Adopted Adolescents and Adults Seeking Help from Mental Health Professionals
By Doris Bertocci, LCSW
The psychotherapeutic treatment of adopted persons is a highly complex clinical specialty.
It is the consensus of veteran mental health professionals with an in-depth understanding of the psychological complexities of being adopted, that these clients’ treatment needs to be in the hands of seasoned clinicians who have obtained advanced training in the unique emotional experiences of adopted people. Until the Psychology of Adoptive Status is more fully developed, with formal trainings made available, therapists treating adopted patients are obligated to be familiar with the relevant clinical literature, and to arrange consultation or supervision with qualified colleagues in the field. In mental health, social work, and post-adoption settings, the setting needs to assist with the expense of this consultation.
When adopted persons seek counseling or psychotherapy in any setting, they are entitled to the services of fully trained and experienced (preferably a minimum of five years post-licensing) therapists who are committed to a process of continued in-service training for themselves. Adopted people are entitled to direct care and privacy with their therapist without being “used” for any other purpose (e.g., training of interns, research without the proper consent protocols), which has ethical implications.
It is understood by specialists in the field that a therapist’s being a member of the adoption triad does not constitute a qualification, i.e., the same training and experience requirements apply to them. It is also understood that therapists treating adopted patients would best have advanced generic clinical training in the treatment of adolescents and adults, well beyond what their state requires to qualify as a clinician. Adoption agency experience, trainings in “adoption competency” and “trauma,” or knowledge of early childhood development provide a good foundation, but they are insufficient for the clinical treatment (psychotherapy) of adopted persons over 12; this requires close consultation re: the Psychology of Adoptive Status, which includes the uniqueness of ongoing and current dimensions of adoption trauma.
Similarly, where adoption and mental health overlap, there are many different “skill sets.” (E.g., infertility and family-building options, third-party reproduction, preparation for adoptive parenting and “home studies”, psychosocial services at time of placement, adoptive parenting skills in early childhood, adolescence, young adulthood, etc., cognitive testing, psychotherapy, family therapy etc.). Having skill sets in some areas does not imply being qualified in others.
Following intensive treatment within a hospital or generic residential program, adopted patients are entitled to careful discharge planning. I.e., they need to know of any options for transition to an adoption-informed therapist in the patient’s community or to adoption-knowledgeable longer term intensive treatment programs. The common practice of hospitals automatically discharging patients into a generic Partial Program may not be in the best interest of some adopted patients. Overall, regardless of the setting, adopted patients are entitled to make informed decisions about finding qualified therapists for their psychological care.