanages, developmental milestones, racial/ethnic identity experiences (for example, awareness of differences from adoptive families and incidents of discrimination or microaggression) and reunions with birth families.

Family narratives: If a client consents and if appropriate in the counseling process, family members may be asked to participate in counseling as well. One effective technique is to ask family members to describe their experience of choosing to adopt, their feelings before meeting the child (now adult) they adopted, what the first meetings were like and what unique traits the person they adopted brought to their family.

Seeking this information builds on the family narrative to include the client’s adoption and integration into the family. The process can also provide valuable observations related to the client’s earlier behaviors, particularly those to which the client would not have memory access. Including the family in the counseling process can also model and facilitate discussion about adoption, racial/ethnic differences and challenges the family faced (and perhaps still encounters) as a transracial adoptive family.

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As Tara and I created her timeline, listing important developmental milestones and including adoption-related tasks, we realized more information was needed regarding her initial adjustment into her family. Tara indicated she thought it would be helpful to ask each family member to share his or her memories and observations of first meeting her as a toddler. Tara also used this opportunity to let her family know she was working on figuring out her “adoption and identity” in counseling.

Tara’s family emailed their accounts and memories of when they first met her. Tara found these messages helpful. They offered important information about how frightened she was as a young child and highlighted all of the survival strategies she employed to feel safe. For example, she initially hid food in her room, rocked herself to sleep and would not engage in physical contact with her new family. All of these behaviors are typical safety-seeking strategies that younger children may use to protect themselves in the absence of predictable and nurturing caretaking.

Tara’s timeline now reflected her “survivor toddler” self and highlighted the inner strengths she possessed even as a very young child.

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Bibliotherapy/cinematherapy: Counselors can offer clients a significant number of quality books, memoirs, magazines and documentaries, many of which were created by transracial adopted persons, as supplemental work outside of session. Counselors can encourage clients to journal about their emotional reactions to these creative works, and this feedback can be used further in sessions. Many transracial adopted persons grew up isolated from others like them, so gradual exposure to those with shared experiences can be a powerful and healing counseling tool.

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Tara read multiple books on transracial adoption and adoptee identity development. In addition, she found documentaries depicting the life experiences of other transracial adoptees, including some that featured reunions with birth families. She found these outside-of-session activities helpful in further normalizing her experiences.

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Reunion preparation and maintenance: Ideally, reunions require preparation and planning to manage the myriad emotional reactions that are often experienced by the adopted person, birth families and adoptive families. Counseling can be effective in offering psychoeducation on the possible emotional responses to reunion as well as its potential impact on the client’s family systems.

Reunion maintenance involves using counseling to help adopted persons manage the multiple new relationships in their lives. In particular, counseling helps the adopted person explore issues related to “divided loyalties” between birth and adoptive families. A reunion may represent the first time that a transracial adopted person is incorporating another person of color into his or her adoptive family system. Counseling based in the multicultural competencies can assist the adoptee in acknowledging issues related to privilege, social class and racial/ethnic differences during reunion maintenance.

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While in counseling, Tara located and reunited with two of her birth siblings via social media. After the initial excitement of the reunion, she struggled with integrating her newly found siblings into her adoptive family. Issues related to race, social class and privilege were continually explored in counseling. This helped to alleviate and normalize the push and pull she experienced as she navigated the complexities of her new family system.

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Adult adoptee support groups: These groups can be helpful adjunct components of the counseling plan. These groups, particularly if diverse in their racial/ethnic makeup, can offer normalization and validation to transracial adoptees via shared experiences. If in-person support groups are not available, then offering online resources, including Facebook groups, may be an acceptable supplemental alternative.

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An adoption agency in Tara’s community did offer a monthly adult adoptee meeting. She found this support helpful, particularly because she was able to meet other transracial adult adoptees who were also in various stages of reunion.

Counseling outcomes

The counseling process may represent one of the first times that transracial adult adoptees experience a safe, nonjudgmental environment where they can actively explore, critique and examine the impact of adoption and transracial identity on their development. The desired counseling outcomes will be unique to each individual. However, counseling offers a structure through which clients may begin the reparation process of examining their adoption stories (including pre-placement circumstances), identifying their attachment strategies, integrating the realities of their differing racial/ethnic heritages (adoptive and birth families) and beginning or adjusting to reunion scenarios.

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Tara worked with me for approximately 14 months. During that time, she was able to repair her adoption narrative by understanding and acknowledging her pre-adoptive circumstances; began working on strengthening her attachment strategies with her family, her romantic partner and her friends; and gradually integrated her birth family and adoptive family. Throughout the counseling process, her identity as a biracial (African American and white) person was examined within the context of social class and privilege and its impact on her development as an adult.

Recommendations for all counselors

Counselors who work with transracial adopted persons can build their skills by considering continuing education course work in adoption, multicultural counseling and family systems. All counselors can implement basic alterations to their practice that will be helpful to this population. These include the following suggestions.

Include “adoptive status” during the intake assessment. Clients are not often asked about adoptive status during intake. This omission can send the message that counseling is not a place where adoption-related concerns can be explored. Add this category in the demographic section of the intake assessment to suggest that the topic of adoption is welcome in your counseling practice.

Include racial/ethnic categories in the “family of origin” section. It is easy to assume that the client’s racial background is similar to that of his or her family of origin. Adding individual categories describing racial/ethnic demographics for the client and important family members welcomes discussion and exploration of racial identity in particular and multicultural issues in general.

“Broach” the topic of transracial adoption as a clinical area to be explored. Norma Day-Vines and colleagues’ 2007 research on broaching described the process by which counselors can effectively attend to racial/ethnic differences between counselors and their clients. The same concept can be used with transracial adoptive status. This status in and of itself may not be the presenting issue in counseling. However, it is important that counselors acknowledge the context and its impact on the client’s overall experience.

Examine the stereotypes or myths held about adoption, adopted persons, birth/first parents and adoptive families. Despite generally evolving sentiments, stigma related to being adopted or making an adoption plan as a birth parent still exists. Additionally, adoption is often portrayed solely as a happy solution for parents and children without also acknowledging the inherent losses that accompany it. To build self-awareness, counselors should examine their own experiences with adoption (in their families, among friends and within their communities) and then consider the stereotypes, myths and beliefs that they hold.

Explore adoption-sensitive resources to provide supplemental support. Research the post-adoption resources available in local family services departments to provide supplemental support for adopted persons. Counselors can also research post-adoption services offered by private adoption agencies in their communities. Finally, the online transracial adoption community is plentiful and can offer support to those clients beginning the process of engaging with others.

 

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Knowledge Share articles are adapted from sessions presented at American Counseling Association conferences.

 

Susan Branco Alvarado is a licensed professional counselor in independent practice and a doctoral student in the counselor education and supervision program at Virginia Tech in the National Capital Region. She is also a 2014 fellow in the National Board for Certified Counselors Minority Fellowship Program. Contact her at salvarado@adoptiontherapist.org. 

 

Letters to the editor: ct@counseling.org